My Scores

Okay.

So this is normally very private information. And people don’t like sharing their scores or their downfalls. In medicine especially, it is a very dog-eat-dog ideology. It can be cut throat (which makes no sense truthfully because you should be competing with yourself more and betting yourself) but stupid and immature people think cutting others down or their “competition” is they way to get ahead.

Dumbasses.

Anywho, I am sharing my COMAT or shelf scores with you. I am also going to share my board scores with you. I want you to realize that yes, these exams are important BUT THEY WILL NOT MAKE OR BREAK YOU.

Only you have the power to do that. Obviously, the better you do the easier it may be for you. However, you can have amazeballs scores and still not match. That’s right, I said it. A good or even a great score will not guarantee you match somewhere. Just as a poor score won’t prevent you from matching. The difference may be is a poor score (like in my case) may limit your opportunities, or at least make you work harder to find different opportunities.

So, here it is.

COMATs/SHELF

I will list each shelf that I took and the score report associated with my test. You can see the topics they test and how they score. It does not however give you any more information such as the types of questions or not. Since I am a DO, again, using COMQUEST is a very good practice test/resource. It gives you very similar questions if not the same questions and a simulated score. Use this if you are taking DO COMATs. I did not do this, because I’m dumb. But a lot of my classmates did. This is one thing I will continue to truly recommend to you.

The lowest passing score is an 82. Honors is I don’t remember. But the NBOME’s honors and KCU’s honors differ. And that is a can of angry worms I won’t open up.

Pediatrics: Score of 100. Score report.

Internal Medicine: Score of 103. Score report.

Surgery: Score of 98. Score report. This one was hard. Lots of fluids questions and had no idea how to answer them properly.

Family Medicine: Score of 105. Score report.

OPP/Osteopathic Medicine: Score of 102. Score report. Did not really study for this one, at all. I think I looked up ribs and sacrum, viscerosomatics. I did look up cranial but had like 2 questions.

Psychiatry: Score of 108. Score report.

Emergency Med: Score of 97. Score report. I did not study for this exam at all.

Ob/Gyn: Score of 98. Score report. First COMAT. Hella nervous for this one.

BOARDS:

COMLEX level 1. Don’t ask me how I did so well on this one. I have no idea.

COMLEX level 2. This was not so good. Notoriously not a ton of people did well on this one. I honestly think it was a bad exam.

STEP 1. I thought I did better on this exam than my level 1. Jokes on me.

STEP 2. Honestly thought I didn’t pass. I mean, I barely did but I truthfully thought I didn’t pass.

Additionally, I am writing this before Match day 2022. I have already interviewed. It is up to the universe now. I am hopeful that despite crappy scores, I interviewed at 2/3 places I did my sub-I’s. I showed who I was as a person in person. But this is in the past and I cannot change anything. I am hoping to be in a better headspace next time around when I take my level 3 boards at the end of my intern year. And despite whether I match or SOAP, I will find a way into the specialty of my choice.

Again, a score is only one part of you. Well not even a part of you, one part of your application. When you are a physician your scores won’t matter. A better score will open more doors for you, but will not guarantee you anything. What else you do (volunteering, extracurriculars, personal statement, LOR’s, etc) is what will help you.

Cheers and good luck!

I got a Nudge From the Universe Today…

Hello!

This is going to a bit more unusual of a post than what I normally post. So let me set the scene for you, and I’m just gunna jump right in…

A few weekends ago I was sitting in my favorite coffee shop in Joplin. I had just arrived and was starting to unpack all of my books and notes. I had a test the next day, and as always, was hoping to get in a few hours of productive study time. The mountain felt high, but I was hoping to chip off a little bit before the exam. Let’s call it extremely hopeful.

Yes, yes… I was that: hopeful.

I was still in good spirits, but also still feeling like I was drowning. Which is the usual feeling in med school.

In hindsight it probably didn’t really matter if I studied at all that day. But I digress.

While opening up my books, a man who had set himself up at a table nearby was walking back. He politely stopped and asked me what I was studying.

Now, I sometimes forget how friendly people are in Joplin. In Michigan, most people aren’t this friendly. And you usually aren’t approached at a coffee shop unless you dropped something or some girl wants to compliment your dress/shirt/bag. So I was a bit caught off guard.

The conversation went something like this:

Oh, I have a really big test tomorrow, it’s on all of the cardiopulmonary system and the kidneys.”

Oh? I have lots of people that I know that work in healthcare. In fact, one of them is a nurse. She is on dialysis…

Hmm…Okay. Not sure why that was important. In fact, I was wondering why we were even going this direction. But alright, it’s conversation I guess.

We got to talking and I later learned his name. But for now, let’s call him M.

M eventually told me the the had interstitial lung disease which is now causing him some depression. Ah! I’m thinking, I actually know what interstitial lung disease is! I don’t know it well (even though I was supposed to know it for my last test… but hey, I know it). And before you ask “Joyce, where the hell are you going with this story?” The answer is I’m about to get there. Calm your tits. Please.

Anywho, long story short and he tells me he thinks medicine is poison.

An interesting stance. One that I obviously do not agree with, but one that I’m sure I will come across more than once in my future.

But a point that I nonetheless wanted to talk about today.

As someone who does not have a chronic illness and as someone who lives a relatively healthy life without many restrictions; I clearly do not have the same hurtles, experiences, or struggles as someone who does. I do not know what it is like to have difficulty breathing. To be gasping for air or feel like you might be suffocating on a fairly regular basis or even all of the time. I understand depression, but my encounter with that illness is different from his experience with it. Simply put, I cannot put myself in his shoes because I have absolutely no reference to base it upon.

But I can understand that he is struggling. That he isn’t happy with the cards he was dealt. And as a future physician, I need to be able grasp this.

This conversation lead me to multiple realizations:

  1. People want to be heard.

As a future a physician, it is our job to be able to lend an ear. Most patients don’t just want to be “fixed” or “cured”. They want to be heard. That their struggles are valid. That their emotions about their struggles are valid. Sometimes they just need to vent. And we need recognize that. Yes, you can say that they can be referred to someone else other than you for this. However, a part of our jobs are to have a human-human interaction. And sometimes, patients just need an our ear.

2. Perspective

I seem to be gaining a lot more of this recently. But perspective in the fact that we know what our lives are; we know our struggles, our obstacles, and what we have to do. But we sometimes don’t stop to think that our patients may have a much more difficult time doing the same things as us given their obstacles. It also reminds me that not everyone has a great experience with medicine. And with that, patients are scared, unsure, or may pushback more because of it.

3. It’s okay to disagree with our patients. Respectfully.

But it means we need to try to understand what is important to them. Their goals may be different than your goals. And sometimes as physicians we have to slightly re-align the goals to be more realistic. Other times, we just need to be on the same page.  Is their life meaningful? Can they do the things they enjoy doing? Do they still have the drive to do the things they enjoy? Can they work on accepting that it may take them longer to do a task now than it did previously? All of these are important. But taking time to just chat with your patient to get an idea of where they are at and sometimes gently nudging them or re-aligning their goals can help them immensely change their frame of mind.

4. And lastly and most importantly, we as physicians and as a medical culture need to stop being so afraid to allow death to happen.

This is the biggest thing that I think we sometimes all forget. Medicine can do many wondrous things. It can save lives, it can improve life and quality of life, and it can extend lives. But it can also extend life with the association of declining the quality of life. And that often times, we as physicians don’t do enough explaining or education that death is not necessarily something to be afraid of.

Do I want my future patients to die? Of course not! I want to give them a fighting chance when it is something that they want and it is within reasonable limits. But I also want them to know that it is okay to decline extra surgeries or procedures. It is okay to say no more. Especially if it may prolong their lifespan, but decline their quality of life.

There comes a point in someone’s life where the answer isn’t always a clear “yes, make me better so I can live longer”. When we are young or younger I should say, the answer is always make it longer. Give them a full life. But when you take someone who is chronically ill or elderly, the amount of sickness or chronic diseases start to pile up. I’m not sure our bodies were ever meant to live as long as we typically do nowadays. And as all of those start to pile up, the quality of life goes down. Sure, most of them are easily fixable on their own. Or if they had a perfectly healthy immune system getting something like pneumonia or a urinary tract infection would be easy to clear. But when put with someone who does not have a healthy immune system, it can seem like attempting to move a very large boulder that is constantly trying to squash you.

So too that, I think as a future physician myself and a lot of my future colleagues need to put our egos aside. We need to start having discussions earlier with our patients about their wants and wishes. So that when shit hits the fan, their family members who aren’t ready to let them go don’t contradict what the patient wants. Because not all family members will agree with what your patient wants. They may be selfish about what they want instead. And even just having that conversation early allows your patients to have the ability to take time and think about what they truly want. Because in some situations, it is better to grant their wishes or let them have a natural death to where they aren’t dying with tubes out of every orifice and hooked up to multiple machines. Or when their heart starts to give out, their defibrillator isn’t constantly shocking them, prolonging death and causing pain.

We also need to be better at discussing that death is not always traumatic. A lot of times, when chronic sickness takes over, your body doesn’t necessarily “kill you slowly”. A lot of times, you will go unconscious because your blood pressure is too low, or you are septic, your metabolites build up in your system, or your heart just gives out.

But it also leads me to this point…

I was sitting there having this discussion with M who I don’t know. This man who clearly wants to vent but also wants to be validated. I thought to myself: I am so wrapped up in my own problems that I forget I have a very fortunate life and situation.

As someone who just came back from Kenya, it is seriously embarrassing to admit that it only took 2 months to forget the perspective I learned while there.

But I also needed this conversation. Call it a nudge. Or maybe a little wind blew in my direction from the universe.

I needed to be reminded of where I was. That yes, this was hard, but that I was doing this so that when a patient like M walks into my office, I can have this conversation with them. That I can reassure them. Listen to them. Allow them that space.

Humans need to feel connected. In a world where we try so hard to be connected via social media, we don’t do a very good job of actually forming connections with people. I’m going to run into having patients who just want to see me to discuss that they are unhappy. To talk it out. For me to remind them or gently nudge them to find the things that they find pleasure in life with. And once that is gone, we should discuss where to go next.

I was at a crossroads in my life before this conversation. The universe gave me a little nudge to remind me that what I’m going through now won’t be the rewarding part. That what I’m doing right this second isn’t what it will be like in practice. That the conversations I have with my patients will be both heartbreaking and rewarding, but worth my white coat.

Just wanted to throw that out there today.