Advice for USMLE 1 and ADHD

[orangethings]

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Hello,

I am an MS2 with diagnosed ADHD and have been on medication, Adderall, for years. I am terrified of taking Step 1 of the boards and was looking for another ADHD person who could share their experience. I'm super worried about maintaing that level of focus and concentration for such a long period of time. Most of the exams we have last 3 hours, and while the question to time ratio works out the same, I'm worried about the sustained amount of time. Can anybody help?



😱

 

[El Chupacabra]

I don't know if yoy are on XR, but an option could be to break up your dosage throughout the day. Ask your physician, but you could technically take 10-20mg three times a day, and that would help keep that dopamine flowing in the PFC. Consult your physician for sure!

 

[kcrd]

I don't have ADHD, but I don't think you should be too concerned about the USMLE. You are alloted about 1 hour (?I think) of break time during the test which you are free to break up between sections as you wish. I took a few small breaks and a long lunch, but if you need to, you could take a 10 minute break every hour.

 

[Megalofyia]

Does anyone ever get accomodations on the USMLE 1, 2, or 3?

What about people who had accomodations for MCAT and other standardized exams?

 

[Blade28]

Have you tried taking practice Step 1 exams? I know Princeton Review and Kaplan have some. That way, you can see how you do in one-hour chunks.

 

[phillymed]

accomidations for the MCAT are rare now basicly because they are even more rare for the USMLE.
I discussed this with people through out AMCAS. Basicly, their stance was that people recieved accomidations on the MCAT and then not on the USMLE. THe result: problems passing the USMLE and a useless MD degree.
The USMLE folks justifly them selves by saying they have the 'public interest and safety' to think about; therefore, they are VERY strict about giving out accomidations.

You could take a shot at getting accomdiations. You'll need specific doccumentation of your diagnosis before age 12.
Whats more, they will use an ADA definiton of dissability (i.e. that it can not just impair your performance, but your perofmrance must be 'below average').
The rub (and not to sound like an MD elitist), but you probably would have not made it to the USMLE if your performance was 'below average'.

XR medications are work well. Ritalin XR seems to help. ANd there is now an even longer release welbutrin. Im not sure if welbutrin has been approved for aduld ADHD yet.

basicly practice, practice, practice, coffee, and more practice...

 

[mutjeng2]

I gotta give you guys props..

Anybody with ADHD who is able to go through med school must have an incredible IQ!

Think about the amount of stuff you need to know and the necessity to sit down for hours to study for it..

having said that i just wanna say that i know a dude with ADHD in medschool he was actually diagnosed during his third year. He studied for step1 and although i noticed him having problems concentrating.. he was disciplined enough to study and pass it on the first try.. and that was before he was diagnosed and on no meds..

good luck..

mutjeng2

 

[Maire]

Dear orangethings,

If you take regular Adderall, take your morning dose about an hour before you start and your noon dose when you take lunch. Take some Ibuprofen at lunch too, at least I found that was better than the headache I got from the computer screen on Step 1. (I took the Ibuprofen during Step 2, and it worked great!) If you are a caffeine addict, as many of us are, do not choose to go off coffee that day or you could end up with a withdrawal headache. Headaches make it even harder to concentrate.

The other thing you have to be careful of is any tendency you have to hyperfocus. If you run into a question that is tough, and you get wrapped up in figuring it out, it is easy to spend far too much time on it. In a regular three hour exam, that doesn't matter so much, because you can make up the time later, but on the USMLE you only have one hour for each section and you can't make it up as easily. If you run across a question like that, just mark it and go on and finish the rest of the section. Then you can go back to it at the end.

One thing I noticed was that I finished most of the morning sections with time to spare, but in the afternoon sections I used nearly all my time. Maybe it was fatigue interfering with my concentration, but I was glad I saved some of the morning minutes and some from lunch so I could still take some short breaks in the afternoon.

I have read that accomodations are difficult to get, and require psych testing and other "objective" evidence of the problem and the necessary accomodations. I didn't even try to apply, because if you get accomodations, your score will indicate that you received accomodations, and your score will likely not be viewed as equivalent to a score received without accomodations.

I ended up doing fine, and I'm sure you will too. If you have any other concerns, let me know.

Maire

 

[orangethings]

Thanks to everybody for all the good words of advice since I posted. I'm not going to try to get accomodations, I prefer to stick to the normal routine as much as possible and definately don't want anything weird looking along with my score. Thanks for the specifics Maire, I usually take some Nsaid as it gets closer to exam time now, and I have forgotten to avoid the headache during the exam. Great suggestion!

I also do have a tendency to hyperfocus when I don't KNOW the answer to a question, and that lately, especially in the face of long clinical vignette style questions, has definately been hurting me. Do you have any other suggestions for dealing with reading the long questions and not being overwhelmed by the distractors?

THANKS AGAIN EVERYBODY!

 

[kungfufishing]

lots of people with the ADHD have taken and done great on step one. I wouldnt worry about the test day itself. worry about focusing yourself to study.

 

[aerial]

I was browsing through a new edition of Iserson's recently-- guess I was too weak to ignore its shocking pink cover-- and there was a page or so dedicated to medical students with learning disabilities. The following is one that I remember reading about: http://www.marshall.edu/medicalhelp/description.html
I know your question was in regards to Step 1 but this link may be a good start to finding more information.

Good luck!
Aerial

 

[aucdiver]

http://www.usmle.org/test-accommodations/guidelines.html#guidelines-adhd

 

[pd1112]

You realize this thread has been inactive since 43's first term, right?