Sunday, June 2, 2013

Stuff That Happened Before Step 1

So, I hinted in the last post that some crazy things happened to me during my Step 1 prep. Not only did I have to plan for an abbreviated prep time (most students at my school take Step 1 in the first week of June, but because I was going to be in Kansas helping at the first session of the Catholic Spiritual Mentorship Program, I had to to take it early), cancel days for three siblings’ graduations, and block out time for daily Mass and prayer (what, three hours of free time not counting meals and exercise??), but unexpected bizarre things happened in a time traditionally kept sacrosanct for study prep.

Thing 1: Scheduling Snafus

I scheduled my test (in January) on May 25 so that I could make the mentorship program. In April, I reassessed whether I should do this, and the test prep lady advised me to hold off on decision-making and extend the test date to June 11 (after the program). When I realized that I did indeed want to take Step 1 before the program (I am so so so so so glad I did, I would have certainly done very poorly if I hadn’t), I rescheduled and went online to get my May 25th date back.

I realized that the appointment I wanted (8am to 5pm on May 25 in my hometown) was gone. There was a 10am to 6:30pm on May 25, but I really didn’t want that, since I’m a morning person and didn’t want to waste two or three of my best hours. I hesitated to take the slot, and during my two minutes of hesitation the spot was taken by someone else who was also online and looking at slots. That was the last May 25th slot in the state. I ended up with a May 24th slot for 10am to 6:30pm. (Happily, I got to Prometric that day at 8:45, being a morning person, and they let me start early, so at least I was still awake at the end of the test.)

Thing 2: Carpal Tunnel

It's possible.
My study strategy is to rewrite what I’m reading and reorganize it, which is a form of the teach-back method. However, rewriting a 600-page review book in my small (like, 8-point) handwriting on marginless computer paper, combined with taking practice questions on a computer that applies pressure to your right volar wrist can give you carpal tunnel syndrome. Believe it or not, I actually induced my own carpal tunnel syndrome by overuse of my wrist studying. I remember thinking at least twice, “huh, my wrist sort of hurts. Hope I don’t give myself carpal tunnel syndrome. That’s probably not even possible.”

I didn’t believe it was carpal tunnel at first, and thought, “it’s just some kind of cramp or overuse fatiguey thing,” until I actually had paresthesias on the palmar surfaces of my second and third digits…then I realized I’d truly lesioned my own median nerve. Sad face! Sadly, this happened right before microbiology (lots of details) and biochemistry (lots of details + not my best subject). But happily, I was able to transition to speaking the material aloud (another form of teach-back), which hopefully worked just as well. I rested my wrist for a few days, and then went back to using it. It still doesn’t like me much, especially since during the program I’m in charge of several laptop duties, including real-time typing of audience responses on a projected screen.

Thing 3: End Game Unexpectedness

So, the last week before Step 1 is taken (called the “end-game” by our dean of students) is a very important time for solidfying an excellent score. In the last five days, material can slip out or things can be can be pressed in, and shaken down. In the last five days, the short term memory can be maximally filled with the silly details like gram stains. And in the last five days, a person can lose confidence and freak out.

It’s very important not to take a practice test within that last week. I did (oops) because that’s what my schedule told me to do, and technically I took them on a Saturday of the week before my Thursday test. I actually took two (NBME 13 and NBME 15) on that Saturday, totalling 400 questions in eight hours.

It’s very important to not make any changes to the study routine within that last week. I did (oops) because I moved home by accident: I had planned to drive to my parents’ house to meet them and drive to my brother’s graduation. But at the last minute their pet-sitter canceled and I found myself house-, dog-, and younger-sister-sitting. Without my desk, I studied at the kitchen table without much issue, except for the one-year-old not-yet-fixed male Golden wanting to be petted, played with, or walked.

It’s very important to have a quiet place to study throughout Step 1 prep, but especially within that last week. I didn’t (oops) because I moved home and didn’t know where quiet places could be found. I didn’t belong to a university in that city, so I had no parking at the colleges with actually quiet libraries. I tried my high school library, which welcomed me warmly but was a little chatty (all girls’ Catholic schools are chatty, big surprise) and then I was interrupted by a tornado-warning-induced early dismissal from school. I tried the public library, which was an even bigger mistake, since it’s a central hub for anyone who needs the (incredibly slow) internet and since it becomes about as quiet as a playground when the three or more surrounding elementary schools get out.

It’s very important to keep whatever you’ve been doing to exerce in that last week. I didn’t (oops) because I packed for a graduation and a few extended family dinners. Modest running shorts are not traditionally worn to either graduations or family dinners. Sans shorts, I was sans running (except for walking the energizer bunny—I mean, the dog).

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