It was a hot summer day as usual, and I was studying for the USMLE Step 1, (The United States Medical Licensing Examination). USMLE is comprised of three examinations and is required for medical licensure in the United States. It is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Every day I was the first student to arrive on campus in the cool morning and the last to leave in the hot evening— and all I wondered was, “When will this monster exam end?”
My second year of medical school was flying by. It was now time to dedicate daily study time for the USMLE Step 1, an exam that often feels like it defines a medical student’s career. Each medical student I spoke to was in a hurry to prepare for this exam, which is one of the first milestones to becoming a physician. The majority of the class would not attend lectures in order to devote their time to study. This exam was considered by most students as the “end all be all.” This exam is crucial because a high score can differentiate you from other medical students when applying for positions in residency programs.
After speaking with classmates who had already taken the exam, I decided to defer my first rotation to ensure I took enough time to prepare for the exam. Although this was a difficult decision, I proceeded with it.
During my preparation, I also had some health complications; including GERD (Gastroesophageal reflux disease) and panic attacks. Everyone who knew me began to see how studying for this exam was consuming me. I seemed to have forgotten how to be human. I no longer did what I used to. Because of my intensive study schedule, hanging out with family and friends was no longer an option. This test was taking over me.
Fortunately, I have an incredible, loving, and diverse support system. Along the way I learned to cope through exercise, deep breathing, meditations, prayers and talking to my family and friends. My sister and my parents held my hand throughout the fight. My sister provided informative feedback and positive self-talk mechanisms. I constantly called her for advice along with my father, whom has been both a professor and licensed clinical psychologist for more than 20+ years. I was fortunate.
However, some days I needed more. My best friend, Nyemachi, a third-year medical student at Tulane Medical School, would periodically call and give me her positivity, telling me that this test was just like other exams I had taken. She reassured me that I needed to believe in myself and let God do the rest. Another friend of mine named Cole, a third-year medical student at California Northstate, regularly provided me with positive feedback and support as well.
On campus, I studied for this exam morning until evening. In the fourth week of studying, just as some self-doubt and negative thoughts began to creep into my mind, I saw my friend Mike, a fourth-year medical student from California Northstate University.
Mike was preparing to take the USMLE Step 2 exam that he pushed back two weeks because he was planning his wedding. I ran into him in the library.
“You should be proud of yourself, you are the first student here each morning and the last person to leave campus in the evening. No matter what score you get, be proud of how hard you’ve worked. It is incredible,” Mike said.
I never forgot that comment because I felt that no one else could see what I was doing aside from what I would tell them over a phone call or facetime, and I never noticed myself being the first person in the library nor the last person out. His comment gave me hope and fueled my desire to keep up the good work and let go of the negative energy.
I would run into Mike in the library and have discussions with him during our breaks. It was nice to have someone alongside me during this time.
The last day before Mike’s exam, he left a note on my truck. It read “A few things to remember”:
- You got accepted to medical school and crushed the first two years –that’s an achievement of a lifetime, and something you should be proud of no matter what.
- This is just one test –it truly will not define you or your career.
- You are almost there, keep pushing for a few more days, stay focused, stay positive, and get some sleep.
- One day at a time, do not push it back anymore.
- Don’t let this thing beat you! Keep working hard and just take it! And move on with your life! (Life is so much better on the other side of step1 –just get it over with so you can enjoy your third year and the rest of your life as a doctor.)
- You got this.
I heard these things when talking to my sister, my parents, my best friends Nyemachi and Cole. But what I needed most was for a peer student to see me going through it, someone that had gone through the same process recently, to empathize with and tell me all of this. I read Mike’s note every time I doubted my ability to succeed.
The process of studying for USMLE Step 1 is isolating, not only because of the months it takes to study before the test date, but also for me, because it took me away from the classroom during my preclinical years. Fortunately, my social support while studying has helped boost my ability to prepare for this monster and the recognition I got from Mike seeing my effort fueled me.
I would like to end by saying that staying connected to those around you, particularly those who can empathize with what you are going through, is of the utmost importance during the Step 1 preparation period. And most importantly, remember, any one test will not define you or your career in medicine. You will be the one who defines your career. And you will be the one who defines yourself.
About Sehra Rahmany
Sehra Rahmany is a third-year medical student at California Northstate University College of Medicine. During her first year of medical school Sehra was an active member of the Interprofessional Committee as well as Co-Vice President of the Sierra Sacramento Valley Medical Society.
Sehra is passionate about promoting mental health awareness among medical students and healthcare professionals. She has published several articles with the American College of Physicians and the Sierra Sacramento Valley Medical Society about the importance of empathy and avoiding burnout. In her spare time, she practices yoga and meditation, and leads meditation sessions within her campus community.
Through her writing Sehra hopes to inspire future medical students as well as advocate for practices that increase well-being among individuals in the medical field.
