the other side (& suggestions for step 1)

Step 1 of the boards, it happened.  Early last week.  And, in typical, John and Anna fashion, we thought SO much would get done since (house clean-up, stack of papers waiting to get finished, catching up with old friends)…our hopes are always so much bigger than realistic possibility.  Now When I finally started writing this post, we were at the beach with some of our oldest heart friends, having just celebrated the marriage between Liz and Zach (more soon!), and I cannot believe we’re already in the middle August.

I wanted to dedicate at least one post to this bitch of a test I just completed.  If you google something along the lines of “step 1 advice,” you will find a string of blogs written by students who would be heart-broken to not break 260 (for those not in medicine, that’s like top 99.9th-percentile), and several written by others praying to scratch 190 (barely passing).  As one might assume, the study schedule/tips for both is overwhelming and intimidating.  To my understanding, I am in neither camp.

In the six weeks that I studied for this exam, I learned a lot.  Probably 30% of what I learned was either interesting (I had no idea of some of the inheritance patterns of Downs syndrome [germline mosaicism]) or helpful (relearning the contraindications of statin therapy in a patient with high cholesterol), at least 65-70% was not (do I really need to know the three different multisyllabic names for each enzyme in the heme synthesis pathway?  will I ever even see a patient with porphyria?).  Some days I studied effectively/productively, most I did not.  While many of my classmates secured 8-14 hours of good studying in daily, I probably averaged around 6–life (and shit) happens.  All this is to say, if you want advice on how to crush the boards, this blog should probably not be your only resource.

If you would like some suggestions on how to not lose your mind in the process (though I can’t promise there won’t be temporary lapses in sanity), here are the three suggestions I received from friends and family that I found benefited me the most:

1. My friend and classmate Alex provided the following: Bring a two burritos.  It’s a day-long test.  In between sections you’ll feel a little beaten down–but then there’s a burrito waiting for you in your locker!  Unfortunately, I can’t eat gluten, but I did stock my locker with probably 3,000 calories worth of gluten-free goodies.  I remember during the MCAT not having the stomach to touch any of the food I brought.  But the first of seven sections of step 1 left me feeling like I had sustained a dementor’s kiss, and having both a GF brownie and a stash of chocolate available helped me find happiness.  (If Remus Lupin’s advice is ever wrong, I don’t want to be right.)
2. From John: You can’t go in scared; go in ready to destroy!  I took the SAT twice, the GRE once, and the MCAT three times.  I taught several MCAT prep courses and tutored many other students privately.  So I believe I can speak with some authority: while you have to know your shit to do well on these tests, you also have to be confident.  There is absolutely a psychological component to performing well on standardized tests.  I can’t say that I ever felt 100% confident, so I recruited loved ones to help out.  Nothing gets me more pumped than a last minute text message from John: “I love you, I believe in you, you worked hard.  Be proud, be confident.  Nom, nom, NOM!!!!!”
3. From me (substantiated by Emilia, Ellen, and Ari [med student, not daughter–though I’m sure she’ll agree]): Once you start the test, do not go back and check your notes.  Do not think about looking up answers after leaving the testing center.  Focus your mind instead on how you’re going to celebrate the marathon completed.  When I took the MCAT for a third time, I almost canceled my score.  The only reason I didn’t was because I had planned a huge party in celebration following.  It feels like the entire month of August is my celebration, filled with weddings and beaches and excursions.  But I also had some very specific occasions that recognized what I had just completed.  When I got home, John and Ari had some of my favorite flowers waiting for me, and John had chilled a bottle of champagne we had brought back from Israel.  We ate steaks and I later vegged watching Gilmore Girls reruns–it was glorious! And this week, Ellen, Christina, and I toasted whiskey smashes and respective drinks at Hop Sing Laundromat.  It felt so luxurious hiring a babysitter, slipping on a dress that was not nursing-friendly, taking a train into the city, and getting tipsy with girlfriends.  Some variation of the above should be a post-step 1 mandate.And now we’ve drastically reduced Ari’s daycare hours, to allow for a lot more of the following (cuddling, and coffee to be sipped and not guzzled–thanks Matt!):