From The Final To The Finale

Let’s take a look at your schedule for the next month. You just took your last mini at Ross and all that separates you from freedom is your CCSB exam, your fourth semester final, and the comp. Then you can finally go home and study for the step! Sounds amazing- I know. Just think of how awesome it’s going to feel when you answer that last multiple-choice question of step one. You’ll be free!

Now before you begin fantasizing about what you’re going to do after you take the step (you’ll have so much more time for activities!) let’s talk about your study timeline starting from the day you take your fourth semester final leading up to your step. I tried to whittle down my thoughts into a few succinct points with the help of a few guest perspectives.

 

Recharge Your Batteries After Your Final

Some of my classmates were in C4 studying for the comp the day after our fourth semester final- I was not one of them. And if you are the type of person who will be in class the day after your final then this post may not be for you.

For everyone else, go do whatever it is that you want to do- treat yourself! Climb Mt. Diablotin, hike to Sulfur Springs, close out Tulips, lay on the beach, or stay inside with the air-conditioner on blast and marathon watch Grey’s Anatomy (I’m only on season eight- ruin it for me and we’ll have problems!). You are going to be studying almost non-stop for the comp and then keep it up when you go home to study for the step. So relaxing, centering yourself, and making sure you are ready for the long haul is priority number one.

 

Start With A Diagnostic Test

After you take into account the random days off that you are likely going to take, you only have about three solid weeks of studying before the comp. Now assuming you somewhat remember the stuff you just took a final on, you might not need to review absolutely everything before the comp. And quite frankly, you won’t have enough time to review everything. That’s why you need to triage the subjects and organ systems and make a study strategy for the comp. And you can’t make a study strategy without knowing what you actually need to focus on. So before you begin studying, get situated in your favorite cube (shout out to E-07!) and take a diagnostic test.

Use it to see where you strengths and weaknesses are. My best piece of advice is to guess which organ systems and subject areas you think you are strongest/weakest in and see how your guesses match up with your results. You might be surprised…or completely spot on!

Now I don’t think you can study everything effectively before the comp. Personally, I did very little for the organ systems that were on the fourth semester final. I focused on third semester organ systems as well as the basics from the first two semesters. I didn’t even touch the respiratory system. But you have to look at the comp as a stepping-stone and not the end goal- step one is the end goal. You can always go back to stuff you skipped after you pass the comp.

 

Put In The Work And Pass The Comp

I firmly believe that the comp is beatable if you put in the work. Most of my friends who failed the comp admit that they simply didn’t study very hard for it. And failing the comp isn’t a big deal. You simply have to take it again and pass before you take the step but it definitely messes with your timeline and possibly your confidence.

I interviewed a close friend of mine who failed the comp. After passing fourth semester he met someone on the island and started ‘reviewing a lot of anatomy’. His only goal for approaching the comp was to attempt to attend Becker everyday and nothing else. And even that simple goal didn’t always get reached.

On two occasions, he even skipped Sunday lectures to attend brunch at Champs knowing that he wouldn’t be seeing those two days of material. He didn’t touch DIT, Kaplan videos, and only did seven UWorld questions. And he only missed passing the comp by four percent- roughly eight questions.

The comp is beatable but you need to put in the work. If you study for it like it’s the step then you should have no problem passing. As the old idiom goes, if you fail to prepare then you prepare to fail.

 

Don’t Stop

An object in motion stays in motion. The same is true with regards to studying. The hardest part about studying is often getting started and getting into a regular routine. When you go home after you take the comp you are likely going to take some time off again before you get back into studying. You’ll be home- enjoy it. Hang out with your family & friends, go get drunk in the city, join a gym- whatever floats your boat. Just don’t take too much time off because once you taste the sweet flavor of freedom you won’t want to go back to that dreary library.

To hammer this point home, imagine taking your first semester anatomy practical exam all over again as a fourth semester. I know I just made some of you cringe at the idea but be honest with yourself- how do you think you would do? I’m sure that as a first semester who was seeing non-stop anatomy everyday that you would have done great! However, as a fourth semester you might not remember the exact presentation of an ulnar nerve injury at the elbow versus the wrist.  Or what nerve roots make up the nerve that runs with the profunda brachii that may be damaged in a mid humeral shaft fracture. My point is that if you are studying for the comp everyday for three weeks that you shouldn’t let it go to waste. All of that medicine is going to be at the forefront of your brain. Keep it there and just keep going or else you may as well start over.

 

Multiple Choice Questions

By the time you take step one you should have fully completed at least one question bank. Personally, I believe four thousand is a good goal (though I only got to 3K). That’s a lot of questions and you need to incorporate MCQs into your daily routine as soon as possible. Do you bike at the gym? Do ten behavioral questions. Waiting for friends at the bar? Do five biochemistry questions. Do multiple-choice questions? Do multiple-choice questions!

My favorite routine was studying in the morning for four hours and then doing two sets of forty-six questions and then reviewing the answer choices after I got back from the gym. Granted, this was when I was in full power turbo study mode…but it’s totally doable. Just find your balance, set a goal, and go for it!

 

Don’t Do Half Of Anything

My dilemma when I started studying for the comp was knowing which resources to use- specifically Doctors In Training or Becker. I began flip-flopping between the two. I watched half a day’s worth of lectures on DIT and half a days worth of Becker lectures and both ended up suffering.

Choosing which resource you are going to use is a tough decision and one that shouldn’t be made lightly but stick with one once you make a choice. I knew that I couldn’t get through all of DIT before the comp so I chose to do Becker. One of my friends did all of DIT before the comp and did it all over again for the step. Weigh your options, pick one, and don’t look back.

 

To Becker Or Not To Becker?

By the time fourth semester had come around I had heard conflicting opinions about the Becker review course but overall I think anyone who used Becker had a good experience with them.

I liked Becker because it gave us a different perspective on the same material we already learned. Behavioral was amazing. I finally understood the intricate differences between all the self-defense mechanisms, personality disorders, and all of the statistics. Go to the behavioral lectures even if you don’t do anything else with Becker. And the other subjects they covered were also my biggest weaknesses that turned into strengths (i.e. pharmacology, physiology).

My friend Kristyn used Becker for the comp. She was extremely exhausted after passing fourth and decided to take a week off to relax and regroup. She told me that, ‘although I didn’t take the comp as seriously as maybe one should, my honest end goal was to just pass the comp and get it out of the way so I could start step studying once I got home’. She continued, saying that ‘for the comp, I decided to mediasite the Becker lectures at Ross and read First Aid for the subjects Becker didn’t cover and in the end it was enough to pass and get off the island’.

So should you use Becker? Only you can tell for yourself. I suggest that you invest at least one day in using Becker and test it out for yourself.

 

In my next post, I’ll go into more detail about the step one Becker course that Kristyn signed up for and the Doctors In Training course that I used for my step studying along with other resources I found invaluable to my step studying (i.e. DIT vs. Becker, Kaplan vs. USMLE World question banks, Picmonic, Firecracker, etc.). I hope you found this post helpful and good luck on your final! As always, feel free to leave a comment, question, or any other feedback and I’ll get back to you as quick as a cat. Meow.

Reflections After Finishing Second Year of Med School

As I walked home last night I glanced up at the evening sky of Dominica. Twinkling down at me was what seemed like a surprisingly bright star compared to all the rest. It couldn’t be a plane because planes very rarely fly over this Caribbean island. It seemed stationary so it couldn’t be a meteor. Confused, I pulled out my Sky Map on my iPhone and discovered it was not a star at all but instead turned out to be the planet named after the Roman goddess of love and beauty- Venus.

Earlier the same day I sat in my last lecture of my first two years of medical school and it felt strange. There was a buzz in the air. My entire class was about to be done learning new material. From then on out, we were to learn everything we already knew but in more depth and with greater stress on integrating each subject in preparation for the step. Except nothing seemed to change. I went to the same place for lunch that I normally do, went and got coffee like any other day, and procrastinated like a pro as always.

It took me until later that evening, looking up at the night sky, to register the significance of this transition. In that moment, staring up at the night sky alone with my thoughts, a smile snuck onto my face. It’s a smile that my close friends know quite well. It’s the same exuberant smile from the moment I first tried to place an IV port in my friend’s vein. It’s the same smile from the galvanizing moment when I successfully found my other friend’s uterus using an ultrasound. It became a smile from the moment that clarified how utterly happy I was to be on my journey in pursuit of medicine.

As corny and ironic as it sounds, I had to literally stare at the planet named for the Roman goddess of love and beauty to remember how much I love learning about the human body. Ever since I was a little kid I’ve always wanted to know how the silent orchestra of salient biochemical processes worked so well in perfect harmony. For me, its breathtaking to realize that I have learned most of the important processes that were once such a mystery to me and that I will one day be able to expand upon the zeitgeist of medicine.

It’s important to remind ourselves of our goals and our original reasons for why we wanted to pursue medicine- to remind ourselves that the sleep, sanity, and social life that we sacrifice are worth it. To remember why we spend our days in the library instead of on the beach.

I got lucky in that I’ve always wanted to learn about medicine and that I am happy to do so. I got even luckier in that I stumbled upon a strangely bright ‘star’ that reminded me of my passion which has given me willpower to complete my remaining exams with the utmost ferocity and determination. My passion and curiosity to understand the human body was a small part of my original reason for wanting to enter medicine but has become an integral engine that drives me to learn everyday. It is what will power me through the next few months leading up the step exam and beyond it as well.

Ultimately, I could try to answer the age-old interview question of ‘why did I choose medicine?’ except I don’t think it’s the most important question for current medical students anymore. Instead, ask yourself- ‘why do you still choose medicine?’.