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Med School Minutes
Med School Minutes is where we discuss all things related to medical education. Provided by Saint James School of Medicine, this podcast tries to educate students on selecting and successfully completing a medical school. Our topics are fun and educational, and our hosts are knowledgeable and fun.
Med School Minutes
Med School Minutes- Ep. 40- Career options and USMLE Prep
#caribbeanmedschool #medstudent #usmlepreparation
Welcome to another episode of the Med School Minutes podcast. Today, our host, Kaushik Guha, welcomed an SJSM Alumni, and the owner of USMLEtrainings.com, Dr. Stavros Vouyiouklis. Dr. Stavors is an expert on the USMLE prep for medical students and in this episode he offers several great insights on how to successfully prepare for the exams. Additionally, Dr. Stavros tells us why he chose to pursue teaching and how he views the work-life balance of an average physician.
Check out Dr. Stavors' review program: https://usmletrainings.com/
SJSM just launched a new website: https://sjsm.org/
0:00- Intro
3:21- Career Options with an MD
11:35- Decision to teach
15:10- Physican vs Entrepenuer
23:31- USMLE Step 1
25:33- Changes to the USMLE
32:30- Time off after NBME
36:40- Subject vs System Based
39:15- NBME Requirement
45:53- Step 2 Changes
51:50- Physician lifestyle
1:02:30- About USMLEtrainings.com
@USMLETrainings
#usmle #medschool #futuremd #indianmedicalstudent #doctor #sjsm
usmle step 1 step 2 residency family medicin internal surgery psych obgyn prep review kaplan financial aid caribbean attending hospital rotations clinicals
Hello and welcome to another episode of the Med School Minutes podcast, where we discuss what it takes to attend and successfully complete a medical program. This show is brought to you by St James School of Medicine. Here is your host, kaushik Guha.
Speaker 2:Hello everyone and welcome to another episode of Med School Minutes, where we talk about everything MD related, with a focus on international students, specifically Caribbean students.
Speaker 2:Today we have a very interesting guest. His name is Dr Stavros and after finishing his MD, he's chosen a path of entrepreneurship and dedicated his career to really helping students realize their dreams of making it and passing the exams. He has over almost two decades of experience managing and handling and helping students do better in step one, step two and step three, and he's essentially an expert on the exam. So we're here to talk to him about what the changes in the structure of the exams in both step one and step two are and generally. You know his passion and his choice to not really practice medicine but go into a field where he is still involved with medicine but at the same time helping students as much as they can. So, without further ado, let's welcome Dr Stavros. Thank you so much for joining us. Dr Stavros, why don't you give us a quick background? This is how we always start our podcasts. We always request our guests to give us a quick background about themselves.
Speaker 3:Well, hi everyone. I'm Dr Stavros Vujiculus. Born and raised in New York.
Speaker 3:I went to biochem, Manhattan College undergrad in biochemistry for years and then I went to the Leavitt School of St James Med School chemistry for years. And then I went to the Leavitt School of St James Med School. I did realize, as I was prepping for the board exams, that I had a certain purpose, certain goals, certain calling. And then I then worked on USMLE prep because I realized that, no matter what I did, it was very challenging to pursue these exams and do very well right. All of us have had issues in these and unfortunately, your career, your future in medicine is dictated and basically set in stone because of these scores right. So what I did was, from being in medicine, I realized I had more of a passion to work with students and physicians to crack the code and help them pass the board exams.
Speaker 3:So 15 years later, I'm on my fifth company as far as adapting to how the USMLE adapts right. So we adapt to better ways to prep our students. And now I'm here talking to you today to make sure that all our students out there internationally and in the States know as much as possible for step one, step two. So then it makes it easier for them, so they they don't have to settle for less. They can then shoot for the stars and achieve their goals and whatever residency they want. So here I am today to provide my knowledge of 15 plus years so you guys can all profit and be better physicians for improving our health care right so essentially they're, uh, twofold, uh, we're killing two birds with one stone, so to speak, by talking to you, dr Stavros.
Speaker 2:Well, one is we're talking about. So obviously, you went through, got your MD and everything, but then you chose to be a serial entrepreneur, completely aside from running a regular practice, and you chose to go into this route. We definitely want to pick your brain a little bit about, once you get an MD, what can you do with it other than practice medicine? Again, I mean I just because for a lot of our students it's like I just my only alternative is to become a hospitalist, but that isn't true, obviously, as your hospitals, but that isn't true, obviously, as your um, uh, you're like a shining example of that, and and you're not just the only one we have several physicians who's gone on to start various consulting companies that actually consult with hospitals entirely admin purposes, etc. Etc. So we want to talk a little bit about that.
Speaker 2:And the other aspect is, obviously, with 15 plus years of experience with five companies, as you said, uh, you have adapted to the changes in the usm. If there is anybody who I would consider to be a expert of at the usm exam, it is definitely you, because you've been seeing the changes first time from the time you took it, it to the time when there were two types, two CS or step two exams then becoming one, then eventually becoming a very involved exam, and then you know, the step one pass, fail, going away. So let's start with you and like so let's start with you and like what alternatives do you think or what would you advise students? Because you know, unfortunately medicine is such an involved practice, like you pay so much of money, you invest so much time, a lot of people just don't think that beyond becoming a hospitalist or beyond practicing, I don't have alternatives.
Speaker 3:What would your advice be to that student? Well, I mean, it's a great question. I'm happy we're talking about it. I myself I'll go back a second so then we can move forward with this question. I realized through my rotations and my studies not only did I love prepping and teaching, but I realized that there was more for me than just being in the hospital. So I was honest to myself and I was very lucky that I was really enjoying what I was doing and prepping students.
Speaker 3:But students now need to realize that you focus hard, you go to school, like you said, you invest, you get into residency if you choose residency. And then what do you do? After? A lot of times, people I've seen doctors not finish residency. They jump out of residency and they what do you do after? A lot of times, people I've seen doctors not finish residency. They jump out of residency and they go. Well, I can't even finish it, I don't know what to do now because they were so into surgery, anesthesia. So what I can say to our students now watching, listening and watching now is you got to be honest with yourself and say, okay, am I choosing internal medicine because I love it, or maybe I'm in love with the idea. Or am I going to surgery because I love it, but do I really know what surgeons do? And other times people are like, hey, I burn out, I'm done, I do not want to continue medicine.
Speaker 3:So if you have an MD, well, yeah, there's, you can be a consultant. There's many different avenues out there to say, well, okay, I went to school, I finished my medical degree. Either you finish residency or not, are you licensed or not. So it all depends, right, if you're licensed, you move on to consulting different companies, pharmaceutical companies, versus you finished MD. And then you say, well, you can then venture into certain specialties that can use your knowledge right. Four years in medical school is a lot, guys. Right. Two years in classroom? You a lot guys. Right. Two years in classroom you get two years of rotations. People can use that knowledge for their advantage in yours, in any, in majority of specialties out there in business.
Speaker 2:Um in this vein. I actually wanted to talk about this. Uh, this is one of our partner hospitals. Um, they the cfo reached out to me very recently and they have a program where they train financial analysts. And they called me up. The CFO called me up and he's like you know, I really want to have MDs come for this program. And I was like, but they're MD're MDs like why would they go into finance? And he's like, well, you know, I'll have you know that. And the CFO was like I'm an MD for our MBBS from India.
Speaker 2:I came to the United States several years ago and I didn't match the first attempt and I needed money. So I started working here. And he's like I, you know, and, and billing and finance, it's not in a hospital. It seems like it's a very different function. So I'm an CPA, so I, you know, know a lot about working in corporate America and being in consulting and stuff like that. But it seems like finance and hospital serves a very different purpose.
Speaker 2:In most companies, finance is quote unquote a back office function or it's a cost center. You're not necessarily generating revenues. But in a hospital, finance can actually generate revenues and correct me if I'm wrong from your experience, dr Stavros, but he said that he feels the most successful financial professionals within a hospital system are MDs, because they understand, they know how to code certain ailments in a certain way that boost the performance of the hospital and make it look better in the eyes of, say, medicare, medicaid, different governments and stuff like that. And he's like it's just easier to train because you know if somebody comes in with a superficial ailment but they have something underlying, a financial. A cpa who has no medical training is not really going to understand that, sure, whereas an md does, and to me that was very surprising. So this particular training program it starts off with like a resident salary but within about two years you become a full-blown financial associate and then you're kind of on a track for a CFO position. And this particular gentleman is a CFO for 50 different hospitals right now.
Speaker 3:I mean that's very impressive. And the reason I mean and that's it's nice that we're sharing this knowledge because, you know, when one of my previous companies, we were employing physicians to be coaches and mentors, and most of the people all 500 applicants, 520, actually they were all American students who graduated or either finished residency or in the middle of they just dropped out, and they're all American grads from top university programs. That's why I say this, because they're burning out, right. So what did all those 520 people do? Reached out to me to get a pay cut from 450, 350, 250 to less than000, $250,000 to less than you know, roughly $80,000 to $100,000 for a coaching position. So well, you're giving up all that opportunity, all that time invested in your life.
Speaker 2:Yes.
Speaker 3:You're happy. You see, that's what people need to understand Right, right right.
Speaker 3:If it's one of you that, hey, I don't want to continue. Yeah, there's a lot of companies that, for example, short-term disability, long-term disability insurance companies instead of having someone who has no knowledge of medicine, they say, well, we'll hire nurses and or MDs to consult and be like the head of the department to say, well, if someone has a back issue, they had a herniated disc do they need four weeks or 12 weeks? Well, if you don't know the reason behind, are they standing versus sitting in their occupation? Right, wait, they have other risk factors. Maybe they need 10 weeks. So you see, men, empties, I need it everywhere. It's just up to the individual. Do you want to practice medicine? Or hey, I'm just tired, I'm burnt out. I want to have a family, I want to see my wife, my husband, my kids and unfortunately, in the system, even though it's a beautiful system, you work in many hours and it's not for everyone. It isn't. I've seen the numbers. So that's why you have to have an option to go elsewhere right.
Speaker 2:So, uh, tell me about this decision, because the decision that you took, like, as you said, while you're doing your rotations, you realized that this was you wanted to be, stay involved in teaching, and eventually you kind of came back. That takes courage, and how do you? Because you know, as you pointed out, it's a big investment, it's an investment of time, it's an investment of money primarily these are the two biggest factors and it's almost like oh hey, I've already invested so much of time and money, I don't care about my mental health, I don't care, care about what I want. It's just, I'm already down this path and I'm going to keep barreling down it, which, you know. I mean, there are a lot of mental health issues that physicians are facing and that's been exasperated over the last, you know, three, four years, during the pandemic.
Speaker 2:How did you manage that decision? Like, what kind of a support system did you have? Did you go through a lot of counseling? Did you uh talk to a lot of friends? What were the steps that you take to really realize that decision? Because I talked to a lot of um students who are brilliant students, but they're kind of at that cusp that you're talking about is, you know I don't know that I wanna do this for about three, four more years. You know I'm kind of done, but I also wanna have a meaningful life and I wanna be, but at the same time I don't know what to do. How do you make that decision? And their biggest thing is I've already invested. I'm almost there. There's light at the end of the tunnel, but that's the light I don't want to walk towards.
Speaker 3:Well, you know well, just to add to that. That's why, when you are preparing for step one, step two maybe pursuing medicine, instead of focusing on something that you have a passion for that maybe you just heard about you need to take this rotation seriously to say, well, I want to be OBGYN, I want to do, let's say, peds or surgery. I will invest my time now in medical school to see, hey, is it for me? Because you might love the idea of being an OB, a guy and physician, but maybe when you find out the hours are that long, you don't want to do that. So that's why a lot of students, they have that love, they get in and they drop off right.
Speaker 2:For me.
Speaker 3:I realized and this goes back and goes into my roots and this is why I do what I do today it stems from passion for medicine. I was a pioneer in my family Parents love them, they did everything for us, for me and my sister Not in medicine, so I was the first person to pursue. I realized in the hospitals through St James, in the amazing rotations, working 60, 70-hour weeks, I realized some specialties were for me and some were not. And if I had, maybe as the school did everything for me, but the physicians I worked with, they did everything for me too.
Speaker 3:But I realized later that if I maybe had a different experience in, let's say, er versus surgery, I would have gone down that path. Instead I said I don't want to be stuck in the hospital 80 hour weeks writing notes, seeing patients being exhausted, maybe not possibly having a marriage, maybe losing my wife, a lot of people I know. I saw the statistics ahead of me and I'm like well, I love medicine, yeah, but I also started doing the coaching, mentoring on the side and that started blowing up. So I said, well, I can continue medicine or I can pursue my actual passion, which is still in medicine, but then make sure doctors get into the profession itself Right.
Speaker 2:Right, right Right, not easy.
Speaker 3:My friend. It's it's a lot, it's's not easy, it's it's a little luck to see what you get into and risk. So that's why that's what I took.
Speaker 2:So you know this is a big debate that is always in our offices. So in my opinion, I should preface this by saying that there's truly four real professions in this world. No, no, disrespect to other folks but there are four real professions in this world.
Speaker 2:No disrespect to other folks but there are four real professions in this world. One is farmer, one is teacher, one is engineer and one is doctor. Everything else is fluff. Mind you, I'm a trained CPA, so my point is that with these four professions you can build civilizations, sure, and you don't need anything else, and everything else kind of follows. Keeping that in mind, I also think entrepreneurs have a very important role, but that is once. Things are like you know, in an economy like the USA, entrepreneurship is very well respected. But you've been both. You've been a physician and you've been an entrepreneur. In your mind, obviously, there's definitely some synergy that you're a physician who's an entrepreneur, but in your mind, which one has more of a let's call it flex, if you will, being an entrepreneur, being a physician it being an entrepreneur, being a physician.
Speaker 3:Well, I mean, for me, I've been blessed with doing both. But again, the reason why I say this is because I work with so many doctors and students now that are in residency and they hit certain, certain specialties and then they're stuck because they go. Well, I invested my time in pediatrics. I don't want to be a pediatrician. What do you do now? That's challenging, right? So I come up with a family of all business family, father, mother, all the Greek families that I know, my cousins no one was a doctor, all in business, so I was fortunate to also have that in my roots. Exposure. Now, that being said, a lot of times doctors want to be businessmen. They can't, the businessmen can't be, doctors.
Speaker 3:They have to learn it right, you have to practice it. But the way I look at it is, I personally have much more freedom, much more because, again, I love what I do right, I can work from anywhere. I had a morning webinar before we got on this podcast 150 doctors and students. Step one prep those individuals. My passion is to help them pass step one to hopefully get to where they need to be right to be a better health care system in the states, right. So for me, I love business, but I was able to merge both business and medicine and just being business software and not enjoying the medicine medical aspect of because I love medicine. Guys, I love it. Yeah, I just don't want to be in the hospital working 80 hour weeks anymore of course.
Speaker 2:Of course. I mean, that makes complete sense. But that's very interesting. They say that. So, um, the main flex is that you are a physician entrepreneur as opposed to. It's not one or the other, it's both. That's, that's pretty cool.
Speaker 3:I can't, I can't, I can't jump and go do something like I might have real estate family, we have real estate other things. It's great, a lot of money. There's no passion there. My passion is medicine. Right, right, right, right I was lucky to find this.
Speaker 2:Um, so tell us a little bit about your companies. You said you had five. Can you tell us why you had five and what's? Your latest company do, and can you give us a little background as to how many students you've helped and how long you've been doing this?
Speaker 3:So to go back, because I'm early 40s, let's say right, 45 years old, I've gone through a lot, especially through step prep, and this goes into explaining a little later the timeline of step, especially through step prep, and this goes into explaining a little later the timeline of step. For anyone to grow and be successful, you have to adjust and adapt to the times. Um, those who don't, you can tell. If you someone provides you advice that isn't updated, it won't work Right. So the companies that I created, um, they're all based upon step one, step two, and as we keep learning and having more success, we can then keep adjusting and adjusting to different prep. Nowadays, live in-person classes aren't as popular as they were 10 years ago 10 years ago I had a live course in Chicago 50 students every month.
Speaker 3:Nowadays it's all remote, you you see. So keep adjusting and adapting to the lifestyle of us. We used to have step one, step two and step three, like you mentioned. Step two, csck. I had a course specifically for cs. We're working side by side with saint james to implement that in our studies. And then the pandemic came, so right. Nowadays my newest company is USMLE Trainings, where we take the technology of Zoom right, the connecting with everyone in the world. We have live webinars and make sure that your content is ready for step one. Right. But also be a better test taker, because I realized through working with tens of thousands of students that you can learn all you want, but if you don't work to improve your test-taking skills, you can study for years and then you don't pass.
Speaker 2:Talk to us a little bit about that, because I have actually noticed students who are very, very good academically and they're actually doing really well in quizzes. In class Teachers are like, wow, this guy's a great student, they're definitely going to ace it, but when it comes to the NBME they're not doing well. And then you talk to them and then you're realizing that they have, like this crazy anxiety. They're having the strategies that they're employing. Again, I'm not an educator, but it just doesn't sound optimal. So talk to me about this test taking strategy. Are you born with it or is this something you can develop? Or, if you don't have it, are you just? You're never becoming a doctor.
Speaker 3:It's a skill like anything else. Whether you want to play a sport, right, this is a sport of sorts. It's a skill and I know because I was in school St James, a lot of universities, everyone does their very best, but we don't really focus on working on test-taking skills. So, read the material, read the PowerPoints, learn the content, yes, but then you have a USMLE exam which is very different than anything else you've ever done before. So that's why I realized that if you don't adjust and expose students like St James and everybody else watching to the question format doc, my friend, doc, whoever's watching reading the material, you have to apply to the questions, like being in the hospital, right, you're in class and you go see patients In class.
Speaker 3:I give you PowerPoint presentation findings, right, there's no connection. So when you read a question, you have to be able to pull out the findings and connect, so to answer your question. It needs a lot of time and practice and that's why one of the main reasons that we do what we do at USMLE trainings is hey, you got to come to us with knowledge. You're in medical school, right? So, okay, you know the basics. The problem is can you put it together in a question reading, understanding and connecting and I see a lot of students American students, international, caribbean. The biggest common denominator is test taking. They study for a year, man, they'll memorize first aid. They fail why test?
Speaker 3:taking okay denominator all across the board.
Speaker 2:Okay, um and um, as far as, um, these uh test taking skills are concerned, um, and do you kind of help them, like through drills, or is it like counseling sessions? What? What does that entail?
Speaker 3:So we meet doctors twice a day, morning and afternoon, which is nice, because not only do we do now, we work on accountability, which is another issue that students have. They need a study partner, they need somebody by their side, they need to be consistent and disciplined. So we meet them twice a day, an hour each time live and people from all over the world jump on students and physicians and we choose certain systems to attack for the day. So I have selected these questions, I go through one by one, I highlight and show them what to do to attack the questions, to save time, to be more efficient and effective and also to learn the material Like. If it's something of concern that I see students having issues with, I always bring it up in our lectures. So they're accountable, they're disciplined, consistent and I'm telling you, with a little practice, anybody can take the test, but you have to practice testing skills.
Speaker 2:Okay, how much time would you recommend students dedicate for, say, the step one? Let's just talk about step one. Good question Is it, like you know, because we I recommend that students should be studying for about eight hours at least three months before the test. Is that too much, too little? What do you think?
Speaker 3:you think to answer the question? Because those who know me, I can talk all day. A typical student who has dedicated prep right, for example, st james, if you give them three months of dedicated prep, meaning nothing else but studying yes seven to nine hours, eight hours a day, three months should be more than enough time to, okay, go the content, answer questions and move.
Speaker 3:But there's many variables, right, there's many variables involved. So the variables are are you a good student? Do you do well in your basic sciences? Are you able to sit in an environment that you choose to study all day? Or are you on YouTube, netflix, you go, hang out. I mean, listen, we've all done that, right, tiktok, now TikTok, instagram, and then next thing you know you're studying 10 hours, but you've only had two hours effective prep.
Speaker 3:So what I realized is to answer the question anybody who has passed every semester in med school, you know decently, obviously you know B's, hopefully B's and A's, and you have a good three months solid with adjusting and checking out where your weaknesses are and assessing. There is no reason why you can't. But then there's people who have issues with memory recall. They don't know the content, they can't stay disciplined. Then obviously, if you can only give four hours a day, you still can't do it. In three months it's going to be a lot longer. It's a sliding scale. So, on average, three months, eight hours a day, it is a decent approach. It's just now. You have to think about the variables for every student and then go from there. That's all it is. That's the honest, okay.
Speaker 2:So now go from there. That's all it is. That's the honest, okay. So, um, now let's talk about the test a little bit. Obviously, you've taken the test, uh, a couple of years ago yourself, and then now, after that, you've kind of uh, built five business businesses around, essentially, um testing and testing patterns. So, if anything, I don't think that there is anybody who is as well-versed with the USMLE Step 1, 2, and 3 better than you, because at some point in time you took these three exams, you passed them for your own career advancement and then you started businesses to help students, help students.
Speaker 2:What in your? If you can give us like a general timeline from the time that you took the test, step one and step two? Let's focus on those two, because our students need to finish those two before they graduate, of course, of course. And how has it changed since the time you took the test for the first time to today, when you're teaching students? We had the pandemic. We saw like monumental changes in the exam. Even USMLE has come out and said that they haven't, they haven't made changes like this in decades. That they've done in the last couple years. So why don't you talk to us a little bit?
Speaker 3:about that, sure, sure, sure. So I mean, ideally before we begin. A lot of students have asked me hey, you haven't taken the test in 10 plus years. How do you know? Well, when we prep our students right, we see their success, we see what works, what doesn't, we adjust, we adapt and then eventually we come up with a formula that works for everybody, right. So that's why, even though I haven't taken the test recently, I feel that every student that works with us I've taken the test because I see what works and what doesn't. Absolutely Way back when I took it, it was a lot easier because the structure was different.
Speaker 3:It was more buzzwords, it was more. If you can understand some phrases, you can recall the information Resources were not as a large amount of resources as we have today. The technology was different, right, so we had few resources versus now people have lots of. They're saturated with resources. But the exam itself has come to a point where it's getting tougher because it's the way they ask the questions. They take a simple disease that you know about and they just create such a way.
Speaker 3:That's third order, it's not just first order. They actually have different steps that you need. That you must know to get the right answer. So that's why step one is challenging. They've changed it from scores because we had scores back then and little by little they keep adding, they keep increasing. You good, yeah, they keep increasing the passing score to eventually fast forward to when they say hey, ladies and gentlemen, we're going to go pass or fail. So that's step one. It used to be a score. It used to increase the number. Eventually Now they went from 50 questions down to 40. It's more challenging why? Because you have to get more questions right. So step one is more difficult in many ways, specifically for that. It's not recall as far as buzzwords, it's more of just being able to connect the dots.
Speaker 2:So you're saying the step one exam has become conceptual, a lot more conceptual than it was before, and this change is relatively recent, or has it been on for like, say, half a decade, 10 years already?
Speaker 3:Or is it?
Speaker 2:just evolving every year.
Speaker 3:You know it evolves because, again, these questions are written by MDs and PhDs all over the world. Right, they've been created for the purpose of the assembly. So I would say in the last maybe six to seven years they started bumping up the cutoff point to eventually changing the style, the format of questions, to then allowing QBanks like Uworld and BOSS to adjust because that's where we use QBanks Right, right, right, right, test and fail. Take it again ideally we want to use a Q bank. So step one got to a point where when they decided to go pass or fail, they did it to alleviate stress because a lot of us out there, without a high score on step one, your future is over in certain specialties. That's, that's how I grew up in medicine right, right right high in step.
Speaker 3:You will never be a surgeon. You have a passion, but, stavros, you will never be. They chose to make it into pass or fail. Do you know? Because of that, all the numbers dropped. You can go on uassemblyorg. You can see the numbers have dropped, MDs.
Speaker 2:Americans. By numbers dropped you mean two people are passing the test okay and this is systemic across the united states. Even us schools are facing the same thing, correct?
Speaker 3:so okay, because they have it on usmorg. It's american medical students international, which are foreign, caribbean and international. All their passing, the passing scores have all dropped, including DO schools too, so and that's accessible. You know we can put the link at one point. It's there, right, right.
Speaker 2:Sure, We'll do that. So by how much do you think it's actually dropped? Or how much, at least from your experience dealing with all these schools and all these students and teachers? What do you think that percentage is? Like ballpark.
Speaker 3:It doesn't have to be accurate, but from your experience, I mean when a test has a 98% chance in the American let's say American students and it goes down to like 94, when the Caribbeans are 94 and that goes to 91, you might think 3%, 4%, 5% isn't that much. But when you see a consistent drop in passing scores all across the board, and then when I myself talk to medical schools and students and they say, dr Stavros, most of my class can't pass a comp exam, most of my class can't pack in it, pass an NBME, which is what we do and sponsor to pass a step well, it's a nice safety net, but there's a problem, isn't it?
Speaker 3:right it's either the test is getting more difficult, which it is, but we, the community, medical school students programs have to work harder to say okay, because everyone's dropping. There's a reason. We have to figure out what to do and a lot of people don't put the time into prepping step one because they figure, hey, it's pass or fail. But yeah, the problem is, if you do fail my era back then if you failed, you come back with a score and you can prove whoever's looking at your application that this student failed. But now they came with a high, maybe 40 points higher than average versus now. If you fail once with a pass, you, if you fail, you come back with a pass. You can't show to the person looking at your application that you scored a 260.
Speaker 2:You see, that's why it's it's important to pass on first attempt but so it's funny that you say that that students are kind of not like just because it's pass or fail, the amount of effort that they're putting in seems to have gone down.
Speaker 1:Yes, I can say yes.
Speaker 2:And we see that with students. It seems like a normal trend amongst at least our students is that after they do well on the NBMEs, they go on vacation and then they go together. So they've been, it seemed. No, but I'm actually being very serious about this and I don't know if you're seeing this amongst your students I mean because I'm localized to st james students and it seems to be a trend that a lot of students are like hey, I did pretty well in the comp, I need a breather, I'm going to go on vacation. And they go on vacation. I would personally like and of course I'm right around your age In my time you don't go on vacation until your end goal is met, which is step one.
Speaker 2:Sure, you don't go on vacation until your end goal is met, which is step one. Sure, you don't go on vacation for the nbmes. And this is something that honestly only happened after the scoring went away. We never saw this before. Yeah, yeah. And I'm beginning to think that this is the mentality like say, hey, you know, I did really well. I mean, uh, and the nbme gives you some sort of a passing percentage. If you take the step within x number of days, you're gonna. This is your probability. If they see a high probability, they're like I'm gonna pass anyway, so I'm gonna go on vacation, and they go on vacation and they come back and they've kind of forgotten everything. They're out of the groove, sure, and they're not doing well. What's your take on?
Speaker 3:that before we continue. I think we look pretty good for our age. We're aging very well, so that's a good thing. Props to us. To go back to that, I have to add some to that to what you just mentioned. Our generation, yes, we hustle, we grind, we go. The difference is, I feel, that the discipline you know we work hard. Nowadays, I feel, those who want to take a break it's either a, you know they just they feel like it's a pass or fail but also sometimes because they're so stressed, they're so exhausted and they're so burnt out because maybe you know the studying, the habits of balancing time management that they need to take a break. So in some instances people need to kind of get get, but when they come back, like you said, they're not in the zone. I feel the pressure is gone and because of that they don't push Like CS, which we'll discuss a little later.
Speaker 2:There's no.
Speaker 3:CS. Okay, so why buy a book for the CS exam? Clinical skills.
Speaker 2:Okay.
Speaker 3:First thing, you guys, step one is a foundation for step two. I have a student that just scored very high in step two 262. He worked really hard. Caribbean student for step one worked really hard, like you guys out there, right during rotations and BMEs and the rotations and shelf exams. He pushed hard. He took four weeks, four and a half weeks to take step two. You know why? Because he did all the work from step one, huh for rotations. Trust me, anyone study on the weekends you don't study at night. His family was a beach but he goes to me. You know what I did. I did what you told me to do and when I had ready for step two, he now has the door open emergency surgery, anesthesia why?
Speaker 3:Wow is he invested and he gave up a little earlier to now. He's like yo the whole year. I'm going to relax respect because I could apply for the match with a high score. Yeah, I'm easy. So, those of us that I work with and those of us listening now talking, if you think pass or fail is nothing, you might just pass, barely pass, but then it catch you later for step two. I'm telling you it will. So if you take anything out of this podcast, is if you really want it, that bad. You know you work hard and not we'll like. We discussed other options in medicine but, yeah, the past fail has alleviated the pressure from us, which that was the goal to do. But everyone's like, oh, I don't have to study that much, I just got to pass the thing, okay good.
Speaker 3:You get caught later. I've never seen it otherwise, it always happens.
Speaker 2:So I want to talk about this a little bit more in the sense that so, for example, most Caribbean schools follow. So there are two ways to do a curriculum right A subject-based or a system-based. Yep, and most Caribbean schools tend to follow a subject-based approach, including St James. But St James is a little different because we have a hybrid where we do a review in a system format Correct in a system format Correct In your experience and I would say 80 to 90% of Caribbean medical schools follow a subject-based or they're following something like us, which is kind of a hybrid mixture of both. Yeah, and the reason we do this hybrid is because we feel like once you teach everything on a subject-based, the system kind of brings it all back. That's it. But in your mind, is there a particularly more advantageous approach versus between subject and system?
Speaker 3:Everyone learns differently. What I realized is from the majority of students I've worked with and myself when I went through curriculums, especially St James subject is the best. Because when you're sitting, when you start in medical school for the first time because this is cool, you start in medical school for a reason you get really confused. When you take a system like cardio and you hit everything within cardio because it's all, it's broken down that way versus you go little by little, you learn anatomy first, histology, embryology. You can appreciate the biochemistry of things, you can appreciate microbiology, the bacteria, the viruses and all the bugs and drugs, and then when you get to systems, oh we're doing cardio, yeah, you know, you learn the cardio. But then when you go over micro, you say but I've been exposed to micro, I've been exposed to the bugs.
Speaker 3:So now I can appreciate the differential of a cardiological disease. Okay, interesting, the person has or, like respiratory person has pneumonia. But then now I can understand why the pneumonia he has is actually tuberculosis, because I did it before, which then I know why it's TB, what drug we provide, what's the mechanism of action and so on. So I've realized for the majority, system is not for everyone. It's usually subject first and then hit the systems hard to bring it all together. Others do it the other way, but it's more challenging that way. I think it's more challenging. Okay, well, it's more challenging.
Speaker 2:Okay, Well, that's good to know. So the other question I did have for you and this is kind of a big debate, especially among medical students I love the thing, let's go.
Speaker 2:Medical students don't want to take the NBME because they think, oh, I don't want to take the NBME Without passing step one, I want to be able to do clinicals. St James, we don't allow that. You have to take past the NBME. If you get a passing score on the NBME, that is the only time you are allowed to take step one. If you clear step one, that is when you're allowed to go into clinicals. Most of our clinical partners, like the hospitals they're all teaching hospitals they mandate that the students have step one. It's not like if we wanted, wanted to, we could even send students without step one. However, there are, like you know, there I think you know this, dr stavros there are over 75 caribbean medical schools. Only about 20 are accredited um. So the ones that aren't accredited um tend to just push students into clinicals.
Speaker 2:Let them slide in and then a lot of students are like and we've had students transfer out Good students come and say, hey, you know what? I don't want to go through the grind of step one, I want to start clinicals right away. So I'm going to go to an unaccredited school because you know they're promising the sun and the moon and everything in between and because of that I'm going to ace it. I'm going to get into clinicals without step one.
Speaker 2:I'm going to finish clinicals, and then I'm going to take step one and step two together. What's your thought on that?
Speaker 3:so I want to mention something. Um, this is from my experience and and I can say what I want to say. Usually it parallels, if not really the same as what I see, with student success. The best way to approach this is to struggle and push now to pass step, because if you don't take the NBME, clearly you don't know if you're going to pass or fail. Fine, those schools that don't really require NBMEs. You fail once or twice. I hope everyone understands that even if you fail once or twice, some states in the country will never give you a license. Some states in the country have requirements to say okay, you come to my state, we want first attempts only. There are other states that have limits of four attempts and six. There's a website I'll provide to you guys you can put on. So that's that, so you can get licensed elsewhere. But some states will never give you a license if you failed one of the exams. That's that. Let's go to jumping over. Okay, we decide to tell students you know what. You don't need to take the NBME. Forget about the step Start rotations.
Speaker 3:They go through rotations, they learn. Now step two clinical knowledge. They finish everything. Your school is happy, meaning whoever's school is doing this and now the students are stuck I'll say the word stuck for a reason to go back and learn step one and step two. One and step two. I have very few students, very few, that were able to attack one and two together in this, in this form. If this, in this new way of of directing students, because it they lose, they lose hope, eventually they go. I finished my rotations, I paid for my tuition, my everything, everything's good. Now who's going to help me? I got to go back and learn everything again after a year and a half of rotations. Right, it's two years Two years yeah.
Speaker 3:And then a year of electives. So it's two years of learning clinical knowledge. And some will say well, I can take clinical knowledge first, step two and then step one. Okay, the chances of passing step two are higher because you've just finished rotations. But that's step one, guys. Without that step one you're not going anywhere.
Speaker 3:And I would say, 90% of people that I know that have attempted this style, this routine, have never finished step one. They've done step two. Step one has been their nightmare and because of that they eventually jump out and they do something else in medicine.
Speaker 2:Right and I think because of that, recently relatively recently the NBME actually doesn't allow that anymore. They don't allow you to take. You have to go sequentially. You have to have a passing score in step one. But I think that that's recent and when you're telling me this, it kind of makes sense that they introduced this, because a lot of students must have done that. They probably took step two and got stuck in step one. They don't have step one, they just have step two. So you think it's not a good idea to do that, right.
Speaker 3:Well, we'll probably get emails, Guys, I get that. But you have to understand one thing the reason why we take it first of all NVMEs. I don't like First of all NBMEs. I don't like, I'll be on record. I like them for what we use them for. I just feel all the schools, including St James we need to do something better about helping students adapt from QBanks to NBME. Even I, when I do them, I'm like wow, these are not easy.
Speaker 3:When you're doing a QBank reading questions, they spoon feed you everything. Ok, nbmes are meant to do two things. They give you a 200 question exam, the first 100 questions. You don't have a break. The questions are very short, two lines, bare minimum. They go what? But the QBanks are three paragraphs and they're 40 questions. They figure, if you're able to answer a 200 question exam and give you the bare minimum and you can still get it right, that means you know the concepts, you know the foundation of medicine, which that means you walk into the actual exam, where they have 40 questions instead of 50 and they have three paragraphs instead of two lines. It's you're going to pass right. That's the whole concept behind mbmes. So, yeah, those who are failing in bmes, it's not, it's been, you're going to pass, right? That's the whole concept behind mbmes. So, yeah, those who are failing in bmes it's not, it's usually concept, but it's also they're not exposed to the way the questions are right.
Speaker 2:So what I'm hearing is that it sounds like the step one exam has become a very conceptual exam. So essentially, if you go and memorize entire u world and emboss and your uh, first aid, yada, y, yada, you're probably not going to pass because you didn't understand anything right.
Speaker 3:Well, back then when I was taking it, we had something called buzzwords. We had certain resources that we memorized, because it was like that Now you can memorize anything you want. If you're a photographic memory, fine, you'd be passing everything. It's very hard to memorize everything because even then they need you to connect. If you don't connect, you can't pass.
Speaker 2:That's all it is.
Speaker 3:Gotcha, gotcha, they've adjusted it.
Speaker 2:Now talk to me about step two. Step two also has had a lot of dramatic changes. Why don't you walk us through what the changes have been in the last decade?
Speaker 3:So step two had two brackets clinical skills, clinical knowledge. Clinical knowledge was the basic exam that teach to see what you know in your rotation. So you go through all the cores surgery, gen, surge, pediatrics, OB-GYN, family psych, peds and then you take a test. That test is going to see what you know. Fair, that's also challenging in itself. The CS exam, clinical skills was something that I mastered that I loved that I was teaching to doctors all over the world because there were five locations in the country where you have to fly in if you were not in the States. Philadelphia was one of them. Chicago was another Five. You know, you come in, you see 12 patients. They were actors. They weren't real patients but they would test your skills. They had a huge list of like a score report, like a checklist empathy, sympathy, medical knowledge, I mean everything and people would fail maybe their English part or their bedside manner part. So that was very challenging, but it actually was one of the best exams because it brought to attention that you need to not only know medicine but you need to know how to handle the patients. Right, OK, Right.
Speaker 3:So the pandemic came. It was on hold. They froze it, Everything froze. For a while it was on hold, they froze it. Everything froze for a while, and they thought about possibly going to an online version and eventually fast forward. They released a statement that they were fast forward. They released a statement on one morning and it said ladies and gentlemen, we've decided to pull the license exam completely off our list, so you don't have to take it anymore. Ok, so that was out One less exam for everybody.
Speaker 3:Problem was, though, that people were going through rotations, not really checking their clinical skills, and then now, to this day, I'm in relationships with many different residency programs, family program directors, and they've told me they go. Our candidates are not as strong as they were in their clinical skills, and that's a combination of the exam and virtual rotations. I mean, I know we maybe have done them a lot of us. We had to to move on most of the students that I know have but you can't learn through the computer, you have to be touching the patient. You got to be hands-on, right. So the clinical skills was something that was a huge blow in the community, was good for students, but now we see the blow Students are not working on clinical skills. They don't really know what to do and how to do it, so it's challenging.
Speaker 2:Okay, and what about CK? Ck was always the knowledge portion, but are you seeing I mean, I believe even that test has changed are you seeing reduced pass rates in ck as well, like you're seeing in step one? What's your experience with?
Speaker 3:that. So the ck exam now is is the biggest, biggest exam to focus on because once you pass step one, again step one is important because if you don't pass, you automatically can't license in some states fair and and granted, when you pass with a P, you still on the same level with everyone else. It's a mean if it pass. Now step two has its highlight. Now it's famous like oh well, now you have to score very high, mm-hmm. So the pressure was taken off of step one, now it's on step two. Before step two really wasn't that big, it was like not step one was a pressure. You know, emily, I feel changed it up and just put the pressure on step two. So step two is more challenging. Step two is eight blocks instead of seven. So you might think it's nothing. But if I asked you to run a marathon and when you finish say, all right, run five more miles, I don't know. I don't run marathons, I run 5Ks. Same concept.
Speaker 2:You do seven.
Speaker 3:Now let's do 40 more, right, Wow? So, and step two is is all about learning the stuff in the hospital. So at the end of the day, the pressure's gone. From step one, you still got to pass it. Now step two, you got to score super high or else you can't get into some specialties. That's more challenging because that's what they require, so they just shifted the pressure around. It is challenging because what if you don't have a strong rotation? What if you go and your preceptor isn't teaching you everything? It's up to you to go home and study. Right, I didn't study, I would go home and relax.
Speaker 2:Personally, I'm like I don't want to keep reading.
Speaker 3:I'm tired. It catches up to you. So, it's a lot of pressure everywhere and that's why now, with step two, doctors I work with yes failing. I don't think people fail step two as much because they're working hard on step one. Right Transition over those who don't do well are those who perhaps are not in medical school anymore. They're trying to come to the States and they're just on their own in a living room and it's hard, right?
Speaker 3:I mean, if you're by yourself, I mean we have each other. We're on zoom now talking. You know, virtually right, there's our home all day studying. I don't know about you, but if you don't have a certain support system, cabin fever, yeah, oh, you're gonna drop fast. And those are the ones that I usually see fail because they go. I can't do it, I don't know what to do anymore there's no guide right. That's where I come in that's, that's awesome.
Speaker 2:So I mean so generally, it sounds like I mean, we've always been talking about how the US is really trying to increase the number of physicians, sure, by introducing, by merging of DO and MD, then introducing so many new DO schools, sure, et cetera, et cetera, allowing, you know, investing more in residencies for IM and FM, et cetera. But on the flip side, they might be increasing the opportunities, but they're also tightening the clamps, it looks like, from the step one and step two portion, because they're not letting. They want better quality to fill those more positions that they're creating.
Speaker 3:Yes, and for those out, we need to know this, that USMLE used to have six attempts, now it's four, so it's six. So, people, we need to know this. That USMLE used to have six attempts, now it's four, so you're six. So, people, unfortunately. You know, I get it. You were tired, exhausted, issues happened. You took the test, somebody passed away in your family, I understand right. But at the end of the day, if you fail four times, you're out of the system completely. They figured if you can't pass the first three or the first four, the chance of getting a tenured residence or slim to none, unless you know somebody very well. Even then it's not going to be successful. So that's the risk. Yeah, the tight end of the clamp. It's medicine. Guys, you're applying for a job in a top university or a possible program that you are one day helping people with their health. They're going to come to you, dr. Yeah their lives.
Speaker 3:Yeah, their lives Sure Lives, of course. So it is challenging, it's doable. You have to navigate well or else it's very hard to get in, that's right.
Speaker 2:I always tell people that actually, both entrepreneurship as well as medicine, these are not professions, these are lifestyle choices. Oh, lifestyle, a thousand percent. A thousand percent, okay, yeah, and because it seems like it's like the amount of work that goes in, the amount of time that goes in to both of these professions, depending on what kind of an entrepreneur you are. But this is not nine to five. If you are looking for a nine to five and work-life balance, what would you say Like this particular? You know, I think a big buzzword nowadays, especially in the workforce across the board, is, oh, work-life balance. What would you say to somebody who would comment or make those comments, especially in the? And at the same breath, they're saying I want to be a physician.
Speaker 3:So those who know me will know me well and I always you know we always speak the truth, right, tough love. If you're in medical school and you realize maybe you're failing or you're struggling semester after semester, okay you figure out why. Right, eventually it has to be. The individual Schools can do what they can. They can't spoon feed. They teach you the best they can. But I realize sometimes students go to school because of family, because there's some pressure which I know. They want the best for us, our parents. But hey, maybe it's not for me, maybe I don't want it.
Speaker 3:Then you slide somehow, finish in med school, you get into residency or you hope to get in. You realize there's no passion. You eventually will burn out, get exhausted, get frustrated, not live your life, not love your life. So I would say, if you're watching this now and you are in medical school, you realize, man, it's not for me. I, you know, I don't want to say jump out, but maybe another option would be beneficial for you, because time is valuable, right, it's your life, it's your future. And then, if you are in rotations, this is what I didn't do, which I want you guys all to do now, when I knew I didn't want to be a pediatrician, I did my PEDS rotation. I'm like, all right, I'm just going to go and get out. But what if I put my heart and soul into it, to expose myself to all of it? Maybe I would have been like, hey, wow, this is actually pretty cool. Versus yeah, I know, I don't want to right.
Speaker 3:So this is different stages, because the biggest thing I've seen are doctors choosing a specialty. I have one guy, a couple of guys that did internal medicine, peds. They got into residency Second year. They want to get out. I'm like what happened? You knew? It's no surprise they didn't love, they just didn't see the sums. They see the sums, they see themselves doing it. I have one anesthesiologist. He finished anesthesiology northwestern love the guy. He goes. I don't want to practice like what. I'm tired, tired. Top university in the states great guy, fine, you know. Top residency northwestern chicago. You're kidding me? Untouchable. He goes. I'm good, I don't want to do it. So something clicked, he. I don't see myself living my life, even if I'm making the money to be doing this.
Speaker 3:So I ask of you from now, see, talk to your doctors, talk to your preceptors. Now dig and say hey, what's a daily life in a pediatrician? Right, right right. Or a thoracic surgeon. Do you know what that takes? You should.
Speaker 2:It's a life if you said life to us, not a job you gotta love it guys or you're not gonna make it, you're not um so, just out of curiosity, what is this particular gentleman doing, who was the anesthesiologist from northwestern good he.
Speaker 3:He was one of my coaches at a previous company for a while and then now he went. East Coast to pursue specialty more in admin. So he has an easy ology. He's board-certified, but he's using his, his knowledge, his education, his experience in more academia and universities need MDs too, guys so yeah things have changed.
Speaker 3:Things are like when I see an influx of people coming to me they want a job and they're leaving 400 to get a lower salary to coach students, yeah, there's a reason why. So, yeah, it could be anything from burning out the program was too intense time management. They are, they were in love with it, but now they don't like it, which we're human, right, we're not robots.
Speaker 2:So things change yeah, that's a very good point. We actually do a lot of work with northwestern um and pretty much in their medical school most of the folks are actually like physicians, like they have an md, they're board certified but they're doing admin work. So it's a very good point that you bring up. So that truly is another avenue for physicians to get into academia and like their head of research, for example. If I'm not mistaken, she's obviously an MD, but she's not an active practicing MD from my understanding.
Speaker 3:But she's board certified and like obviously has a license and everything, but she's teaching certified and like obviously has a license and everything. But she's teaching and you and everyone that I I meet you know I travel a lot and they go to me. Wow, you know I'm really you have a wonderful passion, like I'm just lucky because I love what I do. A lot of them like well, there's no grass isn't greener, you just gotta. You gotta water where the grass is and build it yourself, right? But a lot of people are like, you know, I I want to do more.
Speaker 3:I have doctors who are OBGYN and they started doing Botox injections, so instead of saying well, instead of having all that malpractice, I can get certified, I can go to women's homes, I can have my own little spa and I can start doing injections, make more money. Because at that point they go to me, dr starvers I mean starvers were friends they go. I don't see my kids, I mean they go. I make a lot of money, I just don't see my family. So I've changed. Now I will do different things to enjoy my kids and make more. Yeah, that's, things are evolving now that's you know.
Speaker 2:I mean it's happening and that's very interesting because this is a little philosophical and we're going on a philosophical tangent here. But once I read, I kind of remember I think this was Elon Musk or a really famous person who said the difference between having a lot of money and being rich is having control of your time.
Speaker 2:If you don't have control of your time, you're never rich. Yes, if you're working, you know 140 hours a week and you're making a ton of money, you're not rich because you're not really being. You don't have the time to enjoy that money.
Speaker 1:Yeah, you're right 100%.
Speaker 2:So it's a very good point that you bring up. They're working a lot and they have a lot of money, but at the same time, you know what's the point.
Speaker 3:Now going back to money, because you know money, but at the same time you know what's the point. Now now going back to money, because you know money does make, make, make the world go around. Of course some people choose medicine for the money. Yes, they realize, residency there's. No, I mean, it's very little. You'd be lucky to make six, sixty, five thousand a year. Yeah, three years of residence and a lot of people born in medicine don't know that they call your doctor. Oh, easy, residency, you get very little. Yes, that's before taxes, and then hopefully you get into good specialty, hopefully you want to pursue a certain University. It's usually a business.
Speaker 3:They have certain budgets, right, certain bats or an amount of money to buy. So then those who go in for the money sadly to say, many of them jump out. They go, man, I can't do it like, well, yeah, because you're going in for the money, you realize you're going to make not the money that you wanted to make. So that's another. It's like that's not a, it's not, it's not the right, it's not, it's not a solid passion to have because you run out so fast when you're not getting the money that you really want to have.
Speaker 2:The other point I wanted to make with that residency portion is that you're working up to 80 hours. It's not up to 60 minimum. Yeah, you're working 80 hours a week and when you equate that $65,000 to 80, it's below minimum wage. That's what you're getting.
Speaker 3:And you know I have friends. All of us have survived on that. Whether we have investments, family support, loved ones are cooking for us every day. You make it work. But think of it this way yeah, you know, after taxes you're not making that much and you have to pay rent again Again. If you have a passion, though, you know you make it happy Like I don't care, I'll eat mac and cheese every day, I don't care. But those like well, you know what, it's not for me. Well then, you don't have enough passion to go. Because if you have a passion, like building a business, starting from scratch, moving, taking what I knew from one to build the next one, the stronger one, there's always risk, right, but I have passion in what I do, I'm confident in what I do and I make it work. You need confidence, you need to have that passion, or else it will not work for you. That's what usually happens.
Speaker 2:It's tough, that's crazy. So yeah, I mean, if you equate like an 80-hour work week at $65,000, that roughly equates to about less than $15 an hour. Yeah.
Speaker 3:And what happens is and this is again, I love examples I was working at Cook County Rush University too, and then I was with the University of Illinois surgical team Gen Surge, general surgery and I was with the chief five-year great guy friends to this day. He was married to a family internal medicine. His wife was internal medicine at Cook County. He was University of Illinois chief surgeon. You're being student, right? He goes to me. This is what I was a city go, Stavros. I gotta tell you man, I love my wife, but she always gets me, gets mad at me because I don't get home in time. She's in medicine. She's actually chief of internal at that. Right, right, right. He's chief of surgery. He goes, honey, I can't come home till I finish my surgery. By the way, just came in 10 minutes ago and I gotta have a four-hour procedure even then didn't understand.
Speaker 3:So you see, it's tough like it's no matter what passion, sacrifice me and the right person. You have to set it up the right way. It's not a sprint, it's a race, and if you don't have a support system by your side, it's challenging. Guys, it really is a lot, a lot of obstacles to overcome every day.
Speaker 2:So, dr Stavros, as far as your agency is concerned, your institution is concerned, helping students. If any of our students are stuck, what would you recommend they do? How would they reach out to you? Is there a circumstance when you look at a student and you're like, yeah, this guy is beyond help, I can't help him?
Speaker 3:Well, I mean, I'm sorry, Go ahead Sorry.
Speaker 2:No, so that's why have you had? Are you like rejecting students? Are you willing to help anybody? What's the like? How do you? Are you willing to help anybody? What's the like? How do you? What should a student do? When should they reach out to you?
Speaker 3:So a couple of things. I'm always a believer of providing the best advice I possibly can, and sometimes we're not meant to work with some people because they need more prep, they need more time to build the foundation, because maybe they're out of school, right. But if I, as long as I, can, provide some advice for them to get on the right track, maybe they come back to me a year from now, two years from now, maybe never, but at least they have the right information, instead of going online searching different forums, which I like. But you got to be careful who's out there, because how can you, how can you credit? There's no credibility. You don't know who's saying what, where, how.
Speaker 3:So usually medical students, first semester, second semester, third, fourth, fifth, preparing for step, little by little, is the majority of doctors we work with. We work with doctors in the Caribbean international. As long as you are in school, outside of school, and you want to dedicate and sacrifice, we work with everybody. Very few of them say hey, say hey, I can't work with you, unless, literally, they can't dedicate an hour a day, which is very rare, right, okay? So if they visit usmletrainingscom, forward slash step one, they can go to the website. They'll see my, my webinar, right, learn everything.
Speaker 3:Reach out to us if you need to. You'll talk to me on my staff, and if we feel that you need prep now versus hey, you need to come back to us. If you need to, you'll talk to me on my staff, and if we feel that you need prep now versus hey, you need to come back to us a few months from now. This is why we do what we do best and why all of our students pass. It's just given the right guidance, the right support. Okay, make sure they do well. All right, yeah, I mean, that's the whole point. You got to sacrifice right and navigate.
Speaker 2:We'll do it for you with right and, and you mentioned that all of your students pass um like. Is there like an official statistic on that or?
Speaker 3:you know why they all pass? Because and I'm I, we all say, oh, guarantee the reason why they all pass is if they and again I'm honest, there's some students I don't let I, I do not, I do not allow them to pat to take the test because they can come on and work with us for two months but then they're not strong enough. I'm like, well, I did everything I could and there's no way I can sponsor you. I can actually, you know, advise for you to take your step one because you're still lacking in X, y and Z. So then you know, we provide a little more support. They keep working on their weaknesses and then they go past the test because this is their future.
Speaker 3:Right, I mean, I can't, I can't allow somebody under my support, under our team, to take the test and fail, because when they do, they can't license to some states. Their journey becomes much more difficult and many of them are like man, I got it, what am I supposed to do? I gave up my family and I failed. So, yeah, I take it personal. That's why those who work with us, you're not going in unless, like you said, nbmes and assessments.
Speaker 3:So I can honestly say no one has failed under the guidance that I've provided, following the right resources and the assessments that I need to have before you pass the test. It might take six months, it might take a year. It might take two weeks. The fastest I've done was four weeks with a few students, but again, they need to help people hear this ago I got to do it. No, no, you need to have the foundation right, you need to know the medicine and I can show you the test taking skills to actually make you a rock star test and what's the best period for them to reach out to you?
Speaker 2:is it MD for? Is it MD 5? Is it after they failed the NBME a bunch of times? When is the best time for them?
Speaker 3:to reach out. You can reach out to me after. I would say this there's two parts to this answer. A, for those who are in MD3 and 4, preparing slowly, knowing that an MD5, st James and other schools want you to take an NBME to get sponsored for the step, don't wait to the end, come to us, we'll guide you to make sure you're on the right track. Fine, for those of you who just started medical school last week, last month, you know like I don't want to listen to this guy. I'm not ready yet. Oh no, no, I get it.
Speaker 3:But with what we do is we also have a huge library of videos, so okay what I, what I didn't have as a student is I had resources like right, you could buy videos, yeah, have the Q bank, but no one does it together like this. So I have some students. Now they go to me. Doc, I failed step one. I failed my NBMEs watching your video, going through glycolysis cycle, using this question and teaching you the content behind it. I learned better that way than watching. Videos are great, but nothing is clicking for me anymore. So for those of you like member md1, for example, do you know what? What classes you teach on md1 too, was anatomy histology yeah, yeah yeah.
Speaker 3:So wouldn't it be nice for students to say well, I can listen to my professors and my doctors in St James, but I also have a list of videos from Dr Stavros that I can parallel to expose to questions, no pressure. So then, when you get to MD3, you're like well, I've been watching these for two semesters, three semesters, I'm getting acclimated to the style of questions, which then increases the chance of passing NBME, being more disciplined because they're watching the videos, and then your numbers rise because they pass faster, they get into rotations faster, they get into step two.
Speaker 2:We definitely want that so it's a domino effect right they don't see it, we do.
Speaker 3:They don't see that, though. That's the problem.
Speaker 2:Right, and that's the thing. Know, the whole concept of quote-unquote privilege comes in, and if joining an additional program gives you that privilege, why would you not take it?
Speaker 3:because then you don't struggle for nbme and again if you realize medicine isn't for you, please. You know, and I advise a lot of students, I mean truthfully, they might be married, have kids. Maybe they're doing it to make money for their loved ones other times. Man, it's not for you, that's cool, I mean, accept it.
Speaker 3:But if you're in it and you have love for it. Well, let's get it done, let's pass the test and move on. Just it's navigation, man, it's all guidance and navigation and support uh, thank you so much for these valuable insights.
Speaker 2:uh, if anybody of you need to reach out to Dr Stavros, his contact information will be in the comments below. And if you like the content that we're producing, give us a like, give us a follow. You can download our episodes on any one of your favorite podcast providers, such as Spotify and YouTube. And remember there's no shortcut to becoming an MD.
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