To Fail Isn't Failure Five Things I Learned After Failing Step 1
I can honestly say that the fall to rock bottom never hurt as much as it did that morning. I held my breath as I waited for my score to load and when I saw the three big numbers, emblazoned in red and the bold FAIL right next to them, I asked myself for what seemed like the hundredth time that month, why are we doing this again? I was frustrated. And even more than frustrated, I was infuriated. I cried for what seemed like twenty-four hours and when the tears ran out, I sat there in silence because words were not enough.
I would be lying if I said that I got right back up the next day and went full-force back into studying. The truth is, I had to take a long and hard look at the work I had done so far and do quite a bit of self-reflection both on my study techniques and test-taking methodology but also on my approach and perspective to this process as a whole. But having failed at something is not the same as being a failure, and though it took me a while to figure that out, I did learn some things along the way.
Lesson #1: Self-doubt and fear will be your undoing
Remember the saying “confidence is key?” Post-failure, I understand it more and more each day. When you self-deprecate, when you think to yourself “I’m such an idiot, how could I miss that?” or “There are thousands of people that pass this test on the first try, my degree is a joke,” then you inadvertently start to doubt your abilities, which leads to doubting your knowledge, which ultimately and subtly leads to second-guessing yourself on your exams.
I first noticed this while answering questions in a random practice block on UWorld. My inner trauma of believing myself to be a failure and unworthy of the MD began to manifest in my thought process. I would choose the correct answer, but then ask myself if I was sure because you thought you were sure last time, but obviously you weren’t, and end up getting the question wrong. Rinse. Repeat. For a month until I figured out that once again, it wasn’t my lack of knowledge or content deficits that were causing this part of the problem, but my own self-doubt and fear. Confidence is key.
Lesson #2: Remember your why.
Why did I put myself through this? Is an example of the wrong question to ask yourself after you’ve failed. Why do I still want to be a doctor? Is better, but still difficult to answer while experiencing the level of devastation you’re feeling after failing. Why did I start? Is the question that I chose to begin with. And my answers varied from things like: because I always wanted to be a doctor, because it’s my childhood dream, because I love helping people… and as I began to list my reasons for starting, they evolved into the reasons that I stuck with medicine to begin with: because there is nothing else that I can imagine doing, because I remember assisting in an OR where I got to see the human brain and it was amazing, because I realized in my four years of school that I can do anything as long as I want it and work for it.
When I realized how much this process helped me learn and grow and how much medicine has given me (pitfalls and all) and how it has never taken away, I remembered my why. That I was doing this because I loved it. And love means keeping at it, especially when it’s hard.
Lesson #3: Let people love you.
It is no secret that there is a sort of unspoken shame placed on those who have failed, like a dark (but extraordinarily heavy) cloak. We hear about “red flags” and how “that’s the worst possible thing that could happen,” but then it happens. And the world begins to feel like a sinking ship waving a red flag, too scared to send out an S.O.S. We are afraid to tell our parents. We don’t want our study buddies to know. We can’t imagine our classmates finding out. We did not plan for this, and yet here we are.
We live in a world where the 250s, 260s, and 270s reign. We see their posts, read their advice. We pressure ourselves into trying to fit that model and yet, despite our best efforts, we end up at the other end. The best thing I did for myself in the aftermath of my failure was sitting down amongst the pieces of my broken plan and texting a mentor that I had failed and thanking him for his help. He texted me back and asked: “Can I call you tomorrow?” and in a state of disbelief mixed with gratitude, I told him yes. That single phone conversation saved me from the season of doubt I was sure to have entered. “Pau, it’s okay,” he said, and even though I replied, “but it’s not okay!” He repeated himself: “It’s okay. You took the exam, one of the hardest exams in the world. Next time, you’ll kill it.” And hearing that from a success story, from someone whose opinion I deeply valued, made the difference. So let your friends love you. Cry on the phone. Text them when you’re feeling down. Let them know you are stuck in a rut and that red flag escapes becoming the white flag of surrender and turn into your banner of triumph.
Lesson #4: Stuck is not stagnant.
Having failed in the midst of a pandemic, my CS exam canceled, my CK exam date nowhere in sight, and a retake of Step 1 looming in the future, I felt that I was living my worst fears. Most people say they’re afraid of being alone? I have always said that my biggest fear was stagnancy; looking around in five, ten, twenty years and realizing that I have not grown, changed or improved. Failing Step 1 made me feel as if a year of my life had been wasted.
Being stuck, though, is different than being stagnant. Because when you’re stagnant, you have stopped all efforts. You stop moving, you stop fighting. You have given up and given in. I imagine being stuck more like a car in a mudpit, where you’re revving and revving and pushing that gas until somehow, someway, you’re vaulted out of that pit, mud splattering everywhere, dirt dripping down your front, your hard work and struggle clearly visible. And no matter how long you spent with your tires squelching, fighting against what feels like a bottomless expanse, you never stopped moving. And now, you’re on your way again!
Lesson #5: Make things new.
One of the first things I thought about after failing was this can’t happen again. But how do you pass a test you already failed? The first thing I thought was, I’m going to have to take a look at how I was studying because obviously the way I was doing it the first time just did not work.
And so back to the drawing board I went, listing out resources, ruling out methods that didn’t work for me (sorry, Anki) and discovering new methods that did (hello, Divine Intervention podcasts!). I stopped burning through UWorld just to “finish my first pass” and started approaching the questions by system, creating small notebooks of UWorld journal entries, littered with bright pink Post-It notes of concepts that still didn’t make sense to me. I asked for advice, I sought comfort, I watched videos on test-taking strategies and question approach until finally, I did it: my study methods were reborn and more effective and the results showed.
I went into my exam that morning in March being so afraid of failure because of all the warnings I heard in the months, weeks, and days leading up to test day: anything is better than failure, you don’t want a red flag, just pay the test fee again because you don’t want that on your record. Post-failure, I spent weeks processing, being so angry with myself and at the universe, wondering why months spent preparing went to waste, berating myself for everything I should have or could have done, hating myself for the day I took off six months ago or the nights I was too tired to watch Pathoma. And for the first time in my life, I spent time entertaining Plan B, a life without and away from medicine, one that would earn me a comfortable living without having to take the USMLE Step Examinations. Tempting doesn’t even describe it.
Then, a switch flipped. I stopped tolerating my self-inflicted doom and gloom thoughts and decided to start studying again. I decided to move forward with a post-failure timeline I laid out in a moment of lucidity and began reading, doing UWorld (slowly and without the added pressure) and in the last three weeks, have seen significant improvement in both my assessment scores and more importantly, my understanding.
So yes, maybe I don’t have to be a doctor.
But in the marrow of my bones, I know that I need to be.