All pain, some gain || CPRH || Term 5 SGU
I’m studying health coaching which is a mix of psychology/motivational interviewing and education about nutrition. It always has me comparing my experiences. Especially in how medical school, it’s almost the culture of passing the course has to come at any cost necessary (usually at the cost of my own health).
I’m grateful to set aside dedicated time to check-in. Am I exercising enough, or eating well, or having time to be present? It’s so easy to forget to live in medical school. I could just put my head down and lose 5 years. Anyways, my confession. CPRH was incredibly stressful, so I developed acne, gained 5 pounds, and started losing my hair. I’m going to tell you my fitness goals, so you all can be my accountability buddies. My fitness goals for this upcoming module will be to (1) drink three 24 oz water bottles a day (2) Exercise 4 times a week (3) Meditate 5 times a week. Hopefully, my health will return with good habits.
It’s never a good time to have a life
I had the honor to be a part of a bridal party for the first time! It was amazing to support my friend. Many attendings who finally cross that finish line - got through medical school, through residency, and found a career. They’re there. Where we all dream of standing. But they describe a feeling of uncertainty about who they are without studying medicine. There’s finally that chance to look back and realize how many weddings you missed or the pieces of your personality you forfeited. I hope that’s never me. So my solution? Play more board games on the weekends! But really, I hope to remember to live my life because no one else will do this task.
My forever study buddy
SGU TERM 5 CPRH:
CPRH in general
The Cardiology, Pulmonology, Renal, and Hematology (CPRH) module was 4 weeks of heck. Right off the bat, we took off. There was no orientation. I felt we sure did need orienting to what the heck the rest of the term would be like since technically the majority of the time we’re not inputting new knowledge - rather just expanding (remembering for me) what we do know.
My CPRH schedule
Remember last time we talked and I said my schedule isn’t super chaotic? Well turns out it was a MNI thing. CPRH was full of busy work and distractions. It felt so familiar. How a module can slip right through my hands.
I tried to keep my schedule as consistent as possible. In the mornings I tried to dedicate myself to things that would get me going first like exercise and taking care of my pups. Then a bit of anki to keep those review numbers down and practice questions. I ended up experimenting with USMLE-rx questions and pastest questions. Both are given by SGU. I would do about 20-30 questions and review them by taking notes in FA or putting my incorrect into a filtered Anki deck.
I continued to use Grace/Firehouse Prep’s schedule. However, the schedules are different now. We had an option of “Questions pathway” or Video pathway”. Basically, a hardcore schedule to go through Boards & Beyond and/or question banks before Term 5 is over. I really struggled. It was an insane amount of things to watch. Especially since I hadn’t watched most of the B&B videos before (I wish I had).
On a personal note, I realized during the last week of the module that I’m more suited to the Questions pathway, though Grace recommended most people do the Video pathway to build a better foundation. I found that I ended up watching all the videos anyways because my foundation needed some work. It was also helpful and more satisfying to convert her schedule into checkboxes - for all those to-do list fans out there.
CPRH Content
CPRH in retrospect feels in line with CPR. It was a bit traumatic because it was a transition from MNI (back with CPR it was from FTMC), definitely a lot of content, and really with cardio you can go anywhere in the body.
The shift in mindset is really something to be cautious of. Looking back to Term 4, the expectations of what to learn and study were more predictable. At the time, it really didn’t seem like that but here everything is fair game. What they taught us back in Term 1 or Term 2, what random tidbits they throw in now, even what they haven’t talked about but is mentioned in other resources like USMLE-rx. On a side note, micro and pharm seem to be a little off to the side - more like easy bonus points. The pathophys especially anything that’s got relationship arrows seems to be a fun pain point. It was really hard to hit my stride with cardio being very hard for me and not knowing really how to approach it.
The best compromise and trend I’ve seen from different study schedules is to go back to Boards and Beyond for normal anatomy and physiology, follow it with pathoma and sketchy for memory hooks. And then really invest time in doing practice questions every day to work out what you’ve been putting in. It’s really the only way you can tell if the info is going in, can you access it, can you use it, and see if you can integrate it. I don’t think it matters too much which question bank you use at this point.
Hospital Sessions
I was nervous for the “hospital sessions” to start especially with the set time to be 5AM on the west coast. Traditionally, term 5 students rotate at the local hospital. That sounds super exciting. I used to be a scribe and I could see how advantageous an experience like that can be for next year when we start clinicals. Despite COVID, I know a fair amount of people who moved back to the island for a chance to do this. Sadly just like how we were a week away from doing wet lab, the week before the sessions were to start they were canceled.
For two weeks, they attempted to give us an experience of some sorts. The first session was like watching a car crash in slow motion. When the online group was let into the zoom call, our camera view was placed looking down on a room where the facilitator, the 3-4 onsite students, and a real patient - which we did not know right away were hanging out! We planned to divide the work by having the online students interview the patient - cue horrific slow-motion car crash noises. The camera was so far, we could not hear the patient. We couldn’t even elicit the purpose of the visit. It was a painful 2-3 or so hours. The second visit went much better but unfortunately for the onsite students, we were all online.
Our facilitator was very interactive. It was both anxiety-producing and exciting because the facilitator was just calling people right and left quizzing us. Even for the physical exam, she would bring the camera to the area of the patient we were inspecting. Also, they recorded the breath sounds and heart sounds from the patient! I appreciated the creativity. However, just like that they canceled them and said they have something different planned for us after CPRH.
PCA: We’re still writing essays here?
Can you believe it? I was attending a wedding and met a DO med student. When I described the essay and how it was basically the same day as the exam, she seemed very confused. Yup.
Anyways, the PCA (Patient Care Assignments) felt like a distraction. In theory, you write a SOAP note + a reflective essay (what did you learn, what do you still need to learn, a tieback into academic research) on a case you experienced in hospital rounds. Because of COVID, we had the choice to do our PCA on the 1-2 “hospital experiences” or use the Kaplan iHuman cases. I actually didn’t mind using iHuman. It’s clunky but got some good explanations that helped with writing it. I spent maybe between 1-2 hours using iHuman and writing it.
Exams
CPRH Final
It hurt. It was one of those exams that you close your laptop and accept defeat. I knew the results were going to be horrendous, but the question is repeating Term 5 difficult? Maybe. I swear I panicked and reached out to every available tutor to help me move forward. It really seems like the SGU exams and diverging quite far from being representative to STEP. It’s really disappointing, I was hoping that I could use this time as a pre-dedicated.
Everyone I talked to about the exam seemed to feel similarly about the test. However, I think the couple I talked to who strictly only use lecture materials felt it was difficult but not start-picturing-your-life-repeating-term-5 challenging. I think that’s fair. If you study to do well at SGU exams, hopefully, that’s what you’ll achieve. However, I realized this module that I’ve gotten really good at taking SGU exams without truly understanding conditions and that will definitely wreck me in STEP prep.
We received our scores and I live to fight another day! Something to note is that the curve was ~17% so take that how you will.
Team OCEX
We have 3 OCEX activities scheduled for this term. The first one we completed and the last one we will do are individual. This one was a team effort. Unlike the SOAP assessments from Term 4, we were surprisingly judged on the interview itself. Though it’s only a handful of points, it might be advantageous to put people in roles who you can trust will get the job done.
Outside Resources for CPRH
Of course, Boards and Beyond is amazing for anatomy and physiology. Follow it with Pathoma and Sketchy + M1M2 Anki.
I have to say Anki is a little different. M1M2 doesn’t have corresponding lecture tags because the lectures are now case-based. I tried to do the most with Anki by adding all the cards for each resource tag. For example, after I watch the Sketchy path for hypertension then I add all the cards for that video. However, when using Grace’s schedule, that’s a lot of cards. She recommended having mainly a filtered deck based on the incorrect you get during questions. I felt like my foundations were so poor that I need more than that. The compromise I came up with was looking through the cards and adding the ones I needed. Time-consuming, but less consuming than adding all those cards.
Question Banks
After some anxiety in the class about when we would get USMLE-rx. They are releasing multiple (so many) quizzes every week ranging from 40-70 questions. We only have to attempt 50% of the questions. It’s a little overwhelming how many quizzes they are releasing.
Uworld! We also got the uworld subscription. I can’t decide if I’m going to use it or save it for dedication. I’m intimidated to even activate it, that’s for sure.
Honorable Mentions:
First Step USMLE reviews: I paid the $90 for a weekend review. I think the reviews were interactive and helpful. They give you the slides to review after too. However, I felt the weekend reviews were too broad. They do have group tutoring services. They were very kind and invited me to sit on a session before committing. Though it didn’t work out, they were very kind and understanding.
Ninja Nerd EKG: Wow! Ninja Nerd has come out with pretty cool content since I started medical school. This one is particularly helpful since EKGs and imaging (not covered in this one) come back with a vengeance.
What I would do differently
Find a study group or a tutor! If you’re weak in these subjects like me, it would have been helpful to have someone to help me keep up with the content. Not only that but like Grace suggested having someone to talk/teachback concepts every day would have been helpful. Or even to do questions with.
Review lectures more. Not in the sense of attending or watching, but look through the slides more to catch what SGU-isms are going on.
Anyways so glad to be done with this module! Onto GOER!
Warmly, Rainee
See you in a couple of weeks!