The FIHTTTU Status Exam
After 1.5 years of getting away with doing nothing, reality has set in, and she's ugly, hungover, on her period, and wants to talk. What is this reality I speak of? Well, let me just put it this way: If you want to literally scare the shit out of any medical student, you need only utter five letters in succession: U-S-M-L-E. Yes, ladies and gentlemen, the grand United States Medical Licensing Exam is upon us, and life as I know it shall never again be the same. Granted, I've known that Step 1 of this exam was on the horizon since I entered medical school, but when an exam of this magnitude is a long ways away it is easy to just forget about it and continue slacking off. However, the real exam is now only a few months away, and it has occurred to me that I need to learn everything I was supposed to learn in the first two years of medical school in, oh, I don't know...THREE MONTHS. Now, you may think I'm currently wetting my pants. And you'd be right (actually, you'd be right about 45% of the time independent of anything else). But what about your more manly medical school friends? How can you truly judge what level of insanity they have reached as a result of this exam? What if YOU are a medical student, and you need to know how fucked up you've become after studying for this test, so you know how many of those free samples of Prozac you should be popping?
Given all this, I think it would be useful to come up with a systematic way to document previous, current, and future levels of despair as I begin my USMLE studying by descending into the bowels of the medical library, or, more likely, some crowded coffee shop where I can display my medical school paraphenilia with the hopes of catching the eye of one (of the many) attractive female undergraduates here (Ask me how many times that has worked out so far. Go ahead, ask. Hint: It rhymes with De Niro, and it starts with a "z".).
However, while this seems all fun and good, there is historically no real way to quantify and chart my USMLE progression into madness. Thus, what follows is a questionnaire that I have developed which, like the Mini-Mental Status Exam, has been scientifically standardized and is almost perfectly predictive (and, like parts of the Mini-Mental Status Exam, is also likely a total crock of shit - saying "No ifs, ands, or buts" has been scientifically proven to be a legitimate test for something? Please.). Feel free to answer each question, tally up your score, and see where you stand. Because I'm such a nice guy, I have provided explanations of some of the more obscure items, just in case you are a concerned friend who is not actually a medical student yourself.
The Fuck I Have To Take The USMLE Status Exam
1. How many hours has it been since you last saw the sun? If you are currently a medical student not on the West Coast, add 10 as a rickets-factor correction. If this number exceeds 72, enter 999 and head directly to the nearest spray-on tanning salon. You might blind someone with your pasty whiteness. ____
2. Record the number of times either you or someone you know has used the phrase "high-yield" in a sentence. What is this referring to? Well, it turns out that come boards time, medical students are obsessed with obtaining books or study guides that are "high-yield", meaning that you get the most/best information in the least amount of time. As a result, they begin using this phrase in every aspect of their lives, from "Ya I hear that biochem text is good, but is it high-yield?" to "That lecture was high-yield. I'm glad I was reading my high-yield embryology while I was in that high-yield lecture." Enough. Seriously. You're killing me here. ____
(Note: Do not count non-medical school usages of this phrase. For example, if you are me (SO sorry to hear that) and after 5 hours of studying your brain has fried to the point where you are wondering things like "If you were high and reading high-yield path at the same time, would your brain explode?" and "I wonder if my penis is high-yield", you cannot count those in this section. But feel free to add 100 to your score anyways, because you are obviously losing it.)
3. Remember all those times you felt like reaching across the table in PBL and beating the shit out of a classmate that was royally pissing you off? Add 5 points for each time you have that feeling during a one-week span. Board exam time brings with it a lot of animosity towards your classmates, whether their behavior warrants punishment or not. People see other people studying hardcore and freak out, thus leading to unbelievable amounts of stress, which leads to increasing animosity towards people you probably already hated in the first place, which leads to a decreased threshold of tolerance, which very well may lead to a serious ass-whupping. And yes, Frenchie, your ass-kissing warrants punishment. Asshole. Add 467 points if you actually beat the shit out of someone. Add 10 more if you tried to beat someone up but that person was too big and beat you up instead. Multiply your score by 99 points if someone else beat the snot out of you for whatever irritating crap you're pulling (and stop being such an obnoxious prick all the time). ____
4. Record the number of times you shouted "Thank You Jesus!" in front of the entire class after discovering that, after the boards, you will most likely not see the vast majority of your horrific classmates until graduation two years later. Add 1 for each shout out. P.S. I love you, Trish. ____
5. Document and record every time some outsider does something to piss you off, but you find your brain so drained and dulled after staring at something like the High-Yield Biochemistry (sigh) explanation of the Krebs Cycle for 5 hours that you are unable to do anything about it. For example, say you're me (again, apologies) circa last night and you just walked into the elevator in your building with Subway sandwich in hand, only to discover that you are sharing the elevator with a really thin seemingly benign elderly woman you've seen occasionally. For no obvious reason, she proceeds to hit the button for every floor, gets off at the first floor, and gives you an evil smirk on her way out, leaving you with the options of getting out and taking the stairs or stopping at every floor until you get to yours. Since your leg muscles have atrophied after days and days of sitting and studying, the stairs are not an option. Congratulations, you have just been punked by a 73 year old woman. Your life has reached a new low. I mean, Christ, does this happen to anyone else? Add 935.56 points. ____
6. A pneumonic can be a fun, useful tool to memorize what are otherwise useless pieces of information. Sexual pneumonics, on the other hand, are simply a cry for help. Add 10 points for every sexual pneumonic you have either read about and used or made up yourself. Examples include Cindy Is Kinky So She Fornicates More Often and, for any Arroyo people who might be reading this, Phil Masturbates All the Time. 100 points more if you actually know what these pneumonics stand for. 3,000 points if you managed to come up with a sexual pneumonic that summarizes something that might have anything to do with Pediatrics, you sick bastard. ____
7. Spending long days studying often comes at the cost of a decrease in personal hygiene. Ladies, record the numerical value of the length of one of your leg hairs, in centimeters. Gentlemen, use facial hair. If using hair from other non-sexual parts of the body is easier, use that instead. If you find it easier and more helpful to specifically use your back hair, there is an 86% chance your name is Matt. Also, if people would rather stand next to the homeless guy who hangs out around Starbucks than you, multiply the number you have by the amount of days it has been since you last took a shower. Record the numerical value you have obtained here: ____
8. Since you will still have class during the first part of your study-a-thon, you will still have lecturers blabbing on about something only to go "I guarantee that _____ has been tested in every board exam you will ever take", only to later say something like "And then there is this detail - Ha, I remember memorizing that for the boards, but I don't know it anymore!". Thanks, asshole, that really makes me feel a lot better. Add 15 points for every time that happens. If you call them on it later, add another 50 points for actually paying attention in class. If you cannot hold back your urge to beat the crap out of said lecturer and end up wailing on him or her, divide your point total in half and enjoy your newfound freedom, as you have now been expelled from medical school. ____
9. It seems like, for some people, the longer one stays in medical school (and, by extension, the longer one studies for boards), the dumber one becomes (I think I might have to devote a whole post to this theory). Every time you find yourself raising your hand in class to ask a question that goes something like "Wow...I have a question, but I don't know what it is." (Yes, that actually happened. Twice. By the same person.), add 200 points and consider transferring to culinary school, because at least in that school anything you might be dealing with is already dead. Good grief. ____
10. A lot of studying involves looking at picture after picture of patients with the diseases in question, because the exam is computer-based and there are likely many pictures involved for diagnostic purposes. If, after looking at some of the pictures of Turner Syndrome, Klinefelter's Syndrome, or Prader-Willi Syndrome (which almost always involve overt pictures of naked people), you find yourself sexually aroused, add 20 points. If you experience similar arousal with Testicular Feminization, add 0 points because it is undeniable that she still used to look damn good (even with that 80s hair cut!) despite the fact that she is really a he. If you experience similar arousal after viewing pictures of patients with Syphilis, Gonorrhea, or Chlamydia, you are truly evil and quite possibly the anti-Christ - add 666 points. ____
Bonus Question. You might find yourself venting about how lame this whole studying thing is, only to realize that the even lamer thing to do is to be whining about it by writing up a longwinded and marginally entertaining blog on a Saturday night instead of going out and drinking with your friends. Add 50 points and change your name to Eli. If all of your friends are medical students and are also studying, subtract 25 points because it's not completely your fault. If you have no friends, you are probably still recovering from the ass-kicking you received after annoying the same medical student one too many times with your stupid question-asking/arrogance/idiocy/physical appearance (see status question #3), so tough shit. Actually, add another 200 points because you just reminded me of how much you annoy me. ____
Scoring
Your score < 5: Congratulations, you are not a medical student. In fact, you are probably a nice, normal, cool person. If you are also Jewish and female, I'm available.
5 < Your score < 100: You are beginning to let this test get the better of you. But for you there is still hope for you, as long as you put down your First-Aid book this instant, go out to a bar, hit on a member of whatever sex it is you find attractive, and get a phone number. Then, if it's a girl, give that number to me. Thanks, sucka!
100 < Your score < 1,000: Stand up from the chair you are currently sitting on and admire the permanent butt print have made on said chair. The people around you have been pointing at you for the last three hours. The library/coffee shop/seminary you are currently studying at has placed an air freshener under each of your armpits. Needless to say, you have been studying just a wee bit too hardcore with your USMLE studying, and it's time to give it a rest.
1,000 < Your score < 5,000: You have reached levels of neuroses not seen since Woody Allen used to be funny. Do not pass go. Proceed straight to your local nuthouse and commit yourself. If you are not currently a middle child, acquire the appropriate number of siblings to ensure diagnosis of Middle Child Syndrome. If you are me, remain calm - status quo has prevailed once again.
5,000 < Your score < 10,000: Wow. I'm sure you're going to dominate the board exams, but no one else is going to know it. Why? Because you haven't talked to anyone in three months, and everyone thinks you are dead. That's right. Check the obituary pages from last week's paper. According to your mother, you mysteriously disappeared sometime in February after telling her you were going to the library with a big stack of books. She also said you wet your bed and slept with a pink doll named "Muffins" until you were 21. Thanks mom!
Your score > 10,000: I'm not really sure what to say. Actually, how about this: IT'S NOT WORTH IT. That's right. You're probably gunning for the top residency program in the hardest field, which is the only reason that can explain why you have completely shut yourself off from the real world in order to study for one silly exam. Except you haven't realized that this is just part of the whole process - you have to still do two more years of school, and after going psycho for four months, no one is going to want to get anywhere near you ever again because you are a total freakshow. I'd like to think there is some hope for you, but I'd also like to think that Random House is going to stumble across this blog and offer me a million bucks for my medical school memoirs - so basically, there is no hope for you whatsoever. So go on. Study study study. I just hope you find meaning and happiness in memorizing the five co-factors of pyruvate dehydrogenase. Me? I'll take my $110 in Baja Fresh gift certificates and the porn magazine I got for my birthday.
So what is the great news in all of this? There are three parts to the USMLE exam, which means I get to take a new test in two years, and another one a year or two after that!
I'll drink to that. Right after I finish looking at these pics of Turner Syndrome...
Given all this, I think it would be useful to come up with a systematic way to document previous, current, and future levels of despair as I begin my USMLE studying by descending into the bowels of the medical library, or, more likely, some crowded coffee shop where I can display my medical school paraphenilia with the hopes of catching the eye of one (of the many) attractive female undergraduates here (Ask me how many times that has worked out so far. Go ahead, ask. Hint: It rhymes with De Niro, and it starts with a "z".).
However, while this seems all fun and good, there is historically no real way to quantify and chart my USMLE progression into madness. Thus, what follows is a questionnaire that I have developed which, like the Mini-Mental Status Exam, has been scientifically standardized and is almost perfectly predictive (and, like parts of the Mini-Mental Status Exam, is also likely a total crock of shit - saying "No ifs, ands, or buts" has been scientifically proven to be a legitimate test for something? Please.). Feel free to answer each question, tally up your score, and see where you stand. Because I'm such a nice guy, I have provided explanations of some of the more obscure items, just in case you are a concerned friend who is not actually a medical student yourself.
The Fuck I Have To Take The USMLE Status Exam
1. How many hours has it been since you last saw the sun? If you are currently a medical student not on the West Coast, add 10 as a rickets-factor correction. If this number exceeds 72, enter 999 and head directly to the nearest spray-on tanning salon. You might blind someone with your pasty whiteness. ____
2. Record the number of times either you or someone you know has used the phrase "high-yield" in a sentence. What is this referring to? Well, it turns out that come boards time, medical students are obsessed with obtaining books or study guides that are "high-yield", meaning that you get the most/best information in the least amount of time. As a result, they begin using this phrase in every aspect of their lives, from "Ya I hear that biochem text is good, but is it high-yield?" to "That lecture was high-yield. I'm glad I was reading my high-yield embryology while I was in that high-yield lecture." Enough. Seriously. You're killing me here. ____
(Note: Do not count non-medical school usages of this phrase. For example, if you are me (SO sorry to hear that) and after 5 hours of studying your brain has fried to the point where you are wondering things like "If you were high and reading high-yield path at the same time, would your brain explode?" and "I wonder if my penis is high-yield", you cannot count those in this section. But feel free to add 100 to your score anyways, because you are obviously losing it.)
3. Remember all those times you felt like reaching across the table in PBL and beating the shit out of a classmate that was royally pissing you off? Add 5 points for each time you have that feeling during a one-week span. Board exam time brings with it a lot of animosity towards your classmates, whether their behavior warrants punishment or not. People see other people studying hardcore and freak out, thus leading to unbelievable amounts of stress, which leads to increasing animosity towards people you probably already hated in the first place, which leads to a decreased threshold of tolerance, which very well may lead to a serious ass-whupping. And yes, Frenchie, your ass-kissing warrants punishment. Asshole. Add 467 points if you actually beat the shit out of someone. Add 10 more if you tried to beat someone up but that person was too big and beat you up instead. Multiply your score by 99 points if someone else beat the snot out of you for whatever irritating crap you're pulling (and stop being such an obnoxious prick all the time). ____
4. Record the number of times you shouted "Thank You Jesus!" in front of the entire class after discovering that, after the boards, you will most likely not see the vast majority of your horrific classmates until graduation two years later. Add 1 for each shout out. P.S. I love you, Trish. ____
5. Document and record every time some outsider does something to piss you off, but you find your brain so drained and dulled after staring at something like the High-Yield Biochemistry (sigh) explanation of the Krebs Cycle for 5 hours that you are unable to do anything about it. For example, say you're me (again, apologies) circa last night and you just walked into the elevator in your building with Subway sandwich in hand, only to discover that you are sharing the elevator with a really thin seemingly benign elderly woman you've seen occasionally. For no obvious reason, she proceeds to hit the button for every floor, gets off at the first floor, and gives you an evil smirk on her way out, leaving you with the options of getting out and taking the stairs or stopping at every floor until you get to yours. Since your leg muscles have atrophied after days and days of sitting and studying, the stairs are not an option. Congratulations, you have just been punked by a 73 year old woman. Your life has reached a new low. I mean, Christ, does this happen to anyone else? Add 935.56 points. ____
6. A pneumonic can be a fun, useful tool to memorize what are otherwise useless pieces of information. Sexual pneumonics, on the other hand, are simply a cry for help. Add 10 points for every sexual pneumonic you have either read about and used or made up yourself. Examples include Cindy Is Kinky So She Fornicates More Often and, for any Arroyo people who might be reading this, Phil Masturbates All the Time. 100 points more if you actually know what these pneumonics stand for. 3,000 points if you managed to come up with a sexual pneumonic that summarizes something that might have anything to do with Pediatrics, you sick bastard. ____
7. Spending long days studying often comes at the cost of a decrease in personal hygiene. Ladies, record the numerical value of the length of one of your leg hairs, in centimeters. Gentlemen, use facial hair. If using hair from other non-sexual parts of the body is easier, use that instead. If you find it easier and more helpful to specifically use your back hair, there is an 86% chance your name is Matt. Also, if people would rather stand next to the homeless guy who hangs out around Starbucks than you, multiply the number you have by the amount of days it has been since you last took a shower. Record the numerical value you have obtained here: ____
8. Since you will still have class during the first part of your study-a-thon, you will still have lecturers blabbing on about something only to go "I guarantee that _____ has been tested in every board exam you will ever take", only to later say something like "And then there is this detail - Ha, I remember memorizing that for the boards, but I don't know it anymore!". Thanks, asshole, that really makes me feel a lot better. Add 15 points for every time that happens. If you call them on it later, add another 50 points for actually paying attention in class. If you cannot hold back your urge to beat the crap out of said lecturer and end up wailing on him or her, divide your point total in half and enjoy your newfound freedom, as you have now been expelled from medical school. ____
9. It seems like, for some people, the longer one stays in medical school (and, by extension, the longer one studies for boards), the dumber one becomes (I think I might have to devote a whole post to this theory). Every time you find yourself raising your hand in class to ask a question that goes something like "Wow...I have a question, but I don't know what it is." (Yes, that actually happened. Twice. By the same person.), add 200 points and consider transferring to culinary school, because at least in that school anything you might be dealing with is already dead. Good grief. ____
10. A lot of studying involves looking at picture after picture of patients with the diseases in question, because the exam is computer-based and there are likely many pictures involved for diagnostic purposes. If, after looking at some of the pictures of Turner Syndrome, Klinefelter's Syndrome, or Prader-Willi Syndrome (which almost always involve overt pictures of naked people), you find yourself sexually aroused, add 20 points. If you experience similar arousal with Testicular Feminization, add 0 points because it is undeniable that she still used to look damn good (even with that 80s hair cut!) despite the fact that she is really a he. If you experience similar arousal after viewing pictures of patients with Syphilis, Gonorrhea, or Chlamydia, you are truly evil and quite possibly the anti-Christ - add 666 points. ____
Bonus Question. You might find yourself venting about how lame this whole studying thing is, only to realize that the even lamer thing to do is to be whining about it by writing up a longwinded and marginally entertaining blog on a Saturday night instead of going out and drinking with your friends. Add 50 points and change your name to Eli. If all of your friends are medical students and are also studying, subtract 25 points because it's not completely your fault. If you have no friends, you are probably still recovering from the ass-kicking you received after annoying the same medical student one too many times with your stupid question-asking/arrogance/idiocy/physical appearance (see status question #3), so tough shit. Actually, add another 200 points because you just reminded me of how much you annoy me. ____
Scoring
Your score < 5: Congratulations, you are not a medical student. In fact, you are probably a nice, normal, cool person. If you are also Jewish and female, I'm available.
5 < Your score < 100: You are beginning to let this test get the better of you. But for you there is still hope for you, as long as you put down your First-Aid book this instant, go out to a bar, hit on a member of whatever sex it is you find attractive, and get a phone number. Then, if it's a girl, give that number to me. Thanks, sucka!
100 < Your score < 1,000: Stand up from the chair you are currently sitting on and admire the permanent butt print have made on said chair. The people around you have been pointing at you for the last three hours. The library/coffee shop/seminary you are currently studying at has placed an air freshener under each of your armpits. Needless to say, you have been studying just a wee bit too hardcore with your USMLE studying, and it's time to give it a rest.
1,000 < Your score < 5,000: You have reached levels of neuroses not seen since Woody Allen used to be funny. Do not pass go. Proceed straight to your local nuthouse and commit yourself. If you are not currently a middle child, acquire the appropriate number of siblings to ensure diagnosis of Middle Child Syndrome. If you are me, remain calm - status quo has prevailed once again.
5,000 < Your score < 10,000: Wow. I'm sure you're going to dominate the board exams, but no one else is going to know it. Why? Because you haven't talked to anyone in three months, and everyone thinks you are dead. That's right. Check the obituary pages from last week's paper. According to your mother, you mysteriously disappeared sometime in February after telling her you were going to the library with a big stack of books. She also said you wet your bed and slept with a pink doll named "Muffins" until you were 21. Thanks mom!
Your score > 10,000: I'm not really sure what to say. Actually, how about this: IT'S NOT WORTH IT. That's right. You're probably gunning for the top residency program in the hardest field, which is the only reason that can explain why you have completely shut yourself off from the real world in order to study for one silly exam. Except you haven't realized that this is just part of the whole process - you have to still do two more years of school, and after going psycho for four months, no one is going to want to get anywhere near you ever again because you are a total freakshow. I'd like to think there is some hope for you, but I'd also like to think that Random House is going to stumble across this blog and offer me a million bucks for my medical school memoirs - so basically, there is no hope for you whatsoever. So go on. Study study study. I just hope you find meaning and happiness in memorizing the five co-factors of pyruvate dehydrogenase. Me? I'll take my $110 in Baja Fresh gift certificates and the porn magazine I got for my birthday.
So what is the great news in all of this? There are three parts to the USMLE exam, which means I get to take a new test in two years, and another one a year or two after that!
I'll drink to that. Right after I finish looking at these pics of Turner Syndrome...
posted by The Fake Doctor at 2:04 PM
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