Note To (Future) Self

As a student I often find myself wondering how a professor or an attending could have the expectations that they do for us.  I am particularly perturbed by this because I know for a fact that at one point they were in my very shoes.  How then could they have forgotten how it feels to be on the other side?  I am writing this post in hopes that my future self will stay connected to this, to remind myself as I trek through this journey where it all began:

***

The test is in 3 days, no big deal.  Study.  Flip through notes. Eat. Where did the day go? Dinner. Yawn. Two more days. Sleep.

Two days.  Geez.  I'm getting a little concerned that I'm going to know too much for this test.  Seriously, 48 hours to cover this material? Thats more than enough. TV break.  Review notes. Sleep

One day. Oh my god.  What happened? I had three days, now theres 24 hours.  If I sleep four hours that gives me 20 hours to review.  Theres about five sections.  Four hours per section.  That doesn't seem like enough.  I start frantically flipping through the pages of the text book realizing five minutes in that I have absorbed nothing.  I'm just flipping.  Where is the day going? Its already 1 pm.  I woke up at 7.  By now I should have finished reviewing half the material.  I start counting: 1 pm, 2 pm, 3 pm . . . . 11 pm, 12 am, 1 am.  Thats twelve hours.

Okay good. 12 hours, that should be enough.

Somehow its 8 pm.  I've managed to eat my way through a bag of candy and 3 cans of soda.  All of a sudden totally irrelevant, menail tasks became high priority.  I absolutely had to reorganize the bathroom drawer.  It was happening before I could stop and I had to finish.  Its okay, I've gone through most of the material.

There is an ebb and flow to the panic and serenity.  A little dance, my heart rate fluctuates between tachycardia and bradycardia.  One second its beating in my ears as I see the minutes of sleep slowly slipping away as the night grows closer and my pile of work remains the same.  Another I feel on top of the world, envisioning a 99%.  High pass for me.  Stress. Relax.

Finally I decide I need some sleep.  I'm not one of those people who can pull an all-nighter.  I need a little shut eye.  I drift off to sleep with a page of notes clutched in my fist.

The clanging of my cell phone awakens me from a non restorative sleep and I bound out of bed as the panic washes over me again.  Two hours.  Theres only two hours left.  Is any of this actually going to stick in my brain now? Should I just stop? No.  I know these little details I can't remember, if I can just come up with a way to remember them.  Some mneomonic: krazy kittens gurgling the night.  There is no way I'm going to remember all of this minutia, there is no way they're going to ask about that.

As I reach the exam room the stress reaches its zenith as I pick up bits and pieces of other peoples conversations.  Every so often I heard a tidbit that I don't know and a fresh wave of panic washes over my body.  Its too late now--I'll just have to guess if that comes up on the test.

"You may begin"

I hate that feeling.  The on where you remember where the answer is.  Its on the bottom right corner of the 3rd page, you highlighted it and scribbled a note next to it.  Thats all you know.

Thats the worst.  When you feel like you should have studied just a little bit more.  If you could have just pushed yourself a little bit harder.  Then you wouldn't be sitting here with an exam in front of you and absolutely having to guess on questions.

Somehow your body goes into exam mode, you just start churning out answers.  The test taking monster inside you takes over.  Process of elimination and educated guesses slowly dilutes down to sheer dumb luck and guessing.

The walk home from the exam is awful.  First you have to escape the group of students bickering about question #68.  How do they even remember? I don't want to know.  I jam my earbuds in my ears and high tail it out of there.

On my walk home I pull out my slightly crumpled study guide and race to the bottom of the 3rd page, where I highlighted and scribbled a note.  IL-10.  Thats what it was.  How could I not remember? There's something wrong with me.

What if somehow I literally answered every question wrong? Statistically pretty unlikely but even at 25% would be awful.  What if I fail? What am I going to do? I thought I studied, I thought I knew the material.

I hope they post grades soon.

3 days later . . . .pass. Phew.  Wasn't so bad was it?

***

Panic. Fear. Pressure. Self doubt. Confusion. Restlessness. Sheer exhaustion. Those are all a part of this temporary condition but the fact of the matter is to us, at that particular moment they are all too real.

I understand that some of this is a part of the package.  Medical school is a grueling undertaking I juts wish more attendings and professors could take a second to reflect on what it felt like to be where we were--just to ease the pain for us a little bit.

They say "be the change you wish to see".  Someone check in with me in 20 years and see how thats going.

A BRS is Worth A Thousand Textbooks

I’m going to share with you all what I think is one of the most, if not the single most useful piece of information that I didn’t figure out until about half way through my first year.  Something you may have started to notice is that I like creative titles, it keeps things interesting for the reader but also pushes me to keep the content something challenging to write—something I would want to read.  Anyway so as the saying goes, a picture is worth a thousand words and let me tell you there are some BRS books that are literally worth their weight in gold (I’m using literally correctly here, they are MONEY).  Let me explain a little more.

As I mentioned in the last post study guides are the way I like to study.  Typing up all the information into handy little bulleted nuggets that I can sit and gnaw on.  Although there is much to be said for reviewing individual powerpoints to make sure you understand what the professor is really honing in on, a true understanding of basic underlying concepts will get your incredibly far, especially in physiology (but I’ll leave that for a post on study habits or lack thereof). 

So lets cut to a few weeks into school when there was a book sale where all the M2s and beyond put for sale a bunch of books that they didn’t need anymore.  As I wandered past the stacks of netter flash cards, clinical case files books and a smattering of assigned textbooks I kept catching glimpses of these compact little books with titles like BRS Physiology, Rapid Review Histology, BRS Anatomy so naturally not knowing what they were I figured I’d just buy the one that had the largest stack and figure it out later.  I then went home and proceeded to buy every single required text book from Amazon BIGGEST MISTAKE EVER.  I was kicking myself in the face 3 months later when I realized that one of these little guys I’d picked up from the book sale was sitting on my book shelf staring me in the face as I trudged my way through histology.  

The only "textbook" that was
ever worth what I paid for it

Alright, I know what some of you are thinking, WTF IS A BRS.  BRS stands for Board Review Series.  Essentially these books are created to put together all of the most high yield information for a certain subject and created a bulleted/outline type format of a book for review.  Although these are more useful come time for Step Prep (I’m not there yet so I can’t comment with much confidence) these are hands down the single best study aid you can use for medical school.  Notice I said aid, I don’t encourage skipping all your classes and exclusively using a BRS but as a supplement these are phenomenol.  Different people have different preferences among the different companies for particular subjects and there are a lot of them out there so do your research and get yourself some of those.  If I were to recommend one BRS that is an absolute must have is BRS Physiology by Costanzo.  Just trust me, by the end of M1 you will come to understand how absolutely mind blowingly amazing this book is and that Costanzo is baller status.

This is not to say that there aren’t some textbooks that you’ll have to fork over the cash for because you absolutely need to have a Gray’s Anatomy for Students because there can’t be a review book that is quite as thorough for the little nit-picky things you need to know for anatomy.  You absolutely have to have something like Ross and Pawlina for Histology because the plates at the end of each chapter, in full color, are incredible and there is no resource that can fill in for those.

All I’m saying is you have to feel it out and see what you need and explore what is out there and find a combination of sources that work for you.  Some people swear by class notes and textbooks and if you are that person then by all means do that.  But for the rest of us that need other supplements, that are constantly hoarding sources I would highly encourage and recommend looking into subject specific board review books because they are concise and great for review and they come with review questions (ß another money in the bank situation, in medical school you will become a review question whore, you will do anything for more practice questions). 

You’ll be surprised at how exactly your coursework will follow with the material presented in these books mostly because to a certain extent there is a standardization of what medical students need to learn so the basic, giant, overarching concepts get nailed down pretty hard no matter where you are and so these books are a great little supplement.

That is of course just what I found to be true, as with any advice I give here, it is such an individual process this is just my take on it.  You will start medical school and you will have trial and error and eventually it will click and you’ll find your groove, until then it kind of feels like you’re walking up on a down escalator.

If you have any personal recommendations or general comments or questions about study skills or aids please leave a comment

Moral of the story: when and if the upperclassmen have a book sale be the super informed M1s that charge in their and snap up all the BRS books for $6 a pop.