This is a continuation of “My First Year of Medical School was Hell”. If you haven’t read that post first, no worries! This one will still be here waiting for you when you get back 😊

Forewarning: This is also an extended story time— a novel, if you will. You’ve been warned.

And Persevere, She Did.

I watched it slip away from me, slowly, like sand flowing through an hourglass.

Medical school was …over.

My dreams of earning my long sought-after M.D. degree had fallen beneath me into a hole just big enough to consume all that I had sacrificed and achieved, leaving behind only the memory of what once was.

I had taken USMLE (United States Medical Licensing Exam) Step 1 five times. Five. Five 8-hour tests. Five heart-sinking failures. Five series of seemingly unanswered prayers.  

The only upside was that I managed to create an impressive streak of steadily increasing scores from the very low point of where I first began. Administrators at my school reluctantly admitted that they had never seen such vast improvement before. Over time, I had managed to jump several points from my original STEP 1 score and made major strides in closing the knowledge gap I had accumulated from having such a rough initial start to medical school.

But unfortunately, what I heard from peers about the exam being scaled more harshly for repeat test-takers proved to be more than just a myth.

My steady improvement culminated to the peak of a one-point exam failure, which stung even more than one would expect. I received that score just one year after the USMLE exam committee had announced a one-point increase in the passing numerical score cut-off, and two weeks before it would announce the future replacement of the numerical grading scale altogether with a brand-new pass/fail scoring system. To make matters worse, I was also robbed of the chance of opening that score report on my own before receiving an insensitive early morning phone call from my school letting me know that I was on the list of students who had failed the exam.

I had taken hard hits in life before, but this one certainly hit different.

Through my own research, I knew that the score I made prior to the one-point failure would have also been passing just a few years prior. Which means that there are whole doctors are out here, licensed and practicing medicine, with two of my EXACT same STEP 1 scores. And there’s a whole new generation of doctors who, now and forever more, will never be numerically scored on STEP 1 at all.

Personally, I think it’s incredible that the USMLE exam committee recognized its systematic flaws and decided to throw the old system away. It just sucks that the timing of this shift wasn’t in my favor.

Timing of anything concerning the STEP 1 exam never seemed to be in my favor. Let’s take a look back…

In the days leading up to my first attempt at the exam, I unexpectedly learned that the ex I broke up with shortly before my car accident eventually had a baby with the girl he’d cheated on me with. Along with this and other layers of personal challenges, it didn’t help that my dedicated study period for this first sitting was disrupted by a mandatory, make-or-break, didactic board exam re-take scheduled two weeks before my STEP 1 exam.

Shortly before a future attempt at the exam, I learned that a resident-suicide, which left our entire campus in grief, had occurred just below my unit in my off-campus apartment building.

I had started counseling earlier that year and did my best to protect my mental health in the critical days leading up to each exam date, but had zero control over the random two-hour power outage that would occur at the testing center, six hours into the eight-hour exam that would ultimately end my medical career… by one point. (Yes, I contested the score. No, it didn’t change a thing.)

This is only a snapshot of the experience. If this all seems hard to follow, imagine what it was like in the chaos of living it! It seemed like I couldn’t catch a break, but I remained hopeful. 

While I waited for the opportunity to retake the exam one last time, I applied my new and improved study techniques and knowledge base to the clerkships I was permitted to complete. It felt amazing to perform well and score at A and B level after continuous disappointment with my STEP 1 performance. The courses improved my confidence significantly, and I felt ready to finally put the looming hurdle of passing STEP 1 behind me.

But then there was the COVID-19 pandemic of 2020 that none of us saw coming.

During lockdown, testing centers issued randomized cancellations to operate at half-capacity in compliance with social distancing protocols. I ended up in the half of examinees that had to reschedule. I was hesitant to choose a new date that would fall shortly after a crucial clerkship board exam, given that something similar and out of my control had happened the first time, but I didn’t have much of a choice. There were very few test dates available, and at the time of scheduling I had no clue that the date I selected would also fall shortly after my attendance at a vigil for one of my schoolmates.

A medical student at my school tragically had lost his life in a car accident, eerily around the same time of year of my own car accident from just a few years prior. I didn’t know the student personally, but I was moved by the grief of the several students who did. I wanted to attend the vigil to pay my respects. At the event, I was reminded that death and mourning for others has a way of making us think about our own mortality. Kind of like weddings often make us reflect on our own love lives. The tragedy was heartbreaking, and it left me with a strange case of survivor’s guilt I wasn’t prepared for. As I gently protected the flame on the candle I was holding and listened to the string of heartfelt stories, I couldn’t help but to think about how it could have easily been me.  

This tragedy, alongside the racial and political unrest of 2020 that re-engaged global attention to the Black Lives Matter movement, did a number on my mental health. And the financial aid implications of needing to delay my final attempt at STEP 1 plummeted my finances to an all-time low. I was overwhelmed. But I persevered. I could still feel God’s presence pushing me forward, encouraging me, and filling me with guidance and peace in knowing that there was something I couldn’t yet see waiting for me on the other side of it all.

Despite my performance on STEP 1, I’m proud of myself for passing my classes during my first year, and for passing the classes after that, and the classes after that. My rocky start didn’t provide the best foundation in my program, but I navigated my way through each challenge and unexpected fork in my path as gracefully as I could. And, when my final STEP 1 score report wasn’t what I had hoped for, I had peace in knowing I did everything I could have possibly done with the challenging cards I had been dealt from the very beginning. And I was ready to embrace whatever would come next.

(It would have been nice to have that random $100,000 each student at my institution was gifted by a wealthy donor, just DAYS after my departure from the program, however.)

As embarrassing as it is to speak the number of exam-attempts aloud, I recognize that it only feels this way because of the discomfort in knowing someone could have a knee-jerk reaction in shaming my failures, before ever recognizing the resilience it must have taken for me to dust myself off after each attempt and have the will to try one more time. Sitting for that 8-hour test at all, let alone multiple times over, takes gumption, strength, insurmountable knowledge and an incredible amount of mental endurance. I’d much prefer a medal for persevering for as hard and long as I did, not a scarlet letter. But human nature can make it easier to carelessly pass judgement than to fully imagine walking a mile in someone else’s shoes.

The worst had happened: I had gone after my dreams and failed. Or, at least it seemed that way. Admittedly, I felt defeated. Four years of sacrifice and I only had a mountain of debt and a valley of trauma to show for it. But the way my ambition is set up, that was better than having never tried at all.

Just like an hourglass, I hadn’t noticed the sand of my time in medical school slowly escaping beneath my feet, but I could sense that there was something even better forming from it on the other side. As time would have it, for my next chapter to begin, this one had to fully come to end.

And, in hindsight, I realize that it couldn’t have happened any other way.

Reflections on “My First Year of Medical School was Hell”

I wrote and released “My First Year of Medical School was Hell” three years into medical school, in the days leading up to a make-or-break meeting with my dean, which would determine whether I would be allowed to re-sit for STEP 1 (a re-sitting I was gracefully permitted, but ultimately failed by 1 point). I knew that I wanted to write about my first-year experience one day, even as I was experiencing it. But I figured this would happen some time post-graduation, or perhaps decades after I had trailblazed my way through an incredible career. Ultimately, I decided that my story deserved to be told, even if neither of those things ever happened.

When I shared “My First Year of Medical School was Hell” with the world, I told myself that if only one person were touched by reading my testimony, then it would have all been worth it.

And it absolutely was.

The overwhelmingly positive response to sharing my story was far more than I could have hoped for. I am grateful for the people who I have been able to encourage and for those who have inspired me with their own testimonies. I believe that life’s challenges and triumphs are meant to be shared. My hope is that inspiration, strength and fellowship result from vulnerability in sharing my personal experiences with others. It’s part of what keeps me pushing forward.

There was life before medical school, and there will be life after. Success stories are seldom free of failure, and mine is no different. Being a dreamer in this world also involves being a risk-taker, and those who dream the highest have potential to fall the hardest. The way I see it, even trying at all is a success story.

I believe J. Cole said it best,

“If you believe in God, one thing’s for sure: If you ain’t aim too high, then you aimed too low.”

My personal, academic, and social challenges in medical school have given me the strength to be resilient in all chapters of my life, not just this one. The thing about successes and failures is that they are self-defined. And I have come to realize that the more my faith is tested, the more it is strengthened. As an angel of a mentor at my former school would always say,

“I am more than a conqueror.”

And if God is for me, who can be against me? 

*Queue chorus to “God Favored Me” by Hezekiah Walker*

I didn’t expect for medical school to feel so much like high school for adults, and I was disappointed in how little of an opportunity I had to make a name for myself without one being made for me. People believe ridiculous things, but I’ve come to realize that it’s not my job to dismiss the nonsense. I’ll always know what really happened that year, and in the years that followed. And I will always remember the kind souls who chose to help me dust off the ashes of life’s most tumultuous experiences, rather than choosing to fan the flames. If any of those individuals happen to be reading this, know that I am sincerely grateful our paths crossed.

Truth is, what I shared in “My First Year of Medical School was Hell” is only a fraction of what I experienced that year. And what I’m sharing now is only a fraction of what I’ve experienced since then. I’ve picked up a lot of gems along my journey thus far, and I’m still collecting them. Through it all, I’ve persevered and kept my head held as high as I could manage to hold it while treading through hell and high water. But I’m still standing. God is still good. And *plot twist* I’m STILL going to be a doctor.

Against insurmountable odds, God has given me a second chance and a fresh start. My story is far from over, it’s just beginning.

Emerging From the Flames

There was an episode on the Netflix series “100 Humans” (Season 1, Episode 5) which designed an experiment to determine whether criticism or praise was more effective in producing favorable outcomes. The experiment began with each participant on stage in front of a few judges. The task was for each participant to spin a plate on a stick for as long as possible, with no prior training or practice. Some participants were naturally coordinated and good at this task, while others were not. However, everyone had potential to learn and improve.

Notably, during the feedback portion from the judges, one of the participants who performed poorly was given an extreme amount of praise, while another participant who was naturally incredible at this task was given exceptionally harsh criticism. After the initial performance, all participants were given ample time to practice and improve on their own before being reinvited to the stage to perform the plate-spinning task again for the judges. The participant who had performed terribly initially, and was given exceptional praise, performed significantly better the second time around. However, the participant who had performed well the first time around, but was harshly critiqued, performed much worse than when she first began.

The phrase “verbal abuse” was used in the episode with reference to how harshly the participants were criticized. The experiment was the closest I had ever come to being able to explain to others what I had endured at several points during my allopathic program. The Netflix episode was admittedly hard to watch, but it provided validation that environmental, as well as situational, influences are real. And, when it comes to verbal abuse, it’s not a personal matter of individual sensitivity as much as it is a psychological fact that praise is far more effective than criticism.

The episode resonated with me so much so that I had to exercise restraint in not emailing administration a link to the segment with an attached dissertation about how it was nearly impossible to perform well when I was constantly being cut down with such harsh negativity.

In watching the episode, I felt seen. I wasn’t insane. I absolutely had the potential to flourish. But what I had been experiencing for so long made me feel otherwise.

When I reached out for tutoring during my surgery clerkship, I was paired with a professor who would always roll her eyes, ask me if I knew anything at all, and urge me to go read anytime I answered a question. With that kind of response, of course I was going to meet each subsequent rapid-fire question with hesitation, and later get more test questions wrong, than if I were given any level of praise for the things I did know in practice (which was a heck of a lot more than she realized). Anytime I’d ask a clarifying question, she would scoff, shake her head and scold me. With that kind of attitude, how can anyone learn anything?

Her poor attitude facilitated such an uncomfortable, and borderline scary, learning environment that it got to the point where I developed such strong anxiety about our meetings that I eventually didn’t want to show up at all. (If you choose to watch the episode of 100 humans, imagine experiencing this multiple times over, for hours.) I will never forget holding back tears in that lady’s office, basically pleading for mercy and wondering who in her life ever treated her so harshly to make her be cruel towards a student taking the initiative to seek help and improve.

Thankfully though, some professors in my program were genuinely willing to help students. And I always silently regarded them as angels amongst the chaos. But their acts of kindness weren’t enough to overcome the ever-present unprofessionalism running rampant throughout all tiers of our campus.

If I weren’t already dreading going to anatomy lab, hearing things like,

“Your presence doesn’t matter.”

from a member of my lab group certainly weren’t helpful in maintaining a positive headspace. And, to add insult to injury, it was tough to be excited to participate and learn after visiting the anatomy professor, excited about my personal progress and significant improvement in test scores, and the only thing provided was a head shake and a stern,

“Improvement isn’t passing.”

The environment was not at all structured for students to thrive. Many other students have spoken up about this, but unfortunately not much has changed since leaving the program. Even with the changes that have been made, it’s sad to hear that present-day students are still experiencing many of the same things I did.

I will never forget the time that an administrator called me to her office for no reason other than sheer intimidation. In the meeting, she’d unnecessarily recited my transcript aloud, line for line, called my STEP 1 score “abysmal,” and looked me directly in the eyes with a smirk on her face—growing bigger by the moment as she noticed the lump forming in my throat—and rhetorically said,

“What, do you have some kind of learning disorder?”

She had a reputation that preceded her for pushing students to get them to react and crumble, so I knew to hold my ground. I looked her directly back in the eyes and told her that I had full capability of performing well but had experienced a rough start to school, which unfortunately created a ripple effect. I stated that I was managing many personal things that had happened since then as best as I could.

In the spirit of professionalism, I kept the specifics of those things to myself, as I had been shown that personal problems have no place in professional spaces. However, a little compassion or, at the minimum, human decency, would have been nice. Professionalism is a two-way street, yet people in positions of power often seem to forget that. I digress.

The smug look on her face, sudden folding of her arms and shifting in her chair suggested that she was surprised at my firm response and was game for trying to push my buttons further. I remember swallowing my pride, and that darned lump in my throat, and declaring,

“I can assure you; I am NOT incompetent.”

I got up and left after the statement, and each tear that I had been holding back during our meeting exploded once I left her office. Thankfully, the compassionate secretary who had seen this happen to many students before was standing there waiting to catch those tears on her shoulder. She greeted me with a giant hug and took the liberty of praying over me right there in that moment.  

It’s very challenging to explain to others what it was like in that kind of environment. Even with the level of detail I provided in “My First Year of Medical School was Hell,” I have had to defend my rationale for not receiving help or taking a leave of absence from the program when I had the chance. There was no help. At least, not the help and support I needed at the time.

Even when I was several attempts deep into failing STEP 1, I was refused the professional tutoring option available to students. And, concerning my first year, why would I ever listen to a mean lady in a suit who tells each student that enters her office that they’re never going to succeed in life? Had I listened to her then, I wouldn’t be out here thriving now.

There was even a time during my first year that I was physically cornered by a staff member and yelled at for explaining that it was unfair for me to be failed for not following clinical encounter instructions provided to only half the class. I knew what I was up against and it became clear from that point forward that taking the metaphorical punches as they came and getting back up in the ring was all I really had the power to do. There’s much room for improvement and despite what all has happened, I sincerely hope that one day the school becomes what it has so much potential to be.

I acknowledge that my former school isn’t the only program with these problems. And I don’t like talking about these things much because (1) it was traumatic, and (2) much of my energy had to go towards self-preservation and tackling each task at hand (aka survival mode), rather than attempting to fight a problematic system that had been in place long before I arrived. The inefficiency of so many facets of my medical education was astounding. But a benefit is the positive reputation earned with residency programs that students from my former school are exceptionally resourceful (albeit not realizing that it is because we had to be).

Even with its flaws, I don’t spend too much time complaining about a school that gave me an opportunity that they ultimately didn’t have to at all. All things considered, I am always going to be grateful for the experience, even if it wasn’t what I had anticipated.

Footprints

Persevering through such awful circumstances with very little institutional support is something I have learned to give myself grace for. Unfortunately, I learned that many of the friendships I thought I’d made early on were conditional. After a while, I recognized that most of the people in my circle only gave me the time of day based on who I did or didn’t show romantic interest in. Eventually, the invites to hangout or study stopped, and so did the access to support and resources. And when I called attention to the abrupt shift in behavior, I was told that I isolated myself.

My response to that was always,

“How exactly does one isolate herself from plans she was never invited to?”

Clearly, I would have loved to have people to celebrate with after an exam, or study with in preparation for an exam. But I wasn’t really welcomed anywhere. I wasn’t even in the group chat I knew existed. And, whenever I did get the invite to something, I was always an afterthought. Yet I would put myself out there and usually show up to things anyway because I was hopeful that I’d eventually be accepted. I genuinely liked this group of friends. So it was especially hurtful to realize that many of the people I admired turned out to believe and/or be at the center of absurd rumors about me. It was at that point that I started to fall back.

To this day, I refrain from spending too much time thinking about this part of my experience because it was one of the loneliest times in my life, and it’s honestly sad to think about. I’m starting to tear up as I write about it, so I’ll end that discussion here.

At the end of the day, I don’t have lingering hard feelings for anyone, and I truly believe that I was part of a class of incredibly brilliant, talented and fun classmates, and I was fortunate to have ever met them at all.

If I could go back, I might have done a lot of things differently, both socially and academically, but I have peace in knowing that every move I made was one that I thought was best for me at the time. If there were ever a time when I resonated with the Footprints poem, this had to be it. Although I felt alone, I was never truly alone. God was carrying me through the most challenging parts of my testimony.

As for the school in general, I have an abundance of respect for every student who excels and makes it through. You all are rockstars, and don’t let anyone EVER tell you differently.

The D.O. Over

During my first year of medical school, a then senior passed along a piece of advice that I’ve never really let go of. She essentially said,

“During medical school, things will get tough. Some days are going to be hard. But what I do, is I give myself 10 minutes to be upset about it. I cry. I yell. I do whatever it is I have to do to feel whatever it is I need to feel. And then, once those 10 minutes are over, I get back to the grind. It’s back to work.”

At the time, I had no idea what she meant by that, and if it were realistic— or healthy, for that matter. But later I realized that nothing about medical school is really designed to be healthy. Rather, the reality is that it’s a self-sacrifice for the health and benefit of others. For many of us who choose to pursue this path, we decided long ago (and have had to keep reminding ourselves) that the mental, financial, and time sacrifice put into pursuing this dream is ultimately all a means to that end.

At any rate, after receiving my final STEP 1 score report, I decided that I had a 24-hour window to wallow in any pity party I wanted to throw myself and update anyone who had been waiting in anticipation of the test results. But then, after the pity party was over, and the texts and emails were sent, it was game time. Life had to go on.

It took about three restless nights, a couple of helpful discussions with my research mentor, one very supportive boyfriend, and a bombardment of oddly specific divine nudges for me to decide to bite the bullet and put myself back in the ring of applying for graduate programs. I had received my score report in fall, which meant it was also prime application season. That itself was a gift.

The pandemic had disrupted my two-years-in-the-making plans to spend an academic year abroad conducting research as a prestigious Fulbright-Fogarty fellow. Earlier in the year, I had been competitively selected as a semi-finalist and later offered an award as a Fulbright finalist. But unfortunately, amidst the ongoing travel uncertainty, my dream of spending several months rejuvenating my melanin in the warm African sun, conducting research in Malawi and forgetting the existence of STEP 1, couldn’t come to fruition.

Instead, I hustled and networked my behind off to use my Fulbright-Fogarty finalist status to secure a temporary remote research assistant position with my affiliate university. And, after reaching out to the Director of Global Health Studies at a separate university, I applied for and was offered expedited enrollment for their Master of Science Global Health program.

Two weeks post-med school exile, I had a job and new graduate program. If I knew nothing else, I knew that faith plus works was certainly not dead. And I was hopeful that neither was my dream of becoming a doctor.

But, if I were to be someone’s doctor someday, I wanted to be an informed one. To me, a fresh start was the only way it would make sense for me to sit for a standardized medical licensing exam again. I had the knowledge, but that knowledge could be strengthened. If given a second chance, with the peace of mind and academic and social support I didn’t have the first time around, I knew I could thrive.

I knew that several years of passed medical school courses was worth more in academic weight than any updated MCAT score. But convincing admissions representatives of this fact would be one heck of a task. What I was seeking to do was largely unheard of and non-traditional on all accounts. But I decided that if there was a one in a million chance at admission to a new medical program after withdrawal from my old one, then I was going to go for it.

The divine nudges I had been receiving were too strong to ignore. All signs pointed in the same direction. I was supposed to apply to osteopathic medical school.

The first time I had ever heard the terms “osteopathic” and “allopathic” to describe medical school was back when I was a pre-med, knee-deep in a very expensive application season, during which I had only applied to allopathic programs. After learning that osteopathic training focused on holistic, patient-centered care, I remember thinking that if I had been introduced to the D.O. (Doctor of Osteopathic Medicine) route sooner, I would have undoubtedly used the little funds I had to pursue the doctoral route more aligned with my desired approach to care. Now, through a chain of unpredictable events, I had the chance to do just that.

The Journey Continues

The past five years of my life have been …a lot. But I always believed it had purpose. After several months of waiting, networking, writing, praying and reluctantly preparing for a reality where medicine wasn’t in my future, I received an acceptance phone call that would change my life forever.

I had written in conclusion of the Letter of Intent for my top choice program,

“Despite my performance amidst each unexpected challenge, I knew that no score could erase all that I had learned, and my faith led me to believe that somehow this series of misfortunate events may have been re-directing me to where I have always belonged.

In this time of uncertainty, I remembered my roots. I was reminded that my paternal grandmother had attended night school to achieve her goal of returning to earn her high school diploma. She had a fire within her to finish what she had started. In a recent Zoom family reunion, my uncle revealed that prior to her untimely death in a car accident, she achieved this goal and they had unapologetically walked across the stage as mother and son and graduated together. Unaware of my personal situation, he ended his story with a quote that brought me to tears. He closed his story in stating, ‘Our parents had drive, determination and perseverance. It didn’t matter what came their way, they would overcome it. They never quit. There is nothing you can’t achieve. They would want me to tell everyone that. Never quit.’

And so, I didn’t.”

And I never will.

As for that fresh start, compared to what I experienced the first time around, my first year of medical school has been…amazing. It was a journey to get here. But that’s a story for another time.

Stay tuned. ♥