Thursday, February 26, 2009

25 Things I Learned From Studying And Taking USMLE Step 1 and 2 CK

Excuse my absence the last few weeks, but I was busy studying for USMLE Step 2 CK. Going through review books and practice questions, I came to realize that I had learned many important stereotypes and other truisms from this exercise, of which I'd like to share a few with you. 
  1. Anyone who visits Connecticut gets Lyme disease (Borrelia burgdorferi infection).
  2. Anyone who visits Arizona has coccidiomycosis.
  3. Young African American female? Lupus.
  4. Young African American without Lupus? Sarcoidosis.
  5. Farmers have no clue how to use organophosphates properly.
  6. Shipbuilders work primarily with asbestos to make ships. 
  7. No matter what disease you have, quitting smoking will make it better. 
  8. If you have Hashimoto's disease (lymphocytic hypothyroidism), you're way more screwed than you might have originally thought.
  9. Foreigner with a cough? Tuberculosis.
  10. If you are ever bitten by a scorpion, the only organ system that will be affected is your pancreas. 
  11. Anyone stung by a bee goes into anaphylaxis, so everyone should have an epinephrine pen. 
  12. Everyone from the Mediterranean has thalassemia until proven otherwise.
  13. Every old person over the age of 65 has cancer until proven otherwise.
  14. Every woman has autoimmune disease, gynecological cancer, or osteoporosis until proven otherwise. 
  15. If you do not have a DSM IV psychiatric diagnosis, something's wrong with you. Don't believe me? Check out what new addiction is being added to DSM V
  16. Children only have 4 orthopedic problems: development dysplasia of the hip, Legg-Calve-Perthes disease, Slipped Capital Femoral Epiphysis, or Osgood-Schlatter disease.
  17. No matter what the ethical dilemma is, never consult your hospital's ethics committee - you know ethics better than they do, or the dilemma really isn't that perplexing.
  18. No matter how ridiculous the patient is, you will never fire the patient and always respond calmly and professionally.
  19. Pathology slides on questions are to be ignored because the answer is usually in the prompt. 
  20. Ditto for x-rays. 
  21. The number of drug interactions you need to know is the square of the number of drugs you know. 
  22. Your patients will always have 5 possible diagnoses of which you choose one that seems most appropriate. 
  23. Medicine is too general and too specific all at once. 
  24. The test-making business is a pretty sweet racket if you can get in on it. 
  25. Doctors never make mistakes.
Heh, my facetiousness aside, I do sometimes wonder how all this repetition of stereotypes affects how we ultimately end up viewing patients when we go into practice. Hopefully we're still able to keep our eyes open to things that don't fit the 'classic' picture. 


  1. i totally agree with number 15:))oh this was so funny thanks for all the laugh:))

  2. Great post. If you add "Sinding Larsen Johansson" to the list for #16, you could look like a radiology all-star during case conference one of these days.

  3. Awesome post!

    I have to agree that the USMLE had absolutely no bearing on "real" medicine.

    Now I'm studying for my 10 year recertification boards. And it sucks.

  4. Eli, glad you enjoyed it =)

    James, not gonna lie, had to look that up, but always good to learn something new. It sounds almost like Osgood-Schlatter, but I understand the distinction, and I bet you can tell me like 10 ways it looks different on imaging.

    Grumpy, yea while recertification is a nice idea in theory, I can only imagine what a bear it must be in reality. Not looking forward to it.

  5. I need to remember some of these

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  7. I'm a medical student taking step 1 in a week, and this brought some much needed laughter to my day.

    #5 is so true! It does not matter WHAT that farmer was doing, what he was doing immediately before was poisoning himself with organophosphates.

  8. sweeet! ....i totally enjoyed this! thanx! :-D

  9. haha good read. i'm studying for step 1 and injecting humor is the only way to overcome this beast. thanks for the post.

  10. Haha awesome. Just had the test yesterday and reading this + hindsight + the fact that I'm not stressed anymore makes this so funny.



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