And another day. Exam day. Another exam day. For both the proctors (invigilators) and myself - and many of the other
candidates: they all seemed to be foreign. One guy said he'd done 8 different exams since qualifying - requalifications in
various countries. For myself, there will be more to come; and I hope they're not so fake as this one...

USMLE Step 2 CS (Clinical Skills) - "Standardised Patients," abbreviated history and physical, then a short "Patient Note"

Mexico to San Francisco, stopped and changed overnight in Los Angeles: the city of devils. Five hours in the coach station:
dank, sweaty, flourescent illumination and the crusted bodies of a million passers-through; lines winding around each
other, baggage piled high... I didn't ever want to come back.

And here I am. Not through any choice of my own - really. Well, maybe kind of, a little bit, but not the city that enticed
me: a whole other desire. And no, not a woman. I'm here for my exam: Step 2, Clinical Skills, of the USMLEs about which

Ok, said I would come back to this the other day when I wrote about advice for the USMLE. A couple of links that I have remembered since, or that are now reachable.

Here goes for some random notes related to questions that I'm doing for the Step 1 exam.

Leigh disease: mitochondrial disorder also known as subacute necrotising encephalomyelopathy. Specific defect is cytochrome oxidase. Particularly affects muscle and brain, patients present in early adulthood, have progressive intellectual deterioriation, weakness, ataxia and siezures, then die within a few years. I'm not quite sure why they wait so long to present... but I'm not overly bothered either and am too lazy to look it up further!

Wow, mentioned that I was doing USMLEs at the moment on doctors.net and got quite a response with people asking for advice! Not sure how qualified I am to answer all the questions, but I will do my best... for those unaware, my background is a UK trained doctor who is fortunate enough to have dual nationality. I graduated under the "old system" of medical training with 2 years pre-clinical and three years clinical; that was back in 1999. Since then, I've specialised in paediatrics, travelled around the world, and basically seen the postgraduate training system in the UK fall apart... As such, I figured that now was a good time to bail: the new PMETB Article 14 regulations mean that it is not necessary to gain a CCST (certificate of completion of specialist training) in the UK to be admitted onto the specialist register, but instead it is possible to use experience from the preceding 5 years that has been gained anywhere in the world, provided it is considered equivalent to what the UK training would have been.

Ok, I know I'm crap at this - always have been, actually, although I thought that I started to understand it when I went over the lectures a few weeks back. However, enough time has passed since then that I have once again forgotten it. So today, I tried to do one of the little quizzes that I found available online... it was a "fill in the blanks" and so I put the correct answer below.

Yeah, I'm doing more of this... why? Well, I guess it's not so useful to anyone else, but doing 3x5 cards just isn't cutting it for me for some of the finer details - and there's some wonderful stuff that needs to be shared! Like, for example, reading in bed last night (what, Saturday night?!) I discovered that Golgi was a prolific Italian histologist who did more than just have a few bits of the cell name after him (Golgi Apparatus) - he had multiple parts of the body and various other things named after him, including part of the malarial life cycle! Anyway, I digress. Onto today's wonders...

Learning interesting things by revising for the USMLE... Here are some (random) notes that I'm taking down whilst going over questions again.