MINT OREO CHOCOLATE CHIP COOKIES (AKA THE WAY TO WIN OVER ANY PERSON)

So I once had an unusually weird internal med rotation where I felt like I couldn't connect with any of the residents or attendings so I decided to use my ultimate weapon to impress- these cookies. They may not know my name when they pass me in the hospital but they all remember me as the girl who brought in "those cookies." I SWEAR by these cookies.

They may look weird but if you seriously want to impress, make these cookies for your preceptor, residents, nurses, or that cutie you've been eyeing (LOL).

I modified this recipe from Lovintheoven.com. So here we go:


Mint Oreo Chocolate Chip Cookies

Makes: A LOT OF COOKIES. Probably around 30ish.

Parchment paper
2 sticks of softened butter

3/4 cup sugar
3/4 cup brown sugar
2 eggs
2 teaspoon vanilla
2 1/2 cup all-purpose flour
1 teaspoon baking soda
1 teaspoon salt
18 frozen sliced pieces of Mint Oreo Cookies
1.5-2 cups chocolate chips (preferably dark or semi-sweet) depending on your taste

Preparation:

1. Let the butter come to room temperature. I'd suggest taking the butter out of the fridge about an hour before baking. 

2. Put the Oreo cookies in the freezer at least half an hour before baking.

Instructions:
1. Preheat oven to 325 degrees F. Take the oreos out of the freezer, and slice them (gently) into sixths. Discard any small crumbs (nom nom!) because crumbs will make your cookie a grayish tint.

2. Cream butter and sugars until well combined in a large bowl. Do not over-beat if using a hand mixer. Add eggs and vanilla until well mixed.

3. Place flour, baking soda and salt into a bowl and stir (preferably with a whisk) to combine. Slowly add dry ingredients to wet ingredients (in thirds) and stir in oreos and chocolate chips until just combined careful enough not to break the oreos. 

4. Scoop about half a golfball-size piece of dough onto a baking sheet lined with parchment paper. Place dough in freezer for 3-4 minutes. Bake for 9-10 minutes until slightly golden brown on the sides. *The cookies should look and feel like they're underbaked. Let cool on baking sheet for 5 minutes before transferring to cooling rack (if you can resist it!).

And that's it! Hope you guys win over some hearts :)

Amanda

MY STEP 1 STUDY PLAN

I have to admit, I have been putting off this particular blog for awhile for more reasons than I can name but mostly because I wasn't sure if I wanted to influence what people did for one of the most important tests you could ever take. I have decided to detail what I did for my boards and hope that you guys take everything with a grain of salt and develop a plan that suits your learning style.

Background: I did fairly decent on class exams but I am not naturally a good test taker (I.e. I have to work quite a bit to maintain my grades). Knowing that this would be a struggle, I gathered the resources I found the most helpful during classes and utilized them during boards.

An Overview of Medical School Boards:

• MD's take the USMLE. DO's have to take COMLEX but can also take USMLE. 
• These exams take place following the 2nd year of medical school
• Both exams are roughly 8 hours long and arguably the most important exam in determining which specialties you can/cannot do
• If you pass, you cannot retake the exam for a higher score. If you fail, you may retake it depending on your school's policies

Studying during class/months before boards
I did minor studying the months before board exam time because I wanted to really focus on class material. I still believe that learning class material is going to benefit you more than sitting and doing 100s of questions 6 months out from the exam. I do suggest doing some questions daily but on the subjects you are currently studying in class.

Definitely utilize Pathoma and Sketchy throughout your classwork so you can familiarize yourself with the resources come board time.

****** BUT FIRST. Download my Sketchy Medical and Pathoma checklists!

Resources I used:

• Doctors in Training (DIT): 240+ videos that walk you through First Aid for USMLE
• Sketchy Medical (Pharm and Micro): AMAZING and helped me score in the 90+ percentile in pharm and micro
• Pathoma: absolutely a must and I can guarantee you this is all you need for pathology
• First Aid for USMLE 2016: the bible for Step 1
• Question banks: UWorld and COMBANK

Alotted time for studying: approximately 60 days (beginning of April to June 10th). My USMLE test date was June 4th and my COMLEX was June 10th

Daily schedule (subjected to change depending on my feels that day)

• 8am: wake up, eat breakfast, pack lunch and dinner
• 8:30am-10am: take a 50 question exam on either UWorld or COMBANK
• Break
• 10:30a-1pm: go over questions and summaries
• Lunch
• 2pm-7pm: watch 7-8 DIT videos and any correlated Pathoma or Sketchy videos 
• Workout
• Dinner
• 8pm-10:30pm: review material from the day

There were a total of 240 DIT videos and I finished them 2.5-3 weeks out from my test dates. After I finished them, I upped my questions to 75-125 a day. See below for specifics.

Utilizing Doctors in Training
I don't believe you need this to succeed on the exam. I used it as a tool to walk me through First Aid for USMLE because it explains it page by page using mnemonics and visual aids. I realized early that I can't memorize by reading so watching these videos helped me a lot with getting concepts down.

Tip: when it comes to the pathology, micro, or pharm videos, I ended up opting to watch Pathoma, Sketchy Micro, and Sketchy Pharm in place of these because I knew I would learn better through these resources. I would then watch the DIT videos on these subjects on 2x speed to make sure I didn't miss out on any cool mnemonics.

Daily Practice Questions and Review
At the beginning, I did 50 random, timed questions in the morning (alternating between UWorld and COMBANK) and spent 2-3 hours reviewing them with First Aid. I upped these to 75-125 questions a day. Initially, I used an Excel sheet to type up my questions but this took entirely way too long. I ended up solely taking notes in my First Aid and Sketchy Micro/Pharm book. Ideally you don't want to spend too much time on reviewing questions and this is something I wish I could've realized earlier. But do make sure you are reviewing them adequately!

I did half of UWorld and completed all of COMBANK (a total of 3000+ question)

Full Length Practice Exams
Our school requires you to pass a practice COMSAE (a practice COMLEX) in order to sit for the real boards. We took this one month out from my real exam. These practice exams are only half the questions of a real test (i.e. 200 questions). Timeline for when I took practice exams

• 5.5 weeks prior to COMLEX
• 4 weeks prior to COMLEX
• 2 weeks prior to COMLEX

I took two practice USMLE's at some point but I don't recall when.

Why I didn't end up taking the USMLE
I studied for the USMLE up until two weeks from my exam. Although I was passing, I was not happy with my practice scores and really weighed my options at that point. I consulted several third year students on what to do and the majority suggested I try doing really well on one exam instead of doing mediocre on two. I also had the misfortune of dealing with a breakup during this time so ultimately I decided to devote the rest of my time to COMLEX. I have no regrets at all about this decision.

USMLE vs. COMLEX
See my friend's blog post about this here because he does a heck of a job better than me! I believe that if you get down micro, pharm, physiology, and pathology, you will do well on both of these exams.

The day before the exam
I had to travel a bit to my testing site but I laid in my hotel bed with ice cream, Nerds rope, nail polish, and Netflix the day before my exam and I don't think I could've been more relaxed! I ended up sleeping 9+ hours the night before and was well-rested. The only things I looked at the day before was my Sketchy book and OMT viscerosomatic levels and Chapman points.

Test Day

• If you have to travel to your test site and staying at a hotel the night before, check out your test site location the night prior so you know where it is
• Arrive early, you will have to go through security and identification measures. Sometimes they will allow you to start early
• Wear comfortable clothes. I wore leggings and a zip up sweater with my hair tied up so it wouldn't get in the way
• Bring snacks and a lunch that won't spoil if it sits around (although many people lose their appetite!)
• Bring water, Advil, and a caffeinated beverage if you need it! Also if you're like me, take your allergy medications
• Make sure you are looking at the clock often to keep pace 
• Take your mandatory lunch break to cool down and refuel
• Treat yoself after the exam (for me a nice alcoholic beverage ;)

So how did I do?
Initially I was surprised and then sad and then happy about my score. I fell a little short of my goal and although I won't say my exact score, I am still competitive in the specialties I want (emergency medicine and general surgery).

My opinion on the COMLEX
I honestly felt that the exam did not do a very good job of testing what I knew. I walked out of the exam feeling like I could have taken it 3 weeks prior and gotten the same score. I believe that learning how to take the exam was more beneficial than actually studying material for the exam. So if I could provide one huge advice: practice questions practice questions practice questions!

The topics I found easiest to answer were pharm and micro because simply, there are only so many ways you can ask questions about these. The dean at our school gave us a chart in the beginning that showed a higher correlation between a good score and pharm, micro, and physiology. I think this is very true for COMLEX.

Some tricks, tips, and myths

• Board studying is truly a marathon and you will find yourself getting frustrated but it is better to take the day off to cool down and go 100% the next day. There were many days I would spend 12+ hours in one seat and forced myself to get up and exercise because I knew I was hitting a wall.
• Exercise as much as you can
• Not only will it allow you to take a break, it will also boost your energy and clear your mind. I watched a lot of Pathoma and Sketchy while walking on the treadmill.
• Always get adequate sleep
• It is not worth getting 5 hours a night if you can't concentrate the next day. I consistently slept 7 hours a night during board studying.
• "My friend scored in the 99th percentile and said they did _____"
• You are going to hear so many tips from people once boards rolls around but ideally you want to get advice from someone who tests similarly to you. Ask how they did in class because it might not be ideal to take advice from someone who has a photographic memory or tests differently. 
• How many resources should I use? 
• The less the better, typically. Do what you feel is comfortable because it can be overwhelming how many resources there are
• Give yourself a half day to a day of "catch up" time a week
• Just in case you fall behind on studying or to do weekly chores
• Crockpot meals are your best friend during boards haha
• Take plenty of timed tests
• The COMLEX in particular has a weird timing system where you take the first 200 questions within a 4 hour time slot and you have to pace yourself the entire time. I would recommend finishing the first block of 50 questions in 50 minutes and giving yourself the last 10 minutes to review your marked questions
• Take the day off the day before your exam and give yourself some "me" time! 

Woof, that was quite the blog post! Let me know below if you have any other questions!

Amanda

GUEST BLOGGER: STEP 1 USMLE/COMLEX STUDY PLAN

I am fortunate enough to have friends/classmates that are willing to share their study plans with you guys. While my classmate wants to remain anonymous, he did extremely well on Step 1 for USMLE and COMLEX. This will give all of you osteopathic medical students an insight on how a DO student was able to balance both exams!

B is a current third year medical student in the top quartile of his class. He began studying for boards January of the test year doing DIT Primers and COMBANK questions.

---

Boards are the time of year that everyone gets equally stressed out about the future of their careers. You’ve been studying hard for the entire first two years of medical school then it all comes down to this one or in my case two (USMLE and COMLEX) daunting exams. The exams are so hyped up mainly because they play a major role in the determination of the specialty you want to do which these exams were never intended to do, but with increased competition between specialties programs need a way to objectively determine the differences between prospective candidates. The most important thing to remember while board studying is that it is a marathon and not a sprint, burning out in the torturous 6-8 weeks of constant studying is real scenario. People will try to tell you what is the best method to study, but at the end of the day they aren’t you and likely learn different it is important to go at the speed you deem necessary to master the material.

Resources I used:

• Doctors in Training Step 1
• 2016 First Aid for USMLE Step 1
• Sketchy Medical (I used both Pharm and Micro, but did not like Pharm as well.)
• Pathoma
• UWorld and COMBANK Question banks

Time for studying: Approximately 60 days of hardcore board studying April 1^st – June 1^st (USMLE) and June 9^th (COMLEX).

Daily Schedule:

• 7:30am-9:30am: 40 Uworld question sets/review.
• 9:30am: Start DIT daily videos (I was on pace to finish in 27 days, I think that was 9 videos a day.)
• 12:30pm: Lunch
• 1pm-2pm: Gym session
• 2pm-4pm: Finish up DIT videos of the day
• 4-6pm: Pathoma Videos/Sketchy Micro videos
• 6-8pm: Read chapters or sections that I struggled on with questions that day.
• 8-9:30pm: Combank Questions

After I completed the DIT videos with about 3 weeks left of studying. I would complete the DIT videos on 1.5x or 2x and read chapters in First Aid that I was struggling in. I think this final push helped with the small details that I missed the first time through. I also completed 4 NBME practice tests 1.5months, 1 month, 2 weeks, and 1 week from my exam date.

About the exams themselves:

I was asked to talk a little bit about the differences between COMLEX and USMLE so I will do that now. The major difference between the USMLE and COMLEX is the level of detail. USMLE is very detail oriented, knowing the specific enzyme, pathophysiologic pathway, knowing exact mechanism of action of drugs, etc. Not to say that the COMLEX does not want this material, they do, but the USMLE takes it a step further most of the time. This took a lot of practice to master, but I feel as though Uworld did a great job replicating test questions and prepared me well. Overall, I thought the USMLE was a much better exam. The questions were clear in what they were asking and most of the time there was a clear correct answer choice. Compared to the COMLEX the USMLE questions are written better, the test layout with 270 questions and breaks is much better than 400 questions with no little to no breaks, and the video media/exhibits is much more user friendly with USMLE.

COMLEX was a very random test it felt like many of the questions were out of left field and I felt as though I could’ve studied for 6 more months and gotten the same score. It is essential to know the OPP material like the back of your hand, the questions are difficult and unlike anyway they have been presented on COMBANK and in the first 2 years of studying.

My goal for these exams was 240/650, USMLE and COMLEX respectively. I beat one goal and fell a little short on the other, but at the end of the day I was happy with what I had accomplished and glad it was over.

If I could redo: The one regret I do have is that I should have completed at least one more COMLEX practice test(COMSAE), I completed the one given to us by our school in which I did very well on it one month out from test day. At that point I focused most of my studying on to getting better at the USMLE, when I did this I kind of let some COMLEX material slip through the wayside. In the week I had between USMLE and COMLEX I should have taken one more practice test. 

Bottom line: I personally would recommend taking the USMLE as it gives DO students more options for residency and with the ongoing merger it can only help in my opinion. However, it is important to pass and if you are not confident in yourself you can always cancel the exam.

WHATEVER YOU’RE GOALS ARE FOR BOARDS MAKE SURE TO TAKE A FEW HOURS EVERY WEEK TO ENJOY THINGS YOU LIKE TO DO. HAPPINESS GOES A LONG WAY IN KEEPING MOTIVATION TO COMPLETE THIS JOURNEY!

This is just my two sense and at the end of the day you may not agree with what I said on this at all, but if I helped out any or there is more content that you would like feel free to ask.

MY THIRD YEAR EXPERIENCE: PEDIATRICS

Today's blog will feature my experience in Pediatrics.

Length of Rotation: 4 weeks
Location: Pediatric/internal medicine outpatient clinic. Sometimes at the hospital for newborns.
Environment: 2 doctors, 2 nurse practitioners, 4-6 nurses. I worked with one doctor but if the other providers had children to see, I would work with them (because babieees). I saw from 5-8 pediatric patients a day.
Attire: business casual/professional. I wore blouses with dress capris and loved my comfy Payless Shoes everyday.
Types of Patients: newborns to 16 years of age. Well child and acute visits.
Schedule Type: Routine Monday-Friday from 8:30am to 5pm

Things that were expected of me:

• Take history and do physicals on well child visits. These were different from other rotations because certain ages have a "Bright Futures" form that has certain milestones, vaccinations, etc. that you need to complete. Also, most of history taking was done through the parent instead of the patient.
• Memorize developmental milestones and vaccination schedules
• How to calculate pediatric dosages for medications
• Write SOAP notes on the EHR
• Know the most common causes of ear infections, colds, rashes, abdominal pain, etc. and how to treat it

What it was like daily: 

• 8:15am: arrive to clinic and peek at the EHR for pediatric visits
• 8:30am to noon: see pediatric patients. 
• Lunch time! Thank goodness for drug reps that bring food during most days!
• 1 to 5pm: see more patients!
• I studied in between patients but when I got home I would watch one Online Med Ed video a day and do several Med U Cases.

What I learned: Babies are cute, especially the 4 month chubby ones! But in all seriousness, I learned that you really need to know your milestones and vaccination schedule. I was often pimped at certain visits on what vaccinations the patient needs and what milestones they should meet. There are a lot of well child visits in the first several years (newborn visit, 1 month visit, 2 month, 4 month, 6 month, 9 month, 1 year, etc.) and each have a different Bright Futures form. Also knowing dermatology was clutch because babies get lots of rashes and they all look the same to me (haha).

I also had a difficult time initially examining babies especially newborns because they seem so fragile! But my preceptor told me that you have to really grab their heads when inspecting their ears. They also have pretty stable heads but definitely ask how to hold babies if you are unsure!

Things I wish I could have done more of: I wish I interacted more with the nursing staff and patients. I felt I was very shy during this rotation but I think it would have been more enjoyable had I been more social. I also wish I took the opportunity to ask my preceptor more questions but overall this rotation is pretty straightforward in what was expected of me. 

Resources used for shelf exam:

• Online Med Ed videos
• Med U Cases
• COMBANK COMAT questions
• Case Files: Pediatrics
• This was by far my best COMAT!

MY THIRD YEAR EXPERIENCE: FAMILY MEDICINE

Hi guys! Long time no blog. I have a habit of neglecting my blog when things get stressful but now that I am on a lighter schedule, I've decided to write a series that was inspired by one follower's request. My school provides a guide on each required rotation but I still feel that I don't know what to expect when it comes to a rotation. How should I approach my preceptor? How is the style of asking history and physicals different on this rotation? What should I expect to do on this rotation?

Although everyone's experience will be different depending on location of rotation, preceptor, schedule, etc. I wanted to write a blog on my experiences in each of my rotations so that you guys can have a way to compare your experiences. If you have any tips, I'd love to add them to the blog. I found it really helpful to ask my peers what they did during their rotations so I could have an idea what to expect.

Today's blog will feature my experience in rural Family Medicine.

Length of Rotation: 8 weeks
Location: Rural West Virginia, 6 room clinic
Environment: 1-2 doctors, 2-4 nurses; 2-4 patients an hour
Attire: business casual/professional. I wore blouses with dress capri/pants and loved my comfy Payless Shoes everyday.
Types of Patients: Medicare/Medicare patients, adult wellness exams, minimal acute care, chronic issues
Schedule Type: Routine Monday-Friday from 8am-5pm with free weekends

Things that were expected:

• Taking full history and physicals of adults (rarely children)
• Completing wellness exams (asking about vaccinations, colonoscopies, mammograms, surgical history, medical history, medications, etc.)
• Write SOAP notes (subjective, objective, assessment, and plan) 

What it was like daily: 

• Show up to clinic 15 minutes before my preceptor to log into the EHR and look at the types of patients that day.
• On the first initial day of every rotation, I like to shadow the doc to get an idea of how they do their history and physicals. Every rotation differs in what you ask and what you perform.
• I would go into every patient room and depending on the chief complaint, I would do a history and physical. Many of my patients were wellness exams so many of my questions involved asking about vaccinations, colonoscopies, mammograms, etc. I ended up doing modified physicals according to my preceptor's preferences.
• I was fortunate enough to be able to write entire SOAP notes while in the room with the patient. This would continue until noon and then I would have lunch.
• Patients would resume until 5pm.
• I would be home by 6pm, eat dinner, and read/study for 1-2 hours a night.

Things I learned: I learned a lot about chronic issues like hypertension, diabetes, chronic pain, etc. This rotation was really good in the sense that it eases you from didactic years to clinical years. I used a lot of my mnemonics for history and physicals and I was able to have full conversations with patients. For me, everyday was very much the same, dealing with patients and their chronic issues and medications. Being in rural WV, I did not get much variability. I was able to draw some blood and give shots but it was not very procedure-heavy.

Things I wish I could have done more of:

• I wish I asked more questions to my preceptor and wish I asked the nurses to do more blood draws and vaccinations. Family medicine can be slower pace than other rotations so it is to your advantage to do any procedures that occur. 
• Read more and maybe take my shelf exam more seriously (it was hard to jump back into studying after boards)

Resources used for shelf exam:

• Med U cases (great for wellness exams)
• COMBANK COMAT questions 
• Case Files Family Medicine

MY FAVORITE ORGANIZATIONAL TOOL: CHECKLISTS

Congratulations to all of the incoming 1st year medical students! The 1st years just started orientation at my school and I was reminded of my first week of orientations. I remember thinking I was going to be the most awkward person with no friends and trying my best at small talk with all of my current friends. Very glad I am past that and have settled in well but I know that there are a bunch of you guys out there still nervous and anxious about the real priority- studying.

I have to admit that the first week of classes were overwhelming because I received as many lectures in one week as I did in one semester of college. Multiply that by 3 weeks of material and you have yourself a very anxious student with lots of PowerPoints and lectures to keep track of. 

One of my best friends showed me a checklist that her mentor had given her and I thought it'd be a great idea to keep track of all the lectures in one giant checklist. I made a checklist before every unit and sent it out to my class and it was pretty helpful. Just recently saw on my school's 2020 Facebook page that my tradition of these unit checklists have lived on! Because it has been so helpful to my class, the 2019 class, and now hopefully the 2020 class, I thought I'd share with you guys all of the checklists that helped me be successful in both school and boards! 

See the bottom of this post for the link to all of the checklists!

Below is an example of our Renal and GI unit checklist with all of the lectures, dates, hours, and check boxes for our exam. See the bottom of this page for the link to a template you can use for your course!

My trusty Sketchy Medical checklists for all of the microbiology and pharm videos. 190+ videos is a lot to keep track of!

 

If you are studying pathology, I highly recommend purchasing the Pathoma book and video program. It made pathology a piece of cake in class and boards. I have also included a checklist for this. *Thank you to my classmate Corissa who created this. I have changed the format to be more printer friendly for you guys

 

Hope you guys find these checklists to be as helpful as they were to me. 

Link to the downloads: download here