Second year was probably the worst year of my life. For certain, Step 1 studying was. I was angry all the time. My blood pressure (measured at a GI's clinic) was elevated. I mean 160s systolic. I was fit as fuch then too. I gained weight, I ate like crap. I hated my life. I hated my friends. I did really well... but it wasn't worth it.
I can't see the relevance of what I'm learning. All I can do is create these lists that I incessantly recite to get the right answer. But, damn, the details are too vast. The material comes too fast. I'm overwhelmed. The tedium is getting to me. I can never possibly learn this stuff. Even if I do, how the hell am I supposed to remember it all?
Sound about right?
The good news is that you can forget most of what you learn. Whether or not you see balloon degeneration and mallory bodies of pas positive macrophages on a liver biopsy really only matters if you are a hepatologist (fellowship after medicine separate from GI) or a pathologist. But here's the cool thing. In order to learn all those details, in order to be able to tackle the inane nonsense you WON'T remember, you are forced to learn the important stuff so well that it becomes innate.
Think about it. Before you started "renal" and "hepatic" didn't mean anything. "Liver metabolize... kidney pee" was probably what you walked in with. Now its Bilirubin (Direct Vs Indirect), Albumin, Coags, Estrogen, Portosystemic Shunts, etc. And you recognize these words. You know what they mean. They spark a reminder of WHY (portal hypertension, decreased flow, ascites, shunts). You may not feel that yet. You may only feel the deep dark depression that consumed you being wrapped up for hours a day in a textbook or a classroom. But one day, on the other side of Step 1, you're going to see a patient with exertional dyspnea, and notice that he's got some fluid on his legs, with a fluffly xray and say "damn, this guy has CHF" and you'll save his life.
Promise it gets better. You will work harder. You will work longer. And on someone else's schedule. But it will be worth it. Get through this year and you'll come out the other side stronger, more knowledgeable, and ready to be happy again.
