Wednesday, November 23, 2011

Taking the Boards

Recently, I had the opportunity to sit for Step 2 CK. Most of you probably know this already, but every medical student has to take (and pass) these "board" examinations. there is a lot of pressure. For four weeks, I have been studying for this exam. When I asked students who took the test last year about their study methods, it seemed the only universal recommendation from those who had gone before me was to use the USMLE World questions. After that, the answers varied. Some recommended Kaplan while others recommended "First Aid for Step 2" (by Le and Bhushan). I chose to work through USMLE World questions supplemented with "Crush Step 2" (by Brochert). Reading Crush gave me a nice break each day from the monotony of the vignettes associated with the question bank. I studied for at least eight hours per day (including weekends) to prepare.

Everyone will tell you that Step 2 is easier to prepare for than Step 1. I think my own experience coincided with this for the most part. The old adage is "Take two months to study for Step 1, take two weeks to study for Step 2, and take a #2 pencil to Step 3". This is an exaggeration of course, but I did feel more confident on Step 2 than I did on Step 1. I think the most helpful study tool was the USMLE World questions. I will pass that piece of advice down to students in the class behind me. The more questions you can do the better. I used the tutor mode so that I could take notes on questions I missed or important points within the answer explanations. Then I referred back to my notes each evening as a wrap up to the day. This won't be the best style for everyone, but it simply gives an example of what I did to work through multitude of questions.

I always take my favorite treats with me for these marathon tests. My test day lunch bag included a PBJ sandwich with raspberry preserves (yum!), an assortment of chocolates, and enough diet coke to last a week! It's critical to have a small little delicious energy source ready between questions blocks. My best medical school friend always takes a Dove chocolate bar to her boards. Just anticipate that you will be tired and worn out from question after question that day. Be ready to give your mood a lift with a little indulgence!

That's not all. Next I will be traveling to Chicago for the Step 2 CS exam. To help prepare us for this test, my school has set up a mock exam with feedback. I have spent the last two months on Family Medicine rotations which I hope will help me with my exam skills. Additionally, I am using "First Aid for Step 2 CS" to read up on the best way to write my notes and develop my differentials on that day.

I was able to schedule my exam on a Friday so Matt will be joining me and we will be spending a little vacation weekend in Chicago! It will be the fun weekend we both need after I've been studying for boards for the past several weeks.

Wednesday, November 2, 2011

Call can be hard but you learn a lot!

During my Sub-I rotation, I had two evenings of overnight call that opened my eyes to the demands of being a Family Medicine resident physician.  The first call night took place while I was working on the pediatric floor, and the second during my week on the medicine floor.   Up until this point, I had no idea how different two separate nights of call could be.  On both days I reported in the morning for a regular work day.  Around 5:00 pm, the day shift residents checked out to the night float and they went home. On the pediatric floor, the night float resident and I had plenty of time to get to know each other before the night got busy. We became friends at once!  We had dinner in the cafeteria and as we got to know each other we began to find all of the things we coincidentally had in common.  About 10 pm, we headed to our respective sleep rooms, to wait for our pagers to summon us.  I was able to get a few hours of sleep before our first admission came in.  The resident asked me to go to the Emergency Department to meet the patient and to take a history and do a quick physical.  The patient was a pretty straight forward cystic fibrosis exacerbation case.  I got to practice writing my admission orders and calculating pediatric doses for medication.  After our patient was tucked in, we both headed back to our rooms and laid down for the rest of the night.
My medicine call was entirely different.  I reported for a normal work day and met the night float resident around 5:00 pm.  We didn't have a whole lot of time to get to know each other before the phone was ringing with several new admissions.  We went to work immediately, separating once we arrived to the ED to begin working up two different patients at once.  At the same time, my night float resident was getting pages with questions about patients that were in the hospital.  Most of our night carried on at a similar tempo.  We were able to break away for a late dinner around 10:00 and my resident took that opportunity to teach me a few concepts.  At 3:00 am, our night had slowed down enough for a quick nap before the 5:00 am day crew came.  Instead of letting me go to sleep, my resident decided to give me a quick primer on acid-base analysis.  At first, I groaned to myself but actually, it was the best acid-base lecture that I've had!  It was so busy that it would have been easy to use that as an excuse to not do any teaching. I thought it was kind of him to take a few minutes of his sleep time to teach me something.  I went to sleep at 4:00 am and emerged from the call room at 4:50 am.  As soon as I stepped into the conference area, the resident was asking me to recite Winter's formula!  I faltered from lack of sleep, but needless to say, I will never forget it again after that experience!  I stayed for rounding and morning report which tallied my shift to 28 hours in length. Right at the limit! These long days will definitely take some getting used to.  Intern year will be a challenge!