Monday, October 5, 2015

USMLE Step 1

How do you say it in Espanol? Si se puede? (Unrelated to the topic, but are this guy's eyebrows amazing?)

The workload is very nearly killing me, but it's killing most of my cohort mates even more than it is killing me. Most people who have survived up to this point (we've lost a total of six from our cohort since starting, which is, I've been told, lightly higher than the mean of students to have departed at this point) will ultimately make it through school, and the vast majority should past this exam, which is the first portion of the three-step United States Medical Licensing Exam, although my program has a much higher-than-average acceptance rate because it is a relatively selective program. scores on this test, in addition to allowing us to advance in our programs, will be weighed heavily in our gaining access to quality residence programs.

This is presumably the final exam I'll take in which what was learned in undergraduate studies -- science courses in particular -- would still be considered relevant. After this, what we learned as undergrads impacts our ability to master the new material, but said content no longer in and of itself will be needed.  I'm confident of my ability to master the new material; however, up to this point, my grasp of undergraduate science courses been a major advantage against my peers, and I'll lose some of that edge even though we're not theoretically a competitive program at this stage.

It doesn't help me in the least for anyone else to do poorly, but even if it did, failing this test is not something I would wish on anyone in my program. We've all worked too hard to be bounced now, although most people who fail will just put in another year and repeat a few courses, then take the exam again. A five-year program is actually recommended for most students, although the majority of us will not follow that recommendation unless we're forced to do so by non-passing scores.

Some of what we're hearing about in lecture will help us, but a whole lot of the subject matter covered on the test  is ancient history. Some people like to clear their brains of everything ever learned in a given course once they finish it, but the science portion of our undergrad studies is crucial to scoring well on this test. Fortunately for me, I couldn't forget what I've already learned even if I tried.

We'll take two more steps of this test after the once we're presently facing. The next one will be near the end of Year 4 of med school, and is a bear of a test, part of which will involve preliminarily diagnosing and writing up findings, including the ordering of tests,  for ten actors posing as patients. I fervently hope the actors they have are better than the ones here. I'll go to Los Angeles to take it, where out-of-work actors abound.  L.A. should have the cream of the crop in terms of actors unless all the actors are from L.A. and fly out to the respective sites. (There are a total of five testing sites in the nation for this portion of the exam.)

The final step of the USMLE is taken after the first year of residency. It determines who will be licensed to practice medicine.

We still have the usual tests in our classes, but then we have this behemoth hanging over our heads, as in we can do tremendously well on our work in class yet still be held back another year by a poor showing. The makers of this test claim it doesn't measure one's ability to take tests but actually measures one's knowledge of subject matter.  I  find that claim just a bit incredible, yet still I plan to show up for the test as well-prepared both in terms of knowledge of subject matter and in regard to test-taking skills as humanly possible. If it's so easy to eliminate test-taking skills from relevance in any test, why have other test makers not consulted the makers of this test to find ways of minimize the effects of test-taking skill in their own tests?

I suspect test-taking skill will always be relevant, yet not so much as to to allow anyone to past this test on test-taking skill alone. Still, I will hedge my bets by taking the Kaplan course in addition to the insane amount of studying hours I'm devoting to this cause.


  1. I'm sure you'll do well. Bill often talks about how hard his classes are; then he gets As. I don't envy the stress of having to prepare for the big exam, though... and I wonder how students from less prestigious med schools do. I met some med students when I was a social work student and while they were reasonably bright, I didn't think they were brilliant. I presume most of them are doctors now.

  2. Even in my med school not everyone is necessarily brilliant, although I suspect almost everyone either is bona fide brilliant or is an extremely hard worker. some are both. But in some of the more obscure schools, they probably filled a few slots with people they found under rocks or similar places. Some schools are glad to take those students' money for a couple of semesters before kicking them to the curb.

  3. After talking to many Penn students in cabs, the student doctors were the smartest. To even to get into Penn, you have to be brilliant. I had some great conversations with them. It just occurred to me. You would be a great professor of medicine.

    One woman said she was getting a doctor's degree from the school of medicine. So I said that she was going to be a medical doctor. She said "no." She said that she was getting a doctor's degree in parasitology (the study of parasites). I just saw an excellent show on it on PBS.

    So I started a long discussion on it. I asked her what animals kills the most humans. Do you know, Alexis? She said rodents. I said the answer is mosquitoes. She said she forgot that a million die of malaria. There are many diseases you can get from mosquitoes. Wikipedia says "Nearly 700 million people get a mosquito borne illness each year resulting in greater than one million deaths."

    A little history: New York and Paris had epidemics of malaria until quinine was created. Wiki. also says "Quinine occurs naturally in the bark of the cinchona tree, though it has also been synthesized in the laboratory." When I was done talking to this woman I said "I love talking about parasites." She said "I do too. That is why I am going to do it as a living."

    To comment on what Knotty says, the late Dr. Wayne Dyer says that there is no such thing as stress, only stressful thoughts. To demonstrate this, there were many people that were very upset on 9/11. But they showed people in other countries dancing because of 9/11. They thought that it is great that God had killed the evil Americans.

    I will tell you what is the greatest thing, You are alive! Behold life!

  4. I have a question for you, Alexis, since you have a great command of the English language. Under Dept. of Health & Human Services it says "A botanical is a plant or plant part valued for its medicinal or therapeutic properties, flavor, and/or scent. Herbs are a subset of botanicals." It says when you click on herbs "A plant used in cooking, in tea, and for medicinal purposes." Does this mean that curcumin is a botanical but not a herb like turmeric? Actually what I wanted to find but could not was if the law required to use the part of the plant used on the label like if it says ginger does that mean the root or another part. I guess quinine is a botanical but not an herb.

  5. My understanding of botanicals is that they are anything derived from plants and used as additives. I would think curcumin would be both an herb and a botanical, much as a given polygon can be both a square and a rectangle.

  6. I know you will kick butt on the test. I also think the guy in the picture has amazing eyebrows. They probably keep the rain off most of his face.

  7. Thanks, Alexis! There is nothing wrong with the word 'masticate' but it sounds like another word. In a presidential election a guy lost since his opponent called him a thespian & heterosexual involved in a monogamous relationship. If you run, when you are older, they may call you a thespian & heterosexual involved in a monogamous relationship. If you win, will they call you Mrs. President or Dr. President?