What Can Happen in a Year?

A hell of a lot. Interestingly, if a person's life activities and experiences could be correlated to variations of colors the year, as it pertains to the medical school experience, was pretty monochromatic. However, while writing that extremely long, awkward sentence, I don't think monochromatic is a great term for the year, even for medical school.

Since my last post I have successfully battled to the end of quarter 2, quarter 3, quarter 4, quarter 5, and will soon be facing quarter 6 in mortal combat in the final battle around the first week of March. It is my weathered, exhausted, and sleep-deprived opinion that the first two years of medical school is a data train-wreck and my job is to simply survive that train-wreck and attempt to save as much of the data as I can. The true test of that data gathering will be on June 24, the level one Comprehensive Osteopathic Medical Licensing Examination. It is looking like it will be a truly worthy foe indeed.

I have developed several awful study habits that I would like to share with the internet. My most regrettable habit, the pre-test all nighter (PTAN). The recipe for a PTAN is very simple, however, not everyone can/should do it. All you have to do is start studying at around 8:30 PM or 9:00 PM and continue to study until 7:57 AM. Then take test at 8:00 AM. After taking the test, review notes for an hour or so to make sure you got the easy ones right and figure out what the hell the right answers were for the hard ones. Then, if you don't have labs, standard patient encounters, meetings, or important lectures that day, you go home to sleep a few hours. Then you do it again in a few days for the next test. Sound easy? Well it is. But the "repeat" part is the part that kills the brain cells.

I am not sure what test it was that set me down the dark, dreamless path, but it must have been an awesome one. I mean, it must have shown me that my PTAN paid off right? Seriously, though, I hate the habit but I usually dominate the tests so it is pretty hard to stop. Did it pay off every time? Negative. Especially lately. Let me expound.

First year could be summed up as a "basic sciences/core knowledge" year. Anatomy, Physiology, Biochemistry, Microbiology, and Immunology, are just a few memorable examples of first year. First year was INCREDIBLY challenging and pushed me to my absolute limits in regards to information retention and testing. It was, however, predictable. Oh so wonderfully predictable. I had a well calibrated mental thermostat for success on the approaching tests. I knew when I was worthy for a 90%, 80%, 70%, and down. I just added hours to my study session to achieve greater levels of worthiness. Second year, however, is a mysterious, nasty opponent.

Second year is the year of "clinical reasoning/clinical prep." Pathology, Dermatology, Cardiology, Women's Health, Gastroenterology, General Surgery, and Pediatrics are just a sample of the confidence wrecking machine of second year. Whether by accident or design, our professors write test questions that can be so enigmatic that even with the notes in front of me, the answer would never be clear. Our tests continue to be multiple choice, 8:00 AM, and the PTAN continue, but my success thermostat is completely unreliable. Example: I didn't get less than a 78% on any test my entire first year. The very first quarter of second year, I bombed a Pathology test with a 68%. Studied hard, studied all-night, was completely clueless on the test. It had to be a fluke right? It was simply a sign of things to come. Now my Pathology tests are the most predictable tests I can take. The internal medicine tests and Pharmacology test are true masters of disguise. I can study solid for two days and walk out of the test feeling like I never learned Anatomy. I can study ONLY the night before while taking several "youtube breaks" and "facebook breaks" and walk out with a low 90%. Nothing that I do seems to change the variability and it drives me insane. There is a possible positive outcome to all of this madness.

The bright (semi-dim at this point) side to this testing and learning mess of second year is that it is telling me repeatedly that I am not as awesome as I thought I was. That I don't know everything, or even much of anything. It tells me to cling to the longer, older coat tails of my attendings and supervising residents. It tells me that although Anatomy and Biochemistry had solid answers, I am going into a career full of gray, fill-in the blank, consult a specialist, and look it up on the internet. That I can't catalog data and expect to rely on it to be a good doctor for my patients. I also know almost 100% for sure that I will not be a Cardiologist, Pediatrician, Gastroenteroloist, Pathologist, Pulmonologist, or Family Practice Physician. So, eliminating options can be a powerful and positive experience too.

Surgery is currently the specialty of my future. The top three specialties calling my name? 1. Orthopedics, 2. Plastics, 3. General/Trauma. Will my mind change over the course of the next year in rotations? Hopefully. I started this journey with the goal of being open to surprise - open to the specialty that I never thought I would like. But I know myself pretty well and the top few and the bottom few are most likely not changing rank without a significant "surprise."

I'll be in York, PA for the next two years and they have a great surgical program with several residencies that interest me so the stage is set. My next challenge lays before me in June and no amount of planning, wishing, and hoping that I do now will matter much if I don't fight my opponents in order of appearance!

With that, internet, I leave you what is to be my longest and hopefully not last blog post as a medical student.