Week 6

This was the last week of my first block of medical school! This last week means that we ended with an exam, and it was very stressful. For this block, we focused on some of the prerequisite topics. 

Monday

This Monday was a bit nerve racking. The material we learned in the last two days was focused on the biochemical pathways. We covered the tricarboxylic acid cycle/krebs cycle/ citric acid cycle, oxidative phosphorylation/electron transport chain, and gluconeogenesis in this day’s lectures. To prepare for these lectures, I tested myself on the cycles by writing them out. I also watched the Boards and Beyond videos to get an idea of the important concepts we would be learning. 

This preparation definitely helped because I felt very good about the first two lectures. The third lecture on gluconeogenesis was a bit more difficult for me. There were multiple enzymes and intermediates that were involved. The regulation of the enzymes was also very important to understand and I felt like I was not able to think about them clearly. Thankfully, the professor makes sure to let us know which details are pertinent so the information was not too bad. I was worried that we were going to cover these topics in greater detail. 

The last lecture on Monday was a required mandatory event focused on medical ethics. This session was very interesting because there were topics that I did not even think about when we were doing our case study on Friday. I really liked that it was an introduction to the topics of beneficence, non-maleficence, respect for patient autonomy, and justice. 

Our case study on Friday was about a minor who suffered from a complication that was a consequence of undiagnosed Marfan Syndrome. It was very interesting to think about the diagnostics that we were guided through for this case but through the medical ethics lens. For instance, we were given information about the parents’ genetics. Our professor brought up the point that the parents’ genetics were not pertinent to the case and that we didn’t really need that information. We also discussed how the case would be wildly different if the patient was not a minor. 

After lectures, I think I just spent the rest of the day at home studying. I was still trying to catch up on material from weeks 4 and 5 because there were many details from the signaling and cell cycle lectures that I was very uncomfortable with. 

Tuesday

This Tuesday was a lot more information, and it was extremely overwhelming. The same professor taught so there were summary slides, but it was a bit difficult to wrap my mind around all the information. I was very worried about being able to reinforce this information on Wednesday and Thursday. 

For Tuesday’s lectures, we covered glycogen, the pentose phosphate pathways, and some monosaccharides and disaccharides. These lectures, for the entire week actually, were linked to some diseases when specific enzymes didn’t function properly. It made more sense to think about these pathways in the context of disease. 

For instance, we learned about when an individual doesn’t have functioning Aldolase B. This enzyme is part of the fructose metabolism. When this enzyme doesn’t work well, there is an accumulation of the metabolite fructose-1-phosphate which can result in toxicity in the liver. 

In addition to these lectures, we took a formative pharmacology quiz. We took this quiz in groups, and it was very helpful. Collaborating with my classmates was great because my classmates were able to explain some concepts in a way to help me understand those topics better. This collaboration also revealed some topics that I didn’t realize how detailed the questions were going to be. This exercise is definitely one of the reasons why I love my school. The collaboration is very helpful and insightful. 

After the FOM lectures, there was an hour break for lunch and then there was a lecture for CAS. The focus of this lecture was Lifestyle Medicine. These lectures discussed the importance of wellness and how we need to discuss wellness with our patients as well as practice it ourselves. Lifestyle Medicine is all about the preventive activities we can practice to be healthier. It involves focusing on nutrition, exercise, drug use, sleep hygiene, stress management, and more.

I really appreciated this session because it reminded me why I want to go into medicine. We were able to practice these interviewing skills after with our small groups. I know it was a bit difficult for me to talk to my patient about these lifestyle changes because I was thrown off guard. I know that with practice I will get better, but it was really great having a professor who discussed how she practiced lifestyle medicine in her practice. 

In addition to these CAS lectures and the practice session, we were given an extra hour to practice our own form of wellness. For me, I did yoga and made myself a pizza as my form of wellness. The rest of my day went to studying. I focused on getting through the lectures from week 5 on this day.

Wednesday

Before our exam days, we are given two reading days to study. This means we did not have lectures on Wednesday. I honestly can’t remember much of Wednesday. I know I woke up and did some yoga to start my day so that I would not be overwhelmed. 

I went through my very long list of topics during my studying and tried covering as much information as possible. 

Thursday

For our reading periods, we would typically have CAS on these days. However, it was Yom Kipur so we had the day off. For this day, I woke up and did some yoga again to start off on a positive note.

I ended up studying for a few hours. I don’t really remember much of that. On this day, I had two tours set up so I could see some gyms around my area. These tours ended up making me even more confused about what membership I should’ve gotten, but I decided to put that on hold because I still had a lot to study. 

I ordered some Indian food from a restaurant I used to go to back in undergrad. It was a pretty good way to prepare for Friday. I made sure to go to sleep as early as I could in the evening. 

Friday

I woke up at 5:30am on Friday. I made sure to shower and get ready for school. I ordered some Dunkin Donuts like last time and so I could save some time for studying. I ended up at school around 7:00am and reviewed some final slides. 

For the actual exam, I felt pretty good. There were definitely some hard questions. I also found myself switching some answers but I did not do that as often as I had in the past. One of my biggest mistakes was not using the bathroom before the exam. We were required to be in the room by 7:30am and then we started at 8am. In those 30 minutes, it became clear that I needed to use the bathroom but I thought it was just adrenaline from being nervous. 

But by the 40 minute mark, it became clear that I really needed to use the bathroom. I kept answering questions until I got to around 50 questions. I forgot what we were supposed to do to take an unscheduled break. (We are supposed to raise our hands and hit pause but the test time keeps running).

The exam itself was 69 questions by our professors which included 10 statistics questions that go to our research course grade. We also had 52 NBME questions. We shall see on Wednesday how I did!

Overall

This week was very difficult for me. It felt very isolating and tiring to be studying constantly. The loneliness of studying gets very real. I know that studying some material needs to be done on my own, but it doesn’t make it challenging. 

During my studying, I realized that I really needed to change how I did my daily routine. I think this week I am going to try doing lectures on my own time for Monday and Wednesday. My plan right now is to watch last year’s lectures at 1.5X to 2X the speed to complete them at my own pace. When those are complete, I can review the Anki cards and prepare for the next day’s lectures. I am hoping that by doing this, I will be able to review the material more and reinforce it. 

In terms of my health, I am definitely working on eating healthier and exercising. I knew exam week meant that I would be letting that slide. I am hoping that next exam, I can continue eating healthy and incorporating some more exercise.