Quick Update

A quick update-

All apologies for not updating you all sooner. I am sure you all were wondering if I passed the exit.  It is challenging to come from studying for two years and then study harder ( trust me it is much more intense than studying for that final block exam or even more intense than studying the first block exam in Med 1.) than you have ever before.

I have been asked multiple times for advice about the exit. Here is my advice. Refer back to this post for my thoughts on advice. Take away what you want.

• I went to all of the ICM classes. 

• These are really good for helping to make the information that we learn on the island tangible. The information becomes a little more 'real', if you will. So some of the cases, especially the one where I didn't get the correct diagnosis has burned primary adrenal insufficiency into my head. I didn't really understand it completely before my virtual clinic case. 

• I went to all of the ICM lectures and small groups. 

• These are great for learning the labs. I never knew enough about labs, and it is more memorization than concept in some cases. Each small group discussion will be different, but for me it was fantastic to have that interaction. I used that information for my virtual clinic patients. I tried to ask myself "what labs should I order to confirm my diagnosis?" and "what would I expect the results to be?". These lab values can be very helpful when studying pathologies that have minute differences where the lab values can be a very quick way to differentiate between two different diseases.

• I went to grand rounds.

• Lets face it, no one really wants to go. Sometimes the discussions are interesting and useful. It is also good practice for the future. As a physician we should continue to learn and be well educated in medicine and health care. The best way is to read studies and keep up with research. That is basically what grand rounds help to do for physicians, residents, and medical students. 

• I enjoyed virtual clinic.
 

• Virtual clinic is the place where you get to practice doing what most of you will probably be doing for the rest of your life. Obviously there are branches of medicine where you may not see your patient alive or in person-pathologist and radiologist-are the two that come to mind. I used that time as a time to understand how all of the systems work together which gives me a fuller understanding of the process of disease. Also, writing the SOAP notes helps to show illustrate where some improvement could be made. Getting first hand feedback from a physician was priceless for me. In most cases it was confirmation that I was created to be a physician. 

• I tried each Kaplan professor and attended the classes that I felt would be most beneficial to me.

• I decided to take control of my life and make a choice. I went to most of the Kaplan classes, but there were a few where after I attended the first lecture I knew that I could read the book myself in shorter time. I made a decision based on what my midterm score said I needed to study and based on the amount of time I had left. I don't regret my decision. I am not suggesting you do this. Many of kaplan instructors will help you decipher which information is tested every exam. That is a good way to make sure you know the basics and the most important facts. I have began my intense board exam study now, and I make sure to highlight those and at the very least have a list of "I know that if I get a question on this subject matter I will get it right". 

• I studied my weakest subject the most and for every organ system. 

• Phsyiology. It was my weakest subject area, so in the beginning when we did organ systems, I read my physiology BRS for each organ system as we covered it in ICM. I tried to link physio with every other subject during Kaplan. For example: in biochem we discuss metabolism which deals with hormones and control of metabolism. I reviewed the endocrine physiology behind the secretion of these hormones. I believe that made a huge difference. 

• The night before my final exam I read up on the subjects that we had not covered at all. 

• We did not discuss embryology or behavioral science or anatomy. So I read First Aid for those subjects. I just read. I didn't make notes. In fact, I was in my bed relaxing trying to fall asleep. 

• Plus I made sure to do all of what I did for the midterm as far as sleep and food and breaks. 

Clicking the end test button was somewhat forced and if it had not been, I am not sure that I would have ever clicked it. I signaled for the proctor to come over to ask a question which was interpreted as I was finished (my test was complete). She went to get my score sheet, so I had to click the button which would reveal my fate.

I had a complete Sympathetic (ANS) reaction. My heart was racing and my blood was pumping. You can figure out all of the other actions of the sympathetic nervous system, suffice to say it was a very intense moment.

And then I saw my score - 53%.

I had passed the exit. I would be allowed to sit for the USMLE Step 1 as soon as I felt ready. I was deemed competent and in that moment, the grade confirmed that I had some small gift, talent, or knowledge that would allow me to become a doctor one day.

For those of you who are in Maine now, I know that this post is a little late, but perhaps you can glean something from it.

To all of the Med 4's still on the island and coming to Maine next semester, I wish you all the best.


Until next time,
Amy