"Surviving Exams" by MSIH first year blogger Tamara Kliot

We finished our first semester exams and are currently on break. As I flew back home, I couldn’t help but think, that means I’m 1/8 an MD! For many of us, this day felt so far away. Exam grades are trickling in and second semester of medical school is becoming an approaching reality.  I have been able to reflect on this past semester with some distance between those intense weeks of eat, sleep, study, exam, repeat. Here are a few tips to survive first semester exams (to future 1^styears)!

1.      Draft a Supportive Team

The amount of information you are expected to know come finals is well, to say the least, a lot and a bit overwhelming. It is close to impossible to catch all the important details mentioned in class and studying this vast amount of information is much more fun when you are around other people. Find a few people in class that you can study with, be it talking about material you don’t understand, reviewing the stuff you know, teaching each other concepts, or just sitting next to each other while you each work in complete silence. Exams can be overwhelming and isolating, but it doesn’t have to be if you find the people you work best with and develop a plan. Check out this fun picture a friend drew while I was studying immunology! I will never forget the unique mechanism Tuberculosis uses to evade the immune system.

2.      Visit the Shuk Often

It’s really easy to fall into unhealthy eating habits during finals. I don’t know why, but I’m always craving large amounts of sugar and salt when exam time rolls in.  Cooking becomes more of a hassle and vending machines seem like a good alternative. Going to the Shuk is an awesome way to fill your refrigerator with brain food. With tons of fruits, veggies, and meats there is bound to be something you will want to eat. Going to the Shuk is also a great way to stay connected with reality, since its always bustling and full of life on Friday mornings. There’s no better snack then fresh strawberries from the Shuk to jumpstart your studying, I’m mean just look at them.

3.      Take Breaks, Unplug, and Recharge

You can’t study all the time. You’ll burn yourself out at some point. Take some time to “do you”. Be it hosting a meal with friends, having dinner at your favorite pizza place, playing bananagrams (my personal favorite), going to the gym, running  through the Narnia of Beer Sheva, or taking a trip to Jerusalem to learn more about infectious disease control. Figure out what you need to do to recharge before exam day and make time for it. Check out everyone’s’ smiles on a mandatory study break our class had in Jerusalem.

4.      Find a Good Study Spot 

When classes end and self-structured studying becomes your 9-5 (or much later) job, its important to find a place where you can focus and work, a place that fits your study habits. For some, studying at home is great, but for others leaving the distractions of their apartment is important. If you like to draw things out, find a classroom. If you like to talk it out, find a public space or coffee shop. If you like complete silence, check out the libraries on campus. You might have to get a little creative during Shabbat (as the library and many other places close), but finding a place you can study consistently is crucial for exam success.

5.      Practice, Practice, Practice

No matter how well you think you know the material, practice is key. We have a lot of NBME (National Board of Medical Education) style final exams and there are loads of practice questions you can do that are written like the ones you’ll see on the final and again on the Step 1.  The only way to stay calm and destroy finals is by knowing your enemy (the exam) really well. Don’t be scared and throw yourself into questions as early as possible. You’ll be thankful you did later.

"I get by with a little help from my friends," by MSIH blogger Tamara Kliot

With classes done and exams in full swing, we have an opportunity to reflect on what has happened over the past 5 or so months. We have learned about the important enzymes that allow us to metabolize nutrients and sustain life, the battle that occurs inside us every time we are invaded by foreign pathogens, the intricate design of cells in different parts of the body, the bacteria we should love and hate, the true meaning of statistical significance, and ethical dilemmas physicians face on a daily basis. It has become pretty apparent to me that the fact humans function so well on a daily basis is a miracle. While it’s crazy to think we have learned all this in one semester, I knew I would be studying these subjects. This is medical school after all.

I knew we were complicated creatures, but I have witnessed another level of our awesomeness these past few weeks. Finals are not the most relaxed time for students. The elevated cortisol levels tend to bring out the worst in people. However, that has not really been the case for my class. It was clear from the beginning of school, that people were interested in collaborating. Classmates would share resources they were using, notes they had compiled, or Anki flash cards they had made with other classmates frequently. When classes ended and exams began, I assumed people would be MIA and only surface on exam days, like any other exam period I had experienced in undergraduate.

Since classes have ended, I have been blown away by the amount of generosity that has gone on. People sharing notes, resources, and uplifting videos in our Facebook group. I am constantly getting notifications about this new resource or PDFs or question banks or YouTube videos or outlined notes. While it’s hard to keep tract of what I could be using at times, but its comforting to know we are all working toward the same goals together. In addition to sharing resources, people have also been sharing their time. Classmates have made a concerted effort to check in with each other to see how

people are handling the stress of finals. It’s pretty amazing to see how invested people are in our success as a group, not just the individual.

I’ve been told going into medicine is like running a marathon. You cannot sprint, you have to pace yourself. Even though running and taking exams are individual sports, they are much easier when you have a team of individuals to help keep you honest with your training.  With four exams down and one more exam to go, there is an end in sight. We are about to cross our first finish line in a series of many races and I am incredibly grateful for the team I have here in Beer Sheva.

I mean, how hard can crossing the finish line be when you have people like this in your life?

On Hitting One's Stride, by blogger of the month Seth Morrison

The shuk in Beer-sheva

Once upon a midnight dreary,

while I pondered why I moved to a foreign country,

a strange sensation struck my psyche.

Was it elation, bliss, or gladness?

Lamentation, grief, or sadness?

None of these it was,

though for them many an instance gave just cause;

Instead the passion rubbed the middle,

defied assurance, like a riddle.

My heart had gathered all peaks and vales under its tent,

at long last found contentment.

This describes my recent progression through a set of phases people often experience after moving to an unfamiliar and less comfortable place than wherever it was they came from. Although the individual durations of each vary, it is said that one progresses through four phases in total:

1) the honeymoon phase,

2) the resistance phase,

3) the understanding phase,

4) the assimilation phase.

The honeymoon  period occurs when you first begin living in your new environs. The differences in culture and surroundings are still novel and intriguing. Every day is sweetened by new experiences and relationships.

When the honeymoon period wears off, the resistance phase sets in. This is when the question “What on earth am I doing here” is a perpetual elephant in the room. Small, relatively trivial trials and tribulations of daily life compound to appear as a massive, unsolvable problem. Second-guessing the decision to uproot and move increases in daily frequency, just as reversing that decision is decreasing in feasibility. My resistance phase hit its final climax last week, when our class of 2016 was taking final exams and simultaneously a four-day rainstorm hit Beer Sheva and all of Israel. I usually enjoy rain after having lived in Washington state, but Beer Sheva has a peculiar phenomenon some students have been calling “mudstorms.” This is what happens when rainfall and the fine Negev desert sand blown up by the wind mix in the air to create a clay-like mud vapor that tinges the horizon brown and coats any object that stands in its path, as though the desert wind god had taken up abstract expressionist painting. Consequently, the mental trauma of test-taking and dreary weather blended to produce a potent concoction of gloom that made me ask that question above a few times more than was comfortable.

This week, as I wrote about in my January 14^thpiece, the final exams were a thing of memory, a fleck of dust in my rearview (provided I passed them all, some scores still pending). It was during this week that I had my midnight insight, realizing that I had passed on into the understanding phase, and thus had gained some contentment to moderate the initial highs and subsequent lows of the preceding months. It was a week of reconnections with friends, such as an evening dinner and conversation stretching late into the night. It was a week of re-enculturation, such as spending a morning shopping for produce with the locals in the shuk (market). And, this week the skies cleared and temperatures rose all week long, as if God had revealed the bright Israeli shemesh (sun) to mark a promising new beginning for our class.

Blue sky in Beer-sheva

The assimilation phase has not yet set in and mustn’t be rushed. It’s both reasonable and prudent to give it ample time and space to develop on its own schedule, for that final phase is measured by a rate of furlongs per fortnight, not inches per instant. For now, my stride has been hit, and I have some work to do.   - blogger of the month, Seth Morrison

Jaffa, by January blogger of the month Seth Morrison

There are few feelings quite as nice in the life of a student as the feeling of completing a round of semester-end final exams. When these are finally over, as they are now for our class of 2016, it is like a colossal weight that is lifted off the shoulders. This new-found freedom does not set in instantaneously after stepping out of the examination room, however. The pain lingers for about a day afterwards, like the residual aches a trekker feels in his thighs upon setting down his burden to rest by the campfire after traversing a high mountain pass. Then, after that day has passed, ever so gently the new freedom sinks into the soul as softly as a butterfly alighting on an outstretched palm. The world seems fresh and new, full of color and potential.

Fresh air is breathed by lungs that have known little else but stagnant, indoor, dusty Beer-Sheva air for the previous several weeks of reviewing. Once again the senses are reawakened, and the singing of birds and smells of the earth are noticed and appreciated. Of course, this spirited jubilation is always short-lived in the life of a medical student, for the rounds of intense study, exams, and interspersed periods of liberty are cyclical in nature.

It is in these interspersing periods of relative liberty that I most enjoy setting off on some new small undertaking. This, I think, helps to re-sharpen dulled corners of the mind and to find again fragments of knowledge that you forgot you knew. The undertaking could come in many shapes, sizes, and durations. It need not be doing some noble deed or philosophizing until a brilliant epiphany into the nature of existence is attained. It could be something as simple as walking next to a river, attending a symphony performance, visiting a museum, reconnecting with a friend, or writing a letter to your grandparents. Nearly anything that lies without one’s regular sphere of activities invites contemplation for those with a curious intellect.

So it was with this in mind that, after the completion of one semester and seeing the looming advent of the coming one just around the corner, I set off to spend a weekend in the seaside town of Jaffa on the southern skirts of Tel Aviv. Jaffa is renowned for its oranges (which I did not get the chance to try and which are currently out of season anyway), but it certainly had much more to offer than fruit. The town, possibly the oldest port in the world, is beautiful. Indeed the name, Jaffa/Yafo, comes from the Hebrew and Arabic words for beautiful (יפו in Hebrew). It is perched like a fortress on the side of a jutting hill facing the sea like an amphitheater, and has a density of art galleries that rivals any historic old city. Spending my weekend there achieved the desired effect many times over: it allowed a plethora of new and returning insights to sink into my brain. I watched fishermen bringing in their catch in the afternoon twilight. I saw an African-Israeli family celebrating a wedding in the town’s lovely hilltop gardens.  In the evenings, I heard the Islamic call to prayer belting from minarets, trailing through the chilly winter air, and then mixing with church bells chiming from nearby steeples. In short, the town’s idyllic charm and rhythmic, undulating ebb and flow of life set the mood for a relaxing and inspiring weekend, which was just the lift I needed to be reinvigorated before beginning a new chapter in Part One of my MSIH tale.  - Seth Morrison, first-year blogger of the month

When the going gets tough, the tough get going, by November blogger of the month Jamie Klein

November 1^st  As the temperature begins to drop and the leaves begin to fall, there are a few things American medical students look forward to…

The holiday isle in Walgreens is decked with holly in preparation for Christmas. 

Early morning training sessions for the annual Turkey Bowl officially begin.

 And my personal favorite, the long awaited transition to the infamous holiday cups at Starbucks. 

While other first year MSIH students and myself may have initially felt a few symptoms of withdrawal, I think it is safe to say we are adapting to life here in Israel.

Although I do not celebrate Christmas, my family is all too familiar with my adoration for a good Christmas tune. I am looking forward to continuing this tradition, even without the constant holiday music streaming from my car radio. Surprisingly Turkey Bowl fanatics are more relentless than Cubs fan! The date and location are to be announced (hopefully not on the “basketball court”- since nice grassy fields are a bit difficult to locate in a desert), but GAME ON. And after two and a half months of class on the 6^th floor of Soroka Hospital, the men in Coffee Time finally know our orders. Even though it is no Starbucks, the friendly morning meet-and-greet cannot be beat. 

photo courtesy of Nathan Douthit

While the month of November has many wonderful things to look forward to, we are after all medical students, and the weight of that statement is becoming increasingly more apparent. My classmates and I were politely reminded of this fact as we received the weekly schedule update last Thursday. In the next month my classmates and I will conquer a bacteriology lab report, weekly genetics assignments, a literature review, yet another famous immunology quiz, a bacteriology exam all while preparing for our five final exams that begin at the end of this month. If it seems like we should be overwhelmed, we are! And how will we survive this tumultuous month of never-ending studying? One day at a time, with our Coffee Time cup in hand, holiday music oozing from our headphones while dreaming of who will score the winning touchdown at the Turkey Bowl…well, at least that is how I plan on making it through.  - blogger of the month Jamie Klein

10.12.12 by Jacek Jarczynski

It is now almost 10 pm in Beer Sheva and I am unwinding from what was a very productive, exhausting but overall excellent day.  There was much to review for an upcoming biostatistics exam.  My friend Ashley and I put in a solid 7 hours doing practice problems and making sure we were clear on the conceptual ends of the material.  Much was accomplished today and tomorrow will be the final push as far as the studying is concerned.  After tomorrow it will be just a matter of knocking out the exam.  That was the business end of things for the day.  In the evening the books were temporarily retired and I decided to take a walk through Beer Sheva with no destination in mind.  Just wanted to clear my head and decompress.  On Fridays after sundown the town becomes very quiet and there are relatively few cars on the roads.  It is now much cooler in the evening here and most of the time there is a pleasant breeze zipping by.  I was walking down Ben-Gurion Avenue when from a distance I heard the sound of a beautiful melody.  I walked toward the source of the sound and passed by what looked like a wedding reception in one of the gardens adjacent to the street.  The melody was absolutely authentic to this area.  There was so much life and strength in this music and I could hear people dancing and celebrating behind the walls of the garden.  It was like a breath of fresh air.  Music is so essential … I lingered in the area just to listen a little bit longer.  Back in my room now and I am eyeing my bed … I will sleep like a rock tonight and will NOT dream about coefficients of determination nor will I be 95% confident or whatever % confident that the true proportion of a population is within a range of whatever.  I will catch up with the remainder of that business tomorrow!  

Julia's Top Ten List for Finals, by blogger of the month Julia Rubin-Smith

As November blogger (and December blogger ninja) Ross Green mentioned in his last post, Caroline House is a place where many of us spend a lot of time, especially during exams. For the most part there is a routine to what goes on here, with few surprises (unlike the study room in the student center on the main campus, where a stray cat once climbed onto my laptop keyboard and started inadvertently typing a nonsensical email to my mother). Here are 10 things you can count on seeing here every day:

1) Security guards. Caroline house has security guards on duty around the clock. In fact, it seems that every 15 minutes there is a new one! This serves two purposes: one, keeps them alert. Two, when your dad comes to visit, and tries to marry you off to one of them, the embarrassment will be fleeting. (Hi Adie’s dad!) 

2) Israelis. For those of you who don’t know, Caroline House is the student center for the BGU Faculty of Health Sciences, which includes MSIH as well as the Israeli medical and health sciences students. Israelis who study in Caroline House can be counted on to be there between noon and 7pm, and to be speaking in their “outdoor” voices. The chatter is punctuated by a wide variety of jaunty cell phone ring tones, adding some much needed music to our days.

A typical study table layout. Please don't judge us -
we're very busy, and the Indian restaurant delivers!

3) Junior Israelis. A number of Israeli students tutor local children in math and English. The layout of Caroline house is conducive to tutoring small groups so they congregate here between the hours of 3 and 5pm. I’ll let you imagine what that does to the activity level in the study room.

4) Free dinners. After a few days of studying at Caroline, we noticed an unexplained influx of med students at 6:55pm every day. Turns out, the snack bar upstairs closes for the day at 7pm, at which point the friendly attendant gives away leftover sandwiches, pastries, and soup to beggars 

med students. A great way to save money, though not great for our waistlines!

5) Sweatpants. These are mandatory study accessories for MSIH students. Really, they’re the height of fashion. Some of us have even started sporting BGU sweatshirts, which really round out the outfit. 

6) Sleeping med students. Many of us spend the majority of our days here during exams. We all cope with this in different ways, from bringing our own kum kums (electric tea kettles) to taking cat naps on the couches (and in some cases on plastic chairs). You can also frequently find sleeping med students in the classrooms (during breaks, of course), but that’s a subject for another time.

7) Fantastic parking jobs. See picture. No need for further explanation, I think.

Why would you park there?

8) Sun patches. Now that it’s winter (though it was a balmy 76 degrees today), the sun sets around 4:30pm. I usually go outside for a “sun break” around 3, at which point there is generally one patch of sun on the grass to stand in. On weekends I have this sun patch gloriously to myself. On weekdays the sun patch is completely filled with Israeli students, all standing together and packed tightly as sardines. I don’t know how they do it, but not a single one is ever pushed off the patch and into the shade.

9) Mess. We are slobs. Period. But hey, at least we clean up after ourselves when we leave!

10) Chocolate. Someone ALWAYS brings chocolate. Honestly, I don’t know how we would get through exams without it. Sometimes, when it is not obvious where the chocolate is, an email will go out asking who brought it today. We’re never disappointed! -blogger of the month Julia Rubin-Smith

December 15, 2011, by November Blogger of the month Ross Green

Guess who is back! I guess I’ve had such an eventful last few weeks that I decided to write one more post and sum up what’s been going on in my life lately. As I’m sure you can guess, we are currently in the middle of exam time! At this point we only have two more left, which means that I leave for Spain a week from today! If I haven’t mentioned, Nicole Magpayo and I are spending our Winter/Hanukah/Christmas/Chanukah/Kwanza/Hanukkah break in Spain, traveling to both Barcelona and Madrid. I have never been there before, but everything that I’ve heard makes this country sound really unique and fun so I can’t wait!

Lately, our entire class has been quite stressed out with exams. The Caroline House has a downstairs study area, which seems to be the place of interest for everyone to study (including the Israeli’s who spend most of their time there eating lunch, talking on the phone to someone who is apparently hard of hearing because they are always speaking as loud as possible, or updating their Facebook so that all of their friends know that they got up to take a bathroom break 5 minutes ago). It has been pretty nice otherwise though, because it’s a social, yet studious, environment for us to go to and help each other out.

A cool fountain near my apartment.

I have been spending most of my time studying at home in my apartment though. It’s a nice and quiet environment that I’ve made into my personal little library. I have a kumkum (electric water kettle) with lots of coffee and food right next to me in my kitchen so that I can spend the entire day studying without any distractions (sounds crappy, but it is finals time). Other than that, my days have been pretty simple… Wake up with some coffee and reading, make some food, study more, go for a run, and then study till I get too tired to keep my eyes open. My nightly runs have been pretty nice though. It’s been a way to take a break and clear my mind, while getting outside into the fresh air. Also, I’ve been preparing for my Spain trip (and life in general) by listening to Pimsleur to learn Spanish. It’s been pretty great, and I already think that I’m fluent in Spanish (not really, but I know how to say “Excuse me Miss, do you understand English?)! Pretty good, right?!

I must say also, that there has been a feeling in the air that I was not expecting in Medical School, but I really like. When I used to think about Medical School the image that came into my mind was living in a library, and everyone keeping their notes and study material to themselves so that they succeed above everyone else. I’ve also always heard the “horror story” about the one guy that rips pages out of library books, and gives people wrong information, to reduce the competition. The complete opposite atmosphere is felt here at MSIH! We have an online group where everyone shares helpful links, YouTube videos that they find that explain something really well, or any other study material so that everyone is able to do their best on exams! That really says a lot about the people here, and how everyone not only cares about numero uno, but the rest of their peers. On that note, good luck everyone! Let’s be THAT class, and ALL pass these next two exams!

Adam and David in their new
paratrooper uniforms

This Tuesday night (after our Cellular and Molecular Biology exam) we decided to take the night off to celebrate Nicole’s birthday. We all needed to blow off some steam after the marathon we had the couple of weeks prior, so why not celebrate! After having dinner and some drinks we all went out to the Einstein to dance and just let loose! It was a fairly early night (it’s still finals time) but to take the night off and enjoy some time with the rest of our classmates was exactly what I (and I’m sure everyone else) needed.

Other than that, things have been pretty simple. On a side note outside of the MSIH bubble, my two best friends from home have started their basic training for the Israeli Paratroopers. I was worried that once they started the army I wouldn’t be able to see them anymore, but luckily their base is really close to Be’er Sheva, so even though they don’t spend all of their weekends off with me here, they still have been coming down to spend Saturday night at my apartment so that they can get up and go right to their base.

Ok, back to studying. This time I can say that this is my last post, so I hope you enjoyed reading a little into my life here in Be’er Sheva. I can say, I enjoyed writing, so I hope you enjoyed reading! - Ross Green