COMLEX DONE!!

Well, it’s finally all over. Today I took my comlex test and all I can say is…dang. I literally have no idea how that went, but I do not feel great right now. First of all, it was SO LONG. I got to my testing center super early again, around 715 (it was supposed to start at 8am). It was at the same place as my usmle, so I was very used to the routine. I got into my cubicle (my lucky # again!) around 730 and got through the first 2 blocks without much problem time-wise. I think my second block had a lot of experimental questions because there were multiple audio and visual media one after the other. At least I hope some were experimental, because that block was HARD. I decided to take the optional break (i took only 5 min) because I had to pee and refuel. The next 2 blocks were more frustrating for me. I found that there were so many  short question stems and they expected you to pick the best answer out of many good answers. Also, a ton of micro and OMM. Like, I totally should have studied OMM more, but these questions were so out of my range. I don’t think I would have ever come across them even if I had another month to study. I also think I made a lot of dumb mistakes, which I really need to work on. I just HATE looking over my questions after I do them. I don’t know why but it’s such a drag for me to do it and I get a lot of questions wrong on tests that way. I took the 40 min lunch break but was anxious to get the test done so I went back in early. The last 4 blocks were a blur. Some questions were super straightforward, and some were absolute guesses. The most frustrating part was that I didn’t see any questions on the things that I was expecting, very little ethics, very little pathophysiology, LOTS of OMM. That’s all I remember.

Now I’m literally vegging and planning my week and a half off for summer.

I’m glad it’s over.

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DONE with the USMLE!

Just came home a few hours ago from the prometric center after finishing the USMLE! I am EXHAUSTED! During the actual test I was surprised at how awake I felt, but once I came home, I hit the bed for a quick nap. I brought a power drink and coffee but hardly drank those during the test because my anxiety and adrenaline was running. I’ll give a brief rundown of what went down.

I got to the center 45 min early (I know, I’m a freak about arriving to things early) but it worked out well because I was able to start early. They gave me a key for my locker, I checked in, and sat down to start the exam. They gave me both headphones for audio and noise canceling headphones (they did not fit my small head very well but helped cancel out most noises). 

I got through the first and second block without taking a break. I felt like I had enough time to finish all the blocks but I definitely did not have enough time to go over all the questions I marked. I was marking a lot more questions than I usually do in a uworld block, which made me really nervous…but I think I was just being really cautious. I had a little less than 10 min to review my marked questions which is pretty reasonable but I wish I could’ve gone over more obviously. I took a 5 min break after block 2 to pee and grab a sip of water. Block 3 and 4 were a blurr really. Took a 5 min break after block 3 and a 25 minute break after block 4 for lunch. During all the breaks I felt like I couldn’t really relax and I usually went back into the room before 5 min was up because I was so anxious about getting to the exam. I took a 15 min break after block 5 and a 10 minute break after block 6. It felt really really fast once I was done with the exam and I did not feel great after it. I honestly do not know how I did or if I even passed. I had to make educated guesses on a majority of the questions. However, there were some very straight forward questions that I was expecting on there also. My test had a lot of molecular biology which I though I had covered in my studies but apparently not. I was fearing ethics after doing NBME 15 but most of them were doable. Almost no biochem. But otherwise, I can’t say that it was really heavy in any particular subject. I had the most trouble with the molecular biology questions and endocrine questions so maybe I felt like there were a lot of them but actually, I probably just spent more time thinking about those. Overall, I felt like the test was harder than uworld but easier than NBME 15 (which I thought had so many obscure questions that I’ve never seen the format or concepts for at all). I am crossing my fingers and hoping for the best for this one >.<

If I had to do it all again, I would want to do all of kaplan. I saw a good number of questions that were definitely mentioned in the few videos I watched from kaplan. At first they may seem like very lengthy, dense videos, but I found them to be very helpful on the exam. I would have also looked at molecular bio questions more. 

Welp, I’m taking this night off and on to the next one next week!

The final hours

It’s finally here! 13 more hours until my USMLE and I really can’t wait to take it. I’m not really nervous now, but we’ll see if that changes tomorrow morning. Today I went over some high yield notes and pages from FA that I marked for review. I also did a block of uworld (had to) just to make sure I’m not failing things. I’ve got everything prepped for tomorrow and I’m mentally (if not academically) prepared for this. It’s been a long 6 months coming. The rest of the day I spent resting and working out. I did arms and shoulders of p90x today. Yesterday was plyometrics, which is my FAVORITE video from the series, and I was still feeling the burn on my legs today. I feel like everyday I’m improving my endurance and strength which is amazing. Literally everyday a new muscle, that I never knew could be worked out, is aching (in a very good way). I’ve tried many programs before and I usually quit before the first week was up, but this time I feel really great about p90x. I’m thinking about switching out the yoga day though : / It’s just way too much for me and it’s the only video that really feels too long and boring. I might just do some HIIT and stretching on that day instead.

Anyways, off to eat some dinner, watch some TV and get a good rest before my exam tomorrow!

3 days

I’ve gone through all of FA in 4 days. Wow. These were the most mentally tiring days of… my whole life. Today was really tough because I had to go through repro and resp, both of which I really hate. Also I’m getting my period in a couple of days and it’s really affecting my concentration. This always happens a week before my period- my mind gets really foggy out of nowhere and no matter how much coffee I consume, I still feel fatigued and concentrating is really hard. This makes me really nervous about the test 😦 but hopefully my endorphins will override all of that on the actual test day. There’s nothing else I can really do about it anyways. My plans for the next 2 days are to skim through my highlights and annotations from goljan, pathoma and brs physio. And then review GI and Repro, which are 2 topics I struggle the most with. I also plan on doing 2 sets of timed uworld questions a day (the ones that I got wrong). Then on wednesday, the day before the big test, I’m going to take it easy. Probably just read the rapid review at the end of FA and shave my legs and get my eyebrows waxed since those details of my life have been neglected for the past month -.-

An update on my p90x progress…

I am officially done with my first week! It’s crazy how different I feel already. I mean I am no where near where I want to be, but my calves are aching, my tiny guns are popping out and just in general, I feel pretty healthy. Today was kempo X day and I’m really not a fan. I’m used to doing really hardcore cardio workouts and this was on a beginner level in my opinion. I did get a sweat in, especially during those jumping jack moments, but I wish there was a little more cardio. I’m actually a huge fan of HIIT so maybe I’m just used to thinking, if it’s not HIIT, it’s a waste of time. 

I’m also not following the p90x diet plan, but I started using the myfitnesspal app and it’s AMAZING! It has EVERY type of food/product that you can imagine. I mean I even looked up “costco seafood stuffed mushroom with shrimp” and it was there! It also gives you a breakdown of your macros (carbs, protein, fats) each day so that you know where your calories are coming from. I find that at 10pm when I’m craving a klondike bar, I look at my calorie intake on myfitnesspal for the day and more often than not, I put down the bar because I know it would bring me over my calorie limit. So it definitely helps me keep track of my calorie intake and I highly recommend using it!

9 days

Today was a hard day emotionally. One of those days where I’m sitting down for the whole day studying and wondering why the hell is my life like this at 23? And maybe I should have gone into dentistry.
I’ve got 9 more days until my usmle and it’s getting really rough to try and pull myself to study anymore. First of all, even though there are a ton of things I still don’t know, I am so sick of doing uworld. I can’t bring myself to read through the whole question, let alone all the explanations which makes me wonder if doing uworld is even helping me at this point. Then I go do a block of comquest and those questions seem much more harder to me even though the questions are shorter. When I get a question wrong in uworld, the right answer was usually my second choice. When I get something wrong in comquest it’s because I have no fucking clue what they’re even asking me. This makes me really nervous because I feel like I haven’t seen these concepts at all during my studying. Am I spending too much time focusing on the usmle? Am I going to be that unfortunate soul to pass my usmle but do terrible on the comlex?
So frustrating trying to study at this point. I’m going to take one more nbme (took 2 already + 1 comsae) and that’ll be my last one before the real thing next thursday. I’m really hoping I do better than my last score. I don’t expect to score 240+ at all because I know i’m not at that level but I just want to do better than my last nbme. Then i’ll feel confident for the real test. I’m going to push through this last week and remind myself that this is only one small time in my life and I have to give it all that i’ve got just for this short time. Then it’ll be all worth it (?).

On a totally different note, I started p90x. I know you’re not supposed to change up your lifestyle routine too dramatically near your test, but i’ve been working out pretty hard for the past couple of months and I’ve attempted p90x previously so I felt pretty good about starting it again. I’m only on day 2 of the classic program but I feel great! Last time I tried p90x (about a year ago) I didn’t have great endurance or strength so I started on the Lean program. Now, with a much better fitness base, I feel much better doing the exercises. My stats are NOT impressive really… I’m a 5’4” 100lb tiny female, but I can get through most of the exercises. I don’t own a pull up bar which makes up a huge part of chest & back workouts, but I just modify with free weight chest/back exercises and I still get a good workout. I’m also trying to modify my diet. I eat a pretty healthy diet, but I’m definitely a carb lover, so I’m trying to cut some of that out. Anyways, I’ve exercised regularly my whole life pretty much but I’m hoping that this program will really push me over my plateau.

Today was not even a day

It was a beautiful 80 degrees out today, a warm welcome from the cold & windy days we’ve been having. In my head I was talking a walk in the city, I was laying on the grass reading a book, I was having coffee outside of a coffee shop. But I was inevitably pulled back to reality by the delightful sound of DIT’s Dr. Jenkins lecturing about medicare vs. medicaid and the nuances of healthcare payer systems. BLAH I hate this stuff. I had been doing DIT since 8 in the morning and it was 12 when I took a break for lunch. After lunch I went back to the library, back to DIT, and was fighting intense food coma for about an hour before I came to, then I started actually trying to answer the DIT questions. At 3 I had lab and we were doing cranial for the 3rd lab in a row and my professor turned off the lights and I sat and tried to feel my partner’s head for 2 hours. And one time I closed my eyes and actually felt something but at that point I wasn’t sure if it was the pulse in my fingers or tactile hallucinations or if I was just feeling myself breathe. And then I drove home in the sun and walked back into my house, sat down and did more DIT. I couldn’t focus because there was a swarm of ants where my mom left a mango peel on the kitchen counter and for about a half hour my brain switched back and forth between trying to care about medical ethics and ways to trap/kill all the ants without disgusting myself. So then I ate dinner with my mom and we sat awkwardly together, not saying anything as usual, but letting our mouth sounds and chewing communicate for us. Now it’s 9 and I just finished washing the dishes. I still have more DIT plus school lectures to stream.

Today wasn’t even a day. I don’t know if I actually accomplished anything, I don’t know if anything made me happy today. I don’t know if anything got me excited to start my day or end my day and literally, I don’t have any feelings for today except that it was warm and I was tired a lot and just nothing really. It could have just as easily not been a day in my life than if it was one. Lots of my days are like this, it just starts on its own and before I know it I’m eating dinner, washing the dishes and it’s over. I can’t say that I’m really happy at any point of my day but I’m not particularly sad either. I question a lot if it’s just the overwhelming amount of work from school that’s making me feel like this- am I just coping by feeling nothing about it. I do that a lot. I ask myself how my life would be different if I didn’t go to med school and if it’s stolen away my freedom to travel and practice the things I love. That makes me really sad 😦 Actually that’s the only thing that makes me feel anything.

Robots scare me.

Today was hard. In our school we have this awesome robot that we use to practice emergency medicine. The robot can be programmed to have heart/lung sounds, a pulse, respond to any medications, oxygen or CPR that you give it. It can speak, it’s pupils react to light…it’s pretty much amazing. Anyways today we had a robotics case that was really hectic. She presented with hyperkalemia & hyperglycemia as a complication of missed dialysis (CKD) and diabetes. She was asystole within minutes and on top of that her husband and daughter came into the room while we were trying to intubate. We had to give her CPR which took a while to get into the groove of for us. I was in charge of meds so we gave her IV CaCl, IV bicarb, IV saline, epi and insulin. A group member tried to intubate her once her pulse came back but it was so difficult that it took about 4 tries and 3 people (including me) until she was intubated. At the end of the practical, I was sweating, my face was red and my heart was pumping. I felt defeated, even though the patient did not die and I felt embarrassed in front of the patient’s family. And this was over a robot! The whole way home I was thinking about what we did wrong and how unorganized we were. Was I supposed to give her different meds? Did I intubate her the wrong way? It was definitely not my best performance and I found myself being very lost a lot of the time (and the whole scene lasted only 20 min).

Then I thought I have to work HARD. I have to know my meds so that when it’s a real patient on the table, I know what to give to save her. I have to know how to perform procedures like CPR and intubation like it’s second nature. I have to practice with EVERY chance I can get once I get into the hospitals. This is critical! Not for my life, for real human beings’ lives. And I felt the weight of responsibility that is put on physicians, in particular critical care physicians. I’m not sure if I can actually handle it as a lifelong profession but there will be a time when I need to become so intimate in emergency settings because it’s hectic! and everyone is relying on you to know what to do. So I’ve GOT to learn everything I can. Hopefully when I’m actually in that position I will confidently execute what I need to and not hide in the crowd like I’m so comfortable doing.