REAL LIFE: I failed STEP 1…And Came Back Swinging.

First of all, how are you? Failing STEP 1 was one of the most devastating times in my career; in my life. Anyone asking me how I was doing was Always a loaded question, but it helped to know and feel people cared. Know that I care. 

I speak more on the blow and impact of my STEP 1 failures here. I wanted to spend this post discussing how I OVERCAME. With each failure notice I received, a little piece of me left. I was especially frustrated because I just did not know what I was doing wrong. The “experts” were telling me I needed to re-read everything from 1^st and 2^nd Year and just do a bunch of questions (???). They did not hesitate to dismiss me from school when that “expertise” did not work. I suppose that’s why it felt SO GOOD when I not only won my appeal to get back into school, but also learned strategies so I could successfully finish. But first:

I mourned. I cried long and often. I pray none of you have as long a STEP 1 journey as I did, but no matter the length of time it takes you to pass, understand this: it is ok to mourn. It is more than normal to be upset about the loss of time, nick in confidence, feeling of being left behind, subconscious comparisons to classmates, decrease in funds, and the wherewithal it will take to study for that horrid exam not once but TWICE. Process your feelings and Get. It. Out. Do not stay in the pit, though, because we have work to do.

I appealed. Every negative decision that was ever made about me in school, I appealed it. I DID NOT CARE WHAT IT WAS AND WHO SAID IT WAS FINAL. I don’t know about you, but GOD DETERMINES WHAT IS FINAL IN MY LIFE. And according to Him, I was a Doctor before all of this even began. And so it was. You can’t pass your exam if you are not enrolled in school. Appeal. Go to the highest height and work your way to the top of the totem pole. APPEAL.

I asked for help. I started back studying with my Academic Mentor just like we did to get me through 2^nd Year. She was someone who was honest with me. She was also positive, spoke life over me, and believed with me that I COULD. And it was because I asked for her help and because of God’s divine intervention that my mentor discovered we had a test-taking strategist at my school the ENTIRE time I had struggled. The school simply had not employed his services (he worked in a completely non-academic department) because of personal matters. You read that correctly. The three of us started working together and that’s when:

I employed a more effective strategy: By my final retake of this exam, I was TIIIIIIIREDT. I could barely think, walk, or talk straight. If you can imagine what studying the same material day in and day out for a year’s time…and NOT passing the exam…might do to your psyche. Yea, I was there. I had tried the questions on questions. I had tried Doctors in Training. And while those methods brought me some more points, my scores still didn’t cut it. Working with my test-taking strategist was like coming up for air. His methods were simple, but really worked to show me where I needed to focus more of my attention. Gone were the days of “just study and review and read everything.” Now I had direction. I had focus. And it showed. The strategy is as follows:

– Use a question bank (I stuck with UWorld and Kaplan) and for each question set, complete this worksheet. Aim to make a 70% and up. Once you do that CONSISTENTLY, you are more ready to take the exam. Also aim for the percentages at the bottom of each column:

C – answers you are certain about

SH – strong hunch

WH – weak hunch

G – guess

– For each question you get wrong, bust out your TEXTBOOKS (not review books) to look up the subject matter. Every. Single. Incorrect. Answer. This can take hours to get through 1 question set, but it’s so worth it. Also read the q bank explanation.

– Each day, write down 5 new facts you learned and review all your facts twice weekly. Another professor taught me this one.
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– Meet with a trusted (and positive!!) faculty member weekly to review questions, discuss content, and analyze your progress. Twice per week closer to the exam. Sometimes you just need to ensure your line of reasoning through a question is correct. It’s important to know WHY right answers are right and WHY wrong answers are wrong. An academic mentor can talk you through that.

– For the exam at hand—even if you are using this method for shelf exams—take every single NBME practice test available. Yes, every single one. The fees can rack up, but it’s so worth it! It’s important to get a real feel for exam questions in a timed, test-like environment. When I did this for STEP 2, I scored BIG time! I ended up seeing at least 2 questions from my practice tests WORD FOR WORD on the real test. Every point counts! And we want as many free ones as possible. Take the practice exams and review the answers, reading up on the questions you got wrong. Then review with your academic mentor.

Again, simple, yet effective. Every. Single. Time. I used this strategy, I passed the rest of my exams. Shelf exams and STEP 2. When I deviated, I struggled. When I got back on this horse, I passed. And it is through this strategy that I passed STEP 2 on the FIRST try (after being told I would never) and graduated as a Medical Doctor. 

I did not share my business with everyone. Sure, people mean well, but sometimes do not know what to say in times of hardship and emergency. I did not want to open myself up to a bunch of unsolicited opinions. You know the ones: “Maybe it’s time to think about another career.” “Hmmmm…(awkward silence, should I say it? I’m gonna say it) Should it be this hard? Like should you even be doing this then?” And my favorite, “You should talk to my cousin twice removed Auntie’s friend I met that one time in Colorado who never struggled. Surely she has applicable insight.” I kept my failures very close to heart. Very few knew. When it came to my close family and friends (who are all very supportive!), it was just too hard to talk about. Barely anyone knew until I texted them an hour before I released this blog post the day before graduation. They were all shocked. Some even called me crying. I had to discuss when I was ready and think about the shock factor later.

I got healthy. Failing this exam multiple times put me in a really dark place. There is no way to sugarcoat that and I would not try to. It took some trial and error, but I found a therapist. I wanted a Black female with whom I did not have to overexplain non-medical nuances of my life and I found her. We started meeting regularly. She worked around my study schedule and she really helped me with some coping mechanisms and techniques. Especially as physicians we MUST prioritize our mental health. So much goes into undertaking this profession and if we ourselves are not healthy, how can we positively impact the health of others? Talk to a professional.

I started doing more of what I love. Yes, I love medicine. Yes, I love my patients past and future. Still, I needed something just for me. Surgery And The City  was just for ME. And it has been my saving grace. I fled to New York and lived with my brother in his Brooklyn studio part of the year I spent studying for STEP 1. It was in that studio that Surgery And The City was born. The more I focused on building it—with the limited resources I had at the time—the better I did in school. My brother told me perhaps I would not feel as much pressure to perform in med school and would not experience so much disappointment if I did not put all my focus on just that one area of my life. He was right. Boy was he right.

I got my funds right. I don’t know about y’all, but my school adopted this new policy during my 2^nd Year where they denied financial aid to students until they passed STEP 1. Forget about mental health and well-being, the fact that we are real adults with real bills, and the further compounded stress of an already very stressful situation. My parents helped me, rescued me TREMENDOUSLY! Still, I applied to scholarship after scholarship to assist as much as I could. I have a list of every scholarship I won here. National Medical Fellowships in particular was CLUTCH!!! The money goes right to the students without the school intervening. Therefore, the student can use it for any expenses they have without the school trying to grab it up for tuition first. APPLY! And lastly:

iBelieved. I was hurt. I was mad at God. I tried to give Him the silent treatment and everything. But deep down, I Always knew. I just always knew He did not bring me that far just for the heck of it. I knew He would come through at the end of the day. I just did not know which day or when the end would be. That part frustrated and hurt me to no end. Still, here I am surviving and thriving in ways I would have never imagined. I am praying so hard that y’all experience that and MORE. You CAN Overcome. You WILL Overcome. This is only the beginning, so take heart and Believe. 

Just to recap, I rebounded from my STEP 1 failures by:

Taking the time to mourn

Appealing ERRRRRRRthang!

Asking for help

Employing a more effective strategy

Sharing my story when I was ready 

Prioritizing my mental health

Focusing more on what I love outside of medicine

Applying for scholarships to supplement my income

Believing that God would be GOD and do what He promised me

I really hope this helps, y’all. I don’t see doctors talking about this and I wanted to create somewhat of a survival guide for students with similar experiences I faced. These board exams are not the end all be all and simply measure how well you take a test, NOT your level of skill or your capabilities as a physician and Healer. Know that non-traditional does not mean incompetent. Nor is it the antithesis of excellence. We are STILL Extraordinary and our failures will only make us better, more conscious, teachable, humble, tougher Doctors. Nothing can break us. Not ever. I am here and I am rooting just for You! Here if you have questions. Here if you need prayer. So Doc, get back up. Get back up and PASS.

xoxo, 

Photos by Tina Smith