The timeline of all this stuff comes out through this blog if you read from the beginning, of course, but who on earth wants to do that? Thinking back on everything, and with prospective students I talk to, the entire process of becoming a doctor is frigging confusing.
In other news, after over a year of my mother's pleading, I have a new profile picture. Kagome is dead. I'm probably going to give her about a month of peace before I switch to Ed from Cowboy Bebop, because that's how I roll.
The cliff notes of what I've been doing:
-finish bachelor's of sciences in US while taking MCAT (difficult but moderately priced test)
-2 years of basic sciences in the Caribbean. A more clever blogger than I referred to this as the Bob Marley School of Medicine.
-USMLE Step 1 (giant expensive test)
-1 year of core rotations (internal medicine, pediatrics, surgery, psych, OB/Gyn, etc) at a hospital in Brooklyn;
-USMLE Step 2 CS/Step 2 CK (two giant expensive tests)
-1 year of elective rotations at varying hospitals (okay, still in BK; I'm lazy)
-Graduate with Medical Degree
-Obtain ECFMG certificate (that's a bonus for us foreign kids)
FWI, you're still paying for all of this at this stage. For the last two years, you work in a hospital, but you are a paying student.
During this time, you must secure a residency for when you are out of medical school or you can be a doctor all you want, but you can't practice. A residency is additional training, for which you are paid, and this is what trains you to your specialty. Anyone graduating medical school is a doctor, but only people completing a pediatric residency are pediatricians. The process of securing a residency (since everyone's applying for them at the same time) is called the Match.
The Match:
-September through February of last academic year, choose a medicine specialty you want to practice and apply through a paid central database to programs you select.
-During this time, those programs that want to interview you grant you dates for them. You attend as many as you are able
-Mid February: submit a rank list. This is your favorite programs in order from top to bottom of your preference. How you rank stuff is up to you... location, training, prestige, hotness of fellow residents, etc. The programs are simultaneously ranking you.
-February to March: The central computers match up (get it?) applicants to programs. Programs with unfilled residency spots lose thousands of dollars for having those spots vacant. Applicants with no programs are jobless for a year while their loans go into repayment. Stakes are high. The computer uses an algorithm that tries to match the highest ranking applicant to the highest ranking program. If Pediatrics at Tulane loves Lucy and Lucy loves Tulane, and neither Tulane nor Lucy love anyone more. Match. This takes a while.
-Third Monday in March: Black Monday. The computers release whether students have successfully matched. Location is not disclosed.
-Tuesday-Thursday: Scramble: A list of the programs with unfilled positions is released to the unmatched applicants and a predictable clusterf-- of frantic emailing, faxing, and calling ensues. Applicants may have to switch specialties and explore other geographic regions to ensure a job.
-Thursday: Match Day. At noon EDT, the names of the programs are released to the people that matched there. Most American medical schools have a large ceremony to commemorate this. Some friends and I are making our own.
The name and specialty that is released on Thursday is where you are contractually obligated to go on July 1st of that year to begin residency training. The first year of residency (which used to be more of a transitional year, though now there are still transitional years and preliminary years) is what most people think of when they refer to "interns".
Usually, after your first year of residency, you take USMLE Step 3 (giant expensive test).
Near the end of your residency, you take the board exams (massive excruciatingly expensive tests) for that specialty. You also start a version of the Match all over again around then if you're applying for a fellowship, which is yet another 1-2 years of training for subspecialty fields (like pediatric cardiology).
So there we go... a probably largely unnecessary "Becoming a Doctor for Dummies" guide. Now back to being excited for the big reveal in ten hours.
Showing posts with label USMLE. Show all posts
Showing posts with label USMLE. Show all posts
Mar 17, 2011
Aug 16, 2010
Oh right, the test...
This sort of thing gets weirder and weirder that farther you get in medical school, once stress gives way to apathy and exhaustion.
I got a Wii!! At long last! I can lately join the awesome gaming generation as my treat for finishing that 9 hour beast of an exam. I also had friends take me out to Chip Shop the next night so I could cram some deep fried Reese's and a few English pints. I'm not even sure which is worse for you, but I'll post from the hospital over whether my heart's failing before my liver is.
The exam... boy howdy is it long. Like LONG. Like kind of over any stress you were experiencing and "I wonder how many points I'd lose if I just went and saw a movie in the middle of this nonsense" long. The questions are long. The whole test time is long. The fact that you get 45 minutes of the day to do anything you need to do and it takes 5-10 minutes to sign in and out means it's long and you're hungry. Or dyspeptic from trying to swallow an entire peanut butter sandwich and then trying to shove it a sufficient distance down your esophagus by pouring Red Bull on it and hoping the bubbles will dissolve some of it. Hell, the stuff tastes like battery acid anyway; it should make some headway.
I took it afternoon until night, as I mentioned, which was awesome, though I closed out the place, and lo and behold the place is right across the hall from the offices for Air Jamaica, which is nice because I guess if you do badly enough, they can send you straight back to Grenada without ever letting you set foot on New York soil again.
To be fair, the people at the testing center were really nice, very chill, and the temperature was good. I was able to bring my own foam earplugs (call ahead and ask your center) which is great, because the silencers provided are identical to the ones that they use at shooting ranges which makes them heavy and tight on your skull. Good for drowning out the .45 in the next booth. Overkill when you're trying to think while drowning out the keyboard sounds in the next booth.
Despite the preventative measures, I would recommend taking as many breaks as feasible. Get water, go to the bathroom, cram some calories and get back in. Stretch your back and legs, make a Home Alone face in the mirror, chuckle to yourself and go for round 2, 3, 4, 5, 6, 7, or 8.
Don't overthink the questions because they give you a lot to overthink. If it seems right, just pick it. If you're clueless, pick the most likely (eliminate the obviously wrong) and move on, mark it later.
Getting in and out is starting to encroach on the airport's turf for security overkill. I had to get frisked before going back into the testing center each time, and though she did the job right in front of the security camera, I have a feeling the girl responsible for feeling me up felt as ridiculous about it as I did. That made me feel better about the whole thing. They didn't make me take my shoes off though.
Looking back, I don't really know what I would have done differently studying-wise. It seems like any moment I didn't have my head buried in UWORLD questions was a wasted one. There were still a lot of wishy washy weird judgment call questions, but I don't think any resource could really get you ready for them.
How do I think I did? Geeze, I have no idea. I think I passed, but once I'm getting below an 80 on a test (which I'm guessing I did on this one), I have *no* clue how I do. My mom's set on 261, which I think is about as probable as my riding into a residency at UCSF on the back of a unicorn, but it's a nice thought.
Also, with the exception of recalling some questions almost in entirety (though I was better about that on Step 1), I get massive testing amnesia. I go in... I vaguely remember things like "Oh, block three was really sticking it to me" and "Oh crap; out of time" and "AAAHHHHH MATH!!!" and then I walk out nine hours later feeling puzzled, brain-enema'd and occasionally vurping up bits of Red Bull. I wonder what happened. I go home, watch Futurama and go to sleep. I party the next day and then I sleep solidly for the two after that. Not hungover; not wildly stressed; just completely mentally erased.
So there you have it folks. Taking Step 2 CK is like getting roofied, waking up hours later with a hangover and your kidney missing and the only clue left behind is a note someone's written in lipstick on the mirror and it says "Your testing session for USMLE Step 2 Clinical Knowledge has ended. Thank you for participating in the United States Medical Licensing Examination. Close. (follow the white rabbit)"
And you're just surprised you can still read.
I got a Wii!! At long last! I can lately join the awesome gaming generation as my treat for finishing that 9 hour beast of an exam. I also had friends take me out to Chip Shop the next night so I could cram some deep fried Reese's and a few English pints. I'm not even sure which is worse for you, but I'll post from the hospital over whether my heart's failing before my liver is.
The exam... boy howdy is it long. Like LONG. Like kind of over any stress you were experiencing and "I wonder how many points I'd lose if I just went and saw a movie in the middle of this nonsense" long. The questions are long. The whole test time is long. The fact that you get 45 minutes of the day to do anything you need to do and it takes 5-10 minutes to sign in and out means it's long and you're hungry. Or dyspeptic from trying to swallow an entire peanut butter sandwich and then trying to shove it a sufficient distance down your esophagus by pouring Red Bull on it and hoping the bubbles will dissolve some of it. Hell, the stuff tastes like battery acid anyway; it should make some headway.
I took it afternoon until night, as I mentioned, which was awesome, though I closed out the place, and lo and behold the place is right across the hall from the offices for Air Jamaica, which is nice because I guess if you do badly enough, they can send you straight back to Grenada without ever letting you set foot on New York soil again.
To be fair, the people at the testing center were really nice, very chill, and the temperature was good. I was able to bring my own foam earplugs (call ahead and ask your center) which is great, because the silencers provided are identical to the ones that they use at shooting ranges which makes them heavy and tight on your skull. Good for drowning out the .45 in the next booth. Overkill when you're trying to think while drowning out the keyboard sounds in the next booth.
Despite the preventative measures, I would recommend taking as many breaks as feasible. Get water, go to the bathroom, cram some calories and get back in. Stretch your back and legs, make a Home Alone face in the mirror, chuckle to yourself and go for round 2, 3, 4, 5, 6, 7, or 8.
Don't overthink the questions because they give you a lot to overthink. If it seems right, just pick it. If you're clueless, pick the most likely (eliminate the obviously wrong) and move on, mark it later.
Getting in and out is starting to encroach on the airport's turf for security overkill. I had to get frisked before going back into the testing center each time, and though she did the job right in front of the security camera, I have a feeling the girl responsible for feeling me up felt as ridiculous about it as I did. That made me feel better about the whole thing. They didn't make me take my shoes off though.
Looking back, I don't really know what I would have done differently studying-wise. It seems like any moment I didn't have my head buried in UWORLD questions was a wasted one. There were still a lot of wishy washy weird judgment call questions, but I don't think any resource could really get you ready for them.
How do I think I did? Geeze, I have no idea. I think I passed, but once I'm getting below an 80 on a test (which I'm guessing I did on this one), I have *no* clue how I do. My mom's set on 261, which I think is about as probable as my riding into a residency at UCSF on the back of a unicorn, but it's a nice thought.
Also, with the exception of recalling some questions almost in entirety (though I was better about that on Step 1), I get massive testing amnesia. I go in... I vaguely remember things like "Oh, block three was really sticking it to me" and "Oh crap; out of time" and "AAAHHHHH MATH!!!" and then I walk out nine hours later feeling puzzled, brain-enema'd and occasionally vurping up bits of Red Bull. I wonder what happened. I go home, watch Futurama and go to sleep. I party the next day and then I sleep solidly for the two after that. Not hungover; not wildly stressed; just completely mentally erased.
So there you have it folks. Taking Step 2 CK is like getting roofied, waking up hours later with a hangover and your kidney missing and the only clue left behind is a note someone's written in lipstick on the mirror and it says "Your testing session for USMLE Step 2 Clinical Knowledge has ended. Thank you for participating in the United States Medical Licensing Examination. Close. (follow the white rabbit)"
And you're just surprised you can still read.
Mar 28, 2009
So that's the USMLE
Uhhh... geeze... What to say... there's so much and so little, and I want to make sure to break the silence of "just having taken the examism".
I was looking for USMLE experiences online, but a lot of times, it's like take the exam... and drop off earth. For good reason. Everything's been pointed to that day and then it's not. And then you have to realize you need your health forms in and your stuff finalized and there's all of that. And there are some experiences, but still, it's this big unknown looming beast, and there's so much hype on it, and so many pro tips on it (Kaplan, Falcon, etc) that it's almost like the hype becomes not real and you start wondering what it's *really* like because they're not going to use these buzzwords or test you on that disease you've seen fifty billion times in med school so it's become something *everyone* knows.
Oh, study it, by the way. If Goljan says it five times, then freaking know it. If it's common knowledge among medical students, then know it in obnoxious detail.
The other problem is the exam has an, on paper, incredibly rigid "do not tell people what's on the test" policy... and since this exam determines the whole future thing, and since there's frequently a blackout on information for the final run, I know for me that creates an intense paranoia. What does "don't share info" mean? Obviously it means don't mentally recreate the question and its 20 potential answers the second you get out of the exam and post them on the internet.
Though it doesn't say anything about trying to wikipedia the answers to 336 questions immediately after, because as we all know, that is awesome for your mental health.
But don't discuss the exam during the exam with other examinees, though I've heard you're actually allowed to have the First Aid in your locker and study it during breaks (I didn't confirm that since I had no intention of doing something that was that absolutely likely to give me a panic attack so it was irrelevant anyway), so I'm not sure what discussing it with other examinees (most of whom, I believe, are taking the SAT) would accomplish. Particularly since I think even the USMLE forms are completely different.
Does this mean you can't focus on any topic? What *types* of questions were hard? Is saying "the part of the exam where there was stuff from medical school" taboo? Honestly don't know. So I'll start classically, with what I did, and then talk about what the exam was like.
I also have no idea on where I stand versus where other people stand on study:test. The standard schedule seems to be 8 hours a day and 10 in the final crunch, which made me feel like an utter failure if I didn't spend 8 hours of every day painstakingly copying out the First Aid (this is just the horrendously inefficient way I study, and no, I don't read the notes later, nor are they legible. I just fill notebooks and throw them away!)
It seems like everyone's schedule is "Day 1: Read 600 page book of high yield physiology equations Ishie didn't make it through in 3 months of physio. Lunch. Afternoon: do 700 USMLE World questions. Average 90% Copy all explanations from all 700 questions into arranged notes that have been cross referenced and typed out by subject headines. Read 50 pages of First Aid. Work out for an hour. Attend to my personal hygiene. Get to bed by 10 PM and wake up at 6 AM.
Which *was* my planned schedule, which evolved into
"Week 5. Contemplate the fact you haven't made it all the way through First Aid because while pharm only seems to take most people 1-2 days, it's been 6 days and you still can't keep adrenergic antagonists straight. Wikipedia a disease condition you found in First Aid and were unsure of and plagiarize a three page dissertation on it into your notebook before realizing FA had summarized the highlights in two sentences. Get distracted by an adjunct wikipedia page and follow the Wikicrastination chain until you end up on the mating habits of bonobos. Google "effective USMLE study strategies". Watch old episode of Scrubs. Consider the fact that the residents get pimped in rounds during the first season to be "studying" because you know what C-peptides are. Realize three hours of your life has gone by without doing anything. Check facebook. Realize how much others are doing. Panic. Write out First Aid adding notes in a desperate frenzy until 5 in the morning. Realize you haven't done any questions. Do questions until 6 in the morning. Pull up score. Contemplate career change. Read explanations. Write in the first 10 in detail before hitting a question where 9% of respondents got it correct. "Say 'no one could ever freaking know that!!!' " and skim the rest of the explanations Realize the sun's up, and the chances of getting going by 8 AM are slim. Listen to Goljan as you're going to sleep... realize you're still up. Watch Red Dwarf. Contemplate whether you should try to take a shower before going to bed at 8 am, and decide it can wait. Swear to yourself you're going to get up earlier the next day to keep to your "plan". Wake up at 3 PM. Repeat.
And so forth.
Will it prove fruitful? Who knows. I certainly wouldn't *recommend* it as a study strategy because no matter what score it nets, it should be subtitled "how to live at such a high level of stress and self loathing that you forget how to experience happiness. Or panic anymore. So I suppose that last thing is good.
But the exam... ah, thought I wouldn't get there, eh?
Dibasic's tips are pretty spot on and reflect what other people have said. Oh, especially that 5 minute break after each section. You only get 45 minutes for the whole day so plan ahead. I took one after every section, avoided looking at any notes at all, and pretty much used the opportunity to get up, sign out, use the restroom, get water, possibly calories, at one point a Red Bull, sign back in, and log back in. Even though the testing facility was over an hour away, I drove it in advance and told you about that.
Got there about an hour early and went over microbio flowcharts I'd made and scanned a last minute antimicrobials in the First Aid since the ones without mnemonics really trip me up. They came in around 7:30 and I wandered in. They were quite friendly, and though it was clear it was a whole closely monitored environment, I didn't get the whole grim reaper vibe some proctors give off.
There are lockers you put your stuff in. ALL of it. No water bottles, watches, jackets, etc. Turns out no earplugs either. Whoops. I saw a "USMLE allows earplugs!" thing and thought it was current, but it isn't, so I got mine taken after my first break, but the lady was really nice about and didn't come in and nail me during the exam portion or any of that, so it didn't add to the stress levels.
There are noise canceling headphones, which turned out to be all right though at first they seemed like they were going to be tight and give me a headache. The room itself was pretty quiet, but I am the tightly wound type. One drawback is that noise cancelling headphones are WAY better than earplugs at amplifying your own heartbeat, so I got to do the test to the tune of "Lub dub lub dub lub dub... hmmm... this question sucks LUBDUBLUBDUBLUBDUB".
See how unstable I am?
Uhhhhhh, without going into "put marks on my record so I can't be a doctor ever no matter what I get", the exam is somewhat destabilizing, because some of the questions are ridiculously hard, but here's the kicker, some are RIDICULOUSLY easy. Oh, not many, don't get me wrong, but you do hard and medium questions and BECAUSE of that hit the easy questions and spend an eternity on them because you're going "No... there's a twist here." Once they hit a pattern, I'm also wondering if the easy questions are part of the "HOLY CRAP I FAILED MISERABLY" post-test reaction, because as I first walked out, it was like gut-punch, but I think a lot of the easier questions fly by and then you hit a hard one and you slam your self esteem into it like a car hitting a deer. Either that or I failed it so badly it's completely beyond me.
Oh, speaking of eternity on questions, be careful of the automatic log out feature that calls an "UNAUTHORIZED BREAK!" and flashes a red screen.
How did I know that? Uhhh... somehow spent 5 minutes on a question (bad time management, bad!) and was looking down intently at the laminated sheet I was scribbling on and then suddenly something flashed and it said "Unauthorized break". Which I figured meant "And now even though you've done six sections, we will cancel your exam and send your profile to the feds", but so far it seems to just mean that you have to log in again. And I actually knew about the unauthorized break thing, and still hadn't realized I'd spent 5 minutes on a question. Nothing feels like enough time, and then I found myself feeling like for some questions I was 'half assing', because it was a sacrifice of one question for five. And I did finish all questions though pushed the buzzer on all sections and one, I cut 8 seconds from end of block. Whew.
I ended up finishing fairly short of my scheduled time, I think due to starting early since my "time for the day" clock was running really low. I ended with five minutes of break time left, largely due to there being no clock in the lobby and being intensely paranoid because if your break time cuts into your exam time (the computer tells you at every stopping point how much total break time you have left, how much time left you have for the day, and how long the next block is (an hour) ), it just starts shaving minutes off the exam. Fun. But I did break after EVERY block.
The main study hints I can give now are the ones everyone gives, though I can't authorize any of those since I have no score yet. I put the First Aid into a binder and used it as a central source, as Topher suggested, and tended to expand on it when I didn't know what they were talking about (ie, all of pharm) and then supplemented it. I'm not sure if there's magical high yield books for these subjects. Most pretty much got the job done and covered areas that needed expansion. Wikipedia, though much maligned, DID fill in a lot of gaps, especially in the end game when I needed to clarify stuff.
Uhhh, USMLE World, holy crap. Same thing everyone else says. computer interface is pretty much identical. A lot of people talk about whether USMLE World or the USMLE is harder. I think USMLE World has a higher *proportion* of really hard questions, which I found helpful. I also like their explanations, though it's a humbling program. I started off more in tutor mode and subject oriented since I couldn't see any reason to waste pharm questions when I didn't know any pharm yet and was mid embryo. Toward the end was just trying to do timed unused. I felt like that was a huge bonus, because as stated, time is an issue, and USMLE World has the same issue. I think if I'd stayed in tutor mode for the whole thing, I'd have ended up completing like 10 questions out of 48 for each block.
Right NOW, if I had to do something differently having seen the test, I probably would have spent a bit less time READING two textbooks for embryo and micro (good, and probably would have benefited doing it during class, but used up those huge chunks of time mentioned earlier since I can*not* read a textbook in a day), and done all the USMLEWorld questions twice over, as many suggest. I did well over half on it, but I felt like especially toward the end, that was really good practice, plus my brain was tending to gloss over the review of the First Aid when I was rereading it, so it had to be directly challenged.
I took 2 NBMEs to try to evaluate where I was. Whether they will resemble my actual score, I have no clue. Just really glad it's over. Hopefully until the Step 2.
I was looking for USMLE experiences online, but a lot of times, it's like take the exam... and drop off earth. For good reason. Everything's been pointed to that day and then it's not. And then you have to realize you need your health forms in and your stuff finalized and there's all of that. And there are some experiences, but still, it's this big unknown looming beast, and there's so much hype on it, and so many pro tips on it (Kaplan, Falcon, etc) that it's almost like the hype becomes not real and you start wondering what it's *really* like because they're not going to use these buzzwords or test you on that disease you've seen fifty billion times in med school so it's become something *everyone* knows.
Oh, study it, by the way. If Goljan says it five times, then freaking know it. If it's common knowledge among medical students, then know it in obnoxious detail.
The other problem is the exam has an, on paper, incredibly rigid "do not tell people what's on the test" policy... and since this exam determines the whole future thing, and since there's frequently a blackout on information for the final run, I know for me that creates an intense paranoia. What does "don't share info" mean? Obviously it means don't mentally recreate the question and its 20 potential answers the second you get out of the exam and post them on the internet.
Though it doesn't say anything about trying to wikipedia the answers to 336 questions immediately after, because as we all know, that is awesome for your mental health.
But don't discuss the exam during the exam with other examinees, though I've heard you're actually allowed to have the First Aid in your locker and study it during breaks (I didn't confirm that since I had no intention of doing something that was that absolutely likely to give me a panic attack so it was irrelevant anyway), so I'm not sure what discussing it with other examinees (most of whom, I believe, are taking the SAT) would accomplish. Particularly since I think even the USMLE forms are completely different.
Does this mean you can't focus on any topic? What *types* of questions were hard? Is saying "the part of the exam where there was stuff from medical school" taboo? Honestly don't know. So I'll start classically, with what I did, and then talk about what the exam was like.
I also have no idea on where I stand versus where other people stand on study:test. The standard schedule seems to be 8 hours a day and 10 in the final crunch, which made me feel like an utter failure if I didn't spend 8 hours of every day painstakingly copying out the First Aid (this is just the horrendously inefficient way I study, and no, I don't read the notes later, nor are they legible. I just fill notebooks and throw them away!)
It seems like everyone's schedule is "Day 1: Read 600 page book of high yield physiology equations Ishie didn't make it through in 3 months of physio. Lunch. Afternoon: do 700 USMLE World questions. Average 90% Copy all explanations from all 700 questions into arranged notes that have been cross referenced and typed out by subject headines. Read 50 pages of First Aid. Work out for an hour. Attend to my personal hygiene. Get to bed by 10 PM and wake up at 6 AM.
Which *was* my planned schedule, which evolved into
"Week 5. Contemplate the fact you haven't made it all the way through First Aid because while pharm only seems to take most people 1-2 days, it's been 6 days and you still can't keep adrenergic antagonists straight. Wikipedia a disease condition you found in First Aid and were unsure of and plagiarize a three page dissertation on it into your notebook before realizing FA had summarized the highlights in two sentences. Get distracted by an adjunct wikipedia page and follow the Wikicrastination chain until you end up on the mating habits of bonobos. Google "effective USMLE study strategies". Watch old episode of Scrubs. Consider the fact that the residents get pimped in rounds during the first season to be "studying" because you know what C-peptides are. Realize three hours of your life has gone by without doing anything. Check facebook. Realize how much others are doing. Panic. Write out First Aid adding notes in a desperate frenzy until 5 in the morning. Realize you haven't done any questions. Do questions until 6 in the morning. Pull up score. Contemplate career change. Read explanations. Write in the first 10 in detail before hitting a question where 9% of respondents got it correct. "Say 'no one could ever freaking know that!!!' " and skim the rest of the explanations Realize the sun's up, and the chances of getting going by 8 AM are slim. Listen to Goljan as you're going to sleep... realize you're still up. Watch Red Dwarf. Contemplate whether you should try to take a shower before going to bed at 8 am, and decide it can wait. Swear to yourself you're going to get up earlier the next day to keep to your "plan". Wake up at 3 PM. Repeat.
And so forth.
Will it prove fruitful? Who knows. I certainly wouldn't *recommend* it as a study strategy because no matter what score it nets, it should be subtitled "how to live at such a high level of stress and self loathing that you forget how to experience happiness. Or panic anymore. So I suppose that last thing is good.
But the exam... ah, thought I wouldn't get there, eh?
Dibasic's tips are pretty spot on and reflect what other people have said. Oh, especially that 5 minute break after each section. You only get 45 minutes for the whole day so plan ahead. I took one after every section, avoided looking at any notes at all, and pretty much used the opportunity to get up, sign out, use the restroom, get water, possibly calories, at one point a Red Bull, sign back in, and log back in. Even though the testing facility was over an hour away, I drove it in advance and told you about that.
Got there about an hour early and went over microbio flowcharts I'd made and scanned a last minute antimicrobials in the First Aid since the ones without mnemonics really trip me up. They came in around 7:30 and I wandered in. They were quite friendly, and though it was clear it was a whole closely monitored environment, I didn't get the whole grim reaper vibe some proctors give off.
There are lockers you put your stuff in. ALL of it. No water bottles, watches, jackets, etc. Turns out no earplugs either. Whoops. I saw a "USMLE allows earplugs!" thing and thought it was current, but it isn't, so I got mine taken after my first break, but the lady was really nice about and didn't come in and nail me during the exam portion or any of that, so it didn't add to the stress levels.
There are noise canceling headphones, which turned out to be all right though at first they seemed like they were going to be tight and give me a headache. The room itself was pretty quiet, but I am the tightly wound type. One drawback is that noise cancelling headphones are WAY better than earplugs at amplifying your own heartbeat, so I got to do the test to the tune of "Lub dub lub dub lub dub... hmmm... this question sucks LUBDUBLUBDUBLUBDUB".
See how unstable I am?
Uhhhhhh, without going into "put marks on my record so I can't be a doctor ever no matter what I get", the exam is somewhat destabilizing, because some of the questions are ridiculously hard, but here's the kicker, some are RIDICULOUSLY easy. Oh, not many, don't get me wrong, but you do hard and medium questions and BECAUSE of that hit the easy questions and spend an eternity on them because you're going "No... there's a twist here." Once they hit a pattern, I'm also wondering if the easy questions are part of the "HOLY CRAP I FAILED MISERABLY" post-test reaction, because as I first walked out, it was like gut-punch, but I think a lot of the easier questions fly by and then you hit a hard one and you slam your self esteem into it like a car hitting a deer. Either that or I failed it so badly it's completely beyond me.
Oh, speaking of eternity on questions, be careful of the automatic log out feature that calls an "UNAUTHORIZED BREAK!" and flashes a red screen.
How did I know that? Uhhh... somehow spent 5 minutes on a question (bad time management, bad!) and was looking down intently at the laminated sheet I was scribbling on and then suddenly something flashed and it said "Unauthorized break". Which I figured meant "And now even though you've done six sections, we will cancel your exam and send your profile to the feds", but so far it seems to just mean that you have to log in again. And I actually knew about the unauthorized break thing, and still hadn't realized I'd spent 5 minutes on a question. Nothing feels like enough time, and then I found myself feeling like for some questions I was 'half assing', because it was a sacrifice of one question for five. And I did finish all questions though pushed the buzzer on all sections and one, I cut 8 seconds from end of block. Whew.
I ended up finishing fairly short of my scheduled time, I think due to starting early since my "time for the day" clock was running really low. I ended with five minutes of break time left, largely due to there being no clock in the lobby and being intensely paranoid because if your break time cuts into your exam time (the computer tells you at every stopping point how much total break time you have left, how much time left you have for the day, and how long the next block is (an hour) ), it just starts shaving minutes off the exam. Fun. But I did break after EVERY block.
The main study hints I can give now are the ones everyone gives, though I can't authorize any of those since I have no score yet. I put the First Aid into a binder and used it as a central source, as Topher suggested, and tended to expand on it when I didn't know what they were talking about (ie, all of pharm) and then supplemented it. I'm not sure if there's magical high yield books for these subjects. Most pretty much got the job done and covered areas that needed expansion. Wikipedia, though much maligned, DID fill in a lot of gaps, especially in the end game when I needed to clarify stuff.
Uhhh, USMLE World, holy crap. Same thing everyone else says. computer interface is pretty much identical. A lot of people talk about whether USMLE World or the USMLE is harder. I think USMLE World has a higher *proportion* of really hard questions, which I found helpful. I also like their explanations, though it's a humbling program. I started off more in tutor mode and subject oriented since I couldn't see any reason to waste pharm questions when I didn't know any pharm yet and was mid embryo. Toward the end was just trying to do timed unused. I felt like that was a huge bonus, because as stated, time is an issue, and USMLE World has the same issue. I think if I'd stayed in tutor mode for the whole thing, I'd have ended up completing like 10 questions out of 48 for each block.
Right NOW, if I had to do something differently having seen the test, I probably would have spent a bit less time READING two textbooks for embryo and micro (good, and probably would have benefited doing it during class, but used up those huge chunks of time mentioned earlier since I can*not* read a textbook in a day), and done all the USMLEWorld questions twice over, as many suggest. I did well over half on it, but I felt like especially toward the end, that was really good practice, plus my brain was tending to gloss over the review of the First Aid when I was rereading it, so it had to be directly challenged.
I took 2 NBMEs to try to evaluate where I was. Whether they will resemble my actual score, I have no clue. Just really glad it's over. Hopefully until the Step 2.
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