By Luke Murray
I learned about the Step 1 exam the very first day of medical school. I was acutely aware of its importance and determined to do as well as I possibly could in order to keep my professional options open, so I planned to start studying for it at the beginning of my second year.
I was going to put an hour or so aside each day to flip through my copy of First Aid for USMLE Step 1 to get a ‘lay of the land’ for the first couple weeks and then spend the rest of the school year going through it over and over.
But second year was hard. Harder than first year. And our school didn’t have time carved out of the curriculum for ‘outside study.’ The teachers also weren’t thinking about what and how we needed to learn their subject in the context of Step 1, so I couldn’t just use First Aid as my main textbook. I didn’t get to directly study for Step 1 during the school year…at all.
But I had a plan when second year ended. I would put aside absolutely everything. I’d keep my phone off, my location unknown, and would be just heads-down to study. I knew exactly what I’d be working on each day for the next 2+ months…
But instead, I left the state the same day school ended to be with my girlfriend whose grandmother had just died. I stayed with my girlfriend for six weeks, trying to keep my study schedule and maintain a study routine while simultaneously supporting her during that difficult time. She and I then drove together to another state to watch my brother graduate. A few weeks later, I drove back to my home state to watch the same brother get married. And then my girlfriend and I began a long and painful breakup that lasted up to and through my Step 1 test date.
For more than a year, I made and remade my study schedule to try to reflect and predict the appropriate amount of time I believed I should spend on each subject. I ended up disappointed, frustrated, and generally anxious about taking the most important test of my professional life. As hard as I tried, and kept trying, I couldn’t get my plans to match up to my reality. As a result, I kept a baseline level of anxiety that whole time.
As stressful as this situation was, it’s not unique. I’ve interviewed over 20 classmates about their Step 1 and medical school experiences and they have shared even more drastic and dramatic stories. Family member deaths, divorces, severe sicknesses – these are all things that are bound to happen no matter where you are in your step 1 study schedule or any other component of your professional journey.
Step 1 is certainly the most important test of your medical school career, and you should prepare for it accordingly. But life doesn’t stop just because you’re in the middle of something important. I wish I would have accepted this and allowed for it instead of letting it stress me out and fighting it.
Looking back on those events, I’m glad I didn’t skip any of them – the wedding, the graduation, being there for my girlfriend, and even fighting to keep the relationship alive in the end. I could have scored a little better on my test if I had missed these events or just let the relationship die more swiftly out of neglect, but I’m blessed now to not have those regrets. The addition of the flip-side ‘regret’ of not scoring those few extra points has not caused me to lose a wink of sleep. Who knows? Letting go of all of that stress might’ve even helped me perform a little better on the test…
The only thing I do regret is not accepting the degree of difference that naturally exists between ‘Study Plans’ and ‘Study Reality.’