Tag Archives: Exam

Swim

I survived boards!

To sum it up as concisely as possible, preparing for my Step 1 exam was like diving into the ocean, and I ended up going for a longer swim than I anticipated.  Long story short, I took boards in September instead of during the summer, which is partly why I’ve been away from blogging for so long.

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I also wasn’t sure where to start writing again.  Which is why this post if being written in December, long past the reasonable timeframe for using my I’M-STUDYING-FOR-BOARDS-AND-CAN’T-WRITE excusplanation (my latest neologism: a cross between an excuse and an explanation.  I coined it specifically for this post). 🙂

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Since I’ve taken time off for research before starting my clinical rotations, I had the flexibility to extend my study period, and that’s what I ultimately did.  For some reason, saying I took additional time almost feels like a confession.  I suppose part of me feels a little guilty for having the opportunity to study longer (other med students may not have schedules that are so accommodating), and part of me wonders if I should’ve felt ready sooner.  However, a friend passed on some advice from his sister (a medical resident) that helped to ease my decision: take the time you need, and take the exam when you feel ready.  It’s okay not to rush it.

I think it’s unlikely that any student ever feels completely ready for boards, but at least it’s possible to feel that we’ve done everything we can with the time and resources each of us have.  For me, this was the right choice even if it did mean doing a lot of swimming and diving (figuratively speaking, of course, since my real-life water skills fall into the category of barely-good-enough-to-not-drown).

I finally came up for air after my full day at the Prometric testing center, only to realize that life was waiting for me above water like a clamoring flock of seagulls.  To be honest, part of me wanted to just go back into the water and turn into a mermaid.  Over the last several years, the life of studying (for college, the MCAT, med school, and finally Step 1) has become a familiar ebb and flow around me, and it’s comfortable in its own odd way.

Well, I guess it’s time to get pushed out of that comfort zone.  I’m done with my preclinical years, and there will be no more quarters to define the pace of my life, or daily lectures and midterms, or labs where curiously-shaped cells make faces at me through the microscope lens.

Now I’m gearing up for my clinical years.  I still have a few months to prepare myself, but it’s daunting for me to think about functioning as part of the medical team.  I’ve had opportunities to participate with patients throughout the first two years of medical school, but it was always briefly, as if our interaction were a haiku of three lines instead of an essay of three hundred.  I’ll still have supervision and guidance, but my responsibilities and expectations will be greater, including the expectations I place upon myself.

One thing I’ve been thinking about is how to connect with people on a personal level, because that is important to me.  Sometimes medicine can feel very mechanized, and with the pressures of being a clinical student, I can see myself losing sight of the more ephemeral aspects–the very things that make this pursuit worthwhile.  I’m worried that in trying to navigate wards and find my way around, I’ll lose some of myself.

And maybe I will for a little while, as I try to orient to the life of a clinical student with its early hours (on some rotations) or intense schedules (on others).  But I also have faith that I’ll be able to find myself again if I do.  Beneath my white coat (which still feels like a costume when I wear it), I’m an artist and a writer.  That, I think, will help me find my way home to what I care about: the story, the healing art of listening, the release of telling, the feeling of having been seen and understood.  That’s my hope, at least.

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I was surprised by a rain shower today as I left a meeting at the hospital.  I found some leaves with pearlescent water droplets reflecting the diffuse light, and the constellation of spheres made me think of a universe in miniature.  Maybe this is what souls look like, with droplets of memory and experience coalescing to reflect the light and shadow of who we are inside?

My imagination is getting the best of me.

But I like to think that if each droplet were a little world of its own, and if I were as small as an ant, I’d be able to see and appreciate each one.  And when we meet people, that’s really what we do, isn’t it?

Each of us has our oceans, and each of us is a universe of our own.

Halewright

One Test to rule them all, One Test to define them; One Test to bring them all and into knowledge bind them

Like Bilbo and Frodo did in their times, I am about to embark on an adventure beyond the borders of all I have known.  (Did I actually just compare medical school to the Shire?)  This morning (since this post has taken me past midnight to write), I’ll begin my two-month journey of studying for the USMLE Step 1–an eight-hour long exam which will test all the medical knowledge I’ve learned in the past two years of medical school.  To speak with a bit of poetic license, it is the exam which will determine my destiny.  It is the One Test to rule all tests, the score to end all scores, for the grade I receive on it will influence how desirable of an applicant I am when applying for residency in a few years.

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Thankfully, my future is (in reality) influenced by more than just the score I receive on this test.  Nevertheless, the Step 1 is a very important exam, and I’ll be devoting about 10 solid hours a day to studying for it.  Factor in time for meals, exercise, and the ebb and flow of natural life, and I’ll be starting my days around 6 AM and ending around 9 PM.  As intense as this will be, I’m excited about this block of time to study and really see how everything fits together.  I hope that I will be like a hawk soaring high above the landscape, taking in a panoramic view of everything that is going on so I can hone in on details and dive for deeper understanding.

I like to think of funny things like that.  It makes life more interesting to me. 🙂

Levity aside, it’s going to be an intense two months.  For me, a bright spot is that I’ll be studying with a very close friend, and we’ll be sharing the journey together.  As the old proverb says, “a sorrow shared is a sorrow halved; a joy shared is a joy doubled.”  I’m looking forward to teaming up with my friend to make deeper connections with the material as we grow into the doctors we dream of becoming.

That dream, however, is something I’ve been thinking about recently.

Very recently, for a few bleak weeks, I lost sight of who I wanted to be in medicine.  After nearly two years of studying and training, I felt that my path had led me into a seeping bank of fog.  I couldn’t see my way forward into the life-giving occupation I had imagined when I applied to medical school, and I began to feel increasingly lost.

For several agonizing days, I felt that I had lost my purpose.  After pushing myself in my studies for months while simultaneously struggling with the fact that life goes on even when you don’t feel like you have the reserves to deal with it, I was beginning to burn out.  It’s something that happens, and it’s a real thing.  I don’t think I burned out all the way, but reflecting on the past months, I see that I was beginning to.  I’m okay with admitting that because I know it happens to others too, and I hope that we can begin to dialogue about it more since doing so will help us, our colleagues and our future patients.  It will validate our own human experience.

It’s okay to be worn out sometimes.

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What helped me re-engage with my purpose was a recent encounter where I didn’t feel listened to.  It was a situation when I wanted the comfort of being heard, and I instead felt more like an avatar for my electronic medical record.  The interaction was relatively brief, but served as the wind to blow away the fog I had been muddling through.  I realized at a visceral level that, as a medical professional, I want to help my patients feel heard.  Even if they don’t always want to open up to me, I want each person to know they have had the opportunity to talk and be heard.

Yesterday, I watched a fantastic TED Talk by Dave Isay called “Everyone around you has a story the world needs to hear.”  Dave Isay is the founder of StoryCorps, which started as a recording booth at the Grand Central Terminal in New York to allow anyone to record an interview with another person.  In his talk, he discussed how empowering and validating it can be for people to tell their stories.

Of recording interviews as a radio broadcaster, he said “Over the next 15 years, I made many more radio documentaries, working to shine a light on people who are rarely heard from in the media. Over and over again, I’d see how this simple act of being interviewed could mean so much to people, particularly those who had been told that their stories didn’t matter. I could literally see people’s back straighten as they started to speak into the microphone.” (TED)

This was the other light that helped me begin reconnecting with my meaning in medicine.  I want something more than the technical skills and knowledge can give me; I want to be a healer through stories.  I want to be an artist who creates a space for people to speak themselves into existence.  Going back to the creation account in Genesis, words are what brought substance out of the void.  I think this is what can happen in our lives today when we pay attention to what people have to say–when we pay attention to their experience and their feelings and thoughts and what it means for them to be a human and a patient.

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I’m finding my way again, one step at a time.  So as I study the names of medications like ticlopidine and ticagrelor or diseases like loa loa and acute sclerosing glomerulonephritis, I’m also paving the way for stories to be told.

Since I love words and neologisms, here’s a word I’ve crafted to describe what I want to be:

Halewright (noun)

From Old English hǣlu-whyrta, corresponding to hale (health) + wright (builder, creator)

Someone who aids in bringing healing and wholeness to other humans through the act of listening to their stories.

And so the journey continues…

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Carry On

It’s been one of those days where you come up at the end of it feeling rather exhausted. I keep getting this picture in my mind of the swirling ocean with water as deep and dark as the night sky traced with clouds of foam, and I’ve just surfaced after a long plunge beneath the waves.

Even as I write this my thoughts are wandering about my head, wondering how the pressures in my lungs would change if I took such a dive, and what impact this would have on the respiratory control centers in my body.  I’m guessing this is a side effect of studying for today’s Human Health and Disease exam on the respiratory system (and antibiotics and neoplasia).  We just finished the exam this morning, and although it was intense, I’m happy to have made it through.

I wish I had something more original or profound to say at the moment, but since I’m pretty tired I’ll instead comment on two quotes which help me to find perspective when I need it most.

The first quote I’ve known for a long time, and it holds a special place in my life. My mom taught it to me years ago and it’s been a part of me ever since:

Mistakes are opportunities to learn.

For example, I’ve been tempted to get tangled up in frustration with myself for not planning my studying better.  (I can now empathize with bacteria a bit more, as I’ve finally found common ground with them. We both underestimated the power of antibiotics.)  The antibiotics are more challenging to learn than I had thought/hoped, and looking back, I should’ve started memorizing the information about them earlier than I did. Lesson learned: make flashcards promptly.

The second quote I just came across yesterday, and it was a great encouragement to me.  These words by Winston Churchill capture the essence of the perspective I need at this stage in my life:

Success is not final, failure is not fatal: It is the courage to continue that counts.

These words remind me that this is a journey, a process. It’s a continuum of sorts, and things change.

In a way, this is the same perspective that the seasons give.  Springtime is not final, for blossoms must mature into fruit that ripens and eventually falls from the tree.  Winter is not fatal, for the tree blooms again.  What counts is that the tree sends its roots down into both the warm, rich soil and the cold, frozen earth, that it stretches its branches heavenward in both the bright sunshine and in the slanting rain.

Trees, I think, could be called courageous.

While I know there are times in life when failure literally can be fatal, I am reminded in moments like these to also step back and see the bigger picture.  And then, with the ocean before me, to find the courage to plunge in once again and swim.

Week Two, Quiz One

I am a little more apprehensive than I thought I would be as I sit in the classroom, waiting to take my first quiz in Molecular Foundations of Medicine.  Although it’s only our second week of medical school, we’re already halfway through Mini Quarter and heading quickly towards our final exams later this month.  It is hard to believe we have already reached the halfway point.

This quiz, given under final exam conditions, will help me to evaluate my med school study skills, and I am both eager and anxious to receive its verdict.  We have covered a prodigious amount of information in the past two weeks, and I am still trying to determine which study strategies would be best to use.  Flash cards?  Additional online resources?  Reading and re-reading lecture notes?  Drawing things out?  It will probably be a mixture of them all, and I am hoping that the combination I have chosen over the past fourteen days has been the right one for me.

The rows of tables which usually span the classroom have been rearranged so that we are sitting in pairs.  I take a drink from my water bottle, dig through my backpack to find my watch, realize I have forgotten it, and locate the clock on the wall instead.

Only a few minutes until we begin.

Turning in my chair, I glance around the room at my classmates.  Although I’m still working on learning everyone’s names (something I really hope to accomplish by winter break–I think I’m about 66-70% there), the faces have become familiar.  We are all in this together, I realize.  Our shared hopes and goals have brought us together on this Friday morning, and suddenly, I feel a little less nervous.

About half an hour later, it is over.  I follow several classmates to the elevator, wondering what they think about the past thirty minutes.  While the quiz has been challenging for me, I am satisfied overall with how the morning has gone.  Entering the hall, I move on to the next part of my day–lunch, a meeting, our weekly journal club, histology lab.

Coffee break.

Dinner.

As the sun sets over Stanford, I receive a notice that our grades are up.  Fingers crossed, I log onto our course website and click the link to my gradebook.  My eyes flick across the screen, honing in on a number written in black 12-point font.

I have passed!

Now, on to studying histology…

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And in closing, a few random thoughts inspired by my week:

You know you’re an anatomy student when…

…You go out to dinner with a fellow med student and find yourself discussing bone saws and preserving fluid while waiting for your meal to arrive.

…You watch dissection videos while eating lunch.

…You realize that one of the highlights of your day was mastering the attachment points of five different muscles.

…You are looking for a scalpel and accidentally tell your classmate that you can’t find your scapula.

Have a great weekend!