Liz's Medical School Journey

“Step 1,” “Boards,” “USMLE,” “US Medical Licensing Exam Step 1,” or whatever you want to call it… is dominating my life right now.  If you prefer not to hear about it, then skip this post (and probably the next few as well).

I’ve informally polled my resident and young doctor friends about medical school, and it seems most agree that the Step 1 exam was their lowest point in medical school.  Also, most say they would gladly repeat 3rd-4th year, but  NOT 1st-2nd year.  A high school classmate who is now an OBGYN resident wrote, “Good luck! I have some of the worst memories studying for Step 1, it’s truly the worst Step! Remember, it only gets better after this…”  *sigh* I am at this low point, but have lots to look forward to.

I wish I could tell you more about the history of the USMLE Step exams, but I obviously do not have time for that right now.  I do know at some point, it became mandatory that every 2nd year medical student in the USA pass this exam before beginning third year, including me, of course!  Over the course of this year, I have slowly come to terms with the horrific tests that await me, including my current buddy, “Step 1.”  Now that my test date is less than 3 weeks away, I can tell you all the basics.

The exam is an 8-hour, multiple choice test (seven 1-hour blocks with 48 mixed-topic questions plus 1 hour break).  It is administered by our favorite company, Prometric, who brings us great joys, such as the MCAT, SAT, ACT, LSAT, etc.  The Step 1 exam costs $505, but the real cost is more like $1,000-1,500, once you include the study materials and access to online practice questions.  There is no option to retake this exam, unless one fails it.  In which case, one must retake the exam until a passing grade is achieved.  Each exam is recorded on the medical transcript.

Basically, the score is out of 326 (possible points= # exam questions).  The national average is 215, and the average scores of residents in different areas of medicine vary drastically.  As the deans at my medical school said, “some residency programs are more boards oriented,” meaning they consider board scores to be as important, or more important, than character evaluations or clinical performance.  These areas include Dermatology, Anesthesiology, Radiation Oncology, to name a few.  It is rumored that some of these residency programs do not even look at applicants who score less than 240 or 250 on their Boards.  Fortunately, I don’t believe these professions embody my callings in medicine.

Yet, like all my fellow 2nd year students, I still feel tremendous pressure to do well on the exam.  On my future residency application, this exam score will weigh-in more than my entire performance during 1st and 2nd years.  Given that I don’t know which residency programs I want, or where my husband and I hope to live, I want to keep my options open.  And, most of all, I want to avoid any future disappointments and regrets.  I am humbled by the fact that I have never felt that a standardized test score truly represented my gifts.

At the moment, my mood fluctuates between feeling like “this isn’t so bad, I will  do great,” and feeling like a total impostor to medicine.  Since my last exam ended a week ago, I have been studying around the clock, 7-10 hours of study time daily.  For me, this is the most I’ve ever studied in my life, and it requires mental discipline and stamina.  At first, I thought I was going crazy (feeling anxious, tired, upset, hungry, and restless), but thankfully the human body is quick to adapt.  Today I remembered that it is important for me to avoid total isolation (which is tempting), and hence here is a blog update.

My evolving study schedule I made with sticky-notes, so I can move things around (another student's idea). As you can see, next week is mostly empty.

This entry was posted on Monday, May 17th, 2010 at 6:07 pm and is filed under Medical School Life. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.