I’ve had requests to talk more about my Step 1 plan: what I’ve done so far, what I plan to do in the coming months, and when I’m taking it. So I figured I would answer some of these questions in hopes that it will help at least one person out there struggling along with me. My school’s M2 curriculum ends May 19th and M3 clinicals starts July 1st, so we get 6 weeks between when classes stop and rotations begin to study for Step, take Step 1, and then have some sort of a ‘break’. I’ve scheduled my test to have 4 weeks of dedicated study time, and 2 weeks of break before surgery rotation starts. Knowing myself, I knew I’d want at least 2 weeks to decompress and relax, so that was the main factor in scheduling my test when I did – I worked backwards from how much time I definitely wanted to have off. Because my school is on the shorter side in terms of time off to study for Step, most of us in the program start studying between January – March in order to slowly spread out studying, with that being said, most of the M3’s that I’ve talked to this year told me that they improved their Step1 score by about 30 points during their 4 weeks of studying, so most of us really cram at the end.
My ideal goal for this year was to mainly focus on my school’s curriculum and use some Step1 resources that aligned with what we were learning in school up until spring break. Then my goal was to start focusing more on Step1 than my school’s curriculum after spring break in order to get a solid basis before heading into dedicated study period. In the fall, we had MSK, Neuro, Endo, and Repro blocks, and between winter break and spring break we had Cardio and Pulm. For these blocks, I did my class assigned readings, the associated Pathoma chapters (some 2x) and looked through/annotated First Aid. I also used the USMLE-RX QBank to do tutor mode questions limited to the organ block we were studying. I bought USMLE RX videos in December, and started to go through the videos – my only regret so far was not buying this sooner! So this was basically where I was a few weeks ago… Spring break was in mid February, and from spring break to May, my curriculum covers Heme/Onc, GI and Renal blocks. Over spring break, I focused on some of the chapters in First Aid that we learned during M1: immunology and microbiology (I also wanted to do pathology and pharmacology but that did not happen). I bought UWorld at the end of spring break and have now been focusing on doing between 7-9 tests a week.
My current UWorld strategy is to do timed blocks of 40 questions, which I usually finish in around 45 minutes. Then I go back over the test that same day by flagging any questions I got wrong as well as questions I got correct but don’t feel as comfortable with, and I take notes on all questions I got wrong and about 1/2 of the questions I got right. Basically if I am not 100% confident, I’ll take notes on it. I take notes using the note function in the UWorld program, and I try to limit myself to 2 sentences unless it is a topic that I am really weak on. For me, typing is so much more efficient than hand writing, so this was my main motivator to type my notes. I used the UWorld notes over a word document because it is there and easy to use, and because it can organize the notes based off of topic (pathology vs physiology vs pharmacology) as well as by organ block. You can print or save the notes as a giant PDF file whenever you want and organized in either way. Aside from taking notes on the application, I am also hand drawing some of the figures / charts that UWorld provides. I typically hand draw around 3 – 4 figures per block, and again, there are on topics that I am not as comfortable with.
Looking ahead, my goal is to have completed UWorld 1.5x (1x and then 1x through my flagged ?’s) before dedicated study time starts. I also plan to have finished all USMLE-RX videos and all Pathoma videos by then as well. I know both of these goals are ambitious, but I know myself and I know that I like to shoot high, and that I’m okay if I don’t quite meet all my goals (this does not work for everyone). Maintaining a balance between studying, being prepared for class, as well as staying active and having some self care time is important to me, so my plans/goals might change a little over the next few months. I haven’t made my study plan for dedicated study time yet, so that will be another post in the future. I hope this was helpful, and if you have any questions feel free to connect with me on instagram @beingfranke !
Okay so for a while now I wanted to share my all time favorite tip for success: having a routine. I didn’t understand the need for a routine until I was in the midst of my second year of college when everything started to get extremely difficult and I felt constantly unorganized. Throughout my sophomore and junior years at Princeton, I learned some things about myself that have continued to help me succeed, stay on top of my work, and allow time for self care activities. So I’m going to share my top 5 tips on how to establish and master your routine.
So tell me, are you a fan of routines?? Let me know about your routine in the comments below or find me on instagram @beingfranke
Maevn Uniforms reached out to me to test out their Red Panda and Eon scrub collections. Maevn Uniforms is a Texas-based brand that offers high-quality male and female medical apparel. One thing I really like about the brand is that their main goal is to provide high quality scrubs and uniforms while working with a high level of integrity, reliability and transparency. Those are three qualities that I love to see in a company. I was excited to get the scrubs and test them out.
The Red Panda Collection is Maevn’s classic professional scrub line. The scrubs are very polished with straight clean lines. The fabric is slightly thicker than what I typically think of as an every day scrub, and this really adds to the professional look. The fabric feels durable and high quality. I wouldn’t be concerned about the material wearing down any time soon – the fabric and the stitching is made to last. The pockets were large and easily held a lot of weight/material without distorting the look of the scrubs. I loved that the V-neck had two front patch pockets – they were extremely practical in size and location. Overall I found this line to be everything it was advertised as – polished, professional, comfortable, and practical. If you’re looking for a solid professional scrub line – I would recommend the Red Panda Collection in a heart beat.
The second line that I tried was the new Eon Active collection. This line seriously blew me away. The material is light weight, super soft, and feels like butter. If you’ve ever tried on LuLu-Lemon or Athleta yoga pants – you know the feeling I’m talking about. It’s the type of fabric that you could live in everyday for the rest of your life without getting tired of it. The fabric is designed to be both breathable and moisture wicking. The fabric draws moisture away from the skin to keep you cool and dry. It is also extremely easy to move in these scrubs – I felt like I could do an entire workout in them. This Eon Active Collection is perfect for health care workers that are constantly on their feet (i.e. about 90% of health care workers haha). The waistband cargo pant has the most comfortable waist band I’ve ever worn on a scrub, and the pockets were large but did not distract from the shape or appearance of the scrubs. I also loved that there is a cell pocket that perfectly fits my iphone. Not only was the fabric amazing, but the scrubs were super flattering. Seriously I am now obsessed with these scrubs.
If you’re looking for some new scrubs, definitely check out Maevn Uniforms and let me know what you think!
I spent some time over the holidays reflecting on my triumphs and struggles of 2016, as well as what I wanted to do in 2017. For me, 2016 was not a magical or special year, it had it’s mixes of both ups and downs. For the ups, I ran my very first half marathon in May, which was quickly followed by another half marathon in July, a 10 miler in August, and a 25K trail race in November. I finished my first year of medical school, and then spent an amazing 10 weeks doing clinical research on Binge Eating Disorder in Pediatrics. I subsequently presented a poster on my research and just wrote up the first draft for (hopefully!) publication. I went to a broadway show, NFL game, and saw the Nutcracker. I also tried a few new things, including scuba diving, mountain biking, and get skiing in 2016! I spent a beautiful week in the Dominican Republic, and another beach-filled week in Marco Island, Fl. All in all, 2016 had some pretty amazing moments.
When I was reflecting, I did notice a few trends that I plan to improve on during 2017. The biggest thing that I want to change is how I respond to stress. I realized that when I became stressed or ‘too busy’, I would stop working out, socializing, and meal planning, and my junk food/convenience food intake would greatly increase. This led to quite a few lbs added on during 2016. Similarly, my self-care, exercise, and healthy eating habits were wildly inconsistent. Yes I ran my farthest races to date in 2016, but I also went weeks at a time with little to no exercise. I lost 6 lbs doing the whole 30 in the fall, but then gained 12 back over the next several weeks… I feel like I learned a lot about what is best for me and for my body in 2016, but I did not stick with it and make it a true lifestyle change. Those habits are being left behind in 2016.
So looking ahead, I want to focus on nourishment and consistency. My goal is one of a life style change. I will take my best exercise, nutritional, self-care, and relationship actions from 2016 and turn them into my new norm. I know I’ll have set backs, but the quicker I can pick myself back up after I fall, then the greater the amount of time that I will be on my feet. It starts on Sunday 1/1 with a restart of the Whole30-ish (haha my -ish is the addition of legumes). What are your goals for 2017? Comment below or find me on instagram @beingfranke
During my first year of medical school, there were very few things that I wasn’t learning how to do. Big picture included relearning how to study, manage my time, and grocery shop/cook for myself every week (living at home during my year off had its perks – thanks mom!). Also I had to learn new things, such as the entire first year curriculum, how to interact with patients, how to learn from a case based curriculum, and how to survive in Cleveland during the winter. So to simplify it, last year was a year of growth, but what I want to focus on in this post are the study skills that I learned.
The first, and probably biggest thing that I had to learn was that it was totally okay to change study habits multiple times throughout the year. I had to keep tweaking things until about April when I found what worked best for me. So if you’re an M1 and have been taking notes or studying a particular way since the beginning, don’t be afraid to switch it up if it isn’t working. To give you an example, I started off last fall taking hand notes on all of my readings, and reading all of the Boron Physiology assignments. I learned after the first block that it just wasn’t sustainable. I was wasting way too much time writing things out. I then went to writing really thorough computer notes while also reading every page assigned word for word. This definitely sped up my note taking process, but after a few months I was honest with myself that I just wasn’t retaining the information, and I was probably still spending too much time on each reading assignment. I kept switching my approach every block or so. Seriously the best thing that I did was not being afraid to change my study habits. The key outcomes to look for when deciding what works best for you are efficiency, retention, and completion. So in other words: are you getting through the amount of work that you have to do, are you spending an appropriate (not too long) amount of time doing it, and are you actually gaining knowledge from it / able to remember what you learned later on. I finally settled on a strategy that works for me almost near the end of first year. My strategy consists of quickly look at the readings to decide if they will be useful or if I want to use a different resource. Then I print the reading into OneNote (a Microsoft software), and I actively read by highlighting and scribbling a few notes into the OneNote document right one top or next to the pages. And that’s it. This way I am engaged with the assignment, but it is quick and efficient.
Similarly, my second piece of advice is to allow yourself to find resources that work for you. My curriculum assigned Boron’s Medical Physiology textbook for most of my required readings last year. This textbook is amazing if you want to understand the true mechanisms and biochemistry of physiology, as well as sometimes the evolution behind it. The amount of detail is amazing (and occasionally overwhelming), and sometimes organization of the chapters can make it a little hard to follow if you aren’t on your A game. I read onle Boron for the first 4 months of school before I discovered other physiology textbooks that I also found useful. I found Guyton and Hall to be the right level of detail and clinical orientation for a lot of different organ systems, and I used Costanzo’s Physiology when I wanted big picture concepts (before or at the end of a block for summary). There were a lot of specific organ system related textbooks that I had electronic access too through my library that I loved; some examples include William’s Gynecology and William’s Obstetrics. Also, I found Nature Review Articles to be really useful for mechanistic and more small scale but in-depth looks at specific topics. So in summary, your school is going to assign specific textbooks, but use your library to check a few others out!
Lastly, I learned to set a study routine. My curriculum does not have tests or exams, so it was important for me to stay on top of the material each and every week so as to not fall behind. I worked out a system where I would spend the weekday mornings doing work, Saturdays were spent catching up on the previous week (usually about 6 hours of work), and Sundays were spent reviewing for the week ahead along with chores/errands (usually 6 hours of work, and 2 hours of errands). By utilizing my weekends, I was able to not study most weekdays after dinner. Weekday evenings were able to be my self-care/workout/netflix time, and this significantly helped my stress levels. Your study routine will depend on your curriculum, but by having a routine, you’ll be able to keep your weekly study hours consistent and hold yourself accountable.
I’d love to hear what study skills you learned from your first few months of medical school! Comment below or find me on instagram @beingfranke
Applying to medical school can be extremely difficult and tricky. Not only does the process take almost an entire year, but the planning starts years before with scheduling out required courses and taking the MCAT. The personal statement writing process alone can take months! If this does not sound like enough obstacles to jump though, one additional challenge that I was not even aware of when I applied was having to understand all of the different medical school curricula (okay people this is the plural for curriculum… I wanted to write curriculums but spell check taught me otherwise – you really are constantly learning in med school! haha). When I applied, I understood the basic framework for medical school: the first two years are spent in lecture/class learning the material out of textbooks, and the 3rd and 4th years are spent doing clinical rotations where you are learning in a hands on environment in the hospital. It wasn’t until I had attended a few interviews that I started to realize just how different medical school curricula for years 1-2 can be! Because of this, I wanted to write a blog post that could perhaps shed a little light onto this topic for anyone going through or who will go through this process.
The first difference between curricula, and perhaps one of the biggest differences, is between course based (sometimes referred to as block schedule but this can also mean different things) and integrative organ based curricula. In a traditional course based system, students will take one or a few different courses at a time, similarly to how courses are designed in undergrad. For example, anatomy and histology can be taught together in a block. This means that during that specific block, say for 12 weeks, the students are only studying anatomy and histology, but they are learning all of it during that time. Other courses that are often put together in blocks include genetics & biochemistry, and microbiology & pharmacology (aka Bugs and Drugs). This is drastically different from an integrative curriculum where all of these different topics (anatomy, genetics, biochemistry, pharmacology, ect.) are taught together with regard to a particular organ system (often also organized in ‘blocks’). For example, during one “organ block” (ex: 8 weeks long), students take classes that all have to do with the cardiovascular system. Therefore in a given week, they may have a thoracic cavity anatomy session, a lecture on the physiology of the heart, and a lecture on cardiovascular pharmacology. After one organ system block, they then move onto another organ system (examples: endocrinology, pulmonology, musculo-skeletal system). If you can understand these two types of curriculums, then you have a good grasp on one of the major differences between schools! But as if things are complicated enough, some schools do a combination curriculum where the core basic sciences are taught alone in blocks (such as biochemistry, genetics ect.) and then organ block systems follow (looking at physiology, pathology ect.).
Within integrative curriculums, there are also differences with regard to whether or not physiology is taught along with or before pathology. Some schools like to teach all normal physiology the first year so the students understand how the body is supposed to work, and then dive into pathology, or what can go wrong, during the second year. This is nice because you get to see different organ systems twice, but it can also make for shorter looks at the organ system each time. Other curricula tend to dive all the way into the organ system that they are focusing on – showing both the normal and the abnormal at the same time.
The last curriculum buzz word that you might hear more of, especially as the years go by and curricula get updated, is Problem Based Learning. Problem Based Learning typically refers to small group classes (for example around 8-12 students in a group) where students work together to solve different problems or patient cases. These types of classes focus on integrating concepts, working with others and being a team player! Typically Problem Based Learning is used in addition to traditional lectures or seminars where a professor is teaching the material. They can be really helpful in actually applying the material to more realistic and patient focused situations.
I hope this blog post will be helpful to at least one med school applicant! If you have any questions with regard to curricula or want my opinion on the different pros/cons – feel free to reach out to me on instagram @beingfranke!
Some people don’t love the phrase “work-life balance” because they believe that work should not be dichotomous from life – that you should love what you do and it should be a part of your life. Although I agree that your work should fall under the umbrella of life, I have a slightly different way to conceptualize how I balance all of my interests, passions, and priorities. The way I conceptualize it never had a name until recently. A few months ago I was talking to a very wise and compassionate neonatologist. He told me about his philosophy of “living life in parallel”. To fully understand this concept, I am going to rewind time a bit.
When I was a freshmen in college, I was sure of my passion to pursue medicine. My life also consisted of playing D1 lacrosse, studying hard, having fun with my friends, and a long distance relationship. I saw my life spanned out in front of me in various stages. I was focused on doing the best I could possibly do in academics, with the remainder of my energy divided between lacrosse, my teammates and friends, and my boyfriend. My college friends remember me as super shy and quiet during my freshman year (quite contrary to how they know me now). In lacrosse I was reactive rather than proactive, I showed up and I tried, but now I know I could have done so much more. Freshman year was exhausting but with the focus on getting into medical school, I stayed positive and inspired. I was excited by the future: medical school, then residency, then practicing, oh yeah and things like family and enjoying life would just fall into place once I reached my goal of becoming a physician… right? Well that’s how I thought then, and throughout my 4 years in college this concept of mine changed.
I realized early on in my college career that, yes, getting into medical school is a goal of mine, but it is a goal among other dreams, interests, and aspirations. My lacrosse family really helped me to realize this. I was surrounded by some truly amazing women. They constantly reminded me, and sometimes dragged me, to be in the moment. A few of them are extremely skilled at appreciating all of the little things. As I formed friendships with my teammates and they turned into my family, I learned the importance of keeping my life full. Always focusing on getting to the next step in a career/relationship/goal ect. can be extremely beneficial towards reaching whatever it might be, but it risks allowing everything else to fall from view. Life is constantly moving forward, and unfortunately nothing is promised.
Living life in parallel is exactly what it sounds like. It means that rather than segment your life into periods, life should be filled with what you want longitudinally. It means pursuing all dreams and interests (even the ones that seem far out on the horizon) now. It doesn’t mean to juggle between things, but rather weave the different components of life into one. I’m not perfect at living my life in parallel, but I’ve been getting better at it each and every year. For example, I make it a point to build on my relationship, stay in touch with my friends, connect with my current classmates, explore my new state of Ohio, stay fit and continue to work out, give back to my community in ways that I am passionate about, oh yeah and studying and staying on top of my classes. This blog was also an attempt to hold myself accountable and continue to live my life in parallel. I wanted a way to explore my interest in wellness, health, and writing – so this seemed like a good way to incorporate it into the here and now. Living life in parallel is an action, not a goal. I hope this posts at least makes you think about what your life is filled with, and if it is really what you want in the here and now.
I wanted to explore the definition of health, because although this seems like something a kindergarten student would know, its actually not as simple as we seem to think it is. It seems like a lot of people think that being healthy is to have no physical illness or medical condition. However, the World Health Organization has defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (1). This is how I have begun to see health, and I hope to show you why. I view health as a multi-factorial state. I believe that many things fall under health, such as physical health, emotional and mental well being, social well being, and quality of life. These factors are not independent, rather they are extremely dynamic and can influence each other – which is why they are all extremely important. I think that the health care community can and should always address all aspects of a patient’s health and not just their physical health.
I have personally experienced the complex interactions of my own health. I suffer from moderate-to-severe chronic eczema. I have had it for over 4 years without any “remission”, and it can vary from a small patch on my arm to covering the entire back of my legs, arms and back (about 15-20% of my body). My flares worsen with stress, such as during exam time in college or before medical school interviews. My flares have also made me self conscious for situations where my eczema is fully visible to other people, such as in the summer when it’s too hot to wear long sleeves and pants. Its a tough cycle to control, and I am still trying to figure out all the things that make my eczema better or worse. So far, I found that exercise, a healthy diet, and stress reduction practices really influence (but not totally prevent) my flares.
I love sharing stories about different topics, but I also think it is important to dive into more concrete examples of how different facets of health intersect. One area where this has been shown is in cardiovascular disease. Research has shown that patients with coronary heart disease that are also depressed are more likely to have major cardiovascular events such as heart attacks and strokes (2). It is suggested that this is because depressed patients are less physically active (2). Stress levels and social support in the work place has been shown to increase the risk of cardiovascular disease (3). And heart attacks have been linked to a significantly lower quality of life even years after they occur (4). Although these are very specific associations that have been found, I think they provide examples supporting how different facets of health influence each other.
In the future, I hope to be able to address all of these subcategories of health for my patients. Although physical health is the main area that physicians focus on, I believe they should be aware of their patient’s emotional, mental and social health as well. I think that this focus on the entire health of a patient could be extremely influential for a lot of different conditions, and particularly chronic conditions.
When I look back on this year, I see it in distinct snapshots. Some of these memories are extremely happy, others are rather somber, but most reflect the amount of growth that this year has brought about. This year has given me new friends, a new family. It made me both confident and insecure. It would be impossible for me to explain this year in a blog post. Instead, I would like to share some of those snapshots with you.
I have many extremely positive and joyful memories from this year, both within and outside the halls of the hospital. There were lots of summer festivals where I was able to explore my new city: the little Italy festival, Asian night market, and even a garlic festival (haha I loved that one!). I can smell the 12 pounds of baked ziti that my roommate pulled out of the oven for our friendsgiving dinner in November. There was the 20 some hours spent with friends snuggled in my family room as we watched all 8 Harry Potter movies straight in a row. There were weekends spent hiking, biking, boating, and exploring my new home state of Ohio. And probably my proudest moment outside of the hospital this year was completing in my first half marathon! Within the hospital, there are memories of bonding during orientation week. There was the first time I shook a patient’s hand in my white coat. The time when I finally was able to navigate the series of hallways within the hospital so I could get from school to my car without getting caught in the rain. I can still hear the quick clear heartbeat of the few week old infant as I held my stethoscope up to her tiny chest, and the time I was able to comfort a crying patient without feeling helpless. This past year was full of sparkly bright memories that won’t fade for a long time.
There were also many uncomfortable moments that made me think, made me stronger. There were the interview questions where I wasn’t sure if the patient or myself was more uncomfortable. There was the first day in anatomy where the bodies were cold but the blood still oozed (my program uses fresh rather than preserved bodies – a distinction that wasn’t entirely clear to me until after that first day in anatomy). There were the painted fingernails, the scruffy beards, and the hair scrunchies in anatomy that always snapped me away from the edge of frightening comfortability. The biggest darkest memory from last year however was my first direct encounter of mortality. I shadowed in the trauma ER for a short 4 hour shift. I knew it was possible to see a trauma within that time period, but I don’t think I processed that going into the shadowing opportunity. Within an hour of being there, the trauma pagers were going off. I was set up to observe the incoming trauma right inside the room, against the wall and off to the side, but still very much in the room. The man came broken in as many ways as one could image. I watched for almost 2 hours as the team worked together to try to save the man. Unfortunately, he did not make it. I really wasn’t able to process what I saw that day. It was heart wrenching, but I was also inspired by the trauma team. The way they worked together, the way they made decisions and worked tirelessly for this man was inspirational. Seeing death occur for the first time and having both extremely negative and positive emotions left me confused and uncomfortable. I think I sort of just saved that memory to process later rather than really think through it in the moment.
The highs and the lows pushed me to adapt, and some of those highs were a result of my growth. Sometime in the fall I realized I needed to change the way I balanced my life. I was used to undergraduate school where you had your assignments and you could check off what you finished. What I realized though was that in medical school, the check list wasn’t a finite list of seven things you had to do. Rather it was of things you had to understand, and it’s up to your judgment to decide when you know it well enough. Because of this, I had to learn what my limits were, what I wanted to know. I had to adapt how I worked and how I decided I was ‘finished’ with my ‘check list’. Most importantly, I learned how easy it was to get consumed with studies, yet how important it was to maintain a life outside of medicine. If I was to talk to a stranger and tell them who I am, it would be so easy to just say I’m a medical student, but that is not what I want. It is important to me to maintain a balance of my passions, because medicine is just one of them and I don’t want to lose the others.
Overall, I loved my first year of medical school. I learned a lot but I also had a lot of fun and tried new things. I pushed myself out of my comfort zone (think mountain biking and half marathons ) but I balanced it with some home comfort (Harry potter marathons and roommate movie nights). I look back with a smile and I’m excited to move ahead into second year.
Hi! My name is Caroline Franke and I am a second year medical student in North East Ohio. I love cooking, running, and playing with dogs and kids. I am on a mission to learn as much as I can about nutrition, mental health, and physical well being. Feel free to join along as I try to navigate the world of wellness.
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