Hello Friends!

It’s been a long time since I last posted. Even for the most disciplined and organized person, medical school is very difficult. I must admit I am not the most disciplined, and honestly, I’ll discuss why I need to stray away from the mindset of being “super disciplined” a little bit. 

However, I took my last M1 summative exam on May 27, 2022. I finished my last session at the clinic on June 2, 2022! It’s been such a long, yet, strangely quick year. 

Here’s a picture of me right after my last session at the clinic on June 2nd: 

There were many times in the middle of M1 where I was convinced medical school was going to break me. I think the worst feelings were in the middle of the Neuroscience-Head-Neck block, and the Lungs-Heart-Kidneys block. 

Regardless, this year was amazing. I was pushed so hard, and learned so much. My brain feels like it is so full, yet, there is still so much ahead of me. I only got a tiny fraction of the cake this year, and next year is going to be a slightly larger piece. 

I learned so much more about my weaknesses and strengths throughout my first year, and it was a crazy ride. Each block posed a personal challenge to me. Some of which I will share here, but other challenges I will keep to myself because I do not feel comfortable sharing them with the internet. 

Where do I even begin?

I’ll start by describing what the academic schedule looked like for my school. I know I’ve outlined this curriculum in my previous reflections, but in case you are new here, I am going to give a quick refresher.

Academic Schedule

At my school, I have three courses. The first course is Foundations of Medicine I. This course is focused on sciences like anatomy and physiology, histology, nutrition, pharmacology etc. This course was scheduled Monday to Friday. This course is mostly lectures with Active Learning Classroom activities, Asynchronous Modules, Seminar Room activities, and Weekly Cases. This course has one formative exam in the middle that serves a check-point, and the summative exam is at the end. The summative exam is graded and goes toward our official marks.

The second course is Clinical Arts and Sciences. This course is called “Doctoring” at other schools. This class, after our CAS bootcamp in the first two blocks, was just 2 hours on Thursday and 4 hours every other week for the clinic. The clinic was transitioned to every week when the M2 class finished their second year and began dedicated STEP 1 studying.  In CAS, we have OSCEs or Objective Structured Clinical Examination. I believe this year there were 6 formative OSCEs throughout the year which we lovingly call “FOSCEs” and at the very end of the year we have one summative OSCE which we call the “SOSCE”. 

The third course is the Research course. It has a very specific name, and I think it would give away where I go to school so I’ll just call it “Research”. This course was typically scheduled for 4 hours on Thursday, but it wasn’t every week. One requirement for this course is 6 credits of “selectives”. These courses are essentially electives that we take for our research concentration. For this course, I took a course called Leadership for Medical Students. I’ll devote a whole post to this course because it was really personal and helped me recognize my weaknesses and strengths related to leadership. It also taught me about a specific model of leadership which I thought was fascinating. 

Experimentation

If you’ve read my weekly reflections, you would know that I didn’t do much experimentation for my FOM course during the first block. I knew I had to be willing to adapt, but I struggled with it. 

Truth be told, I was scared to venture away from study methods that I thought were helping me because they worked in the past. 

Here is how our first year curriculum is broken down for FOM:

Block 1: Foundations of Sciences 1 (FOS 1, 6 weeks)

Block 2: Foundations of Sciences 2 (FOS 2, 6 weeks)

Block 3: Musculoskeletal-Integument (MSKI, 6 weeks)

Block 4: Neuroscience-Head-Neck (NHN, 6 weeks)

Block 5: Lungs-Heart-Kidneys (LHK, 7 weeks)

Block 6: Gastrointestinal-Endocrine-Genitourinary-Reproductive (GI-GU-Endo-Repro, 7 weeks)

In the first block, I went to every single lecture. I found it difficult to balance school and my lifestyle. At this time, I realized my plans to use my campus’s gym wasn’t going to happen because it was essentially closed indefinitely. 

Regardless, going to every single lecture did not help me improve my summative exam score. I did better on my formative exam that was in the middle of the first block. This formative exam was set up to show us the physical set up of our exams like how we check into the exam and use the lockdown browsers. 

I also learned that it is very difficult for me to pay attention to lectures. I can do perfectly fine with the first two hours, but by hour three and four, I’m mentally out. I tried finding different ways to keep myself engaged, and for the first few blocks, I made Anki cards very quickly as the lecture went on because I didn’t think note taking on my iPad was helping. 

By the second block, I stopped going to lecture every single day. It opened up more time for me to study, but I did worse on the summative exam. I do blame the awful situation I was put in during the last week, but it was also a wake up call that I needed to really pay attention to how I study and take care of myself. 

In the third block, I finally started anatomy and physiology. Let me tell you, the lab is brutal. For my school, the MSKI block involved 3 days of dissection. We were scheduled for usually two to three hours on each of those days. 

This block was difficult because I am not good at rote memorization. Having aphantasia, it was easier to memorize in high school and undergraduate courses because there was not as much information. In medical school, there is just too much and looking at an image once no longer suffices. Needless to say, I focused a lot of my time on anatomy…and I did not understand how to study medical school physiology. 

How did I figure that out? I only got one anatomy question wrong on the exam, but you know, the rest of the exam had mostly physiology questions. I will admit that I spent whole afternoons studying physiology, but I clearly did not use the right resources or methods. 

The fourth block was NHN, and I was so pumped because I love neuroscience. I will admit that I used winter break to get ahead on some of the neuro, and it was 100% worth it for me. I learned the different spinal column tracts over the break, and spent time learning the basics of the cranial nerves using Boards and Beyond and some Youtube resources. 

The NHN block was my highest score at that point, and I noticed that if I didn’t slack off at the end, I would’ve earned a few more points. For this block, I skipped going to lecture the last week because I was so tired and over it. However, this exam week was amazing because I realized I felt confident and I stopped caring about studying. I literally said “F*** it. I’m done studying, I know it.” and watched a movie and ate my usual restaurant Indian food. The next day, I was calm and rested. I left the exam knowing I did my best, and BOOM got my best score. Was it an A? Heck no, but it was closer than it was before. 

The LHK block was a big dip down. I can’t remember if I even rested between these two blocks. I don’t think I did? I honestly can’t remember. This block made me realize I needed to read the textbook. The irony is that I went into medical school determined to read some textbooks, but gave up as soon as I realized the first two blocks were a hodgepodge of different chapters. (Newsflash, every single block is a hodgepodge of chapters from different textbooks). I gave up on reading the books just because I thought I didn’t have much time. 

However, during the LHK block, there weren’t any recordings from the previous years and the current recordings are poor quality. I decided I needed to read the textbook to get the information that I needed to know. I asked one of my classmates which textbook from our list he used, and he recommended one that has a corresponding BRS book. This combination saved me in the last block. (By the way, this classmate loves books and outside resources and has a vast amount of knowledge on what we are learning so I knew his recommendation was worth it.)

Turns out, reading the textbook gave me more context and helped the information stick in my brain better. Granted, I knew this from high school, but the perceived time crunch in medical school convinced me it was pointless to try reading the books. 

This exam was not the best for me. It was a difficult subject to learn because cardiovascular disease is an issue in my immediate family and with extended family. I pretty much went down a rabbit hole of stress each time I thought about my risk factors and my family’s risk factors. 

This experience is valuable though because no one ever wants to talk about how weird it feels to learn about your own conditions. It can be anxiety inducing, especially if you are caught off guard. I am grateful that I experienced those difficulties now because as I learn more about pathology and pharmacology, I’m sure I’ll be more distracted and anxious. I know I won’t have the same issues though because I have tools like meditation to help me get through those moments. 

Finally, the last block really felt like everything fell into place. I discovered which tools I enjoyed using for studying, and how to study for my exams. Surprisingly, Anki did not play a strong role in the study strategies for my best exam scores. I also learned how to gauge when I push myself too hard because during this last exam week I totaled 48 hours at school between Saturday and Thursday just studying for my final summative exam. Thankfully, all those hours paid off and I got my highest exam score! Again, not an A, but a tiny bit closer this time. 

I will be creating a specific post that goes into which resources I enjoyed using for my first year of medical school. I’m currently gathering all the links that I found helpful and remembering which topics were covered in each video/playlist.

Lifestyle

Figuring out my medical school lifestyle was the hardest part of the year for me. I struggled with balance when I was studying for the MCAT, so I knew I was going to struggle with balancing as a M1. I was very optimistic, and honestly, I was pretty good to myself during the first two blocks. 

But MSKI came along, and my strict regimen unraveled and I realized it was not going to work. Unfortunately, I did not recognize until the end of the year how I should approach each week. 

By the second block, I was frustrated with trying to use my school’s gyms. The health sciences campus gym was not going to open any time soon. Even if it did, it was a sad excuse of a gym that wouldn’t have served my needs. 

I finally got a gym membership at the end of the second block. I chose Planet Fitness because it was the cheapest option. This option is also available when I go back home on breaks so it made more sense than a local gym. 

Despite getting a gym membership, the third block proved to be very difficult for finding the time to take care of my body. I eventually realized part of my issue was I didn’t have the mental energy to plan my workouts any more. I ended up using Anki and walking on the treadmill for long stretches of time to optimize the hours in the day.

By the NHN block, I decided to get a subscription to Alive by Whitney Simmons. I love the app. It makes everything so much easier for me. I will admit though, I haven’t finished the 10 week program because I couldn’t push my body too hard. Instead, its taken me a solid 5 months to finally get to “Week 10” of one of her programs. 

Now why am I saying I can’t be too disciplined or regimented? Well, I realized that when I have a mindset of “I absolutely have to do this schedule,” I use up more emotional and mental energy. Part of it is because I have PCOS, so I feel more fatigued and if I push myself too hard. I just don’t feel good with my physical health. 

That’s part of why I haven’t finished the 10 week fitness program. There were many days where I needed to rest or spend extra time studying. Because for me, it’s better to get my sleep in and get the studying in so I’m not behind on school. I’ve learned that I need to walk around the school on those days and do yoga instead of worrying about going to the gym. 

Why am I trying not to think about being disciplined? I end up guilting myself and feeling really bad because I feel like I failed to go to the gym. I will literally think “I can’t believe how lazy I am, I should’ve gone to the gym now my body is going to get worse.” For what reason am I being so negative to myself? My fear of gaining too much weight in a short period of time plays a strong role. However, I’m the only person putting that pressure on myself to fit everything in. 

Instead, it’s better for me to be reasonable and choose activities that are doable and accept that I can’t get “everything” done especially on busy days with going to the clinic or when I have all three courses scheduled on Thursday. It just isn’t feasible. 

My new mindset is to be gentle with myself and listen to my body. If it’s a busy day, then I’m not going to worry about getting to the gym and studying. I’ll try to incorporate some physical activity if my body isn’t too tired, but I’ll make sure to get whatever needs to be done. 

In addition to fitness, I’m still working on planning meals and prepping them. There are many times, especially in the last week before the exam when I do not feel like cooking. I don’t want to clean kitchen tools and appliances every night. It’s just not what I want to do. I am successful in meal prepping some weeks, but there are definitely days when I am not eating my best. 

Part of my issue was definitely waking up later. I was really good about being in bed by 9pm in the first two blocks. I would start winding down around 8pm, and I was able to wake up at 6am without issue. 

That changed dramatically as the year went on. I was no longer able to wake up at 6am, and I tried pushing it to 5:30am to make more time for studying. It was too difficult. I found myself rushing, and not even making the breakfasts I enjoyed because I wouldn’t have time to eat it. Then when I’m super tired from not getting enough sleep, I don’t make good food choices. It just ends up being a vicious cycle.

I think my goal for this summer is to find more recipes that I enjoy so that I can make sure I use my groceries properly, and have nutrient rich foods to fuel me. 

Medicine

Now, to focus on the aspect of medical school that is super exciting. The actual learning was amazing. My best friend kept telling me that the block usually doesn’t make much sense throughout the weeks, but in the last week everything clicks. 

I really didn’t experience what he meant until the NHN block because that’s when I realized how everything came together. To be fair, NHN is straightforward with the clinical exam maneuvers. There were many maneuvers, but they were directly related to everything we studied in FOM so it was easier to understand what was happening and how I would use it as a doctor. 

For this block specifically, I recognized why I would be testing vibration vs. sharp touches against various extremities. I understood what cranial nerves I was testing when I palpated my standardized patient’s face, and asked them to perform certain movements. It all clicked, and I could think about potential illnesses or trauma that would result in specific presentations. 

It was so much fun. It was also just amazing how in a few weeks, I learned how to test someone’s neurological functions. 

The following blocks were also just as interesting, and I don’t think I experienced the same click in LHK. However, I definitely felt it with the GI-Endo-GU-Repro block so that made me feel like I ended the year on a strong note. 

For CAS, I am extremely nervous about next year. This year, for the OSCEs, they gave us exactly what physical exam maneuvers and cluster exams we needed to perform. 

Next year, we have to start thinking like doctors and figure out what physical exams we want to do based on their chief concern and presentation. I’m really nervous about it, but also can’t wait to see how everything comes together at the end. 

Overall

Honestly, this year was pretty great. I know I have some knowledge gaps, but I plan to start thinking about that in a few weeks. For now, I am making sure I get as much rest as possible this summer so that I am ready for M2. 

Comment below if you have any thoughts or questions!