by Arobe Shiek Goling II, MD (Class 2019)
It has been several months since I successfully hurdled one of the greatest battles of my life – the September 2019 Physician Licensure Exam (PLE). To describe the weeks and eventually the days before the PLE as something difficult is actually an understatement. This is because as the exams come closer and closer, you’ll realize that you won’t be able to finish your readings across twelve subjects. This is on top of the associated emotional and psychological struggle that comes along with the intensive preparation. While it may sound cliché, it is true that one will never be confident that they will pass the PLE. The disturbing imagery that one may fail will always play in one’s mind before, during or even after the PLE while the rest of the world is waiting for the results.
Regardless, the boards season is indeed a learning experience. This season has given me a deeper understanding of my inner character in terms of strengths, weaknesses, and even priorities. This experience made me realize a lot of life lessons which I’ll still probably bring with me as I pursue my medical career.
During the Review Season
1.You should know your own style
Medical internship programs in our country often conclude by the end of June. The PLE usually takes place on the 2nd and 3rd weekend of September. This means that you only have 2 months to review for the board exam. This comes after internship, wherein you had to do to do a lot of monitoring, blood extractions (ABG!!!) and other errands which are technically not under your job description as a medical intern but still you did those errands for the sake of your patients – always.
Hence, it is important to make the most out of the two months. This will require knowing your own style. Some enrolled in review centers, whereas others committed to self-review. Some would wake up early 4-5am and would sleep around 11pm. In my case, I would usually start studying 1pm and end up 4am. Some would opt to study at home, while others would choose to stay in libraries and coffee shops. The point is, there is no specific formula for the boards. You just need to determine what works for you. Perhaps, you can trace back which study style has helped you pass more exams during the past 5 years in the medical school.
It is also important to adjust your style. There were days when my usual style would not work. For instance, at some point, I got tired of highlighting and taking down notes within the handout. This was the time when I shifted my style to using index cards. There were also some subjects that will require a different style. Case in point, anatomy would require you to memorize and, at the same time, it will also require you to visualize certain structures (Tip: a lot of questions in anatomy are asked this way). However, pharmacology would require you to memorize, classify and remember the unique features of hundreds of drugs. This means that your style might be different depending on the subject you are currently studying.
2.Rest is a must
The reality is, you won’t feel comfortable during the two months of review. There will be some days that you won’t feel motivated to get out of your bed and you’ll end up turning off your alarm clock after multiple attempts to press snooze because you are simply tired. You already know that you have had 8 hours of sleep yet you still don’t feel like flipping pages in your pharmacology handout because you are just too exhausted to absorb another set of information which you probably won’t remember after 3 days.
During these times, you are not prohibited from taking a break – but not too long. In my case, I would often end up going to a spa or end up eating ice cream or shawarma which have served as my comfort foods when I was in medical school. Others would tend to visit their loved ones, go to church or watch a movie. The point is, you are allowed to feel that way. You are allowed to feel tired and give yourself a break. However, you also need to go back and continue the fight. Furthermore, this is the part where you have to review all your “whys”. In those times, I would open an album in my phone entitled “Inspiration, Hope and Faith”. This album consists of photos of our family, brothers in my fraternity, closest friends, mentors and even people I have looked up to in the past 25 years of my existence. It helped me a lot.
3.Your support system is important
The medical board exam is more of an emotional and psychological struggle than a mental struggle. This is the reason why it is important to have a strong support system during the review season. You have to remember that you are not alone in this journey and a lot of people are praying for you. Whether you are reading handouts in the library or a coffee shop, the presence of someone can be can be relieving when days are seemingly dark and hopeless. One can count on one’s faith, family, closest friends and even mentors. Mentors are important. They can give you a more mature perspective of what you are going through. A simple “Good luck” or “You are in my prayers” can come a long way for someone who is reviewing for the boards.
During the Exams Weekend
1.Take one round at a time
Medical boards consist of twelve subjects – three subjects each day. You will be given two hours every subject and a one-hour break in between. Expect the worst in every subject. One subject can either make or break you. This is the reason why you have to focus on one subject at a time. There’s no point in contemplating what could have been done to correct your wrong answers. After the boards, you will realize that each subject has a story to tell. One of my seniors in UP Med advised me that during the boards all examinees are probably tired, and you can have a competitive advantage of keeping you strength and sharpness until the end of the boards. Never think that you’ll probably fail because of the first subject and subsequently just opt to finish the boards for the sake of completion. During my time, I fought until the end. I utilized the 2 hours allotted for Preventive Medicine (last subject) even if it is probably the easiest subject among all the twelve subjects. My mindset that time was, I will get the highest possible score for this subject because it may either make me or break me.
2.Best foot forward
You will probably hear your seniors and mentors advise you to have a good sleep a day before the exam. This is the ideal thing to do. However during the boards, you will find yourself still awake around 11pm to 12 midnight. You’ll find yourself immersing under a lot of thoughts (e.g. What will the questions be? What if I experience mental block? Will I pass? What if I oversleep?). These thoughts are all normal. It is important however to do your best to relax physically and mentally at least a day before the boards. Prayers really helped me stay calm and focused during these times. Believe me when I say that your reasoning is better when you are well rested.
There is no time to get sick. During our time, there was a Dengue outbreak. Our mentors in the review center advised us to be extra careful. One should never take their health for granted because it can significantly affect one’s performance. This means that you should not miss meals, hydrate a lot and get sufficient rest.
3.Expect the unexpected
PLE is like your favorite series in Netflix – full of twists. Seniors oftentimes gave endorsements which consist of what the boards covered during their time or even the way the Board of Medicine (BOM) asked questions. All of these helped during the boards. However, the Board of Medicine already knew that these endorsements were circulating. Hence, BOM has learned the art of surprising the examinees. For instance, they can ask a topic that has never been asked in the PLE. They can even ask you questions that are not related to the subject (e.g. in Legal Medicine, we were asked what to do when lightning is involved). This is where testmanship is important – narrowing the choices and choosing the best possible answer. Indeed, the board exam is not a perfect exam. I believe however that its imperfection is part of the battle.
After the Boards
The Waiting game is actually a game of one’s faith
The results of the PLE are often released 3-4 working days after the last day of the boards. Our results were released on September 20 which was around 12:20 am. The days of waiting can be draining not only for the examinee but even their family. This is probably the chapter of my life I would not want to experience again. We were advised to spend time with our loved ones, rest and eat our favorite comfort food. I ended up oversleeping, losing my appetite, and isolating myself. I can say that the waiting game is a game of one’s faith. It is during these times when you will end up holding on to your faith – the reality is that you have done your part and what’s going to happen next is no longer under your control. Our professor in surgery in the review center, one of the most notable professors I have ever had, once asked us, “Are you ready to fail?” Our class did not respond. We were obviously surprised and saddened by this question. He eventually said that one should be ready to fail to win this battle. It took me a lot of time to absorb this thought.
In the end, whatever happens, the examinee should learn how to surrender. The joy of passing can be overwhelming. You will feel that so called “cloud 9 experience” which is filled with hundreds or even thousands of congratulatory messages. For those who did not make it, you have probably heard a lot already of encouraging statements, but this is what I can say: the PLE will not define you and even those who passed the PLE. Also, it’s okay to have a break before you go back to facing the battle again. We will always be here praying for you and we will wait for you on the other side.
It’s also true that the real test comes after the board exam. After the overwhelming joy I felt after passing, I realized that I should answer the question of “what’s next?”. The real test begins when you realize that you are no longer a student, when you are no longer choosing the best answer to pass an exam and when your decision is the only thing between life and death for a certain patient. It can be scary because it is the real world. However, I am also confident that UP Medicine and PGH have prepared me for this dreaded reality.
Life indeed has to go on and I have never been more excited to see the next chapters of my life.