Never be ashamed of your shortcomings of failures. They make better inspirational movies

It's that time of year again. That dreaded time of year when a few of us open up our emails to a letter that says "FAIL" in big, capitol letters. Step one results are pouring in all over the country and some of you are finding out that you did not pass. You think your life is over, that your future is bleak, that your dreams will never come true. Some of you are thinking that you might as well pack your bags now and drop out. Others are worried they will have to take an entire year off from school to retake it. You're thinking about how you'll never match into a residency in your field of choice and you might as well sign up for Family Medicine, because they are the only ones who will take you. You feel hopeless and helpless and lost. And most of all, you don't want to study for and take that DAMNED test again. I feel you friends, I was there. And I'm here to say that you will survive this. You'll make it through. And you may even still get your dream job. For the past two years you have been fed a steady diet of "this test will determine the rest of your lives." That's really stressful, to say the least. You spend two years stressing out about one single test, placing all your hopes and dreams on your ability to pass and do well on this test. Nothing else is given the level of importance of step one. It determines everything, what residency you can get into, what job you can have in the future, how well other people will respect you, what kind of car you'll drive in the future, whether or not you'll live past 50. Whatever you want to do in life depends on your step one grade. It gets so blown out of proportion that you stake everything on your score. And this is the major failing of the medical school educational system. Because step one is a test. Nothing more. It tests your ability to remember random facts about a billion things that don't really matter. It supposedly standardizes you with the rest of your colleagues around the country going through the same education. It tests your ability to take a test. It does not determine what kind of doctor you are going to be. It is not the end all be all. The major failing of the medical school educational system is this fucking test. Testing me on the finest detail of how some system works does not indicate how good of a doctor I'm going to be. It emphasizes the details with a blatant disregard for the big picture. It has everything to do with science and very little to do with the actual practice of medicine. I don't know what the hell any of that stuff does. I would NEVER be able to pass that test again. And more importantly, neither would the attendings I respect and look up to. My uncle is an amazing surgeon, very well respected. Could he pass that? Hells to the no. Half the clinic instructors that you'll rotate with will admit they wouldn't be able to take that test again. Why do you think the first two years are taught by PhDs and MDs who work in labs and do research most of the time? Because that's what a high knowledge of step one material is good for. Yes, it's important to know the mechanisms of how things work. But step one doesn't really even test your knowledge. It's a mind trap. It's designed to be a puzzle that you have to figure out. It is full of patterns. And those people who excel at finding patterns are going to do better. For those of you who failed step one, I'm sorry. I'm mostly sorry because you have to take it again, and that is the really painful part. But your life is not over. Far from it. You're just beginning on your new quest. Any residency program is still open. You're options haven't disappeared. You just have to change to approach to things. The only real failure is giving up. Things are going to be hard, and you are going to have to work harder than your classmates, those lucky bastards who passed that damned test and get to move on with their lives. But you are going to be the stronger doctor because of this experience. Take time to figure out what went wrong and how to make it better. The important thing is to learn from this set back and keep on toughing it out. How do you get through this? The first step is to know you are not alone. Eleven people in my class failed. As far as I know we all got into residency. Some took another year to do it but that was their choice. Some (read: me) scrambled but now love their lives (being a psychiatrist is the greatest thing in the world). People in the class above me failed, people in the class below me failed. Someone else in YOUR class failed. I know a girl who failed four times before she finally passed it. There are many factors that went into us failing, but none of us are stupid or ill-equipted to be doctors. I failed for a multitude of reasons. My anxiety was probably the biggest factor. I could not focus, or study, or do much of anything other than cry. I was not in the right state of mind to pass a test. My poor studying techniques were another. I didn't do nearly enough practice questions. I was afraid to ask for help. My inability to take standardized tests was also high up on that list. I suck at them. I took the MCATs three times before getting a good score. I also let way too much drama into my life. Stupid ex-boyfriend and trying to make things right! I'll blame him forever! Think back to your studying. What was going wrong? What could you have done better? Ask for help. That's probably the hardest thing for a medical student to do. We all need help, we all refuse to ask for it. Don't get tied up in what someone else says is what you should do. The student affairs office has some advice but it's generally cookie cutter advice, and it might not work for you. Going to the FALCON program in Texas might be awesome, but it might not be right for you. Take the test again when you are ready, not when someone else tells you to take it. Don't take more time off rotations than you need to. The most important thing to remember (I'll probably say that at least twelve times. Everything is important. Determine for yourself what is most important to you) is that you are the only person who needs to know you failed. Sure, whoever was on rotation with you probably figured it out when the scores came in and you ran home crying. And the attending you were working with that day may need to know why you ran home crying. Student affairs will know. And residency directors/interviewers will know. The attending on your next rotation doesn't have to know. Your best friend doesn't have to know. Your future colleagues won't ever find out. So if you are a secretive kind of person you don't have to tell anyone. I am not a secretive person (obviously) and felt it necessary to wear it as a badge of honor. "Yeah bitches, I failed step 1. But my patients like me better." I told who I wanted to. Which definitely was not everyone. I was more willing to share it after I had finished and taken it and passed it. But when I first found out I texted a bunch of my friends to let them know. Mostly for the sympathy, but also so they would know why I continued to be a crazy bitch. And that way when a couple of my friends failed they could tell me and we could commiserate together. And for those who didn't pass it they could bring me candy and feel sorry for me. I've been getting comments on my blogs from all kind of people struggling in medical school. Some failed tests, some failed classes, some failed rotations. But everyone keeps working through it. And I'm proud of all of you, because you aren't giving up. No matter how bad it gets, we are survivors. And when I go out there and look for a job I'm going to be able to sell myself so much better than someone who never struggled, because I know more about myself because of how much I had to struggle. And I'm an inspiration for others. Think about your favorite movie. Did the protagonist have an easy time of anything? No, because that movie would suck. There would be no point in watching it. So those classmates of our who go through life with everything coming easy aren't going to get to be the plot of a movie. Their movie sucks. Our movie is awesome. I want Emma Stone to play me. She's got spunk, and she's super cute. She'd make a great me. And my story is better than other people's. I had an easier time writing my personal statement, because I have something to talk about. Most importantly (there it is again!) I am a kick ass doctor. I'm in my second year of residency in psychiatry. Even though I scrambled into my program I'm one of the best residents in my class. Everyone who find out I was one of the scramblers is surprised. I teach medical students and get rave reviews. I just got an evaluation from my internal medicine attending saying I worked at or above the level of a medicine intern (I was an intern when I did this rotation). My six month reviews have consistently passed me with no concerns. My attending love me. And my patients swear by me. I'm officially done tooting my own horn, because really all I was trying to point out is that step 1 (or 2 or 3 for that matter) does not determine your ability to be a good doctor. People will continue telling you that to help you feel better, but I'm living proof that it is true. So study hard friends. Keep calm and carry on. Be proud of yourself for continuing on this crazy journey towards medicine. And remember that if you aren't struggling you aren't really living! I love you all, and wish you the best in your endeavours. Even if I don't know how to spell it :-)