As a party staple and go-to for family fun, board games have a knack for bringing people together as well as ruining friendships (I’m looking at you, Monopoly). Between the forged alliances and interpersonal turmoil that may result, I turn to the subtle benefits of playing such games – intellectual development, strategic analysis, reflective thinking – as I take on a game of a different kind, my first licensing board examination – USMLE Step 1. Unfortunately, there’s no get out of jail free card on this one. After 18 months of pre-clerkship, I find myself at a crossroads, scared, overwhelmed… and with some assembly required.
Medical students, like detectives, use evidence-based methods to build their cases and create narratives. My days as a pre-clinical student have all lead to this exam, so it’s only fitting that I apply the same investigative principles as I attempt to solve the greatest murder mystery. The victim? Step 1. Where did the crime take place? Local testing center. Weapon(s) used? FirstAid, Pathoma, SketchyMedical and UWorld. Who done it? Me (plot twist).
This exam represents the ultimate trivia game, but with a heavy emphasis on basic science and regrettably no pop culture. Instead of brushing up on movie quotes, I’ll be getting intimate with the likes of Hepatitis B serology and the pathophysiology of the coagulation cascade. What exactly am I in pursuit of? As much as I want to disagree, my score will be a significant determinant of my specialty choice since it’s a screening factor for many residency programs. Hearing this as someone who took the MCAT five times, the anxiety and stress I carry with me going into my dedicated study period are amplified more than ever. Unlike a game, I can’t pause, come back and pick up where I left off. This is it. I’m coping by setting goals and possessing conviction that I can actually do this.
Strategy reigns supreme when you’re in it for the long haul. The final battle may last one day, but the preceding war, months. To conquer, one must accept a certain delay in gratification and be flexible in the face of adversity, which are arguably the hardest to do. Planning began with a visit to academic support services where Chris (Senior Program Coordinator for Academic Support Services), my guiding spirit of sorts, and I had a discussion on perspective, realistic expectations and accountability. Perspective. We set a tentative date and looked at the days in-between, detailing a personalized schedule that considered study habits (e.g. group vs. solo study, morning or afternoon study, what resources to use). Realistic Expectations. I wish I was one of those people where things just clicked, but I’m not. It often feels like I work twice as hard to achieve half the results of my peers, and that’s okay. It took me a while to be comfortable with this concept and, more importantly, myself, but well worth it. Comparison is a slippery slope leading to frustration and self-doubt. I recognize that my study plan and limitations are unique to me, as they are for everyone else taking the exam. The competition is between me, myself and I. Accountability. The next couple weeks of my life are set, it’s up to me to follow through. Temporary suffering for a more enduring gain. I also invite you on this journey with me. Making my intentions public keeps me honest and responsible.
Step 1 is that annoying person you never want to pair up with because they claim they’re giving all the information you need to guess correctly without explicitly saying the word itself, but you’re still left scratching your head. We place blame on the test, thinking they must’ve presented something poorly when in truth it’s all there, we just haven’t adjusted our way of thinking. When I reflect on my approach to previous standardized tests, it’s these types of adjustments that I failed to integrate into studying and on test day during early attempts. It was as if they were testing your knowledge of how to take the exam as much as the subject content itself. Once I realized that, scores went up. Acknowledging your own study and test taboos are also a must. I often forget that studying is an active verb and should be treated as such. It’s embarrassing how much I relate to that meme displaying a disproportionately high occurrence of telling people I have to study in contrast to how much studying actually gets done. In addition, I’ve been a casualty of not trusting my instincts, defying all logical thinking and switching answers at the last minute. Why? I don’t know for sure, but will address it in my practice exams.
As medical students, this examination is part of the path we chose and it can dictate our future trajectory. It’s scary and daunting to think my professional aspirations can hinge on a single test, but that fear also reinforces an unparalleled motivation. I conclude on the game of Life because the physical dimensions of the board provide a more digestible frame of reference, reminding me that this exam is just a pit stop in the grand scheme of things. The SAT and MCAT were pit stops as well. Navigating life has required trial and error, even encountering my share of setbacks, but I’ve made it this far. Although the gauntlet of third year still looms, we have reason to be optimistic because there’s much beyond this exam to look forward to.
About Luis Seija
Luis is a native of Austin, Texas, and one of the loudest and proudest members of the Fightin’ Texas Aggie Class of 2019 at Texas A&M University College of Medicine. He is a breakfast taco enthusiast, dog lover, classical trombonist and minority issues advocate. You can follow Luis on Instagram @luiz_sayha.