Medical Boards: Resources

Hello!

Taking medical boards is a big step in your medical career; especially for your first go-around at it. Your first round includes everything you’ve learned in the past 2 years of your didactics. It will also be your first exposure to how they run the exams and what to expect for your next set of rounds.

It is not uncommon for students to use several study aids during your dedicated period. What is that you say?

Dedicated is the time you set aside to solely study for boards. For most students that is about 4 solids weeks. For some it is less and some it is more. I personally took more time, but our school built in time for us to have dedicated. Other schools may not.

Planners:

Before you even get to studying, a lot of students (especially the super type-A) like to have a plan of what they will do. Several of my classmates utilized CramFighter. If one of you gets it, there is a code you can give to others for a discount type of thing. I’m not sure if you can get a group discount like you can with Pathoma and Sketchy though.

CramFighter is just one of many scheduling sites that you can utilize. This one is for boards (specifically for step 1/level 1) so it has literally any and all resources you could think of to add in there. You can do a one week trial (which may be free or you might have to pay a small fee for). I tried the one week trial, but personally as you have to schedule things out and there were so many resources I became very overwhelmed and couldn’t find it helpful. I had some friends that once they were able to make there schedule find this very helpful. In fact, a lot of classmates used this. I’m also the type of person to add too much to my plate and not get it done, so I had a feeling that this would just make me feel worse.

Other possible online study scheduler sources: (not super popular, just did a quick online search):

  • My study life
  • Shovel
  • Study Schedule (more MCAT specific though)
  • Go Conqr
  • Memorangapp.com

Others just used an excel/google drive sheet to make their own schedule and knew which resources they wanted to use.

Sources:

I mentioned the sources I used in my previous post, but you will find a lot of the same top few sources. And for good reason! They consist of concise information and high yield concepts of what has previously been tested on in the boards or what may be tested on the boards. Some programs take what is in First Aid and just make the information easier to digest (i.e. Sketchy).

Top sources:

  • First Aid
  • U world
  • SketchyMicro
  • Pathoma
  • Savarese (for OMT)

Other sources include:

  • Boards & Beyond (B&B)
  • Doctors In Training (DIT)
  • SketchyPath
  • SketchyPharm
  • First Aid cases
  • Anki (using either Zanki decks or your own decks)
  • Online Med ED
  • Osmosis
  • AMBOSS
  • Truelearn (DO only)
  • COMBANK (DO only)
  • COMQUEST (DO only)
  • USMLE Step 1 secretes
  • Kaplan
  • Goljan Rapid Review Pathology
  • NBME assessments
  • Robbins Pathology

As you can see there are A LOT of resources. And there are many many more. The above is compiled from a few different websites and from friends who were studying at the same time I was. In fact, there are many more resources available depending on how you prefer to learn and what you are willing to pay.

Whatever you choose to use, do NOT overwhelm yourself with resources. Pick a few and stick to them. Try to find sources that fill in the gaps of what your other sources don’t teach/review well. This is why the First Aid, SketchyMicro, and Pathoma are all historically used. (Although personally I know friends who preferred SketchyPath over Pathoma). U world is typically used for questions as they are hard, the program is set up similar to USMLE step 1 exam, and it allows you to actively apply your knowledge by answering questions. Anki is also frequently used to help with facts that are just difficult to memorize given it has a proven exposure rate with studying.

Goals:

This will obviously be different for everyone, but you should aim for similar goals. Feel free to reach for higher goals than I set for myself; I was somewhat at the end of my rope by the time my exams were taken.

  1. You need to review all major systems. A great way to do this is either via First Aid and go through the section to review/relearn the subjects, doing Anki cards (which is just First Aid in a different format), or doing a video program such as B&B.
  2. Aim to review First Aid about twice. Once thoroughly, and once where you can quickly review. If you find yourself needing to re-learn something, this gives you a chance to do that on your second pass.
  3. You should aim to do a lot of questions. Doesn’t matter how you get them in: mock exam style, x amount per day, x amount after each section; doesn’t matter. You should aim to do many questions. The more questions you are able to do, the better your testing skills will be and the more knowledge you will gain. I aimed for about 2000 questions before step 1. I had friends that wanted to stick to doing 2 blocks of 40 a day, friends that wanted to review everything first and then just do questions for weeks. Personally, I slowly added in questions to see if I was retaining or understanding the knowledge I was concurrently learning.
  4. Practice taking a few mock exams. My only advice with this one is so you can work through your testing fatigue. You are going to be testing for 8-9 hours in a day. Make sure you can train your brain to stay focused during the long testing periods. It can also help you gauge how long you need to be spending per question, and in combination with taking questions regularly will help you decide if you should be sticking with your gut guesses or re-evaluating your guesses. (I’m a gut guesser; more often than not if I gut guess it is correct, but if I try to change it I usually change it to a wrong answer).

Breaks:

I touched on this in my previous post but I want to reiterated it here: Make sure you schedule breaks for yourself during dedicated. You will be studying long and hard for really stressful exams. Giving yourself downtime will not only improve your performance, but also your ability to focus and your mental health. If you need to seek professional help then do it. If you need to make sure you workout because it helps keep your stress levels down, then do it. If you need to be able to paint your nails or paint a picture, then make time for that. If you need to spend a day getting lost in the woods going hiking to reconnect with nature and reset your soul then you know what I’m going to say; DO IT. Medical school and medicine in general is all about how balanced as a person you can be while simultaneously juggling the stresses of medicine.

Make sure to keep the balance in your life and to not overtip it one way or another. Your body will tell you if you are.

Good luck in dedicated. Cheers!

Kenya Series! Why Did I Choose To do a Medical Mission Trip?

Welcome Back!

I flew back into this side of the world less than 12 hours ago (at the time of writing this), and of course I can’t sleep to save my life… So I’m up writing this instead!

Doing a medical mission trip is a great way to get more experience outside of your traditional learning environment. As a current medical student, this is a great way to actually see patients and improve your clinical skills while still being supervised. The more medical experience you have, the less you will need to be supervised. If you are an undergraduate student, this is a great way to get experience via shadowing, observing, or helping with other tasks in the area.

As part of KCU, we worked with an established clinic outside of Kisumu, Kenya. We did not do a pop up clinic. The clinic we assisted/worked at is currently a non-profit organization in an area where getting medical help is more difficult. Prior to the clinic being built, the community was unable to either travel or afford to get medical help. Others didn’t want to know their HIV status or were worried about stigma. Since the clinic has been operating, more people have access to some healthcare, and the clinic assists with much more as well. Including: counseling services, rides to bigger hospitals, dedicated eye/dental days, assistance with scheduling surgeries or other consultations with outside hospitals, sponsorship programs for orphans and children to go to school, and assistance with parents for improving education. Not to mention the entire center is a safe space for kids to play at.

The clinic does charge to see patients, but it is usually very little. The fees are more of a “don’t take advantage of the system” then an actual fee. And if those seeking help cannot pay the small fee to get your name on the list, the fees are usually waived. If the patient needs additional medications/treatments/care, there may be more of a fee? I believe it was mostly to cover the cost of supplies, but in general most of the care was free. This tidbit wasn’t completely shared with us, but this was the most information I could muster from a few people.

Dr. Bonyo, Dr. Desai, Dr. Abraham, Marylyn, and the students on our first clinic day.

We worked with Bonyo’s Kenya Mission. Feel free to click the link to learn more about this particular clinic. KCU brings students here twice a year. Once for 2.5-3 weeks (which is the one I did) and another that is a longer rotation for 3rd and 4th year students. We worked along side local staff and physicians. There is always an attending on call. All of the lab staff, pharmacy staff, counseling services, and nurses were present at the clinic when we were there as well. Without the staff, we couldn’t have assisted and seen the patients that we did.

While we were there, it was advertised in churches as free health care which caused a massive influx of patients. This is not normally the flow that they see. When we come, we provide manpower; and the community advertises for them to see us so they can get anything taken care of while we are there.

It really is a win-win. The community gets care that they need or otherwise wouldn’t have attempted to get, and we get to improve our skills and be reminded of why we wanted to be physicians in the first place.

While reflecting back on the amazing time I had, I want to discuss my personal reasons as to why I chose to partake in this experience. So let’s talk about medical mission trips today!

Goals before my trip:

While deciding if I wanted to do this trip, I made a list of all of the things I wanted to accomplish while there. I wanted to assess what I felt I needed to improve on as a student and hoped that these could be aligned in some way with doing this trip.

  • The biggest reason I wanted to go was to improve my skills. I wanted to improve my ability to take a history. My ability to do a physical exam, and do so confidently. My ability to present to an attending like I would in my rotations and eventually as a resident. I wanted to improve my basic medical skills such as taking pulse, blood pressure, etc. Even though I had experience through SP’s my first year, I wanted the experience of not knowing the category of the chief complaint. I wanted to test and improve on how I could take care of patient that I had no idea why they were coming in and weren’t reading off a script.
  • I wanted to improve my compassion and my ability to see patients. And I wanted to do it without knowing that if I failed I could just repeat seeing a patient. This goes back to the SP thing, but it really is a completely different experience seeing real patients instead of the conjured ones you see in medical school for practice/assessment.
  • Confidence. I wanted to be able to take all of the above and try to improve my confidence in being a future doctor. Medical school is really good about beating you down or making you second guess your abilities. This trip was to help me realize that I can do this, and that I can get good at it in my future.
  • An experience of a lifetime. I had never travelled to the other side of the world before. I was scared shitless for this. Most people do not (usually) travel to developing countries for vacation. People think of going to Cancun, or Italy, or the Caribbean for vacation. I wanted to experience another country and all of its culture & the people.
  • On this note, I also wanted to be humbled. I wanted to be reminded that even though I have my problems, I wanted perspective that most of my problems in my cushy, developed country of good ol’ US of A were not nearly as difficult as those in a developing country.  The work and labor that I saw people do on a daily basis was astounding. Yet at the same time, it is their way of life and they know no different. I needed to be reminded of that perspective. And what a more perfect time than to do it after completing one whole year of medical school.
Why I chose to go with KCU?

Honestly, I’m a scared little bitch and was too afraid to go to the other side of the world by myself to a country that I had never been to.

Really, that was a huge portion of it. I knew KCU would guarantee as much safety as they could in another country. I researched several other companies outside of KCU to originally go with, and it came down to KCU and one other country. I mainly chose KCU’s trip for safety reasons.

The other main reason is I wanted to make sure I wasn’t going to unintentionally harm a potential patient. With KCU, I knew we would have a professor present with us to sign out and help us learn and treat patients. The added assurance that there was a licensed physician present who could help me learn and grow while still  making sure I didn’t kill or hurt my patient was a pretty great bonus. I could not handle the responsibility of seeing a patient on my own without someone else there after 1 year of medical school.

If you think you can do this without guidance, Imma slap you. You literally know next to nothing in patient care after one year of school. Knowing that there were attendings present helped foster growth. A theme I wanted to stick with on this trip. I was less afraid to learn and try something knew because I knew at the end of the day I would have guidance available.

I also knew that this was an established clinic that KCU had worked with for years. Knowing that I was going to assist in a clinic that existed and would continue to exist after I was going was something important to me.

What I learned:

So much. So, so much.

I’m not even sure I can really put this into words. But Imma try lol.

For one, I gained some confidence. My first two days in clinic I was super nervous; I felt like I had forgotten everything we had learned in our PCM course (or “How to be a Doctor” course) despite having gone over basic skills the night before our first clinic shift. I was scared and unsure how to handle having translators. I was scared to have to practice. We could only order limited labs and imaging was out of the question; so trying to manage that and understand it was new.

I was all of a sudden expected to act in the capacity of a resident per se without much prior experience.

And my professors could tell that I was nervous and not super confident when first starting. They gave me a lot of crap about that. But after day 1.5 I would say, I finally got into the swing of things. And I was KICKING ASS.

Confidence really does carry a long ways though. Your patients feel better when you are confident knowing that you can take care of them. My classmates all told me that I seemed to have it together and that I was kicking butt… even though I was seeing just as many patients as them. (Thanks loves!) And the clinic staff were more likely to help me if I was more confident in what I wanted.

The other obvious thing I gained this summer was improvement in my skills. I didn’t get to see as many patients in Kenya for varying reasons, but without doubt improved my skills in every aspect: osteopathic manipulation, physical exam,  presenting, and overall just owning what was given to me. I came back ready to rock and roll this year and was WAYYY less nervous to perform than I was first year.

But lastly, I gained a whole lot of perspective. My friends and family asked if I became depressed because of what I came into contact with in Kenya. Being an emotional being, I was also expecting that.

However, majority of the people I met and took care of were just happy and content with life. The kids were just happy to be playing. The elders were just happy to sit in the shade and talk and hang out. The women in the fields that we passed by every day to get to clinic were ecstatic just to get their picture taken.

Obviously, as majority of my classmates and I are Mzungu’s (foreigners; white), and we were met with sad stories in an attempt for us to give money. But overall, the people were sweet, friendly, and happy. While away from the US and my stressful life as a medical student, I was reminded of just how truly blessed I was to be where I am. To be in a country where my considered “necessities” are mostly luxuries in developing countries. That I too can appreciate the small and wonderful things in life, and be content on much less.

Like I said before, I am overflowing with what I have experienced in Kenya that it is hard to put it into words.

For undergrads:

I’m well aware that there are several students, particularly undergraduate students, who do “medical mission trips”. I put this in quotes because you likely haven’t learned any basic medical skills yet or have much in the way of medical knowledge. When this is the case, these trips are designed more for exposure with the added bonus of travel for you. You legally cannot do anything medical, and during these trips the company you are with likely won’t teach you how to do anything either. (There may be a few exceptions, but for the most part if you don’t know how to do something they aren’t going to take the time to teach you).

Because you cannot do much in the way of actual medicine, you will usually be involved in more global health tasks. Such as:

  • Teaching English
  • Doing epidemiology in the region you are in
  • Teaching on improved health practices
  • Assisting other medical team members who are seeing patients
  • Shadowing local physicians/observational roles
  • etc.

Why won’t they allow you to practice if you have no experience? 

Well. I’m so glad you asked. This topic is pretty irksome for me.

In the United States and most developed countries, you cannot practice medicine or do basic medical skills on another human being without training. Of any sort. Whether that is a completion certificate for EMT or nursing aide, OR a degree.

Which is my point exactly. 

You likely wouldn’t want to be worked on by a 20 year old without any medical knowledge. It isn’t fair, nor is it ethically right to try to take advantage of those in a developing country. So please don’t expect to be able to do something that you are not qualified to do in another country, just because they don’t have as strict of safety laws or ethics preventing it.

If you want to be a doctor, nurse, or PA and you think you can take advantage of another human in a different country, please bow out of medicine now. You will never ethically be able to justify doing this. 

But overall, doing a medical mission trip is a really great way to get your feet wet. Both before medical school and while currently attending.

I don’t suggest that this be your only exposure before medical school to medicine though. Try to be more well-rounded than that in your application. Having more than one experience (which many can be in your community) and increased exposure to draw on will always help you.

I hope you gained some insight on medical missions trips in the post. Feel free to leave a comment, share, or send me an email with any questions!