Photo by Anthony Tran on Unsplash

Table of contents

1. Preface

2. Main Article

3. OMFS World

4. Stuff

Preface

This week we finally got our first credit score.

For those unfamiliar with how credit works in the US, a credit score measures a person’s credit-worthiness. It is a three-digit number and indicates the risk involved in lending you money 💵.

⬆️ The higher your score, the higher your credit limit will be, and the better your chance of lenders approving your loans.

👨‍👩‍👦‍👦When we got here, our credit was limited, and we had no credit score. If we had to pay for our kids’ music lessons and a bunch of other bills at once, we had a hard time doing it with our credit card.

So we had to use our debit card instead.

But if we do that, we’re not accumulating credit history → our credit score remains low → we won’t be able to raise our credit limit. Catch-22.

💃🕺So for the last six months, we worked hard on it.

We used about 30-40% of our credit, paid it, and then used it again, paid it, and so on. That was a tedious task that required checking our credit balance daily.

🎉 🎈 🥳 So after six months, we got enough credit history and received our first score.

Initially, I planned on sharing it here, but US officials and security experts strongly advise against it 😡😤.

So let me just say that we now have a higher credit limit and we can reapply for an Amazon Prime credit card (which comes with a flat 5% off on any purchase on Amazon).

The first time we applied, it got rejected due to the lack of credit history.

Let’s hope it will work this time around. I’ll keep you posted.

Today’s issue is about failure

😱Sharing failure stories, let alone online, is not an easy task. There’s something about projecting a successful image inherent to human nature, and the need to hide our failures is bundled with this.

We are taught to “deal” with our failures;
I don’t like this term.

Failures should be embraced, SHARED, learned from, and TAUGHT to our students and children.

In the main article today I will share 5 lessons about failure that you can implement immediately into your life.

Enjoy number 20!

Main Article

“I can accept failure. Everyone fails at something. But I can’t accept not trying.”
― Michael Jordan

Storytime!

👦 I started dental school at the age of 24 and medical school at the age of 39 👴.

I won’t bore you with all the details of my academic training, but I will point out that back then, dental students and medical students studied the first three years together with an almost identical syllabus. So when I got accepted into medical school at 39, I went directly into the clinical years.

At the age of 40, I decided to take the USMLE.

😵‍💫It’s a set of three exams (”steps”) necessary for obtaining a medical license in the US. Step 1 being the hardest, as it tests your knowledge from your pre-clinical years.

Yes, a test on something I studied 15 years ago.

I had two months between semesters, so I decided to take Step 1. Reading online, I realized I was taking on an impossible task. Medical students have two years to study for it, and I’m trying to do it in 2 months.

“Decide what you stand for. And then stand for it all the time.”
― Clayton M. Christensen

Sure, I learned some of this stuff before, but, well, 15 years is enough time to forget it all. Regardless, I signed up for the exam, bought a book, and purchased an online source to practice. I used the first month to read the book, as you say, “freshen my memory”.

So Naive.

Then I took my first practice test.

37%

THIRTY-SEVEN.

Is that even a grade?

I Googled to see if I could find someone, just one person, that got 37% while practicing and eventually passed the real test.

None. Not a single one. My online search also made me realize that I should finish all the practice tests and start reviewing at this point (a month before the exam).

What? I just started practicing my first 40 questions! And I got 3,660 questions to go!

So I practiced and practiced, test after test after test.

37

That was my most common grade while studying for the USMLE for the first time.

Just imagine my self-esteem and confidence when I saw that number over and over again on the screen. I studied and failed. Failed, and studied. Over and over again, day in and day out.

At first, it nearly broke me. Never before have I been in a state of failing so many times in such a short period of time. Just think - failing hundreds of times in just a few weeks.

But then, something started to change.

Not the grades.

🧗‍♀️With time, it hardened me. I began to see 37% as an opportunity to learn 63% new things. 63% ways of becoming a better doctor.

Then I took the real test.

I remember leaving the test room after straight 8 hours of a test. I felt like a different person. I felt like a year had passed since I started studying, but it’s only been 28 days…

I felt proud. I acquired a huge amount of knowledge and mental resilience. I realized that my repetitive failures had allowed me to grow, fast.

“Failure is another stepping stone to greatness.” ― Oprah Winfrey

Three weeks later, I got the grade.
I failed.

5 Lessons:

• Nonetheless, it was my greatest hour.
  
  My most significant intellectual challenge and I stuck through it. I ended up repeating the test a few months later and passed it. I can hardly remember the joy after passing my second try, nor do I relate to it as a meaningful experience. But I can vividly remember my walk to the car after failing it, with my head held high, proud.
  
  🏡 Take home messages: Failing is a fact of life. Turning it into an opportunity will get you where success never will.

​

• One month is the amount of time I wasted on passive learning.
  
  I read the USMLE book, watched pathology lectures, and tried to read an obscene amount of flashcards made by others. What a waste of time. It was the equivalent of cleaning the windows while my house was on fire.
  
  🏡 Take home message: Passive learning is a waste of time.

​

• 28 days was the actual time I studied for step 1, and it was all active learning:
  
  Practicing questions, learning from my mistakes, and spaced repetitions. I’ve been a teacher for 25 years, with over 20,000 teaching hours and a few thousand students. I tried every method possible and mentored students at every level possible.
  
  ​🏡 Take home message: Active learning is the only way to go. Issue #10 will teach you how to do it.

​

• 5 questions is what separated me from passing (the test had 280 questions).
  
  I squeezed two years of med school into 28 days and almost made it. Looking back, I thought everything was lost while it was very much possible. You can never know how things will turn out. You just need to keep going, no matter how grim it may seem.
  
  ​🏡 Take home message: You will learn more by almost succeeding than by almost failing.

​

“Many of life’s failures are people who did not realize how close they were to success when they gave up.” ― Thomas Edison

​

• If I could go back in time, and pass step 1 on my first try, would I do it?
  
  Absolutely NOT. My mental toughness, which was way above average to begin with, has reached heights I never thought were possible. Trying to achieve an “impossible” goal, only to find out later that it was within reach, has made me a better teacher, surgeon, scientist, and father. I witnessed my true abilities by failing this “impossible” task.
  ​🏡 Take home message: Go out there and fail something. Go for the impossible and find great things along the way.

​

“It is impossible to live without failing at something unless you live so cautiously that you might as well not have lived at all, in which case you have failed by default.”
― J.K. Rowling

OMFS World

🥼For the OMFS resident -

Being your own critic is key to becoming an excellent surgeon. It's not easy, but growing and improving in any aspect of your career is essential: 

Follow up on the patients you sutured in the emergency department to see the final result; use parallel pins and take final x-rays of your implants; perfect your technique to minimize swelling and pain; and never delegate post-operative complications to your fellow residents. Be there to solve it yourself, and become better at preventing it.

🩺For the non-MD medical professional

Syndrome of inappropriate antidiuretic hormone (SIADH) may be triggered by a myriad of causes, including medications (SSRI’s, NSAID’s), pneumonia, central nervous system abnormalities, and pain. 

The hallmark is hyponatremia with low serum osmolality, high urine osmolality, and high urine sodium. Think about it as a body filled with water, but hardly any urine is produced (”diluted blood, concentrated urine”). The treatment includes fluid restriction and salt tablets. IV hypertonic saline is reserved for severe hyponatremia.

Stuff

📱Application I use - Notion is a popular productivity application with various features to help users organize their work. It has been praised as one of the best tools for managing projects, tracking progress, and staying on top of tasks.

Lately, I rediscovered its power: I started writing this newsletter in Notion, since publishing it on multiple platforms has proven to be a huge headache. Notion makes it easier.

It also proved to be a great tool for collecting data online and seamlessly importing manuscripts into a database.

Check out their great free plan. If you’re in an academic institution, their plus plan is also free.

Epilogue 

That’s it for this issue.

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Have a great weekend!

Shay