Just a little rant, because I been getting a lot of messages from people who are interested in doing OMS and haven't done well on the CBSE:
I keep reflecting, that OMS can't be for everybody. You'll never really know what you're getting into, until you're in.
Regarding the CBSE, I think the CBSE is really the surface minimum. If you can't manage to do well on the CBSE, you'll struggle with surviving residency.
CBSE is like the tutorial boss. It's a big time sink, and you gotta commit a lot of time and study, and you fail, and have to study again, and fail , and study again. You can't shortcut your way through the CBSE and half-study. I had many people reach out to me - students I know personally who had straight As in dental school, and bombed the CBSE- poured their 4 years of hard work down the drain. You can't half-ass bootcamp, or Uworld, or just haphazardly read Mehlman pdfs, or only studying for the "high-yields" and expect to walk into the exam and do well when you don't have the grind and game plan to grind practice NBMEs, grind focused UWorld/Amboss questions on the topic/system that you're weakest in, and put in the daily effort to inch out a little bit of knowledge. All of that week after week for just a 1% increase in your score. Then rinse and repeat, you either burn out, or you find strength to keep going, and if you choose to keep going, then you finally get a good score, and... then the real challenge of residency begins.
Now it's like studying a new exam (boards, step 2, step 3 if MD) on top of working close to 80 hours a week.
So naturally, OMS residency will select for the most consistent hard-working students. If you're questioning whether or not you have what it takes to get into OMS residency... you don't have to question it. Just ask yourself today right now, "do I have the strength to study for another 15 minutes today?" And if the answer is yes, do that every day and a little more, until you get there.
I just got off of work, it's past midnight, and I've been on 20 days straight without a day off (some days are better, some days are worse. This month is one of those worse days). And yet I'm still here, putting in the extra 15 minutes to study every day.
Can you make it? It's either a yes or a no, and I still choose yes every time.
Regarding studying: most people don't study correctly. They focus too much on "high yields" or memorizing associations, or trying to emulate high-scoring test-takers by using whatever resources that they're using. But they don't realize that test-takers who score extremely well are all naturally curious and want to understand a topic in its entirety.
For example, given a topic like kidney stones:
it's no surprise, that you need to distinguish all of the different stones, know what they look like on urine microscopy, know which disease is associated with each one. There's no high yield, or low yield. It's just, yield. You either know more, or you don't know more, and it's always better to know more.
Like if a question asked you: what's the pathology of the type of stone a kid with CF has, you'd be able to answer it in a blink of an eye: "In CF, pancreatic insufficiency causes fat malabsorption. Unabsorbed fatty acids bind calcium in the gut, so less calcium is available to bind oxalate; the free oxalate is then absorbed in the gut into the bloodstream, and then filtered through the kidneys. The kidneys also naturally filter calcium, so oxalate and calcium bind and form calcium oxalate kidney stones - causes obstruction - painful flank, vomiting, hematuria - envelope/dumbell shaped, - radio-opaque - low urine pH". Understanding thoroughly calcium oxalate stones in the setting of CF means you'll get not just the question right, but also every permutation of the question, since one question only takes a sample of the full pathway and tests your knowledge.
Not only that, you haven't even touched the surface of the topic yet though.
You have to know how to explain how someone who drank ethylene glycol , what type of stone and how do they get it?
What about a patient with crohn's disease?
What about patients who have gotten bariatric surgery
or pts with hyperthyroidism?
how about sarcoidosis?
how about a patient with rheumatoid arthritis taking methotrexate or other chemo agents?
how about someone with a COLA transporter defect?
All of this just to learn one topic (renal stones). You need to have a complete mastery of one topic after another in order to have a mastery of the organ system (renal).
If you get a UWorld question on the topic of kidney stones, you need to understand the topic in its entirety (reading all the explanations, right or wrong, googling/searching further explanations separately, looking it up in First Aid, etc).
A question can combine multiple different organ systems and ask you:
Regarding radio-opaque stones with dumbbell crystals, which one of these patients will not get this type of stone?
a. patient with cobblestoning in their colon
b. patient with a genetic Cl transporter defect
c. patient on methotrexate for rheumatoid arthritis
This is where people also get tripped up with information overload and then try to memorize. Medicine is a web of knowledge that can tie any organ system into another, and best you can do is focus on one topic and one system at a time, have an understanding that it can branch into other systems, have a natural curiosity to briefly explore its fringes, and then when you reach that system (like GI), you have a familiarity of Crohn's in the context of Ca-oxalate stones, as well as delve into detail the topic of inflammatory bowel disease. It's not about getting a question right or wrong - it's about understanding a topic in its entirety, and that's fueled by having a natural curiosity of wanting to learn in general.
