Here’s where I am in my medical education: I have finished the first two years of basic science classes spattered with some clinical work with a pediatric preceptor. I made it through four weeks completely dedicated to studying for Step 1 Boards, took the exam, and promptly flew to Mexico to forget all that stress with a nice, warm beach. I sat through a week of introductory lectures and small groups attempting to prepare us for third year and rotating through different clinics, but really just getting me more freaked out than I was beforehand. And on Monday I start my first rotation of third year: Internal Medicine.

I had lots of expectations about how I would be feeling right now. I thought that with Step 1 behind me and the excitement of third year ahead of me I’d be fluttering with happy anticipation. I thought, at the very least, that I would feel relieved to have the test behind me. But because there is a 3-4 week delay before we get our scores, I haven’t been able to completely leave that anxiety behind. I certainly didn’t feel all that confident in my performance after the eight-hour exam, and from what I hear from my fellow classmates, it’s just not the kind of test you leave feeling like you did well (or even passed). The thought of failing and having to go through the stress and exhaustion I went through during the study period is maybe my worst nightmare.

Although I’m excited for third year, I can’t help stressing about boards. Still. It’s incredibly annoying. There are a couple reasons why I can’t seem to let it go, but the biggest reason by far is that if I’m being perfectly honest, I didn’t put in my best effort. I didn’t do enough general reviewing before the dedicated study period and about a week and a half before my scheduled test date I seemed to lose all my momentum. A contributing factor was the extreme back pain I developed from sitting 10-15 hours in a hard chair every day for two and a half weeks. The pain got severe enough that two weeks before my test, I was ninety minutes into a practice exam and had tears streaming down my face and panic building as I realized there was no way I would be able to sit through eight hours of testing and be able to stay focused on anything except the pain shooting up my back. I finished that practice exam by alternating between a padded chair and kneeling on pillows in front of my computer and as you might imagine, I didn’t score very well.

So I resigned myself to the fact that I wasn’t going to do as well as I’d hoped when I had made my study plan. I don’t know about everyone else, but once I’ve decided I’m not going to excel at something, I easily fall prey to not caring about it as much. The day after that particular practice exam, I studied a little, but also wasted a lot of time watching TV on the internet, letting myself complete zone out on worthless sitcoms. This is a defense mechanism of mine that I’m not particularly proud of, but it is what it is. That, in turn, put me even farther behind schedule with my original plans, and although I didn’t have any more long TV binges before test day, I never got caught up with my original plans and I slipped a littler farther behind each day.

I’m disappointed with myself and embarrassed to admit that I let that happen on an exam that is so critical to my future. Yet, at the same time, I get agitated when I think about what I could have done differently. I could have studied more before the dedicated study period, but when would I have squeezed that in? I have perpetually felt that I was barely staying on top of things throughout the entirety of medical school, and yet I’m still mad at myself for not doing more. I should have held on and stayed more focused during the last week and a half before my exam, but I was in constant pain and fighting some serious emotional distress. I’m stuck in a spot where I’m both mad at myself and mad at the situation that made me react the way I did. It’s crappy.

Maybe I’ll get my score back and realize that all this retrospective stress and anxiety has been a complete waste of time and I’ll be just fine. Maybe I’ll look at that three digit score and know that I have a bit of a hole to dig myself out of. And worst-case scenario, maybe I failed and I will have to delay my entry into third year and have another go at not losing my momentum before the most important exam I’ve ever taken. Who knows?

[It’s funny, because I think I vaguely made the same speculative statements about my first anatomy exam. I thought I would be better at all this stuff by now.]

Whatever ends up happening will just be another ting to react to, so right now I’m trying to get myself as mentally ready as I can be for starting rotations tomorrow. Internal Medicine is one of the more challenging and time intensive rotations, but I want to hit the ground running and show my best side. I’m both excited and nervous to have more responsibility and be learning from real patients (oh thank goodness, real people are way better than textbooks!) Even though Step 1 still hovers over me, I am hopeful that in a couple days I’ll be happily overwhelmed by the ever-notorious Third Year!


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