Updates: Records, Exams, Stuff I've Learned

It's been a while, and I have several other posts in the works, but I wanted to get an update post out in the meantime. The past few months have been pretty damn busy. My second year of medical school ended in late April, and from there my class was given 8 weeks "off" to prepare for and take the USMLE Step 1, which is the first of 3 exams needed to become board certified as a physician. Scoring competitively on Step 1 is a key factor in securing a good residency after medical school. For most medical students, Step 1 looms ominously for the first 2 years of medical school and is a constant source of dread. It is a beast of an exam that vastly overshadows even the most intimidating exams that come before it. At 8 hours long, it tests all of the material from the first two years of medical school. The sheer volume of information is immense, and even two years of medical school curriculum doesn't cover absolutely everything that can be tested. Pretty much every student will encounter at least a few questions on topics they've never seen before.

I frankly didn't think about the exam much until the end of 2017, when I had to begin the registration process. I took the exam 6 weeks into the dedicated prep period (which medical students just call "dedicated" #dedicated), slightly earlier than the majority of my classmates. I figured, correctly, that I would be nearly insane with cabin fever by the end of 6 weeks of studying 8+ hours per day, and wanted some time to vacation and relax, since these two weeks after the exam are essentially the last "summer" off I'll ever have. I still don't know how I did on the exam, and will find out in about 3 weeks. I would have done some things differently, namely more practice problems and less reading, had I known what I do now (Step 1 prep materials, by the way, are a huge business and end up costing most students several hundred dollars), but you live and learn. I studied hard, did reasonably well in practice exams, and will adapt to whatever my result may be. 

Before entering dedicated period, I had decided that I would do a powerlifting meet in close proximity to Step 1. I figured that adhering to a rigid training schedule would help me to adhere to a rigid studying schedule, while also providing forced breaks from studying. I do believe this strategy worked, and my training went well going into this meet. I essentially did Ed Coan's program (Ed is probably the most dominant powerlifter of all time), which is simply but intelligently designed. You have a heavy squat, bench, and deadlift day each week, and a fourth day of pump and recovery work for chest, shoulders, and arms. On squat day, you do bodybuilding-style leg exercises after squats. You do chest and tricep work after benching, and back work after deadlifting. You pick a weight goal for the meet in each lift, and work backwards from that goal weight in 10-20 pound increments to determine the weight used in training for each week leading up to the meet. As the weeks go on, the weight increases and the number of reps decrease.

This spreadsheet lays it out pretty well (I used slightly different assistance exercises), but his training program can also be found in "Coan: The Man, The Myth, The Method," which is a very cool book by Marty Gallagher about Ed's competition history, mindset, and training methods.

About 2 weeks out from the meet, I came down with strep throat, which actually didn't affect my training much, although I did see a slight dip in my bench performance in the last 2 weeks. My top lifts in training right before the meet ended up being a 430x2 squat, 280x3 bench (and 290x2, where I received a little help from my spotter on the second rep), and 475x2 deadlift (this would be the first time I pulled Sumo, or wide stance, in a meet). The week before the meet, I randomly decided to look at the records in Revolution Powerlifting Syndicate (the powerlifting federation I would be competing in), and realized that the current RPS NJ state record in the squat for my age and weight class was 430, which I had just hit for 2 reps. I decided that I would be breaking that record. 

http://www.revolutionpowerlifting.com/records/index.php

And so I did. I now have the RPS State squat record with no knee wraps in the Junior (20-23) Amateur (drug-free) 165 lb weight class. The deadlift also went well, but benching was horrendous, especially considering the numbers I hit in training, and the fact that I've previously benched 290 in competition and 300 in the gym. Sad!

My attempts for the 3 lifts were: 

Squat: 405 (good lift), 435 (good lift, state record), 450 (miss)

Bench: 270 (good lift), 300 (miss), 300 (miss)

Deadlift: 460 (I think... good lift), 500 (good lift), 520 (good lift)

I was the only guy in my class, since I signed up late and was placed into the second day of the meet with the 220+ lb. guys. I am, however, currently ranked 7th overall in the total (squat + bench + deadlift combined), 9th in the squat, and 12th in the deadlift in all of RPS, which holds meets in a large portion of the U.S. and even in a few other countries. Despite having no one at this meet to compete against, lifting with the big boys was great. I witnessed a few deadlifts that were just under 800, and a 730 multi-ply bench attempt.

If anyone is ever interested in doing a powerlifting meet, I highly recommend RPS. There is no membership fee, no extraneous rules, and the meets are run well and filled with good people.

A few training insights I picked up along the way are:

• Lifting weights is not complicated. My leg routine for this meet was nothing earth-shattering:
• Squat to 2 top sets, as the Coan program indicated
• Pause (at the bottom) squat (usually) or leg press (rarely) for 2 sets, same or similar reps as for squat
• Leg curl, 2 hard sets of 10-20
• Leg extension, 2 hard sets of 10-20
• Calf raises on machine, 1 hard set of 6-20
• Building my calves and hamstrings helped my squat strength by essentially giving me more "rebound" out of the bottom.
• Machines are useful, and if you're of the "machines r 4 gurlz" mindset, you should reconsider. See the above leg routine. 
• Food is one of the most important drivers of strength gains. I ate as much as I could during this meet cycle, and put on about 10 pounds over 8 weeks (then had to cut about 5 to make weight before the meet). I ate plenty of protein, but also didn't skimp on fats or carbs. Note that very low fat diets and very low carb diets are both rather bad for testosterone levels,^1,2,3 and I wasn't concerned with fat loss at this time. I stayed lean and maintained pretty decent abs. Hard training allows you to, and requires you to, eat more.
• Far too many people neglect barbell rows or don't take them seriously enough. These were part of every back day, and I eventually reached 315x5 and 225x20 with reasonable form. I can count on one hand the number of times I've seen someone row over 225, and 225 is not particularly impressive. Nothing will build back size and strength like rowing hard and heavy. 

As a final note, I want to express my gratitude to my friends, girlfriend, and family for their support throughout my prep for Step 1, and to Nick for always having my back and spotting impeccably at the meet.


References:

1. Wang C, Catlin DH, Starcevic B, et al. Low-Fat High-Fiber Diet Decreased Serum and Urine Androgens in Men. The Journal of Clinical Endocrinology & Metabolism. 2005;90(6):3550-3559. doi:10.1210/jc.2004-1530.

2. Lane AR, Duke JW, Hackney AC. Influence of dietary carbohydrate intake on the free testosterone: cortisol ratio responses to short-term intensive exercise training. European Journal of Applied Physiology. 2009;108(6):1125-1131. doi:10.1007/s00421-009-1220-5.

3. Anderson KE, Rosner W, Khan M, et al. Diet-hormone interactions: Protein/carbohydrate ratio alters reciprocally the plasma levels of testosterone and cortisol and their respective binding globulins in man. Life Sciences. 1987;40(18):1761-1768. doi:10.1016/0024-3205(87)90086-5.