medical school – Page 23 – We're All Med Here

I survived my first semester in medical school

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

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!

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.

First Block of Medical School: Biochem

Whoa…

Just whoa.

Holy shit balls I did not expect this block to be so intense. I have never felt this perpetually tired yet able to function at the same time. What day is it? Who am I? Do I have an assignment due today? IDK anymore.

These first 3 weeks of medical school have been way more intense than I expected it. I got tired of everyone telling me how hard it was going to be, that it “was like drinking from a firehose”, and that you will feel so incredibly overwhelmed and to remember why you wanted to be here in the first place. At the time, I was thinking “yeah, yeah, I know it’s hard. Getting here was hard and I’m prepared for the hard road ahead.” I was ready to start and to get on with my medical training so I could finally become a doctor.

But my god, there was absolutely no way to prep myself for this.

The only way to describe this is to you is you think you are prepared to get your ass handed to you, but there is no way to prepare or explain it other than you just get through it. You just kind of have to wade through it. It will feel like a lot. Some of you will feel like you won’t be able to handle it. Some of you will be able to handle it but not very well. And others of you will on the outside look like its no big deal, but on the inside be questioning your every move. (I really don’t think anyone gets through their first block completely unscathed here; even for former master’s students who had the same professors the year prior).

Remember: there are thousands, hundreds of thousands of physicians that came before you. There are hundreds of those student doctors who went to your school through the same curriculum who made it through before you. If they can do it, so can you.

Scheduling:

Below is the schedule for our week 1. It was intense, and the first day they started us out with a pretty full plate. Over the course of this week, we had 11 biochem lectures and 1 DSA (or additional reading material/lecture material that did not have time to have a set lecture dedicated to itself).

We also had several PCM lectures (or the “how to be a doctor” class), some OMM lectures and labs (or the osteopathic manipulation course), a med informatics course (a library course? or how to utilize the library resources), and a bioethics class.

Week one schedule (I know my editing is terrible). This is as big as I can get it.

The way my schedule is set up is there is a main course, in this case biochemistry (blue), and there are several ongoing courses running at the time. Biochemistry usually had 1-3 lectures every single day. The next two biggest courses are the PCM (gold) and OMM (purple). We have OMM lab once a week and usually at least one PCM lab and/or interactive group involved each week as well. Everything else is either integrated every other week or at a lesser frequency than 1-2x a week (med informatics- forest green, bioethics- highlighter yellow, tutoring- muted green).

Both in OMM and biochem we had DSA’s. So things to learn outside of lecture itself that are testable material and usually either foundational to learn further knowledge or supplemental to help augment another main idea. So important stuff to put in that brain.

This first week we learned basically nothing but metabolism of the body. We did have the foundational enzyme kinetics, delta G, and things of that nature. But for majority of the week it was metabolism (with the exception of heme metabolism). There was a lot of drawing out pathways to try to understand the steps and process itself, and then ultimately how it all inter-related. As a student doctor, you have to know how things are inter-related in the body in order to see if something goes wrong, does it affect more than one thing? (The answer is usually yes).

We had a quiz on the Friday of the first week. We had our midterm on the Monday of the second week. We had another quiz on the Friday of the second week.

This week, it was less hardcore biochem and more molecular and genetics that were integrated in. So for the whole first week, all of our lectures were straight biochemistry. But this second (and third) week, we had genetics, some biochem, physiology, and histology integrated in.

I did not do a schedule for the third week, but there was a biochemistry quiz on the Thursday of the third week and our biochem final was the following Friday. In total, we had biochemistry and molecular all in 3 weeks.

Compared to COB: we had 15 weeks (1 semester) of biochemistry and another 15 weeks of molecular alone. So yea, it was a wild ride. We did not go as heavily in-depth as we did in COB on the science side, but it helped knowing the background of how it worked which made it a little easier to just focus on what I needed to focus on.

How I Studied:

I mean, I was all over the place. For some lectures I did objectives. For most of them I would write out what was highlighted in lecture in my book as writing for me does more to actively get it in my brain than mindlessly typing. I have a blank sketch book that I have written my notes in so it is all in one place. This way I can easily refer to my notes and what I’ve highlighted and have everything in one place in my own words. That way I could re-organize it in a way that made sense to me and also add in information that I’ve remembered or could easily find to connect different lectures together.

I also drew out a lot of the pathways. The only way to really cement them in my brain was to keep drawing them out. If any of them connected together, I needed to physically see it (the second photo of notes shown is an example).

For most of the diseases, for learning what vitamins needed what cofactors or what diseases are caused by vitamin deficiencies/symptoms, and a few definitions, I used notecards. For biochem specifically I used the Anki flash cards. The computer the app was free, but if you use it on your iPad or your iPhone I believe there is a hefty price of $25. Since I’m cheap, I only used it on my computer.

Why did I use this one? Well for biochem since I had limited time and needed to get more in my brain, Anki has the option to immediately redo the card, come back in 10 minutes to show you, or bring it back in a few days time. It’s designed to help space out your learning for maximal memory and retention. Plus it tracks my progress and I would try to do flash cards everyday. If I needed to make a chunk of them, I didn’t study as many of them. But if I was making less flash cards or didn’t need to make any flash cards, I would do a lot of running through them. The nights leading up to the tests I would try to run through all of them. Anki also has the option of how many cards to provide you each day, and the ones you struggled with the most re-appear more often. So there are new ones that get added in to your pile, a chunk that get reviewed, and the ones you struggle with. If you do well on that block or a chunk of it, they will use different cards.

I do use study blue or quizlet for my OMM course information though, but this one I’m less pressed to learn the information in a small amount of time.

Then on the weekends or the night before a quiz, I would review as many flash cards as possible and read through my book of notes. If I needed clarification, I would go back to the slides.

The more passes on the information you do, the better you will learn it. I have a rule of 3: If I can see the lecture material at least 3 times then I will get a good portion of it in my brain; or at least enough to reason through and make some connections when prompted on a multiple choice test.

I.e.: If I look at the material the night before (which only happened a few times) that would be pass #1.

Attending lecture would be pass #2.

Doing my own notes would be pass #3.

Reviewing repeatedly would be additional passes.

Not gunna lie, it’s hard to fit in that many passes of your lecture when you have several lectures a day to get through and a very limited amount of time. But this way most definitely works. Your brain will make the connects faster (or more connections) the more exposure you have to it. Unless you are one of those loser people who have that weird gene/protein in their brain and they only have to read something once and recall everything–> you suck. I wish I had that ability.

Why didn’t objectives work as well for me this year as it did in COB? Time. I simply did not have enough time to go through all of the objectives and type them out. The ones I did do I filled out during lecture. This helped re-organize things for me so that when I went back to write them in my book they were already organized. However, most lectures I was too busy going “What the fuck is going on?” to be able to really sit there and do objectives and “oh my god I don’t have time to look at all of these”.

So ya know, typical thought process for me on the daily.

Testing:

We had 3 quizzes worth 5 points. After our quiz we would sit for a review. This was still the testing environment so we couldn’t take notes, but our professors would go over each question and why the correct answer was the correct answer. These were here for us to judge how well we were getting along in our studies and where we needed more work.

Midterm was 60 questions. The breakdown was 56 straight biochemistry questions and 4 clinical questions (from our CIS lectures–> they integrate real life cases with what we are learning in biochemistry).

For our final exam it was 90 questions. The breakdown was 43 questions of straight biochemistry, 5 clinical medicine questions, 30 genetics questions, 4 histology questions, and 8 physiology questions.

For both the midterm and final exam, there was a post-exam review. In this review, the questions that you got wrong would re-appear, and you could look at the explanation given to why the answer is what it is. During this the professors do not lecture us, but instead it is in text format on our testing app. You can leisurely look at this and go back to look at each question you got wrong multiple times.

How it is different from COB: well we get reviews. Whether that is instructor lead (after quizzes) or not (tests). We also see our raw scores as soon as we hit submit. Now, this does not take into account if we had an answer that wasn’t multiple choice, because the program (the same one you use in COB) doesn’t grade anything that is in essay format or short answer. That has to be physically graded by someone. But since everything was multiple choice in this block, we did not need to wait on additional answers to be graded. However it is still raw, you usually get 1-2 points back on a test because of ambiguous test questions/answers or the class as a whole did poorly on some questions. Or it was keyed wrong. The class average needs to be 85% (or at least that is what I have been told). So if the class average at the end of the course doesn’t hit this, the class as a whole will be bumped to an 85%.

Passing grade for the courses are 70%.

But thankfully with my raw scores I passed 🙂

Please let me know what you liked about this post or any questions you have in the comments down below!