If you could do it all again, what would you do differently?

[2gunornot2gun]

Relaxed more in preclinical years?
Started Step I earlier?

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[flatearth22]

Strong username to thread title ratio

 

[HolySmokes]

Strong username to thread title ratio

I don't think ratios work how you think they work.

 

[chiz2kul]

wouldn't

 

[RedSHIFT]

i would of accepted that minor league stint with the Las Vegas 51's.

 

[Chakrabs]

Perhaps. Only thing I would really change is probably spend less time studying for Step 1. I spent about 7 weeks studying and really got burnt out at the end. Didn't do nearly as well as I wanted. I think ~5.5 weeks would have been ideal. I ended up getting my top choice residency in a competitive field, so probably doesnt make much of a difference in the grand scheme of things.

 

[SteinUmStein]

Perhaps. Only thing I would really change is probably spend less time studying for Step 1. I spent about 7 weeks studying and really got burnt out at the end. Didn't do nearly as well as I wanted. I think ~5.5 weeks would have been ideal. I ended up getting my top choice residency in a competitive field, so probably doesnt make much of a difference in the grand scheme of things.

The diminishing returns of studying more than 5 weeks are way steeper than most people realize. 7 or 8 weeks of studying may actually lower your score if you peak early. Yes, this really happens.

 

[MilkmanAl]

I agree with that. I hit my peak at 5 weeks and struggled to maintain for the 6th.

Knowing what I know now, I would've done a lot of things differently, chief among them going to med school in the first place. Most of the changes I'd make are pretty small, though, and basically would've just saved me a bit of time and stress here and there. I actually feel like I played the game of med school pretty well, overall, and managed to keep my workload fairly low while still getting my top residency choice.

 

[JackShephard MD]

I don't think ratios work how you think they work.

lol

The diminishing returns of studying more than 5 weeks are way steeper than most people realize. 7 or 8 weeks of studying may actually lower your score if you peak early. Yes, this really happens.

It depends on what you call studying.

People will advise you to learn the sciences really well during the semester. Yet, let's say you have a horrible Micro class. Would spending a month before your 5 week dedicated time with good micro cards and a review book help?

The "pre-studying" is just learning the sciences well in the first place. It's difficult to differentiate studying for Step 1 and learning the sciences well.

I agree with that. I hit my peak at 5 weeks and struggled to maintain for the 6th. Knowing what I know now, I would've done a lot of things differently, chief among them going to med school in the first place. Most of the changes I'd make are pretty small, though, and basically would've just saved me a bit of time and stress here and there. I actually feel like I played the game of med school pretty well, overall, and managed to keep my workload fairly low while still getting my top residency choice.

You would have done what differently, not gone to medical school or other things during school?

 

[MilkmanAl]

Oh yeah, sorry. That was a bit unclear. I meant that given going to med school, I'd do some small things differently during it.

 

[Chakrabs]

Oh yeah, sorry. That was a bit unclear. I meant that given going to med school, I'd do some small things differently during it.

During dark times in 2nd yr, I seriously questioned what the hell I was doing in med school. But I honestly couldn't come up with something I could see myself doing as an alternative. It did help me through.

 

[drizzt3117]

I would probably have liked another few days to study for step 1. I took just less than 5 weeks and I think 5.5 is about the sweet spot.

 

[SteinUmStein]

During dark times in 2nd yr, I seriously questioned what the hell I was doing in med school. But I honestly couldn't come up with something I could see myself doing as an alternative. It did help me through.

I think it helps me keep going when I stop and realize there's nothing else I'd rather be doing. Not in a "medicine is awesome!" way, in a more discouraging "I have no other significant interests or talents" kind of way... I think if research worked a bit differently I could have done that, but I digress.

 

[Bartelby]

I think I would have done USMLE World Qbank questions during clinical rotations (or at least try it out to see if it brought up my shelf exam scores). I did fine, but I probably could have done a little better with more practice questions on the shelf.

Other than that I'm pretty happy with how things turned out. I was probably middle of the road in how hard I worked. I took time for personal relationships and accepted doing my best as good enough, what ever that turned out to be. I also lived pretty frugally and was lucky enough to get great financial aid at the best school that accepted me, making my debt burden much lower than it could have been. Now I am going on to a great program in the field that interests me the most (a less competitive one, but that isn't why I am entering it).

I guess you would need to ask me midway through next year if I still feel the same way! Fourth year probably has rose-colored glasses stapled to my face.

 

[SteinUmStein]

I guess you would need to ask me midway through next year if I still feel the same way! Fourth year probably has rose-colored glasses stapled to my face.

I can't wait for fourth year...

 

[thlaxer]

Fourth year probably has rose-colored glasses stapled to my face.

That sounds painful . Great advice in this thread, thanks.

 

[MedianEminence]

I played the game of med school pretty well, overall, and managed to keep my workload fairly low while still getting my top residency choice.

how? share ur secret

 

[MilkmanAl]

Honestly, I just aimed to know the core concepts and most important details from each block and didn't pay a lot of attention to my grades. I've always been very good studying efficiently, so I could get a lot of info down pretty quickly. That ability was also immensely helpful during the 6 weeks I studied for Step 1. Basically, I had all the key pieces down before Step studying due to how I studied for class and then used my time to refresh them and fill in the minutiae. Third year, I honestly didn't do much. The only home studying I ever did for shelf exams was UW questions starting a few days before the exam. Medicine was the exception to that rule. I actually studied pretty hard during that rotation. For the most part, though, I just showed up and worked hard and mostly got A's throughout the year. I'm a pretty personable guy, and that certainly didn't hurt the evals. Fourth year, I front-loaded everything like crazy which made for a pretty rough 5 months. However, I put a couple rotations that I could afford to miss a lot of during December and January, and scheduled a rotation that most people just plain skip in Feb. Consequently, I've basically been done with med school since January and only had a total of ~17 work days in Dec. and Jan. See? Simple!

 

[auburnO5]

I think I would have done USMLE World Qbank questions during clinical rotations (or at least try it out to see if it brought up my shelf exam scores). I did fine, but I probably could have done a little better with more practice questions on the shelf.

Do people do this?

 

[MilkmanAl]

I thought pretty much everyone did.

 

[auburnO5]

Interesting... I had no idea

 

[inspirationmd]

I would have taken 1-2 years off between college and med school. It's not going anywhere and once you start down the path there are very few acceptable reasons to slow the med school to residency path without raising antennas of PD. (ie. Research year, MPH). Saying I want a year to hangout with friends and drink won't work beyond a certain point.

 

[NickNaylor]

Honestly, I just aimed to know the core concepts and most important details from each block and didn't pay a lot of attention to my grades. I've always been very good studying efficiently, so I could get a lot of info down pretty quickly. That ability was also immensely helpful during the 6 weeks I studied for Step 1. Basically, I had all the key pieces down before Step studying due to how I studied for class and then used my time to refresh them and fill in the minutiae. Third year, I honestly didn't do much. The only home studying I ever did for shelf exams was UW questions starting a few days before the exam. Medicine was the exception to that rule. I actually studied pretty hard during that rotation. For the most part, though, I just showed up and worked hard and mostly got A's throughout the year. I'm a pretty personable guy, and that certainly didn't hurt the evals. Fourth year, I front-loaded everything like crazy which made for a pretty rough 5 months. However, I put a couple rotations that I could afford to miss a lot of during December and January, and scheduled a rotation that most people just plain skip in Feb. Consequently, I've basically been done with med school since January and only had a total of ~17 work days in Dec. and Jan. See? Simple!

So overall you didn't regret this approach to learning during your first two years? That's how I've been doing things thus far... I aim to really get general principles and basic concepts down rather than wasting my time on minutia to try and get high grades on our exams. The problem is knowing what is "minutia" and what isn't. On the whole I've enjoyed my time thus far and I'm only now starting to experience some faint burnout, but I'm wondering if this is going to come back and bite me later.

 

[kautionwirez]

I would have taken 1-2 years off between college and med school. It's not going anywhere and once you start down the path there are very few acceptable reasons to slow the med school to residency path without raising antennas of PD. (ie. Research year, MPH). Saying I want a year to hangout with friends and drink won't work beyond a certain point.

Taking two years off was great but I am getting sick of working 8-5 atm (my job and boss are great, just getting demotivated though)

This thread has been useful, thanks!

 

[Pills Of Soap]

Taking two years off was great but I am getting sick of working 8-5 atm (my job and boss are great, just getting demotivated though)

This thread has been useful, thanks!

life is always greener on the other side. a while in, you'll wish you were working and having nothing to worry about. you'll miss getting paid too...

 

[MilkmanAl]

So overall you didn't regret this approach to learning during your first two years? That's how I've been doing things thus far... I aim to really get general principles and basic concepts down rather than wasting my time on minutia to try and get high grades on our exams. The problem is knowing what is "minutia" and what isn't. On the whole I've enjoyed my time thus far and I'm only now starting to experience some faint burnout, but I'm wondering if this is going to come back and bite me later.

I didn't regret my strategy at all. For anyone not looking to dominate med school, I'd recommend it.Picking out the important parts can sometimes be tricky, but that's where using multiple sources for your info can help a lot. If you keep seeing the same things repeatedly, those are tidbits you should know. With a framework like that, it's pretty easy to pick up the small facts (again) once Step studying gets in full swing.

It sounds a bit flip, but if you're not trying to get into an exceptionally competitive residency, the basic formula for a nice success/life balance is to get what you need out of the first two years and then dominate Step 1 to the best of your ability. In other words, it's way better to go balls-to-the-wall for 6 weeks and have a reasonably relaxed 2 years than crush yourself the whole time for a score that probably won't be all that much higher, if any. You'll thank yourself when the interviews start rolling in before anyone has even seen your transcript.

 

[The Imprisoned]

I didn't regret my strategy at all. For anyone not looking to dominate med school, I'd recommend it.Picking out the important parts can sometimes be tricky, but that's where using multiple sources for your info can help a lot. If you keep seeing the same things repeatedly, those are tidbits you should know. With a framework like that, it's pretty easy to pick up the small facts (again) once Step studying gets in full swing.

It sounds a bit flip, but if you're not trying to get into an exceptionally competitive residency, the basic formula for a nice success/life balance is to get what you need out of the first two years and then dominate Step 1 to the best of your ability. In other words, it's way better to go balls-to-the-wall for 6 weeks and have a reasonably relaxed 2 years than crush yourself the whole time for a score that probably won't be all that much higher, if any. You'll thank yourself when the interviews start rolling in before anyone has even seen your transcript.

So if you don't mind me asking, then is it necessary to pace yourself and not go for all high pass and honors? What about competitive specialties? I know how important step 1 is, but i figured studying and trying to get everything down couldn't hurt for studying for the step.

 

[MilkmanAl]

Class studying won't hurt at all. I'm not saying you should learn everything during Step studying. That'd be a whole lot harder. I guess I'm saying that unless you just want to, for whatever reason, studying for honors during the first two years isn't really worth the effort if you're not trying to do something really competitive. At least at UAMS, the difference between A's and B's was almost purely knowing minutiae that I never saw again, so studying the main concepts and most important details, the things you need to know for Step 1, was plenty to get solid scores on most tests. The idea is that, come Step studying time, you're already familiar with the bulk of those topics and either plain know them or can recall them fairly easily when prompted during your review. Of course, there's always the risk that you'll end up falling in love with plastics or something and be at a disadvantage because you didn't bust your ass during the first two years like the other plastics applicants.

If you are, in fact, looking to do a competitive specialty, doing well in the first two years is more important than it is for the rest of the specialties, so I'd try for mainly honors and at least top third-ish of your class. It's a different ballgame when you're up against the most qualified applicants around.

 

[The Imprisoned]

Class studying won't hurt at all. I'm not saying you should learn everything during Step studying. That'd be a whole lot harder. I guess I'm saying that unless you just want to, for whatever reason, studying for honors during the first two years isn't really worth the effort if you're not trying to do something really competitive. At least at UAMS, the difference between A's and B's was almost purely knowing minutiae that I never saw again, so studying the main concepts and most important details, the things you need to know for Step 1, was plenty to get solid scores on most tests. The idea is that, come Step studying time, you're already familiar with the bulk of those topics and either plain know them or can recall them fairly easily when prompted during your review. Of course, there's always the risk that you'll end up falling in love with plastics or something and be at a disadvantage because you didn't bust your ass during the first two years like the other plastics applicants.

If you are, in fact, looking to do a competitive specialty, doing well in the first two years is more important than it is for the rest of the specialties, so I'd try for mainly honors and at least top third-ish of your class. It's a different ballgame when you're up against the most qualified applicants around.

Thank you for the clarification!

Best wishes.

 

[gravitywave]

I thought pretty much everyone did.

i'm surprised more don't. i mean, it's not like people don't know how good UW is after they all use it for Step 1.

 

[SteinUmStein]

i'm surprised more don't. i mean, it's not like people don't know how good UW is after they all use it for Step 1.

Are you guys talking about using the UWorld qbank for IM boards third year? Or are you talking about using the Step 1 or Step 2 qbanks?

Edit: looks like the IM qbank is "coming soon" so you must be talking about the Step 1 or 2 qbanks. Plus it's for IM residency boards so probably overkill for third year...

 

[jules14]

Class studying won't hurt at all. I'm not saying you should learn everything during Step studying. That'd be a whole lot harder. I guess I'm saying that unless you just want to, for whatever reason, studying for honors during the first two years isn't really worth the effort if you're not trying to do something really competitive. At least at UAMS, the difference between A's and B's was almost purely knowing minutiae that I never saw again, so studying the main concepts and most important details, the things you need to know for Step 1, was plenty to get solid scores on most tests. The idea is that, come Step studying time, you're already familiar with the bulk of those topics and either plain know them or can recall them fairly easily when prompted during your review. Of course, there's always the risk that you'll end up falling in love with plastics or something and be at a disadvantage because you didn't bust your ass during the first two years like the other plastics applicants.

If you are, in fact, looking to do a competitive specialty, doing well in the first two years is more important than it is for the rest of the specialties, so I'd try for mainly honors and at least top third-ish of your class. It's a different ballgame when you're up against the most qualified applicants around.

noob question: what would you consider the "competitive specialties?"

 

[gravitywave]

Are you guys talking about using the UWorld qbank for IM boards third year? Or are you talking about using the Step 1 or Step 2 qbanks?

Edit: looks like the IM qbank is "coming soon" so you must be talking about the Step 1 or 2 qbanks. Plus it's for IM residency boards so probably overkill for third year...

12 month UW Step 2CK subscription, to be done in conjunction with MS3 rotations. expensive, but oh so worth it. there really is a dearth of good practice questions for shelves otherwise (MSKAP for IM, APGO has uWise, AAFP has freebies) but my understanding is that UW really is the reference standard.

I will have forgotten the questions by the time i sit for 2CK anyway, so it's not like i can't grab another 30 day subscription and just do them all again.

 

[gravitywave]

noob question: what would you consider the "competitive specialties?"

generally speaking: anything with more US senior applicants than there are slots. gas, derm, optho, radonc, anything surgical

 

[SteinUmStein]

12 month UW Step 2CK subscription, to be done in conjunction with MS3 rotations. expensive, but oh so worth it. there really is a dearth of good practice questions for shelves otherwise (MSKAP for IM, APGO has uWise, AAFP has freebies) but my understanding is that UW really is the reference standard.

I will have forgotten the questions by the time i sit for 2CK anyway, so it's not like i can't grab another 30 day subscription and just do them all again.

Yikes... $400, you weren't kidding. Do you recommend the practice exam too? $10 off if you get it at the same time as the yearly subscription is why I ask.

Edit: one more question if you don't mind - my last rotation is IM so I'll be studying hard for that big shelf and my Step 2 QBank would expire around then. Do people ever take Step 2 at the end of 3rd year, or is it more of an early-mid 4th year thing?

 

[gravitywave]

Yikes... $400, you weren't kidding. Do you recommend the practice exam too? $10 off if you get it at the same time as the yearly subscription is why I ask.

can't speak to that, haven't done my homework. as i said, my plan was to buy another sub during dedicated 2CK study time which won't be until well over a year after my clerkships started.

edit in response to your edit: i would imagine 2CK timing is highly school-curriculum dependent. in my case, i won't be taking it until 6+ months after the end of the clerkship year.

 

[SteinUmStein]

can't speak to that, haven't done my homework. as i said, my plan was to buy another sub during dedicated 2CK study time which won't be until well over a year after my clerkships started.

edit in response to your edit: i would imagine 2CK timing is highly school-curriculum dependent. in my case, i won't be taking it until 6+ months after the end of the clerkship year.

Thanks for the info, I hadn't heard about using UWorld during rotations so that's really good to know. I'm guessing I'll end up in the same boat as you in terms of buying another month-long sub later on, but oh well. Still nothing compared with the blatant robbery that is the Step 2 CS fee.

 

[Chakrabs]

Yikes... $400, you weren't kidding. Do you recommend the practice exam too? $10 off if you get it at the same time as the yearly subscription is why I ask.

Edit: one more question if you don't mind - my last rotation is IM so I'll be studying hard for that big shelf and my Step 2 QBank would expire around then. Do people ever take Step 2 at the end of 3rd year, or is it more of an early-mid 4th year thing?

You can take Step 2 whenever. In your case, it may be to your advantage to just take it right after IM - the material is largely the same and it'll all be really fresh in your head. If you can, study rigorously throughout IM, take shelf, take another week or two to brush up on all the other subjects, and then take Step 2.

 

[2gunornot2gun]

Taking two years off was great but I am getting sick of working 8-5 atm (my job and boss are great, just getting demotivated though)

This thread has been useful, thanks!

anyone regret taking time off?

 

[kautionwirez]

anyone regret taking time off?

You can also think about it this way:

Since I took 2 years off, it subtracts two years of my time being a physician. I lose the salary and satisfaction I gain as a physician.

Taking the time off because of my own personal circumstances has made me a more responsible and mature person. I enjoyed having a taste of independence from my family's support and living the "American dream".

 

[umean2tellme]

Things I would do differently:

1. I would have worked harder in the beginning. I wasted a lot of time in my first year and could have learned things a lot better.

2. I would have worked on some kind of Masters degree during my four years. I want to get one now and if I would have started it in my first or second year I'd be done by now.

 

[username456789]

anyone regret taking time off?

Nope, best decision I ever made.

 

[kydoc]

2. I would have worked on some kind of Masters degree during my four years. I want to get one now and if I would have started it in my first or second year I'd be done by now.

is there any particular reason you wish you had pursued a masters degree? any advantages when applying for residencies?

 

[CatFactorial]

is there any particular reason you wish you had pursued a masters degree? any advantages when applying for residencies?

An MBA would be especially useful to have.

 

[Bartelby]

anyone regret taking time off?

I took a year off. I didn't choose to, I just started the pre-med process late and had to. That said, I am really glad I did. I got to relax a little, earn a (very) modest salary, and do several months of backpacking with the savings from the year. Those are experiences that I can probably never have again--- when I finish residency I will be tied down by a family and a career, and I will not fit quite as well with the college-aged dirt poor youth hostel crowd. I think it is time very well spent as long as you do something meaningful with it, and it also leaves you with perspective on the world that you don't get as a continuous student.

 

[GuerreDePlume]

I probably would hve done it all differently.

 

[2gunornot2gun]

I probably would hve done it all differently.

like what? and why?

 

[colbgw02]

I would have taken some time off. I did well first year, but I got burned out during second year. My grades were affected accordingly. I feel like if I was a little older or had some time off, that wouldn't have been an issue.

Also, I would have had much more of a I-don't-give-a-crap attitude during 3rd year. Now that I'm on the other side of it, I realize that I put up with so much BS from people that I wouldn't trust to mop my floor. If you're capable of emiting pure sunshine for a full year, then - by all means - proceed. But, if you're like me and can only handle so much BS, then I really believe you're better off just telling people where they can shove it. I mean, don't be rude, but don't feel the need to suck up.

 

[GuerreDePlume]

like what? and why?

I would have studied harder in the first two years to understand and really apply the material in a clinical context, rather than just cramming before exams and memorizing stuff without really comprehending it. It was a major handicap during the start of clerkships and it seriously limited my ability to come up with alternative treatment plans and contingencies when presentations were abnormal (which is not uncommon) or complications occurred (also not uncommon). I wasn't able to properly anticipate nor adapt when such situations arose, and it was not only to the detriment of my patients, but also to my learning, and the functioning of the team providing treatment for that patient. Big mistake.

 

[username456789]

I would have studied harder in the first two years to understand and really apply the material in a clinical context, rather than just cramming before exams and memorizing stuff without really comprehending it. It was a major handicap during the start of clerkships and it seriously limited my ability to come up with alternative treatment plans and contingencies when presentations were abnormal (which is not uncommon) or complications occurred (also not uncommon). I wasn't able to properly anticipate nor adapt when such situations arose, and it was not only to the detriment of my patients, but also to my learning, and the functioning of the team providing treatment for that patient. Big mistake.

This is, in part, why I don't advocate the ever-popular (on SDN, at least) "grades in M1/M2 don't matter" mantra. It encourages complacency in many. For me, at least, learning any and everything during M1/M2 helped me not only crush Step I, but made formulating ddx's and treatment plans much easier, and made studying for shelf exams and Step II even easier.

Especially during early third year, when attendings know you don't have any real clinical acumen, you get pimped on a lot of stuff (often minutiae) from the first two years.