Halfway through my first block of medical school! I can’t believe it’s already been three weeks of classes (and four weeks of being a medical student!). This past week was quite hectic because I had two types of assessments. 

On Tuesday, I had my first Formative OSCE which stands for Objective Structured Clinical Exam. This FOSCE was “formative” which means we were not officially graded, and we were given the chance to practice with a standardized patient (SP). 

On Friday, I had my first Formative Exam which was also a chance to practice and experience the testing conditions. 

Monday 

This Monday was a bit interesting. There were some weather predictions that resulted in remote classes. Since we were given pre-recorded lectures, I slept in and made sure to watch the lectures at two times the speed. These lectures were very term heavy, and it made me worried for the exam. 

Other than that, Monday was pretty uneventful. I might consider skipping lectures because I enjoy having the ability to pause during the lecture or rewind immediately when I don’t understand a concept. However, I also really like going to class because it feels like I’m actually in “school mode”. We shall see as the weeks go by. 

Tuesday

Lectures for FOM went by per usual with my Anki making while the professor lectured. However, Tuesday was initially nerve racking because I had no idea what this FOSCE was going to be like. I felt confident in my ability to go through everything we learned up until that class for the patient interview, but I was still nervous about making small talk and actually acting everything out.

Up until that moment, I had usually pretended to wash my hands and make sure the room was a safe environment for the patient (closing doors and ensuring privacy). I was also a bit nervous about going through the Review of Systems, but after practicing with another classmate she was surprised I had that fully memorized so I figured I was in a good spot. 

The FOSCE itself was very interesting! We have a long hallway designated as “Standardized Patient” rooms for the School of Health Sciences. They explained the official procedure to us which usually started with meeting in one classroom at our designated time to check in. After that, we are sent off to two separate hallways full of doors. There is supposed to be a sound that tells us when we are supposed to open the doors and begin the encounter. 

During these encounters, there will also be a timer that goes off to indicate when you leave and the standardized patient will prepare feedback. After that, the standardized patient gives you the feedback.

On Tuesday, they mostly explained this process to us, and we did not go through every motion like that. Instead, we just opened the doors when we were ready and spoke with the standardized patient informally. 

After speaking with some M2s, the best description for this experience is likened to Monsters University or Monsters Inc. Essentially, all the students line up at their designated door and we wait to begin our encounter in the same way the monsters would line up at their doors and scare their children/practicing scaring their children. 

I felt pretty great after my encounter. My SP was very kind and she gave me five points to work on. Surprisingly, I made two mistakes that I typically did not make during my practices. I am very glad we had this practice run because now I know what happens when I’m nervous.

Since my school follows Engel’s biopsychosocial approach with an emphasis on empathetic patient centered care, I was a bit nervous I would struggle to meet that mark. To my surprise, my SP said that our interaction felt very warm and she said she felt very cared for throughout the entire encounter. Her words give me so much hope for my future, and I am so grateful to have the chance to already practice these skills. 

Here’s a selfie from Tuesday: 

Wednesday

I thought I was feeling pretty good after Tuesday, but Wednesday night came around and I was stressed. We had some lectures that day, and I knew very clearly that I was not going to master this new material by Friday. 

It made me very anxious especially as we practiced doing some genetics problems because I was still unfamiliar with some of the new terms. It was tricky because we had three acronyms that sounded very familiar if you went through them quickly. They were “UPR”, “UTR”, and “UPD”. 

UPR for unfolded protein response in the degradation of proteins. UTRs are the untranslated regions of mRNA after mRNA processing. UPD was a new term that stands for uniparental disomy which is a genetic mutation that results in two alleles coming from one parent as opposed to one from the mother and one from the father. 

I felt somewhat better after the rescheduled review session. Our review sessions are typically Monday but was moved to Wednesday. These questions were not as difficult as one professor tends to make them and they were much more representative of the exam questions. 

Despite feeling good about week one and two material, week three material made me so stressed in addition, we had one asynchronous assignment that was complete busy work and took me and my roommate two hours to complete because we had to translate mRNA to amino acids by hand because the program was not working. I was not pleased, but we eventually got it done!

Later that night when my dad called, I picked up and immediately told him about everything I was worried about before he could even say one word. This phone call was reassuring and my dad told me to not worry about cooking food and that he would pay for any meals(bless his soul) so that I could focus on studying. I definitely took up this offer for Thursday night’s dinner.

Thursday 

Thursday morning came around, and we had to go directly to our small groups to practice for CAS. Oddly enough, this session was very difficult for me and my partner. We recently learned about Social History, and for some reason it just felt very strange.

We were both used to going through the whole patient interview, and I think sort of skipping that part and focusing on the new skills was a bit rough. I didn’t know how to ask the questions even though it’s quite simply trying to understand the patient’s life. 

However, this struggle is usually very evident for me the first day I learn the skill and after a few days I am usually very comfortable with it. I am hoping that I find some time to practice this new skill this upcoming week because our next FOSCE is reviewed and will be a telemedicine format the day after Labor Day!

To my surprise, the asynchronous modules for FOM this Thursday were not difficult and only one of them needed a submission. After that, I took a break and went to the 1pm to 5pm research course. This session was still introductory material and we were given presentations by the eight different types of project designations that are available. Between all these designations, there is a lot of overlap so it’s really about finding a mentor and seeing which direction you want to go. 

After the sessions, we were given a quick group activity to review the newest biostatistics modules. It was very evident that no one really wanted to be there so everyone rushed through it to get home and study. I will be going back and relearning that material because i do not think I learned it properly. 

This day ended with some Indian food that I picked up from a restaurant and some more Anki cards. I made sure to be in bed by 8:30pm because i was waking up at 5:30am (half an hour earlier than usual).

Friday 

On Friday morning, my roommate and I sailed through the morning with ease. I woke up at 5:30am and got ready for the day. We both decided we would go to Dunkin’ in the morning for food so I ordered it from the app ten minutes before we left in order to avoid long lines. We got our food with no problems and arrived safely on time. 

Of course, with my luck, not everything went that smoothly. 

For our exams, they try to replicate the standardized testing conditions as best as they can. We have to sign in, pick up some materials, and leave our (clear only) water bottles outside the lecture hall. 

The exam itself is broken into two sections, we call them GEMS and NBME. The GEMS section is only called that because of the web browser we use. Otherwise, those questions are written by our faculty members. For today, we had 44 questions (4 of which were biostatistics which fall into another course’s grading). Then we have 22 NBME questions that are taken on another browser. 

For this exam, we were given the opportunity to review the GEMS questions right after the exam. Usually, the review session is a few days after, but it was our first one so they let us do it the same day. We will never get to see the NBME questions again because they are part of the national board.

For our actual exam, we get 100 questions in total, but for this formative exam we were only given 66. 

Now, they gave us the instructions and I tried logging in. it didn’t work. I tried again thinking I made some mistake in typing.Nope. I was not part of the roster? I got up, and was told to go outside. Part of the reason why we have a formative exam first is to make sure the technology was working. 

Another three students had similar issues so we went to problem solving. It was strange because they gave me a different ID number than I had. After a few minutes of working with the proctor, i was told to go stand with my classmates as she called the NBME. 

We thought it was just a coincidence that there were three of us within the same alphabetical order that had this issue…until I asked my friend what her ID number was and I realized they switched our numbers because we had the same last name. Of course that would happen. 

Anyway, we got it resolved and we didn’t lose any time. The second half of the exam went more smoothly. 

Now my actual feelings about the exam. It felt good overall for the GEMS. I was surprised at how much I knew. I had predicted my shortcomings would be with the genetics questions and those were the questions I got wrong. I was surprised at how my test taking skills have improved. I did not second guess myself too much and only fell into one bad habit twice. I was also able to figure out two tricky questions I typically got wrong by slowing down and spending some time on them. 

In terms of the NBME, I have no clue how that went. Those questions felt much harder and I don’t even know how I will improve there, but I will find out on Tuesday how that went. 

Overall, I know that I have some weaknesses to overcome, and there were multiple topics across the three weeks that I needed to review. I am looking forward to improving, and I am changing my study habits so that I can get to my goals.

The first change is that I am going to make sure I review the lecture material before going to lecture. For instance, I spent today taking notes on the Boards and Beyond videos that applied for tomorrow’s two lectures. I will also be reviewing the slides before going to bed. I believe this will help prime my brain for the next day’s lectures so i am not seeing that information for the first time like with what happened with week three’s material. 

Saturday 

Alright so, Saturday wasn’t very productive. I finally finished up the thank you gifts I wanted to give my letter writers after discovering that my car battery died. I ended up not doing two major chores and canceling a coffee date with my undergrad friend. Don’t worry my parents came on Sunday and my dad replaced the old battery. They also bought all my groceries so I will be only be catching up on laundry. 

I bring this up because life truly does happen while you’re in medical school. It really does throw random inconveniences and challenges at you and you just gotta hope it works out for the best. I’m fortunate that my roommate and I carpool and she would’ve been my ride to class if my car didn’t work. I am also fortunate to have parents who were planning to visit me anyway and took the time to get everything for me. I am also grateful this car battery died out now instead of in week 6 during my summative exam or during week ten when I go to the clinics. 

Overall

This week was pretty great even with the test anxiety. I feel good and I am ready to tackle the next three weeks with my new plans. I already watched some Boards and Beyond for tomorrow’s lectures. 

For my health this week, I did not meet the physical goals that I initially planned. I did yoga two times this week, and I went on one outdoor walk. I think I will be able to finally hit the gym this weekend (they are officially open!). I will also try to go on two outdoor walks this week and maybe do yoga three times. We shall see. In terms of skin, my face broke out into pimples because I stopped using my active ingredients in hopes of fixing my eczema. I am using my active products again and being very mindful of where they go!

In terms of food, I need more meal prep recipes. Let me know if you have any good vegetarian friendly recipes! 

Besides that, I am just very happy this is a new week and I know how to improve myself for the next three weeks! Let me know if you have any questions or comments below!