13 days, 23 hours

I pushed back my test 10 days. I wasn't hitting what I wanted to get on my practice exams, and it didn't seem realistic that I'd get to that target in five days, no matter how much I studied. Also, I've probably spent over $1000 on books and reviews for this exam and all the courses it supposedly covers. I'd like to at least skim all the materials I have.

Oddly, my stress headache has returned. Which is impairing my ability to study. You can't overdose on Ibuprofen right? Damn it. I should know this.

HOLY .... ! IT'S ACTUALLY A TUESDAY! This update on my progressive is appropriately timed, then. And I'm taking the exam on a Tuesday. That bodes well, doesn't it? 

UWorld Blues & A Murderous Rage

Studying for boards is driving me into a murderous rage. It is a combination of self-hatred for not studying more earlier and the incredible disbelief that they want us to know so much.

Also I keep getting diabetic questions wrong on UWORLD, which is probably the most depressing thing. You think you understand the process of something fully only to find there are perverted ways of asking questions that make you question what you once knew as true.

This is hell. I also have normal human being things to worry about, but I'm not paying attention to them anymore. I need to cash checks. I need to move. I need to get a new phone. I haven't checked my blood sugar in three days because I lost my glucometer while trying to pack up my apartment. So that should freak me out. But it doesn't. What makes me chuck the First Aid review book across the room as hard as possible is not the fact that my life has deteriorated to this point where I don't care about my own health and safety. No, it is the realization that I don't know how Rifampin works. I haven't been this angry since I studied carbohydrate metabolism in Biochemistry--a class I was desperately failing. I actually flipped a table when I realized memorizing all the intermediates and enzymes that metamorphose glucose was not going to be enough to do well on the exam.

That's how I feel right now. That I know a lot, but that come test day, everything I know either A) won't be tested or B) won't be enough to answer enough questions correctly.

But I have come way too far to fall apart in the next 12 days and fail Step 1 on June 1st.

12 days.

Board Review Friday

Systems. I'm going to do this by system. Or by subject. But mostly system. I'm going to get really excited and read library books, and draw multicolored pictures, and ask good questions, and find good answers on Wikipedia, about the following subjects in their following order:

1. Immunology
2. Cardiovascular
3. Respiratory
4. Peripheral Nervous System (Autonomics)
5. Anatomy
6. Endocrine
7. Reproductive
8. Liver
9. Biochemistry
10. Renal
11. Gastrointestinal
12. Central Nervous System
13. Microbiology
14. Pathology
15. Pharmacology

Just kidding. There's no way I'm going to follow any structure, whatsoever. A lot of third and fourth year students kept telling everyone: find a study system that works for you, and stick to it. I'm good on that first part. I've found many systems for studying. But I can't seem to stick to any of them. 

However, that being said, I did spend four hours in the library the other day, just reading about B cells and T cells, and it was a ton of fun. I am not being sarcastic. Thoroughly enjoyable. 

I like reading books. I like asking myself questions. And I like drawing diagrams. Hopefully by the time this is over, I will have a cute compendium of colorful notes that I can keep for years and years and share with the next generation of Apantaku's when some of them start going to medical school. And they can laugh or learn from what I will have learned in the next 42 days.

Wait. 42 days?! That's only 6 weeks! That's only one-thousand-and-eight hours. Actually, because it's 4 pm, it's only 992 hours! Terrifying. 

.... Shelf!

Surprise! I have a giant subject exam next Wednesday! I'm terrified! Hence the exclamation points!

I'm terrified because it will be worth 20% of my final grade in my favorite class: Clinical Neuroscience. I had a feeling I'd like psychiatry even when I came to medical school, but it was never something I thought I'd seriously like.

I came in with a pledge to make medicine easier to understand for my patients. I fully believe I will have to see a lot of patients, but I want to make every single one of them feel in control of their health--by giving them the information and the support they need to make their own decisions.

This is why my final research project in college involved looking at the ways doctors communicate with their patients.

And psychiatry, I realize, sets itself up as the specialty that requires communication over everything else. Even with primary care--let's say family medicine, which is still my first love--you talk with the patient, and most of the time, talking is all you need. But you still approach a patient in primary care as an algorithm. History fills in some information, labs and tests fills in the rest. You shake it up, and you come up with a diagnosis. Or several diagnoses.

Psychiatry at the very start basically says: the only way you're going to get anything done is communication. There is no back up plan. You can't be that doctor who is really smart but also really distant--really bad at talking to people. I guess what I like most about psychiatry is that it really emphasizes medicine as an art form.

Regardless, I am now considering a double residency because hey--I'm young. But what I really want to do is qualify for an Honors Elective in Child Psychiatry. That was the most ... electrifying part of this course for me. Many of my friends, I realized, had these conditions. Most memorably, my best friend in elementary school had selective mutism. Which I always thought was interesting as a little kid, but now I understand it and I find it even more interesting.

Anyway, to qualify for the Honors elective I need an A in clinical neuroscience. And right now, without any extra credit, I have an 85%. SO FAR AND YET SO CLOSE. So, the next 6 days of my life will probably be panic, panic, panic.

Adding pain to misery, 50-55% of the exam is on "Central and Peripheral Nervous System" which is incredibly vague. Fortunately, the vagueness was removed by the course director who basically explained this chunk of questions as focusing on... you could easily guess it... my least favorite and, I am not exaggerating this when I say, my most personally antagonizing part of medical education... Neuroanatomy!

Trials and tribulations, right?

Here's to a weekend of staring at brains!

Full Circle

I still suck at board review tuesdays, but I seem to have developed a pattern of writing in every eight days, so expect me to write about something, I suppose, next Friday.

Although the real reason I haven't had anything to write about concerning boards is because I haven't studied. At all. For over a week. For over eight days.

I'm freaking out, but instead of doing something about it (namely, study) I seem incapable of doing anything productive.

I mean I'm studying for school, but school grades don't matter. Hah!

Eventually I'll probably get out of this slump. I can't imagine cramming for the boards. That sounds like a hell no one deserves, no matter how undisciplined, dumb, currently care free, or beautiful* that person may be.

Speaking of actual school, I'm excited for class tomorrow because our hit-or-miss pathology class will be hopefully educating the idiots in my class about what diabetes is. And honestly, I could learn some more about type 2 diabetes too. I'm sick of how much stuff we know about diabetes that isn't mine. I've been skimming tomorrow morning's notes for fun.... Wrong word... curiosity. Looks like a genetic component for type 1 diabetes has been proven in white people. Which is great for me, a curious, half-white person of child-bearing age who really wants to know if my genes are defective or if I'm just unlucky. I want, nay, need to get sequenced. Besides the diabetes I am literally perfect**.

Fortunately there is at least one amazing thing about the lecture notes for tomorrow:

Borg Picard in a diabetes lecture?! 

DAMN! I'm watching television (I was not kidding, I am a failure) and I just heard Lucy Liu say the word "neutrophil." Apparently she's an ex-doctor on the television show Elementary. I approve. And I am feeling pretty lucky. Maybe I will study tomorrow.

*I needed a pick-me-up.

**I still needed a pick-me-up.

God I Suck at This (Board Review Tuesday)

So I missed Board Review Tuesday again. Maybe I should call it Board Review Wednesday and cut my losses.

Panic set in for the first time over my spring break (last week). This was probably due to a few of my classmates posting up pictures of the library to Facebook whilst complaining about how much they were studying.

I still am not 100% sure of how exactly I am going to study for boards, but I have an idea: I will write my own notes for each system of the body. System based learning done the right way because it will be personalized to me.

To start off each section, I would re-familiarize myself with anatomy and physiology of the system. Then I would discuss pathology, including microbiology and immunology if relevant to a specific condition. Finally, I would end with pharmacology and other treatments for the condition.

Hey! This could actually work! Of course, that's what I said about CramFighter, and I'm not really using it anymore.

I mentioned this to a friend--and it seemed like one of the truer things I have ever said--but essentially, the inexplicable feeling of doom that accompanies pancreatic cancer is exactly how I feel about boards. I'm not sure exactly what's wrong, I'm not exactly sure what I should fix: all I know is that I am screwed.

BRT (It's Wednesday)

So I'm a failure at blogging. What else is new?

Regardless, it's BOARD REVIEW TUESDAY (it's Wednesday) so let's review!

There is absolutely NO WAY I can study for combined exams, study for step 1, and expect to stay alive. I've done nothing that I usually find enjoyable in the last week. To continue living this way for the next 107 days... Terrifying.

Let's take a look at a typical day:

7:30 AM: Wake-up. Probably. You let your alarm ring for 17 minutes before falling out of bed.
8:04 AM: Show up to your 8 o'clock class. Reluctantly remove ear-buds when you sit down near the back of the auditorium.
12:00 PM: Congratulations! You've just survived four lectures. (Only three of them were good... and you were on pinterest for a good fifteen minutes at one point).
12:05 PM: Back in your apartment, you think about eating lunch.
12:45 PM: Nope. You just spent 45 minutes dealing with obnoxious e-mail requests and finishing assignments, last minute. Now you go to the freezer and stare at a box of ice cream. You eventually put it back and eat left-overs instead (we're proud of you, you poor bastard).
1:45 PM: It took you an hour to eat. You also had a beer. And watched The Daily Show and The Colbert Report back to back on Hulu.
2:00 PM: You're back at school, doing something "additional" to your actual classes. Attendance is mandatory, although you have no idea why.
3:45 PM: You've finished interviewing what feels like thousands of fake patients (there were only three, but your legs are weak and you're shaking all over. When you're a real doctor, you will likely see forty patients a day. Good Luck!)
4:00 PM: Sit down to study. You can't decide what to study first: Lecture notes from last week or Case Studies for step 1. You listen to your heart. Your heart tells you lecture notes.
5:30 PM: You break. Who cares about parasites? They are disgusting. And now you are hungry. Plus Diane Sawyers is on WorldNews, and you need to remind yourself there's an outside world. Make dinner while watching television. Eat dinner during commercials.
6:03 PM: You pick up your Case Studies book. You skim through 2 and a half cases and stop because...
6:30 PM: Television is on again. It's Wheel of Fortune. You're still human, dammit.
6:58 PM: You're lying on your bed playing an addicting game called Triple Town on your tablet that you bought primarily for school work. Whatever. Triple Town is legitimately awesome. It's like if Farmville and Bejeweled had a baby.
7:24 PM: You really hate yourself. Also Triple Town. You start skimming tomorrow's lecture notes.
7:48 PM: First exposures are always the worst. Hepatitis D will probably make sense to you when you read about it next week. Fifteen minutes before your exam. Go on Facebook. You have 2 notifications. Respond to notifications. Nothing else is happening. Stay on Facebook for the next 11 minutes, waiting.
7:59 PM: Check e-mail. Start G-chat-ing with Charyse.
8:27 PM: You've been reading Jezebel.com and io9.com. You finally stop when you see a medical article on io9 that you kind of understand, making you feel guilty that you're not furthering medicine at this very moment. You make a grand attempt at getting through First Aid Cases. It appears to be working until....
9:44 PM: GAH. You can't read this anymore. You only have five cases left but you don't care. You get some cheese sticks, red wine, and 25 mg of Doxylamine succinate, the finest sleeping pills around.
10:35 PM: You zoned out and somehow ended up writing something on your personal blog that shall not be named. It's angry and sad and if you didn't hate hugging people so much, that's exactly what you would want. You gently slap yourself in the face and finish your First Aid Cases.
11:08 PM: Despite drugging yourself, you're still awake. Though mildly content that you finished all your CramFighter assignments. No, scratch that. Wildly ecstatic. You remember when normal things used to make you happy. You turn off all the lights and watch Futurama until you're at the verge of passing out.
11:47 PM: Once again, you've forgotten to brush your teeth. You stumble to your bathroom to clean your teeth.
12:20 PM: You actually fall asleep. You dream of your adolescence underneath an instagram filter. 

Sadly, that's a pretty accurate description of my days.

Board Review Tuesdays (CramFighter)

Fact: I am "getting serious" with USMLE Step 1 (Boards) studying.
Fact: I am attempting to have a weekly segment discussing various USMLE Step 1 topics.
Fact: I am starting that segment today.
Fact: That segment will be called Board Review Tuesdays.
Fact: That segment is this segment, and I'll start to talk about boards right now.

I stumbled onto CramFighter at around 4 in the morning during winter break, waking up in a panic, realizing that I would be taking the boards in less than half a year. But CramFighter is actually amazing, not just an impotent comfort against the waves of panic attacks that now assault me on a fairly regular basis. It's incredibly comprehensive, it's stylish (rockwell font in the logo, I'm pretty sure), it's simple, and it does what I cannot do: It makes a definitive time-line of what to study.

Well, almost definitive. You can change the schedule at any time by clicking on the "edit schedule" button. And I've been switching my scheduling a lot. I originally decided to read 18 review books in total, do 2185 UWorld questions, and look over 100s (read: 200) of flashcards for pharmacology and microbiology. This would later prove to fail.

But the CramFighter approach is very helpful for people who are preparing for the boards not through on-line or in-person classes, but through reading. It has proven incredibly helpful for me, in that I've actually studied for the boards instead of opening up First Aid and then promptly closing it, putting it aside for tomorrow, eating dinner, and going to sleep.

Ah yes, CramFighter is amazing. But it's not definitive. You can change it at any time, editing your schedule in the following ways:

• Learning Resources you want to use (text books, review books, flash cards, practice questions)
• Time you want to spend each day of the week reviewing
• Order in which you review topics (both systems based and course based)
• this is actually its best feature: it can scavenge for topics in the various review books you own so that you end up reading, say, all you have on psychiatry at the same time
• Days you want to take off (holidays, catch-up days)

So I started off with 18 review books, 2185 Uworld questions, and about 450 flashcards. This proved unsustainable: I was going to end up reading over 70 pages per day and doing about 100 practice questions a week. 

That's terrifying. And after only successfully completing my readings 4 out of about 15 days (and cheating crassly) I decided to remove all my Board Review Series books, 7 in total. Now CramFighter is telling me to read about 30-50 pages per day, which is much kinder to my psyche.  And actually manageable.

Although I want someone to appreciate the fact that I will be spending 2 hours every day on nothing other than preparing for an exam I will take four months from now. 

Pros: Plans my "life" for me, keeps all my books in order, helps me study in the most efficient way possible, knows my name (see above: Hi, Elora!) and seems excited that I exist

Cons: The full version costs $7.99 a month (I'm just going to assume online study/review courses are much more expensive), there is no extrinsic motivation (although most medical students seem to have intrinsic motivation down). 

Overall Impression: They should make this for other large exams, like the Bar. I have no idea how law school works, but I can only assume something like this would be helpful for all major exams that are terrifying and include literally every little detail on an entire field of academia.