How exams work at UIWSOM

I survived final exams at UIWSOM. This was a GRUELING week. The closest thing that I can compare it to was when I prepared for and took my written and oral comprehensives last year when I was finished with my PhD coursework. And to be honest, that still paled in comparison to what I just went through… What follows is a description of how exam week is for the OMS-1 year at UIWSOM. I’ll give as many details as I can, but I cannot discuss particular topics or questions that were on our exams.

So briefly, at UIWSOM, our classes are given in a block system and each block lasts between 3 to 10 weeks. This first block was Essentials of Biomedical Sciences and EMT. Within each block, we have Small Group (SIGS), Clinical Skills & OMT (DOCS), Large Group (LGS), and Gross Anatomy/Histology/Embryology (STRX). The grade for SIGS is based on your attendance and participation in the case studies. Essentially, you only have to have a pulse, be professional, make an intelligible comment now and again, and you’ll pass the course. The grades in the other three activities are based on exams. This is what I will. Now describe.

For LGS, we take an exam called the “CE” or Cumulative Evaluation. This exam covers anything that was said in LGS, SIGS, DOCS, and STRX. Where UIWSOM is different than most medical schools, maybe all U.S. medical schools, is that our exams are not multiple choice. Our exams are written exams, so you really must know your business on a deeper level. There is only so much bullshitting that you can do to pass the exams.

The CE was on Monday of this week. The class was broken up into smaller groups so that we could take the exam in different rooms in Building 2. Check in for the exam started at 0715 and was complete by 0755. If you arrived after that time, you likely would not get to take the exam. The exam was broken up into three blocks of 14 essay questions each. Block 1 went from 0800-0945; this was followed by a 15-minute break. The second block went from 1000-1145 and was followed by a 30-minute lunch. The final block was from 1215-1400. If you finished early, you could leave but we were not allowed to hang out in the building nor were we to discuss the exam with one another. The exam was taken on the ExamN lockdown browser.

The next day, Tuesday, we took the DOCS exam. The exam was divided into two parts. The first was the History & Physical exam and this was taken in the CIELO Patient Simulation Center with mock patients. The second part was taken in the OMT lab with one of the OMT professors as the rater. For this part of the exam, we were matched with a student and took turns being the patient.

The History & Physical part of the OSCE started at 1230. The class was broken up into groups of 10 to 12 students and each group of students had to arrive at the CIELO, check in, and then the check in staff gave us a number that corresponded with our exam room. At the appointed time, we were escorted to the exam room, and we had a few minutes to read the prompt on the door. The prompt was a scenario that gave some basic information about the encounter and what we were to do. After reading the prompt, a buzzer went off and I knocked on the door. The mock patient said “Enter” and I entered and started what I was supposed to do. Once I’d finished gathering information and examining my patient (we were allotted 16 minutes), we had eight minutes to type up a SOAP (Subjective, Objective, Assessment, & Plan) note. After the SOAP note was completed, we waited until we were escorted to the OMT lab for the OMT portion of the exam.

The OMT station was a timed, 12-minute station. The instructor who was also the rater, gave us each a red folder that contained information regarding the type of OMT exam and/or treatment that we were to perform. Once a buzzer went off, if you were playing the role of the physician, you instructed your patient to disrobe and then you started the exam. As you were doing the exam, you had to verbalize what you were doing and why, verbalize key anatomical landmarks, state what you were looking for, name the somatic dysfunction if applicable, etc. At times, the rater would ask a clarifying question, but they did not otherwise communicate. It was really kind of an odd feeling because me and my partner were standing there in front of her as she sat at a computer typing notes on our performance of the exam. We were not to communicate in any way, as you might imagine. Once the exam was done, the rater would ask, “Is there anything else that you would like to add?” If nothing, we were done. We dressed and exited the OMT lab.

The final exam, arguably the most mentally taxing, was the anatomy or STRX exam. We had that today and again, the class was broken up into two groups for the exam. My exam time was at 1230. When I arrived at Building 4, I checked in and then our group was broken up into two groups. One group proceeded to the lab for the visual lab practical and the other group proceeded to the large group lecture room for the microscopic anatomy portion of the exam. Each portion of the exam consisted of 40 questions, and we had 90 seconds to write an answer for each question before a buzzer would sound for us to rotate to the next station.

The exam started at 12:45 and ended at 1510. When I got to the last six questions of the microscopic anatomy, I was mentally DRAINED. Few of the questions were straight up “identify this” questions. No, everything was a 3rd or a 4th order question. Like they would show a basophile and ask what does this cell type do and when is it activated? Or If I cut off this blood vessel, what collateral can supply this tissue? You had to really know your stuff.

UIWSOM does not give letter or numerical grades; the idea is to cut down on competition in the class. Everything is graded Pass, Pass with Recommendations, or Fail during the OMS-1 and 2 years. In the OMS-3 year, you can Pass with Honors, Pass, Pass with Recommendations, or Fail. I feel that I did well enough to pass everything, probably pass with recommendations, but at this point, that is all I care about. I need to make some modifications to my study strategies for this next block, Musculoskeletal & Integument, that starts on Monday. For example, I need to go back to making flashcards; I got away from them because they were time consuming but in retrospect, they really do help with my memory and retention. I am also NOT doing a study group. Study groups are good when you have a good group but sometimes, you just don’t mesh well with the people that you are studying with, or you find that the effort that you put out is not equal within the group. I found that my study group slowed me down. Finally, I now understand the depth that we are expected to go into so that will help when I answer the lecture objectives and make my flashcards. I’m going to rest tonight, and tomorrow, I’ll prepare my poster for the AMA Research Challenge. Saturday, I’ll start getting ready for the new block that starts on Monday. Seven weeks of MSK and Integument!

Lessons learned after completing the first block of medical school

I just wanted to share my thoughts after completing the first block of medical school. I’ve learned so many lessons and I hope this helps those who are beginning the journey, or even having second thoughts regarding their commitment to the journey. Hope this helps💙

REFLECTIONS: Lessons learned over the first block in medical school:

1. Self-doubt will set in. Comparison to others will set in. Imposter syndrome lurks around every corner.

2. Medical school is a mind game, and you have to learn to wear blinders comfortably. Horses run with blinders for a reason. If you compare your race or judge your race according to others standards, you will always feel inadequate. Run your own race!

3. A great support system is necessary and essential to your success. If you have people around you who are undercover jealous or are not working towards their goals, what you do may “offend” them. If you keep people like this in your life, it is a recipe for YOUR disaster. I understand why a kitchen strainer is vitally important. The kitchen strainer sifts food particles from the water and like the kitchen strainer, you must sift through the people in your life. Once you do, you can see clearer and not be weighed down by other people’s burdens.

4. Those who respect what you are doing, are genuinely concerned, and are cheering you on will respect your needed boundaries. They will not be “offended” when you must tend to your business. Your relationships will pick up where you left off and you’ll talk in between AND there will be no “injury” to the relationship. You will find out who only cares about their emergencies and demands being your issue and they make an issue when you do not respond. They will never understand, especially depending on their motives and level of selfishness, why you are grinding so hard. Don’t try to make them understand. Sift them from your life.

5. Medical school challenges you to control what you can control and not feel guilty or obligated for those things you cannot control or is not yours TO control or fix. You start analyzing, “What is mine?”, “What have I taken on?”, and “What do I need to give back to the person who it belongs to?” It challenges you to also make arrangements for those things that temporarily require your necessity to ask for help.

6. Even Superman needed help. You cannot be all things to you and everyone else AND it is ok. You must believe that. And know it’s ok. It does not make you weak. It makes you strong and human. GET HELP with daily tasks and obligations and those who have signed up to do and more importantly being paid to do, INSIST THEY DO what they are supposed to do or find others who will. It also hits you in the face that winning overworked, over stressed, overextended award of the year is overrated.

7. No is a complete sentence. I cannot is too. No explanation do you have to give others and if they are for you they will understand.

8. Let your light shine. Not for bragging rights because you should understand, all things come from God. It’s not for those who are members of the National Negative Association. But you are letting your light shine freeing others to know that they can let their light shine to. If you can do it they can.

9. It’s not your obligation to continue to drag people across their destiny finish line. Somewhere, they must do what you did. Be inspired. Do the work. If they don’t, count it as a seed being planted and pray for the harvest to yield. If it doesn’t, it’s not your farm to tend to.

10. Self-care and congratulations, including celebrating small and large accomplishments are necessary. Even if you must do it by yourself. Do not wait or depend on likes or comments because after a while, most of the likes and comments will stop after you continue accomplishing your goals. Be ok with that if the why you do it is out of the right motive.

11. This is a weeding out period. The school is not weeding you out, but you will see that people will weed themselves out. Read that again. Read it one more time. Your responsibility lies with what you must complete. Not with how what you complete makes people feel. Trust the process and what the Lord allows. Do not get distracted.

12. Everything that can happen, will happen. It’s a distraction. Recognize it, step over it, and continue the race.

13. You cannot do any of this without prayer and God (or whatever you believe in as the higher power). Do not even try to. And when you depend on God, give it to God, and just be accountable for YOU doing the right thing, 1-13 are easier.

14. Get rest when you are tired. You do not have to feel bad or justify. You are not a robot.

15. Open your mouth to your professors. They are people too and life happens to them as well. When you can advocate for yourself, it makes them respect you and give you a chance. Accountability and responsibility is vital. Do what you can do as much as you can in advance to prepare for classes because they are coming. Your stress level will thank you.

16. Time management is crucial. Boundaries are vital. You have to make You Important and paramount. Your support system is very important. #16 will help guide you through your process to accomplish 1-15.

17. Whoever is left after the process were meant to be part of your life. They’ve stood with you. Be thankful, but know, there will only be a handful of people.

BONUS: you will recognize how much people stay operating out of feelings and not facts. Don’t get caught up. That’s not your cross to carry.