## Sunday, February 8, 2015

### Half of First Year is Gone

I blinked and the first half of my first year has flown by.  I intended to write more frequently, but I have been so busy it just didn't happen.  What are my impressions so far?

1. It isn't that bad!  Before I started, I was warned over and over just how completely impossible and daunting medical school is.  I was extremely nervous about this, because everyone worries about doing well.  After half a year I can tell you that it just isn't that bad.  Don't get me wrong, it is difficult, but not in the way I was expecting.  The concepts that we are learning aren't very difficult to comprehend, however the difficulty lies in the amount of information you have to learn and the extreme level of detail that you need to achieve.
2. Be prepared for long hours.  The first six months is like a boot camp.  Some people figure out things pretty quickly and are able to eventually spend less time than at the beginning.  For me, I am still working on finding the best approach to maximizing my grades.  I have tried many different approaches and each time I have spent a ton of hours.  I still haven't reached my goals yet, but I have seen a constant improvement which means I am moving in the right direction.  The hard part of medical school is learning how to learn.  The most important thing is not to quit trying and changing things when you don't get the result you are expecting.  You have to be humble and willing to admit that your approach may not be the best.
3. Pick only one student group to participate with.  There are so many student groups that want your participation that you could easily become overwhelmed doing extracurricular functions.  This is a huge trap and it robs you of valuable study time.  I think people should be involved in at least one group though.  It is a nice social outlet, especially if you spend all your time studying.
4. Find an organization system.  Whether it be a calendar, a to-do list.  There are so many assignments, labs, activities, and other items that happen within a week that it impossible to keep track of it unless you have it organized.  What works for me is a sequential list ordered by when it is due (date + time).  Every day I look at that list and make sure I have completed the top items before moving on.  I didn't start doing this until I missed the deadline for a paper I was supposed to write.  I knew about the paper, but thought the due date was later.   That really hurt my grade and was the wrong way to learn my lesson.  Learn from me and just start out doing that.  You will thank me.
5. Anatomy sucks the first few times.  After that you just stop thinking about it.   I joined the cadaver team so that I could do all the dissections.  I wanted to do this, because I learn better by doing and seeing than by memorizing a picture.  The first time I was nervous about how I would react to a cadaver.  Once we started the first dissection the nervousness went away pretty quickly.  After that I would only get a headache after about 2 hours of constantly smelling the formalehyde.  Take some Ibuprofin just in case.
6. Formaldehyde - It stinks.  Don't make the mistake of wearing your street clothes to a dissection.  They let you wear a lab coat over your clothes, or you can wear scrubs.  Take the scrubs option.  Get a pair of scrubs that you will burn later and use only those.  The worst thing in the world is to be studying later at the library and to keep getting whiffs of formaldehyde from when it seeped into your clothes.
7. Avoid the temptation to complain.  It is almost a past-time for undergraduate students to complain about their class.  "Why are we doing calculus?  I will never use this in the REAL world..."   So far I haven't seen anything that I won't ever use in the "real" world.  Yes there are probably a few things I will use rarely, but it is all applicable and important.  Try to enjoy all of the material.  It will make it that much easier to remember when you have to study it again for the Steps.
Those are the impressions that immediately come to mind.  I have immensely enjoyed my experience so far.  I am always up for answering questions, and can't write about something else if someone is interested.  If you are still trying to get in, don't get in.  It is worth it!

## Thursday, July 17, 2014

### How to Score 270+ on the USMLE Step 1

I came across the following post while reading through Step 1 experiences over at SDN.  By now you may have noticed that the content of my blog has switched to focusing on Step 1 and the first two years of medical school.  Most of the stuff I am posting here is actually so I don't forget it.  I want to come back and look at this as I start to study more aggressively for the steps.  I know that most people will study for it during the six weeks after their second year, but after you read the following I think you may come to the same conclusion as I.  Waiting until then, while you can be successful, will not yield an optimal score.

The following is a write-up posted by "Golf med student" over at SDN

## Friday, July 4, 2014

### How to Honor Your Tests in Med School

Someone posted the following on SDN.  I thought I would catalog it here for future reference.  It comes from a thread where people are arguing about how people manage to get 100s on tests in med school.  Suddenly this guy pops in really late to the discussion and drops a bomb.  It was the only good advice given, and I intend to follow suit.

--------------

I had a horrible go of it in first year and failed four courses despite working long hours studying. I looked around and was in disbelief that anyone was getting or could get 100% or near that on these tests.

When i was blessed with another chance at the year, i went to each member of the top 10% of my former class and took them to lunch to pick their brain.

They told me consistently the same thing...and it worked for me the next year to get near 100% all the time...you should plan to review the testable content a minimum of five times before the exam. This seems very daunting but each subsequent trip through is much faster because you have seen and understand the interrelationships of the content sections. I struggled to do this at first, and had to set a time limit per page and set a timer. When the timer went off, regardless of how far down the page I was, I turned and started on the next page. I also had to limit the number of sources I used to study from to a dictionary, anatomy atlas, and the recommended syllabus (it was a bound set of provided pages back then). At the top of each page I made a hash mark each time I had reviewed the page. By the fourth, fifth, and sixth time through, I could flip the page at about a ten second clip and recite the core material per page. As others have said on SDN before, its not hard to know how to achieve success in these classes, it is hard to do it though. In my experience repetition is key.

This was my experience…yours may be different:
Barely one time through the content = barely pass
two times through = pass to slightly above average
three times through = above average to high pass
four times through = high pass to honors
five times through = honors to top three scorers
six plus times through = top three scorer

## Saturday, September 28, 2013

### Over Joy

As I sat in the Library reviewing my Physics notes, I heard that distinctive note from my phone informing me that a new email had arrived to my inbox.  I quickly flipped over to take a look and felt my blood run cold when I saw who it was from.

The dreaded moment had finally arrived.  I was about to find out if my dream would finally come true, or if I would be forced to spend yet another year of my life trying to prove that I am worthy of the medical vocation.

I called my wife over to share the moment with me.  Initially she looked at me with a confused look.  Why was I interrupting her study?  Finally she acceded to my wishes and walked over.  I pointed to the screen, and then clicked to open the email.

On behalf of the Executive Dean, I am very pleased to offer you an acceptance...

I literally felt my body start to shake.  I was in disbelief, so I started to read the email again to make sure.

On behalf of the Executive Dean, I am very pleased to offer you an acceptance...

The words had not changed, yet my mind still could not comprehend.  My body continued to shake uncontrollably, and my wife embraced me from behind.  She was already crying, which caused me to cry too.  These were tears of joy, tears of disbelief, tears of pent up emotion that craved release!  I can't imagine what the other people, who beheld such an odd spectacle, were thinking at that moment.

My wife rushed off to call everyone and relate the good news.  I sat there in a daze, still trembling as emotion and adrenaline coursed through my body.  I realized at that moment that over the past seven years I had convinced myself that it would probably never happen, yet I was stubborn enough to keep trying in the face of the impossible.  Now I was confronted with reality, that it was possible, and the door to my dream had finally opened.

In retrospect, as I think about this now, I have never been so excited, happy, and relieved to have been given permission to start something.  Something that will take more effort, time, and dedication than anything I have ever tried in my life.  It is ironic, because many people would think it is over, but no...that was just the beginning, the first step on a road of training that will last at least 8 years.

This moment will forever be engraved in my mind.  I payed a high price to reach this starting point, but looking back on my credentials they are only average at best.  I can't help but believe that a miracle was enacted on my behalf.  I would love to take credit for this, but the truth is I must defer to the athlete who has just scored a touchdown and raises his hands to point heavenward.  I personally know several applicants with way better stats than me that were rejected.  Somehow God saw fit to turn the hearts of the Admissions Committee in my favor.  In turn I would also like to raise my hands heavenward and point to Him, because I can really see no reason why I am better than anyone else.

The blessing of God, have given me reason to be overjoyed and grateful at the same time.  At least once a day a surreal moment overwhelms me, sending me back to that email once again just to make sure;

On behalf of the Executive Dean, I am very pleased to offer you an acceptance...

## Friday, September 6, 2013

### Step by Step

 All Rights to Mcraw-Hill and junk

The first two years of Medical School exist to prepare you for one seminal moment in your medical career.  That moment is when you take your first Board exam called "USMLE Step 1".  The last four years I have been so focused on sitting for the MCAT and getting into Medical School that nothing else has occupied my mind.  Although I have not been accepted into Medical School, I  recently started focusing on it and making plans for how I will approach it.

Although there may be some debate about this, I believe that the one key component which will allow you to apply to any residency unimpeded will be your Step 1 score.  I always thought that as long as you score a 99 on the Step 1 you could write your ticket, but this is not the whole story.  There are actually two scores and even if you are in the "99" range the second score can vary anywhere from 240-270+.  From my research I have been able to determine that scoring a 250 is very good, the top people are in the 260 range, and the godly freaks are in the 270 range.

Getting into Medical School will make me supremely happy, however that isn't my ultimate goal.  I will probably be accused of "gunnerism" for my approach to medical school, but I prefer to think that I am going into my future studies fully informed about the process.  As a non-traditional student, I am lucky to have already lived and done many of the things I wanted.  I have traveled the world extensively, lived abroad, married a wonderful woman, and enjoyed many reunions with friends.  As an undergrad I only wanted "to get my degree".

This time around, I want to see what I am really capable of, to fully embrace the process, and actually push myself to excel.  Most importantly, when it comes time to choose my residency I don't want my academic performance to have closed any doors.  I want the freedom to choose from any residency.  Even if I ultimately choose Family Medicine, which does not require a super high Step 1 score, I still want to have had the option to choose Neurosurgery or Dermatology.

Traditionally most Medical Students will use their 6 week break after the second year of Medical School to study for and take the Step 1 exam.  I plan on starting much much earlier.  From my first day I am going in with one thing in mind, to crush that test.  I will use every resource available to me to ensure that I am more than prepared on test day.

I have been formulating a plan to achieve just that, but it is still not complete.  What I have learned from the MCAT, is that I am not a super-freak that will be able to collate 2 years of study in just 6 weeks.  Taking the long term approach and making sure I continually maintain and refine my medical knowledge as I learn it, is really the only way I can expect to come out with a top score on that test.

Of course all this planning is still dependent on getting accepted into Medical School, so here is to hoping my interviews go well.

## Monday, September 2, 2013

### Why Can't I Get Off the Couch?

I always wondered why, when I wanted to get something done, I couldn't find the strength to get off the couch to do it.  Today I discovered the culprit and you will be surprised as to who is responsible.  The answer is gravity my friends.  The equation for gravity is as follows

It is important to understand that gravity can be exerted between any two objects, and using that equation we can find what the force is between two distinct object.  So bear with me as I quickly describe what each variable stands for, so that we will all be on the same page.

F is the total Force of Gravity, m1 is the mass of one object, and m2 is the mass of a second object.  For our discussion I am m1, and the couch is m2;  r corresponds to the radius between both objects, which we can basically say that it is the distance they are away from each other.  Finally G is the universal constant of Gravity.

What I want you to pay attention to are two things.  First the radius variable.  As the radius decreases the Force of gravity becomes much greater.  As radius approaches zero the Force approaches a value close to infinity which means, my ass is going to be glued to that couch and there is nothing I can do to escape.  It is just too strong!

Oh, but gravity hasn't finished with me yet, because that brings me to our second observation.  Pay attention to the m1 and m2 variables.  Well, if I increase the mass of one or both of the objects in this system, yes you guessed it, the Force of gravity once again INCREASES!  This is where I really have a problem with gravity because the amount by which my own mass increases is directly proportional to the amount of time my ass is glued to the couch, which by now we have determined to be nearly all the time since the radius is close to zero and the Force is near infinity.

It is a vicious cycle my friends, and Gravity has me in her cold hard grip.  She is a fickle lover, jealous of all distractions.  Will I escape?  My mathematical calculations lead me to believe that there may be little hope, but that is not why I am writing this.  I want this message to reach you, dear reader, so that when you see a couch you will know that you should run and run far.  Save yourself, it is already too late for me!

## Tuesday, August 20, 2013

### The Vagaries of Change

 A Beatiful Sign Close to My New Home

Things have changed since I last posted.  I quit my job and moved 850 miles away from my home.  The day I took the MCAT my wife shared a surprise with me when I got home.  She told me that she had been accepted into a Graduate program at Tulane University.  I was absolutely shocked by this, because it was something I never expected.  Somehow, in less than two months I was able to find a new place to live, a new job, and relocate to an entirely new city.

I am now settled in and we have established our new rythm of life, however things are different.  For one, living arrangements are vastly different from before.  I went from a three bedroom house with a nice yard, to a tiny 1 bedroom apartment.  When my neighbors have friends over, I can hear it.  They often wake me up in the middle of the night, which is something that never used to happen before.  The hallway often carries suspicious odors that whisper to me their nighttime activities.  I never realized that living in an apartment would mean being more intimate with your neighbors...you literally share everything with them, whether  you want to or not.

The smallness of our apartment and the need to walk everywhere has also drawn my wife and I closer together as well.  We have been spending much more time together, and I am now thinking that bigger is not necessarily better.  Most people dream of having a big house, but I am not so sure I want one now.  I don't like that family members can hide from each other by going to other rooms in the house.  I especially don't like the maintenance duties of a large house.  Cleaning, upkeep, and yardwork take up so much time.  Now these are things I don't have to worry about, and I love it!

 A View From my Morning Commute
My work routine has changed as well.  After moving here, I decided that I would bike to work everyday instead of driving the car.  Many things contributed to making this decision, such as traffic, expensive parking rates, and my lack of knowledge of the city, however, the main reason is because I was really craving a way to lose weight.  As an aspiring Physician I think that it would be hypocritical to meet patients as an overweight person.  If I am going to preach the high principles of healthy living, then I must also follow those principles as well.  My problem is that I hate going to the gym, especially when I have to do it by myself.  Forcing myself to bike to work accomplishes several things at once.  It allows me to learn the city, it provides me with a means of transportation, and it ensures that I get a healthy dose of exercise every single day.  With a 22 mile round trip I have already managed to lose 10 pounds in two weeks.

All of this upheaval has been difficult, yet instructive as well.  I have learned that sometimes we need a drastic change that will take us out of our comfort zone.  In the short month I have been here I have totally revolutionized my lifestyle.  I look back on who I was before and I am amazed at the change that has happened in only one month.  Most people battle to keep things from changing, because that way they never have to face a scary or uncertain situation.  It is those situations, that makes us grow the most.  The more of them I experience, the more I look forward to it.

All of this has caused me to evaluate my personal goals as well.  Last year I was so sure I would get accepted into Medical School that I was rocked when the rejection came.  This year, I decided I have to prepare for it.  I must have a contingency plan in place so that I can smoothly transition into plan-B instead of being caught unprepared.  I was scared to quit my current profession before, because the stability that an Engineering income provides is very comforting, however I have realized I am reaching a point where I need to go the extra mile if I am really serious about Medicine.  If I am not accepted this cycle I will be going to Graduate school starting in January to study Neuroscience.  I have finished all the pre-med courses that I can take at a community college.  The only thing left ot me now is some GPA redemption by going through a Graduate program.  GPA redemption isn't my only goal, because I also want to study something that I find interesting while also continuing to prepare me for Medical School.

Change can be scary, but change is necessary.  The saddest thing to me is to see someone who has done the same thing, in the same place, for thirty years or more.  I know there are probably many reasons for this, but to me it looks like they were scared to go further, so they decided that where they were at was "good enough".  The possible risk to go further was too much for them so they settled.  I hope that I never settle in my life.  I hope that when I reach my goal of becoming a Physician that I will go even further from there.  I never want to be satisfied with where I am at, because the alternative is scarier than any nightmare I could ever dream up.