Preparation has Begun

After a very short vacation (aren’t all vacations “too short”?), my USMLE Step 1 prep has begun -_-

I’ve opted to take the 7 week live lecture course from Kaplan here in the US. So that means I’m living in hotel for the next couple of months.

Class started a few days ago and it’s already been hell. I barely survived 4 hours of lecture a day in the first 2 years of medical school and now it’s 8 to 9 hours a day in Kaplan. Although it is common for some students to just study on their own, I chose Kaplan Live, because I needed structure to my study plan. I’m simply not motivated or self-directed enough to come up with my own study plan and just start reading random books.

At least I’m not doing it completely alone. There are 5 of us in total from SGU in the class, so there’s some camaraderie in the room.

Officially 50% of a Doctor!

All the exam results are finally in and I passed all my classes! That officially ends Basic Sciences and I can finally return to the USA for good! Leaving the island is exciting yet scary as there are a lot of big changes to come. But I finally made it! And I never deceled (which is a total miracle).

Now to get ready for STEP 1

House of Cards

Tomorrow marks the beginning of final exams. The is a very delicate chain of events in motion that require each level to provide a secure foundation for the next step to proceed.  Yet each step is extremely fragile and failure could topple the whole superstructure.

If I don’t pass Pathophysiology and Pharmacology, then I will have to spend another 6 months on this prison island. That would cancel my Kaplan Prep Course, which in turn means no USMLE Step1 and thus I won’t get to start clinical rotations in the United States.

At lot is at stake here over the next few days. More than anything, I just want to go home to the US; more than taking Step 1; more than starting clinical rotations. It’s been a long 2.5 years here on the island and I’m tired of it all. If I have to spend another semester here I don’t think I  could handle it.

So here we go…. luck, karma, divine intervention… I’m mustering anything I can for this last push. It’s literally do or die.

My First Dead Patient

On my second visit to the hospital, I was assigned a man in his mid-50s with end-stage CML to interview and examine. It was difficult to understand him due to his atrophied tongue, missing teeth, and thick Caribbean accent, but we talked for a fairly long time. I didn’t form any real emotional connection to him, but we laughed a lot about how drinking rum was the only thing to pass the time on the island.

The attending physician that was with me at the time just notified me he passed away about a month after I examined him.

On physical examination it was clear that he did not have much time left. His spleen and liver were so enlarged that their inferior borders were at the level of his umbilicus and distending his abdomen. But I thought he had at least 6 months or a year left.

What made him so memorable was all the advanced pathology that could been seen on his physical examination. You almost never see CML this advanced in the United States. But being in a developing country, all that was available was supportive care.

I didn’t expect this to happen to me soon in my medical career. I’m not even done with my second year of medical school.

I’m not sad. But I’m definitely sentimental about it. I probably won’t ever forget him. Rest in peace, sir.

Bump in the Road

I’m beginning to contest the notion that Term 5 is easier than the dreaded murderer of medical students, Term 4.

I did terrible in the first round of exams. Worse than ever before in my entire time here. For some reason I was overwhelmed this time with the amount of information being thrown at me. Over 300 drugs in pharmacology and 400 pages of slides in pathophysiology finally broke the camel’s back. I even managed to screw up my clinical medicine exam too. I attribute it to the fact that I am not a “memorizer”. I have never been the type of student to memorize long lists of unrelated facts simply for regurgitation on exams. I have survived this entire time by only committing the most basic facts and concepts to memory and later synthesizing them together come exam time.

Usually, I float a little above the class average, but now for the first time I’m in academic hot water. At least I haven’t gotten any e-mails from course directors or academic advisers requesting me to “make an appointment”.

I’ve been stuck in clinical meetings all week to prepare us for our 3rd year hospital rotations. But the whole time I’m thinking, “what’s point if I’m going to be stuck on the island for another year?”

How I Survived Term 4

With the new batch of 4th Termers starting Pathology today, I thought I would share how I managed to pass what most consider the most difficult term here (although I am beginning to believe Term 5 is actually worse).

#1. The best piece of advice an upper termer ever gave me was to ignore everyone’s advice (and yes he did see the irony in that statement). Just continue to do what you’ve always done to be successful so far. If you’re a textbook kinda student, read Robbins. If you usually need lecture, then go to lecture. Don’t drastically change your study habits to something that hasn’t work for you in the past simply because you’re terrified of pathology.

#2. DO NOT IGNORE MICRO! It is simply too much to cram before the exam.  Fact: a lot of people do worse in microbiology than pathology. Give micro at least 1 hour of your study time a day, if not 2. Sometimes I would study pathology all week, and weekends (20+ hrs) were purely dedicated to micro.

#3.  Take path lab seriously. Most people think it’s a waste of time. But you might not have time to go back and study the disease your group mate presented in detail.  Pay attention to the differential diagnosis the tutors highlight. They are exam gold.

I’ve also noticed about half the people who decel Term 4 do so purely out of fear even though their grades are fine. That is something I will never understand. Good luck 4th Termers…. you’re going to need it.

 

100 Days Left

A few days ago was the “100 days left of basic sciences” mark. In the past it has always been a tradition for Term 5 students to celebrate the final stretch before they complete MS2 and become clinical students. For some reason this Term 5 class did not celebrate it as wildly as previous terms, but I personally took the time to acknowledge the hallmark.

It’s been quite a journey up to this point. It is now the beginning of my 3rd year on the island and I can’t wait for these 100 day to be over (provided I don’t bomb pharmacology). I think my classmates that are staying for Kaplan Step 1 review over the summer are insane. But then again most of them haven’t been here as long as me.

I’m tired; tired of the school, of the people, of the same damn restaurants and bars. The cycle is so predictable that I can determine, with about 85% accuracy, what term a random student is by their body language, attire, and what time of day it is.  I’m still burned out from Term 4. I just want to go home and start clinicals because I know  that’s where I’ll shine. I’m a HORRIBLE classroom student, but I’m a force to be reckoned with on the ward.

100 more days of suffering…..here we go.