Exam done. What next?

So..... The big exam is done.

On the bright side, one of the hardest exams in my medical training is over.
On the dark side so to speak, it was probably the easiest thing out of the whole 'let's get the residency in US' malarky.

Onwards and upwards as they say!

One month exactly.

What a week! To summarise the excitement of the past week in few words: phone stolen, new phone bought, project finished, deadline missed, rent paid and new attachment started.

It will never happen to me. A common school of thought of many individuals, myself included, until that something actually happens that is. I never thought that my phone will ever get stolen, not because I am some sort of special munchkin, it is just that kind of things that happens just to other people, right? Well, reality check is not pleasant. My phone was stolen out of my bag at a tube station. A significant chunk of my life just gone in less than few seconds. One does not realise the full impact of dependency on something until that something is withdrawn. I don't remember the time when I felt so at loss, cut out of the modern world in moments feeling rather powerless. Thankfully, the modern world is at ease with Internet, and on the other hand things are not that bad.

Exactly 1 month to go. One month is such a variable quantity! It could drag on forever when you are away from a loved one, or it can zoom by when there is a nasty exam awaits at the end. Why can't we switch the perception? Dragging on during revision and zooming past in separation? A wishful thinking.

Lying here on my comfortable bed, cozily curled up under the duvet listening to a calm sleepy breathing of my loved one. I wish could freeze this moment. Time, stop! Give me a break from this endless race!

'Oops! How did that happen?' Days off revision.

Oh dear.. Somehow I just took 2 days off revision. Realizing such fact evokes surreal feelings, somewhat like 'Oops! How did that happen?'. It was the end of my orthopedic attachment on Friday, a much longed for end of the orthopedic attachment, which warranted an evening off. The evening off has lead to a late night, the late night has lead to a late morning and a caffeine withdrawal headache, which in turn has lead to becoming human by about 4pm in the afternoon and then it was time to cook dinner.

I am afraid to even look at my schedule.

How to stay awake (or at least try to).

It is somewhere in the middle of the night, only the lonely traveller is rushing to the safety of the old travel-lodge that sleepily blinks into the night. There is only a medical student sitting at the table, leant over the thick books revising for exams. Or something like that.

How do you stay awake during the nth hour of revision in that long long night? A search engine presents the standard selection of articles with advice to 'get plenty of sleep', 'exercise' and 'eat a healthy diet'. That is all great, however if I had time to get plenty of sleep as they advise, I wouldn't bring up the question in the first place.

If to steer clear of prescription medication, here are few techniques to support some sort of brain activity during long revision hours that work for me.

Coffee: a staple drink and it does work. A good bold roast of freshly ground coffee is not only a much needed crutch but also a legitimate 15 minutes break in the long stretch of reading, writing and memorizing.

Caffeine tablets: if a standard mug of dark roast no longer works, one can try caffeine tablets. However it is rather easy to take a bigger than optimal dose, and instead of enthusiastic revision to spend the night in cold sweat on the bed feeling queasy. Not exactly the result one aims for.

Water: drinking as much of cold water as possible. It actually works, one feels more awake, either because the well hydrated brain thinks better or the frequent bathroom trips make it impossible to sleep.

Breaks: taking a 15 minute break every 1.5 hours improves the concentration. If to believe memory curves, we memorize material better at the start and at the end of the study session, which is not the case for the material covered in the mid-session. Hence it follows if we minimize the 'middle' bit of the revision  at any one time we will retain more material. I want to think this is true.

Questions, questions, questions.

Right, on the home stretch with Pharmacology. Last 15 chapters of lectures, followed by an overview of notes, and then it is questions-here-I-come. Starting to feel the strain of revision now, especially after tucking into the question bank for the first time. Realizing that all of microbiology has to be read over was not the brightest point in my day, especially when it adds on to an already substantial workload.

Second and third order questions are mind bending. It is not enough to just recognize that something they are talking about in the stem, but also know rather detailed background information on that something. After starting the question bank, one gets this sinking feeling that the optimal knowledge level is a long way ahead and the exam date is approaching terrifyingly fast.

Back to books, spore forming bacteria, oh how I missed you from my microbiology review days..

Doubts

The day is getting closer and closer, and just like a knee with damaged ligaments, the confidence gives way more and more frequently. Is it humanly possible to memorize all this information on a part time revision schedule? More personally, do I have the energy and intelligence to get the top mark? Positive thinking and motivational quotations tell one to think positive, 'you are the best', 'you can do this' and so on, but do they change the reality or do they just make one delusional about own abilities? 

Studying part time for Step 1 is tough. The whole concept of personal life does not exist, revision takes over the world for the 9 weeks in the run up to the exams. Everything becomes about time management and time efficiency. All of a sudden other previously insignificant time wasters become magnified to gigantic parameters. Tutorial running at a slower pace, a patient late for the clinic, people walking slowly and blocking the pavement, train delays... all of these things suddenly become an unacceptable hinderance to one's day. 

Th big question is: are all the very best efforts enough?