sanguinemare

May 6, 2013

Studying for Step 1

Getting into the full swing of studying – I’m at T-3 weeks + 1 day right now, and need to really ramp up the studying.  I think after today, I’m going to try to update daily with a brief entry on what I’ve done every day so there will be a record somewhere in case anyone wants to know the step-by-step process of studying for this humongo test that basically determines your medical career (or what you can apply for with reasonable hopes of matching into at any rate haha).  Before I start my records, here are the things I have bought/otherwise acquired for Step 1 for your reference:

Materials:

Pathoma (book and lectures), USMLEWorld Q-bank,  South Biochem, Clinical Microbiology Made Ridiculously Simple, BRS Physiology (5th edition, Linda Costanzo), Robbins and Cotran Review of Pathology, First Aid 2013, Netter’s Atlas of Human Anatomy, Kaplan’s Q-bank, Goljan audio, NBME exams, Kaplan Q-book.

I first bought Pathoma during the school year since we got a good deal on it as students.  Same with a USMLEWorld Q-bank that I didn’t touch until last week.

In April, I bought: Clinical Microbiology Made Ridiculously Simple, BRS Phys and studied from those, borrowing a Kaplan Q-book and Robbins and Cotran Review of Pathology from a friend to do micro questions.  Was thinking about buying Lange/other pharmacology flashcards, but decided not to after reading reviews.
Later, I of course bought First Aid 2013 (new and improved from the 2012 version and much less errata), and also Netter’s Atlas of Human Anatomy (for reference) and my own copy of Robbin’s Path (see above).  I also bought Kaplan’s Q-bank last-minute last week just in case, but I’m not sure whether I’ll have time to do it yet.

Other resources include: Goljan audio (a classmate at school also downloaded short-audio versions, which is great to put on an mp3-player/ipod), South Biochem (audio and handouts) and NBME practice exams.  Hopefully no one sues me for putting this up or takes away resources because of this post T__T.

Timeline:

So here’s what the rough timeline of what I’ve done so far (with first a word on how studying was with grad school on top of it…so skip the first long paragraph if you don’t want to read about that):

Medical school ended around March 22, which was about 9 weeks ago or so.  Most of my MD classmates start clinical clerkships this week, so they all had to finish before May 2.  However, us MSTP’s have an extra month because we still had grad school throughout April.  From what I’ve heard from upperclassmen/current MSTP classmates is that people in the grad school “themes” all finished 2 weeks ago, and that they either have tests or had a presentation or two on journal articles related to their classes.  Each class is also usually only about a month long.  I, on the other hand, actually had it pretty tough this time since I’ve decided to do a Nutritional Science PhD, which is off the beaten track, so I have to pioneer the way so to speak.  I only had 2 classes this semester, but both were whole-semester long classes that only ended last week, with writing assignments every week (this is all on top of taking all the regular med school classes mind you), and one of them was a grant writing class that also had a couple quizzes and required a grant proposal written throughout.  The final grant proposal was due last Monday, which was the same day my final review paper was due for my other class (along with other projects)  Basically, April for me was spent working on grad school – Class 1: writing/editing the grant proposal and peer-reviewing other people’s grant proposals for hours, and preparing a powerpoint scientific presentation on a paper (which takes hours for me, even for a 15 minute presentation), then Class 2: Researching/preparing for a mock, taped interview session (on acupuncture), researching and presenting another powerpoint scientific review on green tea, then preparing for a consumer presentation on the topic with a handout that also took hours T__T, and finally, writing a review paper (on different studies!) on green tea.  I should say that the grant proposal was on the Paleo diet.  So no overlap between classes unfortunately, which many of the other students were lucky enough to be able to do.  (My topic for the Paleo diet was already chosen by someone else so I was told to choose something else for the other class).  I think the mindset of studying for tests and med school is drastically different than the mindset of a writer/presenter.  I never really realized that so clearly even in undergrad with my double major in the humanities and the sciences.  But here, while trying to flip the way I organize my thoughts so much in such a short space of time, I have recognized that they really are like two sides of the brain.  Needless to say, studying was very difficult in that context.

So, not much studying was done during April, and I am currently left with basically the same amount of time as a regular med student (or maybe less since I didn’t study for Step 1 at all during med school except for chapters 4-5 of Pathoma during Heme-onc, which I re-did anyway for Step 1).  There are two major things that I did accomplish in April though, and that is to go through all of South’s biochem review (audio along with the handouts) and read through all of Clinical Micro MRS (minus the last 2 chapters on antibiotics in the future and a recap of diseases for bioterrorism, both of which I just skimmed), and did a few micro questions in the Kaplan Q-book and Robbins Path.  I may have also gotten in a few chapters of Pathoma and BRS phys in.  Hah, so I did do a little more than I thought, phew.

Since last week, which was my first week of full day studying (which I was not nearly as productive at as I should have been…), I did Pathoma, BRS Phys, and First Aid (FA) for pulmonary and 1 question block on UWorld for it.   Man, going through answers for the test block took literally 4 hours, I kid you not (and I thought my friend who just took it was exaggerating when she said that… she was spot on.)  I also did manage to go through the same 3 resources for GI and finish a question block, but that was all for the week (including yesterday).  I suppose I did lose a couple days because of clinical orientation on Thursday and I flew home Saturday (listening to Goljan and annotating FA on the way as best as I could with a passenger that kept trying to talk to me on the 4-hr leg of the flight >.<), but still, it’s been hard to focus.

So yes, need to really ramp it up.  Did Renal on Pathoma yesterday, and a question block for hepatobiliary on UWorld that I am currently going through right now before I decided to type this up hehe.  I am way behind my schedule (I thought I’d be done w/ MSK and onto neuro by now HAH as if) so my goal today is just to catch up as fast as I can – hopefully after going over questions, I can finish Renal on FA and BRS phys and do a question block… won’t be too expectant that I can do much more than that.

Oh a comment on studying schedule – I’ve only been doing like <8 hrs previously, but starting yesterday I’m doing around at least 10 hrs, waking up at ~6:30am (thank goodness for jet lag in my favor here) and working until 10pm, with breaks for meals.  I have heard that an avg of 12-14 hrs a day is normal at this point (and really should have been true starting at least 4 weeks out from the test).

Ok, I think I’ve spent enough time here… I hope it was somewhat helpful on understanding the life of a med student while studying for boards and what the timeline should be like for your own studying if you decide to go to med school.  I would eventually like to also post some of the crazy/weird mnemonics/ways of remembers stuff I’ve come up with on a separate post to keep track of all of them, but we’ll see if I have time haha.

Bye!

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March 20, 2013

Last day of preclinicals… and the general overview of medical school

It’s kind of surreal, but it’s here.  Today was the last day of our pre-clinical years – the last day we will be sitting together in the same classroom, listening to lecturers and seeing the same faces every day.  Technically yesterday was our last day of real lecture – today was just a couple of review sessions before our very last test in this building.  It’s hard to believe that this is it… the culmination of 2 years in medical school.

For those who don’t know, medical school is divided into 2 “sections”, if you will.  The first two years are called “preclinical” years because, as the name implies, it is what you learn before entering the 2nd half, which are your “clinical” years.  Preclinical years are where you spend every day in lectures or small group discussions on medical cases, and you do all your basic science and medical learning.  It includes courses on things like anatomy, physiology, biochemistry, microbiology, etc, as well as organ systems like our school uses, so going through cardio (the heart), respiratory (lungs), GI (bowel stuff and all organs in the abdominal area), renal (kidneys), musculoskeletal (muscles and bones), neurology (brain), hematology/oncology (blood and blood-related cancers/diseases), endocrine (hormones), and the last one we are just finishing up, reproduction (gonads and related diseases).

After this and before entering the clinics, we all have to pass what is called the Step 1 of the USMLE Board Exams (or Step 1 for short).  This is what is going to take up my life for the next two months or so.  The Step 1 is like the MCAT, but probably 100x harder.  It’s made up mainly of clinical vignettes, or short clinical scenarios, that you have to decipher to get at the right answer.  It’s also usually formatted in a “2-step” manner – meaning, they could give you a long story about a patient, but instead of just asking you what the patient has (which would be a 1-step thought process), they would ask something like “what is the genetic mutation most likely associated with this?” or “What other conditions are commonly associated with this?”  So you not only need to be able to recognize what the problem is, but you also need to know all the other random facts associated with it.  On top of just the difficulty of the exam is the fact that for many specialties, especially competitive ones, this is a key determinant to whether or not you will get interviewed, or even if the rest of your application will be looked at.  So in a sense, your Step 1 score will determine what specialties you can feasibly apply for.  Just passing isn’t nearly good enough, especially with the fact that the numbers of medical students are currently increasing, but the residency cap is still in place and thus residency spots are getting relatively more and more limited.  Pretty intimidating huh?

Assuming you pass Step 1, you then move into the clinics for 3rd and 4th year.  The clinical years are basically when medical students really get their feet wet on working in the hospital and being part of the medical team.   3rd and 4th year medical students are the ones who get spend the most time with patients and writing up reports and presenting them to the residents (post-med school trainees) and attendings (who I think of as the “real” doctors).  I think there are core clerkships you need to take, like medicine, surgery, OB/GYN, etc, after which you now need to take national standardized exams called  and then there are electives that you can choose from if you’re interested in them, which include more of the specialized topics, such as anesthesiology, dermatology, orthopaedics, etc.  There’s a lot more specialties than there are rotations for electives, so you need to be thinking about which to choose early.  At the end of 4th year, you take Step 2 of the Boards (which has 2 parts – a knowledge portion (CK) which is like a regular test, and a skills portion (CS) which tests your clinical skills with simulated patients.  You also apply for residencies that year.  After getting into residency, in the first year, you are called an intern, and the following years, you become a resident.  That’s as far as I understand it anyway 😛

As MSTP, it’s a little different for us.  Most schools follow the same schedule we do, which is first two years as preclinical years, then take Step 1, then enter our labs/PhD programs, defend our thesis and earn a PhD, and then go back to medical school to finish our last 2 years in the clinics.  We’ve recently changed it so that 2nd years have the option to do a family medicine elective rotation first before entering the labs, which I think is a good idea because we’ll be coming fresh off of Step 1 and will be able to apply some of our clinical knowledge before going off to a different world for 4 years or so.  The last two years of MSTP’s here have said they it was a good experience as well, so I’m looking forward to it.  Part of the reason for this change was apparently because some residencies, like those in California, require a family medicine rotation before applying, so that’s something to note.  We also only have 1.5 years to finish our 3rd/4th years for some reason, which is another reason why it’s good to get that rotation in early.

Anyway, hopefully that was informative, or at least wasn’t too boring or redundant (I vaguely remember posting something briefly about how the MSTP schedule works out sometime last year or so…)  Sorry if I did end up repeating myself, although I think I understand clinical stuff a bit better now.

Ah, I’m going to miss the people in my class.  As an MSTP, we’re already going to be pretty disconnected with our classmates to begin with, but now also around 1/3 of our class are going off to branch campuses, so it’ll be even harder for me to see them around.  :\  I have heard that the hardest for MSTP’s  is when Match Day comes in 4th year for our respective classes, where everyone finds out where they’re going to go, and everyone we knew in med school will really be gone and scattered around the nation.  I’m slightly depressed already thinking about it, haha.  Ah well, it’s been a good two years.  Best of luck on Step 1 everyone!

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