A Bit of Encouragement for My Second-Year Colleagues Preparing for Level 1 (Step 1)

Have you ever thought to yourself, “Man. I can’t believe I signed up for this"? For 2 years, I’ve worked so incredibly hard, increasing my vocabulary 10-fold; reading, learning, and integrating the anatomy and pathophysiology; understanding diseases I’ve never heard of before or may have convinced myself and classmates I now have. Yet that ticking time bomb of the Level 1 (Step 1) board date steadily creeps closer and closer. Then one day I’m supposed to take this 8-hour test that people tell me will dictate the rest of my life. You know the story. You’re living it right now. It’s overwhelming. It’s trying physically and emotionally. It’s easy to feel isolated. Nothing about the journey you’re embarking on now is easy. With the increasing pressure put on performance and the rising number of medical students who experience depression or commit suicide as a result, I think it’s of utmost importance to take a step back and reassess the situation.

I want to provide a perspective that you lose when you live the reality of going to class and studying for the looming test and hitting repeat on your routine every single day those first 2 years. It’s an important test, yes. By all means, do your very, very best. However, bear in mind that standardized multiple-choice tests neglect to show you the incredible gifts each of you have and will bring to your respective niches of medicine. In the third year, you get to interact with patients every single day. Through trial and error, through the highs and lows, you get the opportunity to figure those gifts out.

There will come a day very soon where you will stand in the OR for the first time holding diseased organs that up to that point you have only read about in textbooks. You will learn how to use your hands to fix disease and improve quality of life. On your OB rotation, you will witness the incredible event of life being brought into the world and learn how to care for both mother and baby. Internal medicine will teach you how to care for and manage people with chronic medical conditions, and the following month on your psychiatric rotation you may be able to give hope to a patient who otherwise felt despair. The gift of the third year is that every single day provides an opportunity to touch a patient’s life—whether it’s through picking up on a physical exam finding that would have otherwise been missed, making the right diagnosis, nailing the treatment for the disease, or merely being a shoulder for a patient to cry on through a difficult time. Your studying now, regardless of the number you receive, will enable you to do those things and make a positive difference, I promise! That’s what this journey of medicine is about after all, isn’t it?

Remember that a numerical score doesn’t define you. Yes, it may make certain dreams easier or harder to obtain, but don’t give up. If you have a passion for something, you will find a way to make it happen. If I’ve learned anything from this year, it’s that a passion for medicine, diligent work ethic, eagerness to learn, and the ability to be teachable take you much further than a number. Patients will never know you by a number but by the way you treat them and their unique situation.

One final thought I want to share with you is one of my favorite quotes by L.R. Knost that I believe captures the roller coaster experience of medical school: “Life is amazing. And then it’s awful. And then it’s amazing again. And in between the amazing and the awful it’s ordinary and mundane and routine. Breathe in the amazing, hold on through the awful, and relax and exhale during the ordinary. That’s just living heartbreaking, soul-healing, amazing, awful, ordinary life. And it’s breathtakingly beautiful.” Hold on, my second-year friends, through this trying time of board studying: Your amazing, post–boards life is right around the corner!


Victoria Lipinski, OMS-III
Campbell University School of Osteopathic Medicine

Victoria Lipinski, OMS-III

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