The internal medicine shelf exam was a rough one. Thankfully, I expected as much. Several upperclassmen and classmates who had taken this test before me warned me that it would feel less like “an internal medicine shelf” and more like a hodgepodge of questions from all subspecialties. They weren’t kidding. I was really glad I had taken 5 other shelf exams before this one. My main (read: only) goal last Friday was to finish all 100 questions on the test and not run out of time like I did on surgery. I met that goal with a few minutes to spare–in fact, after I made sure I had bubbled in all the intended spaces on the scantron, I watched the remaining 2 minutes tick away on the online clock being displayed on the projector screen. Even though I was still sitting in that chilly classroom, surrounded by the sound of papers rustling and pencils tapping, counting down those seconds was like counting down the time on New Years Eve.
Because of the expectations of the clerkship, there wasn’t as much time to study compared to other rotations. Like many students before me, I focused on the 1300+ internal medicine questions in UWorld instead of trying to read through a review book or two as I’d tried to do on previous rotations. Aside from the time I spent flipping through the Pocket Medicine “purple book” (so helpful I’d call it the must-read of 2014) and scrolling through UpToDate when I had a question, UWorld was just about all I used to study for this shelf. I won’t see my score for another 6 weeks, but I feel like this strategy helped me to retain a bit more than if I had tried to keep with my more ambitious approach from other rotations–less is more, if you will.
You’re all caught up on my life now. Immediately after the exam on Friday, we third years gathered in the student lounge for an “end of clerkships” party with catered hot chicken (a Nashville favorite) and ugly Christmas sweaters galore. I went out for Indian food with a few friends that night and headed home the next day. I’ll be with my family from now until the first week in January, and I plan to catch up on books, family time, music projects, and sleep while I’m off campus.
After we went our separate ways that Friday afternoon, some of us realized that that would really be the last time all of us would be together as a class until we graduate in 2016. The next stage of our medical education allows us to take more ownership of our schedules and meet requirements at different times and at various places across the country and world if we so choose. For example, when I return to Nashville after my break, I will be starting my 3 month research rotation, but others will be staying home to take Step 2 or to just relax for a month before starting again. I think I’ll have a lot more free time during January, February, and March than I’ve had over the past 9 months, and I plan to take advantage of that for sure. But I’ll miss the moments of class solidarity that having a more structured course schedule afforded us. Perhaps we’ll find creative ways to keep in touch while we’re all out carving our own paths over the next year.