Hello from home my friends and family.

I am unsure how to start off this post. The COVID-19 pandemic has been a shock to us all and has had a drastic impact on everyone’s day-to-day life. For medical students (and everyone I am sure), it has brought about much uncertainty and anxiety.

For Denzel and I, 2020 is the year that we will apply to and interview for residency programs. Residency is your first job as a doctor after completing medical school. The application process is rigorous and several requirements must be met in order to be considered a competitive candidate. We have worked hard the past three years to complete these requirements and now, as fourth year medical students, we are preparing for our board exams and completing elective rotations in our specialty of choice to get strong letters of recommendation for our application.

Our plan was to take February and March off to study and complete our two preliminary exams and our USMLE Step 2 Clinical Knowledge exam. Leaving us only with our Step 2 Clinical Skills exam that we have scheduled in June. Thankfully, we completed and passed our preliminary Step 2 CK exam (NBME CCSE) in February.

Due to the circumstances, our Step 2 CK that was scheduled for April 1st was postponed and our preliminary clinical skills exam that was scheduled for April 4th is now set to be taken online.

We were planning to be back in the hospital resuming electives in April. At this time, we are unsure whether these electives will be taking place or not, but we do not have the highest hopes that they will. Unfortunately, this elective was an audition rotation for Denzel. A rotation he picked, in the specialty he is interested in pursuing, at a hospital he would be interested in attending residency at.

For now, medical students have been attending rotations in an alternative online format. We suspect if April rotations are cancelled, this would be the option offered to us.

At this moment, we are unsure how these “set-backs” will affect our residency application timeline. We have both felt an array of emotions: fear, sadness, defeat, worry, etc. However, we know we are not alone and that all medical students, whether from Caribbean schools or American schools, are experiencing the same challenges we are.

With plans being uprooted, I wanted to share how Denzel and I are coping and utilizing this time.

1) Continuing with workouts- home edition.

Our goal has been to get at least 60 minutes of exercise and 30-60 minutes of yoga per day. We usually do yoga at night with candles and the fire place lit to maximize relaxation.

Check out our favorites and some other FREE options below:

  • Les Mills On Demand: get a 14 day free trial. We love Body Combat, Body Pump, Body Step (check out this affordable step you can purchase to do these workouts), and GRIT. Body Flow is the yoga we do daily!
  • Orangetheory at home workouts on YouTube: these are about 30 minutes of cardio and “weight” training. If you have no weights, they give some ideas for household items you can use to create some resistance. Check out Walmart if you want to purchase some affordable dumbbells for home.
  • Beachbody On Demand: get a free 14 day trial. There is 100’s of workout options here!
  • Down Dog: this is a yoga and Pilates app that you can download on your phone or iPad. This app is free until May1st for everyone and until July 1 for K-12 students, teachers and healthcare providers.
  • Core Power Yoga: they are offering free select online classes during the stay at home order.
  • 2244 Hot Yoga: they are posting free 60-90 minute yoga workouts which you can do with them Live on their Facebook or just do after they post.
  • Whitney Simmons: she is posting free 30 minute at home, no weight workouts almost daily.
  • Dance with Dre: if you are feeling like dancing, Dre has several hour-long hip-hop dance workouts and even does live classes every now and then.
  • LIVELOVEPARTY.TV: this YouTube channel has hundreds of Zumba videos and you can just play them for however long you feel like exercising
  • Snap Fitness: 90 days free online workouts

2) Spending time outdoors hiking.

Another way we have been getting some activity in is spending time outdoors walking on local trails. Parks are still open in Michigan, so we try to do this at least 1-2 times a week. We are even planning on getting bikes this week to turn our walks into bike rides!

Use this link to find some trails near you!

3) Reading for leisure and playing board games.

Thanks to my mom, I had a few books I was meaning to read whenever I had some time. One down, four to go!

Denzel and I expanded our board game repertoire and we have been trying new games every now and again. I think he has also enjoyed having virtual video game meet-ups with his friends back in Texas (pretty sure this was a thing they did before quarantine lol).

4) Altering our study schedule.

This was a big one. Two weeks before we were supposed to take Step 2 CK we got the news that it would be postponed. The earliest date available as of now to take it is May 4th. We had to decide at that time whether we would continue with our rigorous 12-hour study days for another 6 weeks or slow down with plans to restart 4 weeks out.

A lot of people commented “at least you have more time to study”, but if you have studied for a board exam before, you know that sometimes you do not need more time to study (maybe a few days or a couple weeks at most, but certainly not an extra 6 weeks). When you have a date set for an exam, you work to prepare in a way that you are at the peak of your knowledge around test day. You also schedule how and when to use your resources (thousands of practice questions and about 5 practice exams). Plus, you want to do all of this while combating burnout!

With a mere 800 UWorld questions and 2 practice tests left to prepare for our exam, we decided to slow down on Step 2 CK studying until we had a better idea of what would be happening in April.

We did decide to increase the rigor of our Step 2 CS studies in preparation for our online Kaplan CS practice exam (hopefully April 4th). We put all the cases from First Aid for Step 2 CS on index cards and we randomly select one to practice in its entirety- timed and with a patient note.  We then review it together and talk about what we missed or did well. Since our exam is going to be online, we are spending this week practicing in a completely verbal format, which includes verbalizing the physical exams.

The plan is to recreate a month-long study schedule focused on Step 2 CK again for April with hopes of taking our exam on May 4th.

5) Cleaning our home.

I created a list of cleaning tasks that I haven’t had time to complete in our home that I have slowly checked off including scrubbing the floor boards and organizing closets. I find cleaning to be relaxing and often clean when I feel stressed!

6) Trying new recipes.

With limited protein options at the store, we have been experimenting with different recipes. I had never cooked with shaved beef or beef short rib before- we tried Philly cheesesteaks (this was not for me, but Denzeli enjoyed them lol) and beef short rib tacos with homemade tortillas (inspired by a fellow med student). Denzel also tried his hand at baking cookies which turned out pretty darn good.

7) Researching and taking notes on residency programs. Working on our personal statement.

We decided to take some time to research residency programs that we want to apply to. Since we plan to couple match, we started creating a side-by-side chart with programs in close geographical areas. We are now looking into each program and taking notes on details that are important for us. Thinking about residency and looking into programs has also ignited some excitement for us during this time and reminds us of the end goal.

We have also made it a point to take notes here and there for our personal statement (another part of the residency application). Whenever we have conversations between us about residency, what we are looking for and hoping for in the future, and what we have been through thus far to meet these goals, ideas and thoughts come to mind that we write down in a word document. That way when we are ready to sit down and compose our personal statement, the words have come from months of thought.

8) Volunteering.

I think in general as a human being during this dark time, it is hard to stay at home and watch people suffer, patients and people who are actively working to fight this virus. Even more as a medical student in my final year, I feel so close to the fight, yet so terribly useless sitting at home. If you are feeling the pull to help out in these times, here are a few ideas:

  • Volunteer at your local food pantry or Meals on Wheels to help supply families in need with food. Meals in Wheels volunteers deliver meals to seniors. Many of these organizations are taking precautions to protect their volunteers including limiting exposure to others and providing protective gear.
  • Local hospitals are seeking donations of all kinds. This includes cloth face masks to cover their masks that they have to reuse. If you are able to sew, consider sewing face masks and donating to your local hospital. I hear Joann Fabrics is giving out supplies for free and when you bring the completed masks back they will donate them. If you want to sew some masks, but do not know where to donate them, please contact me and I will find a place for them!
  • I have seen some students call local hardware stores, tattoo parlors, salon and spas, etc. and asking them to donate any PPE they may have (gloves, masks, gowns, etc.) This is something you can do from home! See what our local hospital St Joes is in need of below:

If anyone has any other ideas on how to volunteer during this time, please let me know!

OF COURSE, STAYING AT HOME is the best thing you can do to help others right now. Staying at home is saving lives.

This is probably the most unexpected blog post I ever thought I would write. Is this pandemic more unexpected than a hurricane and school on a ferry? Not sure. I hope and pray that this will soon pass and that we will all come out on the other side as better humans. I hope we can remember the time every human being was subject to the same enemy. It didn’t pick a color, an age, a sexual orientation, a gender, a socioeconomic status. This pandemic is a struggle we will have all experienced. This crisis has brought about unity between people of all different creeds, who have radiated love and support for our healthcare providers and other essential workers.

For the time being, there is no use in overwhelming ourselves with the unknown. For me, it helps to think of the right now. Right now, we can stay home and we can continue to prepare to be doctors. We can reach out to the people we love and care about who are risking their lives fighting this virus everyday- our heros and our role models.

Take a look at how amazing people are:

 

 

 

Two years later and the time has come to tackle our second set of board exams- the USMLE Step 2 CK (clinical knowledge) and Step 2 CS (clinical skills). But of course, not before we pass the preliminary exam… THE COMP for both exams.

If you have followed YBtoMD for a while now, or if you have had a chance to read about our experience with the NBME comp for the USMLE Step 1, you know that the comp is a source of great frustration and anxiety for Denzel and I. So even though we felt more confident in our clinical knowledge after preparing throughout our third year, we couldn’t help but feel those same feelings creeping in.

OUR EXPERIENCE ON TEST DAY

Let me tell you, I have never in my life walked out of an exam feeling as awful as I did on February 10th. I was enraged. I was sure we both failed.

I felt fine going into test day. Not 100% ready for the real exam, thankful that this exam was a practice test, but also nervous because of our experience with comp for the Step 1. (Want to read about our multiple trials and errors for NBME comp for Step 1? Click here).

My first two question blocks were on the easier side. I felt like I knew the majority of the answers with some questions here and there I was not sure about. I was finishing the blocks with plenty of time. Then I took my 10-minute break after block two. Denzel said he felt like he was having a bad test day and that his first two blocks were hard. I figured maybe his second half would be easier and mine might be harder.

We headed back into the second half of the exam. The questions were harder, things I had never heard of before (anyone ever heard of Hypothenar Hammer Syndrome?? Me neither). I had 2 minutes to finish EIGHT questions in my third block. People, I was in full on panic mode. I scanned each question, which of course were all essays, for words that stood out and just selected random answers that went with that word. My fourth and final block, the same thing happened…

As soon as the time ran out, I sat there in my chair for a few minutes just dumbfounded. A small tear may have rolled down my cheek. We checked out and Denzel and I literally did not say anything to each other for minutes. We finally broke the silence once we got into the car. If you had seen the uproar that ensued, you might’ve thought we were in a fierce debate on whether we preferred Popeyes vs Chick Fil A chicken sandwiches.

The plan was to go on a short trip to Texas the following day while we waited for our results, but when we got home, Denzel was so disappointed that we almost cancelled the trip. Instead, we spontaneously decided to leave right away and switched our tickets to that evening.

One week later, we finally got our results:

Contrary to how we felt on test day, we both passed and did well. Jeez, you just never know with these exams. The worse you feel, the better you do. I wonder why that is? All I know, is that effective studying and preparation ahead of time always wins.

HOW WE STUDIED

The most effective way to prepare for these exams is to study throughout rotations for shelf exams and to be involved as much as possible in rotations. It is easier to remember presentations, next best steps, and treatment options you have seen in actual patients.

Having a strong foundation made studying for this exam much easier. I remembered most of the material, so I only had to strengthen my knowledge instead of build from the ground up, which I felt like I had to do a lot of for the USMLE Step 1 and its preliminary exam.

We completed third year in December and decided to schedule our preliminary comp exam for the Step 2 CK on February 10. We had an elective scheduled for January and planned to take both February and March off as dedicated study months for the Step 2 CK comp, the actual USMLE Step 2 CK exam, and the Kaplan Practice CS exam.

During January I was able to study only 1-2 hours a day due to my busy elective schedule. I studied 3-4 hours on the weekends. Once my elective ended, we had about 8 full days to study before the exam. What we did to prepare was simple:

  1. Re-watched all Online Med Ed videos and took notes on them
  2. UWorld questions on random and timed and added notes on them to the Online Med Ed notes.
  3. Just as I did with the Step 1 exam, every time I noticed I was getting things wrong repeatedly, I would write them on a sticky note and stick them to the wall in front of me. After a while, I stopped getting these questions wrong.
  4. One practice NBME exam online
  5. Emma Holliday videos for subjects we felt necessary (I re-watched Internal Medicine, Surgery and Pediatrics)
  6. TAKE THE DAY BEFORE THE EXAM COMPLETELY OFF TO DO ANYTHING YOU ENJOY WITH ZERO THOUGHTS OF STUDYING. This is a life changing technique. My mind feels so much more at ease since I have begun doing this before test day. I have intense test anxiety. I would barely be able to sleep before my exams and when I did, I would dream about the exam. Since I started taking the day off before my test, I almost have my test anxiety completely under control. I highly recommend trying this.

This is the simple study plan we followed for the comp. Most importantly, we had a set study schedule just as we did for Step 1. This helped us stay on track for our quickly approaching test day.

WHAT IS NEXT FOR US

Now it is time for us to prepare for and to take our real deal USMLE Step 2 CK exam. Of course, the first thing I did when I found out we passed was create a detailed schedule for our dedicated study period. Our plan is to schedule our exam for the end of March which gives us about 6 weeks total of dedicated study time. We plan to use the same resources: UWorld, Online Med Ed, Emma Holliday and NBME practice exams and UWorld Self Assessments.

We will also be practicing for the Kaplan Step 2 CS practice exam which we take April 4th with Kaplan On Demand videos and the First Aid for the USMLE Step 2 CS.

After our exams, check back for a post on our experience! (Psst.. I might be sharing my schedule and notes too!)

Wish us luck!

What was the pediatric core like?

Finally, the rotation I have been waiting for, my pediatric core rotation and it was just as amazing of an experience as I had imagined. Peds core was a 6 week rotation with 3 weeks in an outpatient pediatric clinic, 1 week in the neonatal ICU, and 2 weeks on inpatient pediatrics.

Peds clinic offered a diverse experience. I saw a variety of ages from newborns to teens who were about to graduate from the pediatric office. I had the opportunity to be hands-on and independent in my history and physicals- lots of sports physicals, school physicals, and newborn exams. I also was able to practice writing notes. There were children with different pathologies and ailments both acute and chronic. The best part was learning little tricks and hints that my attending had picked up in her years of practice.

I adored the NICU and felt like I learned so much in the short time I was there. We split up the babies between the students and presented them during rounds with the attending, which were probably the most intense rounds I have experienced in my third year (high school math skills, where ya at?). Of course my favorite part were the babies themselves, I loved helping with feeds and just rocking them throughout the day. They are so small, but so incredibly tough.

During inpatient peds we had two jobs- do the physical exams on all the newborns and take care of any children admitted to the hospital.  A physical exam on a newborn is, not surprisingly, very different from a children’s or adult’s physical. It is one of the first exams the newborn will get and it can help identify any anomalies early. On inpatient we saw children with asthma exacerbations, pneumonias, appendicitis, psychologic presentations like conversion disorder and infants with jaundice. It was interesting to learn more about interacting with children and with their parents.

How we studied for the pediatric shelf.

We learned from our last 6 week rotation to start studying right away (be gone procrastination!!!). We started week one with Online Med Ed and tried to complete and take notes on all the pediatric videos. I thought this was a good way to compartmentalize pediatric conditions which I hadn’t really learned about much before. It was like a blast from the past with step 1 knowledge. I really wished I had time to re-read some of First Aid for Step 1, especially the sections for genetics, glycogen storage diseases, MSK and ortho, etc. Some of those facts came up often in the Q banks so I do plan on re-reading First Aid over my winter break.

I also tried to do as many UWorld pediatric questions as I could, these were similar to the shelf. I took notes on all the questions whether I got them wrong or right. I never did this before, but I felt like it helped integrate the knowledge from Online Med Ed to the question stem. I felt like the key to getting the answers right on this exam was being able to contrast between similar presentations. For example, kids with a limp- if you can remember the key differences you can answer the question correctly.

I also watched the Emma Holliday Pediatrics YouTube video twice over with the powerpoint notes. I feel like that always brings things together for me, its like a great overview of the entire rotation in 2 hours.

I purchased and took two out of four of the NBME practice exams online and took them on timed. Denzel and I reviewed the answers together afterwards and researched the answers we were not sure about. There were a few that we could not find an explanation from and we asked our attending to look over them for us, I found this very helpful.

The test itself was challenging as usual. It was a mix between easy questions and confusing questions. I feel like for the most part I was able to work through the questions, but there was definitely some that I felt were worded strange. In NBME fashion, there were a few questions on stuff that was not covered in my study material.

After the exam, we took a celebratory trip to Traverse City to refresh ourselves for our next rotation: OBGYN! I think it is important to take a break between rotations to relax and reset. It is also a good weekend to take care of the household and plan for the next rotation.

Comment below or reach out to me if you have gone through the pediatric core rotation and have anything to add to this post.

Want to see how my other rotations have gone and how I studied for my past shelf exams? Check these links:

Internal Medicine

Surgery

Family Medicine