True dat. I agree completely.
I have been having some reservations about kissing buttock to get a grade, so I have opted to focus on doing the best I can with my patients, working hard, and learning as much as possible.
I can completely control my shelf grades, Step 1 score, and Step 2 score. If I do not succeed on them, it is because it MY OWN DAMN FAULT, not because I didn't know the right people.
To be honest, how my patients think of me has mattered to me much more than colleague opinion. Medicine, after all, IS a business, and the patients are our customers. I have worked crappy jobs through my undergraduate education, paid and borrowed my way to get into medical school, and had to do it on my own without family help. (1st generation college graduate, let alone graduate medical education).
As a person from a humble background, I have always adhered to the "patient comes first" philosophy, perhaps at the expense of not buying into academic politics. I am not too proud to do things that some have snubbed their nose at, like making psych appointments for patients that need it, asking nurses if they can change the food we're giving them, etc.
I used to not worry so much about standardized tests, but after the MCAT, I came to realize that it DOES matter when everything is said and done. After applying to out-of-state schools and every in-state school, I learned that the out-of-state schools cared most about the MCAT because they really have no way of validating an "Honors" or "A" at "John Q. State University" in the same way that residency programs have no yardstick of grades from "Pam J. State Medical School." A dean at a U.S. medical school told me this in person at an interview out-of-state. I had traveled thousands of miles and came within a few points of a dream, only to be told that out-of-state applicants require higher standardized test scores in order to justify accepting them when in-staters have first dibs on slots. In the same fashion, a surgery residency director told several medical students in a meeting point blank that the same goes for Step 1. He said that many residency program directors across the country will deny left and right that they don't use the test to screen applicants, but they do it anyway because they have to in order to deal with the volume of hopeful medical school graduates opting for slots with limited availability.
After all, what does an "honors" at "Pam J. State Medical School" REALLY mean? You like the same music as the attending resident? You knew upperclassmen that told you what the right things to say were? You had better coaching from your alma mater from undergrad who have teamed together to provide an unfair advantage?
I opted to study for the boards 2nd year. Ironically, my class grades went up because I was able to go through a review book 2-4 times before the tests, listen to Goljan several times, and do 8-10 years worth of old test questions, whereas before I was lucky to get through the syllabus 2x, lectures once, and only 1-2 practice tests. I simply matched what was on the syllabus with BRS Path, First Aid, etc, and broke everything down into digestible morsels.
Repetition is the only way for me. I must have a hard head or something and need information constantly reinforced for it to sink in. It didn't really matter how I did it--writing notes, listening to myself read First Aid after recording, reading something over and over again; the only effective measure for me on how well I would do on a test was the number of times I could get through the material and how much time I spent doing questions and learning from my incorrect answers. Since review books tend to focus more on USMLE concepts than phD randomness/medical esoterism, I opted to go that route.
ABSOLUTELY NO REGRETS. I would rather not succeed on my own terms than rest my fate in the hands of others. At least I can learn directly from my own mistakes instead of having to discern between any of my potential shortcomings (not that there are any 😉) and that of others.
