Took IM shelf

There’s a hesitation that stops me from posting anything here. I’m not used to having any sort of outlet and this is online, which is much more public than I am used to. It has the potential to be scrutinized, which then makes it more difficult to show any sort of vulnerability. But I’ll try with this as it should be an outlet.

I took my IM shelf this morning. I felt much worse than the first time, but the practice that I took 2 days ago ended up being 10 percent higher than passing. So, I’m not too worried about failure.

I started my last rotation, in OB/GYN, with the next class, so I don’t know anyone in my group, but they all look up to me for advice, at least temporarily. I’m over at Oakwood now, which is a good 45 minute drive. I should get up at 5:30 to make it there before 7.

 

Burnout in IM study week

There is a massive difference between the potential and excitement of planning and the misery of doing. My mind is constantly in the planning stage, so even when I am doing a previous plan, as is the case today, I plan on what I could do in the future. It disrupts the study and causes constant revision in plan. The plans change so much that I realized that it may not be worthwhile to tell other people any of my plans, as they invariably change. For example, my original plan for this terrible week was to read all of step-up to medicine, however, now I have changed it to simply focus on questions – they tend to be higher yield and I should be able to do over 1000 of them. That has been my plan, and, for the most part, I have been able to do it. The initial planning is an emotional crest, then the emotions sway downwards with time and execution of the plan. Eventually I am left trudging through an emotional trough, as is the case today. Everything tends to fall on a sine-wave, so I shouldn’t get too distressed as everything will come back into place. But right now, as I go through with the plan, I feel lonely and unable to reach out to any. At school and the library, where I was earlier today, I emotionally closed myself of. I secretly loathed everyone around me. Eventually it was too much and I had to leave, had to come back home, where I could at least be alone with my loneliness.

I met with mentors over the course of the week and decided that I would pursue family medicine, hopefully in a rural and unopposed program. This means that family med doesn’t compete with other fields (e.g.: OB for deliveries). However, I set up to meet with the family med adviser and she said she wanted to meet with me anyway to discuss continuity clinic. That is a 6 month clinic that I went to every week. I have a strong suspicion that I either failed and will have to retake it. Why else would she want to discuss it?

Also, it should be noted, that today the SCOTUS ruled in favor of gay marriage. Even when I try to seclude myself, I can’t help but be surrounded by this fact. It is all over facebook, reddit, and even my messaging group. When older people and parents are asked about their lives, retrospectively they anchor personal life events to world news. This is the case here as well. I can say, “when gay marriage was legalized in the US, I was burned-out studying for my makeup internal medicine shelf in the week I was supposed to have off.”

 

Change in plans

So much happened in the last couple of days. First and foremost, I found out that I failed my internal medicine shelf and the remake is on July 1st. This drastically changes my schedule over the next week. I need to drop reschedule my Step 2 CS, which was going to take place on July 11 in LA. Now, there’s no way I can study for both. I have no I idea why I failed. I can only account for it due to the fact that I spent too much time on questions an not enough on reading. I plan to read all of step up to medicine over the course of the next week, which is 70 pages a day. Goddamn this sucks…so much for having a break between internal medicine and OB/GYN.

The new diet is actually going really well. It all cooked up more delicious than I expected. The plan has you eat 3200 cal one day and 2900 the next. I cooked enough for this plan and I can’t eat anywhere near the recommended amount. I stopped counting the calories and started simply trying to match the plan. I ate 5 meals today, when it scheduled 6.

Due to the new change in plans, I can’t really meet up with any of my friends. They met for drinks yesterday in Ann Arbor and today they went to Buffalo Wild Wings in Dearborn to watch the US vs Colombia game. I just have to push through the next week without burning out and I’ll be fine.

The library is such an interesting place. You see way more kids and old people than anywhere else I normally go. There’s also, for some weird reason, a lot of gorgeous girls all over. My friend said that once you get out of your head, the library was the best place to pick up girls. I would go up and talk to some of them, but then I rationalize that I have 70 pages to read. I’ll worry about all of this after the week of studying. Damn.

Plans as of 6/20/2015

I have always had plans focused on the distant future, the next few weeks, and the day. It becomes very easy to lose track of plans and become depressed with lack of results. Therefore I plan to write up a plan today and revisit it in 3 months, at the end of September.

Long Term Plans:

Take step 2 cs on July 11 in LA. OB/GYN rotation takes place July and August. Then take the month of September off to study and apply. Send out ERAS to schools in mid September and take Step 2 CK at the end of September.

Figure out what to specialize in. I have been telling everyone that I was going into pathology for the last 3 months, but now it seems like that would simply be…boring? Too comfortable? What I realized recently is that everyone has their own personal legend (a term I took from The Alchemist), in which they drive themselves internally to achieve a goal that is personal to them alone. For me, I have been thinking about going abroad and either doing the Peace Corp or WHO or Doctors Without Borders. I have contacted the recruiter for the Peace Corp, however, I don’t know if it would be worthwhile to do, as it may be very difficult to bounce back into a grueling academic setting after doing something so different for 2 years. I told my Dad yesterday about my desire to go abroad and he told me to go into family med as that is a universally understood field that is chronically in demand. You just sacrifice status and pay relative to other fields. I’ll think about all of this.

Approach more women. I have tried online dating and briefly dated a girl this last year, but I have not been satisfied with this situation. A few years ago I read up on pickup and I read forums and subreddits about it. I know the theory, but theory is completely in vain without any practice. Practice is the only thing that matters. It just comes so unnaturally to me, as I assume it does for everyone. An effort must actually be made on my part to change this. Realistically what am I going to do though? I can’t go to clubs in the middle of the week – or even on the weekends now that I think about it…Online dating was OK, and I’ll just take a break from it until I’m done with OB/GYN, just to clear my head and work on myself. Instead, I will try to approach in the daytime. This is much easier to rationalize yourself out of, however, I should be able to hold myself more accountable with this blog…I’ll do more approaches and write about them here. The worst thing that happens will be that I end up with a story.

Write: I wrote a book between 25-27 and gave it to my cousin to edit. I should get in touch with her…Apart from that, I need to start a new project. I have the notes for another book like the first, however, the first one wrapped up well enough to make anything similar to it feel derivative. I tentatively have a plan for a detective story.

Music: I have the ideas for an album, however, I don’t have the manpower. The plan is to create song demos, then contact people who can help expand each song, then to record a final version in a studio. Put it for free online. The point is to create. You’re not going to make money in music. So, I need software and to set up for recording.

Daily plan

There are 5 things that I plan to do every day. When I do them all, I put an “X” on my calendar. Ideally I would have a chain of “X”s in a row and I would have further incentive not to break the chain. However, the longest chain I had was 20 days. I think writing this in this blog will help out. The 5 things are

1. Diet: I have simply tried eating less that 1800 calories/day. That was the only restriction. That’s how I’ve been for a few years. Recently though, I plan to try something new. I googled “How to get a 6 pack” (I know, I know…) but I came across a 8 week diet plan from Men’s Fitness. If I coordinate it right, I’ll cook everything on Saturdays (which is what I did today) and plate everything the night before for each day. This takes a long time on Saturday, but it shouldn’t take too long in the week. Hopefully I’ll see some change in 8 weeks.

2. Exercise: I really just plan to workout every day for 20 minutes. I have a 5 day cycle: Arms, Delts, Chest, Back, and Legs. Consistency is key here more than a definite goal. The gains will really be made with adherence to the diet.

3. Meditate: I have found this weirdly difficult to do. It always seems like a chore, even though I realize I can think clearer after and that I become more productive. I’ll try to do this first thing in the morning and before any studying.

4. No Porn: This one is pretty easy once I get away from it for a few days. The benefits are much more mental than the other things on the list. It affect libido by giving an artificial stimulus to a real human instinct. Without the stimulus, libido and sexual response feels much more natural. Relapse with this usually was due to the fact that I lumped all 5 together. I would say, “Oh I ate too much today. I won’t be able to mark an x on my calendar. I may as well see what porn I’ve missed.”

5. Questions: I have tried to do at least some questions from a Q bank every day, either Kaplan or USMLE World. As of now, I finished the first pass of uworld and still have the majority of Kaplan to do. However, I am around 30th percentile in uworld because I rushed it just to finish. I need to redo them until I know them solid. Then the plan is to get “Doctors in Training for Step 2 CK” for September. In fact I should get that now.

Alright, now that I’ve written out my long-term and short-term plans I feel pretty motivated! I made a note in my calendar on my phone to check back to this post in 3 months to see how it all goes.

 

Day 1, haven’t shaved in weeks…

This should incentive me…hopefully. I figured I should know the very basics of what making a website entails, as I spend a great amount of each day on them. But more importantly, I actually want to create a blog. Someplace where I can muse and let my mind wander, where I can set up goals, explain past events, or rant about whatever. I had a journal, however, I lost the physical book. With that in mind, this seem more accessible and useful. The focus should be on writing out my thoughts. That’s it. That’s why its just a stripped down website without comments or links. That may change though.

Many thingsĀ  cloud my mind every day, and writing them down should help me reflect and sort them out.