Milestone: 1st subscriber on youtube.

Yay. I got my first subscriber to youtube channel. Awesomeness.

Why Christmas holds a special place in my heart!

Christmas time is a special time for me.

This has nothing to do with gifts. I am not a material kind of guy. There are, usually, not that many things that I am interested in buying. Also, if I want to buy it I would’ve bought it already. I won't wait for Christmas. When I do buy something, it is likely to a cheap a book that I just can’t wait to devour. Otherwise there isn’t much that I anticipate getting.

To me Christmas has meaning because two related reasons.

The first is that it is my father’s birthday. My father holds a special place in my heart. He’s a cool dad. As a result of it being his birthday, we as a family spend it Christmas together always, which brings me to my next point.

The second part of Christmas that I enjoy is that I get to spend it with whole family. The food always tastes good in great company. We get to talk and eat and relax. Not a bad combination that can be beaten.

I had a great time this Christmas. The spreads for the day were dished up my sister. She flexed her cooking skills in the kitchen, conjuring up something special. We ate and ate and ate. Whew. I’m sure I gained an extra 5 lbs this day.

I hope everyone enjoyed their Christmas as well, and if you do not celebrate Christmas I hope you had a good time off from work. 

Why do I succeed?

I heard this quote while listening to a video on youtube. I thought it was awesome. 

“Why Do I Succeed?
I succeed because I am willing to do the things you are not. I will fight against the odds. I will sacrifice. I am not shackled by fear, insecurity, or doubt. I feel those emotions drink them in and then swallow them away to the blackness of hell. I am motivated by accomplishment, not pride. Pride consumes the weak-kills their heart from within. If I fall, I will get up. If I am beaten, I will return. I will never stop getting better. I will never give up, ever.

That is why I succeed.” - by Anonymous

The two most important resources for passing the Step 2 CS

If you disrespect any of the step exams you will fall short and fail the exam. The most important thing for these exams is to prepare in the right manner. My focus for now will be on the CS examination. I will give you the two basic resources to pass the CS exam.

The first thing use is the right book. There are a few books out there. The two most commonly used books used are the Kaplan CS and the First Aide Cs books. I used first Aide to study.

I found First aide to be more than sufficient as a resource. It is divided in a way that covers all the necessary aspects of the exam. If you use First Aide in the right way you should have all the knowledge needed to pass the examination. If you are interested in me writing about how to use first aide let me know in the comments or via email. 

The second most important thing for the exam is… Guess. If you said fish and chips you are wrong. Lol. Just kidding. It is having a LIVE practice partner. The key word is live. You want to run through the whole clinical encounter, from taking history to doing the physical examination, as realistically as possible.

This is where I went wrong. I studied on my own and did not give this exam the respect it deserved, as a result I failed my first attempt. I rectified this and got multiple LIVE partners. I would drive for miles just to make sure I had someone to practice with. On a few occasions, I would drive to a friends place early in the morning, and wake him up to practice. I had to make the effort to practice. If I did not put in the effort, I would not have a practice partner regularly, and if this resulted in another fail I would have only myself to blame.

During my second attempt at the CS, it was difficult to find a consistent study partner. This is the case for most people, and might also be the case for you as well. I had to be creative. I used multiply people to practice. I worked with some for only one day. Luckily for me, I had multiple friends around. All that was necessary was to make the effort to go to them. I did this. 

Finding a book to use is easy, finding a consistent partner is hard. Knowing this I started to help others by serving as their practice partner. I first worked with friends and then with other people as a practice partner. I share with them what worked for me in passing the exam and helped them prepare in the right way. If you are interested call the number in my bio.

Good luck. Crush that step!

The anxiety of applying to the match

Its 10/26/16 and I have not received a single FM interview yet. Tic toc. Applications opened in September 15,2016, tic toc. Many have received numerous interview invites, but I have received nothing yet. Tic Toc. Some programs have already filled all their interview slots. Tic Toc.

The nerves as time goes by. I am in the same position as last time. Well not necessarily the same since I have at least one im interview. I want family medicine interviews. Will I get any interviews? Will I even get the opportunity to match.

No matter, what my nerves do, I know one thing. I will push to the end. I will contact these programs over and over. Why? I am interested in them. 

Edit:

I wrote this on 10/26/16,  at a time I had no interviews. Today, 12/14/16, I am sitting on 5 interviews. The Match is getting more and more competitive now so interviews are tough to get especially when you have a blemish on your USMLE transcript. I pray I do well in my interviews. Practice, Practice, Practice is the name of the game. 

What did I do after I got a 185 on UWSA to boost my score.

I get numerous questions from residents as well as img’s trying to take the step 3 exam. The most common question so far is what is it that I did after I scored a 185 on the UWSA test?

Unlike the other exams –step 1, 2 ck- which have numerous self-assessment exams, the step 3 only has 2 self-assessment exams currently. They are the 1 nbme exam and 1 uworld self-assessment exam (UWSA). As such you have to judicious in your use.

The self-assessment exams only test you on one portion of the main exam, and that is the multiple choice section. There is no CCS portion to the nbme and the UW self-assessment.  

The passing score of Step 3 is 196 at this point- it will most likely go up soon so make sure to check. As such a score of 185 is failing grade if you assume that the nbme and the UWSA exams correlate with the score you will get on the actual exam. Honestly, the only way to use the self-assessment exams is to assume they correlate. This brings me to my next point.

You must take your self-assessment exam early enough so that if you do not do as well as you want you have time to study and boost your knowledge or consolidate all the info you get from the different sources you used.

Last piece of advice before I share my routine is that the Step 3 is a really hard exam. If you have a low score I would advice against taking the exam soon after getting a poor self-assessment score. 

What I did after my UWSA score of 185?

I had between 3-4 weeks between my UWSA exam and the USMLE Step 3 exam. Also, I spaced out my 2 days over 10 days. Each day of the 3-4 week period before the main exam followed the snap shot I’m going to paste below. This is what I did on 8/30/16 but the other days were similar.

Routine:

8/30

-        4am- 5am: exercise-> review of ccs flash cards

-        5-550: step 3 notes

-        6-650 stats and ccs review:

-        7-750: mtb

-        8-850: questions: 2 UW blocks. Was soo tired that I could barely concerntrate. So I stopped and slept till 1 and then did the last block.

-        Reviewed questions till 630

-        630-730 relaxed

-        730- 11 archer videos  (2 hrs and 45 min)

How I prepared for my Step 3 Exam

How I prepared for the Step 3 examination:

Total studying time: 1 year = 10 month lax with 2 month intense studying

Resources used:

   1)       Step up to medicine (read once through and then revised my notes from then on)

   2)      Mtb (read multiple times)

   3)      Secrets: only the biostats section

   4)      First aide step 1: only the biostats section

   5)      Uworld qbank: went through it once.

   6)      UW CCS cases (51): went through it once

   7)      Crash CCS: went through the first 120 cases as part of a study group.

   8)      Archer CCS: watched 2 videos- strategy video (3 hours) and the next video in line (10hrs). GREAT RESOURCE!!!!

Practice tests:

   1)      Uworld qbank: 59%

   2)      NBME (done before uwsa): 320

   3)      UWSA: 185

USMLE STEP 3 score: 206

Study schedule:

In the first 7 months, I eased my way into studying. The first book I tackled was Step Up to Medicine. I started by reading 5 pages a day so to build consistency. Then I moved to 10 pages, and finally 20 pages a day. I finally finished step up to medicine around May.

The next book I tackled was MTB. I read a chapter a day. If the chapters where less than 20 pages I would read about 2 chapters. I was done by the end of June.

In July, I added working with study groups to my routine. I had 3 study groups in total: CCS, statistics, uw qbank.

From July to my test date Sep 16, I studied from 4 am- 11pm. There were breaks in between of course but it was still intense. I did not want to look back on this exam thinking I could have done more. Pass or fail I would know I gave it my all.

In summary, I started slow and built up momentum. At the very beginning I mapped out the resources that I would use and how much time it would take to complete them. I followed my schedule as well as I could. It all worked out in the in the end because I passed!!!!

Things I would change:

   1)      I would start doing CCS a little earlier

   2)      I would read first aide along with MTB sections. Note, I am not saying the whole first aide book. I would just read the sections that correspond with the chapters in MTB. There were some tough step 1 questions on the exam.

Good luck!!!

My Step 3 experience: Day 2

Thoughts:

I gave myself a 100% chance of failure.

Does anyone look at scenarios and calculate the probability that a certain result will occur? Not sure what you do, but I definitely do that. And my outlook through the second half of the exam was yp… I am definitely failing this test.

The Exam

Today, I took my second and final part of the two day exam, the beast known as Step 3. I described the first day in another post so I won’t go into that here. Let’s start with the length of the exam. It was longggggg (notice the extra g’s.) It was 9 hours long! I used almost every minute of it.

The night before I tossed and turned because I was sick. I couldn’t stay asleep. The first thing on my mind was that I would have a problem with the stamina for the exam. But, surprisingly, that was not the case.

Rather, walking into the exam center, first thing I did was use the bathroom with ease. Lol. One must be free before battle. I then took a huge swig. Actually… multiple swigs of my monster energy drink. Then I took on my first block.

I ended up finishing almost two monsters for the entire exam. I pulled through stamina wise. I did not lose energy. I did not get tired. That was a good thing.

Now the content of the second day. The second day is divided into mcq and ccs. There are 6 blocks of mcq. For me each block was 30 q long and 45 min in length. Whilst doing the mcq I was holding on to the hope that I just might pass. I saw a glimmer of light. However, when I hit ccs blocks that light got dimmer. 

After each ccs block, I had a mini mental fight with my negative voices. You missed this. You missed that. By the end of the exam, the negative voices had me thoroughly convinced that failure was a 100% probability.

Why did I think I failed? In my first ccs case, while I treated the patient appropriately I did not do some of the routine counseling, like counseling on smoking cessation etc. Also, one of my patients actually seemed to get worse with the treatment that I instituted, and then when I advanced the clock and the case ended. In retrospect, after running through the cases in my mind, I believe that I treated the patient appropriately. But, and that’s a big but, I can’t be sure because the cases just seemed to end abruptly.

Now, hours after the exam, after speaking to friends, running ccs cases and mcq’s through my mind, and reading about others experiences online a sliver of hope rose again that I just might pass. 3 weeks of torture.

Pass or fail. It is something that I have to deal with.

Update:

My friend told whenever I feel like I failed an exam I usually do well. He was right! I passed!!!!

My Step 3 experience: Day 1

My Step 3 day 1 experience:

Time prior to exam:

Woke up on time. Had breakfast and left the house in time, at 615am. I got to the testing center around 7am even though my exam was at 8am. They called me earlier telling me to get there by 715 am latest. I signed in, used the bathroom, took a couple of swigs of my monster that I had prepared in a bottle. It was action time.

Prometric center Experience:

I have taken numerous prometric tests for more than 7 years. Today was the best experience I have had in a center. 

They were attentive and prompt. When I stepped out to use the bathroom, they made sure I got back to my exam quickly, making me skip others who weren’t as pressed for time- for example, those getting checked before commencing their exams. 

My experience in other prometric centers weren't good, ie. speaking leniently. For one of my exams, I went out to use the bathroom. I came back and stood waiting as the minutes went by. Finally, after they had finished having their conversation with no sense of urgency they signed me back in. To say i was fuming is an understatement. I had to control my emotions to make sure it didn't impact my exam. 

How did this bad experience affect me? I was afraid to step out for a break because a 2 min break becomes a 10 minute break, and this all has an impact on your timing. In addition to the difficult exam questions you have to deal with your anger and try to calm yourself down because of the complete lack of care they had for your remaining time.

In short, the staff present during the taking of my step 3 exam were professional, and friendly. Their attention to detail allowed me to focus all my energies on what I needed to, the exam... And boy did I need all my focus. 

The exam:

The whole exam was rough. It was one of the roughest exams I have taken to date. There was a lot of biostatistics and a lot of step 1 pharmacology questions.

When I first I looked at my first block, I compared the number of questions to the amount of time to solve them. The ratio was better than uworld qbank so I assumed I would have so much time left over, time I can use to look back at my uncertain answers. certainlyu!. Nope! I blinked and all that free time was gone.

I struggled with first block. The questions stems were long. My mind was not fully primed and firing on all cylinders. The stats questions were placed towards the end. Time was running out. I was rushing. I looked at the long question stem of the stats questions. I used my normal approach to stats questions. I was still off I guessed and moved on.

The thing that bothered me about this was that I am usually good at stats questions. I had a good method of approaching them. I was just not completely relaxed. At the end of the first block, there are a few second count down before you automatically get put on break, or before you have to select to continue to the next block. I used that time to take a breath, calm myself down tell myself your method works, just work a little faster a little loser.

The second block was a little better in terms of stats questions and from then on I felt a little better for the stats questions.

The rest of the exam was extremely hard for me. The questions were long. A lot of the questions seemed ambiguous. However, I did my best and pushed through.

How was my stamina during the exam:

I was worried I would be exhausted for this exam. That did not happen. The exam flew by. I was so shocked that I only had two blocks left and even calculated the time I was supposed to finish. How did I approach the exam. I slept at a good hour. Slept for as long as timing would allow. I drank –a few gulps- monster before I got tired, before I walked into the room to start the test, and I took a sip after every break.  Possibly constantly doing at least 3 uw 40 q blocks in a row might have helped a bit. Most importantly thank you lord.

Impression of the 1^st day:

-        I really do not know. I felt it was excessively hard. I felt like I did not know enough, that I wasn’t ready for this exam. Now all I can do is wait for day 2. 

Where have I been?

I've finished medical school. Finished my Step 3 examination. I am applying to the match this year. There is a lot to write about. There is a lot to share.

I'm baaaaaccck :)