Comedic Relief – Funniest College Prank Ever

My college roommates in our apartment in 2005/2006. Pot-luck roommates and ended up living together until we graduated. Love these girls.

One night my sophomore year of college I came home from a long shift at Buffalo Wild Wings to find my room had been toilet papered by my friends and roommates. I remember being mad for some ridiculous reason (maybe because I paid for the toilet paper??), but looking back it was quite hilarious. However, nothing quite approaches the level of hilariousness presented in this video.

A group of BYU students has taken the cake with a recent Easter prank they pulled on their neighbors…you must watch this:

Original Story Here – Via KSL.com

Medical School in Indonesia

Today I’m excited to introduce to you Anna, a 22 year old medical student from Bogor, West Java province in India. She is in her last year of clinical clerkships at Universitas Pelita Harapan medical school, a bilingual (Indonesian and English) open to both local and foreign students.

Currently, Anna is undecided on a specialty, but is interested in both Neurology and Emergency Medicine. She has five more rotations before she finishes, so it will be interesting to see what she decides on! She blogs at Surreal Hours and you can catch her on Twitter @a_elissa.

She contacted me a few weeks ago asking if I was still open to having more posts in the Medical Education Monday series. I’m so thrilled that y’all find medical education in various countries as interesting as I do…it’s certainly been great to hear about all the different systems.

If you are (or someone you know is) a medical student or physician in a country not yet covered, please have them contact me! Here’s what Anna had to say about Medical School in Indonesia:

Getting In:

How old is one when they begin medical school?

We begin medical school directly after high school. However, some schools are open for students who already have an undergraduate degree, this is usually the case for foreign graduates.

What exams does one have to take to get in?

  • Public Schools: National exam called SPMB that is designed for a specific major, but is valid for any universities. This exam is not the actual entrance exam, it’s only for filtering out students who are academically eligible for a certain major, in this case for medical school. A prospective student sitting the medical school SPMB also needs to fill out a list of schools of their choice. The result of the exam is then sent out to those schools, and he will receive a notification about his acceptance. There is then another exam and an interview from each school that he has to complete and pass before being formally enrolled.
  • Private Schools: Each school has its own entrance exam, usually consisting of basic science focusing on human biology and chemistry, and an interview. Students applying for scholarship may be required to sit an additional exam.

Is there any required pre-requisite coursework?

The national high school system divides the curriculum into two major programs: Ilmu Pengetahuan Alam or IPA (Natural Sciences), and Ilmu Pengetahuan Sosial or IPS (Social Sciences). One has to do the IPA / Natural Sciences program to be eligible for medical school. If a student graduates from a foreign curriculum, like Cambridge or the International Baccalaureate (as in my case), then he must have taken at least biology, chemistry, and maths.

Is it a competitive occupation?

Very.

What are you called at this stage of training?

A high school graduate.

Being In:

How long is it?

5 years.

How are the years broken down?

  • The first 3 – 3.5 years are pre-clinical years. Using the new block system, we learn basic anatomy, physiology, biochemistry, and immunology for the first year, then system-based approach for the remaining pre-clinical years. The actual division of the organ systems depends on each school. In my school, it is musculoskeletal, cardiology, pulmonology, gastroenterology, genitourinary, endocrinology, neurology, obstetrics and gynecology, dermatology and venereology, tropical medicine, hemato-oncology, and emergency medicine.
  • Students who have completed the first 3.5 years are considered graduates already, and are granted the title “Sarjana Kedokteran” (Bachelor of Medicine). They can quit at this time and start working non-clinical jobs.
  • The last 1 to 1.5 years are clinical/clerkship years. We do 9 minor rotations and 5 major ones. They differ by duration: minors last 4-5 weeks, majors last for 10-12 weeks. Minor Rotations: Neurology, radiology, psychiatry, ophthalmology, ENT, oral medicine, dermato-venereology, anesthesiology (including critical care), and forensic medicine. Major Rotations: Surgery (including emergency medicine), internal medicine, obs/gyn, pediatrics, and public health. Upon completing the clerkship, we then graduate as Medical Doctors.

Describe your typical day.

  • Pre-clinical: Class starts at 7:30 AM. Some days start with lectures, some with PBL discussions. Labs are usually in the midday. On the last period every Friday, there is a plenary session where the PBL case study that week is discussed with an expert. The day usually ends at 3:00 PM.
  • Clinical: In my hospital, office hours start at 7:00 AM and end at 2:00 PM, while outpatient clinic starts at 9:00 AM. The first thing we do in the morning is write SOAP notes of ward patients, then wait for the attending physicians to come for the morning round. After rounds, activities vary according to department. We may have academic activities, like tutorials or case study presentations, or we may go to outpatient clinic and have academic stuff later in the day. For surgical specialties, most operations commence at around 10:00 AM, depending on the number and difficulty of the cases that day.

If you choose a specialty, when do you have to decide by?

There’s no requirement for that. Age-wise, residency programs only require applicants to be less than 30 years old by the time of entrance.

What are you called at this stage of training?

  • Pre-Clinicals Years: Medical Students.
  • Clerkship Years: Our formal name is “dokter muda” or junior physicians, but we are more often called with our colloquial names, “co-ass”, from the Dutch word co-assistant. We still use a lot of Dutch medical terms in spoken conversations.

Getting Out:

What exams do you have to take?

The law is changing as I’m typing this. There used to be no exam getting out, as each rotation in clerkship already has its own exam. However, the new bill proposes for a national board exam. It is still undecided whether the exam will be a test for theory or clinical skills, or both.

Do most people graduate?

Yes.

When are you finally considered a “doctor?”

When we have taken our Hippocratic Oath at the end of clerkship (and after the board exam, if the new bill passes).

Do you have additional training after MS or do you start working immediately?

Again, the law is under some changes. The new law requires an unpaid 1-year internship in a hospital chosen by the government. After that year, doctors can work independently.

What’s the average debt for attendance?

There is no debt, except for scholarship students. Regular students pay the full fee. Scholarship students will pay back by working for their universities or teaching hospitals immediately upon graduation for a certain period of time, usually 2n + 1.

What are you called at this stage of training?

A doctor. More formally, a general physician.

Being Out:

What’s the average salary?

Depends on where you work. The general rule is the same everywhere: it’s higher in private institutions than public ones, and is also higher in bigger cities than in rural communities.

Is the job security good?

Yes. There is a high demand for doctors throughout the country, especially outside the main islands of Java and Bali.

Can you switch specialties?

Yes, but people rarely do this.

Can you go back and choose a different specialty?

Technically, yes, as long as one has not reached the age of 30 by the time of entrance. However, I have never heard of anybody doing that.

What are you called at this stage of training?

A specialist.

Breaking The Rules

A recent article called “To Tweet, or Not To Tweet: Physicians Misusing the Internet” discussed a new JAMA study which apparently found that…

“92 percent of state medical boards in the United States have received reports of [online] violations ranging from inappropriate contact with patients to misrepresentation of credentials.”

I guess this is supposed to be shocking, but I was really somewhat underwhelmed with the information (I was actually more shocked it wasn’t 100% – which state has had none…because that’s awesome). It’s exceedingly easy to report a violation that occurs online, since it’s permanently etched in the history of the internet, so of course there’s a large number of state boards receiving reports on violations that occur online.

The discussion is relevant and interesting, but clearly written with a negative attitude and watch-your-mouth, paternalistic tone (like many of the recent articles and research publications on social media in medicine, unfortunately). A quick search finds that the doctor on the answering end of this Q&A session has a rarely used Twitter account (@RyanGreysen) and no blog (that I could find, anyway)…clearly making him one of the least effective people to be discussing these issues unless his only advice is going to be to avoid a presence in social media all together.

However, that’s not exactly the point. What irks me so much about the recent onslaught of negative-nancy articles on physicians in social media is that they pretend that the internet is some delinquent hangout for the physicians who can’t seem to conduct themselves professionally. The tone of these articles comes across like Twitter is where we gather to join in HIPAA-violating hippie parties and have inappropriate contact with patients.

The tone implies that these things don’t happen on the elevator, at the football game or in the corner bar. The article (and many others like it) repeatedly discusses the need for educating physicians on the “rules” of online behavior and “how to conduct yourself online.”

That is not the problem.

The fact that the online world documents breaches is the problem.

Venture into any hospital hallway and you will be bombarded with far more private information in a circle around one ward than you will in a full days Twitter stream.

The issue is not that we’re gathering online and violating HIPAA because we don’t know how to conduct ourselves online, the issue is that it’s recorded here.

By saying we should educate physicians on how to act online we imply that either:

A) Unprofessional conduct is not occurring off-line.         OR

B) It’s more important to watch what you say here because it’s documented.

 

Is it important to watch what you say here because it’s documented?

Absolutely. Unequivocally. Yes.

Is it more important than it would be in your local Chili’s?

I sure hope not.

 

Sure, you’re less likely to get caught if you’re talking about private patient details in Chili’s, since it’s not being recorded and all, but that doesn’t make it ok. As a kid my mama would tell me,

“Doing something bad when you know you won’t get caught doesn’t make it any less bad.”

Doesn’t that rule still hold true?

What I’m saying is that these are not separate entities. Just because reports aren’t getting filed about physicians discussing private patient details in elevators as often as they are about physicians discussing private patient details online does not mean it’s happening less. It means it’s recorded less. That is not to say that there is no room for guidelines or advice about conduct in social media, just that online behavior is not inherently different than offline behavior. @SeattleMamaDoc really said it best,

“We are worse in the elevator than we are online.”

We don’t need to educate physicians on behavior online, because this problem is not unique to the internet. We need to educate physicians on keeping private patient information to themselves. On using some common sense and respecting co-workers and patients alike. Not just on the internet…everywhere…including on the internet. The physicians who are violating privacy and acting unprofessionally in the elevator are the ones who will talk about their patients online. This is not a problem inherent to an information medium, it’s a problem inherent to a person. And I’m not sure it’s one that can just be “educated” out of someone.

Thus, this is not about our online conduct, it’s about our conduct…and as soon as we make it about online conduct we imply that it’s only important to follow the rules if there’s a really good chance you’ll be caught if you break them.

 

Image 1: Pixomar | FreeDigitalPhotos.net

I Love My Job – Medical Educator Edition

As a first year I began working alongside a Pediatrician who would become pivotal in shaping my view of doctors and specialty choice. The way she loved her job shined through every single day (and still does as I work with her in third year) and the example she was to me became key in my discovery of the importance pursuing a career in a field you love holds. She showed me how important it was to choose a specialty you are truly passionate about…partly because it benefits you, but mostly because it benefits your patients.

As I mentioned a few days ago, residency applications are looming on the horizon and, with that, comes the promise of graduation (uhh…I hope, anyway) and “the real world.” As I struggle to decide what I want to be when I grow up I find that speaking with people who truly love their job is not only incredibly eye-opening, but exceedingly inspiring to me. Last semester I began asking around to find some healthcare professionals who love what they do and are willing to tell y’all about it. I hope to build a resource here so medical students struggling with post-graduation planning can get a look into the day-to-day life of various areas of medicine and, hopefully, find a piece of themselves in one of these inspiring stories.

I started by asking Dr. Michael McKenna, pediatrician and pediatric program director at Indiana University, what he loves about his job as a medical educator and how he ended up in the position.

Here’s what he had to say…

J. Lo in The Wedding Planner, when asked why she is a wedding planner:
“Y’know, ‘Those who can’t do, teach?’ Well, those who can’t wed, plan!”

While the above quote is a common phrase, I wholeheartedly disagree. People who teach don’t do so because they can’t hack it otherwise. They do it because their passion for their field is so great they can’t help but spread their knowledge, experience and passion to others.

I am a pediatrician, but the reason that I have been asked to write for Mind on Medicine’s “I Love My Job” series is because I teach newly minted doctors how to be pediatricians.

I am a Medical Educator.

I initially thought I was going to be a Pediatric Endocrinologist because it was the only organ system that made sense to me.

But before I had a chance to go on to fellowship, I had to pay my time to the State of Indiana.

No, I wasn’t making license plates in a minimum-security correctional facility. In medical school, I participated in a tuition payment program to serve in a medically underserved area. After residency participants needed to payback their time before doing any kind of fellowship. So, Endocrinology would have to wait.

Luckily, this did not preclude me from receiving the greatest honor of my career, serving as a Chief Resident of my residency program. Most residencies have one or more Chief Residents leading during their last year. In our program, Chiefs are expected to create the schedule and call schedules for the year. They also do a great deal of problem solving. Most importantly, Chief Residents teach residents and medical students. It was this aspect of my Chief year that changed the direction of my career.

Ever since I was a kid, I considered being a teacher, but being young and foolish, I didn’t consider it “cool enough”. These thoughts came flooding back during my time as Chief, as I realized medicine and teaching could be combined into one career. Ever since, I’ve had one all-encompassing (albeit cheesy-sounding) goal… helping residents become the best pediatricians they can be.

You don’t have to be Chief or take special classes to become a medical educator. The main quality needed is passion. I encourage everyone to incorporate medical education into every career path. 

The best medical educators I know, just like the best doctors, are always adding to their knowledge base. For educators, this means attending workshops about giving feedback or creating curricula. You can even get a Master’s Degree in Medical Education.

The day-to-day flow of a medical educator varies depending on specialty and  interests. The main question of career medical educators is, “Who is paying for your time?”

In medicine, you pay for your time by seeing patients in order to bill and generate revenue. Teaching doesn’t generate any revenue. Instead, I have to convince the Chairman that I am worthy of receiving money from the budget to teach.

Medical education is a great way to keep your career exciting. Each day is different. I might be mentoring a resident, seeing patients, developing a new workshop or a myriad other tasks on my “to-do” list. More importantly, being around learners all of the time constantly exposes me to their thirst for knowledge, keeping me excited about medicine.

Many students and residents are paralyzed by the perceived gravity of choosing a career, believing that once they choose their path, they are committed to it FOREVER. That is not true. Your MD (or DO or MBBS) opens many doors. If you ever get stuck in a rut, you can always find a new adventure without up-ending your life with a new residency. Bring a learner into your practice, teach at a nearby medical center, be a mentor. Be a medical educator!

Because of the way my clinical time is set up, no one is ever going to say that Dr. McKenna is my doctor. I am sure this sounds like a sad statement. Isn’t that why most people go into medicine in the first place? Yes, on occasion I long for that, but I have something much better. If I do my job right, I will have hundreds of pediatricians that will proudly (at least I hope!) say, “Dr. McKenna taught me how to be a pediatrician.”

That is why I am a Medical Educator.

Michael McKenna is Associate Program Director of the Pediatrics Residency at Indiana University. He conducts scholarly work in the areas of social media and medicine as well as mentoring of chief residents. More importantly, he blogs about pop culture, academic medicine and history (occasionally all 3 together!) at Mamihlapinatapei (ironsalsa.wordpress.com). You can also follow him on Twitter @IronSalsa or email him at mpmckenn@ iupui.edu.

Image 1: sakhorn38 | FreeDigitalPhotos.net
Image 2: scottchan | FreeDigitalPhotos.net

Dogs That Eat Bugs & Spiders That Eat People

If you know me in real life (or even just read this blog or my Twitter occasionally) you’ve probably figured out that I have three dogs who are equal parts crazy and awesome (and by equal parts I mean 97.4% crazy, 2.6% awesome). They occasionally wreak havoc on the neighborhood, but once in a while will do cool things like keep me from getting a speeding ticket….or save my life when my husband isn’t home.

A bit of a back story:

I am terrified of spiders. Terrified may not be the right word, more like completely phobic of them. It’s seriously irrational and absolutely ridiculous, but I cannot control. In Psych I learned that I qualify for an actual diagnosis based on the DSM criteria for specific phobias.

One summer night after my freshman year of college I was staying at my mom’s house overnight while she was out of town or something. After I ate dinner that night I walked around the corner and into the hallway to find what can only be described as an octo-legged, girl-eating monster staring me down from the rug. My first inclination was to run for my life and scream for someone to kill it.

Then I remembered I was home by myself for at least the next 24 hours and at some point I would probably need to go down that hallway, considering it was the only way to get to the either of the bathrooms in the house…whose idea was that design?

This wasn’t just any spider, either – it was a wolf spider. If you’ve never encountered one of these satan-filled creatures be warned, they not only have the ability to jump Mr. Chow-style right at your face, but they are also not more afraid of you than you are of them…especially if you’re me.


Now, I never kill spiders if I have a choice, but if I’m the only one around I’d rather knock the sucker off on my own than let it run under a couch so it can hunt me down while I sleep, therfore Raid is a staple in my house.

Unfortunately, I was staying at my mom’s house and while she did have Raid, it was the type that’s meant for taking down wasp nests…basically it shoots chemicals out with the force of a fire hose in attempt to drown an entire nest of flying aggressors before they can attack you in buzz-filled anger.

I seriously considered going to the neighbors house and having them come help me out, but I was afraid it would disappear before they came and then I’d be forced to sleep in my car.

Anyway, I used the Wasp Raid from approximately 12 feet away to knock the creature off (along with his friend who appeared in what I can only assume was an attempt to save his buddy or claim revenge on the buddy’s murderer) and it got the job done…in fact I’m pretty sure any insect within a 30 feet radius likely encountered rolling waves of bug-killer emanating from the pond created by my weapon of choice.

I then proceeded to leave the body on the floor under a large bowl until my mom could get home and dispose of the body the next day. That night I tiptoed past the body, locked the bedroom door and slept on top of the covers with my chemical-filled fire hose in hand.

Because I was afraid it would wake back up and come for it’s revenge? I don’t know…it seemed like a good idea at the time.

Anyway:

A bit more recently I was sitting cross-legged in my desk chair reading about the Kreb’s Cycle or something equally interesting and was totally ignoring Wrigley, who was playing with what I thought was a toy right under my chair.

When he started growling I almost didn’t even hear him, he does it all the time – usually when he’s playing or trying to get my attention.

Why does he growl?

Because, by failing to appropriately channel my inner Cesar Milan, I praised him for it when he was a baby. Come on! It was just so cute. Imagine a little 2-lb baby Wrigley growling at your toes.

You know it’s cute. You would have encouraged it, too. Stop judging me.

When the growling evolved into a manic bark accompanied by insane cat-like scratching I finally glanced down to figure out what all the commotion was about. I’m sure you can guess what I found – a (slightly smaller but still rather large) creepy arachnid hanging out right where my feet would have gone had I uncrossed my legs.

It was in about four pieces by the time I looked down, which was totally gross, but I guess that’s my fault for ignoring the dog’s initial warnings of what I would call danger and I’m sure Wrigley would call total-excitement-slash-yummy-snack.

So, my 20 lb dog basically saved me from the heart attack that would’ve occurred had I set my feet down on top of that thing and since then he’s alerted me to numerous other offenders in the house.

It’s like he can sense that I need someone to protect me from them…

or he likes to eat bugs.

Either way it’s a win-win…and that’s why I no longer get onto my dog for eating bugs. 

Image 1 and 3 | WowFunniestPosts.com

Image 2 | GIFSoup.com

What’s your biggest fear?!

10 Blogging Rules To Follow

I used to resist referring to myself as a “blogger,” it just seemeds like such a large shoe to fill with people out there who write so much more graciously (and humorously) than I…and often about more important things. I guess after this much time I can start to embrace being called a blogger, even though I still feel a bit like a fraud saying that. Occasionally, people will ask me how to start a blog or if I have any tips for them as they work towards creating a space for their thoughts. Here’s a few rules I try to follow for myself, most of which are based more on my experiences as a reader than as a writer – the things I appreciate in blogs I look up to and enjoy.

Wordy Version:

The beauty of blogging is that if someone doesn’t like what you’re writing about, they don’t have to read it. So, own your material, whether boring, hilarious, informative or crazy, it is yours and you created it. No matter how your blog evolves, and it should be allowed to evolve, it needs to always be yours. I started this blog as a mostly personal blog and it has evolved into a conglomeration of medical school, personal stories and general information. Write about what you want and be open to your blog growing and changing along the way.

If you are happy with what you’re writing, that is all that matters. Always write posts that are worth reading, but remember that a post worth reading is one that you think is worth reading. This is your space and you get to decide what does or does not belong, what is or is not worth reading. You may not think reading about my crazy dogs or life timeline is interesting, but I love those posts and having them recorded here is more than worth it to me.

So often I see people not write for three days…or three weeks…or three months…and come back apologizing. Unless you are Frank of PostSecret, it’s highly unlikely people are sitting around fretting over the fact that you took a blogging break…in fact they may have not even noticed you went on hiatus. Sometimes life (or a surgery rotation) happens and you can’t write. It’s okay…don’t come back apologizing, just come back. Pick up where you left off – you have nothing to apologize for. In that same vein, take some time off for crying out loud! The internet isn’t going anywhere, we’ll all be here when you come back.

This is especially important if you’re just starting out with your writing – set goals for how often you want to write, how long your posts should be, etc. When I first started blogging my goal was to write one post per week, because any more than that seemed overwhelming at the time. Now I really just write when I feel like I have something to say that’s more than 140 characters, but at first I wasn’t always sure I had something to say until I just sat down and started saying it.

Your readers deserve your attention – they are visiting your blog and reading your content, the least you can do is listen! If a reader disagrees with your opinion, welcome it…accept it…discuss it. The only way to grow in this life is be open-minded and you can’t do that by immediately discounting opinions other than your own. If a reader emails you, respond. If someone poses an interesting view or question in a comment, write back to them or create a post in response. Find ways to engage and interact, it will serve you well in the future.

Post a link to your blog on your Twitter or Facebook if it seems appropriate, but don’t only post links to your blog. Nobody likes a spammer. If the only thing you ever tweet is “HEY CHECK OUT MY NEW BLOG” your only followers are going to be that naked girl who tweets links to diet pills and her friend who has the miracle acne cure.

The Golden Rule of blogging – link your references. If you reference an article or another blog or a person or a tweet – link it! It’s common courtesy, you’d want your work linked back. And please don’t steal photos, use a creative commons-type source for your pictures and link back to their photographer. Don’t Google Image search and include those pics in your post, this is not only basic courtesy…it’s avoidance of plagiarism, which we all learned about in 2nd grade. Cut & Copy = Plagiarism.  Sometimes you simply can’t remember where you read something you reference and that’s fine, but cite your sources if at all possible.

If you are posting 4 times per day you are overloading your readers. Once per day is fine, less is great, more is definitely overkill. Others may disagree with this one, but I delete any blog that regularly has more than once per day out of my reader (barring the occasional blog with multiple authors or which aggregates info & posts from other sources). Almost universally anyone who has that much to say rarely has anything to say that is really worth reading.

This may be the most important rule of them all – posts need a format. Use bullet points, headings, numbering and formatting. Break up your post with images if relevant. Make your writing look pretty – remember in junior high when you’d have to write papers and make them double-spaced? Same principle. It is no lie when I say I will often spend an hour writing and 2 hours formatting a post…it’s just that important.

Barring the rare exception, posts should not be extremely long. I typically write a post and come back to it the next day to whittle it down to the important stuff. Fluff is not your friend in blog-land.

 

Bottom Line:

  1. Own your space & teach it about Darwinian Theory.
  2. Be proud of work you create and create work you are proud of.
  3. Never apologize for time off, nobody even noticed you were gone.
  4. Set goals for yourself, especially in the beginning.
  5. Interact with readers and embrace opposing opinions as opportunities to grow.
  6. Don’t be an annoying spambot or annoying spambots will be your only followers.
  7. Follow the Golden Rule: Link back to others as you’d want others to link back to you.
  8. Don’t flood your readers…nobody can write 5 great posts every day, not even you.
  9. Make posts easy to read, formatting can make or break your writing.
  10. Fluff is for Build-A-Bears, Moon Pies and school essays, not blogs.

 

What rules do blog authors that you appreciate and look up to consistently follow? What would you add or subtract from my list?

 

Image: Michal Marcol | FreeDigitalPhotos.net

Sh*t Med Students Say

Haven’t talked to me in a while? Here’s what you’ve been missing:

“So, he was telling me he gets a lot of sand in his eyes…but…uh…he’s always been like that…so…um…but he told me about it…so maybe it’s…I dunno…maybe it’s clinically significant.”

 

And on that note, holy wow our surgery rotation is intense. See you guys in late February…I’ll be the one with the bags under my eyes and mascara tears of fear (or sweat droplets of 85° burn ORs) permanently stained on my face.

 

Mind On Med Ultimate Guide to Studying for USMLE Step 1 and COMLEX

A couple of months ago I asked a few of my favorite online medical students to answer a few questions about their experiences preparing for Step 1 and COMLEX. They gave me some very insightful answers, so I wanted to share them with you. This post is simply to create a comprehensive answer to the question we all have as second year med students, holymaterialexcessiveness how do I even begin to prepare for this? Believe me when I tell you that these 4 students have amazing advice & guidance. I’ll answer the same questions from my point of view in another post. For today, though, let me introduce you to my guests:

            

Step 1: June 14            Step 1: June 24             Step 1: Early June         COMLEX 1: May 27

Blog: APM                   Blog: MD2B                  Blog: Lancet                 Tw: @endlessrant

Tw: @astupple             Tw: @grecoa3               Tw: @michaelbmoore

 

I’m ecstatic with my score.

 

I am very happy with my score. I originally set my goal around average – which is 220 or so. After taking a few practice tests, I realized I could aim a little higher and ended up surpassing the new goal as well. I used this score calculator online. It factors in UWorld, NBME, and practice questions to give a score estimate and I found it very helpful for setting my goals.

In general, I am very happy with my score. It wasn’t perfect, but it wasn’t ugly either and really, unless you are shooting for something super-competitive, that should be your goal. The test is a reflection of how serious you are and the effort you are willing to put into a task, but it is also a measure of your ability to answer arbitrary arcane of standardized multiple choice questions on a specific day in May, June or July. For me, it’s like running a marathon in under 4 hours – not going to get you into the Olympics. It’s my best. In retrospect, that sounds like a total rationalization, but hey…it’s my rationalization.

Yes & No. Going into the exam I had determined a score range that I would be happy with. My actual score ended up being the literal bottom of that range. When I got my score, I started laughing. One point less & I would have been in tears. So yes – I’m happy, but (as always) I would have liked to done better.

 

No formal prep classes. My school had a week of formal review in late May provided by one of the prep companies with a wonderful live lecturer. I was happy with it and the videos provided with it were good, but if you hadn’t done a lot of prior prep-work it wouldn’t have saved you.

Doctors in Training. I highly recommend it. I was reluctant to use it, because it’s essentially a guided tour through First Aid, but it really keeps you going at a fast pace for 15 days (the length of the program).

 

I used two books: Goljan Pathology and First Aid, and supplemented with the classic textbooks from each supporting discipline. Goljan Pathology is not for everyone, but it is worth taking a serious look to see if it suits you. I found it ideal because it was clinically applied pathology, written with STEP 1 in mind. I did all of USMLE World, taking time to read through the explanations. Also, I listened to the Goljan audio recordings of his STEP 1 review several times through during the year to learn pathology in general.

I predominantly used First Aid for Step 1 and UWorld question bank. I also used specific books for weak areas – Rapid Review Biochemistry, BRS physio (super high-yield) and Microbiology Made Ridiculously Simple.

Book: First Aid for USMLE Step 1 Resource: Kaplan Q-Bank (on PC/Android/iPad). A note on Qbanks, your choice of Qbank is not as important as your discipline in using them. If you are a MSII you should be deep into a Qbank – start as soon as you can and use it often. A month with the best Qbank is not going to make up for lost prep time.

First Aid for Step 1 + Saverese OMT Review = The complete COMLEX study package. Practice Questions – COMBank & COMSAE

 

I studied non-stop for five straight weeks after second year was over. Prior to that I thoroughly read through Goljan and First Aid once with friends as a study group before the end of second year classes. We started this before Christmas break, meeting roughly once a week. The group wasn’t a huge time investment and it paid off tremendously because, when full-time studying came, I knew where to look to sharpen areas that I’d become rusty on.

I ended up studying for 4 weeks and a few days. After formal lectures ended the school gave us a maximum of 6 weeks to study for the test. I tend to get distracted very easily when I’m studying, so I knew that a schedule would be important to keep me on track. I would wake up around 7 and get to the library by 8. I would study until lunchtime, when I would walk back to my apartment and grab some food and take care of other errands. I’d get back to the library around 1 and study until 5 or so, when I usually took a class at the gym. At night I’d eat dinner and do a set of practice questions out of UWorld, and get to bed around 11 or so. I used a systems-based approach to studying. Our curriculum was systems-based, so it made sense to me to review the material the same way I learned it in the first place. I didn’t even start studying for the USMLE until our last class ended in May. Instead, I focused on the coursework and doing well on my tests, since these covered each topic more in depth than Step 1. You only have a few weeks to study before the exam, which isn’t nearly enough time to re-learn everything from the start of 1st year, so learning the material well the first time through is key.

 My school did not give me time to prep – our classes ended a week before our mandatory live prep course. I tried to get 2-3 hours of prep a day regardless of my class schedule. I would use the review materials/Qbank pertinent to the organ system/specialty we were studying at that point. It’s not as hard as it sounds.

I started studying concurrently with classes in January 2011. This might seem early, but I consider myself a slow reader & my weakest subjects were biochem & micro (2 BIG subjects & sections of FA). I used the Taus Method where you annotate each section of FA using a review book. Study time varied by week & topic I needed to cover, but I aimed to put in 4 hours/week of board prep on weekdays & at least 4 on the weekends. I then studied for 2 weeks after classes ended. During that time I’m guessing I studied 10-12 hours/day.

 

The day before the test, I broke the rules and did some reading. Personally, I feel more relaxed just reading stuff. That way, I don’t have to convince myself that it’s okay not to do any preparation. I’m not a hyper-focused person who’s too neurotic to relax, it’s just that I prefer to read over material rather than not.

I still had some questions left to do in UWorld, so I finished them early in the day. I spent the day packing to go home for a few days, cleaned my apartment, hit the gym, and went to bed early.

I reviewed my ultra-high-yield/most commonly asked questions…Brachial Plexus, Dermatomes, Cranial Nerve Exams, Characteristic Drug Side Effects/Reactions. Mainly for nerves and to give me something to do.

I got a massage, ate a great lunch, watched Inglorious Basterds & reviewed FA. Everyone says “Don’t study!” I disagree. Don’t try to learn anything new, but do set a cut off time – mine was 6pm. I went to bed at 11pm.

 

Take some time preparing a lunch that will be tasty, you’ll actually want to eat, and that’s easy to store in a 1 cubic foot nonrefigerated locker. Figure your lunch out the day before and don’t forget napkins and all that. Also, pay attention to what foods make you tired an hour after eating and avoid those.

I took the exam early in the morning (it’s an 8 hour exam). I recommend taking lots of sugary snack and caffeinated drinks, because it’s a marathon of a day. The exam has a tutorial section and a lunch break built in, but you can skip both. I wouldn’t skip the tutorial, because there are a few ways that the test software differs from the practice tests. Also, the lunch break can be split up. I took breaks in between each of my exam blocks to stay fresh.

Bring snacks, one for each break and your own water. Sounds dumb, but make sure you do it. Make it tasty, but not too tasty, with a good mix of complex and simple carbs (Power Bar). If you need caffeine, re-caffeinate at lunch. A day long test is as much a physical challenge as a mental one.

Make sure to have a snack during your breaks. You won’t be hungry during your break, but you will be 15 minutes after it ends.

 

The one thing that I regret is not taking more full-length practice tests. I don’t think I ever sat for 8 hours straight during my preparation and the fatigue definitely got to me on tst day. I consider myself kind of tough, used to working 8 hour days and longer, but I was surprised at how my focus was off. If I were to do it again, I would have done two or three 8-hour practice sessions, just like the regular test day; get up at 6AM, make a quick breakfast, and then go to a room and do nothing but questions for 8 hours. It sounds awful just writing it, but considering all the work invested, this time developing test stamina might have had a big impact. Last comment: I would seriously consider not taking ANY notes or doing ANY highlighting. Just read and do questions. Your brain is amazing, and trying to force it to remember stuff with notes and highlighting just gets in the way.

Most of my classmates took about 5 weeks to study, and began Monday after our last final exam; this gave them a week or so afterward to travel and relax before third year began. Hands down, the best decision I made was taking a week off to go on a trip BEFORE I started studying. Most of my classmates thought I was crazy, but when I came back I was fresh and relaxed. My other biggest strength when it came to studying was that from the beginning I wouldn’t let myself get freaked out by what everyone else was doing – some friends would literally do nothing but eat, sleep, and study. I didn’t get bent out of shape about it, because I just can’t study that way. I made sure to take time for the gym, and my favorite TV shows. I took weekends off from studying and did fun things. I think it helped keep my mind clear and stress level down.

Great question. I waited until January before my test to make a freaked out OCD schedule for my prep. I wish I had done that sooner.

QBanks – if you are only taking the COMLEX, a 3 month subscription to COMBank is all you need. The questions are indicative of what’s on the actual test. If you think you want to take the USMLE as well, then stick with UWorld & get a 1 month subscription to COMBank. Take a practice test. There are several available on the NBME website for $50 each and they are definitely worth it. They are made of retired questions and it is exactly how the actual test will be (but only 200 questions instead of 400). My suggestion is to take one about 2 months before your exam so you have a baseline & then another 1 month before so you can see how you would do on a real exam. The downside to the COMSAE is that you don’t get an answer key. They score it for you & give you a breakdown, but not explanations so they aren’t really helpful for learning – just assessment. I took 2 & my actual COMLEX score was 60 points more than what COMSAE predicted.

Night People Smart, Morning People Happy?

I remember as a kid staying overnight at my grandparents’ house during the summers – the days always seemed to start out with the two of them getting up at (what seemed to me) a ridiculously early hour. They’d sip black coffee and chat and my grandma would fry up some bacon and scramble an egg for my cousin and I when we finally rolled out of bed well after the sun had said it’s good mornings and roosters had crowed their songs.

“The early bird gets the worm!”

they’d say…or

“Early to bed early to rise, makes a man healthy, wealthy and wise.”

As intelligent as the two of them were and as much as I wish it was a joy for me to get up at 5:00am, this study researching circadian type or “diurnal preference” has left me feeling vindicated, to a degree, regarding my tendency towards late nights and mornings. Indicating the contrary of the old adage, the article seems to say that people who stay up late and sleep in are, in fact, a bit more intelligent. Did you really need proof in the form of a scientific study to show that you that night-owls are smarter? Yah, neither did I.

However, this study does say that “morningness” has a significant positive correlation with life satisfaction and I can definitely agree that I feel better and more productive when I get up early and get my day started with the sun (and a cup of caffeine).

So, what does all that tell us? Not much other than there are lots of studies out there looking into all sorts of things you’d never have expected. Interesting, to be sure – helpful, maybe not?

So, life satisfaction and intelligence-wise, who do you think wins? Night owls or morning glories?

I’d love to stick around and see what you all have to say, but none of your answers will change the fact that it’s 10pm and my alarm is set for 4:45am tomorrow. Wonder what forced early-rising is correlated with? I’m speculating a positive correlation with amount of caffeine consumed prior to 10am.

Image 1: photostock | FreeDigitalPhotos.net

365 Days of (Mobile) Photos – Week 19

November 2 – November 8

Day 127: Queen Mae and her cheetah toy minion.
Day 128: Art Heals Expo at the First Friday Art Trail. Always a blast.
Day 129: Coffee Date. 🙂 I missed him while I was on nights this week! I was gone before he got home in the morning and he got home after I left in the evenings. No fun!
Day 130: Hoarders - Medical Student Edition. Why (and HOW?!) could this much nonsense have ended up in my white coat pockets in just over a week?!
Day 131: Severed leg AND missing eye? Someone put poor mister cheetah outta his misery...
Day 132: Someone's starting to feel much better. 🙂 Barely limping and ready to run a marathon at barely 5 wks post major knee operation.

 

Day 133: Probably the only book I bought first year and still refer back to occasionally.