Tuesday, July 31, 2012

Wednesday, July 18, 2012

USMLE War Jounral: 23 Days After Test Day

First of all, it is ridiculous how long they make you wait for Step 1 scores, not to mention how hard it is to find out when your release date will be.

That being said, I cannot believe it took 23 days to find out.  For 23 days, I have held my breath.  The test left me feeling really crappy and I imagined some below-predicted performance.  Last week at 16 days post-test, all results for tests up until June 22 were released.  Some of my friends found out they had passed and I was happy for them.  I also gave up on being apprehensive.  My time off was only winding down and I was not going to let anxiety get in the way of enjoying my time off.  I went out more frequently with friends, got through more of the book I am currently reading (Genius on the Edge by Dr. Gerald Imber on the life of Dr. William Stewart Halsted, the father of modern surgery).  Still, it felt awkward trying to do things toward my career and I even shied away from writing more on the subject.

I found out that my score would come Wednesday, July 18.  This morning, I rolled out of my futon to my computer.  My school was going to have my results posted before the NMBE posted my score report.  I clicked through the menus to the appropriate screen to find the three-digit number that would matter more to me than any other three-digit number in my life. 

238

I had passed.  And comfortably, too.  For those who do not know, the cutoff is 188 and the average usually hovers around 220 year to year.  The standard deviation usually hovers around 20.  I was satisfied.  I knew this score would be fine for my intended field (internal medicine).

I spent the rest of the day in unremarkable celebration.  I went to the comic book shop, treated myself to a beer with dinner, and watched the second part of Che which I had started the night before.  I texted all my friends from high school who had been supportive throughout the last couple weeks and called my family and medical school friends.  For now, its too early for complete reflection on all my methods and the advice I recieved.  There likely be another post on that in the future.

Elsewhere in the world, things were getting crazy.  The hottest summer in a long time was having what was likely to be a low point at 85.  On the radio, the crisis in Syria was escalating.  Later I read an article on how Rush Limbaugh tried to argue that the new Batman movie was an anti-Romney film because of the similarity in sounds of the name Bain and Bane.  Little did he know, Bane was created in the 90s, well before anyone really gave a damn about R-Money. 

Sunday, June 24, 2012

USMLE War Jounral: 1 Day Until Test Day

Last week I tried to make a video post since it was my last week at home.  Obviously, that didn't work so I am back to the tried and true written word. 

Saturday I came up to my parents house since my test is in Strongsville.  I did not get much done (as anticipated) but I get all of today to myself to casually just review stuff.  It has not started great, however.  See, for the past couple years, I actually do not sleep in my old room at my parents because I seem to get a real bad sinus allergy.  The pillows are different than the other ones in the house and I think that I am allergic to something in them.  True enough, I woke up real early today to sneeze.  I could not use the guest room last night because my brother's girlfriend and her siblings came over on their way back home (they live quite far from where my parents' home).  I have never been woken up by allergies before and I hope I can get the basement to myself tonight.

Because tomorrow is the big one.  Various movie quotes from before epic battles have been running through my head.  I cannot wait to be done.  My plan afterwards is to walk over to the sports bar next to the testing center and eat hearty.  And drink beer, too.  After that, July will be mine. 

Sunday, June 10, 2012

USMLE War Journal: 15 Days Until Test Day

At this point, my fellow medical students and I have been out of classes for about 19 days (which seems unbelievable).  This week I noticed a lot of my colleagues starting to wear down but many seemed to have anticipated this and cope in their own ways. 

Here are two more sketches from the past couple weeks.

This first one is my version of my school's old logo.  Since my school has changed its name and logo I really do not think (and hope) that there are any problems with me posting this.  At the very least, I have only good things to say.  I was a really big fan of the old logo from a graphic design standpoint.  Symbolically, it told you every thing you needed to know about my school.  Like any good logo it had seen some slight changes throughout its use but it was still recognizeable.  Mine does the same in making some slightly different design choices.










This second one is a sketch of the superhero Dr. Mid-nite after the famous painting The Doctor by Luke Fildes, which I have wrote about before.

Tuesday, June 5, 2012

Step 1 Art: My Tribute to the Original Orignal Green Lantern and his Children

This is the first of many just-for-fun sketches I've done in my spare time to do something creative during Step 1 studying.  There's quite a bit into why I decided to draw the characters I did.  A couple days ago, DC Comics announced that in his new incarnation, Alan Scott, the original Green Lantern, would be gay.  As a big fan of Alan Scott and the JSA in general, this has been one of the most bothersome of the changes at DC Comics. 

It's not that I have anything against gay people.  In fact, I have many gay friends and I am a fan of many gay fictional characters.  As a matter of fact, Todd Rice aka Obsidian, Alan Scott's son (the blue guy on the left) is an openly gay character from the old DC.   




What bothers me is DC's discarding of Alan Scott's rich, albeit more obscure, 70-year-history as a DC character and the work of the writers and artists that helped make that happen all for what is nothing more than a publicity stunt.  In the preceding weeks before the announcement, DC teased that they were making an "iconic" character gay and there was much speculation on who this might be with names like Tim Drake (one of Batman's Robins) and Wonder Woman thrown around.  But when it was annouced that Alan Scott was the character that was coming out many including myself have felt it is the king of all cop outs.  Sure he is a Green Lantern but he's only really known in comic circles these days so most people are probably just as confused when it was announced that Miles Morales, a Afro-Hispanic-American, would be the new Ultimate Spider-Man. 

While I do appreciate DC trying to be progressive, it feels that the LGBT movement has been undermined to generate more publicity for itself (a common theme lately).  I doubt sales this week will be that much more increased or gay readers will be more drawn to DC titles.  So the victims of this little marketing ploy?  Just the original Alan Scott and, until some comic book universe tweaking occurs, his kids Obsidian and Jade.  If you knew the old Alan Scott, you probably enjoyed that everything about him was old.  I mean, his costume for most of his history has been a red shirt tucked into green pants with a cape!  However, the other DC characters respected him as a veteran.  He represented that Golden Age morality that is impossibly forthright and good and survived for 70 years despite the changing of the times.  And maybe it's appropriate that such a character is retired now but I really would rather he was still around. 

Sunday, June 3, 2012

USMLE War Journal: 22 Days Until Test Day

Well this last week started off great and by great I mean I had a low-grade fever for three days.  Next time I am going straight to acetaminophen.  NSAIDs just wouldn't keep the temperature down long enough.  It was not really a preference thing - I was just hoping to treat myself with whatever I had laying around the house.  On day three, I gave in and went to go buy some acetaminophen. 

This is exactly the sort of unexpected thing I anticipated when I built in leeway in my schedule.  There were times where I couldn't power through anymore and had to lay down.  It seemed the more I tried to do board studying, the higher my temperature got.  What made it worse was I had terrible sleep those nights.  I got up every two hours it seemed.  Unable to exercise due to illness, I found myself a little depressed from not having some kind of non-academic outlet.  Watching TV is a little too passive for me and sometimes I am not in the mood to read (although I did read a ton of comics while sick).  The past couple days, I started drawing again, mostly superheroes.  I am not a a particularly amazing artist or anythign like that.  My own honest assessment of my own work is that it is a slightly above average amateurish style.  But it did give me something to do.  When I finish my first one I might upload it.  My second one is my own take of a classic medical painting.         

Sunday, May 27, 2012

USMLE War Journal: 29 Days Until Test Day

So I have been studying for my board exam for just under a week and I have set up Sundays to be kind of a free-for-all day.  I can catch up on stuff if I am behind on my schedule, hit harder on stuff that has been giving me trouble, do chores, etc.  I must confess this was not an original idea of mine but I like building in flexibility when I make schedules. 

I've also scheduled in time for myself at the end of every week day.  I study pretty much from 8 am to 6 pm everyday and then give myself most the rest of the night for dinner, a workout, even reading and tv.  Before bed, I like to go through cases or quiz myself on stuff I need work on.

For my question bank, I use USMLE World, probably the best bank out there.  After two years of medical school, I have (amazingly) a good working knowledge of the medical science out there but what the question bank is good at is helping me hunt down all the little details I may have overlooked and need to pick up on.  First Aid is good but even it does not have all the answers sometimes (although I do have the 2010 edition).  This week alone I already ran into a few USMLE World questions that had no/inadequate information on certain topics like JAK/STAT pathways and direct factor Xa inhibitors (a relatively new class with rivaroxaban as the only FDA approved one currently; older drugs such as fondaparinux have also had Xa inhibitory action).         

In First Aid's defense, there is a ton of information out there and the majority of it has been miraculously summarized into one volume.  Medical information alone is always changing as well.  I cannot even remember all the times I was tested on a current guideline for screening just to hear it get changed next month.  I have begun to wonder how much the USMLE itself has changed since its creation.  Perhaps I will investigate this after I take my own test.

UPDATE: As soon as I finished writing this I got an update on my phone about the US Preventative Services Task Force recommending against using PSA screening for prostate cancer.  They suggest physicians discuss the reliability of PSA with their pateints.  They also admitted we don't have any good tests at the moment for prostate cancer.