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Studying for the USMLE Step 1 While Managing a Mental Illness

  • by Ken Noguchi
  • Feb 03, 2016

Blogger and med student Ken Noguchi shares his experiences tutoring students who manage a mental illness in medical school, as well as his thoughts on the medical school community as a whole.

As an MD/PhD student, a peer tutor, and the author of SideNote, Ken has a lot of experience in the medical school world under his belt. As a student with personal experience in managing a mental illness while studying for the boards, Ken has served as a mentor to students facing the same obstacle. Ken is well aware of the challenges of managing a mental illness in the medical school atmosphere.

Ken has noticed a history of medical students comparing themselves to each other. “Medical school is macho,” Ken said, “I think that’s one of the biggest barriers for med students dealing with mental illness.” For Ken, mentoring medical students is not only about preparing for the boards, but also part of his larger vision for medical school. Ken sees much value in fostering a medical school community with stronger, team-oriented relationships between students. “When one student goes it alone, it harms the whole,” he said.

What worked for Ken

We asked Ken what worked well for him when studying for Step 1. While his peers continued to pull all-nighters during their study period, Ken told us “I had to be very conscious of how I managed my time. I think you have to be a really good planner. You need to know how much studying you can handle.” For Ken, daily exercise was key. “Exercise helped me feel energized in the morning and kept me conscious of going to sleep,” he said.

How Ken’s students succeeded

When mentoring his peers, spending time crafting a plan was a significant part of the solution. “One student I had took the boards twice and failed. For him, studying-related anxiety was the biggest factor,” Ken said. “He wouldn’t be able to study for more than four hours or so.” In his mentoring session, Ken proposed a time management solution for his student. “We’d have him study in the morning, work out at lunch, then work with me in the afternoon. That way the day is broken up, and it was good for him to work with me.” Ken remarked on medical student teamwork more generally as well. “Even for people who are more solitary, I would encourage them to do at least some work with their peers.”

I had to be very conscious of how I managed my time. I think you have to be a really good planner. You need to know how much studying you can handle.

– Ken Noguchi

Another obstacle students faced was overemphasizing certain aspects of their study materials. “It’s the obsession that comes with anxiety and depression. It’s easy to get caught up in details that may not have a big impact,” said Ken. “One woman I worked with would get overwhelmed when she didn’t understand the details regarding a certain topic. That would send into her a bad cycle of beating herself up and losing motivation to study.” Ken suggested carefully choosing a resource that helps you avoid falling into a cycle that could derail your study plan.

Pathoma was the best for this,” said Ken. “It was the most streamlined resource I could find. If you are focusing too much on details that you don’t understand, Pathoma can be helpful. I wouldn’t say to only use Pathoma, but you can spend the bulk of your time on it. I found it covered a higher percentage of the topics on the boards, without being too cumbersome.”

In addition, “I also encouraged my students to realize that doing well on Step 1 and being a knowledgeable doctor doesn’t mean that you have to know everything,” Ken told us. “I told my students that even if you don’t understand right now, we can revisit this topic later.”

For Ken understanding oneself and attending to the personal needs of each student were core values. “When medical students seek treatment, that will not only benefit themselves, but medicine as a whole. Because that’s one more mentally healthy doctor, who can help other doctors, and benefit the community.”