Match Day! March 20, 2009

First of all, I want to say sorry for not posting yesterday (Match Day)… it was truly a busy day and I wanted to give you all the quality posts that you are used to .  Hopefully you at least saw my Twitter status with the great news!

So I show up to my match celebration 15 min before the refreshments were to begin being served, which was an hour and 15 min before we got to open our envelopes.  I was so nervous that I literally ate only 3 grapes and 2 orange slices!  I was running around talking to everyone, wishing them luck, etc.  The one day that I chose to actually be early to an event and it was driving me crazy.  About five min before it was time to open the envelopes my Dean took the stage to share some stats.  Apparently 78% of the class would be staying on the same coast – with 40% staying at hospitals affiliated with my home institution, and 24% at my home institution specifically.  As far as specialties go, 32% went into primary care, followed by 21% in surgery/surgical subspecialties, and 9% in radiology.  “All others” made up the remaining 38% (with 8% being Ob/Gyn).  Clearly I was distracting myself from the anticipation by taking notes!

Then the clock strikes and my Dean has all of our family and friends go outside to the terrace.  I had no idea what was going on.  I thought they were going to make us open the envelopes in solitude or something crazy!  Then we are told to go outside.  All of our envelopes are taped to the window in alphabetical order.  I find my envelope and grab my boyfriend.  We walk all the way to the back corner of the terrace.  I really only wanted he and I to be a part of this moment.  I flip my envelope over to open it and there’s a photographer standing right there!  So much for privacy.  I tear into the envelope (and the letter) and unfold it frantically.  There it was… the name of my #1 PROGRAM!!!  I started jumping, and laughing, and smiling.  I hugged and kissed my boyfriend so many times.  He did such a great job of capturing it all with my camera.  I was in total disbelief at what I was reading.  I must’ve read #1 program’s name over and over and over.  I actually took a picture of it to be sure!

Next I proceed to call my parents who were both excited.  I also called my best friend who got her #1 program as well!!  I spent the next hour running around to all of my classmates to see where they were going.  It was such an intense experience.  There were tears of joy and tears of disappointment filling the room.  There were hugs and kisses, screams and laughs.  Such an intense amount of emotion it was a bit overwhelming.  The hardest part was seeing the faces of the classmates that I knew didn’t get their first choice.  I suppose that’s the downside of the 3 week waiting period.  By the end, people were alot more open to sharing where they were going to end up.  So when I asked where they ended up, we both would know that they didn’t get their number 1.  Even more shocking was a classmate that was a stellar student, had stellar interviews, great personality, and got their 4th choice.  This classmate was just in shock… it’s still an amazing program, but since we’ve talked about it extensively, I knew how heartbreaking it was.  In the end though… at least we matched!

I spent the rest of the day eating and drinking.  First with my boyfriend.  Then with a few of my close classmates.  Then with my best friend and her classmates at a neighboring school.  The night concluded with me putting the final touches on my poster and heading off to the club and dancing the night away.  I suppose my school was smart for making us have to be at school the next morning for poster presentation set-up at 8am!  I definitely drank less and came home earlier because of that obligation.  That won’t stop me from partying tonight!

My last point, for those readers that have not yet applied, I will update my “Numbers” posts under the USMLE Books & Advice page if it may help to give you insight.  If I could match my #1, so can you!!

MedObsession on Twitter March 7, 2009

During the election I was pretty hooked to CNN for the political commentary.  The broadcasters used to always talk about Twitter.  They would post questions and then read the comments live on air.  I had forgotten about it until recently.  My intern has a crackberry like me and was on “TwitterBerry” one day.  He instructed me on the ins and outs of Twitter.  Basically, it’s like constant facebook status updates.  People can become “followers” of your page to stay up to date with your posts.  You can also reply to other posters’ updates as well.

My first reaction was that this seems way too invasive!  I heard that there was a celebrity “twittering” during the delivery of her baby.  So I immediately deactivated my personal twitter.  I decided that only my close friends and family need to know what I’m doing moment-to-moment, and they can get all the updates they need by calling and texting me.

However, I thought about my readers.  My blog has had increasing numbers of readers, with 4800 views alone last month!  I know that my time during Ob/Gyn residency will be limited, and thought this could be a good way to still stay in touch with my readers.  I created a Twitter page for my blog: http://twitter.com/MedObsession, this link is also post on my blog roll.  I’ve also subscribed to my own RSS Feed and displayed it in the right-hand panel under “twitter updates.”  For those of you that don’t have twitter you can read the updates on my own blog.  For those that do, you can click on each of the status updates and it’ll take you to the page to favorite it or to reply!

We’ll see how long I keep this up…

2 Year Blog Anniversary December 3, 2008

I can’t believe that another year of blogging has passed!  My blog has definitely grown over the year, as have I.  This post will be full of links to posts with the most hits over the past year, and to some of the ones that were important to me.  I first saw my monthly readership triple when I became syndicated in March 2008: I’m syndicated!.  My main topics included the transition from being a nervous third year medical student: Hmm…Excellent?, to a confident third year medical student earning honors in several rotations (Ambu Med, Psych, Medicine) and my proud moment of being selected for the medical honor society: Alpha Omega Alpha.  I also talked about my personal life and experiences with relationships: Long Distance Coming to an End, Valentine’s Day, Cooking for His Parents, and A Surprise Concert.  In addition, I polled the readers for opinions about things I don’t understand: Diamonds Are Forever, Right?, Insight into the Cheating Mind.  I even went on a game show, Deal or No Deal Part 1, Part 2, Part 3, Part 4, Part 5, which I now realize I never did a “Part 6″ post for.  I guess I owe you one.  My monthly readership then more than doubled again in July 2008 when I became a 4th year (MSIV, Finally) and started talking about applying for residency: Advice for Applying to Residency, ERAS Submission, MyERAS, taking boards: Step 2 Preparation, The Numbers, Step 2 and interviewing: Ob/Gyn Interviews.

Over my 2nd year here are some of the stats for those of you that are curious.  Check out the post from my 1st year: 1 Year of Blogging.  I put the total for each category with the amount from each year alone in parentheses to compare the years:

256 Posts (Year 2: 143, Year 1: 113)

470 Comments (Year 2: 325, Year 1: 145)

3144 Spam Comments (Year 2: 1983, Year 1: 1161)

21084 Visits/Page Views (Year 2: 17439, Year 1: 3645)

—-Best day ever: Year 2 – 376 (November 19, 2008); Year 1 – 85 (July 1, 2007)

—-Best month ever: Year 2 – 3316 (November 2008); Year 1 – 479 (June 2007)

To date, the top three pages are: “Ob/Gyn Interviews“, “About Me“, and “Step 1 Books & Advice“.

The top three posts are: “MyERAS“, “BRS vs Goljan Pathology“, and “Done with USMLE Step 2“.

As you can see I have quadrupled my annual readership, and my best month this year has 7 times more readers than my best month the prior year!  It is very exciting to have new readers and new people commenting on the posts as well.  I hope that you keep coming back to read!  Please pass on the link to your friends: www.medobsession.com.  That’s right, for those of you that may not have noticed, I bought my own domain!

The Numbers, Step 2 October 7, 2008

I PASSED USMLE STEP 2 CK and CS!!!!

Like I did for Step 1, I will post how I did on the Kaplan QBank, the USMLE CBT test, and the online NBME practice tests.  I’ll also post how I did on the exam so that you can see the trend.  FYI: My score trended up from the predictions and I improved by 12 points from Step 1!!! I’m so excited that I just took the exam early.  Looks like it scored me an interview at Yale too.  Studentdoctor.Net has a forum for current applicants and about 5 people had been offered interviews at Yale on 9/26… I guess the release of scores put me in the running and they offered me an interview right after these scores released on 10/7.  I didn’t listen to everyone who said to take the exam later if I did well on Step 1 and it paid off! This is the part of 4th year  I was looking forward to; all I have to do is survive 10 interviews and a few more rotations…

Update: I’ve matched… so I posted my score below.

Now on to the numbers:

Done with USMLE Step 2 CK August 29, 2008

Wow… didn’t think that I would get to write these words so soon… I’m DONE with Step 2! Officially, a huge weight has been lifted off of my shoulders and now I can spend the rest of this 4th year applying for residency, interviewing, and having tons of fun since I have NO MORE TESTS!!! Now that I’m done celebrating… well only temporarily, I just wanted to post my reflections of the exam. For those of you that don’t know, it consists of 8 distinct 46-question blocks and 1 hour of “break time” to be distributed as you please. I decided to do things like this (skip to the paragraph below if uninterested in the scheduling). As you will see, I knew that I’d have a little more stamina in the morning, so I did them in 92 question spans, versus the afternoon, where I pretty much needed a little breather after each block to regain my focus, drink a Coke, use the restroom, etc.

Skip Tutorial (adds 15 minutes to “break time”)

Block 1

Block 2

10 minute break

Block 3

Block 4

5 minute break

Block 5

30 minutes (lunch)

Block 6

5 minute break

Block 7

10 minute break

Block 8

DONE!

I thought that this test definitely had a different feel than Step 1. The most obvious should be that there is an additional block of questions, as Step 1 only had 7 blocks of 50-questions (although I’ve heard they only have 48-question blocks now). That definitely required me to have alot of stamina to make it from 8 to 5! For Step 2 CK, the majority of question stems ended with, “what’s your next step in management” or “how will you treat this” or “what could have been done to prevent this complication” and a lot less of the simple “what’s the diagnosis.” There were even a few questions where you lock in your answer to the first part of the question stem, then they give you more of the case and you answer an additional question. Another thing that has changed since last year when I took Step 1, is the addition of media questions. For example, they may show the doctor perform a physical exam or play a heart sound. Some of the questions you didn’t even really need to listen/watch, but at least it added some variety and made it a little fun.

Now, don’t get me wrong, I said it had a different feel than Step 1, not necessarily that it was easier. There were still some basic physiology, biochemistry, and microbiology questions on there that were very reminiscent of Step 1. I couldn’t resist the urge to come home and look some of those things up (since I hadn’t looked at my First Aid for USMLE Step 1 in quite as much detail as I’d hoped) and somehow, I managed to get quite a few of them right! When I tell you I was psycho studying for Step 1, I really was! Apparently my studying back then was effective since I was able to accurately recall that info even when I though I was “guessing” on those today. Anyways, I felt the Kaplan questions were definitely harder than the real test. The practice NBME and USMLE sample CD questions were definitely more reflective of the real thing. In fact I would say that I had 2 identical questions today. I’m sure that I’m only remembering things because it caused some emotion (happy or frustrated), but it seemed like my test was heavy on OB/GYN (happy), ID (intermediate), and Peds (frustrated). I swear there were some diseases that came over and over! As for the study material that I used, I felt that First Aid was definitely useful, but even more helpful was the Kaplan USMLE flashcards. It goes through the 200 diagnostic test you need to know for the exam, and quite a few of those tests showed up on the exam and helped jog my memory.

Anyhow, I will definitely post another “numbers” post once my scores come in to show how I did on the Kaplan Qbank, practice NBME tests, and the USMLE sample questions compared to the real thing. Now I am going to resist the urge to go through the entire First Aid book like I did for Step 1 because there’s no looking back and I just have to wait for my score. I’m off to Atlanta tomorrow for my away sub-I… I guess I didn’t give myself much time to celebrate and pack!

Improving! August 27, 2008

Sorry the posts have been short/lacking lately.  I’ve been trying to stay focused on getting ready for Step 2 CK!

Yesterday, I took NBME Form 3 for the Step 2.  My score has increased 16 points since the practice test that I took that was given by the school .  I’m pretty pleased, since that’s higher than what I got on Step 1.  Now I just need to get a few more points on my side and get it done on Friday!

Almost Caught Up! August 25, 2008

So I’ve finished up reading First Aid for the USMLE Step 2 CK, Crush Step 2, and the Kaplan USMLE Flashcards!! I haven’t quite finished the First Aid for the USMLE Step 2 CK Cases, but that’s not going to be too anxiety-producing for me.  Now for the next 3 days I’ll just be doing questions like crazy, and doing a quick re-read of the First Aid that now has all of my annotations.  My plan for tomorrow is to wake up and take the full-length practice test so that I can get an idea of how to last through 8 hours of questions with only 1 hour break!!

 

PS. Looks like my Medicine Letter of Rec is definitely going to be great!  I met with my attending today just to talk about my career, etc. and he confirmed he’ll be writing me a great letter .

No More Breaks August 20, 2008

I had a great time at home, but as I expected, it put me behind schedule by a few days.  I’m now officially 2 days behind and am forced to study extra each day to catch up!  So far I’ve gotten through 11 of 18 chapters in First Aid for the USMLE Step 2 CK and 11 of the 30 chapters I was planning on going through for Crush Step 2.  I essentially read First Aid and then add the bits from Crush Step 2  that were missing.  I’ve also been annotating from the respective chapters in First Aid Cases for the USMLE Step 2, which is a nice way for me to do some application of my reading.  At the end when I re-read for review, I will only have to focus on reading one book.  In addition, I have done 6 of the 13 subjects in the Kaplan USMLE Flashcards.  The disappointing part is that I have only gotten through about 450 questions in the past week and a half.  I have 9 days to go and 1790 questions to go!  I guess I was so caught up in the reading/flashcards/annotating, that I neglected the questions.  So I’ll be picking up the pace and averaging 200 questions a day to catch up… along with my reading. 

Man, maybe I should’ve just waited until Christmas to see my family .

USMLE Step 2 CK Preparation August 11, 2008

I decided the best way to start troubleshooting how I should study would be to take a look at the practice NBME and see my weak and strong areas.  The scoring was based in three categories: Physician Tasks, Normal Conditions and Diseases, and Disciplines.  The breakdown definitely showed that I’d was on the had Medicine/Psych/Neuro half, and that Peds/OB.GYN were the first rotations of the year! Here was my breakdown from best to worst in each category:

Physician Tasks

Diagnosis

Understanding Mechanisms of Diease

Principles of Management

Preventive Medicine & Health Maintenance

 

Normal Conditions and Diseases

Normal Growth & Development: Principles of Care

Diseases of the Respiratory System

Cardiovascular Disorders = Diseases of the Nervous System & Special Senses

Mental Disorders

Gynecologic Disorders

Immunologic and Blood Disorders

Disorders of Pregnancy, Childbirth & Puerperium

Nutritional & Digestive Disorders

Renal, Urinary & Male Reproductive Systmems

Endocrine & Metabolic Disorders

Musculoskeletal, Skin & Connective Tissue (I guess it’s good I’m not doing Ortho…)

 

Disciplines

Psychiatry

Medicine

Surgery

Pediatrics

Obstetrics & Gynecology (I’m gonna blame it on the fact that this was only my 2nd rotation of the year, I still think I’ll make an excellent OB/GYN)

 

So pretty much I’m going to study in reverse order with my weakest areas first, using First Aid for the USMLE Step 2 Clinical Knowledge as my primary resource for content and Kaplan Q Bank as my primary resource for questions.  I also have review books from each of my rotations and Crush Step 2 as additional content resources and then USMLE Step 2 Secrets and Deja Review USMLE Step 2 as additional question resources.  I’m gonna chip away at it one day at a time, hopefully at least 8-10 hours a day.  In the next 2 weeks I’ll throw in the practice Kaplan test and the practice NBME to make sure that my scores are improving.  Wish me luck!

USMLE Step 2 CS Recap August 6, 2008

Yes, I’m done! Now for the recap:

When I took Step 1, people made fun of me for taking a practice drive to the testing center. Well, I should’ve done that this time around! I left my place around 7:25 and made it all the way to the second to last turn with no difficulty. Then I made a right instead of a left and that took me a mile out of the way before I could turn around. But, I remained calm, eventually made a U-turn and made it to the parking garage with about 4 minutes to spare. Then I get to the parking garage and see that parking is $10 a day! I’m thinking, “I already paid $1025 for this test and they couldn’t cover the parking fee!” However, once I made it upstairs, the first thing that the secretary asked for after my ID was my parking ticket to validate it. From that point forward, I was candidate #13, which sounds like an unlucky number, but we were also on the 13th floor so I figured that was a lucky coincidence.

Each of us is assigned a number, given a badge with the corresponding number to pin on our shoulder and our lapel. We are then taken to the break room which has cubbies and desks with our assigned number. You have to lock everything in the cubby room, but are allowed to keep snacks or lip gloss at your desk. The door is locked; we take a seat and the orientation begins.

Here’s how the day went:

8AM – Start Time

Orientation video and remarks

Encounters #1-5

Lunch (30 minutes, provided sandwiches, salad, fruit, cookies, and beverages)

Encounters #6-9

Break (15 minutes, cookies and beverages still displayed)

Encounters #10-12

Test Day Survey

3PM – End Time

Overall, I felt that the day went pretty quickly. We had 15 minutes for the history, physical, and patient education/counseling. Then we had 10 minutes for the patient note, and I was so happy we could do it on the computer since I can type faster than I write, didn’t have to worry about legibility, and I could delete!

As for my mistakes: I only ran out of time with one patient, and I had to speed through my closure as the proctor opened the door for me to exit. This was right after lunch, so beware of the food coma! There was another patient where I did the Neuro exam (sensation, motor strength, DTRs, etc), but somehow only did CNII, forgetting the rest of the cranial nerves! There was 1 patient (the first) that I totally forgot to ask about medications and allergies. There was one that I asked about allergies, but forgot to write in the note (and noticed as I was proofreading right when I had to press “submit”). Otherwise, I felt that I did a good job of eliciting a history, doing the proper physical exam, answering the challenging question, educating the patient, and closing successfully. The patient note was not too bad and there was only 1 where I could not come up with a 5th differential diagnosis. Usually it was broad enough to be able to come up with 5 differentials and 5 workups.  Hopefully these mistakes didn’t cost me a “PASS.” I’ll keep you posted.

I felt that the CPX exam was very good preparation for the types of cases and to get practice with the timing of the H&P and practicing the patient note. I thought that the First Aid for the USMLE Step 2 CS was definitely a great resource for preparation. The book did a great job of pointing out the key questions need to get a maximum number of checkmarks. It was also accurate with the “Challenging Question” portion of the practice cases, which was useful to have practiced beforehand. Well, I’m happy I am done. Now I need to start getting ready for Step 2 CK!