Making the move from the second to third year of medical school

Transitions can be scary, especially when you’re in medical school. It is often very helpful to hear the wise words of the DOs and students who have already been through these changes.

In this Q&A, Laura Frackiewicz, OMS IV, who attends the University of New England College of Osteopathic Medicine, shares her best tips for the transition from the second to third year of medical school. She discusses how she approached studying for COMLEX as well as scheduling and prepping for rotations.

When did you take COMLEX Level 1 and how did you prepare?

I took COMLEX Level 1 at the end of May (my second year) in 2023. My medical school ends the semester at the end of April, so I gave myself four to five weeks of dedicated study time. I used the UWorld Qbank (six-month subscription), TrueLearn, AMBOSS, Sketchy, Pathoma and Savarese to study for boards. For my own personal boards preparation, my goal was to build mental endurance in terms of gradually increasing the question amount and total blocks completed. I also wanted to increase my physical endurance to be able to mentally focus at my best for an eight-hour exam.

Overall, my rough study schedule started during my OMS II second semester in January, when I began to transition my study focus from class-focused to a more boards-focused mentality. During this time, I focused on modifying my schedule to incorporate boards material into school-related material more than I had in previous months. I tried to do 10-15 questions that paralleled with whatever I was learning in medical school, and as I progressed to May, I found that I built mental stamina and endurance, which allowed me to complete more questions effectively.

I began to focus on maintaining a consistent schedule which included daily questions, supplemental material, daily movement/exercise, healthy meals and at least seven to eight hours of sleep per night. As the semester progressed, I began to increase my question load every day and transitioned to “timed” mode rather than “tutor” mode to practice simulating exam-like conditions. In March my goal was to consistently complete 20-30 questions each day, and by April my goal was to do 40-60 questions each day.

During dedicated (end of April to the end of May) my goal was to complete 60-100 questions a day. It was also equally as important to review every single question (correct and incorrect), and to figure out why I answered the way I did—particularly noting if a question was missed due to weak content knowledge (this allowed me to review said content), versus did I miss the question because I read the stem or answer choices wrong (this allowed me to perfect my test-taking mode to carefully read important aspects of the question/answer choices), versus if I guessed (which would prompt further investigation as to why).

I also found it helpful to use a notebook to write down key missed concepts, mnemonics or topics that I constantly reviewed up until test day. I was able to complete all the Sketchy Micro videos, the entire Pathoma book and associated videos and the Savarese book prior to dedicated, which helped greatly with the microbiology, pathology and osteopathic manipulative medicine (OMM) portions of the COMLEX exam.

As much as test-taking strategy and studying played into my boards preparation, I also took the time to incorporate self-care and mindfulness into my journey. I used Headspace for daily meditation and mindfulness exercises and worked in daily walks or gym sessions where I used the time for me and did not study or think about boards—mostly I watched reality TV or listened to music, which helped me recharge for the next study session.

My friends and I also embraced a weekly “Wellness Wednesday” during our four to five weeks of dedicated, where we would all silently and separately study at a chosen location and then go to a group workout class at a local Barre fitness studio. This helped us all to connect during a stressful time and gave us something to look forward to—knowing we were in this together kept us all grounded.

How did you schedule your third-year rotations?

When I scheduled my rotations, I did not know what specific specialty I would eventually choose, but I knew it would be in a primary care field—either pediatrics, family medicine or internal medicine. My goal was to schedule these three rotations during the first half of the year to help me decide what I liked best and to gain experience earlier rather than later. I had previous experience observing surgical specialties and knew based on my interests that I preferred the primary care end of medicine rather than surgery, so I coordinated my schedule with the primary care specialties in the first half of the year and the surgical specialties in the second half of the year.

What should students expect during clinical rotations?

The first and second year of medical school are the didactic years—very classroom-based, where you are studying from lectures and PowerPoints with an emphasis on more frequent test-taking with lower-stakes exams. The frequent tests allow students to become acclimated to longer and more endurance-based exams, eventually preparing you for board exams. During the third year of medical school, you are out of the classroom and working in different hospitals, clinics and outpatient settings to gain experience in the core specialties to help you decide where your interests align and what specialty you will ultimately end up pursuing for your future career. During your clinical rotations, you are able to apply what you have learned in the classroom to real patient scenarios and begin learning the clinical side of medicine.

What resources did you use to prepare for rotations?

I used a variety of resources, and they varied depending on the rotation:

• OB-GYN: UWorld Qbank
• Surgery: Surgical recall and UWorld Qbank, as well as practicing suturing with a suture kit (available on Amazon)
• Pediatrics: Step 2 First Aid pediatrics section, AMBOSS, TrueLearn Qbank, UWorld Qbank, Pocket Pediatrics book and Divine Intervention Podcast–Pediatrics
• Psych: UWorld Qbank, TrueLearn Qbank, AMBOSS and Sketchy Pharm
• Family Medicine: TrueLearn Qbank, UWorld Qbank, AMBOSS and Divine Intervention Podcast–Family Medicine
• Internal Medicine: TrueLearn Qbank, UWorld Qbank, AMBOSS, Pocket Medicine IM book and Divine Intervention Podcast–Internal Medicine

How did you study for the COMATs?

For my own personal study strategy for the COMATs, I used Microsoft Excel to create a calendar of the rotation and took the number of TrueLearn and UWorld Qbank Questions for that specific rotation (i.e., psychiatry block) and built a study plan with the number of questions I needed to complete for the rotation over a six-week period. I also took the number of questions that I consistently wanted to complete each day to meet this goal and integrated that into my plan—leaving wiggle room and flexibility to adjust. There are some days that are more difficult than others, so it was helpful to have a consistent goal of questions per day without being too regimented so that I could adjust as needed to be prepared for test day.

After completing an allotted number of questions, I would review questions (similar to how I reviewed questions for boards) to learn why I got a question wrong—was it content weakness? Misreading the question stem or an answer choice? Missing key information in the question stem? Or was it a straight guess? Once I figured out why I got a question wrong, I could guide my studying accordingly. When reviewing questions, if I did not know a concept, I would use resources like AMBOSS or Sketchy to solidify/review the content. I also listened to the Divine Intervention Podcast during my commute to my rotations, which helped to reinforce my learning.

Related reading:

The joys of primary care

Task failed successfully: How I turned my failed board exams into a triumphant residency