The Big Day

Boards Day was on Wednesday, June 18. This date is BURNED into my brain, because I’d spent about six months (since I’d picked the test day) remembering it as an important date. BURNED.

Anyway, the day went just fine. I woke up around 7, and ate breakfast while doing 25 questions on USMLEWorld. The idea was to get into the groove of answering questions, since I had noticed from practice tests and doing sets of questions that my first block was always my worst-scoring, regardless really of the difficulty of the questions. At the practice session, there was a 10%-point difference between my first and second blocks of questions. That is kind of ridiculous. So anyway, the plan was to simply answer questions in a timed setting (25 questions instead of 48 questions like a real block would have), and not score the block or look at answers.

Hahaha, like that was going to happen. I ended up scoring okay on the 25 questions, and I skimmed over the answers of the ones I’d missed. I don’t recall if any of those questions ended up on my actual exam, but more than anything, it was a way to soothe my Savage Test-Taking Beast.

Left the apartment at 7:45 AM, with plenty of time to get to the test center by 8:30. However, they were doing construction on the highway near my apartment, so a 13-minute drive (I’ve timed it) took nearly 45 minutes, instead. I was going out of my mind in my car, eyeing the left curb, wondering if I could squeeze by. It turned out fine, because I am stupid and somehow got it into my head that I had to be at the test center 30 minutes prior to the scheduled 9 AM start time, when it fact it is only suggested that you show up 30 minutes prior, and instead I could not be more than 30 minutes late. Oops. So, all that sitting in my car yelling, “OH MY GODDDDDD, 8:17 AM!!!!” was for no real reason. At least it got me awake.

I had planned on eating a real lunch sometime in-between testing blocks, since you schedule your own breaks between the 7 hour-long testing blocks. But I brought a ton of snacks and drinks, and simply ended up eating a granola bar or piece of fruit in-between most blocks, instead of having a real lunch. Post-lunch food coma was not something I wanted to contend with. I lost track of how many blocks of questions I’d done, and completely lost track of time because you aren’t allowed to bring watches into the testing room. All I knew of time was the tiny countdown clock in the upper left-hand corner of the screen. It felt very post-apocalyptic or Brave New World, if you ask me.

As for the actual test itself, it was basically the Best of Times and the Worst of Times. I would get incredibly, almost laughably straightforward questions, followed by questions with options A through J and the most convoluted patient histories. During one block, I spent all of my remaining time trying to figure out one question that I just didn’t “get” — and I finally understood what they were asking for, and the second I reached out to grab the mouse and change my answer, the computer program’s dialogue box popped up and told me my time was up, and switched over to the “take a break” screen. SERIOUSLY. It was unbelievable. The only thing that made up for it was when I got a question that I never ever would have known, if I hadn’t miraculously looked at ONE study sheet I’d made back in August 2006, when we first started histology, during my last day of studying on Tuesday. I have no idea what possessed me to actually read the study sheet I’d dug out from under my bed, but MAN, am I glad I somehow looked at it.

So, you see, it was both the Best of Times and the Worst of Times. I can think of no other words to describe Boards than those of an author who pretty much embodied the dread and joy of learning in my youth. Yeah, I just compared Boards to Dickens. But like reading Dickens, studying for Boards is finally over, and I never ever ever have to do it again. Yay!

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Boards Studying, Days 18 – the end

Right, so I kind of stopped keeping such great track of what I did every day with Boards studying. Suffice it to say that I would wake up, check email while eating breakfast, head over to the library, and do the following:
– read some amount of First Aid
– read some amount of whichever review book I’d brought along (are you getting the sense that I was kind of just running around patching up whatever gaps in my knowledge without a real plan? Because I was.)

Then, I’d have a hurried lunch, followed with doing some questions on USMLEWorld.

Add to that a ridiculously unhealthy dinner (Whole Foods makes a surprising array of microwavable dinners) while watching an episode of House. Then, back to the library to:
– despair of ever being done, or of doing well on the test
– more questions on USMLEWorld

Every night’s nightcap was listening to an hour or more of Goljan audio. I had to stop listening right before bedtime, though, after I had a dream that Dr. Goljan was my therapist, and that he decided I needed more hours of therapy than I was currently getting. It was, to say the least, quite disturbing.

Toward the end of Boards Studying Mania, I switched to listening to Goljan audio and doing 50 questions in the mornings, before heading off to the library. The last week of studying was reserved for going over the entire First Aid book again, which was actually the most helpful thing I could have done. I kept thinking that I should have been doing more questions, but in retrospect, it wasn’t really helping as much, by the end. There were questions that I would get, where I knew I could find the answer in First Aid, but I didn’t know what the answer actually was. In the end, doing questions and finding that I’d already made notes on the exact tidbit of knowledge in First Aid, but didn’t remember doing so, was much more frustrating than if I’d just re-read the book alone. If only Boards had been open-book or open-notes. Oooh.

People I know kept pushing their test dates back, which was one thing that we had been advised not to do. I don’t know why people advise you not to push back your test date, especially since if you really do need the time, it can only help you calm down and learn. But I can see how it might make procrastinators lose steam. I have to say that on Friday or so, with my test coming up on the following Wednesday, I started to panic and didn’t think I could finish my admittedly ambitious schedule. (As a side note, I wish WordPress could upload Excel files so that I could share my crazy Boards Schedule, although I guess I could convert it into a jpg or ppt or doc (all of those are supported by WordPress) to upload.) I’d forgotten, though, that I’d built in a half-day off on Tuesday, the day before my exam, to run errands and relax and maybe watch a movie. Since I was kind of running behind and worried that I hadn’t studied enough, I decided to ditch the half-day off, and simply keep studying. The night before a big school exam, I would be studying to keep things fresh, so why not study the night before Boards? I did take an hour out of my day to head over to Whole Foods to buy pre-made meals (breakfast, dinner) and snacks for Boards Day.

I ended Tuesday night, June 17, at 9 PM. I packed up a few books I needed to mail home, watched the Lakers get trounced in Game 6 of the NBA Finals (hoping it was not a portent of my own Finals to come), and was in bed by 11:30 PM. I didn’t fall asleep until after midnight, but it was still about as much sleep as I was expecting to get.

Enter if you dare

I call this one, “Time Capsule on a Door.”

White board with crazy scrawl about the 4 main types of collagen found in the body, with obligatory picture of how cells stick to the “floor” of their layers.

Obligatory ‘nsync picture — I have to say that this was part of a Halloween costume last year, and I couldn’t bear to throw the picture away. Do you know how many magazines I had to flip through to find an actual group picture, not just Justin Timberlake? A lot.

LGBT Equality sign, or whatever the kids are calling it these days. Maybe this is why I seem to have a secret Gay Magnet.

My life in a snapshot. Yikes.

I won’t even show you the picture of my mirror, currently covered in the synthesis steps of collagen fibrils. It’s getting hard to see my reflection in the mirror, with all the scrawl.

We love acronyms

I was doing test questions on the renal system (kidneys and bladder), and came across this gem in the answer explanation:

“Straining on urination in the elderly male patient suggests bladder outflow obstruction (BOO). The most common cause of BOO is benign prostatic hyperplasia (BPH)…”

For some reason, this made me laugh and laugh. The most common cause of Boo!, like someone jumping out and scaring you. Or, boo as in “my boo,” like your beloved. Either way, hilarious.

(I have to get my kicks from someplace. If it means laughing at theoretical elderly men with enlarged prostates, then SO BE IT.)

Boards Studying, Days 11 – 17

Tuesday, May 27, 2008
Day 11
1) 45 cardiology and respiratory system questions.
2) started reading respiratory notes in First Aid
3) 40 minutes of Goljan audio #8
Total number of hours: 10 (WHOA)

Wednesday, May 28, 2008
Day 12
1) finished reading respiratory notes
2) 50 cardiology and respiratory system questions, 25 cardiology questions, 50 respiratory questions = 100 questions! (WOO!)
3) re-listened to Goljan audio #8
Total number of hours: 9

Thursday, May 29, 2008
Day 13
1) read endocrine and reproductive notes in First Aid
2) 45 endocrine questions, 10 reproductive questions
3) Goljan audio #9
4) House, “Fidelity,” which ended up being about African Sleeping Sickness, caused by the parasite Trypanosoma brucei and the tsetse fly. I don’t really know much about treatment, because clinically, it’s not seen very often in the United States. The other Trypanosoma-transmitted disease, Chagas disease, is at least slightly more often seen in US clinics, probably because it can hide for long periods of time, and because there are more immigrants from Central and Southern America than from Sub-Saharan Africa.

Friday, May 30, 2008
Day 14
1) 50 endocrine and reproductive questions
2) Finished Goljan audio #9
3) took a shortened day to watch Sex and the City the movie. It was INSANITY at the movie theatre for the 10 PM showing. We were standing in line with 23984123 other women, mostly falling into two groups: older ladies who were dressed up, made up, and DRUNK, and high school-aged girls who were dressed up, made up, and FAKE BAKED within an inch of their lives. My friends and I were the least well-dressed people there. Whatever, I put on REAL PANTS (okay, jeans) for the movie theatre! I got out of my sweatpants and flip-flops that I have been living in. I consider it “dressing up,” at this point. Heck, I consider clothes that don’t smell an upgrade. Sorry if I’m gross — I’m just barely a person anymore.

Saturday, May 31, 2008
Day 15
1) read gastrointestinal notes in First Aid
2) 90 questions on gastrointestinal system, 10 questions on endocrine system
3) Um…?

Sunday, June 1, 2008
Day 16
1) read all hematology-oncology notes in First Aid. I LOVE heme-onc (okay, that’s is a lie. I tolerate heme, but I LOVE onc), so this was a good day for me.
2) Goljan audio #10, 11. He yelled a lot during these lectures.
3) no test questions
Total number of hours: 9

Monday, June 2, 2008
Day 17
1) 130 hematology-oncology questions
2) Goljan audio #12, 13 (about 90 minutes of lecture)
3) House episode “Poison,” about pesticide poisoning. Notable episode only for the differential diagnosis, which included organophosphate poisoning. Organophosphate poisoning, usually due to pesticides, causes irreversible phosphorylation and inactivation of cholinesterases (an enzyme that degrades neurotransmitters so that the nerve endings aren’t constantly being “pushed” on). Overdose of acetylcholine neurotransmitters leads to the STUMBLED collection of symptoms: Sialorrhea (drooling), Tremor, Urination, Miosis (pupil constriction), Bradycardia (slow heart rate), Lacrimation (teary eyes), Emesis (vomiting), and Diarrhea. It can be treated with atropine (which is also used to treat glaucoma!) or pralidoxime, although the latter drug is better for early treatment.
Total number of hours: 11 (WHOA)

Still life

Boards studying, still life at home, 10 AM.

Boards Studying, Days 9 & 10

May 25, 2008
1) started reading cardiology notes in First Aid. Read all of the cardiology chapter of Rapid Review Pathology. OH PATHOLOGY, I have missed you so much!
2) 9 questions on histology, 20 questions on immunology (YUCKY), and 10 questions on cardiology = 39 questions.
3) finished Goljan audio #7, 45 minutes.

May 26, 2008
1) finished reading cardiology notes in First Aid.
2) read some Molecular and Cell Biology notes — I got a question wrong on ELISA on Sunday, and that just pissed me off because I’m usually good at questions on lab techniques!
3) 35 questions on cardiology.
4) 10 minutes of Goljan audio #8.
5) One of my favorite episodes of House, “The Socratic Method,” which ends up being about Wilson’s disease. This episode (and an unrelated story about Roommate Rebecca from college) made it easy to remember Wilson’s disease during school. Also watched an episode of Good Eats, because the universe loves me and somehow our week-long “trial” of Food Network has lasted 3 weeks. (We didn’t used to get Food Network, which is a TRAVESTY, because I do not need Fox News or 3 kinds of HBO if I don’t have Food Network, okay?)

Total number of hours spent studying: 9.5, which is pretty good, especially considering it was a holiday and the library was closed (ALSO a travesty), and so I had to study mostly at home. Studying at home is always a problem, because the bed is right there for napping, the TV is right there for watching, and my laptop is right here for checking email obsessively.

To do today: respiratory system! WOOHOO!

Boards Studying, Days 7 & 8

It’s the one-week anniversary of studying for Boards! Ugh, I’d like to break up with Boards. I think this relationship has already run its course.

May 23, 2008
1) read some notes on microbiology (viruses!)
2) did 50 questions on microbiology
3) listened to 45 minutes of Goljan audio (finished #6 of 37)
4) hit the JACKPOT of House episodes with s1 episode 4 “Maternity” — it was about an outbreak in the maternity ward! Totally money, because I’d just finished reading about all these crazy infectious diseases, and what you do to test them and treat them. Watching the episode consisted of a lot of pausing the DVD so I could look up the latest bug on the differential diagnosis. It was AMAZING, because the list covered bacteria and viruses, so it was like my entire day, encapsulated in an hour-long TV show.

Total number of hours spent studying: I dunno, around 9.

May 24, 2008
1) read notes on immunology
2) read notes on some pharmacology (drugs)
3) 20 questions on microbiology, 30 questions on pharmacology
4) no Goljan audio today
5) watched the season finale of Grey’s Anatomy instead… Grey’s is really, really light on the medicine, but I guess it was the season finale so I couldn’t really expect much in the way of actual content. Also, they mis-described the IRB. Internal Review Boards, or Institutional Review Boards, are formed by each hospital or research facility. There is no single national review board for clinical trials.

Total number of hours spent studying: around 9

Boards Studying, Day 6 – May 22, 2008

What I did today:
1) did 26 more USMLE World questions on embryology — no more embryology questions left!
2) started microbiology and immunology notes
3) did 30 microbiology (but not immunology) questions on USMLE World.
4) 20 minutes of Goljan audio (part of #6 of 37)
5) no House, but did spend 1 hour at the Medical Student Research Committee’s journal club meeting, talking about a pretty short paper in Science testing the use of farnesyltransferase inhibitors in treating progeria, a genetic mutation that causes premature aging in children. The hour was totally made worth it when the professor leading the discussion mentioned that one of the enzymes used by the disease is also known as HMG CoA reductase, the enzyme that statins work on to lower high cholesterol. And then he went through a quick sketch of cholesterol synthesis, and I was totally grateful for that tiny tie-in to Boards studying. I know, I’m super lame.

Total number hours spent studying: approximately 8 (YIKES, I’m falling behind).

Boards Studying, Day 5 – May 21, 2008

Accomplished today:
1) read notes on Embryology
2) 25 questions on USMLE World (need to do more embryology questions)
3) 45 minutes of Goljan audio (finished #5 of 37)
4) no House, but rather, spent nearly 2 hours watching the American Idol finale. Oops.
5) Registered for a practice session at the Prometric center. Unfortunately, the only date available was June 3, which is earlier than I wanted. But at least it was available.

Total # hours spent studying: about 8

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