From Step 1 Failure to Emergency Medicine Residency | Dr. Alyssa Makowski on Clinical Reasoning, Aphantasia, and Medical School
In this episode of Dr. Tisdall Unfiltered, I sit down with Dr. Alyssa Makowski, a newly matched emergency medicine resident whose journey through medical school was anything but straightforward.
Alyssa was one of the strongest students I had ever worked with, yet she repeatedly struggled to cross the exam threshold required to move forward toward Step 1. What followed became one of the most remarkable transformations I’ve witnessed.
We discuss medical school failure, STEP 1 preparation, clinical reasoning, learning styles, mentorship, burnout, impostor syndrome, and what actually separates memorization from true understanding in medicine. Alyssa also opens up about discovering she has aphantasia — the inability to form mental images — and how that fundamentally changed the way she had to approach learning medicine, anatomy, and pathophysiology.
This conversation is especially important for medical students, pre-med students, residents, educators, and anyone struggling with standardized exams despite being highly capable clinically. We explore why some intelligent students continue to underperform on medical board-style exams, how confidence and resentment affect learning, and why medicine ultimately forces every student to confront their weaknesses honestly.
If you enjoy long-form discussions on medical education, clinical reasoning, pathophysiology, and physician training, make sure to follow Dr. Tisdall Unfiltered for more expert interviews and conversations.
Get my free 6 week clinical reasoning series (12 high-yield multiple choice questions with MD-written answers): https://www.drphiliptisdall.com/mcq-email-series [https://www.drphiliptisdall.com/mcq-email-series]
Clinical Pathophysiology (Edition 2) is now available for purchase! For the complete textbook, students should purchase both Volume 1 and Volume 2: https://www.amazon.com/dp/B0GY6JSBX3?binding=paperback&ref=dbs_m_mng_rwt_sft_tpbk_tkin&qid=1776937676&sr=8-1 [https://www.amazon.com/dp/B0GY6JSBX3?binding=paperback&ref=dbs_m_mng_rwt_sft_tpbk_tkin&qid=1776937676&sr=8-1]
I’m building out our community where Dr. Tisdall will be teaching live online. For more information, head over to drphiliptisdall.com [http://drphiliptisdall.com]
Watch the full video episode on YouTube: https://youtu.be/sJldsWiPBTY