These Are A Few of My Favorite Things

Reading back through my old blog posts (because that's a really good use of my time right now...), I realized I have a bit of an obsession with naming.  Besides all the other names of diseases/procedures/etc. which I have proclaimed to be my favorite name, I have two new favorites:

The first is Rickettsia rickettsii, the bug so nice they named it twice! (It causes Rocky Mountain Spotted Fever, a disease endemic to the East Coast, go figure.)

The second is a finding in syphilis called the Argyll Robertson pupil aka the prostitute's pupil - the pupil constricts with accommodation, but not in response to light.  So it accommodates but does not react, and has syphilis.... just. like. prostitutes.

Practice Questions

When I get a question wrong but I understood the concept, I give myself credit in my head.  "Ok, ok, you forgot that gentamicin was an aminoglycoside, but you totally knew that aminoglycosides cause ototoxicity, and that's what the point of the question was."  So let's assume I got that right.  In fact let's just assume that the 55% I got on the most recent question bank is closer to an 80% (just to be safe).


But in the opposite situation when I have no freaking idea what the question is even asking, and I happen to blindly guess the right answer, I totally still believe I deserved to get that question right, and not only do I certainly not lower my score in my head, but I even give myself an extra pat on the back for my clearly superior random guessing skills.


With the USMLE World questions, they also tell you what percentage of people picked each answer choice.  So if only 30% of people picked the correct answer, and say 40% of people chose the same incorrect answer that I did - well, I get credit for that question too (in my head), because oooobviously the majority can't be wrong (yeah, yeah 40% isn't a majority, you know what I mean though).

Mood Swings

I don't know if it's the constant flow of information into my brain, the amount of hours I spend by myself, the soul-sucking USMLE World practice questions, or what ....but lately the littlest things have been able to set off either a state of euphoria or just as easily reduce me to tears and foot-stomping.




 The other day I thought of the BRILLIANT idea of melting swiss cheese on an english muffin for breakfast (as if it's even an original idea..) and I was so pleased with myself that you would have thought I had just found out I won the lottery and that this guy to the left was going to serve me breakfast in bed followed by a shower of diamonds (because apparently that's my fantasy).





Now fast-forward 4 hours later and it was time for a real study break (as opposed to all the mini-breaks I take constantly).  I sit down to watch some TV and CAN.YOU.BELIEVE.IT, any channel I was interested in watching had a commercial on.  Naturally I took this terrible disappointment as a personal affront, decided God was probably out to get me, and realized I was definitely going to fail Step 1.

And that is how Step 1 studying has turned me into a crazy-pants.

How I constantly feel. Welcome to my life.

More People Who Aren't the Same

I would like to clear up what I can only assume is a very common misconception.  Courvoisier's Sign (you know, an enlarged but non-tender gallbladder) is in no way related to the cognac (or even Busta Rhymes)!!  I know!  Mind-blowing, right?!

Ludwig Georg Courvoisier was a biliary surgeon from Switzerland while Emmanuel and Felix Courvoisier were a father and son from France who supposedly served their delicious cognac to one of the Napoleons.  Try to keep them straight in your head - you never know what will show up on test day.

Nail Update

My nails have been TERRIBLE.  I used to think I just bit my nails all the time, and it wasn't really a stress-related thing.  But it's definitely both.  I do bite my nails all the time, but I also definitely destroy them with a lot more vengeance when I'm stressed.  Also sometimes studying is so boring, so boring that biting my nails becomes more interesting than anything else.  I've seen comics about how even staring at walls suddenly becomes interesting when trying to study.  Well biting my nails is my staring at walls.

You are definitely not getting a picture update because they are gross, and I can barely look at them, nevertheless take a picture of them for the world (yes, the world, that's how popular I think I am) to see.  I did buy a bouncy ball at Duane Reade yesterday and here's to hoping that playing with it will help me stop at least a little (if nothing else, it should really make my downstairs neighbor become more fond of me).  Otherwise maybe I should invest in a nicotine patch.

my savior?

My Step 1 Study Sources

Just in case I do absolutely fantastic on the boards (or I guess also in case I totally bomb them), it might be nice to know what I am using to study.  In my past I have had a SERIOUS problem of too-many-sources-itis, a fairly common disease in which one buys lots of expensive text books and review books and thinks one must read all of them, and therefore learns none of them to the degree of detail necessary (physiology's Rhoades and Bell was the worst book-buying decision I've ever made). 

For path and pharm this year, I learned my lesson and bought NO textbooks.  I used only the lecture notes and some USMLE World practice questions, and that was it.  There was barely enough time to get through the lecture notes before each exam - having more things to read would have been a serious added stress!  And the strategy worked out pretty well.  While I'm sure there were some facts that I didn't learn for each test, I knew enough facts to do well.


For Step 1, there are at least, AT LEAST, one billion review books.  Now, I don't think anyone is stupid (cocky?) enough to try and use real textbooks during board review time.  But even just having more than one review book to me is stressful (there are many people who would disagree me on that one).  I think that everyone agrees that First Aid is the Step 1 bible.  Where people disagree is if it's really enough or not - some people say if you know First Aid inside and out, you're fine - others say it's not sufficient.  Whether or not those others are right, I don't think I can learn First Aid inside and out PLUS another book (or more) inside and out in 6 weeks.  And I think throwing more review books into the mix will make me learn each of them worse, and my personal opinion is that it's better to learn at least one book really really well (for me, I repeat, for ME it is better).

Goljan (he arm wrestles)

Of course, just reading a book is not nearly active enough, and also not integrative enough.  So I am also using the Kaplan High Yield lectures (they were changed this year to more closely follow First Aid, and they basically read the book to you, with a few extra facts or integrations here and there), and of course Goljan's pathology lectures.  I'm assuming anyone in med school past or present knows about Goljan.  But for those that don't - UCH.  I hate him.  I do.  I think if I ever met him in real life I would absolutely hate him - he's incredibly cocky, he's a little sexist, he's a lot condescending.  But he writes review books and gives review lectures and they are AWESOME, and you are at a huge disadvantage if you haven't listened to his lectures (so I've been told).  So I listen to them (begrudgingly).  And of course the number one source is practice questions from USMLE World.  The Kaplan High-Yield series comes with a question bank also, but I only plan on doing those questions after I have done the UWorld questions enough times that I can get the answer without even reading the question.

That sounds like a lot of sources after I just said I only want to use one - but the Kaplan lectures are basically a reiteration of First Aid, and the UWorld questions are practice questions.  So my main sources are First Aid and Goljan lectures with lots of practice questions.  I'm not using Kaplan's MedEssentials, Rapid Review, BRS, Deja Review (although I really like the cleverness of their name), or any of the other books that are out there, although I'm sure there are many great ones.


I do have one exception though:

I've heard from a few (hopefully reliable) sources that knowing neuroanatomy really really well can be the difference between a good score and an amazing score.  Apparently there are lots of pictures on the test so if you know the anatomy well, you can figure out the lesion/defect/whatever without even having to think about it or figure anything out, and what might otherwise be impossible points become easy points.  So I also bought High Yield Neuroanatomy.  I also am in possession of Clinical Neuroanatomy Made Ridiculously Simple - but I think I'm going to stick with High Yield for now (and maybe in some miracle alternate universe when I'm days ahead of schedule, I'll also read the other one).





Now even in those 20 seconds of searching the internet for images of these books to post I just stressed myself out SO MUCH because the sites that came up are all blogs on how you have to use Rapid Review, or you better be using a text book or lecture notes to fill in First Aid's gaps, or you better get a 280 on Step 1 or you might as well die, or you should have started studying 3 years ago, and other good advice of that sort.  Ahhh.  Enter self-doubt! 

I need to stay away from the internet and keep repeating to myself that my method will work, and really I just need to study instead of stressing about studying!

My Study Space

I recently moved to Jersey City.  I can't even begin to tell you how good it's been for my mental health to not be living in Newark anymore (sorry, Cory Booker - I'll happily move back if you marry me).  I felt very strongly about moving before second year classes ended so that we (Jenna and I) would be nice and settled before board studying began.  I love the new apartment for lots of reasons (reason #1 being washer and dryer IN the apartment - well, no, reason #1 being that I no longer live in a dorm), but it's also really conducive to studying.  Lots of windows and light plus a big dining room table where I can spread out all my study crap.  We each have a desk in our room too for a change of study atmosphere (or quiet alone time) when needed.

While I'm trying hard not to be obsessive-compulsive about studying (first of all, I can't with the construction going on across the street, and second of all, that's just not healthy), I think having a comfortable place to study is really important.  Plus I've been trying to pretend that my dining room is an office I have to go to each morning so I don't feel like such a lazy bum who never gets out of pajamas or goes outside - so I try to get dressed and eat breakfast before I go and sit down there, and I do things like eat lunch and dinner and procrastinate somewhere else (across the room on the couch).  Except for facebook, gchat, and reading Dear Prudence columns on Slate - I do those right in my "office" - don't tell my boss.  I do recognize that this does not fix the whole not-going-outside thing, just the lazy-bum-in-pajamas part.


So without further ado, here is my Step 1 study enclave:

Note: Bag of chocolate chips not a necessary part of the study atmosphere, but they certainly don't hurt
Second note: Buddha is good luck

Step 1?

Soooo I may have missed one or two all of the blog posts over the last few weeks.  Ironically, I've actually been less stressed in the last few weeks than I think I've been all year.  But having free time and doing normal people things really made me not want to write blog posts.  And so I didn't.  I'm sorry.  Hopefully absence made the heart grow fonder, and you're ready to accept me back with open arms (Open eyes? Since you're reading the blog and all?). 


Well second year is finally done.  I chose not to write any posts during our statistics and epidemiology class, but that happened.  And now it's over!  My classroom learning is ovaaaah.  We have six whole weeks of NOTHING to study for Step 1.  Finally finally we can just study, with no other distractions, nothing else to do all day every day but study, no other excuses, nothing else to take our time away.....

Ahh!  The freedom is paralyzing!


So in the interest of not-wanting-to-study, let me explain more.  USMLE stands for the United States Medical Licensing Exam - we take Step 1 now, Step 2 during fourth year, and Step 3 sometime during residency after which I can become a board-certified doctor.  Sooo, I'm clearly well on my way.


I'm also completely unoriginal, as there are about 20 million blogs out in cyberspace about how and what med students have used to study for this massive test.  My blog is different mainly because it's written by me (and therefore better ....just kidding-ish).  In no way, shape, or form will I be giving study advice (I'm talking to you, future readers who google "step 1 blog" or "step 1 study advice") because what the heck do I know?  I also am giving up on my Tuesday-Friday posting schedule, and from now on will be writing posts when and if I have something maybe interesting to say and actually have time to say it.

So for now, I guess I go study.  I'll let you know how the whole don't-procrastinate-have-discipline-and-just-freaking-study thing works out.

Also, who wants to talk about the season premiere of Game of Thrones?