USMLE NIGHTMARE Scenario

[SomeSurgeryDoc]

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Two nights ago, the night before a huge cardiovascular exam I had, my apartment buildings fire alarm went off at 3:00 AM and completely screwed up my sleep - I basically felt I had no sleep that night. We had to evacuate the building and wait 45 minutes before we were allowed back in by the firefighters. So basically that completely screwed up my concentration and I had trouble focusing during the exam at 8:00 AM.

OK, even though my exam performance was messed up on for the cardio exam, my bigger issue is this same thing happening the night before the USMLE. What could I do if I this happens to me during the night of the USMLE??? I mean, I don’t want to screw up my entire life and residency options by not being on the top of my capacity the morning of the USMLE because of a fire alarm that didn’t allow me to have any sleep. Could I choose to reschedule the day of the exam and if I had originally scheduled to take it in June, I doubt there would be any spots open before the required date in Mid-June? What else could I possibly do?

Thanks in advance for your input and advice.

 

[ShyRem]

You can drive yourself nuts this way.
"what if there's an accident on the way to the exam and I'm late?"
"what if my apartment floods?"
"what if my car won't start?"
"what if I lose my ID?"
"what if there's road construction and I get lost on the detour?"

It sounds like the fire alarm thing was a one time deal. Fire alarms happen. If you're really worried about it, get a hotel room close to the testing center. But you may still have a fire alarm (and personally I never sleep well in a hotel). I suppose to really be sure you won't have a fire alarm you could sleep in a tent the night before.

As for rescheduling, if you reschedule with less than 5 days notice there's a fee involved. For some exams at the prometric site, if you try and reschedule with less than 2 days notice you forfeit all fees, but they don't state this policy as active for the USMLE.

 

[SomeSurgeryDoc]

the thing is though, that this is not the first time this happened. I'm in the middle of DC so it is not an out of the world assumption that this might be happen. Just in case it does happen, how could I deal with the situation?

 

[gstrub]

Dude, you can't function despite being awakened by a fire alarm? Get over it man...suck it up. If you can't function properly on little to no sleep, then just give up now...it will only get worse, especially if like your screen name you aspire to be a surgeon.

 

[njbmd]

Two nights ago, the night before a huge cardiovascular exam I had, my apartment buildings fire alarm went off at 3:00 AM and completely screwed up my sleep - I basically felt I had no sleep that night. We had to evacuate the building and wait 45 minutes before we were allowed back in by the firefighters. So basically that completely screwed up my concentration and I had trouble focusing during the exam at 8:00 AM.

OK, even though my exam performance was messed up on for the cardio exam, my bigger issue is this same thing happening the night before the USMLE. What could I do if I this happens to me during the night of the USMLE??? I mean, I don’t want to screw up my entire life and residency options by not being on the top of my capacity the morning of the USMLE because of a fire alarm that didn’t allow me to have any sleep. Could I choose to reschedule the day of the exam and if I had originally scheduled to take it in June, I doubt there would be any spots open before the required date in Mid-June? What else could I possibly do?

Thanks in advance for your input and advice.

Why not treat yourself to an upscale hotel for the night. It sounds like for you, this is the best option. Get some rest and relaxation. You could try one of the Radisson's with their comfort number bed or Sheraton with their "sweet sleeper". If you are going to worry about this, take it out of the equation. You can't plan your life around "what ifs".

I will tell you that if your performance is totally dashed with loss of sleep, you may not want to consider surgery or any of the surgical specialties as career options. I can't tell you how many tests (USMLE, ABSITE) on little or no sleep. It's just part of the job. You may want to consider those night before interruptions as part of the training for what's to come. Conditions are rarely ideal in medical practice.

 

[Law2Doc]

Dude, you can't function despite being awakened by a fire alarm? Get over it man...suck it up. If you can't function properly on little to no sleep, then just give up now...it will only get worse, especially if like your screen name you aspire to be a surgeon.

Agree with this. This is a field where you are, guaranteed, going to be expected to make intelligent decisions despite being sleep deprived. We all do it. If you cannot the USMLE is going to be the least of your problems -- lots of people are going to die on your first internship call night.

 

[Law2Doc]

Why not treat yourself to an upscale hotel for the night.

Hotels can have fires and fire alarms too.

 

[seraph524]

What if the world blew up? 😵

Don't worry about it too much...like the posters said above, they WILL drive you crazy.

 

[SomeSurgeryDoc]

i'm just saying that for the exam that potentially determines what kinda doctor youre going to be, you'd be at quite a disadvantage if you get your sleep disrupted in the middle of the night by waking up at 3:00 AM and waiting outside for 45 minutes. not the best way to start the usmle

 

[gstrub]

This is absurd. The test does not determine what kind of doctor you are going to be. You determine that. Standing outside for 45 minutes at 3am won't make your score drop...being an idiot makes your score drop.

 

[Pinkertinkle]

i'm just saying that for the exam that potentially determines what kinda doctor youre going to be, you'd be at quite a disadvantage if you get your sleep disrupted in the middle of the night by waking up at 3:00 AM and waiting outside for 45 minutes. not the best way to start the usmle

I couldn't sleep till 3 am that night before my test. When you wake up the adrenaline hits and nothing matters.

 

[HEADintheCLOUDS]

This is absurd. The test does not determine what kind of doctor you are going to be. You determine that. Standing outside for 45 minutes at 3am won't make your score drop...being an idiot makes your score drop.

Hey guys lay off......the op is right.

I know what he is talking about. last night I woke up in the middle of the night to use the bathroom and when i woke up in the morning i couldnt think.

I called the school today and told them that i quit med school becasue i can no longer think!🙄


PS. i wanna be a surgeon

 

[SomeSurgeryDoc]

so are you denying that someone in such a situation would be at a disadvantage?

 

[Law2Doc]

so are you denying that someone in such a situation would be at a disadvantage?

We are saying that LOTs of people won't sleep the night before an important exam, both from internal or external causes. You have to get past that, and manage to function on the lack of sleep. Your body is designed to go > 24 hours without sleep and still survive. You will sleep the following night.

 

[had2piknowEM]

I got 3 hours of sleep the night before Step 1...I couldn't fall asleep, just laying in my bed staring at the ceiling from 10 pm until 3 am. I did fine on the test...don't stress yourself our man. It's likely that the more you think about not being able to sleep the night before a test the more you won't be able to fall asleep at all.

 

[njbmd]

Hotels can have fires and fire alarms too.

Gee, never heard of a hotel having a fire. 😉

 

[Blade28]

You can drive yourself nuts this way.
"what if there's an accident on the way to the exam and I'm late?"
"what if my apartment floods?"
"what if my car won't start?"
"what if I lose my ID?"
"what if there's road construction and I get lost on the detour?"

I agree. No sense worrying about it.

But I agree that if it's truly freaking you out, a hotel might not be a bad idea. (But they have fire alarms as well!)

By the way, if you're going into surgery, you'll likely be exhausted the day of your ABSITE (yearly in-service) exam - this can happen in the other fields as well!

 

[lilnoelle]

Yeah, I'm guessing a lot of people can't sleep before Step I.

I have to get up once to twice a night every night and usually don't get back to bed for 20-30 minutes each time. On bad nights (if the kids are sick) I'll be up 5-6 times during the night and it seems like I don't get to go to sleep at all before I have to get up again. This doesn't change what I have to do the following day.

This type of thing happens. I'm betting that both me and my kids will be sick the week of Step I and I will be sleep deprived AND unable to even look at a book that week. It sucks, but thats just the way it is. If you plan for it, (but don't be rediculous enough to worry about it) life is easier.

 

[OncoCaP]

Spend the night on a park bench. Problem solved.

 

[Maxprime]

This, indeed, does sound like a USMLE NIGHTMARE!!!! Well, I mean, one that could happen - although probably won't . . . and even if it did, it's just less a few hours less sleep you'll miss out on after studying for an exam for months on end . . . maybe you should take a night off and relax?

 

[njbmd]

i'm just saying that for the exam that potentially determines what kinda doctor youre going to be, you'd be at quite a disadvantage if you get your sleep disrupted in the middle of the night by waking up at 3:00 AM and waiting outside for 45 minutes. not the best way to start the usmle

I promise you that I didn't sleep very well the night before my USMLE Step I but did extremely well anyway. I woke up several times and finally got up at 3AM because I just couldn't sleep at all. Nerves can disrupt your sleep.

When I got in front of that computer and started answering questions, everything was fine. I was exhausted at the end of the test but I was OK. It was done and that was that.

What everyone is trying to tell you is that you need to relax. There are a million possible things that can happen but will they happen? Probably not. If you are not comfortable in your home, go to another location but above all, try to do whatever it takes to calm yourself.

Like most people who have prepared well for that test, you will probably sit down, answer the questions and do what you need to do on that exam. It really isn't that momentous.

so are you denying that someone in such a situation would be at a disadvantage?

You will never know if something or nothing affected your performance. You get essentially one shot at this exam (unless you fail) and you do what you have to do. Just don't stack the deck against yourself before you start by worrying about things that might or might not happen.

I have seen people work themselves into a "state" about this exam only to take it and kick themselves for getting so worked up. In the end, you will do what you will do.

Just prepare and review as your needs dictate and you are likely to be fine. Do be aware that you can "talk yourself into failure" as well as "talk yourself into acing" that test.

 

[smq123]

i'm just saying that for the exam that potentially determines what kinda doctor youre going to be, you'd be at quite a disadvantage if you get your sleep disrupted in the middle of the night by waking up at 3:00 AM and waiting outside for 45 minutes. not the best way to start the usmle

I guess this is going to sound a little callous, but I think you're worrying too far in advance.

As others have said, one of the most prized characteristics in medicine (particularly in surgery) is the ability to roll with the punches and make the best of any situation.

And while I know that you're really worried about a fire alarm disrupting your sleep the night before the test, please be aware that others have faced far greater challenges while taking the USMLE, and have survived just fine.

For instance, from this thread: http://forums.studentdoctor.net/showthread.php?p=5298799

The system crashed at my test center. It was a horrible experience because no one would explain to me what exactly was going on and whether or not I had lost everything and would have to retake. Fortunately I didn't but my tachycardia didn't let up for quite a while.

One of my classmates had a blackout (during the calif power outage/shortage) in the middle of his last block. He actually had to take the whole exam over again a few weeks later. Thing is he already paid for a vacation package and went on it knowing that when he got back he had to take the beast all over again.

For me on the mcat I was on the end of the verbal section, when the proctors declared you have 10 minutes left. I started to freak cuz I was nowhere near done so I started to just bubble in all Bs for my answer choice. 10 minutes go by and the proctor says oops, you actually still have 10 minutes left. So these foolios declared 10 minutes left when we actually had 20, but by that time the damage was done I couldn't get to together to go back and do the questions I'd just filled in an answer for.

And, my personal favorite:

You know how you have that nightmare where you're taking Step 1, and you accidentally kick the power cord of your computer? And the screen suddenly goes black? And you sit there for that purloined moment, eyes transfixed by the vacant pixels, hoping you'll stroke out before you crap yourself?

Yeah, that happened to me.

Fortunately, they powered it back up and it returned me to the very question I left hanging.

Good times.

So, don't think so hard about the "what ifs?". It'll be all right. 🙂

 

[mjl1717]

Why not treat yourself to an upscale hotel for the night. It sounds like for you, this is the best option. Get some rest and relaxation. You could try one of the Radisson's with their comfort number bed or Sheraton with their "sweet sleeper". If you are going to worry about this, take it out of the equation. You can't plan your life around "what ifs".

I will tell you that if your performance is totally dashed with loss of sleep, you may not want to consider surgery or any of the surgical specialties as career options. I can't tell you how many tests (USMLE, ABSITE) on little or no sleep. It's just part of the job. You may want to consider those night before interruptions as part of the training for what's to come. Conditions are rarely ideal in medical practice.

I like the classy hotel switch also, you deserve it.. But as L2D say you could have a fire alarm there also..
Another thing as already known- " no cake walks in medicine" and I totally agree take it like its part of the training..You are a fighter.. { whether you want to or not!!}

 

[chicamedica]

I am joining the club of people who couldn't sleep before step 1. This was not because of any fire alarm or disruption. It was plain old nervousness and overdose on caffeine. I ended up sleeping fitfully for about 1 hour. Went to take my test. Lived through it. Actually did decently (not superstar but still above average), even though i thought i failed it. It was very hard concentrating towards the end. But friends, it can be done. I did it, many others have too, as apparent from the posts so far, and from colleagues i've talked to. Consider it a trial of being able to think towards the end of an overnight call

However, if you can help it, I highly recommend getting a good night's sleep beforehand. I probably would have done even better if i did.

 

[SomeSurgeryDoc]

thanks for all the posts everyone (even the more "callous" ones)- puts a good perspective on things🙂

 

[Blade28]

"what if my car won't start?"
"what if there's road construction and I get lost on the detour?"

Ah, reminds me of things that I was warned about before the MCAT!

(1) Have a backup plan in case your car doesn't start. (A nice family member, friend, public transport, etc.)

(2) Drive to the testing facility beforehand to learn the location/surrounding area. I did this for all four steps of the USMLE - this is especially important for Step 2 CS when you're likely in a foreign state.

 

[Ashers]

Ah, reminds me of things that I was warned about before the MCAT!

(1) Have a backup plan in case your car doesn't start. (A nice family member, friend, public transport, etc.)

(2) Drive to the testing facility beforehand to learn the location/surrounding area. I did this for all four steps of the USMLE - this is especially important for Step 2 CS when you're likely in a foreign state.

I left my apt WAY early for the MCAT and USMLE. With step 1, they at least let me start the test about 45min before my actual start time since I arrived early. With the MCAT, I just did last minute studying in my car. I also always drive the route the day before the test if I don't know it.

 

[MossPoh]

Just don't go to sleep. Then you don't have to worry about burning alive in your bed. I'm sure you'll get a second wind right around 7 a.m.

 

[Terpskins99]

I was used to pulling all-nighters before exams, so my scheme to avoid this was to pull an all-nighter TWO days before boards. I should definitely become tired then, right?

Well, the night right before boards I brilliantly decided to study with my buddy until 11 pm... and I ended up getting ultra anxious and didn't sleep for the second night either.

So I walked into the prometric center and took an 8 hour exam with no sleep in just under 48 hours. Not only did I pass, but with the help of 2 Starbucks mocha frappuccino's and 3 cherry cokes I cracked the national average.

So to summarize...

+

+

+

+

+

= Pass​

 

[Blade28]

I left my apt WAY early for the MCAT and USMLE.

Not used to mainland driving yet? 😉

 

[Rhuby]

My solution for big tests is to get a massage the day before. That'll knock you out for the night and you will be very well-rested. And of course what everyone else has said, life happens sometimes and there is nothing you can do about it.

 

[Ashers]

Not used to mainland driving yet? 😉

Hehe. I like Maui driving (no freeways and few 1 way streets). I get so stressed driving on Oahu, especially in Honolulu. It's not quite as stressful as driving in Chicago or LA. Oh yeah, and this whole driving in snow thing sucks. =(

(I also showed up realy early for the SAT, especially when it was held at a rival high school. No Hawaii time on tests days for me.)

 

[Blade28]

Nope! Hawaii time is no good for exams. 🙂

Honolulu driving is getting worse and worse - and it's probably too late for a rail system as well. 🙁

Rival high school? On Maui? Baldwin?

 

[BrainBuff]

This reminds me of one night in Las Vegas, a few years ago. We were awakened by a rumbling sound followed by fire alarms. We were in the 24th floor of the hotel. Apparently there was an earthquake going on. My gf started screaming and going out the door calling out for me. I figured it was the 24th floor and it was 3 oclock in the am...so I just covered my head with two pillows and stayed in bed.....

I am not going into surgery though..I hate waking up early in the am, even for emergencies..

 

[Ashers]

Nope! Hawaii time is no good for exams. 🙂

Honolulu driving is getting worse and worse - and it's probably too late for a rail system as well. 🙁

Rival high school? On Maui? Baldwin?

I went to Baldwin for 2 years (after I left Seabury). I took the SATs and ACTs at Maui High and St. Anthony, I think I had a test at Baldwin once too. At least with taking the tests on Maui, I always knew people, and we could just talk story before.

Maui driving's getting really bad too. You can always tell when an airplane has recently landed because of all the traffic going both ways, and there's a good time to be on certain roads before the big planes start coming.

 

[Ashers]

Oh, I just remembered partly why I'm slightly neurotic about getting to tests early. I slept through the ACT once in high school. That's when I took standardized tests for fun, so I didn't really care, but my mom did. Now, I set 3 alarms, wake up before any of them, and I'm there way early (to ensure that stuff's less likely to happen en route, like major traffic jams).

 

[Gut Shot]

Thanks in advance for your input and advice.

Wow, it looks like you've finally encountered "life," where things aren't as you expect, and you sometimes have to make due the best you can. I hope your impending seventh birthday is all you wanted.

 

[SomeSurgeryDoc]

.

 

[Flaxmoore]

Ah, reminds me of things that I was warned about before the MCAT!

(1) Have a backup plan in case your car doesn't start. (A nice family member, friend, public transport, etc.)

(2) Drive to the testing facility beforehand to learn the location/surrounding area. I did this for all four steps of the USMLE - this is especially important for Step 2 CS when you're likely in a foreign state.

I did the same thing for the MCAT. My wife was going to drop me off (she had somewhere to go, and it's on the way), and we had both our cars ready. Even if the 184K-mile Red Baron wasn't up to the task, the Red Star was ready.

 

[FenderHM]

youll probably get no sleep, bomb the exam, and have to do a family practice residency in north dakota

 

[Blade28]

That's when I took standardized tests for fun, so I didn't really care, but my mom did.

For fun?! 😱

 

[Ashers]

For fun?! 😱

Yeah, I took a bunch of SATIIs just because I could. I didn't need to take the ACT. I took a few APs without taking the classes too.

 

[SocialistMD]

I will tell you that if your performance is totally dashed with loss of sleep, you may not want to consider surgery or any of the surgical specialties as career options. I can't tell you how many tests (USMLE, ABSITE) on little or no sleep. It's just part of the job.

Seriously. I took Step 2 and the first day of Step 3 both post-call. Plus, for Step 2 I got there about an hour late because some guy got hit by a car a couple of cars in front of me and I had to stop and "help" until the paramedics arrived. P.S. You generally can't cure dead. Anyway, my car decided it didn't want to start when I got back in it and I had to get a jump from someone else there. In the end, it was my lowest score of the three exams, but I still passed with room to spare.

 

[lilnoelle]

Seriously. I took Step 2 and the first day of Step 3 both post-call. Plus, for Step 2 I got there about an hour late because some guy got hit by a car a couple of cars in front of me and I had to stop and "help" until the paramedics arrived. P.S. You generally can't cure dead. Anyway, my car decided it didn't want to start when I got back in it and I had to get a jump from someone else there. In the end, it was my lowest score of the three exams, but I still passed with room to spare.

Wow😱 Thats quite the story. I tend to expect crazy stuff to happen to me at inopportune times, but thats extreme.

 

[mjl1717]

Seriously. I took Step 2 and the first day of Step 3 both post-call. Plus, for Step 2 I got there about an hour late because some guy got hit by a car a couple of cars in front of me and I had to stop and "help" until the paramedics arrived. P.S. You generally can't cure dead. Anyway, my car decided it didn't want to start when I got back in it and I had to get a jump from someone else there. In the end, it was my lowest score of the three exams, but I still passed with room to spare.

Some story!!! And the OP is complaining about a fire alarm?

 

[mjl1717]

Seriously. I took Step 2 and the first day of Step 3 both post-call. Plus, for Step 2 I got there about an hour late because some guy got hit by a car a couple of cars in front of me and I had to stop and "help" until the paramedics arrived. P.S. You generally can't cure dead. Anyway, my car decided it didn't want to start when I got back in it and I had to get a jump from someone else there. In the end, it was my lowest score of the three exams, but I still passed with room to spare.

Some story!!! And the OP is complaining about a fire alarm?? {Geez, thats not even a cherry bomb}

 

[SocialistMD]

Wow😱 Thats quite the story. I tend to expect crazy stuff to happen to me at inopportune times, but thats extreme.

I just kept thinking "this can't be f-ing happening," and was waiting to wake up at any moment. Still, as I said, the test ended up going fine, but I still haven't found out what that guy was doing walking down highway 59 at 6:30 in the morning.

 

[TRAMD]

I had to travel for my USMLE Step 1 and my dad went with me. He snored LOUDLY the entire night in our hotel room. I got very little sleep. It is very possible that I wouldn't have slept well even if he weren't there because of nerves. If you let your anxiety about everything besides the test pile on top of your anxiety about the test itself then you will likely not sleep well anyways.

Don't study the night before, go out to eat, relax with a movie and go to bed early to assure that you get enough sleep. You will be fine.

 

[FenderHM]

you know what you can do? if youre really worried about sleep... on some days theyll let you take the exam from 1pm-10pm instead of 9-5 or whatever. as a night owl thats my plan, Im usually up til like 3 or 4 am anyway, so why should i change my schedule for step 1? (i realize ill have to figure somwething else out for 3rd year)

 

[Blesbok]

But what if a meteor falls through my ceiling and performs a makeshift BKA of my right leg the night before the exam and I am unable to drive my car because it is a manual and I am therefore unable to make it to the testing center. What if?