The 16th percentile

No easing in

Orientation ended on a high. I'd spent the week before it setting up meetups, and by the end of orientation I had a group of friends I already trusted. Then the real thing started, and there was no warm-up.

At Liberty, lectures began at 8 a.m. and ran well into the afternoon. The volume was relentless. Our first exam was only two weeks away, and it would cover everything from those opening lectures.

I went to every lecture with my new friends and tried to keep pace. I had a plan, and I felt good about it. I was going to focus on the big picture. Everyone around me seemed to be drowning in minutiae, stressing over details that felt impossibly specific. I wanted to build a framework instead: understand how the pieces fit together, and let the small facts hang on that structure.

It felt calm and grounded. What I hadn't really asked was how much detail the exam would actually expect.

The practice questions

The weekend before the test, my friends and I met for a group study session. One of them had written a detailed set of practice questions, and we worked through them together.

I remember the thought clearly: these are really thorough, maybe too detailed. Some of what my friends knew seemed overly specific. I told myself the real exam would focus on the bigger picture.

But there was a quieter thought underneath that one. What if I'd underestimated how deep we needed to go? I noticed it, and I set it aside.

Walking out feeling good

The morning of the exam I was nervous but felt prepared. I'd stuck to my strategy. I worked through the questions methodically. A few tripped me up, but that's true of any test.

When I walked out, I felt surprisingly good. I thought I'd done well.

The smoothie shop

After the exam, our group went for smoothies to decompress. That's where things started to shift.

The conversation turned to the test, the way it always does. My friends started walking through specific questions: what they'd picked, why, which detail made the difference. And over and over, they were talking about details I had skipped.

The more they talked, the more doubt crept in. They sounded so confident, so locked in on every small fact. I started to wonder what else I'd missed. By the time I finished my smoothie, the good feeling from the testing room was gone.

The number

When results came out, I'd scored in the low 80s. The class average was 88. My percentile for that test was a painful 16.

I hadn't failed. But it was the lowest percentile I'd have in all of medical school, and it hit like a punch to the gut. I'd come to medical school wanting to be an orthopaedic surgeon, one of the most competitive specialties there is. Two weeks in, I felt like I was already falling behind in a way that might cost me that dream.

What surprised me was which part hurt most. It wasn't the score itself. It was the comparison: sitting in that smoothie shop realizing my friends had prepared better than I had, and that I'd watched it happen in group study and explained it away.

Taking a step back

Once the sting faded a little, I made myself look at what had actually happened.

My strategy wasn't entirely wrong. Understanding the big picture was still the right goal. I just hadn't executed it well. In group study, my friends had been nailing details I'd overlooked, and I'd assumed they were over-preparing. The truth was simpler and less flattering. I wasn't prepared enough.

So I changed three things.

I reorganized my notes so they were thorough enough to review quickly and effectively. Big picture first, but with enough detail underneath to actually answer a question.

I leaned on my classmates more. Instead of quietly deciding my approach was better than theirs, I started asking how they studied and borrowing what worked.

And I made a promise to myself about comparison. I wasn't going to measure my progress by how well other people were doing. I was going to measure it against my own last exam.

The second test

By the time the second exam came around, I felt more prepared and more confident. I kept my focus on the big picture, but this time I backed it with enough detail to answer questions thoroughly.

When results came out, I'd scored a high A.

That moment was about more than a number. It was proof that I could adapt. The person who walked out of the smoothie shop two weeks earlier felt like he might not belong. The person who opened that second score knew he could figure it out.

I carried that lesson through the rest of medical school. There would be other hard exams, and other changes to make. A few months later I'd overhaul my studying again and move to board materials. But the 16th percentile was the first time I learned that a bad result isn't a verdict. It's information.

What I learned

• When something isn't working, be honest about it, even if it means admitting a classmate's method is better than yours.
• Comparison hurt more than the score did. Learn from other people's methods, but measure yourself against your own last exam.
• Setbacks are inevitable. What defines you is how you respond, adjust and grow from them.