Step 1 Guide Part 1: My Story

Sorry for the long wait, everyone. As of press time, it has been four months since I took Step 1. It feels like an eternity ago; with each passing rotation it fades deeper into the “trauma” portion of my memory. But looking back, I am also grateful that it happened. The Step 1 period forced me to define for myself why I want to do medicine and what I want my career to look like in the future, and a lot of the positive changes that have made my life so happy now were made during that time, through a lot of pain and anxiety and tears. 

I have to begin this by telling my own Step 1 story. It’s not perfect at all—it’s pretty messy, and I made a lot of mistakes. But I feel like the best thing I can tell you is my story, and what we can learn from it, so here it goes. (A lot of this is also detailed in my Sonic X Christ and Cartoons post, but here’s the story in all of its detail.)

I came into medical school super revved up and ready to go; I was grateful for the chance to even get into med school, and I worked really, really hard. I kept my momentum from college going all through first year, but especially as the year drew to a close, I felt my energy fading. By the end of first year, I was dead tired. I thought I was going to go home for my last summer off, but I got a research opportunity in LA, so I stayed in LA for most of the summer. With most of my friends gone and being too insecure for the most part to build relationships, I spent a lot of my spare time on YouTube, Netflix and Instagram, using their instant gratification to numb the pain of loneliness in LA.

Second year came, but my loneliness and bad habits stayed with me going into the school year. I still did fine in all of my blocks (I passed every single test and got a couple of very high grades), but with every passing block my motivation decreased. I knew that I had to work, and that I had to pass all my tests and do well on Step 1 and get good grades, but I had forgotten why I was doing all of it. The social media wasn’t helping; I was constantly looking at other people’s lives and dreams and worlds, and I wondered often why I wasn’t there instead. And I was still lonely; I had started making new friends, but I was afraid to put myself out there in order to develop the relationship. I still found myself turning to Instagram to numb my social anxiety. Before long, I became scared to express my true feelings to anyone. I began to live in my own bubble, where no one could enter.

Enter Step 1 time.

I started doing UWorld questions in January, like everyone told me to, but I didn’t look at the questions I was getting incorrect; I was doing questions just to do questions, and barely reading First Aid. I didn’t ask anyone for advice for a very long time, and I hated looking at medical advice blogs online. The breaking point came around when I started taking practice tests and got absolutely abysmal scores. I went home for our dedicated study time (best decision I made!) and my parents called my bluff almost immediately. I had to push back my test date by quite a bit of time, and I felt awful. I thought my parents would just yell at me, but to my surprise, my mom took me onto her bed one day and made me actually talk about my loneliness, insecurities and problems with social media for the first time. And then she surprised me again; she didn’t rip into me, but she gave me a dare; drop the social media for three months (including the rest of my Step 1 study time). I accepted her challenge.

The next several weeks felt horrible, but they were probably some of the most defining moments of my career. For about a year I had been burying my head in the sand of social media so that I didn’t have to look at my anxiety; now, I had to face it head on, and it was awful. It felt like every hour I had to fight the impulse to collapse in panic. I could hardly eat a whole meal; I would wake up in the middle of the night with anxiety in my chest and in my head. I fought this fear with faith. What sustained me was the sheer grace of God and the prayers of a lot of faithful people, including my parents, my brother, and multiple friends. Another thing that helped was texting my friends back in California. I couldn’t set up anything formal like the stuff I’d seen on social media, but I could send them a text to ask how they were doing and cheer them on. So I did that to about 16 people, and they responded to me. Their responses literally fueled me with joy. They filled a void that Instagram could only paper over, the void that can only be filled by real, genuine relationships.

Something that I also had to do at that point was to revisit my goals in medicine. During those days it felt like I would spend forever in my room in front of First Aid, only allowed to go outside for 20 minutes at a time for a walk, never allowed to socialize again. I knew in my head that it wouldn’t be forever, but every day felt like an eternity. So what I did was to write out things that were going to happen in my future, and what I wanted to happen in my future. So for example, one of the first things I wrote is, “I will return to California for third year, and I will see all of my friends again.” I know that looks obvious, but when you are alone and in Step 1 mode, it can often feel like the near future is never going to come! So I had to write simple statements like that, and before long it turned into faith statements about what I wanted in the future, like “I will match into (my favorite specialty—TBA) and be happy on Match Day.” I used my childhood imagination to see myself on Match Day in two years with my parents and all my friends, smiling and being happy. I also wrote letters to myself telling myself why medicine is the best fit for me as a job, and reminding myself about what I want to do with my career. That helped mentally propel me through the 15-hour days of studying endless amounts of facts.

Test day came and went. It was the least anxiety-inducing day I’d had in a while, because I was actually prepared—prepared for the test, and prepared with actual motivation for a career in medicine. After test day, my parents surprised me and sent me to the Netherlands and Belgium for four days to decompress. I came back home, and then went straight back to California to start third year with all of my friends, just as I said before.

And that’s how my story ends—happily, and with a good score to boot, but with PLENTY of lessons learned. Since this post is too long already, I will put those lessons in the next post.