Saying Goodbye to 2nd Year

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Many people have said that the second year of medical school is the hardest and most grueling year of all.  I’ve heard countless people tell stories of how busy, exhausting, and completely consuming 3rd year is, but it is always followed up by the statement, “But I’d take just about anything, including getting hit by bus, over 2nd year.”

To be completely honest, this was in fact one of the most challenging years of my life for reasons that extended far beyond the rigorous course work that we were faced with each and every day and the ever-looming presence of Step 1 (the exam that makes even other medical licensing exams cry themselves to sleep out of fear).

HOWEVER, I can honestly say that despite the challenges that we faced this year, I will look back on 2nd year with fond memories and a never stronger sense of the presence of God’s guiding hand in my life.  Let me take you through a quick whirlwind tour of what the end of this year was like and what made it so challenging, but I promise there’s a light at the end of the tunnel so keep reading!

From January on, the only thing that 2nd year medical students across America have on their minds is Step 1. This is the mother of all exams; it is 8 hours long and covers all of the content that we have learned in the first 2 years of medical school – anatomy, physiology, cell & molecular biology, immunology, behavioral science, biostatistics, preventive medicine, biochemistry, pharmacology, pathology, pathophysiology, psychiatry, and neurology.  Now this test wouldn’t be such a big deal if it didn’t have so much weight toward which field of medicine we will ultimately be able to enter.  It’s basically the MCAT of residencies and our scores will either make us eligible for competitive specialties like surgery, ophthalmology, radiology, or not.  The saddest part, in my opinion, is that students who may excel in those fields because of their clinical skills and passions may not have the chance to experience those professions because this exam holds so much weight in residency applications.  This was one of the things that I struggled with the most near the end of the year.  I watched countless classmates, who I know will be incredible healers struggle beneath the weight of the pressure that this exam places on students.  The tensions were certainly high and at times the morale was low, however, I can say that the silver lining through it all was learning to trust more in the fact that God has called us to this place to serve in a profession that he will placed us in.  If he has gotten us all this far, then surely he will see us through to the end.

Despite the challenges that we faced during 2nd year, I promised that there would be a light at the end of the tunnel.  Medical school is a process that is so much more than simply learning how to be a doctor; it is a process that challenges people at the very core of who they are and I can honestly say that I have enjoyed that challenge.  I’ve been stretched and forced to grow in ways that I could have never imagined.  I have been required to search for the true reasons why I chose to enter this profession.  I have made the best friends of my life because of the common struggles that we have faced together.  I have been inspired to grow in my walk with God.  I have learned more than I ever thought was possible.  And I have been humbled by the realization that I will never be able to learn everything there is to know about the workings of the human body.  Although the process has been challenging, frustrating, and seemingly impossible at times, I now stand on the other side of the first two years of medical school and can say with confidence that I wouldn’t change anything and would do it all over again in a heartbeat.

 

I would be remiss if I did not take a moment to thank the incredible people who helped make this year both meaningful and enjoyable!:

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My study buddies, Scott and Justin.  We met both years for 2 hours almost every night, 6 hours every Sunday, and ran through at least 45,000 flashcards – about 15,000 cards times a minimum of 3 repetitions. I couldn’t be more blessed or more thankful to have had them by my side through this journey.

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My fellow “Carrelers,” Keri, Krisalyn, Melissa, Stephen, James, David, Linden, Casey (not all of whom are in this picture). I spent my afternoons studying with these wonderful friends in the Study Carrels of Alumni Hall throughout 2nd year.  I have been continuously inspired by each and every one of them and have been spiritually and emotionally uplifted by each of their friendships.

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Dr. Werner, our famed professor of Pathophysiology and the Dean for Medical Student Education to whom we owe our gratitude for continuously inspiring us to never stop learning and to be the absolute best physicians we can possibly be.

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And my classmates, who I love with all my heart!  Coming to Loma Linda and joining these incredible, talented, brilliant, God-fearing, and all-around absolutely wonderful people was the best decision of my life!

I have a pager and a white coat with my name on it???

Kristina, Third Year Medical Student

First year – check. Second year – check. Step 1 – check. Orientation week – check. Tomorrow, with white coat on and pager in hand, I step onto the wards.

It’s both exciting and scary that these mile markers for medical school have passed already. For so many years I have been learning from behind a desk, and now it is time to actually do things.

As I look back on the last two years, it is pretty incredible to see how I’ve changed and been molded to face the changes of medical school. The experience has enabled me to get to know myself in a more raw and vulnerable way. I’ve discovered strengths and weaknesses that I didn’t realize during my college years. If this has only happened in the first two years, I cannot even begin to imagine the changes I will experience in the last two years!

With Step 1 (part one of three board exams that dot the path to becoming an MD) behind us, it’s so interesting to even see the changes my classmates went through in such intense stress. I saw some burning out, some are peaking just at the right time, some in a panic to get the highest score possible, and some at peace with just getting it over with. I realize that we have all come to this point in order to become physicians by mostly studying, studying, occasional OSCE…studying, studying, …and more studying. Yet this is one of the first mile markers of many that REALLY stays with us significantly into the future. I really try not to think of that too much as I wait for my score to arrive sometime in July.

Although it has been draining, I have gained some of the valuable things this year. One of the best things I have experienced is making new friendships and strengthening existing friendships like never before in my life. My friends that I have made in medical school are definitely ones that I will keep for the rest of my life. This is one thing that I have absolutely loved about second year of medical school. In college, I had a harder time getting and maintaining friendships. I’m not sure why. Maybe I spent too much time in the chemistry lab, or maybe I just wasn’t a friendly person! But this year, the hardships have made friendships stronger, and that is something that I will always treasure. Because it’s these friendships that get you through the rough times, and it’s these friendships that make the good times even MORE awesome.

Another thing I’ve really learned this year that has been VERY important for me to “turn off the chatter”. There are always people around you suggesting the newest and best resource for preparing for classes and step 1. The class nearly goes into a panic at the beginning of second year trying to find the best books and notes and flashcards and dropbox pdfs in order to succeed in classes/boards. Early on, I found that this kind of talk reallllly gets to my head. And even though I managed to turn the chatter off first year, I had to do it all over again second year. As a result, my days grew to be spent entirely at home with studying from 6am to 11am, working out, eating lunch, studying from 1pm-6pm (with an occasional 20 minute power nap thrown in), dinner break, then studying from 7pm till about 10pm. Repeat the next day. Yes, it did get a bit lonely at times, but I was MUCH more at peace and much more focused.

This past week we had orientation, which was…..interesting. We had a lot of lectures about smoking cessation, preventive medicine, ethics, and some about how to succeed on the wards. There were ups and downs in my attention span, I will admit.

Thursday night was the clinical commencement dinner for our class at Castaways restaurant. It was so awesome to see everyone in nice outfits, all done up for the occasion! But what I think I loved the most was seeing how relaxed everyone was. Seriously, I don’t think I’ve seen such relief on our faces in all my time here. Now, come our first presentation to our attendings in a few days, I don’t think that will be the case! But, I loved seeing so much happiness then.

The program consisted of a vocal rendition of “Let it go” by some of my classmates (Hans, Ben, Vincent, Jackson, Vanessa) and I along with an encouraging and educational speech given by Dr. Werner on how to succeed in third year (probably the most informative speech of all orientation week). It was an awesome evening of no studying, good food, awesome friends, and a gorgeous sunset.

So in short…third year starts tomorrow. Without a doubt, I am SO happy second year will be over and behind me. But about third year, I’m not going to even pretend like I know what is going to happen, because frankly, I have no idea! I’m sure I will miss the days that I could completely control my schedule and plan my fun activities around my studying. However, at the same time, I so appreciate the first two years of molding me into being a better doctor and a better friend. I have grown in my solitude of prayer and study this year, and now I’m ready to continue growing around patients, attendings, residents, and nurses.

And the saga continues…

Sincerely,

Kristina…now MS3

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My First Step

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The time has finally come.  There is only one thing on the mind of a second year medical student at this stage in his or her education: USMLE Step I.  Pop your head into any of the few Starbucks coffee shops around Loma Linda sometime this week and I guarantee you’ll see a couple wide-eyed, fear driven students feverishly scribbling in a giant binder or answering practice question #1,532 as the date of their test quickly approaches.

Rewind to about 3 1/2 weeks ago.  There I was sitting in my last lecture of MS2 as Dr. Werner finished up his epic course in pathophysiology by teaching us about complement disorders.  To be honest, my mind was on anything but the immune system.  Over the next two weeks, we would be spending our time taking test after test to wrap up the in-house portion of our medical education, after which we had 2-3 weeks “off” to finish preparing for Step I. It was going to take a lot of discipline and time management to juggle studying and just staying alive! Before I knew it, Dr. Werner was giving his last bits of advice, reassuring our abilities, and ending with a simple, “Well, have a good life!” And so it began. The beginning of the end of the beginning.

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The Very Last Lecture…

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Dr. Werner Gives Me a Good Sendoff

Flash forward to the present day.  This time around, I survived my in-house exams, and excelled! The relief (and realization that I was crazy enough to do 2nd year TWICE) was only short lived, as I knew I couldn’t celebrate a finish line until I had passed through the final gate of Step I. Onward and forward!

“Now hold on a minute Ryan,” you may be saying to yourself, “What exactly is Step 1?” For those of you who don’t know, the United States Medical Licensing Exam, or USMLE for short, is an intense, three part set of examinations that every MD student must pass in order to become a board-certified physician.  Step 1 is taken after the 2nd year of medical school, Step 2 is taken after your 3rd year of medical school, and Step 3 is taken after you have your intern year of residency (after being a doctor for a full year).

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A Typical Prometric Testing Center

As for Step 1 itself, it is an eight-hour, standardized exam that consists of seven 1-hour blocks of 46 questions, with one hour of break time that can be taken whenever the examinee so desires.  Along with clinical performance, interviews, and letters of recommendation, Step 1 is widely said to be one of the most important factors in determining where a medical student works after medical school.  Score too low and a lot residency programs won’t give you a second glance; score high enough and you will be considered a competitive candidate; what constitutes a “good” score depends on what specialty a medical student wants to pursue after medical school. It takes a score of 188 to pass, with most examinees scoring around a 225.  As you can see, there is a LOT riding on this exam.

I take Step 1 on May 29, so my time to review is growing shorter and shorter. Step 1 could throw anything from the basic medical sciences, from neurology to anatomy to pathology to pharmacology, etc etc etc.  If you think that sounds overwhelming, let me assure you, it is!  Because this test is so expansive, there are many different ways students can review for it.  The majority of medical students stick to one main resource, supplemented by other books that can help areas of deficiency.  Behold, First Aid:

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This 600+ page text attempts to take all the most commonly tested material (referred to over and over again as “high yield”) and squish it into one easy to read manual.  But even though it’s very accurate about what should be reviewed, most students choose to supplement their studies with additional resources, just to be thorough.  Other resources I am using include a pathology review text called “Pathoma,” the USMLE World Question Bank, an online course called “Doctors In Training,” and official NBME practice exams.  After I take Step 1, I’ll let you other medical students who may be reading know how well, and hopefully not how poorly, these resources prepared me for Step 1!

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An Afternoon of Studying At Starbucks

So as the seconds count down to facing off against this monster of a test, I have been trying to maintain a fairly regular schedule. I’ve been waking up at around the same time every morning, I’ll spend a couple hours doing my online review course, then I’ll do a block of 46 practice questions, review those, go back over my day’s work, go to sleep, rinse and repeat! It’s pretty rigorous work trying to hit all the high points before Step 1, but as my practice exam scores have shown, review is going well so far, and my biggest challenge will be to avoid burning out.  Only 8 days left to go!

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Study, Study, Study…

In other news, Loma Linda was recently visited by a representative of the Be the Match bone marrow donation program.  As you probably already know, Be the Match maintains a registry of people who could be used as possible donors to those in need of a transplant.  The need of these patients is highly specific, so only a perfect matching donor can safely donate his or her marrow.  Most who join the registry never match with someone, or if they do it is usually 10-15 years after they have joined. Well to make a long story short, I joined the registry along with a couple of my classmates, and after having been listed as a donor for less than a month, I have already matched with a patient!  My blood was drawn for confirmatory testing to ensure that I am indeed the best match, and if all goes well, I could help out a 71-year-old male with myelodysplastic syndrome! I can’t believe how fast it happened and am feeling incredibly honored that I have the ability to donate for someone.

Ok, back to it! See you on the other side!

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My Upgraded White Coat Awaits…

Step 1: One more point.

Ryan, MD/MA Bioethics Student

May is that time where everyone is furiously studying…except for the seniors…  Of note is the proximity of USMLE Step 1, arguably the single most important test in medical education.  For those unfamiliar with USMLE, Step 1 is one of three all-day written exams necessary for licensure in the US.  Step 1 covers comprehensive basic sciences, and is taken at the end of sophomore year.  So for those who are studying for Step 1 or any other exam in any other school, I’d like to offer a bit of encouragement in the form of a personal story.

First, the moral:  every bit of studying counts.

Some of the more competitive residency programs have a threshold Step 1 score (this is a screening method, because they’re competitive and they can).  This threshold varies between institutions.  In researching orthopedic residencies, I recently found out that I’m one point shy.  Just one point too low to even apply to a few certain residency programs.  Sure, I can apply to many others, but it hurts to feel excluded like that, knowing that it’s only my fault.  But would studying a bit more have even made a difference?  In my case, yes.
Step 1 doesn’t have a one-to-one correlation between points and questions, but it’s very close.  There was one fact that I had memorized wrong during that unit in lecture, and I kept getting it incorrect on my USMLE World question bank.  I just didn’t restudy it with enough focus.  Low and behold, that same question (nearly verbatim) showed up on Step 1.  Go figure, I got it incorrect.  What bad luck.  It was the one question I looked up when I got home (don’t do that, by the way).  In the words of my hockey coach when I messed up, “You just didn’t want it bad enough, huh?”  It’s not that I didn’t want it.  I just didn’t do it.
Many people get the post-test regrets of “I wish I had studied just a bit more.”  Instead of a vague feeling, I have a discrete example of why that’s true.  I hope this little anecdote isn’t discouraging (as it was to me as I experienced it).  It would be easy to say “I’m going to make mistakes no matter how much I study,” or “comprehensive over two years? or “last-minute studying will make a difference.”  And I can’t stop you from drawing that conclusion.  In this case, Dr. Werner was correct:  you’re just as likely to get a question from the last lecture of sophomore year as from the first lecture of freshman year.  However, the point of this story is to give you that extra push, that resolution to keep at it when you’re already exhausted.
So keep studying, because every point matters.  Hopefully you won’t learn that the hard way.

My Family Tree

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Babienco. Though I proudly claim the US as my home, I’ve often been asked about my surname’s country of origin.  To be honest, it’s not something I had thought about that much, as Babienco is just a surname, something I’ve carried around my whole life. Even though I’ve been told my last name sounds rather Ukrainian, I’ve often joked about it being Italian (while pronouncing my last name with a Super Mario accent). This all changed about two weeks ago, when I made a surprising discovery that lead me to a deeper understanding of my heritage.

The other night, Brianna and I thought it would be fun to “google” my last name and see if I shared any relation with her dad’s friend from dental school, who shared the same last name as I. Babienco isn’t a common surname like “Smith” or “Brown” so we wondered if there could be any connection. I’ve googled my name before, but this time something I had never seen before popped up. We followed a link to a webpage featuring a picture from the Loma Linda University Digital Archive:

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The caption read “Axentie T. Babienco Studying in his Library.” Below was another description that said “Loma Linda University School of Medicine, class of 1929.” Brianna asked if I had ever heard of an Axentie T. Babienco before, to which I replied I hadn’t.  Our curiosity growing, we sent a message to my dad who promptly replied, “Axentie is my dad’s dad. He practiced in San Diego where my dad grew up.”

I was shocked! Almost 85 years ago, my great-grandfather had graduated with his MD from the very school I now attend! This whole time, I thought I was the very first in my family to go into medicine.  But in reality, not only do I have a direct ascendant that practiced medicine, but someone who attended Loma Linda University! Without any clue, I have been continuing a journey started by my great-grandfather.

Not only that, but I guess my great-grandmother, Lucille Babienco, continued to live in Loma Linda until she died in 1992.  She was buried in Montecito Memorial Park, only a few minutes from where I currently live.  I’ve been so close this entire time and had no idea!

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These discoveries naturally led to other questions about my family history. My dad forwarded me some documents that tell the story of how the name Babienco came to America from Ukraine in the late 1800’s.  I won’t go into too much detail now as I could go on for hours and hours about my great-great-grandfather’s imprisonment and exile for trying to preach Adventism, and how he was smuggled into Romania and then Canada to have the ability to practice more religious freedom. It is quite the story so you should ask me about it sometime! 😉

For now I am just incredibly honored to continue a legacy of Babienco’s at Loma Linda University (turns out Axentie’s younger brother Allorie Babienco also graduated from LLUSM), even though I am just now discovering one even exists! I hope that doesn’t sound elitist or arrogant or anything, but I hope you can imagine the surprised look on my face when I discovered my dream of practicing medicine isn’t as unique as I once thought it was. Pretty cool if you ask me!

Speaking of dreams, my class and I share this common dream of acing a little exam we have coming in less than 60 days… USMLE Step I is just around the corner! I’m not sure if I ever explained the “joy” that is Step I, so stay tuned for a future blog post that highlights a not-so-little exam every med student must pass on his or her way to earning a degree!

Before I go, here’s some completely unrelated pictures from a random trip Brianna and I took to Arizona the weekend before last.  She felt bad I would not be getting a real spring break this year (I spent it doing a Step I review course), so she was only the best wife ever and took me to see my favorite baseball team play a spring training game or two:

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Go Reds!

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Surprise Stadium, AZ

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Getting Autographs! Matt Latos Signs My Baseball.

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Brianna Waits for Brandon Philips

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So Cool!

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Great Seats at Goodyear Ballpark

59 days to USMLE Step I!