Step 1: Anxiety dream

I'm already having anxiety dreams about the USMLE Step 1.

Last night, after having taken the dreaded test, I opened up the envelope with my score and saw "188" staring back at me. 188 is on the border of passing and failing, depending on the national performance for that test and recent tests. The national mean is somewhere around 222, one standard deviation above the mean is somewhere around 140-145, and a top score is 270.

Needless to say, I was horrified. In my dream, I was trying to assimilate the fact that I would not have the residency of my choice and would not even be able to go into the specialty of my choice. It was very traumatic.

I accurately predicted my MCAT score in a dream a week prior to the exam, but the Step 1 is still 4.5 months away. Maybe 188 is what I'd get if I took the exam a week from now - that wouldn't be so bad. An astute classmate friend noted that the dream can't be true because we get our scores by e-mail, not snail-mail. As silly as that sounds, it makes me feel better.

The USMLE Step 1 is a stressful exam - there's a lot riding on it. It's perfectly natural to have feelings of anxiety about it, even this early. What's most important, though, is that this anxiety is handled in a healthy manner.