Advice requested

[f1doc]

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[SlaveOfTCMC]

Hi folks,

I don't post here very often, but I find myself in a pretty awful situation at the moment. Any and all advice is welcome - I realize I am in for a reality check.

Here is the situation - I am currently scheduled to take Step 1 this friday. I was originally slotted to take it last week, but I pushed it back due to new onset of a chronic illness that cost me several weeks' worth of study time. I don't want to play this up too much, I'm a strong believer in the "**** happens, deal with it" philosophy. Due to the fact that my school gave us 6 weeks in total to prepare, I knew this was going to be a challenge.

A week and a half ago, I took NBME 11, and got a 190. I wasn't horrified - I was well behind on prep, I was tired when I took the practice exam (5 hours of sleep), and I took the exam in one go, without any breaks between question blocks - as a result, I made a lot of silly mistakes. Even so, I knew that even accounting for silly mistakes, I needed to double down and study harder.

I did so, cramming as much knowledge into my brain as I possibly could. I read more of Goljan, did more Uworld questions, and read as much of FA as possible.

Fast forward to this weekend - I took my final practice exam (NBME 12) today, and scored lower (a 182) . I have not YET started my final review (was planning to do so Sunday - Thursday), but I was still horrified. I did better in some subjects, but did worse in others, than the original practice. And this time, I was alert, fresh, an focused - and really felt like the exam was easier than the first time!

That brings us to today. Understandably, I have no idea what to do. This is the first time I have ever struggled with a standardized exam - I realize there is very little if any correlation, but I more or less breezed through all my previous standardized exams with relatively minimal studying, and scored high in both (SAT + MCAT).

Clearly, something is wrong. Either I am simply trying to cram in too much information in too short a time, or I am simply burned out (I have not taken more than a day off since I started studying), or I am simply incapable of memorizing vast amounts of information.

My options are limited at this stage - I cannot push my exam date back any farther. I am supposed to start 3rd year on Tuesday. I can either:

1.) Push my exam back to Saturday or Sunday. Monday is not an option, as there are some mandatory events at my school that cannot be skipped.

2.) Talk to school administration about pushing it back by a longer period of time. The dilemma is that in order to start our 3rd year clinical rotations, we MUST have completed taking Step 1. This leaves me at their mercy - I have no idea what they will say or if they will accomodate my wishes. I've never had any sort of academic issues, so I have no idea how receptive they will be, and frankly this option scares me.

3.) Just go ahead and take it on Friday, cram until I can't any more, and then pray I pass.

My future goals: I am seeking to get into a respectable internal medicine program. I had my heart (no pun intended) set on cardiology, but now I am willing to settle for any subspecialty that is mildly interesting to me.

Thanks for reading (the 2% of you that likely made it through this). I'm hoping the community can offer me some constructive advice. Cheers

Sorry to hear about that.

If I were if your position, I would maximize the time I can study/cram without sacrificing professionalism.

I am not trying to be a goody two shoes, saying that. Rather, it is imperative that you get a good working relationship with your clinical preceptors. Being late or no-showing is not starting off on the right foot.

Best of luck.

 

[mastamark]

Hi folks,

I don't post here very often, but I find myself in a pretty awful situation at the moment. Any and all advice is welcome - I realize I am in for a reality check.

Here is the situation - I am currently scheduled to take Step 1 this friday. I was originally slotted to take it last week, but I pushed it back due to new onset of a chronic illness that cost me several weeks' worth of study time. I don't want to play this up too much, I'm a strong believer in the "**** happens, deal with it" philosophy. Due to the fact that my school gave us 6 weeks in total to prepare, I knew this was going to be a challenge.

A week and a half ago, I took NBME 11, and got a 190. I wasn't horrified - I was well behind on prep, I was tired when I took the practice exam (5 hours of sleep), and I took the exam in one go, without any breaks between question blocks - as a result, I made a lot of silly mistakes. Even so, I knew that even accounting for silly mistakes, I needed to double down and study harder.

I did so, cramming as much knowledge into my brain as I possibly could. I read more of Goljan, did more Uworld questions, and read as much of FA as possible.

Fast forward to this weekend - I took my final practice exam (NBME 12) today, and scored lower (a 182) . I have not YET started my final review (was planning to do so Sunday - Thursday), but I was still horrified. I did better in some subjects, but did worse in others, than the original practice. And this time, I was alert, fresh, an focused - and really felt like the exam was easier than the first time!

That brings us to today. Understandably, I have no idea what to do. This is the first time I have ever struggled with a standardized exam - I realize there is very little if any correlation, but I more or less breezed through all my previous standardized exams with relatively minimal studying, and scored high in both (SAT + MCAT).

Clearly, something is wrong. Either I am simply trying to cram in too much information in too short a time, or I am simply burned out (I have not taken more than a day off since I started studying), or I am simply incapable of memorizing vast amounts of information.

My options are limited at this stage - I cannot push my exam date back any farther. I am supposed to start 3rd year next Tuesday (the 14th). I can either:

1.) Push my exam back to Saturday or Sunday. Monday is not an option, as there are some mandatory events at my school that cannot be skipped.

2.) Talk to school administration about pushing it back by a longer period of time. The dilemma is that in order to start our 3rd year clinical rotations, we MUST have completed taking Step 1. This leaves me at their mercy - I have no idea what they will say or if they will accomodate my wishes. I've never had any sort of academic issues, so I have no idea how receptive they will be, and frankly this option scares me.

3.) Just go ahead and take it on Friday, cram until I can't any more, and then pray I pass.

My future goals: I am seeking to get into a respectable internal medicine program. I had my heart (no pun intended) set on cardiology, but now I am willing to settle for any subspecialty that is mildly interesting to me.

Thanks for reading (the 2% of you that likely made it through this). I'm hoping the community can offer me some constructive advice. Cheers

You are probably just stressed about it. I would say talk to the necessary person to allow you more time. I had the same problem a few weeks ago. My NBME scores were all over the place and it wasn't because of a knowledge deficit but stress surrounding this thing and a bit of standardized testing issues.

I know many won't agree with this, but if you can get yourself an extra 2-3 weeks, and you can afford it, consider doing an online prep course. Not that you have learning problems, but stress tends to send us scattering. They may keep you on task and you may maximize that time. A system will help most IMHO. I started off my NBMEs before studying at 200, which I was fine with at first because I just started. Then after 4 weeks I scored 200 again, a week later I fell all the way to 179 and it freaked me out. I ended up jumping from a 210-217 in one week, which happened to be a week before the real thing, which it was closer to 230+ but hey after taking it I hope I at least passed the thing altogether.

Depending on what you want, you might be able to get huge gains in 2-3 weeks, but one week is a stretch. Not because you cant learn it, but the stress may be a big factor. You never know though, sometimes just grasping a few missed concepts can lead to a huge jump in scores.

Good luck

 

[quepatho]

I get the feeling I know where you go to school...it sounds a lot like where I go to school...esp if it's in f1...

IF it is where I go to school the advice I have is: The administrators can and will help you IF you tell them you are not passing. But you will probably have to contact them. Contact the Dean in charge of Student Affairs and this person will tell you how to proceed.

It might not look amazing with the administration, but it will look a lot better than a fail on Step 1.

I apologize if i've made too many assumptions here.

 

[f1doc]

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[f1doc]

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[quepatho]

I spoke to the Dean, and my only recourse is to either take a year off, take the exam, and then do research, or take the exam now and hope I pass. Contrary to logic, if I fail the exam, I am allowed to skip my 2nd rotation, retake the exam, and then make up that rotation in my 4th year (losing an elective rotation in the process).

My question to you:

What are your recommendations? I'm not too excited at the prospects of taking a year off, but I don't know how it will reflect on me if I fail the exam, either. My goal is to get into a decent internal medicine residency so that I can enter a fellowship of my choosing. Here's my tradeoff:

1.) Take the exam, and hope I pass. If I don't pass, bust my *** and make sure I pass the second time. I don't lose any time, and I stay on schedule for a 2013 graduation. I know that if I pass on the first try, it will be by a narrow margin (190+)

2.) Take a year off, ace the exam, and do some research after I take the exam. Probably won't reflect well that I took a year off, but I won't have that black mark of a fail on my transcript. Downside is I lose a year (I'm already 24).

Suggestions? Comments? Thanks all

Hmm, yeah it definitely sounds like you go to my school (that's the kind of attitude they have around here). Although I was told that in emergencies (like if I went in and told them I was going to fail), they'd let me put a 3rd year rotation in 4th year. But that it had better be an emergency. (I was told this privately by the dean of student affairs and that they would not like it at all if I had to do it).

BUT, first of all, I don't think it looks bad to take a year off. AT ALL. I don't think it looks bad even at ALL. I nearly nearly nearly did that myself because I am totally LOSING it only having 5 weeks to study. Research is always a good thing! Also, I know of at least 4 people who are doing that just because they want to do research (on top of the 8-10 MD/PhDs).

The only reason I haven't taken the year off (and I mean the ONLY reason) is because I have a significant other who wants me to graduate at some point in the future. I'm 26, I'm even older ;-) I already took off two years before I even started. If you want a fellowship, taking an extra year for research is only going to help you even more.

But if it's really important to you to graduate on time, then just cram First Aid like no one's business and go in and I would *bet* that you would pass.

*Edit: Did you ask them at all about the possibility of a scheduling change to put your elective first? So you'd have more time to study?

 

[happylunchbox]

Downside is I lose a year (I'm already 24).

I'm sorry you're dealing with this--did your dean make any recommendations? He/she may have more insight since she'll have the benefit of knowing your performance until this point and how similar students at your school have done on step 1.

Also, realize that being 24 years old with half of med school behind you puts you on the younger side of things. While it sucks to loose a year (if you decide to go that way), it's not like you'd be pounding Ensure to try to keep up with your peers.

Good luck with your decision.

 

[f1doc]

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[quepatho]

I did indeed ask about moving my schedule around in every which possible way, but the answer was a flat-out "Not possible". It's incredibly frustrating that the incentive is for one to fail rather than take a bit of extra time to pass, particularly since I thought I had a reasonable explanation.

Ah well.. I am edging towards taking the year off, in any case. A year of my life lost perhaps, but it's well worth it to ensure that I end up where I want to be with my career. Thanks for the advice! You're absolutely right, there's no reason why taking more time should hinder me. Good luck with your studying

Thanks for your well wishes.

Try not to think of it as a year lost, but a year towards working towards the fellowship of your choice, having the options you want.

Taking two years off did a good thing for me getting into medical school; I had a lot of options and I got a good scholarship to study here. I'm SURE taking time to do research (maybe also volunteering?) will help with getting into residency even more.

Again, I'm actually kind of envious of you taking the year off. You will have a lot of freedom to *decide* what you want to do. It is NOT a mark of shame in any way. It would absolutely be my first choice under normal circumstances.

Remember that this is NOT a mark on you - some schools give their students 10 weeks to study for Step 1. And yes, it makes a *huge* difference not having the extra time, despite what any administrator might say.