DOCTORS' LOUNGE
ing highly and matching into competitive specialties. Residency
programs have “cutoff ” scores, below which they will not grant an
interview. More resources and question banks are touted as essential
for success on Step 1, and the cost of these resources is often placed
on the students. “First Aid,” the go-to handbook for material covered
by Step 1 was around 100 pages in 1993. This year’s 2020 version
is more than 800 pages.
We are told that our scores indicate nothing about our future
abilities as physicians (and I believe this wholeheartedly), but there
is no ignoring the enormous impact the scores can have on our lives
and the trajectory of our careers. The gravity of the test has only
become clearer over my time in medical school.
It is no wonder that medical students around the world are will-
ing to rise and meet the challenge, accepting the gauntlet thrown
down by the National Board of Medical Examiners executives. We
don’t know any better than to devote ourselves to what we are told
is important. My classmates (and myself included) have turned
towards Step 1 studying with an obsessive, modern focus, using
spaced-repetition learning to frantically engorge ourselves with
tens of thousands of community-sourced, electronic flashcards,
watching online video lectures and visual-based cartoons to learn
microbiology and pharmacology. Our desks overflow with Step
1 prep books, cups of coffee, iPads and laptops for taking notes,
learning the language of medicine all the while - how it euphemizes
and distances itself from reality. Poor prognoses, lesions, infarctions,
insults, deficits, all our bodies endure, but they are just words I
read from my laptop screen as I study silently in a library. It seems
STAY
Connected
www.glms.org
peculiar to be so disconnected and removed from real diseases that
affect real people. I wonder why the information we learn is sorted
into boxes labeled “High yield” and “Low yield.” Could these same
boxes be labeled “Useful for future patients,” and “Not useful?” Or,
“Tests academic competency” and “Does not test competency?”
Regardless, medical students are more than willing to go to
great lengths to do what is asked of us. I know what a privilege it
is to receive a medical education, and to be given the opportunity
to practice medicine. At times it feels as though our second year
is meant to be a crucible, a trial by fire, so that when we start our
rotations, our minds will be forged into something stronger. I often
think about the generations that have come before me, and the work
that was done to push the boundaries of our human knowledge,
so each successive generation learns a greater part of the whole.
Not long ago, I saw an elderly man sitting in the library. He
seemed composed, serene even. His desk was empty, save for a lamp
that softly illuminated the textbook he was reading, and a yellow
notebook filled with his handwritten notes. To me, he looked like
a true life-long learner, and I wonder what made him seem so dif-
ferent from me. Perhaps the only difference is time and a few more
board examinations.
Reference
http://www.nrmp.org/wp-content/uploads/2018/04/Main-Match-Result-and-
Data-2018.pdf
Nicholas Chen is a second-year medical student at the University of Louisville
School of Medicine.
facebook.com/Greater-Louisville-Medical-Society
@LouMedSociety
@LouMedSociety
linkedin.com/groups/Greater-Louisville-Medical-Society
APRIL 2020
33