Tag: step 1

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Top Blog Posts for Medical Students

I recently came back from a trip to Barbados where I gave the incoming first semester class of Ross University some advice on how to succeed in med school. Here’s a summary of my top med school blog posts broken up into various categories:

Med School Study Tips

Med School Study Resources

USMLE resources

Clinical Rotations

Should You Go To a Caribbean Med School

Discusses the discrepancy in the match rate between US-IMG’s and US MD and DO graduates

Residency Tips for Med Students

Residency Tips for Residents

Ross University Specific

Interviews with Residents in Various Specialties

Interview with Fellows in Various Specialties

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How To Study For USMLE Step 1

I’ve been getting a lot of messages on Instagram about how to study for USMLE step 1 so figured I would put all of my answers into one concise blog post. First off, take my advice with a grain of salt. Actually, you take anyone’s advice on how to succeed in medical school with a grain of salt. What worked for me might not work for you. That being said, I hit my goal of getting a +240 score on USMLE step 1 and this is how I did it.

 

 

Step studying starts day 1 of medical school

I struggled a lot my first semester of medical school because I had to learn how to learn. Everything you see from day one of medical school can show up on your USMLE’s. So my biggest advice on how to study for step 1 or step 2 CK is to learn everything right the first time around. Remember that at the end of the day you aren’t studying to pass your classes. You’re studying for your step exams.

 

 

Start using question banks early

I’ve previously written about how to study in medical school, my favorite resources in medical school and my favorite resources for USMLE Step 2 CK. A recurring theme is question banks. Again I will reiterate 2 things: (1) that question banks are meant to challenge you to apply your knowledge and find gaps in your knowledge to then go back and study and (2) UWorld is the gold standard. Save UWorld for when you are truly in your two months of intense step 1 studying. But when you are in medical school I encourage you to use other question banks like Kaplan. I used Kaplan as a second year medical student while I tutored gross anatomy to supplement my knowledge base and show me the scope and depth that I truly needed to know for the test. Incorporate question banks as early as possible.

 

 

Use your resources consistently

Just like question banks the rest of your study resources are important tools for success. The more you use them the more valuable they become. For instance, if you plan on using Picmonic you should start using it early in medical school. It loses its value if you only start using it in the months leading up to USMLE step 1. Similarly, don’t stop using whatever resources you found valuable during medical school. If you used Pathoma then keep using it. If you used FirstAid then keep using it! And if you found that you didn’t like certain resources then don’t use them!

 

 

My background

If you don’t already know, I went to Ross University School of Medicine. Back when I started at this Caribbean medical school it was strictly an accelerated program. We did the first two years of medical school in 18 months (they now have a ‘slow’ track too). This gave me 2 full months of strict step 1 studying before I started third year clinical rotations. On top of those two months, we finished our last semester of 2nd year a month early to allow us to study for a comprehensive exam that we had to pass in order to leave the island. So I was refreshing my knowledge for one month before I started my non-stop, pedal to the metal step 1 studying.

 

 

My resources

I used everything that helped me succeed in medical school. That included the following:

 

 

Overall and daily schedule

I had 2 months of strict step 1 studying time. I used Doctors in Training (DIT) which acted as the backbone of my study curriculum. DIT created an awesome two month calendar for me. Inside that timeline I put one true weekend off for a snowboarding trip. Other than that I isolated myself and didn’t really go out much.

My daily schedule consisted of the following:

  • 730am – 745am: review Picmonic
  • 745am – 8am: review notes from yesterday
  • 8am- 9am: 1 full UWorld question set
  • 9am- 12pm: reviewing UWorld
  • 12pm-1pm: lunch break
  • 1pm – 5pm: 4 hours of DIT videos
  • 5pm – 8pm: exercise, dinner, relax
  • 8pm – 10pm: relax and passively review topics

I hope this helps! If you have any more specific questions drop them below. As always don’t forget to subscribe so you don’t miss my next post!

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How To Learn More, Faster in Medical School

It’s been awhile since I used Picmonic. It was my go to medical school resource when I was a first and second-year med student and was even more valuable while I was studying for USMLE step 1 and step 2 CK.  The more I used it, the more valuable it became. It is still to this day one of my three favorite medical school resources, which is why I was so excited to team up with Picmonic to help spread the word!

 

 

What is Picmonic?

Picmonic is an online app that helps make studying easier, more efficient, and a little bit more fun. Let’s face it; medical school challenges you with a relentless barrage of information that requires absolute dedication to memorizing. And the worst part about studying in medical school is a simple fact that some stuff doesn’t make sense. You just have to memorize it. I’m talking about subjects like biochemistry, nutritional deficiencies, pharmacology, and microbiology. That’s why Picmonic is so amazing. It uses vivid pictures, stories, and wordplay to get all of that expensive medical school facts that you just have to know into your brain!

 

 

Let me just show you what I’m talking about

Each subject has a unique Picmonic ‘card’ that uses visual storytelling and pictures as mnemonics to help you remember more. They’re even better than flashcards! This is the Picmonic card for erythema nodosum, and I still remember it and use it to this day during residency. Inevitably during morning report, noon conference, patient presentations, or when I’m teaching my medical students this subject pops up. And my co-residents are just as shocked as my friends in medical school were when I rattle off the disease associated with erythema nodosum, represented by the Nodosaur with red bumps on its legs.

 

What I also love about Picmonic is that its cast of characters stays consistent throughout the Picmonic universe. For instance, take a look at the erythema nodosum card again down below. You’ll see a ‘cock (rooster) at sea’ representing coccidiomycosis circled in red.

 

 

Now check out the card for coccidioidomycosis. It’s the same rooster at sea, again circled in red.

 

 

Now take a second look at the coccidiomycosis card, but this time check out the granny-llama representing granulomatous inflammation, circled in yellow below. Now check out the same granny-llama circled in yellow on the Picmonic card for granulomatosis with polyangiitis (Wegeners).

 

 

And again, we see the same granny-llama representing granulomatous inflammation on the card for granulomatosis with polyangiitis (Wegeners).

 

 

 

Buy Picmonic Now!

Ultimately, I wholeheartedly believe that Picmonic helped me pass and succeed in medical school and helped me ace USMLE Step 1 and USMLE Step 2 CK (and even bails me out every once in awhile during residency). The more esoteric and difficult to memorize a subject is the more Picmonic flexes its muscles.

 

 

So if you’re tired of reading about Picmonic and ready to try it out, here is what you should do:

  1. Go to https://www.picmonic.com/redeem and enter KittyKatzFree for 2-weeks of free access to Picmonic!
  2. Once you’re ready to purchase: use my link to get 30% of any fixed term subscription!

 

 

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Spotlight interview: Joey from Brooklyn lands a PM&R residency

I know him as Joey from Brooklyn and had the pleasure to rotate with him before he was Dr. Seldin. Here’s what he had to say about his journey to landing a Physical Management & Rehabilitation (PM&R) residency.

 

 

Tell us a little bit about yourself. Who are you professionally? Who are you outside of the hospital? What was your path to medicine?

The best way to tell about myself is to start from where my family is from. My father is from Brooklyn and my Mother is from Queens. I grew up on Long Island and my wife is from the Bronx. And its not hard to tell when you talk to me, my accent says it all.

I went to college to the University of Buffalo and received a BS in Psychology. During this time I became very interested in Fitness and Nutrition, performed in Body Building Shows, and learned from one of the greatest Trainers in Buffalo John Schweikhard. This love for fitness and nutrition pushed me in the direction of perusing a masters degree in nutrition from Columbia University. While earning my Master’s I lived in Washington Heights and would spend my free time on the Upper West Side (UWS). One Friday in June of 2008 I was in a Bar on the UWS of Manhattan at a place called Burbon St. I was there early and she walked in, I looked at her and said “yo legs come over here” and we hit it off. At the end of the Summer, July 28, 2008 I was in a bad accident and lost my right eye. This was hard time for me. I finished my masters thesis a few months later. 90% of the people I studied with at Columbia went right into medical school all over the country.

I lost my flow, this was the first time in my life that I wasn’t in school anymore and didn’t have a job and didn’t know what to do. After a year and a half, when I had more confidence after loosing my sight and multiple surgeries, I fell back on my fitness and nutrition knowledge and decided to professionally train people. At the same time my little brother starting to box and I put a lot of effort into helping him train. I would make his meals and slept on his couch in return. Then I came to a point when I realized I needed to really go for what I wanted my whole life which was a to become a doctor. At this time I was professionally training several doctors and one of them who was a cardiologist said, ‘if you want it then go for it’. I took the MCAT and honestly very did poorly. So I took it again, and again and again. Finally I was at a party and this kid who was shadowing at one of my client’s offices was like, ‘I’m going to Ross’. I didn’t know anything about this school and said to myself it is worth a try.

Outside the hospital I am a family man, I had my son two weeks before the start of my 3rd year of medical school. It was hard to give time from my family and study but I pushed through. I had my 2nd child 6 weeks ago. She was due the day before we started residency but she arrived early. It was perfect timing because it gave me a chance to get to know her.

 

 

What specialties did you apply to? How did you come to choose them?

Before I started medical school, I came to know this field called PM&R, Physical Medicine and Rehabilitation. While I was training clients I came to build a lot of great relationships. One of them worked at North Shore LIJ hospital system and he helped me volunteer at their hospital in the PM&R division. I didn’t know it at the time but this small step may have gotten me the career I have today.

So I knew in my head before I started medical school that this may be the field for me. What most people don’t know is, I kept an open mind during my 3rd year of medical school and really enjoyed all of my rotations. The closest thing to PM&R for me was emergency medicine. I also met the best attending physician there who really inspired me and peaked my interested in that field too.

So I applied to both PM&R and EM.

 

 

So going into PM&R means you have to do a transition year. Did different programs have different requirements for that transition year?

Most programs require you to complete a preliminary year in either internal medicine, family medicine, surgery, or a transitional year (this is like 5th year medical school- you rotate in surgery, OB/GYN, medicine, the ICU, EM, and some electives). Some programs have a categorical position, meaning you do your first year in that program as a medicine resident. Medicine is the most relevant in my opinion. The thing I didn’t know was that internal medicine preliminary spots are very hard to get. See, the ophthalmology, dermatology, radiology, and anesthesia guys and gals are going for IM prelim spots as well. So they’ve got the top step scores and they are US students. Where I am just in the top of the scores applying as an international medical graduate.

 

 

What was it like applying and interviewing for both of them?

I truly enjoyed the interview process and anyone who knows me also knows I am a talker. And when it comes to interviews, I thought to myself this is probably the only time I can get away with talking about myself all day. Another thing about applying to specialty fields is you don’t get interviews until October and until late December. It was mid October and I had like 4 interviews. My buddy applying to IM had like 20 by the end of September. Then all of a sudden I was bombarded with them.

 

 

How many programs did you end up applying to? What was your reasoning for that number of programs? How many interviews did you receive for each respectively?

I applied to 129 programs but I didn’t break the bank like other people I know. It ended up costing about $1,600. I applied to 10 transitional, 39 PM&R, 55 EM, and 25 IM programs. I got 10 PM&R, 10 IM Prelim, 6 EM, 1 TY interview for a total of 27 interviews. Of these interviews, 6 of these interviews I got by bugging programs to interview me and one of them is where I matched.

 

 

How did you end of ranking your programs?

My ranking was not an easy task. I went on a lot of interviews and honestly there a few things to consider for you rank. Some people rank based on location, academics, specialty, and other things. For me the most important was location. Staying in NY and being close to both my wife’s family and my family meant a lot.

 

 

What was the most challenging aspect of applying to PM&R?

There are not a lot of programs and in many programs are only 2-4 spots per year. I think there is only like 116 spots in the whole northeast.
For EM the IMG is non-existant these days. The programs are big into US students. There was lots of spots, lots of programs but I got only a few interviews.

 

 

Any crazy stories from the interview trail?

So SUNY Downstate PM&R pre-interview social, was at a bar in the village. It was open bar with top-notch drinks. The kicker was that we had to drink a certain amount to get a discount. So the residents had us downing beers and shots. I drank 6 Chimays and Duvels and downed a glass of Jonny Walker Blue. Then I had the interview the next day…good thing it wasn’t until 12pm.

 

 

What do you think were your greatest strengths about your application?

I applied locally. There are by far the most programs in NYC and having ties to an area can boost your ranking. I also scored very well. It is a special feeling when you go on an interview and pretty much know you probably have better scores then most of the people sitting next to you. If you go to Ross you know how hard it is to make it off that island and you know how hard you can work. I know I can work harder than anyone out there. I had a child right before my 3rd year of school and still was able to go up 17 points on step 2.

 

 

In contrast, what were your greatest weaknesses about your application?

The medical school I attended I would say was the greatest weakness. But is only the limiting factor for getting interviews. 80% for sure if you get an interview, they really want you otherwise they wouldn’t interview you.

My first interview was at Stony Brook PM&R, the director said, hey you go to Ross, great school. I laughed hard in my mind. Turns out that a resident many years ago at Stony Brook was a super star. On the flip side, there are hurdles with advanced match. See you can score a PM&R place on match day but that is only years 2-4 for your residency. You still need to also match in prelim as well. Now I matched in both of course otherwise I wouldn’t be talking to you about it. But sometimes a programs ranks someone in PM&R and the person doesn’t secure a prelim spot, and can’t soap into a spot either. Pretty much just fucked.

 

 

How did you do on the USMLE’s? What were your step scores? Do you think your step scores negatively/positively affected the number of interviews your received?

Step 1 242 and Step 2 257. They definitely helped me and I looked up the average scores on the ERAS stats list. No one scored as high as I did in 2014 in PM&R on Step 2. I know if my scores weren’t as good I would not have gotten close to the number of interviews I had.

 

 

What advice would you give to other Caribbean and/or American medical graduates who want to apply to PM&R?

Take every interview you can get. Also make sure you can rotate at a place that will let you go on your interviews during your rotation. On one of my electives I went on 4 interviews in one week and they didn’t give me any shit about it, which was great.

If you have shit scores, plan for back ups. Don’t be foolish. And if your scores suck, make sure you can relate to the field you are going for and kill it on the interview. I know one guy (and if he reads this will know who he is) has bad step one scores, but improved on step 2 but still under the average and landed a great residency. The reason is he related to the field and in the end of the day you only need one place to rank you (or two places if you’re going into PM&R…one prelim and one advanced spot). Even if it was your last rank, it’s better than nothing.

Take your test seriously. In June during my last 3rd year rotation I took a practice NBME and got a 220. I took another NBME one month later and got a 225. I finished 3rd year and had 4 uninterupted weeks to study. I took my 3rd NBME and got a 235. Took another 1 week later and got a 236. I wasn’t too happy at this point. But had got a lot down in the last 2 weeks of studying. 1 week before my exam, I took the USMLE World self-assessment got a 256 and was happy. 1 week later and got a 257. Holy shit was I happy.

Don’t worry about how many hours you will work as a resident in one field or anther. Before I started I didn’t know if I could really do this. But I did know I can push myself hard. Honestly I am up at 5 am every day, get to hospital 6-6:15am and finish about 5-6pm on a regular day. Not to mention short call and weekends. But I never feel like I can’t do it. You will do it. You’re so busy that the day flies by. You know your job is awesome when I go in on a Saturday at 6:30am and look at my clock and its 5pm and I need to get these last few notes done before sign-out. You can do it too I promise. I really can say that I love my job.

 

 

Thank you Joey for giving us a candid look at your application process. Be sure to subscribe so you don’t miss my second interview with an unmatched psych applicant.

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Spotlight Interview: a family medicine resident who failed step 1

Emily Chan is a Ross University graduate who successfully matched into her top choice residency program. However, it wasn’t an easy route to residency. As a Canadian citizen she could only apply to programs that would sponsor her visa. Oh and she also failed USMLE step 1. Here’s her story.

As a close friend, I know you pretty well. Can you tell my followers a little bit about yourself? Who are you professionally? Who are you outside of the hospital?

I’m from the beautiful area of Niagara Falls, Canada. True to stereotype, I am polite, love maple syrup, and say “eh” often. I received my Bachelor’s in biomedical sciences at the University of Montréal – in French.

Professionally, I am a hard worker and a team player. I show up to the office or the hospital with a smile and do my best. People have described me as a problem solver because I will come up with quick solutions for anything.

Outside of the hospital, I indulge in my hobby of cooking and baking. Nothing makes me happier than sharing good homemade food with friends. I also attempt, with varying degrees of success, to justify my paid gym membership even though I hate working out.

You matched into your top choice family medicine program. That’s an amazing accomplishment. Why did you choose to apply to family medicine?

Thank you! It is the most amazing feeling. I knew since I was 12 years old that I wanted to be a family doc. I’ve always loved talking to people and listening to stories about themselves, their families, and their lives. I believe that every personality fits in a certain branch of medicine. How will you know? Trust me, you’ll just feel it, you’ll know. Family medicine was my perfect fit.

Where are you from originally? Did you want to match in the US or Canada? Did you experience any extra hardships trying to match in American programs as a Canadian?

As a Canadian, I knew the odds were not in my favour across the board. Many factors influenced my choice to not pursue a Canadian residency. Canada made it very difficult for me to apply (poor matching stats, inconvenient availability of mandatory tests, and difficulty to obtain Canadian electives). I felt that if my own country made it so challenging for me to come back, then I wasn’t going to put up a fight. Instead, I concentrated all my energy to match in the US. I am very glad my strategic gamble paid off. Yes, you face discrimination because as a resident you will require a visa. I was ineligible to apply to many programs because they did not want to deal with the headache of visas. Disappointing, sure, but I don’t blame them.

Speaking of hardships, I remember the day that we all received our step one scores. You and I, along with three close friends of ours, were living together in Florida. I remember the moment when you came downstairs from your room and told us what every medical student dreads to even think of. That you failed step one. What happened? Why do you think you failed? Were you doing poorly in school? Did it come as a shock to you?

Oh that dreadful day… It was awful! I was so glad to be surrounded by friends like you when I found out I failed. You all rallied around me in a big group hug and reassured me that everything was going to be ok.

Failing Step 1 was a huge blow and I did not expect it at all. Granted, I’m not the strongest student so by no means did I expect to have a stellar score. I just expected to pass. So when I learned I was a few points shy of passing, I was crushed. I had done fine in school up to that point. I never failed any tests on the island, never repeated a semester, and I even passed the comp on the first try. Everything suggested that I’d be fine.

In hindsight, I realized what I thought was enough preparation for the test ended up being insufficient. To tackle Step 1 a second time around, I had to prepare more than ever before.

What was step 2 CK like for you? What steps did you take to make sure you didn’t make the same mistakes again?

Step 2 CK was definitely better than Step 1. I will say, all the self-doubting and insecurities resurfaced when I was prepping for Step 2. I spent 6 months studying and even delayed my test till October – meaning I applied to match without a CK score. As anyone and everyone will tell you, it’s best to apply to match with a full and complete application but mine lacked the CK. It was a risk I was willing to take. I absolutely could not afford to fail a second USMLE exam. Aside from doubling the time I dedicated to study, I got weekly tutor help to go over questions on UWorld that I got wrong. I also made sure that I took plenty of practice tests.

How many programs did you end up applying to? How many categorical? How many preliminary? How many interviews did you end up going on?

I applied to every single FM program in the US for which I was qualified. All categorical, no prelim. I spent a little over $3,100 on my 140+ applications. In the end, I only had 2 interviews. Yes, you read that right, two interviews. One interview was where I did all my core rotations in 3rd year. I got the other interview because I clicked well with residents from that program while attending the AAFP National Conference. I knew from the get go that on paper I was less than stellar so I worked hard on networking. I attended family medicine residency fairs like it was going out of style. In 12 months, I attended 3 residency conferences.

What was match day like for you?

Every medical student will tell you that match day is a nerve-wracking day, and for me, it was no different. I was hoping to match but I also mentally prepared myself that there was a good chance I would not match. When I learned that I successfully matched, I cried tears of joy and relief. Knowing that I beat the odds was the most incredible feeling. It validated all the people along the way who believed in me and said I would make it. I now had proof that outside people (not just family and friends) believed I was worthy of pursuing this profession.

I know we’ve talked a lot about a major weakness in your application but what do you think were your greatest strengths about your application? What set you apart from the other applicants?

Academia has never been my forte. I knew clinical years were my time to shine. It’s what I do best; it’s where I feel most comfortable. I worked diligently and was rewarded with A’s in all my core and elective rotations, except surgery. I genuinely connected with my attendings and they wrote me beautiful letters of recommendation. My strong LORs were undoubtedly a key component to my match success. I’ve always been a people person so interviews came naturally to me. When applying to medical schools, I had 4 interviews and was accepted to all 4. I knew I had strong interview skills. I harnessed that same energy and left my 2 residency interviews feeling confident.

The fact that you failed step one, the proverbial kiss of death to any applicant’s dream of obtaining a residency, but still managed to match into your top choice family medicine program is quite an accomplishment. In closing, what advice would you give to a medical student who failed or didn’t do well on step one?

I want people reading this to say to themselves, if she can match her top choice in her dream specialty with a 203 Step 1 score, a 215 Step 2 score, and only 2 interviews, I can do it too. One failure does not define you. You will encounter people along the road who will encourage you to quit medicine (one of my Ross professors counseled me to pursue non medical careers) or take time off (I was strongly encouraged to delay my graduation date and my match by a year) or give up all together. Take all that advice as fuel to prove them wrong.

Thank you Emily for bravely sharing your inspirational story. You are proof that it is possible to fail USMLE step 1 and still earn a residency. I’m sure it was an emotionally tumultuous path and taught you a lot about yourself along the way.

—

UPDATE: Unfortunately due to the high volume of requests to speak with Dr. Chan I can no longer forward her private email. If you have questions for her please comment below. After sufficient questions have been posted we plan to release an updated blog post with the most frequently asked questions. Thank you for your understanding.

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Spotlight Interview: matching in Canada from a Caribbean medical school

Dana is a Ross University School of Medicine graduate from Toronto. She went through both the US and Canadian matches and successfully matched into her top choice Canadian program. I interviewed Dana about her experience going through the match and the difficulties she encountered along the way. Here’s what she had to say:

 

Tell us a little bit about yourself. Who are you professionally? Who are you outside of the hospital?

If I could describe myself professionally I would use the words inquisitive and dedicated. For as long as I can remember I have had a constant need to know how and why things work the way they do (growing up this was often to the annoyance of my parents). I’ve always strived to excel in any position I hold so I believe my dedicated nature has really found its niche in medicine. Outside of the hospital, I would describe myself and adventurous and thoughtful. I love to travel, try new things and for the most part view the world as limitless. I also don’t make hasty decisions and I place significant value on the relationships in my life.

 

How many programs did you apply to? How many categorical? Prelim? How many in the United States? How many in Canada?

Originally I applied to approximately 100 IM categorical US programs. I did not apply to any back up programs or prelim spots, against my medical school’s advice. I spoke with other colleagues and was aware that they applied to 150-200 programs on average, but my plan was to stay in large cities or close to the Canadian border. After only receiving 4 interviews in the first 3 weeks I applied to the remaining 150 IM categorical programs available in the US (this was a humbling and expensive lesson). The Canadian match was a few months later and after my experience in the US I applied to every Canadian IM program, I believe there’s 7, as well as a dozen Family Medicine programs.

 

What as the most difficult part of applying to both the Canadian and the American match?

I think the most difficult part was that each system uses a completely different application. This meant that I couldn’t just use the same documents twice. I had to rewrite statements of interest and reformat resumes, which is an enormous task. The letters of recommendation could be the same but I had to bother my preceptors twice to use two different uploading systems.

 

Roughly, how does the Canadian match work? Can you end up with both a Canadian and an American residency?

Luckily CaRMs (Canadian Residency Matching Service) match date is about two weeks before the US match date. This is great since your chances of getting into a Canadian program are much poorer than a US program so ideally you would want to try this route first and use the US match as a backup if it doesn’t work out. If you match into CaRMs you are automatically withdrawn from the US match. You are also never able to find out how you were ranked in the US match.

 

How did you end up ranking your programs? Would you have rather gone to your least favorite Canadian program over your top American program?

It was a difficult choice deciding how to rank my programs since being close to home, Toronto, was important to me but also the quality of the program. In the end I ended up ranking my first choice US program as the one that I believed was the best place to be academically, which happened to be the second closest geographically to my home in Canada. When I submitted my rank list for CaRMs I reluctantly ranked a program that was across the country, but did so based solely on the fact it was in Canada. If I would have matched at this program I would have been automatically withdrawn from the US match, as I mentioned earlier, so I knew that would mean giving up my first choice US program. This was definitely the most difficult decision I had to make in all of my ranking.

 

How many interviews did you go on in the end? How many in the US? In Canada?

In the end I was invited to 7 interviews in the US and 2 interviews in Canada. Some of these interviews were in very undesirable locations for me, but I felt it was good practice to keep all my options open since I was not invited to a lot of interviews. In the end I ranked them all.

 

Any crazy stories from the interview trail?

At the end of one of my interviews I realized my middle button of my blouse was undone. No idea how long that was like that for.

 

What did you find to be the most frustrating part of the interview process?

The days were way more exhausting than I expected them to be. The travelling combined with the anxiety about the day really gets to you after a while. A couple of my interviews started at 7am for morning rounds and didn’t end until 3 or 4pm. These days were long enough without having to also roll out my charm for 8 hours straight.

 

Do you feel that coming from a Caribbean medical school hindered your chances to match back home in Canada?

Yes, but I don’t think my chances would have been any better coming from a US or European school. The Canadian match first and foremost ensures all of its Canadian graduates have a residency. There are designated spots for international medical graduates (IMG’s) in the CaRMs match, but they are very few for very many.

 

What do you think were your greatest strengths about your application? What set you apart from the other applicants?

I believe my work experience prior to Ross University was a strong point of my application; most programs asked about this during the interview process. I also made it a priority in my personal statement to express the hardships that came along with studying in a third world country and in constantly relocating during clinical years. In the end I believe that the impression I left on the staff during an elective rotation is what set me apart from the other applicants.

 

In contrast, what were your greatest weaknesses about your application?

A big weakness in my application was my USMLE Step 1 score. I was having personal troubles and knew going into the exam I was not as prepared as I should be. In hind sight I also wish I spent more time on my personal statement. I left it until the last minute and did not allow time to have people proof read it and critique it.

 

How did you do on the USMLE’s? What were your step scores? Do you think your step scores negatively/positively affected the number of interviews your received?

My USMLE Step 1 score was a full standard deviation below average, which I am disappointed with and believe negatively affected my interview invitations. I worked hard to redeem myself on USMLE Step 2 CK and scored 30 points higher, which I am very pleased with. On the Canadian version of the USMLE, the Medical Council of Canada Evaluation Examination (the MCCEE) I received two standard deviations above the average, which is the score I’m most proud of.

 

What advice would you give to other international medical graduates who want to pursue residency in Canada ?

I would tell other Canadians that if they want a residency in Canada to just try! I heard countless times along the way that it’s impossible as an IMG to get a residency in Canada. For this reason I was preparing the whole time to get rejected, but I worked really hard and was one of the lucky ones. If things would have gone the other way I was very excited for my US residency programs and looking forward to spending more time with our lovely neighbors to the south. Either way I would recommend that you keep all your options open; being an IMG does not mean you cannot have the residency you want.

 

Thank you Dana for sharing your experience with the Canadian and US match process. Going through the Electronic Residency Application Service (ERAS) was frustrating enough for me at times so I can only imagine what it was like to do it twice. I wish you the best during your internal medicine residency and hope to hear more from you soon.

Next in the spotlight series is an interview with a family medicine resident who failed step 1. Subscribe so you don’t miss out!

 

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Spotlight Interview: a pediatric resident who also applied to OB/GYN

I sat down with Zack Manier, a Ross University School of Medicine graduate from St. Louis, who will be starting the first of his three year pediatrics residency at The Children’s Hospital at St. Peter’s University Hospital in New Brunswick, NJ. He is the first interview in a series of blog posts that will shine a light on the match process.

 

Tell us a little bit about yourself. Who are you professionally? Who are you outside of the hospital?

Let’s see…I grew up in a typical Midwest suburb outside of St. Louis, MO. I was one of those 4.5 GPA kids who could study the morning of with little effort and get an A and was in every AP class you could think of. I was a big band and orchestra nerd (hey, it was the cool thing at my school! We had football players in marching band, okay?) but a beach bum at heart. I love the sun and the sand, and can’t get enough of the ocean. I got out of the Midwest and moved to the Sunshine State for undergraduate, completing my BS in psychology at the University of Central Florida in Orlando.

Professionally, I feel like I’m empathic and relatable with my patients, and definitely a good listener. I consider myself more common-sense and witty knowledgeable than book smart, and am most definitely not a gunner. I am not afraid to speak out when I know something and will not back down if I know I am correct, but I am a team player and refuse to make others look bad for personal gain, as so many do (you will come to unfortunately find out).

 

How did you end up at Ross University?

That last-minute study mentality caught up to me in my science classes in college, causing me to not be accepted to medical school the first time I applied (study hard, kids!). I had not considered nor heard about Caribbean schools and was looking into go down unda’ to Australia for school, when I discovered the “big three” Caribbean schools. Because they accepted year-round applications, and I did not want to delay starting medical school another year, I decided to apply. I applied in April, interviewed in May, and was accepted to all three in June for the August class. I went with my gut and chose Ross University, and I couldn’t be happier with my decision. My eternal wanderlust and love of the tropics had me going to the right place.

 

What residency specialties did you apply to? How did you come to choose them?

Pediatrics and OB/GYN and I ended up matching into pediatrics. It was always pediatrics from the start, and my core rotation confirmed that. I was actually dreading OB/GYN (as most medical students do). It was my last core rotation; my attending told me, “You’re not going to be a pediatrician. I’m going to make you an OB/GYN by the end of this.” I highly doubted her, but she was right. She was amazing, and working side-by-side with her opened my eyes to the world of OB/GYN. I think it completely depends on your core experience…I had a friend who had a HORRIBLE OB/GYN core, so she hated it. I probably would have never come to love OB/GYN if I was in her situation. I can fully say that Dr. McDonald at AMC single-handedly kindled my love for OB/GYN.

So I ended up applying to both because I had a genuine interest in both. I would have been happy with either. Neither was a backup.

 

How many programs did you end up applying to? What was your reasoning for that number of programs?

I applied to 75 pediatrics programs and 50 OB/GYN programs, so 125 total. Some may say that’s a small number, especially within the individual specialties…they’re probably right. I felt I was less competitive for OB/GYN, hence the lower number of programs. Basically, I went to every program’s site and added it to my list as long as I met their requirements listed. I then removed any programs I knew I definitely did NOT want to go to, whether based on location or other things I found on their sites. That landed me at roughly 125. I’m also super anal/obsessive-compulsive, so applying to 126 or 124 would have driven me nuts (aka not a rounded number). I know, maybe that’s not the time to act that way, but I can’t help it. So I may have tacked on or removed one here or there. In the end, I was comfortable with that amount of programs and amount of money I was spending. I never once felt I over- or under-applied.

 

How many interviews did you receive in each field?

I received six pediatrics interviews and four OB/GYN interviews. Whoa! That’s not very many! No, it’s not (see below). But hey, they say if you have 10 interviews, you’ll basically match. Checkmark. Plus, I know people who matched with way less than me and people who didn’t match with more than me. Don’t let it get you down.

Of note—I only ended up going to 9/10 interviews. The more I looked into one of them, the more I felt it wasn’t for me. Yeah, canceling an interview when I had so few may be crazy, but hey…why spend extra money and time on a program you have no interest in? How do you know you don’t like a program? I can’t tell you that…you just do. It’s just a feeling you get. I was confident enough with how my interviews had been going that I didn’t think I needed that one.

 

How did you end up ranking the programs? (looking at the perspective of why you ranked a pediatric program higher or lower than an OB/GYN program)

I sincerely ranked my programs based on the programs themselves (and partly based on location). I was not going in ranking one specialty higher or lower. As soon as I returned from an interview, I inserted it into a list appropriately based on comparison with previous interviews. You just get a “feeling” when you’re there.

One program was already lacking in pre-interview communication, so I already had a bad taste, and ten minutes into the interview, I knew it was not for me. It was so bad that I considered not ranking it at all. I ended up ranking it just because I really felt I would not end up there (and I didn’t), but I ranked it very last, and even that was a struggle.

My top choice happened to be OB/GYN (so I obviously didn’t match my top choice), but that was solely because it was a new program that I felt was amazing, and it was in the south (no snow, hell yeah!). It was Atlanta, to be exact, where I had done my cores and a city I fell in love with.

One program was pretty amazing, but the location was so rural that I didn’t think I would even enjoy any free time I did get. It just didn’t meet my lifestyle needs. Even the residents said that they flew somewhere every chance they got, even if it was just a weekend. I ranked it lower on my list because of that.

If you must know, they ended up ob—ob—peds—peds—peds—ob—peds—peds—ob. Completely mixed, like I said. That’s based on things like program directors, attendings, residents, schedules, various opportunities, and the overall feeling I had at each program.

At the end of the day, I said I would be happy if I matched within my top five, which I did. I am excited about the future, and feel like I ended up exactly where I was meant to be. (But we can follow up on this in a year lol)

 

What was the most challenging aspect of applying to two different fields?

Definitely writing two personal statements! This is so critical…you can’t really even tweak one to fit the other specialty. Okay, maybe you could for internal medicine and family medicine, but definitely not my two specialties. It was a lot of extra time.

Keeping track of what type of program I was at was also key. There are two ways you can go about it…the honest, “I’m applying to [insert specialty] also,” or the not-so-honest “I love [insert specialty] and am only applying to it.” I went with the latter. I was confident enough that my interviews were not going to overlap or affect each other, so why put any doubts in a program’s mind? As far as I’m concerned, treat each program you interview at like it’s your top choice and you are so excited to be there, and give everyone you meet that same impression.

Originally, there was also the concern of “What if I get interviews for both specialties at the same hospital?” I decided I would deal with that if/when the time came, but, fortunately for me, that never happened. I can’t give any advice on what to do there except to go with your gut and be prepared to deal with the consequences, whether good or bad…you don’t want to get caught in a lie.

 

Any crazy stories from the interview trail?

So, one OB/GYN program (that awesome but rural one), we were each supposed to have three 30 minute interviews. Someone cancelled last minute, so a few of us got an extra interview. Lucky me, I ended up with four 30 minute interviews. TWO HOURS OF INTERVIEWS?! I thought that was crazy. To top it all off, one of them had me suture during the interview, and another had me do laparoscopy WHILE asking me interview questions. Good thing I can multi-task! Side note, we were also given an article about REI ahead of time and told to read/be prepared to discuss it…only the program director was asking about it, and I didn’t have an interview with him. So I basically read it just for fun.

I was also told in advance that one pediatrics program I was interviewing at basically just pimped the entire time and that several people came out crying. Although I did hear that some people were asked medical questions depending on the interviewer while I was there, I was not. So, do not believe everything you hear or get worked up/nervous in advance over something. Just be confident with yourself. I did have two interviewers there though…one lasted 45 minutes, and she just grilled me on if I think Caribbean schools are akin to US schools, and whether or not our USMLE step scores reflect that. Okay? Whatever. My second interview was the assistant program director and basically told me my file looked good and she would be happy to have me, and I was done in five minutes, no questions asked.

The program I said I almost didn’t rank? Basically, everything was bad. Too much to type. But let’s just say that it was an OB/GYN program, and the resident who was giving us the tour had wanted pediatrics, but ended up in OB/GYN (don’t ask me how that happened). On our tour, we passed the pediatrics group, and he said, “Hey peds, have fun! It’s a great program…unlike the OB/GYN program.” Um…ok. That sealed the deal. If your own residents are bad-mouthing your program to prospective residents…not a good sign.

Finally, you will run into “talkers”—people who talk themselves up way more than they should just to feel good about themselves and make you feel worse. Ignore them. You can tell who they are. I had heard about one girl who I had not yet had the pleasure of meeting yet on the trail, until I finally ended up at an interview with her. I knew right away it was her. She poopooed on anyone who went to a foreign school and acted like she came from the Ivy League, even though she was simply at an average run of the mill Midwest med school. She was also reapplying, as she didn’t match her first time applying to OB/GYN. She was gloating about how she now had over 60 interviews but couldn’t find the time. “I had a program call me last week and say they really want me but just don’t have an interview slot.” Bullshit. That’s how you know. You don’t go from not matching to 60+ interviews in your year off. You’re not Mother Teresa. Ignore those people, please.

 

What were your greatest weaknesses about your application?

My biggest weaknesses, I felt, were my step scores, without a doubt. I was actually surprised at how many interviewers told me my scores were just fine, but who knows if they were just saying that. I didn’t really get grilled about them at all. I found most people want to get to know you for you…they’re already past what is on paper. So focus on that in your interviews. I did feel, however, that my scores limited me in the application phase, as I didn’t meet score requirements for some programs here and there. That’s when scores really matter…they will get you more interviews.

 

In contrast, what do you think were your greatest strengths about your application?

My biggest strengths? Everything else. I had all A’s in my cores and electives (which led to a strong MSPE), and I had STRONG letters of recommendation. Almost every (if not all) program complimented me on my letters. Those rec letters are so important…scores/grades are just numbers on a page, but letters tell the program who you are and how you work. I also feel that I’m a strong writer, and I was pretty pleased with my personal statements. I was only asked about them occasionally. Finally, thankfully I had a pass on CS and I improved from Step 1 to Step 2, which are both critical, especially with weaker scores.

 

You’ve already given a lot of great advice but many of my readers will still ask, how did you do on the USMLE’s? What were your step scores? Do you think your step scores negatively/positively affected the number of interviews your received?

I kind of touched on this above, but as for the scores: 217 on Step 1, 222 on Step 2, and first-time pass on CS. Why? I don’t think I put as much effort into studying for them as I should have. Based on my school’s exams/shelf exams/GPA, most would’ve thought I would’ve done much better. I expected higher scores and was disappointed with them, but there’s nothing you can do at that point except make sure the rest of your application is strong, which I did. I do think it affected the number of interviews I received…I obviously would have received more with higher scores. Many programs filter initially solely on Step 1 scores…even though you may meet their online requirements, they eventually have to filter out people once they receive so many applications. My saving grace was CS and the score improvement between steps, no matter how small the jump. Just don’t go down!

 

Lastly, what advice would you give to other Caribbean and/or American medical graduates who want to pursue a career in pediatrics?

Obviously you want to do well in your pediatrics core, but don’t slack in the others! An A in pediatrics and a B in everything would be the same as a B in pediatrics and an A in everything else. You need to be well rounded. Pediatrics is basically all the adult specialties combined into one, just for little people.

Strive for an A in your pediatrics rotation, and go above and beyond to make sure you can get a STRONG letter from your attending. However, if you end up having a bad pediatrics core, do not let that deter you from pediatrics or make you feel like you have to choose another specialty. Just make up for it in pediatrics electives.

Speaking of electives, take pediatrics electives and take them early. Get letters from each attending, even if you think you have enough…you can never have too many! Your application is due in September, so only electives up until then will appear on your application. I made sure to take my pediatrics and OB/GYN electives prior to that. After I submitted my application, I just took easy/blah electives so I could focus on interview season…they don’t really matter THAT much, after all (especially when you just can’t wait to be done with school).

Think long and hard about why you want to go into pediatrics. Convey that in your personal statement. Don’t lie. The most common interview question is “Why [insert specialty]?” You need to be able to convey to the interviewers that pediatrics is where you belong and what you’re meant to do. Don’t half-ass anything.

Join the American Academy of Pediatrics, and try to go to a conference. I didn’t make it to one because of my schedule, but even membership shows interest and dedication, and you’ll be ahead of the game.

Finally, try to get some inpatient experience. Many foreign schools don’t have a lot of inpatient pediatrics opportunities, so if not in your core, try to find an inpatient elective…a non-affiliate if necessary. I’m going in with only one week of inpatient experience, and that was in the NICU. I was questioned about it twice (I think) throughout my interviews, but I had a good answer/explanation prepared, and my interviewers seemed to like my response. I’ve been reading and studying a lot, but I can only imagine inpatient experience will only help better prepare you for residency.

 

Wow, thank you Zack for sharing your story about your route to a pediatrics residency. I look forward to hearing about your intern year in the months to come.

Next in the Spotlight Series will be an interview with an unmatched surgical applicant. Scroll down and subscribe below so you don’t miss out!

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How to Prepare for the Comp

Here is how I approached the comp and used it to help prepare me to succeed on step 1 of the USMLE.

 

It’s just a practice test

At the end of the day the comp exam is a practice step 1 exam and nothing more. I took five practice exams when I studied for step 1 and step 2 respectively. These were NBME practice tests and were just like the comp because the comp is a practice exam that is meant to show you were you stand. Sure, it will suck if you have to retake the comp but your end goal is to crush step 1! So don’t worry about passing or failing the comp. In the long run it doesn’t matter if you pass or fail. If you fail, it means that you aren’t ready to take step 1. And hey, I passed the comp on my first try but I certainly wouldn’t say I was ready for step 1. I still required two more months of studying in order to get my scores up.

 

Pass the comp but focus on step 1

Back in my day we had 4 weeks to study for the comp after our fourth semester final. I understand that times have changed but my study strategy should still ring true. My strategy was simple: I wanted to pass the comp so I didn’t have to worry about it after I left the island. However, at the end of the day the comp doesn’t really matter. All that matters is crushing step 1. No residency program will know if you passed or failed your comp exam but they will certainly know what you got on step one.

 

Don’t try and study everything

It doesn’t pay off to try and study everything before you take the comp because there simply isn’t enough time. During my third and fourth semester I was using the Kaplan step one question bank to study for the NBME final exams so I chose to use a Kaplan diagnostic test to see where I stood. Turns out I sucked at everything but there were certain subjects I was particularly bad at. As I suspected, my best subjects were ones that I had just studied for my fourth semester final. Strategically, I chose not to study these subjects and hoped that I would remember them when I took the comp. Instead, I focused on a few organ systems that I was particularly bad at, specifically pulmonology, nephrology, and gastroenterology. I also chose to focus on cardiology because it is the single organ system that takes up the largest composition of questions on step one.

 

Start studying for step one when you start studying for the comp

When I left the island I had already studied four organ systems (the three I sucked at plus cardio). It wasn’t sufficient enough to allow me to skip them during my two months of preparation for step one but it gave me one hell of a head start. Again, it doesn’t matter if you pass the comp or not. Sure it will suck if you have to take it again but you have to keep the long-term goal in mind of not just passing step one but crushing it. Passing step one might get you a residency but killing step one will get you an amazing residency.

 

And do practice questions. Lots of practice questions.

The more practice questions you do the higher you will score. There is simply not way around it. By the time I took step 1 I had completed half of the Kaplan qbank once, all of UWorld, and all of the questions I answered incorrectly in UWorld once which comes to a grand total of 3,000 questions or so. Some people did all of Kaplan, UWorld, and one or two other qbanks but I personally felt like that’s overkill but everyone is different. UWorld should be the minimum though.

Practice questions will not replace your studying but instead should supplement and guide you in which topics you need to study. Practice questions show you your weaknesses and give you topics to go back and study. I suggest one full question set which should take you one hour followed by three hours to review those questions. Then study for four hours in the afternoon after an hour break. Then eat, sleep, repeat!

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What is ‘The Match’?

Are you in medical school? Sick and tired of explaining the process of step exams, clinical rotations, the interview process, and the dreaded match algorithm to your friends and family? Send them this post before you go home for the holidays and hopefully everyone will have a better idea as to when they can start calling you doctor if they haven’t done so already.

First let me recap the med school timeline for you so we’re all on the same page. The first two years of medical school are the basic sciences. It’s the classic classroom experience where we learn all of the science behind the medicine. This takes roughly two years and culminates with step 1 of the US Medical Licensing Exam (USMLE). Or the COMLEX (Comprehensive Osteopathic Medical Licensing Examination of the United States) level 1 if you are in an osteopathic school.

Now if you have a friend, family member, cousin, or are simply Facebook friends with a med student then you have likely heard of these exams. Or at least heard us complaining about studying for them. So what can possibly make these tests so important that we take months off to study for them? Although stellar board scores alone won’t secure you an interview they can certainly ‘pose a problem when they are significantly below the mean. Board scores have become ‘a threshold that must be achieved in order to receive an invitation for an interview’ (3). It’s a way to weed out thousands of applicants to a smaller pool of hundreds of interviewees to a handful of residents depending on the program and specialty.

Each specialty can be loosely broken down into highly competitive, moderately competitive, and less competitive specialties based on information obtained from previous residents who matched into each one respectively. Highly competitive specialties including dermatology, neuro surgery, orthopedic surgery, plastic surgery, radiology/oncology, radiology, urology, opthalmology, and otolaryngology. Moderately competitive specialties include emergency medicine, OB/GYN, and general surgery. Less competitive specialties include family medicine, internal medicine, neurology, pathology, and psychiatry (3). One of the important pieces of data used to signify each fields competitiveness is the average board score of matched applicants into those respective fields. More competitive fields can use a higher cutoff. So again, a high board score doesn’t guarantee you anything but a low board score can filter you out of the process.

—

For instance, The following graph is taken from the 2014 National Resident Match Program (NRMP) data that is available online here.

step 1

This chart “displays the step 1 scores for matched US seniors and independent applicants by specialty. The horizontal bars are median values for successful applicants and the vertical lines show the interquartile ranges (the top and bottom scores of applicants). Scores are generally higher for more competitive specialties, but there is still substantial overlap when specialties are compared” (1). The same thing goes for step 2 scores. You have to do well and, on average, everyone does better on step 2 than step 1. In 2014, the average step 1 score for matched applicants was 230 and the average step 2 score was 243 (1). Here’s the step 2 chart:

step 2 scores

And if you were wondering to yourself, ‘what the hell is an independent applicant’ the answer is anyone who isn’t graduating from a US allopathic medical school. That includes students from Caribbean schools and also American D.O. programs (1)

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Okay, so you finished your first two years of medical school, wrote your step 1 exam, finished your third year of medical school, and wrote your step 2 exam. Now what? At this point you start applying for residencies. A survey performed by the American Medical Association (AMA) of 1,000 fourth year medical students from US allopathic programs from the showed that students applied to an average of 36.4 programs.

apply

This is where the dichotomy between ‘US senior applicants’ and ‘independent applicants’ is really staggering. Caribbean medical students are known to apply to upwards of 100 programs. Personally, I applied to 144 programs for internal medicine. So what’s so important about interviews these interviews? To answer that question we go back to the NRMP match data which shows that the greater the number of interviews you have the greater chance you have to match (and not be unemployed come July 1st).

contiguous rank list

This chart for internal medicine shows an applicants probability of matching based on the number of contiguous ranks. Contiguous ranks means that when it comes time for an applicant to rank programs, that the programs on an applicants match list is in the same specialty. Meaning that programs that you rank one through five are all in internal medicine. Not internal medicine and pediatrics. And in order to get that contiguous rank list you need interviews.

10 interviews seems to be the magic number that most students strive to surpass. What’s the probability of matching if an ‘independent applicant’ like myself gets 12.3 interviews? It’s still above 90% and I’d take those odds any day in Vegas. So 10 interviews seems to be the magic number that most students strive for. That still means that there are students out there who have 10 interviews and don’t match but your likelihood increases with the more interviews that you get.

So how does ‘the match’ work? It’s a complicated computer algorithm similar to what sororities use during rush (you know, minus the computer algorithm). Applicants make a list of the programs they want to go to, each program makes a list of which applicants they want, the information goes into a computer algorithm, and the algorithm spits out the match. Watch this 2-minute video to really understand it:

 

 

So in summary, get good board scores so you aren’t filtered out, score at least 10 interviews, don’t be a weirdo on the interview, and hope that you match. On Monday, March 14th applicants find out IF they matched. This gives unmatched applicants a week to participate in the SOAP (supplemental offer and acceptance program) and attempt to fill unmatched residency spots. Then on Friday, March 18th applicants across the country find out WHERE they matched. Then come July 1st, new interns start nationwide. Happy holidays!July 1st

 

 

1- Charting Outcomes In The Match. Characteristics Of Applicants Who Matched To Their Preferred Specialty In The 2014 Main Residency Match. 5th ed. Washington, DC: NRMP, 2014. Web. 23 Dec. 2015.

2- LWW,. “Going “Fourth” From Medical School: Fourth-Year Medical Stu… : Academic Medicine”. N.p., 2015. Web. 23 Dec. 2015.

3- Katta, Rajani, Samir P Desai, and Samir P Desai. The Successful Match. Houston, Tex.: MD2B, 2009. Print.

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Test Taking Strategies: how to maximize your score

Your USMLE step 1 and step 2 scores are the most important pieces of information in your residency application. However, acing your board exams isn’t just about knowing the science but also about having strong test taking skills. At the end of the day, your score is a combination of how smart you are multiplied by how hard you work divided by your test taking skills. Here are my test taking strategies to maximize your score on test day.

 

Find your weaknesses

It’s hard to improve your test taking skills if you don’t know where to start. So do a question set of UWorld or two and while you are reviewing your answers figure out why you got the question wrong in the first place. In my mind, there are two broad categories of why you get questions wrong. The first is that you straight up didn’t know the answer because you didn’t know the science or medicine behind the question at hand. The second category of incorrect answers is due to poor test taking skills.  So if you get a question wrong because you didn’t remember the auto-antibody that correlates with autoimmune hepatitis then don’t stress out about it. Just go study that subject material. However, did you fluster over this answer choice for five minutes? Did you eat up all of your time trying to remember the answer? That’s a test taking strategy and is something you have to work on.

So first, (1) figure out if you got the answer wrong because of a lack of knowledge versus poor test taking skills. Next, (2) continue to jot down the reasons why you got these questions wrong. Eventually, you might (3) find patterns in why you get questions wrong.

 

Recognize patterns concerning why you are getting questions wrong

So at this point you should have completed a few question sets and collected some data concerning why you are getting questions wrong. Maybe you are a great test taker and you just need to study the science a little more. If that’s you then stop reading this blog post and go study! If you’re like me, you might need to make a plan moving forward concerning how to improve your test taking skills. Some reasons why I got questions wrong in the past were because:

  1. I wasted time on ‘easy’ questions and had to rush through questions near the end
  2. I changed my answer choices
  3. I would be thinking about question number 1 while I was reading question number 2
  4. Test taking anxiety
  5. Stupid mistakes

Next, I will go into how I overcame these test taking weaknesses of mine and hopefully you can mimic what I did and overcome your deficiencies.

 

Overcome minor anxiety by simulating test day

A soccer coach I once knew used to hate when we took practice shots from a stand still. He felt that during a game you rarely had the opportunity to take a shot when the ball wasn’t already moving. It didn’t simulate the game realistically. Likewise, you need to prepare for the exam by answering practice questions against the clock. It will simulate the anxiety of test day and, hopefully, make you more comfortable when answering questions in the hot seat. This helped me get over my minor test taking anxiety. Those butterflies in my stomach.

Power poses are also a great subconscious confidence booster. Long story short, if you have positive, confident posture it will translate into a slight increase in real life confidence. That goes for test day too. Check out this TED talk that goes into more depth on the topic.

As an aside, this post is mainly for test taking strategies. Minor tweaks that can improve your score. Which means that if you have severe anxiety to the point where it is truly inhibiting your ability to take tests then please seek professional help. There is no shame in speaking to a psychiatrist about your test taking anxiety and they are much better equipped to help you flourish come test day. Same thing goes for people whose attention span could use a little artificial endurance.

 

Don’t overthink it and stop changing your answer choices

I recently tried this new ice-cream place in Brooklyn called Ample Hills Creamery (if you live in the area you NEED to go there). Looking at the menu I instantly saw the words ‘Salted Crack Caramel’ and knew what I wanted to try. Except then I saw other delicious looking options like ‘The Munchies’ and ‘Mexican Hot Chocolate’ and I started second-guessing myself even though I knew what I wanted to get. Likewise, when it comes to test day don’t overthink your answer choice. If you think you know the answer then click the bubble and move on to the next one. JUST CLICK THE BUBBLE AND MOVE ONE! Your first inclination is often your best guess…especially if you aren’t sure why you think it’s the correct answer choice (sometimes your gut is smarter than you and not just with regards to ice-cream).

UWorld also has a great tool to see where you are making your mistakes. I found that I had a greater number of answers that I changed from correct to incorrect that the other way round. By making a ‘click and move on’ rule I increased the number of questions I got right. It might only get you one or two questions right in each question set but they add up quickly. Especially when step 1 and step 2 are 7 and 8 question sets long respectively.

The only exception to this rule is if I went back to my question and found that I completely missed something. Oh, the patient had a myocardial infarction because he did cocaine! I’m gonna change my answer from beta-blocker to calcium channel blocker. Boom. Science bitch!

 

Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth

There were a lot of easy questions on step 2. Things that everyone gets right like ‘give IV fluids’ or ‘compare to old chest x-ray’. Then there are the cluster of questions that make me wonder if I forgot everything or if I just straight up never learned it. For example, on step 1 I remember a question on neurofibromatosis type I but I forgot that it is also often called von Recklinghausen Disease. At the time, I wasn’t sure if von Recklinghausen Disease was the same thing as neurofibromatosis type I or not. Instead of ruling IN the correct answer I simply ruled OUT the incorrect ones. With this approach I was left with only one possible answer choice and ended up picking the right one.

Ultimately, this isn’t anything new or groundbreaking that you haven’t heard before but its worth hearing again. When it comes to these standardized tests every question is worth an equal number of points. I hope that these test taking tips will help you get a few more questions right and help bump up your score because every little bit counts. Happy studying!