USMLE STUDY UPDATE

Ok, so a while back I said that I would be taking the Step 1 in December. I am now studying for a January test date. I reserve the right to change that based on my NBME practice exams that I am taking at the testing center. I am using a study schedule made out by Topher for my last six weeks of study. His blog is fantastic! I know the exam has changed a little since he took it, but the concepts are the same and most of the material is the same. Plus, it is a huge encouragement when I know that he made a 240/99.

My study materials, Goljan audio coupled with a little rapid review, First Aid Organ Systems, Kaplan for each subject (provided as part of my tuition) and the Qbank. Uworld Qbank. First Aid.

I took two months off between finishing my fifth semester and beginning my serious studying. I began reviewing all of biochem, slowly. I made my own notes and drew out pathways. I then went to Immuno, and then I kind of got off track and started bouncing around. I have come back together and I am studying all of cardiovascular including blood disorders, and continuing with the schedule that I mentioned above. I am also using my Kaplan Qbank to help guide me to where I need more review as well as my Uworld assessment. I have been annotating my first aid with everything. I plan to try to write out the notes that I need to review eliminating the stuff that I know I know. Maybe Ill just mark through them in the first aid so that I have a visual of my progress.

My biggest "aha" moments have been understanding material that seemed so foreign in my Medical classes. For instance, I had a terrible time learning cell signaling ("This is important, you better know this"). I didn't understand Gq, Gs, or corticosteroids vs hemorrhoids. Just kidding. But you get the point. It was incredibly difficult for me to understand. Now I completely, well almost, understand and I can tell you which drugs use which receptors and the cell signaling mechanism.

Another area when I thought I would never understand the material was ANS. I thought I would die before I ever understood it completely. I get it! (mostly).

There are many other areas where I can tell you that during the classes I struggled to make sense of it, and now it just all comes together and makes so much sense.

My advice is to take it slow (as slow as is possible in four weeks) and learn it well. You may not feel like you know it, but trust yourself. Do the end of chapter questions and review the material if you don't understand it. The best way to learn is to get questions wrong. Prepare well for your exams on the island, and you are preparing well for the Step 1. I haven't seen anything in the text books that wasn't covered at some point in my time on the island.

Others suggest making a schedule and sticking to it. I am trying, but it is very hard to study all day everyday. I am away from my family with another family who is a great support. They make dinner every night and I make my own breakfast. They do the dishes and clean the house, and buy the groceries-pretty much everything. I cannot emphasize enough that that it is exactly what you need. It is imperative to have your mind clear for studying.

I am cutting it short, but I hope you can glean a little information from this short entry.

Until next time,
Amy

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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

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Congratulations! Board Scores are IN.

     One of the first terms you will hear in class, Cell Biology probably, is "high-yield". What the heck does high-yield mean? It means that it is usually tested on the Boards. Another term that is tossed out about two hundred times a day on campus. The Boards are the USMLE Step 1, 2, 3. First priority for medical students is to score very well on the USMLE (United States Medical Licensing Examination) because it determines your residency placement. It is a comprehensive computerized standardized exam to be taken after your second year in medical school. Basically it tests your knowledge of the basic sciences, and apparently current research knowledge. The latter isn't a large part of the test and you can do very well without reading research and medical journals daily.

    The scores for some of those students that took the examination from UMHS recently are back! Those that have told scores have said they did well. A 240 (99) is the "golden" score and some of those that have taken it from our University achieved above it. They did super! So, Congratulations Doctors! Success. Now kick butt in rotations and on the Step 2 CS, CK.

     This is a great indication of how our University prepares us. So Congratulations to UMHS profs and adminstrative staff!

      T-335 days until I take Step 1

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