Tag Archives: Third Year

Step 1… Closer to Being a Doctor

It’s been quite a while since I’ve written anything on this blog, and I’m sorry about that. I had to make a decision back in January, and it was really tough. Do I…..

1) Study really hard all day and every day for Step 1 so that I can become a doctor.


2) Continue to blog, increasing my status as an internet celebrity and cementing the love that both of my readers have for my writing (and one of them is still my mom).

I obviously went with the first option. I studied long, hard, cold days for that stupid test, and I’m here on the other side of it with a majority of my sanity intact. If you are here to read a little about the test, skip on down a few paragraphs for my take on the exam and studying. Sadly, studying for days and days on end does not lend itself well for blog posts. Frankly, nothing interesting really happened. My wife did a bunch of fun stuff, and I made sure to get out and do things in the world on a weekly basis, but the vast majority of my time (even weekends and evenings) was spent in the library or at my desk.

I received my score a few weeks ago, so I am past the nervous period of waiting for those 3 digits (hopefully 3 digits, I’d hate to be the first guy to score less than 100!). I did ok, but I feel like I was capable of scoring higher, which is a little frustrating. I would straight up just tell you guys what I got….but you know, it’s the internet, Obama, NSA, etc. I’ll just say I scored a little bit below average, which is kind of my place in the world of medical school. Not really dumb, but also not smart. It’s a good enough score for most of the specialties I am interested in, but it makes some of the competitive specialties more of a reach (orthopedics, for example). Thankfully, I’m not a super gunner (see below for explanations of new words) and I’m not trying to become a plastic surgeon at the Mayo Clinic, so my score should be just fine. To compensate for my subpar score in the dating scene that is residency applications, I plan to make sure programs know that I also have a terrific personality.

So how specifically did I study for this test? First Aid, UWorld, SketchyMicro, and Doctors in Training. Before you copy those down as bullet points, you need to read the next sentence. Figure out how YOU learn as a student, and tailor your studying to that. For example, if you don’t learn well from videos, don’t buy Doctors in Training, because you’ll just be wasting your time. I’ll run through these resources in order of importance:

1) Uworld – this is a giant question bank (2200+) that closely resembles the questions on the actual test. You simply must do the entire bank of questions. Don’t procrastinate doing these, either. Start early, take notes, and review your answers. This is as close as you can get to the actual exam, so spend a lot of time here.

2) First Aid – The Step 1 Bible, everything important can be found here once you learn where to look. Definitely have this open often. Definitely add information to the margins. Definitely never just sit and read this book. It’s not meant to be read. Because everything is in outline form, you won’t learn much from reading the words. It is useful to browse through sections to remind yourself of concepts you have already learned, but not very useful as a way to learn complex concepts.

3) Sketchy Micro- this is a series of cartoons drawn by some genius (who is also now rich). Each of the cartoons give you little memory aids for bacteria, viruses, etc. This is stupidly helpful, especially because I didn’t learn anything from out Microbiology course. It’s fairly cheap, quick and easy to watch, and I guarantee that it will add points to your exam. I hear they are also coming out with Sketchy Pharm for future tests, which should also be very helpful.

4) Doctors in Training – this is the least mandatory of all study options. First off, it’s pretty expensive. Secondly, it’s fairly time consuming. Last but not least, it’s pretty expensive. There are some advantages to it though. Let’s say you have your heart set on a specialty that is not competitive, so you just want to pass the test and have a score that starts with a 2. If you buy DIT, watch the videos, and fill in the workbook, you are going to pass the test. They do a good job covering material efficiently, and they have spaced recall built in to the workbook to help drill in some of the details. It seems like their motto is “If you don’t remember it the first time, you’ll remember it the 8th time”.

My last few thoughts on Step 1 are especially pertinent to students who didn’t do well (like me….just kidding). After just a month or so of clinical exposure, I’m beginning to realize how little anyone¬†cares about Step 1. I think it gets overhyped to second year students (at least it was to us). The material tested on Step 1 has very little clinical significance or correlation. Attendings and residents have been very emphatic that we are just now beginning to learn actual medicine. Finally, there’s a lot more that goes in to your residency app than your Step 1 score. If you want to be a plastic surgeon or dermatologist, you may want to work crazy hard and score well, but don’t freak out because you scored 5 points under the average for your specialty.

To close out this post, I need to include a little dictionary (for people like Mom) who may not be familiar with some of the “buzzwords” of clinical medicine. I will use these words frequently in future posts. This will be on the test.

Attending – this is an actual, fully licensed physician. They lead treatment teams and represent the light at the end of a long tunnel. The attitude of the attending often determines your fate as a med student. Good ones will teach well, have a good attitude, let you do cool stuff, and let you leave to go study. Bad attendings pimp you mercilessly, make you stay tediously long hours, are cynical and jaded, or just aren’t involved with anything going on.

Pimping – this is what happens when a senior team member asks questions to a junior member, usually in a pressured setting. It’s kind of like teaching, just scarier and with a lot more crying. Pimping can be aggressive, like an attending asking rapid fire questions to a medical student in front of everyone at rounds. It can also be helpful, like a resident asking you which structures you can identify during a surgery, then helping identify ones that you have missed.

Resident – these people do most of the actual work. Residents have graduated medical school but not finished the required residency. They are doctors, but don’t have the freedom (or responsibility) of an attending. Residents come in several flavors. Interns are fresh out of med school and are highly supervised. Each successive year past intern year, residents are given more responsibility until their final year, where they transform into the chief resident, who does everything. Residents work long hours, are not appreciated by anyone, and can be the best/worst part of your rotation on the service as a medical student.

Rounds – the sacred ritual of medicine. This happens once (or more) daily, and comes in a few flavors. Walking rounds are exactly what they sound like. The team walks from room to room. First they talk about a patient in the hallway, then they go and see that patient. Sometimes they just talk, then people see patients later, but you get the idea. Sometimes everyone sits down at a table and just talks about the patients. Sometimes rounds only take 30 minutes. Sometimes it takes hours and hours and hours. Students often present their patient(s) during rounds, giving an attending or resident a chance to pimp the student on that disease/treatment.

Tune in next time for ER stories, featuring the lady you got drunk, passed out while smoking, lit her mattress on fire, and had to be admitted for simultaneous burns AND being super drunk (at 10am on a Monday). Or, tales from OB-GYN, featuring the legendary lady with a BMI of 92. I’m more motivated to write when I see stuff like that on a daily basis.

Thanks for reading!