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Saturday, May 1, 2010

Hindsight is 20/10: Parker Edition, Part 1: Academics

As I asked several people back in the day for their nuggets of advice--things they'd do differently if they had it to do over again, several people eventually asked me for mine. I gave them what I had the time to give, but now that I have a break in the action and have more time, I'd like to compile the list and flesh it out. I'll break this up into 3 parts: academics, student clinic, and outpatient clinic. This post will address the Academics side...

* I wish I had known that the information would lack depth. For example, we were instructed to memorize that HLA-B8 goes with DISH (Diffuse Idiopathic Skeletal Hyperostosis), but we didn't cover what an HLA test is. I did not feel I came out knowing my stuff. We scratched the surface, glossed over concepts, threw big words around, and drilled some meaningless factoids and word associations to pass the board exams, but that was about it.
* I wish I had known about the importance of keeping up with studying. This way, you just do a certain amount of bookcracking per day - you spend less time studying and you retain more come the next lecture, or exam time.
* I wish I had known that subjects like Embryology would be so relevant, especially as it lends itself to practically every other subject.
* I wish I hadn't taken the B.E.S.T. class. It's an elective, an awesome class taught by an awesome instructure and it yields great results quickly. However, it was held on Wed afternoons at 3p right after our 1p-3p lecture, and if there was a 1p assembly, our 1p lecture got bumped to 3p, and since B.E.S.T. was an elective, the bumped lecture took priority, so class was canceled. By the way, tuition was not prorated even though we had to miss 3 of the 14 classes for this reason. I wish the school had told us about this before we paid extra (over and above huge tuition) for a class we could attend maybe half the time (we had to miss a few other times too, for reasons we couldn't control).
* I wish I had known about the Harrison's physiology book. Not that Guyton is bad, but Harrison is the medical standard and it's plenty decent, and if we want credibility in the healthcare world, we have to study from the same sources so we can speak the same language.
* I wish I hadn't written down everything in Tri 1. I missed a lot of info just by trying to write it all down.
* I wish I would've gotten way more involved with lunchtime clubs. They don't cost anything, they don't require anything, they don't assign anything, and they don't expect anything. You come, soak up info you're actually interested in while eating lunch, and that's it. Piece of cake, no obligation, and an enriching experience. Motion Palpation club could've really helped me!
* I wish I'd known that I wouldn't learn to adjust in adjusting classes. I didn't get a single cervical adjustment to move properly until somewhere halfway through Tri 4 (you start learning in Tri 3, but it took that long to get any cavitation), and there were plenty of moves I was just getting the hang of in Tri 8 and 9!
* I wish someone had told me to skip a class or blow off a lab every once in a while to catch up on sleep or to go work out. Either would've done wonders to lower my stress level and improve my health.
* I'm glad I didn't just study old tests. Old tests come back to bite people, both in the short term and the long. In the short term, ppl got burned when a fresh question or answer unexpectedly showed up. In the long term, people screw themselves and their future patients by not truly learning the info, so when patients turn up with these conditions, these new docs who never retained the info are less effective and less qualified. They also lack confidence, so the practice builds slower. The real tests aren't the Scan-Trons in school, they're the patients in real life.
* I'm really glad I signed up for (and showed up for) NBCE Board Part 1 reviews *twice*. See, you take Part 1 when you're in Tri 5 or 6, when you're already the most frazzled and burned out you've probably ever been in your life. You may not absorb much. Once you sign up, you can take the classes any time, and you only pay once - you can take them again at no charge. We took them once in Tri 4 with the class ahead of ours. I took good written notes. When we took the classes again with our own class, it was review for us, and we had the luxury of sitting back and listening.
* I'm seriously glad I also took NBCE Part 4 reviews twice. Parker models their Clinic Entrance practical exam after the Part 4 board exam, so many people figure, "I passed Clinic Entrance and it was a piece of cake, so I won't go to the Board Review classes." Bad idea! First of all, ClinEntrance was about a year ago, and you will have forgotten things. Also, you may have picked up the bad habit of taking shortcuts (or other bad un-board-examly habits) during your stint in outpatient clinic, and you will fall back on those mistakes when you're in the autopilot state that big exams tend to hurl you into. Regardless of what they tell you about Parts 1 and 2 being graded on a curve and Parts 3 and 4 not curved, they actually are curved, just like 1 and 2. Those who don't go to board reviews You will not only want to sign up for board reviews, but you will want to show up. And not just once, but twice. This way, you can write your notes the first time, study them, and then sit back and really watch the second time. Part 4 is an expensive test and it is the most common NBCE test that will delay your getting your license.
* I'm glad we went and scavenged all the books that profs recommended. Sure, they're little out-of-print books written 30 years ago and no, they're not required texts or anything, but these turned out to be little gems you can't get anywhere else chock full of rare, hard-to-find information, written by maverick MDs and DOs of yester-decade. They give me an edge when it comes to helping patients.
* I'm glad we listened to the brave soul who strongly advised people to take extracurricular classes and seminars; he said it would give us the motivation and insight into how we could take the information we were learning academically and apply it clinically (in other words, what did what we were learning mean, and why should we care?) The weekend seminars were extra work and took away from precious free time, but I don't regret going to any of them and in fact, I wish we would've taken more of them. They gave our boring school info a whole new significance.
* I'm glad someone told me how fast it would go. Tri 1 seemed to take a year by itself, but everything else flew by like milemarkers after that.

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