Retractions and Reactions

Retraction: My last post erroneously stated that no-one reads this blog. In addition to myself and web crawlers, both people and magical wooden puppets read my thoughts. The Arthur at Ross U Blog regrets the error.




There are some sayings I dislike. The phase "Bad news comes in three's" is one of them. Not because bad news usually comes in one's, but if they occur in a short enough time-span we lump them together into triplets. Not because bad news usually has some silver lining.

Its pretty simple: Bad news actually comes in four's.

Firstly: Christmas cards and gifts that were mailed from Canada have yet to arrive to my domicile. There is a good chance they will never arrive.

Secondly: I received the score for my Comp test and received a 64, when the passing score is a 65. Ouch. Right in the kidneys. More on this later.

Third: I'll be celebrating yet another birthday far from friends and family.

Fourth: Awkward conversations with disappointed parents for the foreseeable future.


I started writing this post several days ago, focusing on post-exam breaks. However, as I began to tease apart the finer details of the causes of exam stress, the whole of the universe began to unravel. Or at least that's what I tell myself when I start writing pages of incoherent rambling. Instead, I've combined parts of that post with thoughts on the Comp examination and studying in general. If it feels disjointed, it only appears so because I applied crazy glue between different paragraphs, thoughts, and recipes for tomato sauce.
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Among topics studied for medical examinations, the Law of Diminishing Returns applies. One can attempt to memorize every protein, cell type, mechanism of action, etc... but:

• only so many questions can appear on a test
• some knowledge is considered more pertinent than other knowledge, depending on the scenario
• examiners tend to ask questions on what they consider more pertinent

Every student takes the Test. In school where grading hierarchy exists, there may also exist the Meta Test. Here, student's efforts are additionally spent trying to determine which topics are High Yield ("HY") and thus most likely to show up on a test. This may includes trying to obtain copies of previous year's tests, leaked concept sheets, 'remembered' questions from previous students, and even behavioral analysis of professors.

Among the many pieces of advice I've heard, the most memorable include:

• "If Prof P steps away from the podium while speaking about a topic, its HY"
• "If Prof. Y reads it directly off a slide, its HY"
• "If its a behavioral problem, always pick the mushiest answer choice possible"
• "Prof Z typically tests only first-line drugs"
• "Prof B personally said he would be testing from one of these 4 things..."
• "Prof A tells pretty girls whats on the test, so we usually send M every semester to talk to him"

Besides the fact that I'm running out of variables and pseudonyms,  some of these pieces of advice were highly suspect (typically the former), while the latter tended to be pretty accurate. Other methods violate the student honor code (but in the case of a high school classmate breaking into a locked office, they may also break local laws). Perhaps expecting a group of intelligent and competitive students to only compete ethically is unrealistic, because in the world of professional [anything], ethics doesn't win you gold medals; it only keeps you from losing a gold medal. Maybe the fact that these students are all competing in the field of medicine (which I've been told holds ethics highly in present day) means that winning shouldn't be everything.

Before I received my Comp score, I personally tried to distance myself from relying on concept sheets and 'remembered' questions, because I believe they interfere with true learning and education. Everything could be important in the right circumstances. But in my observations, friends that utilize these tools have performed well (and even better than I typically do), often for a fraction of the effort. I am (rightfully) an idiot for ignoring all these tools available to me. But are they worth it?

Perhaps raising my grade to an A- would have felt like a nice pat on the back. It would have let me apply to the leadership position in certain clubs and groups, which is a nice talking point when applying to future residency spots. It would have let me apply to do my fifth semester in the Saginaw, Michigan campus instead of the default Miramar, Florida campus. It may have gotten me into one of the more highly coveted track programs that is offered by Ross U. And most importantly, simply having a high grade would be a talking point on my future applications for residency positions. 

I do somewhat regret the choice I made in the past to ignore concept sheets. Residency spots for IMG's don't come easy, and any strong asset in obtaining future positions should be fought for, tooth and nail. My decision in the past were made because of the benefits I saw at the time; however, many of the benefits of a high grade were only gradually revealed. For example, I only found out about the minimum requirements for being a student group leader in third semester, while applying. Track programs were only recently instituted by Ross, in my fourth semester, when they decided that both GPA and Comp performance would play a role in student placement. Faculty only revealed in fifth semester what sorts of information appears in the Dean's Letter.

Do I regret not utilizing concept sheets and remembered sheets for the present? Once again, yes and no. The thought of spending an additional 3 months studying for the Comp is not appealing. Watching friends move on and start rotations 2 months before I do is a righteous bummer. Having to live at home again is like spiritual flatulence: noisy, socially disruptive, and associated with a diet high in beans. But on the bright side, I've completely revamped my knowledge of many biological and disease processes. What was once full of holes and misconceptions from 2 years of studying, forgetting, studying a different emphasis under a different professor, forgetting again, getting disease processes and proteins confused, seeing contradictory lecture notes vs study notes vs textbooks, memorizing associations simply because a professor said to memorize them...I can finally start anew. And I have. My knowledge of the core P's (physiology, pharmacology, and pathology)  has never been stronger, and this is still just the beginning. I have many months ahead to hammer out all the kinks in my memory.

So, applying this pseudo-science and learning about HY topics has its benefits, both for that student's present (allows maximizing time spent studying and minimizing the effects of the diminishing returns) and for that student's future (increasing competitiveness for future applications). But if you are OK with being an ethical 'loser' that ends up happy in less competitive positions, then be ready to live contently, albeit with some regrets.

As a side note: I have read that under our new Dean, Ross is looking to remove the use of the Comp as a barrier to writing the Step, and simply use it to help students identify weak areas. I believe this to be a step in the right direction, but this is only a tiny cog in the machine, and is not unique to Ross by any means. I've spoken with students in other medical schools where the sharing of concept sheets and the like is also commonplace. This report suggests that the problem continues even in the future down in a medical career.

Are there solutions to this problem? Alarmingly, I ask you: do you think this is a problem?

Even more alarmingly: DO YOU THINK THIS IS A PROBLEM?!?!?!?!

Maybe another day, my disembodied readers. For now, enjoy a story being written by a friend of mine, entitled Lovers in a Dangerous Time.