Monday, July 20, 2009

back to work, sort of

Tomorrow, I"m starting volunteer work with my primary care doc, to get some experience before I begin clinicals. He told me a while back that I should get in touch with him after I took the step, so the other day, I took him up on it. For the next month or so, I'll be working with him two or three days a week. I haven't talked to him too much about it, but it looks like I'll be seeing his patients, taking a history, doing an exam, and reporting to him what I find and what I'd do. Then, I'll see the patient with him, and see how close I was. I'm hoping this will give me some good practice before I have to do it for a grade. I suppose that tomorrow, I'll find out how useful ICM was or was not.

I've done thousands of patient interviews as a paramedic, but I think it's going to be a lot different as a medical student. For one, I actually know what I'm looking for now. And probably most importantly, I'm now expected to know what to do with the patients for current and future treatment....not just how to keep them alive for the 10 minutes they're in the back of my ambulance. I think I'm going to like it.

Friday, July 17, 2009

How do people find my blog?

I was just looking at my blog's recent numbers, and was surprised to find that I've had well over 150 people visiting my blog lately! I was curious to find out where they were all coming from, so I took a look at the google searches that bring people here.

Some were obvious, like searching my full name + blog. Other times, they're searching for a particular picture that I've liked to from my blog. But, one of them caught my attention today. One of the people who found my blog did a google search for "The USMLE destroyed my life." Whoever you are, I"m sorry that it was so awful to you! I hope it all works out OK.

If you're curious, that google search hit on a combination of my review of Goljan lectures, and my USMLE experiences. I have no proof, at least yet, the the USMLE is going to destroy anything.

My USMLE experience

Looks like I've taken a little blogging vacation after the step, but I'm back. At least, I'm back for now. I haven't yet decided what I'm going to do with this blog, now that basic sciences is over. Anyway, here's my impression of Step 1.

All of the USMLE exams are given at Prometrics centers, which is a business that does nothing but give exams. Actually, they give about 400 different exams, including the USMLE. When you come in, they'll check your scheduling permit, ID, and have you put everything (including wallets, watches, and snacks) in a locker. Then, they'll finger print you and take a digital picture. After the check in is complete, you're given two small dry erase sheets, headphones to cancel out the sound, and they take you to your computer station. Every station is individually tape recorded. Basically, there is no possible way that you are going to cheat on this exam. The center was pretty much brand new and very nice. The employees were also very friendly and helpful.

Although I was extremely nervous going in, I felt more at ease once I began the exam. It is absolutely 100% identical to the FRED 2 software that USMLEWorld is now using. So, if you create yourself a random exam of 7 blocks of 48 questions, you'll know exactly what to expect. Taking the USMLE really felt like taking an extremely secure UMSLEWorld practice test. The questions were also very similar. There were some that were easier than World, but I thought that most of them were of similar difficulty. It is VERY heavy on path, and moderately heavy on micro and pharm. After taking the exam, I really wish I spent more time studying path. I only had one embryo question, and only a couple anatomy questions. They really do not use buzzwords anymore, so I wouldn't expect to see "currant jelly sputum," koplik spots, owl's eye inclusions, or anything of the sort.

You are given a total of 45 minutes of break for the day, to use whenever and however you want. However, if you finish a block early, or do not use the full 15 minutes for the introduction, the time is added to your break time. I wound up with over an hour and a half for lunch (which I didn't use most of), and still over an hour left when I finished the exam. There was only one block that I came close to using the entire time, but I usually finished with 15 minutes to spare. Unless you are a very slow test taker, you should not run out of time. Every time you leave though, you will be fingerprinted on your way in and out, and have to turn your pockets out to prove you're not brining anything in. Like I said, security there is no joke.

Overall, it was probably a little harder than I expected it to be, but only because I was expecting it to be a lot easier than USMLEWorld. Many of the questions were difficult, but none of them were unfair, and I never felt like they were trying to trick me. As you have probably heard, they're specific on their question writing rules, and there are NO negative questions on the exam. If only AUC would follow USMLE's question writing guidelines....

Now, all there is left to do is sit around and wait for the results. Waiting for results SUCKS, but it is MUCH better than the past many weeks of studying. I have been spending a lot of time sleeping, seeing movies, and basically doing whatever I want, with no stress at all. It's nice. I really cannot believe the exam is over. The whole time, I never really felt like I was taking the USMLE, until I walked out and was given a piece of paper that says "Your testing session for USMLE Step 1 has ended." It was really nice to get that sheet of paper. It's a sheet of paper that I have been both dreading and looking forward to, since before med school even began. But, for better or for worse, it is over now. If this is the official end of basic sciences, then my first half of medical school is now over. Unless my brain took a major dump on me that day, I passed the exam. In just over a month, I will begin clinicals, and I'm very excited for that to begin.

Not that long ago, I thought that college would never end, and I'd never actually be in medical school. And, even on those days that I knew I'd get to medical school, it seemed like forever before I'd get through basic sciences, take the USMLE, and move onto clinicals (which I've always been excited about). Well, that time has flown by, and here I am. In less than two years, I will be a physician...I can only hope that the next part of med school goes by just as quickly.

Tuesday, July 14, 2009

Veni, vidi, vici

Finally, after years of dreading this day, I have completed the USMLE Step 1!! I have absolutely no idea how I did, but I'll post my impressions of it later. For now, time to go home and relax, with no worries or stress...something I have not done in a very long time.

-- Post From My iPhone

Almost there

5 out of 7 blocks complete, only 96 questions left! I have NO idea how it's going to turn out though. Time for some lunch, then back to Prometrics to finish up

-- Post From My iPhone

Monday, July 13, 2009

The day is about to arrive

In less than 3 hours, it will be the day that I take the USMLE. With any luck, I will be sleeping by that time. I made sure I woke up relatively early this morning, I've taken 50mg of Benadryl, and I'm hoping that will do the trick. Do I feel like I know everything I could? No. Another week would be nice. But, I have a feeling that no matter how long I'd study, I'd always want another week. So, I've resigned myself to the fact that I know all that I am going to know for tomorrow.

Tomorrow has been a very long time coming, and I'm both excited and nervous to get it over with. I hope the USMLE gods are nice to me, and give me a random assortment of questions heavily biased towards the material that I have reviewed the most. In just a few hours, I'll find out. For now, my alarm is set (2 of them, actually), my scheduling permit is in the car, and I'm doped on up sleeping meds. Goodnight...wish me luck!

Sunday, July 12, 2009

1 day left!!

It's been a long time coming, but tomorrow is my final day of studying before the USMLE! The plan is to go through all of pharm again, and then probably whatever path I can review before it gets too late. I'm going to the gym at 6AM tomorrow morning, so that way I'll be tired enough to hopefully go to bed early and fall asleep. I'm beyond ready to be done with the studying, but I don't feel like I'll ever be ready. I'm just hoping that what I've done is at least enough to get me into the 230's, if not better. Probably going to come down to what version of the exam I happen to get, and if it's heavy on the things I know, or things I skipped over. Also, sometimes things just seem to come to me. Hopefully, Tuesday is one of those days.

For now, I'm going to finish up a little embryo and then go to bed. Early morning tomorrow!

Saturday, July 11, 2009

2.5 days

Closer to two days, but I still have a lot to do tonight! Shortly, I'll be finishing up path (finally). After that, I'm going to do a full review of biochem, and probably some more questions. I've been doing a lot of questions lately, which is why it's taken me so long to get through path. I'm really hoping that USMLEWorld is harder than the actual exam, because some of those are HARD! I also did a bunch of questions in Elsevier's new USMLE Consult q-bank. They're similar to USMLEWorld, and also use the new FRED 2 USMLE interface, but they do seem a little easier. If the actual step questions are similar to those, I should be good to go!

I'm starting to get a little nervous now though! I can't believe that after all this preparing, the exam is just a couple days away. It feels like no matter how much I study, I'll never be completely ready. USMLEWorld exams sometimes make me feel very good (when I get 80%), and sometimes not good at all (when I get 60%). I guess I shouldn't really worry too much about those scores anyway right now. Probably just best to do as many questions as I can and review whatever I can. So, I think that's what I'll do...

Thursday, July 9, 2009

Almost there

I've got 4 full days left of studying now, before the USMLE on tuesday! I just took the USMLEWorld practice exam to see how it's coming along. I was going to take the NBME comp, but USMLEWorld is a little cheaper and the same length. Unfortunately, I'm now left a bit confused as to what my estimated score is. USMLEWorld gives you an estimated 3 digit score, but if you plug that into the score calculator that a lot of people seem to use (found here), it gives me an estimated score which is 10 points higher!

Obviously, I'd prefer the 10 point higher score, but either way, I'm doing OK. Not fantastic, but OK. Ideally, I'd like to get a 240 or so, but I would settle for a score in the 230's. Anything lower than a 230 is really not going to cut it for me though, so I'm hoping that doesn't happen! The comp shows that my weakest areas (by far) are micro and biochem. I was doing pretty well on those sections on USMLEWorld Q bank though, so I'm thinking maybe it's just been a couple days, so I've forgotten details. In any case, in the next 4 days, I will do a complete run through of pharm, micro, and biochem, at least once, to make sure I get all the last minute details. I'm thinking that will bring my score up 5-10 points, since many of the questions I missed were things that I definitely knew, but just slipped my mind.

If I do get another 5-10 points, and assuming the score calculators are at least moderately accurate, I will wind up with mid 230's to mid 240's. Mid 230's would make me happy. Mid 240's would make me VERY happy.

Oh, and even in the unlikely event that my score doesn't raise above the lowest estimate that I got tonight, it would still be looking good for Falcon! I'm already 40 points above my comp score from AUC!

I'm healthy! ...mostly

My doctor told me that I had to get labs drawn before he'd prescribe me anymore Ritalin, just to make sure it wasn't doing anything it wasn't supposed to be doing. Fortunately, as you can probably tell from a previous post, I got one final prescription before my labs came back. In any case, labs came back today, and I'm healthy! Actually, pretty much every lab value is exactly in the middle of the acceptable ranges, so they really couldn't be too much better. And, even better, I actually knew what all 2 pages of results meant! Stuff like RDW, MCHC, MCV, eos, baso, T4, etc. used to confuse the hell out of me, but not anymore! Although, I guess that after 2 years, it would be pretty bad if they still did.

Unsurprisingly, my LDL (bad cholesterol) is fairly high, and my HDL (good cholesterol) is low. But, my LDL is lower than it has been in the past, and my HDL is only one point below normal. The other cholesterol-related values are all normal. All of that could probably be easily fixed with one cholesterol medicine, and it likely will be eventually, but not too big of a deal at the moment. Damn that familial high cholesterol!

OK...57 more pages of Goljan Path before I let myself go to sleep.

Tuesday, July 7, 2009

Today could have been the day

But, fortunately, it wasn't. Originally, I scheduled today to take the USMLE. I'm not really sure why i thought that 2 weeks would be enough time for me to review, but I'm glad I pushed it back! Since I pushed it back pretty early, there was no fee involved (you can move the date up to 5 days before the exam, without a penalty). I just finished pharm and immuno today, which really only leaves me pathology to get through. Of course, pathology is the largest and most important part of the exam. So, definitely would not have wanted to take the step without reviewing path! Reviewing path will also involve some review of micro, pharm, and really everything else, so it's a good thing to finish up with. I'm hoping to finish path by Thursday, and then take either an NBME or USMLEWorld comp Thursday evening. That way, I can find out about where I am, and figure out what I need to focus on for the remaining few days. The final date for the big day is next Tuesday, a week from Today. That will still give me a month and a half vacation before I begin clinicals, which will be very nice and is much needed!

Monday, July 6, 2009

Oh yuck!

Some foods just should not ever be made fat free, sugar free, light, or anything of the sort. Among these foods are ice cream, cheese, and chocolate. Well, I just learned today that chocolate pudding should also be added to this list. I carelessly pulled a chocolate pudding out of the refrigerator today and was greeting with a very unpleasant surprise. Don't think there's a difference between sugar free pudding and regular? Let me assure you that there is. Did you know that you get about twice as much energy from fats as you do from carbohydrates or protein? Well, now you know, and knowing is half the battle (according to GI Joe).
I think that packaging should have to reflect the taste of the food, to protect people from making the same mistake that I did.

Sunday, July 5, 2009


I want to update my blog every day, and I really do mean to. Lately, I think I've been pretty good about keeping up with it. But, there just isn't that much to write about that I think anyone would be interested in. For the next week or so, it's just studying, followed by more studying, followed by more studying. So, that's what I did today...more studying! It's just as exciting as it sounds. I cannot wait until this exam is finally over! One week and two days to go!

Friday, July 3, 2009

I must have this!

Behold, the Three Wolf Moon "Official" T-shirt:
Amazon.com_ Three Wolf Moon _Official_ T-Shirt 100% Cotton Short Sleeve Shirt KIDS - TEENS & ADULTS.jpg
I am seriously considering leaving med school and quitting the gym. There is nothing that could make me half as kick-ass as owning this shirt. Girls will want me and guys will wish they were me. Just imagine the damage you'd do if this thing came in sleeveless.

I'd highly suggest checking out the comments on the amazon page....they are hilarious. Below, I have copied two of them (if you're too lazy to click through)

5 stars
This item has wolves on it which makes it intrinsically sweet and worth 5 stars by itself, but once I tried it on, that's when the magic happened. After checking to ensure that the shirt would properly cover my girth, I walked from my trailer to Wal-mart with the shirt on and was immediately approached by women. The women knew from the wolves on my shirt that I, like a wolf, am a mysterious loner who knows how to 'howl at the moon' from time to time (if you catch my drift!). The women that approached me wanted to know if I would be their boyfriend and/or give them money for something they called mehth. I told them no, because they didn't have enough teeth, and frankly a man with a wolf-shirt shouldn't settle for the first thing that comes to him.

I arrived at Wal-mart, mounted my courtesy-scooter (walking is such a drag!) sitting side saddle so that my wolves would show. While I was browsing tube socks, I could hear aroused asthmatic breathing behind me. I turned around to see a slightly sweaty dream in sweatpants and flip-flops standing there. She told me she liked the wolves on my shirt, I told her I wanted to howl at her moon. She offered me a swig from her mountain dew, and I drove my scooter, with her shuffling along side out the door and into the rest of our lives. Thank you wolf shirt.

Pros: Fits my girthy frame, has wolves on it, attracts women
Cons: Only 3 wolves (could probably use a few more on the 'guns'), cannot see wolves when sitting with arms crossed, wolves would have been better if they glowed in the dark.

5 stars
So I'm looking for threads that say, "Hey baby...I'm real boss!" when I stumble upon this epic creation. The wolves spoke to me in a language all their own; it was like German, Mongol, and Bitchin all mixed together. I mean, one wolf howlin at the moon is major...but three???

I ordered next-day air (if only there was same day!), and, of course, a size smaller than usual to ensure the closeness of the wolves to my chest hair. When the package arrived, I tore it open, and I SWEAR angels sang. I think it was Freebird. I immediately removed my "No Fat Chicks" shirt, and replaced it with this finery. Lemme tell you: AW YEAH.

I'll spare the details of my conquests since I started wearing this shirt; suffice to say, I'm swimming in a sea of babes the likes of which are usually found on those K-Tel infomercials. I'm also more confident at work, and expect to be promoted to cashier soon. I owe everything to this shirt (I should say "shirts", since I now own 23 of them).

These guys probably have no idea what to do with all the ladies they're pulling.

Thursday, July 2, 2009


This is AUC's webpage, found at Did we forget something here? Perhaps the webmaster might consider adding a title and putting something in place of the Latin placeholder? Classy....
American University of the Caribbean School of Medicine.jpg

Wednesday, July 1, 2009

magic pills

Today, I stopped by the doctor's office. Finally, I can study again!