Relief

One of our professors, Dr. GoodAdvice, advised us to take a practice exam from the NBME (National Board of Medical Examiners, the people who write the boards), which will estimate your USMLE step 1 score, ten days before you plan on taking the Step. Dr. GoodAdvice told us that if you want to go into an extremely competitive speciality like dermatology, you need to get a score of X ten days before the exam. If you want to go into something less competitive with more residency programs, like internal medicine or pediatrics, you need to get a score of Y. Dr. GoodAdvice also told us that if do not meet a score of Z ten days before the exam, postpone your examination. The USMLE step one exams is extremely important in residency applications and if you pass the exam, you cannot retake it to increase your score. Basically, this is a one shot deal.

It is ten days before I plan on taking USMLE step one. I've always had a bit of test anxiety, but since starting medical school I've noticed a pattern of my test anxiety. I usually get really, really nervous two to five days before an exam. Then by the time I take the exam, I'm still nervous at the start, but I'm okay once I get going. Well, today was completely different. I've been dreading taking the USMLE practice exam all week. I was really afraid that I wouldn't be ready. However, I knew I had to take the practice exam because if I wasn't ready, I needed to know 7-10 days before the exam so that I could move the exam. I think I've talked about the scheduling of the exam, but is is a process. Moving the exam is doable but you need at least a week to do it. When you apply for the exam, you are given a three month window to take the exam. If you move the exam, you must move test date within your three month window. If you need to move out of that three month window, I think you might have to start the whole process from scratch, but I'm not certain.

Anyway, there was a lot riding on this practice exam and I think it is the most nervous I've been taking an exam. This exam was four blocks of fifty questions and each block lasts sixty-two minutes. After you complete a block, you cannot go back and change any questions. This is the format of the USMLE step one, except that the USMLE step one is seven blocks rather than four. I started my first block yesterday and I wasn't sure of the first question. No big deal. After being unsure about the first five or six questions, I started to get more nervous and was planning for the worst case scenario. Then the next fifteen to twenty questions I felt much more confident about. It is amazing how every question you are not sure about stands out and is easily remembered, but all of the questions that one feels confident about just fade into the background. I kept checking my pulse during the exam (since there is a clock at the top of the screen to let you know exactly how many seconds you have left). I usually have a resting heart rate of about 60 beats per minute. During this exam, my pulse ranged from 120-150 beats per minute, but my mind remained clear. I felt like I still could reason my way through things fairly well especially when I took 10-20 seconds to just stop and breathe/relax. Nonetheless, by the time I clicked the button to see how I did on the exam, my hands were shaking. Then relief: I did okay. I met the marks that Dr. GoodAdvice gave us. I didn't do as well as I hope to do next week, but I put so much pressure on myself for this practice exam that doing well on it is a huge confidence boost. This probably sound strange, but I'm grateful I was so nervous today. This practice exam gave me a chance to practice stopping to take a few breaths, centering and then concentrating on my task at hand, despite being nervous. I am really lucky that I had a chance to practice and gain confidence in myself. Those four hours today, hopefully, will pay dividends next week and later in my career. There will always be times that I get nervous (everyone does), but having the ability to calm myself, focus and be successful are necessary skills that I've proven to myself I possess.

Now, I've got ten days to practice taking more exams and review errors I've made so that I can reach my goal USMLE score!