Get my free 6 week clinical reasoning series (12 high-yield multiple choice questions with MD-written answers): https://www.drphiliptisdall.com/mcq-e... In this episode, I sit down with Dr. Alyssa Makowski to talk about one of the hardest realities in medical education: what happens when a highly knowledgeable medical student still can’t pass the exam barrier required to move forward. We discuss Step 1, comprehensive exams, clinical reasoning, memorization vs understanding, learning styles, aphantasia, mentorship, medical school burnout, and what it really takes to become a doctor. Alyssa shares her journey from being the first person in her family to pursue medicine to nearly walking away from medical school entirely — and how changing the way she learned medicine transformed everything. If you’re a medical student struggling with exams, confidence, study methods, or trying to understand how to think clinically instead of just memorize facts, this conversation is for you. I’m building an online community where I’ll be teaching weekly webinars that focus on clinical reasoning and pathophysiology. For more information, visit drphiliptisdall.com. Watch the If You Can't Draw It, You Don't Know It playlist: • If You Can’t Draw It, You Don’t Know It | ... Watch the Think Like a Doctor playlist: • Think Like a Doctor and Pass Step 1 Watch the Dr. Tisdall Unfiltered: • Dr Tisdall Unfiltered Follow me on socials: Instagram: / drphiliptisdall Facebook: / drphiliptisdall TikTok: / drphiliptisdall Spotify: https://creators.spotify.com/pod/prof... Apple Podcasts: https://podcasts.apple.com/us/podcast... 00:00:00 Introduction to Alyssa and the Reality of Medical Exams 00:01:29 Becoming the First Doctor in Her Family 00:06:32 Choosing Caribbean Medical School 00:09:19 Why She Couldn’t Break the 70% Barrier 00:13:33 The Faculty Meeting That Changed Everything 00:19:54 Returning Angry — and Learning How She Actually Thinks 00:21:06 Discovering Aphantasia and Rebuilding Her Study Method 00:25:07 The Breakthrough That Finally Changed Her Scores 00:30:02 Why She Chose Emergency Medicine 00:32:47 Match Day, Residency, and the Meaning of Failure #MedicalSchool #USMLE #Step1 #ClinicalReasoning #MedicalEducation #MedicalStudent #Pathophysiology #MedSchool #FutureDoctor #DoctorLife #Step1Prep #MedicalPodcast #MedicalMentorship #MedicalStudents #ResidencyMatch #StudyMedicine #MedicalTraining #ClinicalMedicine #MedicalSchoolMotivation #DrPhilipTisdall