I thought Step 2 was supposed to be easier. After several hundred questions into my practice question test bank (USMLEWorld), I'm not feeling very confident. I was hoping to be hitting at least 60% and 10% higher than the average for students using the questions. But I'm at about 50% and a few percent lower than the average. It sure makes it harder to motivate yourself to study the long hours and takes more tests. I haven't seen any improvement in the last two weeks.
COMLEX is two weeks from Monday and I still have to review three books and answer 1500 more questions. Actually answering them is easy, it's going through the detailed explanations and trying to learn what you missed that takes forever.
Now I'm just hoping to get the same or better score than I did on Step 1. Adding 5 or 10 points would be great, but I'm playing defense at this point.
Went to see the new "Die Hard" movie with Colton tonight and had a good time. Watching John McClane get beat up on screen was a nice relief from getting mentally beat up - and very humbled. You certainly don't get through these exams with illusions about your own intelligence.
I don't have much mental of physical energy for housework or working out. I'm going to try and get in a 35 miler tomorrow. But I haven't gone swimming in a couple weeks. And the yard looks like crap.
On the good side, my rotations look solid and I'm happy with my choices. I completed of my residency application Personal Statement and my Emergency Medicine (EM) Dean/Advisor is reviewing it for me this week. The spreadsheet is looking pretty close to complete with 40+ programs worthy of applying to.
That's about it. Life feels a lot like last summer with another monumental set of Boards that rules your life for a time. Then I'll have four months to really focus on and learn EM back in the clinical environment while trying to impress Residents and Attendings. It will be playtime compared to Boards.
Saturday, June 30, 2007
Friday, June 22, 2007
Slow ramp up to Step 2
I really trying to get back into 12-hour a day studying for Boards, but the motivation just isn't there. I'm doing just ok on USMEWorld test questions, so I know I need to study harder. I also need to get back into working out regularly.
I guess I've used the last few days to take a break. I pretty much just vegged out over the weekend and played a PC game called Gothic 3. Monday Becky and I went to see The Police in concert (not the best, but fun for folks that grew up in the 80's).
Still trying to get final confirmation on my rotations before I start buying tickets. But the phone have been sidelined by a visit to the Vet, working with a sprinkler guy on repairing our system and watching the boys in the morning. I even had my first bike flat in AZ today and wouldn't you know it, I had to get a rescue from Becky. My replacement CO2 cartridges weren't threaded, so they didn't work the same manufacturers nozzle!
I guess it's time to get into gear. Put the hassles and delays behind, and get focused. I took my first practice tests in awhile today at my old desk in the 24-hour study lounge. I may just move back in tomorrow and start leaving all my books there. The third years will be leaving soon for rotations and the new PAs haven't discovered it yet, so I've almost got the place to myself.
I guess I've used the last few days to take a break. I pretty much just vegged out over the weekend and played a PC game called Gothic 3. Monday Becky and I went to see The Police in concert (not the best, but fun for folks that grew up in the 80's).
Still trying to get final confirmation on my rotations before I start buying tickets. But the phone have been sidelined by a visit to the Vet, working with a sprinkler guy on repairing our system and watching the boys in the morning. I even had my first bike flat in AZ today and wouldn't you know it, I had to get a rescue from Becky. My replacement CO2 cartridges weren't threaded, so they didn't work the same manufacturers nozzle!
I guess it's time to get into gear. Put the hassles and delays behind, and get focused. I took my first practice tests in awhile today at my old desk in the 24-hour study lounge. I may just move back in tomorrow and start leaving all my books there. The third years will be leaving soon for rotations and the new PAs haven't discovered it yet, so I've almost got the place to myself.
Friday, June 15, 2007
No more AZCOM classes ever!!
Wow. Just finished the MSIV (fourth year) final. Feels better than I expected. It was very stressful the last few days. Kind of Deja Vu from the second year tests. We had three weeks of lectures eight hours a day. In the end, about 70 hours of testable material. The handouts wouldn't even fit in a 4" 3-ring binder!!
Some of the material was good, but a lot was mediocre or worse. So I skipped most of the classes and studied for Boards the first two weeks. Made it through Crush and about 20 hours of Kaplan lectures. This week, I've skipped most of the lectures to go through the handouts. Luckily, as with the third year final, classmates banded together and signed up to make reviews of individual lectures. On our class website, at least 2/3 of the lectures and reviews that highlighted material the guest lecturers emphasized - or even outright said would be testable.
I got through my first reading yesterday around noon! And the material was so fragmented and disconnected that it was very hard to synthesize. We covered OB/Gyn, RadOnc, Renal, Ophtho, Heme problems, Immunology, transplant surgery, GU surgery, Ortho surgery, Peds ortho, Peds emergencies, Onc emergencies, Neuro and much more. I made it through the reviews and my highlighted material once more just in time for the test at 8am. Adding to the stress was the fact that last year they had to give back 25 questions because it was so tough and they didn't want to fail anyone.
That last point will be tested again this year. So classmates didn't take this very seriously. They aren't going to hold you back, and it isn't going to affect your residency applications at all. But who wants to have to take it again? Or do whatever torture Clinical Education thinks up?
On a good note, it looks like my rotations are coming together. I feel pretty confident that they will all come through. Some calls on Monday, then time to start planning logistics like housing, flights and transportation. And time to start studying hard for Boards!
The downer for the week was third year results came out and I didn't do as well as I hoped. I did ok, but failing the stupid surgery tests the first time, somehow pissing off the Attending at the VA and just doing ok on everything else hurt my class standing. I did average for the class on the OCSE (even though I got lots of compliments when I reviewed my notes with the Prof?!?), MSIII final, COMLEX and remaining post-rotation exams.
If I had to do again, I would have spent more time studying Clinical Ed's stupid objectives instead of studying my patients and what the Attendings asked of me. I don't like being locked in to someone else's study schedule when I could learn more from the Attendings on the job. I respected my Attendings (in general) more and enjoyed the freedom to study topics that came up in UpToDate. Oh well, I don't think it's going to change anything. It's just too bad our school doesn't have Honors for rotations, because I think that would have really helped me.
Now it's time to sit back and enjoy the weekend. I will get back into my workout schedule - including a nice long bike ride. Hopefully my vision will come back after three intense weeks of didactics! Then it's time to buckle down for Step 2 Boards.
I believe I have a much better game plan for the next year than I did for third year. At this moment OHSU and Carolinas are probably my top picks for Emergency Medicine residency. So I'm feeling pretty good about the immediate future.
Finally, it was interesting to hug friends this morning and realize many of us won't see each other again until graduation. Most of us are going out of state for at least some of our audition rotations. With no classes and only four post rotation exams (Neuro, IM, EM and Critical Care) we're more likely to bump into eachother on the wards than anywhere else. So it was a lot of farewells and "good lucks" for Boards, audition rotations and interviews.
Some of the material was good, but a lot was mediocre or worse. So I skipped most of the classes and studied for Boards the first two weeks. Made it through Crush and about 20 hours of Kaplan lectures. This week, I've skipped most of the lectures to go through the handouts. Luckily, as with the third year final, classmates banded together and signed up to make reviews of individual lectures. On our class website, at least 2/3 of the lectures and reviews that highlighted material the guest lecturers emphasized - or even outright said would be testable.
I got through my first reading yesterday around noon! And the material was so fragmented and disconnected that it was very hard to synthesize. We covered OB/Gyn, RadOnc, Renal, Ophtho, Heme problems, Immunology, transplant surgery, GU surgery, Ortho surgery, Peds ortho, Peds emergencies, Onc emergencies, Neuro and much more. I made it through the reviews and my highlighted material once more just in time for the test at 8am. Adding to the stress was the fact that last year they had to give back 25 questions because it was so tough and they didn't want to fail anyone.
That last point will be tested again this year. So classmates didn't take this very seriously. They aren't going to hold you back, and it isn't going to affect your residency applications at all. But who wants to have to take it again? Or do whatever torture Clinical Education thinks up?
On a good note, it looks like my rotations are coming together. I feel pretty confident that they will all come through. Some calls on Monday, then time to start planning logistics like housing, flights and transportation. And time to start studying hard for Boards!
The downer for the week was third year results came out and I didn't do as well as I hoped. I did ok, but failing the stupid surgery tests the first time, somehow pissing off the Attending at the VA and just doing ok on everything else hurt my class standing. I did average for the class on the OCSE (even though I got lots of compliments when I reviewed my notes with the Prof?!?), MSIII final, COMLEX and remaining post-rotation exams.
If I had to do again, I would have spent more time studying Clinical Ed's stupid objectives instead of studying my patients and what the Attendings asked of me. I don't like being locked in to someone else's study schedule when I could learn more from the Attendings on the job. I respected my Attendings (in general) more and enjoyed the freedom to study topics that came up in UpToDate. Oh well, I don't think it's going to change anything. It's just too bad our school doesn't have Honors for rotations, because I think that would have really helped me.
Now it's time to sit back and enjoy the weekend. I will get back into my workout schedule - including a nice long bike ride. Hopefully my vision will come back after three intense weeks of didactics! Then it's time to buckle down for Step 2 Boards.
I believe I have a much better game plan for the next year than I did for third year. At this moment OHSU and Carolinas are probably my top picks for Emergency Medicine residency. So I'm feeling pretty good about the immediate future.
Finally, it was interesting to hug friends this morning and realize many of us won't see each other again until graduation. Most of us are going out of state for at least some of our audition rotations. With no classes and only four post rotation exams (Neuro, IM, EM and Critical Care) we're more likely to bump into eachother on the wards than anywhere else. So it was a lot of farewells and "good lucks" for Boards, audition rotations and interviews.
Monday, June 04, 2007
It's official, I'm an MSIV!
Well it took much longer than anticipated but we finally received our grades today on both our standardized patient exams (OSCEs) and our MSIII final. I did ok on the final and am satisfied with the grade. Not a stellar accomplishment, but I easily passed.
I also passed the OCSEs as well, but it wasn't as pretty. I did fine on the history gathering portion of the test and middle of the class on the physical exam, but in the third on the plan portion. One consolation is the grades for the latter seem to be stacked together tightly. Forty spots in class rank on the plan grade were separated by only four percentage points.
Tomorrow morning at 8 am we have an hour review of the OSCEs and I'm sure this is going to be a very vocal, lively discussion of grading methodology. The biggest disappointment is that the feedback I received wasn't very helpful. I hoped to see copies of our SOAP notes with hand written notes including suggestions, corrections, etc. But this may be WAY too much to expect from our Clinical Education department.
As for everything else, I'm skipping a lot of class to study for Step 2 Boards. I feel pretty good about my study strategy: know Crush and Boards & Wards cover-to-cover, watch 120+ hours of Kaplan lectures and do at least the 2300 question bank I've purchased from USMLE World. I'm sure UpToDate, Wikipedia and other resources will help where explanations to questions I get wrong aren't detailed enough, but this feels like the right amount of study material.
As for the missed lectures, well I just hope that I can read the lecture notes next week before the final for a day or two and pass the stupid MSIV final. I also have to pass Wednesday's OMM practical, but the review made it seem like a pretty low key affair. Hopefully two hours of technique review tomorrow night will be enough.
At the same time I'm trying to nail down audition rotations. Arrowhead in CA looks locked in for August, after the Boards. Then it's a Peds ER rotation at MUSC (Med U. of SC) in September. October is still up in the air, but I hope to get either the Tufts or UMass EM programs. Both are in MA outside of Boston and could give me nice Letters of Recommendation (LORs) from a NE ER physician - very useful for any residency applications in that area. Finally, November looks like Carolinas, a NC EM program that has a great reputation. It's later than I would like, but the only slot I could get.
It's kind of nerve racking wondering how many programs to apply to, how many to audition at, what baggage the DO degree carries, and what randomness factor plays into all this. I sure wish there were more West Coast programs worth applying to. Of the 25 or so programs I have listed in my spreadsheet at the moment, only 3 or 4 are in the West, 1 is in the Midwest and the remainder are in the East.
It's also a pain to think about spending another three months away from the family entirely and an additional one only coming back for weekends. But with all of the aforementioned questions hanging over me, it seems like the best way to create a rank list for the Match that will get me into one of my top three choices.
I also passed the OCSEs as well, but it wasn't as pretty. I did fine on the history gathering portion of the test and middle of the class on the physical exam, but in the third on the plan portion. One consolation is the grades for the latter seem to be stacked together tightly. Forty spots in class rank on the plan grade were separated by only four percentage points.
Tomorrow morning at 8 am we have an hour review of the OSCEs and I'm sure this is going to be a very vocal, lively discussion of grading methodology. The biggest disappointment is that the feedback I received wasn't very helpful. I hoped to see copies of our SOAP notes with hand written notes including suggestions, corrections, etc. But this may be WAY too much to expect from our Clinical Education department.
As for everything else, I'm skipping a lot of class to study for Step 2 Boards. I feel pretty good about my study strategy: know Crush and Boards & Wards cover-to-cover, watch 120+ hours of Kaplan lectures and do at least the 2300 question bank I've purchased from USMLE World. I'm sure UpToDate, Wikipedia and other resources will help where explanations to questions I get wrong aren't detailed enough, but this feels like the right amount of study material.
As for the missed lectures, well I just hope that I can read the lecture notes next week before the final for a day or two and pass the stupid MSIV final. I also have to pass Wednesday's OMM practical, but the review made it seem like a pretty low key affair. Hopefully two hours of technique review tomorrow night will be enough.
At the same time I'm trying to nail down audition rotations. Arrowhead in CA looks locked in for August, after the Boards. Then it's a Peds ER rotation at MUSC (Med U. of SC) in September. October is still up in the air, but I hope to get either the Tufts or UMass EM programs. Both are in MA outside of Boston and could give me nice Letters of Recommendation (LORs) from a NE ER physician - very useful for any residency applications in that area. Finally, November looks like Carolinas, a NC EM program that has a great reputation. It's later than I would like, but the only slot I could get.
It's kind of nerve racking wondering how many programs to apply to, how many to audition at, what baggage the DO degree carries, and what randomness factor plays into all this. I sure wish there were more West Coast programs worth applying to. Of the 25 or so programs I have listed in my spreadsheet at the moment, only 3 or 4 are in the West, 1 is in the Midwest and the remainder are in the East.
It's also a pain to think about spending another three months away from the family entirely and an additional one only coming back for weekends. But with all of the aforementioned questions hanging over me, it seems like the best way to create a rank list for the Match that will get me into one of my top three choices.
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