Doctor Psychobabble

I finished taking the USMLE Step 3 a few hours ago. I have to say, it wasn’t quite as bad as I thought it would be. I won’t find out if I passed for another few weeks, so I can’t completely celebrate yet. But I’m hoping that I passed, and if I did, I will never have to sit for another USMLE exam for the rest of my life! Sweet!

After the exam, I pampered myself with a pedicure and eyebrow waxing. Then I came home and shaved my head bald. Yes, I have decided to lose the mohawk for the time being. For one reason, I thought it might be a bit more professional (yes, you all probably know I have a lot of thoughts on that). And the other reason is that my bald head is totally low maintenance, and I feel that a low maintenance haircut is the best way to approach my intern year.

I plan on going out in a bit to have some dinner and drinks with my friends in celebration of finishing my exam. Then I have four days until I have to begin “residency activities.”

My orientation and other training begins on Monday. My first official day of residency “work” is on July 1st.

So, I really only have four more days to enjoy my freedom. And enjoying it is what I plan on doing!

Photo: Taken outside my kitchen window a few days ago.

It’s 2:00 p.m. on Tuesday. I have returned from taking the first part of the two day exam, the USMLE Step 3. You are allowed up to 8 hours to take the exam. I finished in a little over 3 hours. No, this is not abnormal for me. Actually, it’s about average as far as my exams go.

The first day of testing includes 336 multiple-choice items divided into 7 blocks of 48 items; 60 minutes are allotted for completion of each block of test items.

When I walked out of the exam, all of the proctors’ jaws dropped to the floor in disbelief. They couldn’t believe that I had finished in so little time. Actually, one of the proctors even implied that I had somehow managed to cheat on the exam. Luckily, I eventually convinced her that I was not a cheater, but merely a fast reader and exam taker.

Anyway, I’m halfway finished with the Step 3!

How do I think I did? Well, I always think that I did worse then I actually do. So hopefully, that is true this time around as well. There were definitely a few questions where I totally guessed and quite a few questions where I couldn’t quite narrow down the best answer!

Oh well, only time will tell. No use stressing over it now. I just hope that I did as well as I did on the practice exams.

I’m going to mostly relax for the rest of the day today and run a few errands. I think I earned it. No studying for me, though. My brain is tired.

Tomorrow my relationship with the United States Medical Licensing Exams will hopefully be over forever! Yay!

Photo: My doggy Scope wearing my socks while sleeping in his doggy bed. Yes, I like to torture him sometimes for my own personal amusement.

I have finished studying for the USMLE Step 3. If you know me well, you’ll already know that I have stopped studying for this very huge exam, well in advance of sitting for it. Well, I officially finished studying earlier today. I have done well on the practice exams. I feel that it’s futile (although somewhat tempting) to attempt to shove more facts into my already overly inundated brain. But, I know what I know, and that’s all there is to it.

I studied for the USMLE Step 3 in about three weeks. I will soon post how I did so, but for now, just know that I crammed a lot of information into my little brain in a very small amount of time.

I’m ready to do this.

This is the last “medical licensing” exam that I’ll ever have to take, if I pass. I will have to take board exams in psychiatry, of course, but that’s far down the road, and I prefer not to think about that.

For now, I will bask in the knowledge that this is the last USMLE exam that I will ever have to take. Ever.

My exam day will start out tomorrow morning at 8:30 a.m. And then I have to go back the next day at 10:15 a.m. for another full day of testing.

I can do this. I know it.

See you all on the flip side!

Photos:
1) The “sushi delivery vehicle” outside my fave sushi restaurant in my ‘hood.
2) My pre-exam “brain food.”
3) Me, happy about eating sushi and happy about taking the exam!

Part of My “Yo Brooklyn, Fuhgeddaboudit” Photo Series

Today was a great day. I woke up early this morning and took the NMBE practice exam for the USMLE Step 3. I scored very high! Yay! Now if I can just get these clinical case scenarios down, I should be good to go. Only 3 more days until the exam!

Afterwards, I went on an incredibly awesome 12-mile run, over the Brooklyn Bridge, and all of the way into Chinatown, and back. It was amazing! I totally remembered how awesome it is to run over NYC bridges, and it made me realize that I should run a little less often in the park, and a little more often on the roads and bridges of New York City (it’s more dangerous, but can be oh so exhilarating!)

Now I am post-shower and about to watch the new Alice in Wonderland movie on DVD (thank you, Netflix!) I will then proceed to pig out for the rest of the evening, in order to make up for my 1,200 calorie deficit from the run!

See you all on the flip side.

Photos:
1) The Brooklyn Bridge at night. From Andrew Mace on Flickr Creative Commons.
2) A graduation card sent to me by my sister. The post office ate a big chunk out of it, and sent it to me in an apologetic bag.

For those of you who didn’t read my latest Medscape post (yes, I know it sucks that it requires a login…I’m talking to you, TOM) I can tell you that it involved me practicing for the USMLE Step 3.

You see, the USMLE Step 3 is a two day exam. The first day involves a standard long day of answering multiple choice questions, which happens to be the format of most of my exams in medical school. But the second day involves something called “Clinical Case Scenarios.” It’s basically a “virtual patient” setup, where you are presented with a patient, and you have to make all of the same decisions that you’d have to make in real life. You have to place orders, run diagnostic tests, and even counsel your patients.

But the problem is that with the “CCS,” you don’t have any multiple choice options. Just like in real life, you are presented with a real patient, and you have to make real choices, without a nice, neat list presented in front of you.

What I’m finding incredibly terrifying and disturbing is that I’m not as good at these “real life” scenarios, as I am with multiple choice questions. Yes, I can still remember to do the basic things, but I find myself forgetting to do things that I “know” to do, but forget to do, because I’m not prompted with a list.

In three short weeks, I will be a “real doctor” at a “real hospital.” My patients will not be nicely packaged questions, with a wonderful multiple choice list of options of how to treat. They will be complex, complicated humans. And I will have to diagnose and treat them like a doctor is supposed to. And that scares the crap out of me!

This is what goes through the mind of an intern. And an intern, soon I will be…

Photos: From my recent med school graduation day.

Please do check out my latest post on “The Ink Blot” at Medscape/WebMD. It involves a very scary moment that I had a few hours ago.

Click Here to View the Original Post on Medscape

Registering for the USMLE Step 3 is a little bit different than registering for the first three exams. First of all, you must already have your medical degree. Secondly, you actually have to apply through a state licensing board.

I started the process of registering (and paying) for the Step 3 over two weeks ago, but I just now became eligible to actually register for the official day to take the exam. It turns out, the days that I wanted to take the exam (it’s a 2 day exam) were already taken, so I had to register for earlier dates.

I will be taking the USMLE Step 3 next Tuesday and Wednesday (June 15 and 16). That’s earlier than I had anticipated.

So, it’s time for me to really buckle down and study my little toosh off. I really believe I can do this, and I really believe that I WILL do this. So, here goes everything. T minus 7 days until the exam!

Photos: From my med school graduation ceremony several days ago.

As an update to my last post, my studying for the USMLE Step 3 is progressing well. I’ve realized that trying to study for an exam of this magnitude in such a short period of time is actually quite insane. But as I stated before, I am kind of an insane gal. My goal is to do at least 200 questions a day, and so far that is working out well.

I was inspired today to create an artistic photographic project. My idea is to come up with very stereotypical scenarios, but to then change one item very drastically. My first idea involves baby slings, or what I think of as baby papooses. These have become incredibly popular in New York City, as evidenced by this site (Slings in the City), and there was an interesting article, written in the New York TImes, about this phenomenon.

I live very close to an area of Brooklyn known as Park Slope. It is well known as an area for predominantly caucasian, affluent, mid-thirties, well-educated parents with young children. A quick walk through Park Slope will immediately douse your visual system with images of youngish men and women “wearing babies,” walking their dogs, and buying stuff in trendy shops.

So, my spin on this stereotypical image is to replace the baby in the sling with a doggy in the sling. Of course, I don’t actually own a baby sling, so I had to make a very quick, makeshift one out of a fitted sheet. The images in this post are my first attempt at recreating the cliched image of a young mother, with her child in tow.

We’ll see how/if this project turns out. I’m excited either way.

Disclaimer: I actually think that baby slings, and contraptions to “wear your baby” are pretty cool, but I guess I like to put ironical spins on trendy things. Or something.

After much consideration, I have decided to take the USMLE Step 3 in about one month. What the heck is that, you ask? Well, it’s the very last of the Medical Licensing Exams that I am required to take, to prove that I know how to diagnose and treat patients in the United States. You must have your medical degree before you take the exam. Many states require that you also have 1-2 years of residency under your belt before you take it, but the lovely state of Connecticut (that’s the wonderful loophole) does not.

Most residents choose to take the Step 3 in their second or third year of residency. However, it turns out that I am not most residents. I have decided to take a leap of faith and sit for the examination prior to beginning my residency.

Now you may ask, why the heck would I choose to do that? Well, of course, I have my reasons. The primary one being that I’d rather get it over with now, instead of having to stress out over it during my already stressful and time constrained years of residency. In addition, other than 4 months of internal medicine and 2 months of neurology in my intern (first year) of residency, I will only be focusing solely on psychiatry and psychiatric patients during residency. The Step 3 tests on everything (medicine, surgery, ob/gyn, pediatrics, etc.). So, I feel that there is a better chance that I will do well (and have to study less) right now, when all of that information is still “fresh” in my mind from medical school.

Most people also usually take at least a few months to study for the Step 3. Again, however, I am not most people. I’m going to attempt to study my little tooshy off for the next month, and then sit for the exam. Will this crazy, harebrained plan work? I certainly hope so. One thing that I do have going in my favor is that I took a similar studying approach to both the Step 1 and the Step 2, and did well on both of them. So, if history does in fact repeat itself, I should succeed with this plan.

I mentioned in a previous blog post that I couldn’t register to take this exam because of my lack of funds. Well, it turns out that an anonymous donor (okay, it was actually my mother) made it possible for me to do so. Thanks Bob, I love you!

So, here goes everything. It’s goodbye to boredom, and hello to studying!

Photos:
1) Me with my USMLE Step 3 study book.
2) Micah on stage at his graduation.
3) Micah in his graduation garb.
4) Sunday at the after-grad party.
5) Sunday and Lizzy arm wrastlin at the after-grad party.
6) Kendra at the after-grad party.

I realized today as I was walking through the park (that’s when I have many of my realizations) that I feel pretty stupid. It’s now been almost one month since I’ve had a “job” (med school was my job) and other than reading the occasional journal article and some non-fiction “pleasure” books, I really haven’t otherwise been stimulating my brain. I haven’t had to think about how to diagnose or treat a patient. I haven’t had an exam to study for. I haven’t had a very good reason to really use my brain. And because of this, I have this secret fear that I might be becoming stupider (yes, stupider).

Originally, my plan for my 2.5 months away from the hospital was to study for and take the USMLE Step 3. However, as it turns out, the Step 3 is a very expensive exam, and since I have very little money to my name, I am not able to register to take it.

So, I must admit that I haven’t been studying, or otherwise challenging my brain in about one month. Because of this, I fear that I might be losing all of the medical knowledge, which I supposedly gathered in the past four years of medical school. If I were to be presented with a patient right now, would I know which questions to ask? Would I be able to perform an appropriate physical exam? Would I know which labs to run and imaging to perform? Would I be able to come up with a differential diagnosis? Would I be able to devise a proper treatment plan? Or would I just stare at the patient, completely dumbfounded? I am beginning to fear the latter.

I also just realized that this is the longest period of time I have been jobless and out of school. EVER. Well, at least since kindergarten. Other than “summer breaks” during elementary school, I think this is the longest period of time that I’ve had “nothing to do.” It feels incredibly strange. And I’m pretty sure that my brain is wilting.

I fear that I will never be able to retire. I simply need to have work to do. It is my nature. Thou shalt not deny thy nature.

Yes, I digress. But I guess that is the problem. I can’t believe that I am actually DYING to start residency. I’m sure that I will be feeling exactly the opposite in 1.5 months. I guess we shall have to wait and see!

Photos: The first one is of my graduation tickets in Madison Square Garden. Yay! The next 5 are my blossoming “urban garden,” hanging from the child safety bars on my windows.