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.
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