Tuesday, February 22, 2011

Everything Has to Give? A Little?

I feel like I am doing a half-assed job at everything these days. It seems that there is nothing in my life that I am working really hard at, getting good results, and feeling proud about.

There seem to be two opposing forces: medical education vs everything else. Medical education seems to win most of the time, but not even in a really-impressive-colon-cancer-study-head-of-the-class-and-rocking-exams sort of way. Just in a holding-on-by-the-seat-of-my-pants kind of way.

I am trying to figure out how to juggle reviewing old and current curriculum, as well as maintaining some sort of USMLE study regime,  and keeping up clinical skills review.

My program is pass/fail so do I shoot for the 'just pass' (i.e do the bare minimum of school curriculum to get by) and study-til-my-eyes-bleed for the USMLE? Because ultimately the USMLE has more of a direct impact on my future than what I am doing right now.

[Sorry, I know that the above statement may strike fear in the hearts of the general population: you don't want to think your doctor ever uttered the statement, "so do I shoot for the 'just pass'" but the reality is, there are only so many hours in the day and I can only study so much.]

The thing is, in an ideal world every day, or at least every second day I'd like to:

-do at least a smidge yoga
-play mandolin
-read (something that is not a textbook)
-sit down to eat
-read 10 pages from first-aid book
-watch a Kaplan review video or two
-make some flashcards
-plug away at current information for PBL sessions
-flick through histology slides, anatomy images
-work on presentation for review group
-read other blogs
-listen to some Goljan
-spend QT with Tobie
-do about 10-40 review questions
-sleep at least 7 hours.

But instead I usually:

-work on PBL but do a skimpy overview of everything
-sleep 7 hours
-make a handful of flashcards
-scramble something together for review group
-feel like I am a horrible student
-have lots of feelings of self-doubt and fear towards USMLE

This is not good.

Don't get me wrong, after working in the ED for five years I am pretty comfortable with only knowing a tiny bit about a wide range of things.  But at some point during my studies here it'd be nice to feel that I am doing something really well. Even if that thing is playing mandolin or running. Better yet, have it be biochem so I can stop waking up in a cold sweat in the middle of the night.


Grumpy, M.D. said...

I'd say your 2nd group is all I remember doing. I just studied pretty much nonstop during the first 2 years. Not so much driven to be the best, which I wasn't, but to just pass.

ulyssesthedog said...
This comment has been removed by the author.
Anonymous said...

You know what they call the guy who graduates at the bottom of his class?


At the risk of sounding trite, you just gotta keep plugging away. Medicine is a cruel mistress, so it's good that you're at least making a mental effort to include non-mediciney things in it.

OMDG said...

ABB --

If it were me, I'd focus doing well in my classes. At my school there was a pretty good correlation between class material and the USMLE though, in that people who did well in classes tended to do well on step 1. Then you can put the finishing touches on the step 1 studying when you have a break later, and it will be easier since you did such a good job on class.

As for free time, well, as you know there is none in med school. I suggest synergy. Eating/ Tobie or Mandolin /Tobie, or Working out/Tobie can be combined. I recall working out 3, maybe 4 times a week (actually still do), not every day.

As for first aid, 10 pages is A LOT to do a good job on in a day. Maybe look over overlap with what you're studying now? Also, I'd save the review question until the month before the exam, but that's just me.

Hope that helps. You're doing great, btw. Anyone who says this is easy is a lying gunner asshole.

James said...

When I started to feel this way during my first two years I would try to remember what all my non med school friends were doing. Working at job most of them hated. I would then try to view med school as my job, but a job I often loved. So I would try to put in an honest 7-8 hours each day towards med school in one way shape or form. I found that with 8 hours of "work" I still had enough time to do the things I enjoyed. I couldn't do ALL the things I wanted to EVERY day, but there was definitely enough time.


Sarah said...

I think med school is a profoundly dysfunctional learning system. You take people who are used to being very competent and want to help people and then put them in a situation where they are not competent at anything (preclinical: too much material, drinking from a firehouse experience, clinical: whenever you start to feel comfortable on a rotation, the block ends and you start over) and they can't even help themselves enough to stay in clean laundry and fresh food.

You just keep going. And eventually it's over. It is supposed to suck, it's not that you just aren't doing it well.

Absentbabinski said...

I know exactly what you are talking about! I was mulling over a post on exactly this topic on my ride home from school today.

I think I will do one, too.

But I really feel for you, it really does seem like too much sometimes and I've wondered several times this term if something is going to snap in me.

Keep on rocking, though. You got in and I like to think that shows you are capable. A smidge of self-doubt/ feeling overwhelmed just shows that under all the ability and ambition you're human ;)

Liana said...

Well I've been back in the student role now for 2 months and I will say this: it sucks. I'll admit I kind of thought that going back to school would be a nice break but dammit, I'm in lecture 9-5 five days a week and then I go home and study and I'm stressed out about the exam and it sucks.

I much prefer practice.

So yeah, I feel your pain.

PGYx said...

I agree with OMDG re: focusing on coursework, which should correlate well with the USMLE. If your PBL is anything like mine was, it should also help you once you start rotations even with your ED background. You might consider doing short sets of review questions targeted to your current module a couple of times a week. When you redo them during boards month you will remember them. If you find the material in a question set is really foreign, cut the number of questions you do but use them to guide your PBL study.

You're asked to cover a ton of material but when you repeatedly put one foot in front of the other (as you've been doing!) to cover the material as well as time allows, it all comes together with time. This is particularly true closer to & during board study.

PGYx said...

A lot of people idolize First Aid, but I found adding as many notes to my Goljan book (from both his audio and the QBank I used) to be much more helpful in promoting a framework of understanding. I'm not a fan of the list-like format of FA, so I used it as my backup repository of study notes when info didn't fit well in the Goljan text. I did not look at every FA page, while I reviewed some pages many times.

One of my PBL classmates went through FA twice (fully!) and did Goljan audio only (no book). We both used the same QBank. We each scored 99 on the USMLE with 3-digit scores within 2 points using the resources that we liked most.

Btw, the text & e-book resources I knew well from PBL served as my main info sources when I needed to review topics in greater depth during board study month. Picture my office floor coated in open books and this desk: http://coldgirlfever.blogspot.com/2008/06/found.html

I can honestly say this was not a month of balance for me, so I can't help you much there.