Category: MBBS

One of my dreams during MBBS(Bachelor of Medicine and Bachelor of Surgery) was to run away from all the craziness of the doctor world, and traveling served this purpose. To treat myself after my final year exams, I planned to go on a long Europe backpacking tour. However, my roller coaster ride began in the first few days of the final year of MBBS. My brother was interning in Prague and invited me to go along with him on a West Europe trip for two weeks. Although I was worried if I could pass the final year exam by going out for two weeks, I still was excited about the trip and agreed to go. After the tour, I had no other goal but to prepare for USMLE, and that is how my journey began!

I started researching clinical electives and found a few classmates interested in pursuing it during the holidays following final year exams. Since I had some issues with getting all the paperwork on time, I was able to fetch only a research elective at Johns Hopkins Hospital in Pulmonary and Critical Care dept.

February 2016 – April 2016 – Research elective

While I was doing my elective, my preceptor heard my plan for the future and suggested that I write my step 1 in the next six months and apply a year earlier. He is an American, and I wondered if he understood my Indian medical school situation. So I cross-checked with my senior, who me told that although it is risky to do, it is still doable. Quickly I had to change my gears and come up with a new plan.

I returned to India and joined my internship meanwhile, also preparing for step 1. Due to unexpected health issues, I was physically sick and pushed into a rehabilitation kind of situation after a month of returning to India. When I was in the hospital, I got my scheduling permit, and without thinking twice, I booked my exam date for September 14th, 2016.

September 14th, 2016, Step 1 Exam: – 242 score

With my step 1 score of 242, I was able to apply to only Mayo Clinic, Johns Hopkins Hospital, Harvard Medical School, Cleveland Clinic, and University of North Carolina Medical School for clinical electives for April – June 2017. Here again, I was late to apply because of delayed paperwork. Although I heard back positively only from three places, Harvard, Mayo Clinic(Rochester), and Hopkins for April, May, and June 2017 respectively, I considered myself extremely lucky.

April 2017:    Massachusetts General Hospital           PICU rotation

May 2017:     Mayo Clinic Rochester                             Pulmonary Medicine Inpatient Rotation

June 2017:    Johns Hopkins Hospital                           Pulmonary HTN & Lung transplant rotation

I had booked my step 2 CS date in July, and my center was in Philadelphia, PA. Since all my rotations were inpatient, I had good enough practice to improve my interpersonal and note typing skills. On the weekends, I practiced my ICE skills. With this background, I finished my 2CS and went back to India to give my step 2CK.

July 5th, 2017, Step 2 CS exam: – PASS

Since I wished to apply for the Match 2018, I had to complete my step 2 CK in the first week of August so that I could receive my exam score in time to apply. Hence, I had only a month to prepare. I did that as well and resumed my internship to complete my extension.

August 7th, 2017, Step 2 CK exam: – 243 score (that 1 point is crucial!)

While I was completing my extension, I gathered my letters of recommendation, finalized my personal statement, researched International Medical Graduate(IMG) friendly Internal medicine programs and applied for the Match. By the time I completed my Internship in November, I had most of my interviews in hand.

In Summary, my timeline was something like this:

Research elective – February 2016 to April 2016  

Step 1 Exam – September 2016 – 242

3 clinical electives – April to June 2017

Step 2 CS – July 2017

Step 2 CK – August 2017

Applied to 221 Internal medicine programs on September 15th

Had 9 interviews towards the end of November 2017

Mid-January 2018 – Done with interviews.

And the routine happened, on March 12th, opened my ‘Did I match?’ email to see

and on March 16th opened my ‘Where did I match?’ email to see

At the beginning of my MBBS(Bachelor of Medicine and Bachelor of Surgery) course, I was struggling with studying my portions, although I was spending more time than usual. Hence, when my friend introduced me to residency in the United States of America(USA), I thought that maybe I could try my luck in foreign lands. At the beginning of the second year, I familiarized myself with the United States Medical Licensing Exam(USMLE) exam format. Back then, I didn’t know what was in store for me. I wonder if I knew what it entailed, I would have bothered to go through the USMLE process. Although it was a complicated process, I guess I was lucky compared to many others.
Based on my MBBS exam experiences, I felt that I would be ready to prepare for step 1 only after completing my final year exam. So my plan for step 1 in May 2015 was something like this(yes, I had planned three years ahead of the Match):

Pass Final year MBBS: Jan 2016

Internship with 2 weeks of extension period: March 2016 to March 2017

Do 3 clinical electives: April 2017 to June 2017

Come back to India and prepare for step 1: July 2017 to December 2017

Step 1 Exam: end of December 2017 (total 6 months of prep)

Step 2 CK exam: in April 2018

Observerships: 2 of them in May and June 2018

Step 2 CS exam: in July 2018

Apply for the Match in September 2018

By this time I wanted to get 4 US letters of recommendation(LoRs) and keep my Educational Commission for Foreign Medical Graduates(ECFMG) certificate ready. Following this, I planned to begin preparation for step 3 during the interview season and give it in December 2018. This was similar to what my senior of four years did and what I had planned to do as well.

However, I followed a new and weird path and ended up getting matched to the University of Connecticut Internal medicine program and will be beginning residency soon in June 2018. How did I manage to do that?

Even though I started preparing for second year final exams 1.5years earlier, I still was stressed during all the exams. Yet again, I had worked very hard and I believed that I deserved some vacation time. But this time it was different, I definitely had learnt my lesson after first year and I improvised my study time table with previous experiences. Just like in second year, I started studying from the first day. Also, I decided to have some fun in third year.

I went as deep as the sea floor and as high as the mountains in India, along with a luxury trip to the busiest place for Indians in Middle East(can you guess?*). Along with vacations, I went to attend cartooning classes and cleared my music junior exam. Apart from all this, I renewed my interest to read novels, doodle and surf the web. For a bit of academic touch, I tried studying Kaplan notes along with my friend. Since I was not able to study anatomy,biochem or physio in second year(due to overload of study material), I tried again to study those 3 subjects. Even though I was only partially successful, Kaplan notes and USMLE prep gave me hope for the future that I don’t have to byheart the textbooks forever. I did too many things in third year and writing all about them won’t suffice to say that, I never let an opportunity pass by.

One carry-home message from my third year prep is that, I had read every chapter of all the 3 subjects(PSM, Ophthal, ENT) well before 3 months of third year final exams. In the end, I was just revising the topics though I remembered nothing. But revision was easy once I finished underlining the first time.

As far as individual subject progress goes: How much ever I tried to tackle my favorite PSM, it wasn’t possible. So I had to resort to brief reading and giving my personal touch to answers(the beginning of many more). I was lucky to have been placed in a good unit with a good teacher who used to show every case in OPD for findings in Ophthal. Clinical cases helped me learn the Ophthal terminology and clinical features soon. Since I was interested I surgery, I thought that I liked ENT by default though it didn’t work out that way. This was the tough nut in third year but it had to crack with exam pressure.

On the whole, third year taught me that I can have fun in MBBS if I managed my time.

* it’s Dubai, UAE

PSM: Preventive and social medicine, ENT: Ear, nose and throat/otorhinolaryngology, USMLE: Unites States Medical Licensing Examination, OPD: Out Patient Department.

Once I recovered from my first year exam shock, though I passed, I knew that I needed to strengthen my study strategy to survive my next set of final exams. I believed it was beginner’s luck which helped me pass MBBS first year exams. My one year of vacation was sufficient to pull me back into the game. Without wasting even a second, I was studying parts of anatomy, physiology and biochemistry which I had skipped. Finally, I was understanding the subjects by referring to Netter’s, students’ Gray’s, Guyton and Satyanarayanan. Just like other Indian students, I too believe the fact that, students memorize for exams but study later to understand. That is what I did and even the terms didn’t seem to be so confusing anymore.

My savior subject in second year of MBBS was Pathology and Robbins was the Gita. I spent 6 months familiarizing pathological research and even though I didn’t understand a word, I tried to read research articles. I thought by the end of 6 months, I would magically learn Microbiology and Pharmacology but it didn’t work out that way. So I tried strategies to become proficient with the various terms of micro and pharmac, for which I took another 6 months. By the end of a year, I had studied Pathology but was in the beginner level for Micro and Pharmac, and all I knew in Forensic was what I had seen in post-mortem postings. 

How I learned Microbiology which included General Microbiology, Bacteriology, Virology, Mycology and Parasitology is a huge mystery. My strategy to learn Micro was to get used to the bacteria names alone first, followed by noting down all the criteria to classify bacteria, and I made a table for all the special investigations required for diagnosing a bacteria. Once I had a complete idea of the bacterial world, I did the same for virology. My Micro textbook had a simple and concise portion for Mycology and for the first time ever I understood Micro at the first read. Later I chose to raise the bar for Micro by reading Panicker and loved the illustrations given there. That is when I realized that Micro was a beautiful subject and our opinion depends on the source we read from. 

As I was getting comfortable with Microbiology, Pharmac was another lunatic world. Using the same strategy as micro, I made a note of all drugs names in a small notebook for my easy reference. I watched online videos and used google extensively to familiarise myself. Though the indications for use of any drug was easy to grasp(thanks to patho and KD Tripathi) I never could learn the adverse effects and contraindications for all group of drugs. And the vast anti-microbial spectrum for each antibiotic was a huge pain. Finally, I gave up the day before my pharmac 2nd theory paper and it’s still puzzling how I miraculously scored more than 50%. 

With all the tricks I had, patho, micro and pharmac were manageable but I was out of ideas to study forensic. It was then when I found this amazing app ‘Random Number Generator’. Though I wanted to read the Forensic textbook, I didn’t want to have false expectations and blindly bought Singi solved questions papers book. My one and only guide book in whole of MBBS. With the app, I used to select a particular page number and study only those questions on that page. Yet another wonder, I passed forensic too. 

The reason why I’m surprised to have passed any subject in MBBS is that my study standards until PUC were pretty high and MBBS was a whole new game. I had to change my perspective, formulate new plans and lower my expectations to study, perform and to guess results. So by the end of 4th term, my mantra was to get 50% or more. It has helped me survive till final year now.

The moment I left my house to go to my college on the first day itself, I decided to sit back and enjoy the show i.e. First year of MBBS. Even when they showed us our table cadavers for the year, naked embalmed bodies, I never panicked and took my first pit-stop sportively. It took me an entire year to be thorough with the terms, ‘medial-lateral’, ‘anterior-posterior’, ‘proximal-distal’ and ‘coronal-sagittal’. I knew heart, brain, muscle, eye, leg, hand, lungs, stomach, liver, blood and air. New terms like: pectoralis major, acromion, clavicle, pollicis brevis, pancreas, haustra, ligament, sural, peroneal, sciatic, tibia, fibula, femur – almost every other word, was like learning some sophisticated new language which I hadn’t signed up for. Every day, I questioned my fate and had no idea what the hell I was doing, learning this crazy language.

As far as physiology was concerned, for a student like me who prepared for IIT-JEE, it should have been interesting because it’s just like physics, but with stupid terms like cardiac output, osmotic pressure and blood volume, I lost interest! To top this all, my physiology practicals teacher was a real-world doppelgänger of professor Trelawney. I was not in a nerd-mood to read Guyton, so I read AK Jain and my interest for physiology was on the far negative side of the learning scale. Sitting for my third internals of physiology, I looked around and couldn’t understand how everybody was writing stuff in the paper; I was blank regarding the subject. That is when I knew that my strategy had to change regarding the subject and took up the challenge to study physiology. So, for the first time when I realized the beauty of physiology it was 1 month before my finals exams!

Biochemistry: the only reason why I read this subject was because I liked it. I loved organic chemistry in PUC, so this was the only subject without crazy unknown words. I knew carbon, oxygen, bonds and reactions. Not that it was any great, but it was like home for a year. Even then it was vacation time for me, so I did not study this subject also, until it was a month for finals. 

While I struggled to adjust to this new world, I never left a chance to dissect my table cadaver, filled with ascaris lumbricoides(another lunatic word) from oral cavity till large intestine! One among the many ‘first-time-in-my-life’ things, pricking my finger by myself for hematology experiments was super cool. It was incredible to look through the microscope to see my own red blood cells, leukocytes and platelets. 2 hours of biochemical reactions to test for urine glucose, ketones, proteins was refreshing but the viva which followed sucked the life out of me by the end of the day. All these beautiful experiences gave me hope, that MBBS might be better than I envisioned it to be!