From Boston, happy autumn! Here’s a picture near my house.
Around this time of the year, squirrels should have already built their nests, and premeds are getting interviewed at medical schools. Third year medical students no longer exist, and fourth year medical students are taking care of their residency process. For me, I’ve just past the midway point of my second year of medical school and board examination. A few weeks ago, I started to prepare for the boards. When people decide to prepare for the boards is up to them, each medical school gives their second year students time off before their examination to dedicate their time to it. However, due to the high stakes of your permanently recorded score, must students start preparing for it earlier — some students have started studying since last year, some started this summer, the large majority seem to wait until fall or winter to start thinking about it — it’s a personal choice when you decide to start it. For myself, I have a hard time evaluating what I do and do not know, so answering questions works for me whilst taking the same course: I do psychiatry questions during the psychiatry section of class. In essence, I’m trying to eat my cake and have it too, I’m trying to use the boards as an adjuvant to class or vice versa.
If you’re not familiar with the boards, and most notably the question style, this succinct best flow chart below explains the situation the best…
Here are the resources (besides lecture material) I use, so far:
- Goljan (high yield notes) – there’s a mix of materials, written and audio, you can choose what works for you.
- Board Review Series (BRS) – I supplement this when needed. The lecture notes will be more detailed, but BRS is best used IMHO to get the big picture.
- First Aid (notes) – I’ve started to just take notes straight into it. When I get questions wrong (any question bank), I just look up the topic in First Aid, see if it’s a fact that I never heard of or not, then I finally just annotate straight into the book.
- Sketchy Medical – this is a must have for all second year medical students. You will feel absolutely ridiculous using this in public, but your blushes are worth the pay back. I watched the videos and used the provided PDF ‘images’ as Anki (flashcards). Thankfully, they’re coming out with a Pharmacology series, I will definitely pick that up.
- UWorld (question bank)- the school strongly suggested we just stick to UWorld and some other materials they’ll update us about later, they also told explicitly told us to avoid a certain company. We were told they ask the appropriate level of third order question that we should see on our boards. I started with just doing 3 UWorld questions a day, I started only within the same subject as I was learning. Now, I do 6 in-subject and 4-5 previous subject questions. Afterwards, I just review what I got wrong and annotate that into First Aid.
- Anki – I’ve used it intermittently. It can get sort of boring to do, but it does help a lot if you just have to remember a lot of details. For myself, I’ve learned the simpler and less “busy” the card the better and faster I’ll memorize the card duo. The trick to making Anki useful is to speed up the rate it takes you to make cards. If you have a diagram, table, or image to memorize then use image occlusion. To my knowledge, and at least on my Mac, image occlusion is either missing or obscured away in the Apple compatible version. If you’re using an Apple, then you can install Wine. The Wine program will allow you to run windows programs on your Mac. If you design a two-item table in Excel (both Windows and Mac), then you can save it as a .CSV. A lot of people don’t like using Anki because it takes too much time to make cards. I remember, in my first year I’d spend hours making cards, now it only takes about 20-minutes to do the same amount of work to make them. For me, it was just important to not try to make a card for every little detail and not lose focus of the medium and big picture.
- Doctors In Training (DIT) – I just received a confirmation order, and I should be receiving it soon. I’ve heard very positive things online, especially last year when second year students were tweeting about their board results. When I get some time to sit down with it, I’ll update this blog with a review of how it worked for me.
- Pathoma – it seems like I’m the last person in my class to use this, but I just started to try it out this week.
- PubMed – often, a handful of lectures can be summed up by a short well written paper.
Anyways, that’s what I’m doing for the boards. I really don’t like adding new things into my study schedule — the more wonderful the tool the more time it usually takes to learn how to use. For this, I use First Aid as my nexus of information by taking notes into it. If I see an article on PubMed that explains it the best, then I write down a couple of words plus the PMCID so I can look it up later. So, for any source of information (especially when using multiple) I find it’s important for me to keep good track of references. I’ve even found it useful to cite First Aid pages within First Aid itself, for example at times where two concepts go together seamlessly (in my mind). If you’re in the gallows of the first year, hang tough, when you finally figure out how to juggle flaming sharks as a MS1 you’ll be able to transfer a lot of the skills over to MS2.
I use my course grade as a barometer of how well I’m balancing my position as a medical student, research, volunteering (mentoring), shadow, clinical duty, board studying, and personal life. To pass each module you need to have an average equal or greater than 72%. This year, I follow the suggested set-point given to us by our academic advisors, I try to keep my average around 85% — I’m willing to miss a few points on a written exam if it means doing the things I like. Anecdotally, I’ve heard striking a balance is key:
- I’ve heard of a minority of students going hard on board studying, but neglecting the grades, and they had to remediate courses and lose time studying for boards anyways.
- I’ve heard of a minority of students going hard on course work (nearly achieving perfect scores), not studying for the boards until the last minute, and ultimately having to retake the boards to get a score a more representative score.
- On the flip side, I’ve heard of a smaller minority who by virtue of doing nothing else but study successfully destroy the boards and the coursework, but then had to take a gap/research year to become more competitive in terms of extracurricular — this is obviously a very specific case, and really only something worth thinking about for extremely competitive specialties. Though, in the scheme of things, this is the best of the three problem situations to have.
Anyways, have a great weekend!