I survived my first semester in medical school

I’m about to get really real with ya’ll.

Courtesy of giphy.com

I’m finally done with my first semester of medical school and I’m officially 1/8th of my way to becoming a doctor. It is surreal to me that I’m already done with one semester! It flew by, but at the same time, it took forever to get here.

You know how you feel like you are stuck in limbo, like floating in the same spot endlessly, but also have travelled so far in such a short time? Like a weird time warp situation? That’s exactly what it feels like right now (for me at least). Which is hilarious, because at the beginning of the school year so many people told me that that the days will feel long and be crammed full of things to do, but the end of the semester (and my 4 years) will go by quickly.

I didn’t want to believe them. But yea, they were pretty spot on.

To be honest, I feel like I know nothing. I’ve learned so many things but at the same time am not sure if I can easily recall half of what I learned. There were many times this semester that I had to review what to ask before an SP encounter (where we have an actor with an ailment and we are taking a history and doing a physical exam) despite the fact that we’ve had no less than 6 encounters and I was a previous scribe. So I should have been prepared.

This whole process has been so incredibly humbling. I don’t know how physicians that I’ve met out in the world are so pompous, arrogant, and are so high up on their righteous high horse, because quite honestly, going to medical school has made me realize just how little I know and how much growth and knowledge I need to attain.

But, as a human, I’m really good at focusing on the negatives. So I’ll first focus on what I don’t know and the things that were a major struggle bus for me, before ending things on a lovely positive note! (Because no one likes a negative Nancy).

Things that could have gone better:

The first thing is by far the feeling of inadequacy and constant feeling of imposter syndrome.

I had a bad case of this right from the start of medical school which only got worse over the semester. Even with being able to talk this out with friends/classmates who are also dealing with this, with E, and with the school counselor, I still had a really hard time with this.

I knew there would be things I wasn’t good at. Which for type A personalities, is a hard pill to swallow in general. But at the same time, I was about to experience a lot of things at levels I had never had access to before and needed to at least be able to pass or be somewhat competent in it. (I’m not a complete type A, but I did spend my entire childhood and teenage years as a perfectionist dancer; some habits are hard to break.)

But those pills were really hard to swallow when it was a task that I was just barely passing at.

Failure. Or getting really close to failing. 

I’m sure I’ll have plenty more of this. And yes, I’ve had some failures or less than stellar performances. Some of that I let my anxiety get to me. Some of that I just didn’t have it in me to try. And some of that was completely out of my control because no matter how much time I spent with a subject, I just wasn’t getting it.

Take this last block, renal, for example. I failed both tests. Both. Tests. Both were less than a 70% (which is a passing score).  I barely passed the course thanks to the 5 point quiz and a curve.

Now, I know there are many classmates that this happens to on more than one block that we’ve had this first semester. I get that I am lucky that it has only happened to me once. Hell, I know classmates who haven’t passed a block and will have to repeat it over the summer.

I get that I passed, and that I shouldn’t necessarily be freaking out this much over it. And believe me when I say that is about the happiest I’ve been all semester because I was terrified that I wasn’t going to pass this course. But I was most definitely terrified there for a hot minute because I’m not used to it and have a hard time going with the flow (sometimes).

I’m most definitely still learning how to deal with failure. Let’s leave it at that.

-Getting over being un-motivated.

Still need to work on this one. Not gunna lie, I’m good at not doing anything after a test. Especially since we start a new class either that same day or the following day. But my problem is I don’t start anything sometimes for days after. Need to work on trying to get motivated sooner.

In general just getting motivated has always been my problem. I’m really not that surprised that it didn’t get much better since starting medical school. But hey, it’s something to aspire to improve upon.

-I’m constantly trying to figure out a better way to study/take notes.

This one is still stressful. I have an idea of how I want things to go. And even though I continue to try to study actively, there are plenty of times where studying is still passive. Why? Because my brain certainly isn’t functioning at the same capacity it was at in July.

I know that by filling out objectives, reading, and handwriting notes works great for me, but I don’t always have time for that. So; still trying to figure how to best take notes for me, and even when my best hours of the day are for studying.

It really is a constant battle.

-You have to learn to play the game.

You already had to learn how to play the game to get into undergrad. Although honestly, with how many universities and colleges there are now, you are likely bound to get into at least one that tailors to how you did in high school (which can be good or bad depending on how you look at it).

You had to learn how to play the game in undergrad. That is a struggle bus for sure. Especially since you are somehow also supposed to figure out how to be alone and adult for the first time too!

You had to learn how to play the game for taking the MCAT and getting into medical school. This game was the hardest for me. It took me 3 tries to get in and many years prior to that in undergrad to try to figure out what I needed to do. This game is the one you have to master just to get into the door of medical school, the one where a school gives you the chance to actually try. For some of you, this game will be easier. But if you are like me, this game was hard to understand because it felt like the rules kept changing.

And then, you have to learn to play the game in medical school. Now this is different. You have gotten in, there are many many resources available to you, and if your school is like mine, they have policies and practices in place if you slip up academically (granted there are guidelines for this that you have to meet in order for this to be offered to you). So say you fail one or two courses in your first year, you retake them in the summer. Or say a big life issue happens and you need to leave school for a hot minute, depending on the situation and the details surrounding it may mean you miss one block and come back or come back the next year. So I mean, there are lots of exceptions to the rule here and KCU really does try to make things work.

The real game here is learning the academia way versus the real-world way. You will likely be taught by a mix of PhD’s and physicians (both currently practicing or those who have stopped practicing to focus on teaching). Usually the physicians will teach you the more “quick and dirty” ways of learning something or recognizing something, because you need to be quick and can’t spend an hour trying to say, analyze an EKG. The PhD’s will focus on you learning all the little details of big concepts, and you have to learn to take the tests the way the PhD’s write them.

Some of my professors are really straight forward in the way they teach and the way they test. I have some that will say hey, know this slide or this big picture concept well. Why? Because it may be on the test but they also like it on boards. Or, professors who give plenty of practice questions so you have an idea of how they write questions. And then I have professors that come test day you never know how they are going to test, what they may be testing on, or even if the question makes sense so there is always that (yes, I’m still salty about my renal course okay?)

Positive outcomes from this semester:

-I’ve made some pretty great friends. 

The fact that we are all going through this together bonds you, because you are all having to overcome these hurdles. I’ve also met some of the sweetest people ever, and plenty of them who are willing to put me back in my place or fact check me when I need it. Although I don’t go out much, I’m really happy to have made these friendships!

-My relationship with E has gotten much stronger. 

I was worried about this one. There was a hot minute where I thought the stress from both our lives were going to change our relationship and not for the better. But since going through a semester and mellowing out to each other, I’d say these struggles have definitely bonded us more.

-I’m much more comfortable in being able to at least take a history from a patient (still working on the exam part, and the timing part).

So I’ll go more in depth on this in another post discussing my PCM experience and first semester with this course. But from being a scribe and being used to only focusing on writing a note, to actually being the one to ask the questions and try to get to the bottom of why they are having the issue is much different. I can at least be comfortable asking questions in a non-awkward way, which is a step in the right direction for me. I was truly terrified of getting through that barrier.

-I somehow actually know how to do several osteopathic techniques and can easily tell you how to do them.

I will also go more in depth into OS, but basically when I was a wee one first starting off earlier this semester I had no idea how to even feel for anything let alone understand how to do do anything. Now, I still have trouble feeling what something is supposed to feel like on some techniques, but overall I’m actually pretty confident about being able to do a good 5-6 techniques/overarching principals!

-Utilizing my classmates to help.

They are learning literally the same shit you are. At the same time. Because you all get tested on it the same day. If you really don’t understand a concept but its 11pm at night at your professors aren’t on campus anymore, ask a classmate. They may actually understand that concept and can spend time teaching it to you (one, because they want to show off their knowledge and two, teaching it makes you learn the concept better). In turn, they may have a question about a concept that you may actually know and can help with. If they can’t, they likely know someone who does understand it and can point you in their direction. I’ve most definitely employed this many times this semester.

Also, since everyone knows how to do do OS (osteopathic skills/manipulation), you can usually ask any classmate or friend to help you out. You (hopefully!) get relief and they get to practice. Win-Win!

-Overall my test anxiety has improved!

Which is weird, because I most definitely thought it would get worse given how often we get tested (usually once every two weeks, some weeks we have multiple tests or evaluations in the same week). But honestly, for my regular class tests my anxiety has improved. For other encounters, however, I still get nervous.

-And finally, I’ve tested myself to some limits and didn’t break.

This one may seem weird for some of you, but as someone who has suffered with mental health issues in their past, I was terrified of what the stress of medical school would do to my mental health.  Thankfully, I’ve only suffered a few crying spells and a handful of anxiety attacks. Which, is basically what most medical students go through!

Courtesy of giphy.com

I’m sure there are more things, both positives and negatives that I didn’t touch upon. But let’s be real, my brain is still a little fried from this semester and this post is getting long! But as always, let me know what you liked or didn’t like in the comments, or what you would like to see more of.

Cardiopulmonary

Okay. This block was intensely fast with a lot of heavy and difficult things to digest, with all of it being really important. I mean, you can’t function without a working heart or working lungs, so learning these things are vital (literally… haha get it? as in vital signs? no? … okay never mind…) to being able to understand how the body itself works. (I chose not to try to post during this time just to try to stay on top of my course work.)

Currently, my class is a test class for trying out a new scheduling block. What this means, is they took 3 whole weeks out of the academic year to give us 3 weeks back during the summer. Now, this was done so we could use this time to build up our CV’s in-between our first and second year so we look more competitive for residency. They initially explained it as they took out parts of the course that absolutely weren’t vital for the boards, and that is how they could condense the time.

Where and how they took it out is still a bit of a mystery for me. I heard through the grapevine that they took a whole week out of cardiopulm, a whole week out of neuro, and a whole week out of MOD (which I think is more disease related and is structured to transition us for second year- I’ll let you know what it is when I get to it). All 3 courses are pretty important. Well actually, pretty much every course in medical school is important. So, if the above rumor of a week was taken out of each of these courses is true, why these were the 3 blocks chosen to have days removed beats me! There are a few current second years who state that not an entire week was taken out of cardiopulm (given how it lands with Thanksgiving), but it has definitely been a wild ride so far this block. Either way, the course directors chose to shrink down the curriculum and our class is the first to see if it works or not.

Initially it didn’t really bother me for the courses, since other than in MSK, there was a fair amount of time for things (in retrospect here). So it was no big deal. Now that I am in one of those courses where a whole week (allegedly) was removed, its kinda a big deal. It could also just be that there is so much to learn, that it was going to feel intense anyways, but I digress.

My Mindset During this time

Before the Midterm:

Okay, this is a lot. Like a lot a lot, but I might be able to power through it. I’m pretty much staying on top of it, and I’ve had multiple passes, so I think I might actually do decently on this test! (I even did a ton of practice problems too btw…so proud of me.)

I was confident. I felt like I knew a lot of the material, and the fact that I spent multiple times with each lecture made me feel pretty damn good.

How I felt before the exam. Confidence was on point! (courtesy of giphy.com)

Right after my Midterm: 

Courtesy of Wifflegif.com

Imposter syndrome is real. Feeling inadequate is real. Feeling like the dumbest person in med school is exactly how I’m feeling at the moment.

I was feeling pretty defeated. I cried a lot after the exam and practical. I had spent so much time with the material only to feel like I knew nothing on the test. Or at least I was confident enough when answering questions only to find out I had answered them wrongly.

During this test our time was cut down per question. We also had an increased number of test questions, so overall the odds of finishing with much time to spare was slim. I finished answering my last question with 2 minutes to spare and that was after I had to quickly read through questions and make a gut answer because I didn’t have a ton of time to read them.

Not to mention I thought the practical was pretty hard, and I almost started crying the second I turned in my paper for the practical. It was just a bad day for me, I let a few things get to me, and it shot down my confidence pretty badly.

Fast forward a few weeks later…

Right after my final:

I’m finally done. I’m happy to be on break but upset that I feel like I studied so incredibly hard for these tests this round for it to not really show. I’m not asking for A’s here people, but I would like to think I could do a bit better prior to the curve setting in.

The funny thing about this test block is some of the weird graphs/cycles we learned I’ve seen before in COB. However last year, I didn’t really understand them very well despite the amount of time I put into it. This year thankfully, they made much more sense. Maybe it was because I really spent a lot of time with it. Maybe it was because it was my second time seeing it. Who knows? But I did finally learn or at least understand some of those important concepts I was supposed to grasp last year (lol).

Lecture and Exam Breakdown

For the lecture midterm:

Anatomy= 29

Embryology= 21

Histology= 4

Physiology= 46

Total: 100

I gotta tell you, the histology and embryo are not my favorite things to learn. I love the professor teaching them, but I really dislike the topics. They make pretty much zero sense to me in all aspects no matter how much time I spend with them. It really is quite a damper on my spirit at times, especially when there are a large amount of questions dedicated to the material on the exams.

For the anatomy practical: 50 questions, similar to all the other practicals I’ve mentioned in other posts.

For the lecture final:

Biochemistry= 8

Clinical medicine= 19

Histology= 10

Pharmacology= 9

Physiology= 54

Total: 100

The physiology portion of the first test was very much focused on pulmonary, which interestingly had a lot of math involved in it. The math on the test didn’t always make sense, and turns out I think I spent way to much time trying to mathematically figure it out than what I actually had time for. Because of this, I finished my 100th question with 2 minutes to spare, and that was only because I gut answered a fair amount of questions.

The second time around there was much much less math (since we focused on cardio physiology this time, and also didn’t have embryo and gross anatomy which was a plus!), I made sure to get about halfway through the questions or more by the first hour in. This way, I would (hopefully) have more time at the end to go over my flagged answers and see if I could rethink through them or get an extra point.

As stated above, we had our time cut down this time. In actuality, we’ve had our time chipped away at slowly since starting school, it just had the biggest impact on me (and a lot of my fellow colleagues) this time around. Maybe it felt worse because we had a lot more questions this time around. Maybe it felt worse because of the heavily involved math for certain questions. Either way, the time cut down on top of the actual tested material and types of questions asked made it very difficult for I would say about 85-90% of my class to finish before the time was up for the first test. I didn’t see very many people on the midterm get up and leave before everything timed out. There were a lot more people on the final that finished before time ran out, given the type of questions asked. And personally in my opinion, I think because there was much less math.

How I studied:

Hmm, I did a varying degree of different things with this test block. Now, I’m not in the top 10% of my class, so for all I know I could be studying absolutely horribly. In all honesty, how I studied in COB was much more lax than how I have to study in medical school. But as mentioned in prior posts, each person has their own way of digesting the material and their own way of accomplishing their goals for medical school. Actually, I kinda wish our school would get rid of school rank and go to a pass/fail system, this way I couldn’t be categorized based on the specific nuances of each course, just if I passed or not. But, I’m pretty sure they aren’t getting rid of the class rank system any time soon.

Prior to the midterm I didn’t go to every class. However, I did make sure to stay on top of the lectures. There was a lot packed into the first midterm (26 lectures and DSA’s), so I needed to stay on top of the material to get through it all! For the second half, I mostly went to class to get my first pass in. We had 23 lectures and DSA’s the second half, which didn’t feel nearly as awful as the first half (which is weird, because its only 3 lectures/DSA’s less).

For Histology:

I would go to class for these lectures. I really really don’t get histology, so at least going to passively hear it is better for me so far. Although if I’m really tired, I’ll just watch the lecture later. The second pass for histology would be to fill out the objectives/in-depth look at the lecture again. Third plus pass would be to review my filled out objectives and look at the histo specific slides.

There is a book for histo but I don’t find reading in the book super helpful for histo for me. I just gives me more details to confuse me with! So I stick to the information on the slides and the practice that our professor gives us.

For embryo:

I mean, I don’t understand embryology either, but I feel I have to write down every other word during the lecture. Because of this, I actually won’t  go to lecture, and instead will watch the recording. I find I have to stop the recording so often to type things down/ get the full picture that I would most definitely miss 75% of what was said if I went to class, making me more confused. So first pass was to watch the lecture and take notes. Second pass was to fill out objectives (if I could) to try to digest the material better. Third plus pass was to review the objectives and/or watch the recordings multiple times.

There is a set book for embryo, but just like histo, all the extra details actually confuse me.

For anatomy:

Oh man, blue boxes. I ignored this in MSK and learned the hard way on it. For some tests, they test heavily on blue box material from Moore’s book (one of our required texts, also happens to be the same author/book from the COB program). Other tests they don’t test as heavily on them, but its always when I don’t pay attention to them that they happen to pick out more to test on.

For anatomy lectures, I have learned that I can either actually sit in on the lecture in real-time or just watch it. The first pass (just like for histo) is to in-depth look at the lectures and take notes. The second pass I will fill out objectives and draw certain structures in my book. The third plus is reviewing the objectives and my notes/drawings.

Since we had anatomy lab for the midterm portion, constantly reviewing the anatomy or at least keeping up on it was very helpful. I tried to use my anatomy time to reinforce what I learned in lecture. I also made sure to start trying to look for structures on my structure list while in lab. That way, if I had questions I could try to flag down a tutor or an anatomy fellow.

In addition, we had less labs for CP this round in lab, and way less structures to learn or things to do in lab. Because of this, we had more time in lab to actually review/look at structures than we did in MSK.

For physiology:

Oh man, this information was a lot, and it was very detailed and heavy. I had to do multiple passes. Pretty sure I needed at least 3-4 or more for each lecture to really get it to sink it. Which is partly why I was mad when I didn’t get a higher score on my midterm. The pulmonology information was very math heavy and a lot of numbers to remember/understand. The cardiac was more conceptual and less math which was nice. For the midterm I did a lot of practice problems (again, math related and tbh I suck at math). For the final, I didn’t do many practice questions other than during our Q & A sessions because there wasn’t nearly as much math. It as mostly interpreting the cardiac cycle/venous return curve questions that I was able to understand quite well.

For biochemistry:

I honestly did this stuff last-minute. We had 2 lectures right before the test (and by right before I mean the Thursday and Friday before our Wednesday test…) that I watched and just took notes on. There were some practice questions hidden in the lecture that I used, but other than drawing out the pathway and just taking plain old notes, I didn’t do anything additional.

For clinical medicine:

I learned how to read EKG’s this block!! YAY!!!!

Courtesy of wifflegif.com (P wave missing here people and T wave doesn’t look normal…)

Learning this was actually a lot of fun. In fact, I’m pretty sure I did the EKG lectures and practice about 4-5x just because I was happy to finally be doing doctor-y stuff. I attended all of these lectures because I was so excited, and I believe I only got 2 of the EKG questions wrong (if my memory serves me correctly from the review early today). Basically, attending lecture and just reviewing the slides was enough. We have 2 really awesome physicians who are still practicing ER medicine when they aren’t teaching, and they are all about teaching us the “quick and dirty” way of going about things to make sure we get the correct answers, understand, and don’t do extra work. I really really like these professors.

For pharmacology:

Attending lecture/viewing the recording was my first pass. For this time around, we had one actual lecture. This lecturer tends to give us a pre-recording/lecture to view AND DSA material to digest before the actual lecture, and then during the lecture has case studies/questions available. I honestly took forever to digest the pre-material before looking at the recording, but after going through all of this initially, I just needed to refer back to my notes that I took to review. I didn’t bother with doing objectives or anything like that for this.

What I would change if I could do it over again:

I needed to spend much more time with embryo. I feel like this was a huge downfall my first test and even though I tried to spend time with it, it was very complicated and warranted more time to really try to understand it. I also likely would have benefitted from watching the other campus’ lectures on the material as well, but I don’t super love how the professor teaches. Because of this, I usually don’t watch their lectures on top of mine for embryo, but in this case, it could have helped.

The other big thing I could (or should) have changed was asking my professors more questions. I had plans to go to office hours and ask questions, but I’m really bad at doing this. My pride usually gets in the way. My reasoning is always “I haven’t caught up yet and I need to catch up first before asking questions” or “I just need to spend more time with it to understand it… I can figure it out myself”.

Courtesy of wifflegif.com

Only one more course to go before the end of my first semester guys! So excited!

As always, let me know in the comments below what you liked or didn’t, what you found helpful, and what you want to hear about!