How to Survive Medical School: Step 2 CK and CS

Over the past couple of months, I’ve received a flurry of emails and Instagram messages about USMLE 2. These messages have one common question: “how do I study for USMLE 2 CK?” These questions, by my interpretation, are sent by medical students who are a bit more flustered than the medical students who send inquiries about USMLE 1. There are probably a couple of reasons for this. For one, there is insane pressure to receive a higher score on USMLE 2 than USMLE 1. If you crushed USMLE 1, you’re left kind of wondering…how can I reasonably do better? And, understandably, if USMLE 1 did not go the way you wanted…the pressure to do extremely well on USMLE 2 is high.

The awesome thing about USMLE 2 is that you’ve been studying for this exam since you started your clerkship year. The manner in which you prepared for your shelf examinations is honestly the way you should prepare for USMLE 2. I won’t address in this post how I approached each particular subjective given that there are three posts that address my approach to OB/GYN, Internal Medicine, Family Medicine, Surgery, Pediatrics, Psychiatry, and Neurology.

You figured out the kinks of studying for standardized examinations when you studied for USMLE 1. Aspects that I addressed in my USMLE 1 post such as registration, study schedules, and etc. aren’t worth revisiting in this post. Give yourself some credit. You already know how many hours you can study a day, how many days off per week you need to feel like a normal human, and what examination snacks are gonna carry you through test day. I say all of this to reassure you: you are going to be great. I say all of this because I am still extremely aware of how panicked I was before USMLE 2 and I was legitimately more stressed for USMLE 2 CK than USMLE 1.

Why? Well, I think people downplay USMLE 2. I asked quite a few people the year above me for their advice for Step 2. The advice I received was minimal: “you don’t need more than two weeks or so. It’s easy.” You guys are going to do well on this exam, I have faith in you, but it is by no means easy. Like all standardized examinations, USMLE 2 CK can be tricky. There are questions that are you almost guaranteed to look at…skip…come back to…look at…shed tears…say a prayer…make an educated guess. That’s fine and honestly to be expected.

In this blog post, I’ll share my approach to receiving a 250+ score on USMLE 2 CK and share a little bit about how I prepared for USMLE 2 CS.

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Guest Post: Why Medicine?

“Why medicine?” is the questioned I answered when I asked my undergraduate professors to ask letters of recommendations. It’s the question I answer when strangers and I exchange snippets of our lives in airports, on trains, or in the grocery store. “Why medicine?” is the question I answered in my medical school interviews and to an extent in my recent residency interviews. “Why medicine” is the question I ask myself when motivation runs low. Life of a Medic reached out to a handful of individuals in the medical blogosphere to share our answer to “why medicine” in 10 words.

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Check out the rest of the contributions here!

 

“I am tired of knowing nothing and being reminded of it all the time.” – F. Scott Fitzgerald

Four core rotations down. Three more to go. Today marks my second week of clinical duties on the psychiatric ward. It’d be a lie to say I’m not nervous about this rotation in particular. I mentioned some of my anxiety to one of my colleagues today and he responded: “oh c’mon, Ajibike, you’re always nervous at the start of a new rotation.” To an extent, he is right. There’s an overwhelming sense of I know nothing that accompanies the start of each rotation. It seems as though the moment when I feel comfortable on a new service is exactly when it is time for me to move onto a new team.

Everyone who knows me knows that I love F. Scott Fitzgerald. Many of his works are fixtures in my list of favorite novels. When I stumbled upon this quote, I knew it would serve as an honest introduction for this post. This quote = mood.

MS3 is the year during which you amass a ton of clinical knowledge.

MS3 is the year during which you learn to not “sweat the small stuff.”

A MS4 told me at the start of my MS3 year that I should be prepared for moments when 150% effort will be rewarded with an evaluation that reads: “Good student.” She told me that it’s important to hold learning the art and practice of medicine as my main priority rather than impressing attending and resident physicians. Unsurprisingly, I followed her advice with: “Okay…I hear what you’re saying but what can I do to be a good medical student.”

She gave me three pieces of advice that I still find incredibly valuable:

1. Know your place.

2. Take ownership of responsibilities related to your patient(s).

3. Present well.

What does it mean to present well? Each discipline has their own twist on the history & physical or SOAP note…but at the end of the day, a good presentation is: concise, thorough, and accurate.

The major 🗝 to a good presentation is: organization. On my first couple of clerkships I made my own templates to record information on each of my patients. I also toted around an myriad of documents (physical exam maneuvers listed and described and an extensive review of systems). On each team, I learned what my attending wanted from me and adjusted my presentations accordingly.

I felt a lot of pressure when I started my pediatrics rotation. I came into medical school with an interest in pediatrics and so when the rotation rolled around, I wanted to impress my attendings. At that time, I got my hands on a Perfect H&P notebook.

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This notebook fits in a white coat pocket and is affordable – only $15 guys! The notebook supplanted all of the documents I was carrying around in my pockets. I’ll talk a little bit about how the notebook is constructed in a moment. I will say that this notebook is perfect for wards work. Sure, certain disciplines may require a bit more material on topics not specifically mentioned in the notebook. I’d say that this notebook is a great organizing tool for internal medicine, surgery, family medicine, and pediatrics. I can’t speak to neurology or OB/GYN as I haven’t completed those rotations yet. I will say that I don’t think the notebook is as helpful for psychiatry.

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The template has checkboxes for basically ALL the physical examination findings and symptoms (for review of systems) you could possibly want. I will say that the section for laboratory results is on the small side.

One aspect that I really appreciated is the sect ion for differential diagnosis. On so many rotations, I haven’t been required to present my differential for each aspect of the problem list. That’s honestly been a disservice to my education but I’ve found that  forcing myself to think of a differential (of at least 3) has helped me to present more sound assessments and plans.

I’m hooked on this notebook and I fully intend to pick up another one before I start my sub-I in June!

If you guys have tips and tricks for presenting on the wards, I’d love to see them in the comments below!

Disclosure: Perfect H & P provided this notebook for free to be reviewed on this blog. All opinions are my own. 

“The new year stands before us, like a chapter in a book, waiting to be written.” – Melody Beattie

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Happy New Year! My hope is that all of you have an amazing 2016 filled with love, happiness, adventure, and unforgettable moments. If you’re anything like me, you see the start of the new year as a moment to reflect, grow, and become a better person. I love making (keeping few, breaking some) resolutions. I make resolutions at the top of the year (which I reevaluate at the start of each month), prior to the start of Lent, and on my birthday.

As some of you faithful readers probably would have guessed, I have a system for making resolutions. I start with five categories — academics, personal health, faith, passion projects, and relationships — and make 1-2 goals per category. In short, these resolutions push me toward finding more balance in my life.

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“Punishment has become the social fabric of everyday life.” – Victor Rios

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Before I launch into the subject matter of this post, I just want to make a quick comment on the recent decisions made by SCOTUS. As a physician-in-training, I recognize that my career in medicine does not operate outside the realm of politics. It is not only the legislation regarding healthcare (such as the recent Affordable Care Act decision) that is relevant but also the other major decisions such as (1) fair housing, (2) marriage equality, and (3) clean air — decision is pending.

The legal fabric of our society gravely impacts the quality of life of our future patients and thereby their health status. It’s important, as our patients’ advocate, for us to care about politics; for us to speak up for equality (in whatever form that comes). I’m proud of my country.

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