Monday: New Week, New Goals

I've been frustrated had a near break down/panic attack about Step 1 this weekend. See, I was doing really well, upwards of 50% on my UWorld blocks and then suddenly...a string of scores below 40.  I'm trying not to focus on the cumulative % correct, this is a learning process, I get that, but it doesn't stop me from freaking out at 3 am on Sunday.  Three goals for this week:

1. Do not drop below 40% on any UWorld blocks (So far, so good.  45% today.)

2. Spend my time really understanding the questions: right and wrong (I'm going to reduce the number of questions I'm doing from 26 to 20). 

3.  Breathe. Remember this is a learning process.  Forgive myself for making mistakes.  Every wrong answer is an opportunity. 

Twizzlers

Further proof that I never took Immunology: I just did a 26 question block of JUST immunology and I only managed 46% correct.  You might think, NBD, but yo, I studied immunology exclusively last night so that I could do well on an all immuno block today.  I feel like a moron and a fraud.  I'm told both of these feelings are normal while studying for Step 1.  I know that I should just use these questions as an opportunity to learn the immunology concepts that I am obviously struggling with, but instead I'm just mad.  I'm releasing my anger by eating my twizzlers aggressively, which accomplishes...nothing.

I never took Immunology

Ok, I did take immunology, but that doesn't mean I learned it!  Immunology was a struggle for me.  I just looked up my grade: 86%  This does not compute.  I knew when I took immunology that I didn't understand it.  I knew what I had to memorize and what I had to do to pass, but I also knew that I barely, and I mean barely grasped even the basics of immunology.  I am reminded of this when I see that immunology is my lowest scoring subject in UWorld with 25% correct and 8th percentile.  Ouch.  I'm trying to go over my notes from immunology, but I don't have any.  Let this be a lesson to those of you who have not yet taken immunology, TAKE NOTES.  To anyone who understands immunology, send some knowledge or suggestions on review books my way; first aid is rather sparse in this subject area as well. :-/

Daunting

I'm back to doing random questions on UWorld.  I tried just doing one section at a time (i.e. Biochem or Cardio), but the UWorld questions are so integrated (this is a good thing) that I was still jumping around in First Aid.  The reason I went back to random questions is that I was worried that I was artificially inflating my UWorld score by reading from First Aid and then doing questions.  Ideally I guess I would learn a topic really well and then do UWorld to see how I am synthesizing the information and solidify my understanding, but I haven't figured out how to do that every day.  Each section of First Aid is only 30 or so pages, but it's all of the physiology, pathophysiology, and pharmacology of that organ system.  I could try to master each section and then do UWorld questions, but then I don't think that I'd be doing UWorld questions on a daily basis.  Right now I'm doing 23 UWorld questions per day and annotating my First Aid book.  Oddly enough, I like doing UWorld because it focuses me and it's a little reminder that I have to keep on studying (especially on days where I get less than my cumulative average...ouch).

I've started adding Pathoma to my study regimen.  I'm going through each of the Pathoma chapters along with my First Aid book; it's certainly more time consuming, but Dr. Sattar is just so amazing that whenever I do one of his lectures I feel like I've gained something.  I've been watching his lectures/reading his book all year so I'm already familiar with what he's saying and just adding stuff into First Aid.  I think having the book/video subscription all year has definitely helped because pathophysiology is one of the things I've scored the best on in UWorld.  Surprise, surprise, Pharm is among my worst subjects.  I want to care, but I can't.  I'm still doing the DIT question sets that they send out on Monday, Wednesday, Friday.  I do feel like they're useful because they give me exposure to stuff, but I don't know if this is a good use of my time.  Like I said, I'm just trying to trust the process, put my faith in DIT and hope that when my dedicated study period rolls around, I can sit through the DIT lectures and do really well on the exam.  I'm hoping to have gone through all of UWorld once before the dedicated study period, annotated all of First Aid on my own so that I'm familiar with it, listened to Pathoma all the way through, and finish all the DIT primer videos.  Suddenly my to do list seems incredibly daunting...especially while I try to balance my normal schoolwork.   Fingers crossed.

Let's be really ambitious about tomorrow

I got very little on my to-do list done.  I just kind of felt like napping, even though I had a full night's sleep last night.  I skipped classes and just kind of ambivalently made my way through my UWorld questions.  Oh, and then I whined about how tired I was to anyone who would listen.  I finally started doing work around 10 pm.  Not my finest hour.  I'm going to be really ambitious about tomorrow.  It's going to suck, but I think the attitude I need to change my attitude.  Instead of approaching all my studying with this feeling of dread, I should just be really ambitious about what I want.

We don't choose our patients

I don't normally write about patients, but today I had a patient tell me that they were sure that I was a blessing.  This patient, like so many other patients, tugged at my heart strings.  Here's the thing: I have too many feelings, and sometimes patients, for one reason or another, hit too close to home.  When this happens, it throws me off my axis.  I know I have to learn to control it, but I haven't yet.  I've barely learned to deal with it, and sometimes the only way to deal is to shut it off.  Sometimes you have a tough patient and you just have to steel yourself.  Today's patient was the definition of a sweetheart, and that was part of the reason this patient hit home for me.  As I'm leaving, my patient says, "You've been such a blessing.  You've got a sweet face and I won't forget it.  I know you were sent to me as a blessing.  Make sure you keep your heart open."  This patient thought I was sent to them, but maybe it's the other way around, maybe they were sent to me.  To help me keep my heart open.  People think doctors are cold and unfeeling, and I get that, sometimes you just can't, but I've always had too many feelings, and maybe that's why I'm supposed to be a doctor.  We don't choose our patients, but maybe we get the ones we need.  Keeping a thought for this special patient; grateful I was able to learn today.  

It feels so good to be a gangster

I just got 90% correct on my UWorld block.  Now, I realize that this is an outlier; my cumulative performance is still only 45% right and 22nd percentile.  This means that I'm doing slightly worse than if I were just blind guessing and that 78% of people using UWorld are doing better than me.  Still, it's nice to take a UWorld block and not feel like I need to eat ALL of my feelings.  Maybe one of these days the thick blue line on the cumulative performance graph will approach the average test takers...sigh...dare to dream. 

Things I suck at (<22nd percentile): 

Anatomy

Embryology

Genetics

Histology

Immunology

Pharmacology

Things I suck less at (>22nd percentile)

Behavioral Science

Biochemistry

Biostatistics

Microbiology

Pathophysiology

Physiology