Boards II

I am ambivalent about Boards. On the one hand, I think it is actually a useful and (dare I say it?) rewarding experience to reflect on the 18 months of the first and second year. We covered a lot of material, and I want and need to integrate all the blocks into an overarching uniting theme. When I see a patient, I won't have the luxury of knowing which block his disease falls in. With something like acute abdominal pain, the differential could involve something from any block: appendicitis (Prologue), AAA (cardiac), lower lobe pneumonia (pulmonary), pyelonephritis (renal), GERD (GI), gastroenteritis (I3), colon cancer, ruptured ovarian cyst (life cycles). I was trying to think of a BMB one: maybe Munchausen's (that's a stretch) or acute angle closure glaucoma (which we didn't technically learn in BMB, but we did do the eye). I think I'd actually really enjoy the experience of looking at things I learned last year with the perspective I have now.

But the USMLE is also a standardized test, which I strongly dislike. I think they distort people's attitudes toward learning (learning for a test rather than for knowledge or patients). Boards don't predict how good of a doctor someone will be, but they are used by residencies to assess applicants. They don't adequately reflect the skill or knowledge base we are taught in medical school nor the skill or knowledge base a doctor needs. Of course, I recognize the limitations; there needs to be a licensing standard, and a multiple choice exam is one of the few ways that is actually feasible. It's a necessary evil.

Over this winter break, I should start studying. I have decent test taking skills, but the way I prepare is not efficient compared to many of my classmates. I strongly dislike review books, and I oppose the ridiculous commericalism surrounding standardized tests. I studied for the MCAT on my own with textbooks. But I recognize that it's hardly the best way of approaching these things.