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All I Need to Know for Step 2 I Learned From Television

Colin_son_144x144Colin Son -- I have a friend who likes to pretend he is an attorney* and he hates the television show "Law & Order". The pace and the drama of the show are so much more than what being a criminal attorney is really like. Apparently. Personally I think he’s just being prudish. I get a lot out of shows set amongst my future profession.

For those who may not know, the United States has three licensing exams which all states require future physicians to pass as a prerequisite for getting a license. The first exam, the USMLE Step 1, covers basic science material like biochemistry and physiology and pathology. The second exam, the USMLE Step 2, covers clinical science topics like how to treat hypertension. The third exam, the USMLE Step 3, is usually taken after graduation and covers, more in depth, the clinical practice of medicine.

I take the USMLE Step 2 this week and I’ve been preparing diligently for it; mostly by watching medical dramas and sitcoms on television.

From shows like "House" I’ve learned that the old adage "when you hear hooves think horses not zebras" is baloney. I now know that a dyspneic asthmatic actually has C. psittaci and not an asthma exacerbation, even if the question stem doesn’t mention birds anywhere. I also know that breaking into patients' homes or places of work can be a valuable diagnostic tool.

From shows like "Grey’s Anatomy" I know that all of my fellow residents and the ancillary hospital staff, at wherever I go to residency, will be attractive. Such gives me motivation to pass my Step 2 so that I can get to residency.

From shows like "ER" I know that everyone who comes into the emergency department should get immediate CPR. On a Step 2 practice question I was doing, a mother brought her young son into the ER for bilious vomiting and the question asked for the next step in management. The answer choices didn’t include CPR, so I had to write it in myself. Also, I’ve learned that CPR often works.

From shows like "Scrubs" I know to watch out for the janitorial staff at whatever hospital I’m rotating at as a resident. Also, that I can spend large parts of the day when I take Step 2 daydreaming and fantasizing and still finish the test with ample time.

I feel really well prepared to head into the testing center and conquer my test. I owe it all to Hollywood and its accurate portrayal of medicine on television.

*Okay, he passed the state bar and is an actual practicing lawyer.

August 28, 2008 in Colin Son | Permalink


=) I remember the days when I was studying for step 2 CK; it was crazy. The approach to medical issues on TV is hectic and has nothing to do with the reality of clinical practice. You don't get the usual "mysteries" that House gets on a weekly basis, well probably you'll get one once a year. In the ER most of the patients have a flu or a common cold; I was actually happy once when I heard the speaker shout out "code blue in the ER" at night while I was on call. Hollywood's portrayal of the gorgeous female residents is exaggerated. Sure you do get to find some hot female doctors now and then but come on, Grey's Anatomy??? that's overdoing it.

I do feel however that the USMLE exams do tend to concentrate on some diseases that most physician's will never see in a life time such as "Kluver-bucy" or "C. psittaci" [ I have never been in a cave in a long time =P ]. Sure it's good to have the knowledge but that does not make you a good physician by default [I know I tend to derail alot].

Anyways peace out

Posted by: Sam | Aug 28, 2008 12:11:53 PM

hey there >>> i do agree with u that the tv shows r really of benifit to me in my career >>

Posted by: Rashed | Aug 29, 2008 8:41:41 AM

i loved your post. very amusing.:)

Posted by: | Aug 30, 2008 4:43:31 AM

Even better: when idiots (I'm sorry to be mean, but it's so true) cite Grey's Anatomy in their personal statement when applying to med school. That's how NOT to get an interview, kids.

Posted by: Jessica | Sep 2, 2008 10:56:22 PM

I must admitt, thanks to Hollywood I've learned that even if your patient has asystole it is imperative that you should defibrilate him; also, it takes 2 to 3 seconds to intubate someone. Oh and that doctors are strong, handsome men with blue eyes and sexy smile... right...
Thanks for the post, I enjoyed it :D.

Posted by: monica | Sep 3, 2008 8:11:04 AM

Hey, what about the Golden rules of the Fat Man from "The House of God"? I practically waltzed through my surgery rotations on those! "There's no body cavity that can't be reached with a 14G needle and a strong arm"

Or maybe I'm getting old...

Cheers from the Netherlands!

Posted by: Lennart | Sep 3, 2008 9:50:56 AM

Your post is awesome... everything is sooo true... every now and then I get asked, by friends or people not practicing medicine, if the doctors are as hot as McDreamy or McSteamy and if I've had ever defibrillated a patient and "brought him or her back to life"... NOT AT ALL!!! (and it's true... the doctors on TV shows almost always defibrillate patients on asystolia!!!)... ER for me has been asthma, fevers, flu, a nice looking wound once in a while... I still get astonished when I hear the younger students talking about how the TV shows got them into studying medicine... those TV shows got nothing to do with reality... after all why would someone looking like George Clooney mind studying medicine??? I'm just kiddin'...

nice post, I really liked it...

Posted by: Elizabeth | Sep 3, 2008 9:58:33 AM

Medicine is never as glamorous as they show it on tv...but i havta admit,sometimes there is stuff on these tv shows which make me open up a book and look for it...

Posted by: AHZ | Sep 3, 2008 11:15:03 PM

he, he... nice post. enjoyed reading it. =) at the beginning i was a hardcore fan of house, until i got to know medicine a bit better (that means being in an actual ward and doing a clinical evaluation of a patient), then i dropped the show. i got nervous every time i watched it. the ease with witch house orders invasive procedures is fascinating. i, too, would like to order biopsies here and there, angiographies just for the jist of it, and let's not mention CT's when you don't know what to do (and after it's easy to find your patient cuz' he/she is glowing from all the Grays =)). the positive stuff i got from house was from the entry on Wikipedia where you got links to diseases and so i learned something.

with scrubs is different. i like that every part in it's being funny has a message at the end, and it's closely related with what being a doctor is (like how can you help a patient if he doesn't want to be helped etc.). and i like Cox the nazi, cuz' it reminds me of a resident i know =)

bottom line, these TV shows are a good past time if you turn off your medical part of the brain and concentrate on the other part of the story. =)

Posted by: matko | Sep 5, 2008 12:15:05 PM

Hilarious! Especially what u said about ER.. They show ER like a military medical unit where victims keep coming in mostly requiring CPR and calling surgical team to give a hand.

Posted by: A.A | Sep 5, 2008 7:40:39 PM

Super Funny you forgot to mention the directors and their individual sense of power!!

Posted by: Samuel | Sep 6, 2008 5:56:11 PM

I enjoy Grey´s Anatomy is a reminder of how medicine should be, in that way my hair would always be perfectly straighten and I will never study at all... If someone has seen any of this guys study please let me know....but I do have something true about this show, on an episode I remember Meredith Grey crying (not for Mc Dreamy) but for a death patient and I thought this doesn´t happen in real life at all, weeks later I starte peds rotation and I saw a 5 year old girl die of a Wilms tumor, all of a sudden I remembered going to the cafeteria to buy strawberry jello because she couldnt eat and this was one of the few foods she tolerated. I did cry and thought well reality overcomes fiction....

Posted by: pippi | Sep 6, 2008 8:50:13 PM

Well, a lot of people just apply to medical school because they watch this shows... When they are in the middle of the carreer realize they don't like it.

Posted by: mari | Sep 7, 2008 10:04:05 AM

a lot of people just apply for medical becuase of those shows the after a few years they realize they are not good for it.

Posted by: vanesssa | Sep 7, 2008 10:08:38 AM

hey , thanks for the post, it was awsome. some times i think what if it was really so simple to pass Step 2 CS, as Alex did after failing for 1st time in Grey's anatomy. though the feeling is gd, but do such things really happen in actual life, i mean every1 really taking time to help u out n stuff like that. Gd entertainers but pretty far from reality.

Posted by: yasir | Sep 9, 2008 10:42:07 PM

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