When I wrote several months ago about milestones, I was referring to the traditional birthdays, funerals, weddings. And now I have scheduled one that relatively few people (though frankly, probably most of the people reading this blog) will ever endure. I've scheduled Step 1 of my USMLE (United States Medical Licensing Examination) for April 26, 2007 at 9am. I've allowed myself a solid 31 days to study after school ends, which should allow for several days off for relaxation. I've heard people do it in 27 or 28, but I think I'd rather take a few days to let my brain rest. And technically I think I can reschedule as long as I give them 5 business days of notice, but I don't anticipate doing that. Like many of the tests life presents, board exams are scary. In spite of the fact that Michigan students tend to do quite well, and that I generally do reasonably well also, I am not-so-secretly terrified that I will fail. And by fail I do not mean that I will not achieve the 95th percentile that apparently many of my classmates before me have achieved. I'm talking about not making it to the passing mark, and having to do the whole thing over. Honestly, I'm not even sure whether I'm more horrified at the prospect of having to explain to residency directors the fact that I failed, or having to take another month of sequestration and misery to study and prepare. Basically, as I keep telling myself I've decided, failure is not an option. But whats a well-meaning medical student to do? We are assured that no amount of targeted board studying before the month-long study interval will help. We are also assured that our Michigan educations will see us through and that truly, we could all walk out of M2 year, take the boards, and pass without doing any extra studying at all. And yet the pressure remains. "Michigan students really excel," we're told. "You'll be fantastic," we're promised. While these statements ostensibly assuage any fears and squash the perceived need to treat our board review books as required bedtime reading, they really just build up the idea that we must do well. I suppose it's merely the beginning of a long career of dealing with outside expectations, external evaluation and standardized judgment. And if I'm really honest with myself, I'd have to acknowledge that this is hardly the beginning - consider state-wide standardized testing in elementary school, the SATs and ACTs, MCATs and GREs. I've been part of a bell curve since I was little, with score cards as regular as the change in seasons. At this point all a student can do is hold up a sheet of paper with a few random ink marks, look in the mirror, and ask, "Do I see myself in this sheet of paper?" With any luck, and a little personality, the answer is no, and always will be.
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