Applying to Residency

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What’s In My White Coat: Surgery Edition

From top left:

1. ID and scrub card: It’s always a good idea to have a pair of clean scrubs available.

2. Scalpel: For emergency airways. (Seriously, you should always have one with you. At the very least, you can hand it to someone who knows what to do.)

3. Dr. Pestana’s Surgery: This should actually be in your scrubs so that you can read it during downtime (in pre-op, for example).

4. Stethoscope: You need to evaluate bowel sounds for post-op checks.

5. Xeroform gauze

6. Lube: Because every GI bleed and acute abdomen requires a DRE. (You've heard this joke, right? Q: When is it okay for the medical student to skip the DRE? A: When they don't have any fingers.)

7. Scissors

8. Phone charger: So you can charge up while you’re scrubbed in.

9. Tape

10. Forceps: Useful for removing packing. (Make sure to discard or clean after each use.)

11. Lunch!

12. Highlighter and pens

13. Gum: For post-call morning breath.

How I Learned to Stop Worrying and Love Step 2

First of all, you know how everyone says Step 2 is much easier than Step 1? They are correct. If you were conscious during your 3^rd year clerkships and you spend a reasonable amount of time studying, you will be able to get a better score than you did on Step 1. Many people have asked me how I studied for Step 2, so I decided to write a quick blog about.

(Disclaimer: If you’re applying to Ortho, Neurosurg, Derm, or Ophtho, none of this applies to you. You just need to talk to one of your people.)

I chose not to take any time off to prepare for Step 2 because I had a six-week Psychiatry rotation at the end of 3^rd year.  This rotation is lovingly referred to as “Psych-cation” because the hours are pretty amazing (usually 8:30-ish to lunchtime). In other words, I knew I would have time to study. So I scheduled Step 2 for June 29^th, which was three days after my Psych shelf, and two days before the first day of 4^th year.  (Yay! One day of vacation!)

I ordered First Aid for Step 2 CK and Step 2 Secrets. (I didn’t use the latter very much, although it is a good resource and has great derm pictures.) Because I had used UWorld for my 3^rd year clerkships, I reset the Qbank and started over. The Step 2 Qbank has ~2,200 questions and I studied about six days per week, so I ended up doing ~60 questions per day on the days that I did study.

When I first started studying, I needed to refresh my memory on general concepts, so I would choose a chapter in First Aid and spend an afternoon reviewing the topic in details. I also referenced my First Aid for Step 1 often (I know, I know), because it usually has more detail than the Step 2 book. I also reread Pestana. For everything else, I referenced UpToDate or Medscape.

I completed the entire Qbank in untimed tutor mode. This is because I was using UWorld as a study aid, not as a way to practice test-taking strategies. (After taking seven shelf exams during 3^rd year, I felt pretty confident in my time management.) I took my time on topics that I knew I struggled with (i.e. renal), but I sped through questions that I knew well, or missed only because I made a silly error.

Two weeks before my test date, I bought an NBME practice test and did well on it. I didn’t use any of the practice tests for Step 1, and I don’t have a good reason for why I chose to do it this time. I just felt like it. Then, two days before my test I took another NBME practice test and I did NOT do well on it.

I. Freaked. Out.

My predicted Step 2 score was lower than my Step 1 score, which is obviously not a good thing. I texted people. I almost cried. One of my friends advised me to take another practice test before deciding to push my test back, so I took the UWorld Step 2 Self Assessment. I got a good score on that, breathed a sigh of relief, and stopped studying. And the rest is history.

If I could change one thing about how I prepared, I would NOT take the NBME practice tests. That freak-out was not worth it. Everything else worked really well for me. I ended up scoring 19 points higher on Step 2 than I did on Step 1 and am content with my score.

Please feel free to ask questions or share your strategies in the comments below!