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  #1  
Old 11-18-2014
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Romania You must read this before starting usmle preparation

Maybe a lot of information, but very good explaned , what you need, what to do, and what thing will increase your mood, your power, and long preparation, found this article if can say , but want to be visible for all...
Best wishes for all people who choice to follow this long journey...
Good luck...
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Foods that Boost Brainpower
Every organ in the body needs energy to function and the brain is not an exception. You may not be aware of it but the quality of your study will ultimately affect your score on the test. Performing at the highest level possible begins with the food that you eat while you prepare for the USMLE.
1. Fatty Fish Ė Have you ever studied after eating a hearty meal of Japanese cuisine? I have and it felt like I could absorb material without getting exhausted. Thatís because cold water fishes like salmon and tuna are loaded with omega-3, an essential fatty acid that nourishes the mind. Your cell membranes are virtually made up of fats, including omega-3 and a steady supply of this fatty acid keeps
cell membranes elastic. Furthermore, omega-3 helps improve blood circulation in the brain.
2. Cruciferous Veggies Ė Eating vegetables will not only help keep your body in great shape, it will also boost your brainpower. If you eat salads, make sure it contains cruciferous veggies like broccoli, cauliflower and cabbage. These veggies are rich in antioxidants such as vitamin C and carotenoid, a compound known to protect the brain. With your brain never shutting down, it creates a lot of waste products known as free radicals. These unstable atoms or group of atoms seek stability by destroying other cells. Antioxidants are the perfect weapons against free radicals as they target and destroy these atomic groups, keeping your brain and body healthy.
3. Chocolate Ė Who says you canít have a good time eating healthy foods? Dark chocolate is rich in flavonoids, another antioxidant that can keep your brain in great shape. Moreover, eating chocolate stimulates production of dopamine, a neurotransmitter known to boost retention and learning. So the next time you feel the need to get your sweet fix, ditch sugary candy bars and stick to dark chocolate.
4. Whole Grains Ė When you eat refined carbohydrates like bread, your body experiences an energy rush which is followed by a crash. The energy spike may help in getting your study started but youíll certainly pay for it as you would feel drowsy and lethargic within an hour or so. Do not make the mistake of building your study schedule around this spike and crash cycle by only consuming whole grain foods like oatmeal and brown rice. Whole grain foods keep the blood sugar levels steady and without the crash, you will be able to study longer.
5. Berries - These little fruits are big in antioxidants that protect your brain from free radical damage. Add them to your daily cereal or oatmeal to minimize the effects of age-related damage to your brain. You can also munch on berries while you study instead of wolfing down inordinate amounts of greasy chips.
6. Water Ė Many people would rather drink soda than water to quench their thirst. They erroneously think that the sugar they consume will help keep them up and running for their study. Do not follow the example because keeping yourself hydrated with water can definitely help improve your performance. A study conducted by researchers in Ohio University revealed that people who were sufficiently hydrated performed significantly better on brainpower tests in comparison to those who drank inadequately.
7. Coffee Ė Moderate caffeine consumption can improve reaction time, attention span along with other brain skills. However, overdosing on caffeine can backfire and make it difficult for your brain to process information.
From this list, you can create a daily diet plan with the intention of feeding your brain with the nutrition it needs to perform at its peak. Although some of these foods are quite expensive, look at it from an investment point of view. At this point of your life, you are not only investing on your health but on your career as well.
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Great Study Snacks
When you are exhausted from your study, sometimes the initial instinct is to go to the fridge or pantry for a quick snack. If thatís the case, I suggest that you get rid of junk and processed foods and substitute them with incredible snacks that make your break count by replenishing your body with essential nutrients. Below, you will find a few healthy munchies that are perfect replacements. 1. Bananas Ė This fruit may not be the substitute that you have in mind but bananas are great study snacks for a couple of reasons. First, bananas need very little preparations. A quick peel is enough but if you want, you can also prepare a banana smoothie.
Second, bananas are packed with nutrients that can do wonders for your brain. The fruit is rich in potassium which facilitates transport of needed oxygen to your brain. It is also a great source of magnesium which helps in cleaning up protein metabolism byproduct. When you translate these effects to learning, bananas can give you energy for improved retention and focus.
2. Green Tea ĖKeeping your system flooded with caffeine is never a good idea. Instead of consuming one pot of coffee after another just to stay up, drinking green tea is the better alternative. Green tea contains L-theanine, a chemical that will keep your system running and buzzing like a well-oiled machine.
3. Kale Ė Steamed or roasted kale may not whet your appetite like pizza does but nutritional facts speak for itself. The vegetable contains B-complex vitamins which are great for deriving energy from nutrients. It is also rich in iron and copper, minerals which are essential for fuel generation and oxygen transportation. Lastly, kale is also packed with folate which facilitates blood flow to the brain. Therefore, munching on this veggie will definitely result in a resurgence of mental energy.
4. Walnuts - If you want something yummy and healthy, you would not go wrong with this last selection. Walnuts are great sources of a particular type omega-3 fats known as DHA. This type of essential fatty acid improves brain functioning and healing. Furthermore, walnuts also contain antioxidants and phytosterols which are great in limiting free radical presence in your brain.
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Foods to Avoid When Studying Having a list of which foods to consume while studying is great.


If you commit to a nutritious diet, it wonít be long until you reap the rewards. You will feel lighter and more energetic. More importantly, you will be able to hold your focus longer and retain information better, like a heavy fog has been lifted off of your mind. To continuously enjoy these benefits, here are foods that you should stay away from while reviewing:
1. Soda Ė Although itís more fun and satisfying to consume a fizzy drink instead of water, the amount of sugar it contains should make you think otherwise. According to Livestrong, a 12 oz. can of Coke has more than nine teaspoons of sugar, exceeding American Heart Associationís recommended daily maximum intake. Sugar might give you a brief energy surge but the ensuing crash makes consumption a no-no, especially when you are reviewing.
2. Greasy Potato Chips Ė While greasy chips are incredibly tasty, a study conducted by researchers from the University of Cambridge might convince you to think twice. Investigators revealed that eating excessive fat like greasy food can negatively affect memory and cognitive functioning. These effects are the last thing that you want when you are trying to absorb complicated medical material.
3. Energy Drinks Ė Small amounts of caffeine can boost your performance for a period of time but the tendency for some is to rely on this substance. Keep consumption of caffeine to a minimum because once your system gets used to it, you will need more and more just to maintain a decent level of focus. Stick to healthier alternatives like caffeine-free tea and water.
While you are nourishing your body in a manner aligned with your goal to excel in the USMLE, pushing yourself too hard may not be the best way to achieve this goal. In the next section, I will show you how important it is to include breaks in your study schedule.
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Importance of Taking Breaks


Sometimes, the desire to achieve a particular goal compels people to test their limits. However, your brain is just like any muscle when it comes to performance: at a certain point, it needs rest to continue working.
In 2008, researchers from the University of Illinois discovered that the brainís attentional resources decline after focusing on one task for an extended period of time, resulting to decreased focus and subpar performance. In the same study, researchers revealed that brief diversions significantly boost a personís ability to concentrate on a particular task for long periods of time.
Moreover, people who are fatigued are more vulnerable to experience burnout, moodiness and aggressive behaviors.
So what could be done to maintain a certain level of focus without experiencing any negative effect? Nathaniel Kleitman, a sleep researcher and physiologist, may have the answer.
Kleitman explained that the ultradian rhythm plays a vital role in waking life. This cycle simply shows that after 90 minutes, the brain moves from higher state of alertness down to a lower state as part of the rest-activity cycle. Therefore after 1 and half hours of intense studying, forcing your brain to absorb more material is useless because it is already on a lower state of alertness.
When your brain is in its resting state, you have to give it time to recharge. Help your brain revitalize by doing one of the following:
1. Take a Walk Ė Many studies have shown that walking for 20 minutes can be beneficial for both your mind and body. Walking is known to improve retention and focus. So when you feel like your brain canít take it anymore, walk around the block instead of forcing yourself to study more.
2. Socialize Ė Instead of using your break time to check social media updates, why donít you visit friends and personally see how they are doing? Back in the day when humans lived inside caves, they relied on each other in times of stressful events. Sure, the USMLE is not life-threatening like a hungry giant bear prowling around the rocky abode but human interaction has been known to trigger the release of beta-endorphins. These chemicals uplift a personís mood which reduces stress and facilitates learning.
3. Sleep Ė Some people try to project superiority by claiming sleep is for the weak. They can pump out and beat their chest all they want but the facts will not change. Studies have shown that a 30 minute nap can do wonders including improved retention and increased mental alertness. It appears that the body is designed to ask for a breather in the afternoon, roughly 8 hours after waking up.
Now that we have nutrition and rest covered, itís time to tackle the importance of physical activity. You may not be all that thrilled knowing that exercise has to eat 30 minutes to one hour of your day, time that you could have spent studying. Nevertheless, working out provides certain benefits that may prove worth your while.
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Benefits of Exercise for Improved Performance



Many USMLE test-takers think that working out is a non-essential activity. Keep in mind, the goal is to make sure that every aspect of your life is contributing towards your ultimate objective of excelling in your upcoming medical licensing exam. Take a look at the upsides of regular exercise and then decide if it provides enough value to be included in your daily schedule:
Improved Retention
The hippocampus is the part of your brain responsible for forming, organizing and storing memory. As people age, their hippocampus begin to shrink and this condition usually starts by their late 20s. A smaller hippocampus leads to decline in terms of performance on memory test and memory loss. Regular exercise can reverse such degenerative state.
In 2011, a study narrated in the New York Times showed that exercise has the potential to promote hippocampus rejuvenation. In the study, senior citizens were grouped into either the stretching program or the walking program. Both groups followed their respective program for a year.
After the program, brain scans revealed that participants from the walking group had significantly grown hippocampus. On the other hand, participants from the stretching group had shrunken hippocampus. The experiment goes to show how important it is for you to exercise if you want to score well in your exam and continue to be an excellent physician in the future.
Increased Focus
Aside from improved retention, exercise can lead to enhanced focus. In 2009, a researcher from a Canadian educational institution for children with learning disability conducted a study to back up this claim. Students were required to work out on a stationary bike or a treadmill for 20 minutes before starting their math class. The research revealed that the participants experienced significant improvement in their abilities to concentrate and store information.
Use this information to your advantage and make the most out of the lectures you attend in medical school. The more lessons you absorb in class, the easier it is to recall and retain information.
Uplifted Mood
If you have been working out prior to attending medical school, you can recall more than a couple of experiences where you felt good after running or hitting the gym. This positive effect of exercise seems universal as researchers from Duke University conducted a study to prove that exercise improves a personís mood.
In the study, researchers selected people suffering from depression and grouped them into two. The first group worked out while the second group medicated. At the conclusion of the study, participants who exercised reported higher levels of mood improvement in comparison to those who stuck with prescription medication.
Itís quite difficult to retain complex medical information if you are feeling a little blue. If thatís the case, exercise and add color to your life so you can stay on track with your study.
Reduced Stress Levels
Finally, many people do not understand the pressure medical students feel while preparing for the USMLE. Some students, especially foreign students, carry the hopes and dreams of the entire family on their shoulders. Such level of stress can be debilitating and can definitely hamper learning. There are times when thinking no longer helps and if you are at that point, perhaps regular exercise can help you handle the stress.
Working out for 30 minutes, at least three times a week, can help you attain a peaceful mind and a healthy body by releasing feel good hormones that significantly reduce anxiety. Furthermore, physical exertion like lifting weights, running, or shooting hoops can effectively drain studentsí energy, allowing them to sleep like a baby. All in all, exercise is a healthy and effective way to deal with stress.
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Creating a Plan of Attack


Preparing for USMLE STEP 1 is nothing like studying for the finals. You canít study a week before the exam and expect to do well. It will take you several months of intensive review and during this time, your life will revolve around absorption and retention of information. Asking for tips online is something you donít have to do because you already made the smart choice of picking up this book. I have created a study plan for examinees who have 30, 60, or 90 days to prepare for STEP 1. The review schedule is a good template to follow to put a definite structure to your study. Take note, though, that the review schedules are not set in stone. You can always adjust the schedule depending on your individual needs. You may be great in one subject and not so great in another, so if you feel like a particular subject needs more work, then itís up to you to adjust. The important thing is to create a schedule that you can thoroughly follow based on the templates provided in this book
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Identify Strengths and Weaknesses


Your first order of business is not to outline your study structure. Many examinees have been successful with STEP 1 because they understood which subjects they have a firm grasp on and which subjects need more work. They knew very well which topics should be allotted more time for further study and which topics can be reviewed later on. Being able to distinguish concepts that you have already mastered from areas that you barely understand will enable you to create a schedule according to your learning needs. To know your areas of strengths and weaknesses, self-assessment exams are available at:  Kaplan  USMLE World You can use the results to give you a good picture of which areas you need to focus on. When have identified which subjects you need to prioritize, you can move on to the creation of a study schedule that you will follow.
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Recommended Books for STEP 1



If you want to ace STEP 1, you need reviewers that do more than accurately and comprehensively discuss medical concepts. You need books that also provide hi-yield materials. For many students, the time they have to prepare for the exam is usually not sufficient. Needless to say, every hour you invest on studying any resource should pay huge dividends come testing day. Therefore, you want to make sure the books you read offer material that will actually appear in the test.
Countless books are available in the market today but we have selected five of the best so you can stop looking and start reviewing.
First Aid
All of the study schedules from the previous chapter recommend using this material and for good reason. USMLE test-takers refer to this resource as the Bible and the alias remained because of the bookís merits. First Aid for the USMLE STEP 1 provides so much hi-yield material that it is often suggested as an examineeís central study resource.
Its 25th edition offers 784 pages of hi-yield materials in addition to photographs and diagrams that facilitate learning. If you want to own STEP 1, the first step is to learn First Aid by heart like you are its author. If you do that, you will be more than familiar with the items that typically show up in the exam plus little known material that surprisingly appear.
Of course, committing to memory almost 800 pages of complex medical concepts is a herculean task but itís something that is being done every year by dedicated test-takers. Therefore, do not be intimated by the fact that you need to master this book from cover to cover, especially if you follow our 60 or 90 day study schedule.
While this review material is the most popular, there are others that will fit the bill.
Fundamentals of Pathology
Dr. Sattarís reviewer follows the outline format and contains 350 pages of hi-yield material plus high resolution images to enhance learning. Fundamentals of Pathology is part of the list because it is the perfect complement for STEP 1. More importantly, the book comes with CDs that provide supplementary information. Actively watching high quality videos while analyzing text is a surefire way to learn and retain information that will likely show up in the exam.
Board Review Series Physiology
Another book that follows the outline format for quick scanning, Board Review contains 350 questions that closely resembles USMLEís style. Furthermore, Dr. Costanzoís reviewer offers correct responses to the questions with well-thought-out explanations and exams at the conclusion of each chapter. The biggest upside of this resource is the USMLE-formatted examination found at the end. The comprehensive exam enables users to practice and get used to USMLEís style of questioning and degree of test difficulty.
BRS Physiology is available in print and online formats.
Board Review Series Pathology
If you feel like Pathology is one of your weaker areas, this BRS reviewer is the perfect material that will help you turn the corner. This valuable resource contains key concepts of disease processes, fundamental pathology, and concise descriptions and colored
illustrations of organ system disorders. Like the other BRS book in the list, the reviewer also comes with end chapter exams in addition to the comprehensive USMLE-styled test at the end of the book. Rapid Review: Pathology
Many students see the similarity of this material with BRS Pathology in terms of content; nevertheless, the method of delivery is very different. Dr. Goljan, author of many medical review resources, included more than 1,000 full color images in this reviewer. Best of all, the book comes with access to 400 plus online questions that follows USMLEís style complete with rationale.
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Recommended Question Banks



Professional sports team make their preparations in two ways. First, they study the Xs and Os and from there, formulate a game plan that works well against the opponent. Second, they put that plan into action in practice sessions and see if it needs tweaking. They repeat the process until the team thinks theyíve prepared as well as they could.
For USMLE STEP 1, the books/reviewers are your Xs and Os. You use these materials as the backbone of your game plan. Questions banks are available so you could apply what youíve learned. Below, you will find a short selection of question banks that have proven their worth over the years.
USMLE World QBank
This resource is another popular choice of USMLE STEP 1 test-takers. When you feel that you have comprehended a certain section of First Aid, the next logical move is to practice applying what you have learned. No other material does that job better than USMLE World.
First, USMLE Worldís method of asking questions very much resembles the question style of USMLE STEP 1. Furthermore, the items that you will encounter in USMLE Worldís Qbank are more difficult than the ones you will face in the actual test. These two factors alone will make you feel as if you are preparing for the Olympics when in fact, youíll just be competing on the national level.
Now, the best reason that makes USMLE World a top resource is the explanations that come with the answers. You are getting your moneyís worth with this Qbank because the system offers detailed rationale for every right or wrong response. If you use this resource to the fullest, you will learn how to verify your answers using your deductive prowess.
Kaplan Qbank
While Uworld is the most widely used question bank among STEP 1 test-takers, Kaplan Qbank is not far behind. It offers more than 3,000 STEP 1 questions in addition to an examination that closely follows USMLEís questioning style. Furthermore, Kaplan Qbank provides a vast amount of audio-visual content including high quality images, videos and heart sounds. The resource also provide full explanations of the answers but what sets it apart from other Qbanks is it offers over 200 lectures from experts on the most difficult items.
USMLE-Rx
Much like other Qbanks, USMLE-Rx STEP 1 Qmax offers subscribers access to thousands and thousands of high yield STEP 1 questions. However, what separates this resource from the rest of the pack is it guarantees subscribers will pass the exam. USMLE-Rx believes that results from their self-assessment exams are highly predictive of an examineeís actual USMLE performance. Check out USMLE-Rxís website to know more about their 100 percent pass guarantee.
Exam Master
Dr. Pasleyís Exam Master offers 2300+ high quality USMLE-styled questions with detailed explanations for every answer choice. This resource stands out from the group for two reasons. First, subscribers have access to practice exams which provide personalized score reports so examinees can make adjustments on their study. Second, subscribers can create their own flash cards where they can input and save notes and other important material.
Firecracker
This resource will immediately pique your curiosity because it offers examinees one thing that other Qbanks do not: free one month subscription. Firecracker is not just your typical Qbank. It made the list because its system enables subscribers to integrate their study with their med school lectures. Letís say todayís school discussion focused on the kidney. You can read all about the kidney on FC so you can flag and review related subjects. Then, Firecracker will quiz you on the subject.
The best part of this resource is that users are given personalized review plans based on quiz results to address weak areas and retain strengths. By doing questions daily, FC believes that users are bound to commit material to long-term memory.
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The Importance of Taking NBME Self Assessment Exams


Through practice, you are able to hone your skills. However if you want to be certain that are ready for the competition, you need to participate in tune-up games. In the world of sports, these games are usually friendly and coaches execute their game plan to determine which areas need last minute adjustments.
The same is true for STEP 1 examinees who are looking to assess their progress. The only difference is you are both the player and the coach. You take a practice exam and from the results, you can gather information that will help you make critical tweaks.
The NBME Self Assessment exam is the perfect platform that will check your readiness for STEP 1 for three reasons:
 It covers half-length of the exam with items that closely resembles material you will find in STEP 1.  It provides score breakdowns which enables you to identify your areas of strengths and weaknesses so you can make adjustments as you move forward with your study.  NBME Self Assessment exam has been known to predict test-takersí performance in STEP 1 with tremendous accuracy. Therefore, your results will give you a clear idea of how well you will do in the actual test.
These three resources work hand-in-hand to boost your chances of hitting your target score. One allows you to learn the material, the second lets you practice, and the last predicts your readiness. As mentioned above, STEP 1 is predictable and you can take advantage of that by studying resources that have accurately predicted material that will show up in the exam year after year.
USMLE World is a critical resource and if used properly, examinees can expect better STEP 1 performance. However, many test-takers perceive the top notch Qbank differently and in doing so, they commit several mistakes that hinder them from making use of the resource to its fullest extent.
The next section focuses on five ways to make the most out of USMLE World.
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How to Take Advantage of USMLE World



Those who scored more than 240 points in STEP 1 knew very well how to make the most out of their study materials. They understood how to integrate information from different sources. Moreover, they were able to come up with the correct answer by ruling out other choices. No other resource is more effective than Uworld in enabling examinees to synthesize information and accurately eliminate incorrect options.
With the significant benefits offered by Uworld, here are important tips that will allow you to squeeze the juice out of the fruit up to the last drop.
Begin as Early as Possible
Most examinees think that itís better to read first before taking on a Qbank as difficult as USMLE World. While the strategy of reviewing before testing may work when these test-takers were still in college, itís a mortal sin to do the same in STEP 1 preparations where time is of the essence.
USMLE World enables users to tailor question sets according to a particular discipline. The best way to take advantage of this feature is to start tackling questions as soon as you have learned something from your lectures in medical school. Perhaps, you already finished your course on biochemistry. If so, use USMLE Qbank to test your knowledge on the subject by practicing on a few sets. If you are done with anatomy, then answer sets on anatomy.
Following this method gives you several benefits. First, you start reviewing as soon as you are done with coursework, giving you a head start on your preparations. Second, you expose yourself to hard questions early and that gives you confidence to tackle difficult questions later on. Lastly, reviewing early on increases your chances of retaining information and allows you to notice areas where you still need work.
The upsides of beginning as early as possible are too good to ignore, but weíre only scratching the surface here.
Take Time to Understand Explanations
Many students think that going through UMSLE World Qbank is the same as taking a pop quiz. They provide the answers, wait for the results, and then see how well they did. This is a blunder of Biblical proportions.
Those who have achieved their target scores appreciate the well-written explanations provided by the Qbank. To master the content, you need to take time to read and understand the explanations. If you do, you will be able to take home the pot of gold at the end of the rainbow.
Whatís great about these explanations is that you completely grasp the reason why a particular choice is correct while the others are not. For example, if the item is about the neurotransmitter GABA (Gamma aminobutyric Acid), UWorld will explain why a particular choice is correct. However, the benefits do not end there. If you read every word given in the explanation, you will also learn why other choices are incorrect. Therefore, the explanations solidify your understanding of a subject and thatís where learning usually occurs.
Reading explanations will definitely consume a lot of time but thatís how you get gold or anything valuable. Time and consistent effort have always been the secret to success and the formula remains the same for those who want to fly high on STEP 1.
Integrate UWorld Learning with First Aid
First Aid is not the easiest material to read. This book is like old professors: highly efficient and masters of the subject but you canít stop yourself from dosing off once they take the floor. Digesting information as is will never be stimulating. However when you try to integrate explanation from Uworld to your First Aid review, studying suddenly becomes a little more exciting.
What usually happens is that students study First Aid in the morning and then answer Uworld questions in the afternoon. A more effective approach would be improve the afternoon session by answering Uworld questions and at the same time integrate the explanations to corresponding sections of First Aid. This means, you have to take down notes, highlight, and provide remarks on your First Aid book based on the explanations from Uworld.
By studying material again and again in different ways, you strengthen neural connections and improve the odds of retention.
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Think of USMLE World as a Learning Resource



Test-takers usually make the mistake of thinking that Uworld and NBME Self Assessment exam have the same purpose: to measure progress. If you are thinking the same, itís a good thing you picked up this book.
While Uworld will provide feedback on your current level of knowledge on a particular subject, it will be a shame if your study will come to gradual halt just because you are not pleased with the results. It is typical of med students to back track their review instead of moving forward to the next block because they scored less than exceptional on a particular subject in Uworld.
Again, USMLE World Qbank is a learning resource. You will learn more if you take the next set of questions as opposed to looking back to see where you went wrong. Therefore, it is always best to take the next block and learn from the explanations than to take a step back with the hope of scoring better the next time around.
Study Qbank Content More than Once
This last tip works well with the first one. If you study as early as possible, you are giving yourself the time to go through Uworld more than once.
Our mind and body follow the same principle in evolution: what you donít use, you lose. Therefore if you want to retain the information you absorbed a few weeks ago, you have to study and read the same material again. Studying takes a lot of time, especially with the massive explanations offered in Uworld.
So donít waste your time thinking about numbers or starting on easier Qbanks to give you confidence. Begin with Uworld Qbank as early as you can so you will have the luxury of time to go through its content more than once.
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Setting Up the Proper Study Environment



Now that you have the ideal resources to study for STEP 1, the next factor that should be considered is your study environment, especially if you elected to review all by your lonesome. Even if you have the best resources at your disposal, you cannot maximize retention if your surroundings are not conducive for learning.
Itís difficult to study if you are always distracted by ambient noise such as dogs barking incessantly or if other people keep bothering you for whatever reason. A few decades ago, these are the major disturbances you have to worry about but with todayís technology, you also need to consider distractions from your mobile phone and social media. With so many stimuli that can divert your attention, you have all the more reason to ensure that your selected location is free from any form of distraction.
The first step in creating the ideal study environment is understanding how different factors may hamper learning. Once you are aware how these variables affect your level of concentration, you are ready to create the perfect study setting. Lastly, staying in one spot for two to three months to study is never ideal. Therefore, this book also offers different locations that you can visit to review from time to time.
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Different Ways Environmental Factors Affect Learning



Before you can create an environment that facilitates learning, you need to know how several factors get in the way of learning.
Music
While music is considered as food for the soul, the magic it offers is usually abused. Many people prefer listening to music while studying, believing that the act can keep them alert and ready to learn. However, scientific research has proven that not every type of music can provide learning benefits that people hope for.
First, a recent study by Nick Perham suggests that learning new information is best when music is not available. In his study, participants were required to recall a series of sounds given in a specific order. Those who listened to music while completing the task
experienced significant drop in performance in comparison to participants who carried out the job in total silence. However, Perham states that listening to music prior to working can enliven your mood and enhance arousal.
Another research suggests that listening to preferred music can do more harm than good. Researchers Smith and Morris conducted a study wherein participants had to recall a set of numbers in reverse while listening to preferred, stimulating, or zero music. The research concluded that those who listened to their music of choice performed the worst, indicating that a participantís attention shifted to the songís lyrical content or the memories evoked by it.
However, a research revealed that listening to a particular type of music actually facilitated cognitive performance. A study carried out by Hallman and others in 2002 showed that participants achieved better results on memory and mathematical performance tests when listing to calming and relaxing music than those who did not listen to any type of music. Moreover, the study exposed that listening to aggressive and arousing music disrupted cognitive performance.
I emphasized the effects of music while studying to separate myth from fact because many students give music too much credit. From these studies, you can easily conclude that only relaxing music such as classical or jazz can facilitate learning. Listening to other types of music whenever you are studying can make you less efficient.
Scent
How your study spot smells can affect your concentration. Do you smell the neighborís cooking from your room? Are you distracted because the coffee shop smells so good? Your environment doesnít have to smell disgusting for you to be distracted. When it comes to scent, sometimes the pleasant ones tend to be more troublesome.
Lighting
An important part of studying is the availability of adequate lighting. Concentrating is difficult when you have to strain your eyes to read due to insufficient lighting. In 1999, researchers from the University of Georgia revealed that poor lighting reduces the brainís efficiency to collect information.
Temperature
Once you are a doctor, you need to be stone cold in dealing with diseases but now that you are still a student, studying in cold environments can distract you. According to researchers from Cornell, people are likely to commit mistakes when working in environments with low temperature (60 degrees or 20 degrees Celsius). The body uses a significant amount of energy to stay warm, energy that could have been used to focus better.
Clutter
Some people deal with clutter better than others. Nonetheless, clutter can be a form of distraction, especially if you canít find your study materials because they are buried under a pile of clothes.
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How to Pick Location Perfect for Studying


Now that you have a good idea on how environmental factors can affect your study, you are in better position to pick or create your ideal study spots. Considering the atmosphere, access to resources, and causes of disruption will help you in your selection.
Atmosphere
In choosing your different study sites, you need to consider environmental factors discussed above. Does the place play soothing music, or does it smell too appetizing for your own good? Does it provide sufficient lighting and can the thermostat be controlled? Do you have enough space for your study materials?
Your chosen places of study should meet these requirements at the very least or else you wonít be able to absorb information efficiently.
Access to Resources
After having a short list of candidates, you can narrow down your choices by thinking about access to resources. The first thing you need to consider is the availability of electric outlets and internet access. You have to be online to answer Qbank questions. Also, the type of food and water served should be taken to account. You want to eat healthy foods that supply you with a steady amount of energy throughout the day.
Causes of Disruption
Thereís just so much that you can control in life so for factors that you do not have power over, the best that you can do is to minimize their effects. If you are living with other people, be sure to inform them of your mission and let them know your availability. When studying, the internet can either be your best friend or your worst enemy. Be sure to use apps like LeechBlock and Nanny for Google Chrome to help you fend off the temptation of checking social media updates.
While considering these three major factors can help you select the best candidates for study spots, you can quantify the features of a location using Virginia Techís Study
Environment Analysis. Use the tool and provide your input for each candidate to assess its suitability for study.
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Best Places Where You Can Study and Absorb Information Effectively




Reading lengthy medical texts and answering tough questions for two to three months will take a toll on your psyche, especially if you are always studying on one spot. You need to move around and change your settings from time to time to keep your preparations fresh. STEP 1 is arguably the toughest exam youíll ever take and thereís nothing you can do about that.
What you can do, however, is to change your outlook on your preparations. Sure, the exam is difficult and the road to achieving your target score is walked with grit day in and day out. Therefore, you have all the more reason to make it a point that you make your journey as delightful as it can be. One way to do that is by finding interesting locations to study so when you look back, you can always say that you traveled with grace.
1. Patio Ė Those who feel the pressure of making it through STEP 1 would probably lock themselves inside the bedroom, flipping pages inside a dark and cramped area. The stress of passing may also affect you but donít let it control your preparations. Instead of hiding inside your room, go out and work under the warmth of the sun. Vitamin D from the sun elevates your mood and increases your energy levels, which is perfect for someone who needs to stay alert to absorb information.
2. Bookstore Ė You may have read your much loved fictional story on the floors of your favorite shop but if not, then let me tell you how easy and comfortable it is to read inside a bookstore. An hour or two of studying inside an establishment designed to inspire reading beats staying at the comfort of your own bed.
3. Park Ė Have you ever sat down at the middle of a park to just immerse yourself at the serenity of the place while everything outside is struggling to keep up with demands of modern living? If you have, then bring your study materials next time around. You have the sun, fresh air and calming music from resident birds. These factors can only facilitate learning and retention.
4. Beach - Most people think of the beach as an exciting escape from their daily lives. You donít have to run away from your life because as a physician, you are building one that doesnít require diversions. If you happen to take a weekend to enjoy one of Mother Natureís greatest gifts, be sure to bring your resources with you. Research suggests being closer to the sea reduces stress levels and
promotes exercise. These effects are exactly what you need to keep marching forward.
5. Study Buddyís Place Ė Staying inside your house or dorm room does nothing to stimulate your brain. However if you choose to swing by a friendís place to study, the brain reacts differently. In 2006, researchers found the brain is stimulated by novelty. You can use this arousal to enhance learning.
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Raise Your Level of Commitment
***
Every medical student both dreams and dreads USMLE. All aspiring doctors live with the hope of passing the medical licensing exam with flying colors but those same souls are terrified of what they have to do to see their dreams manifest in reality. If you feel like your insides are in an intense tug of war between optimism and despair, do not think for once that you are the only one going through that battle on a daily basis.
On the contrary, you should congratulate yourself for pressing on even at the presence of anxiety and fear. However to achieve your ultimate goal of earning your medical license, you need to raise your level of commitment. Passing USMLE is not enough, especially if you want to be part of competitive residency programs. You have to set specific goals, eliminate distractions, and hold yourself accountable. The process is definitely not easy but the rewards such as ď_________ (your name) M.D.Ē are everlasting.
Importance of Setting Goals
Medical students take USMLE STEP 1 and STEP 2 because both exams are requirements for graduation. Moreover, completing all USMLE tests with passing scores is the only way for med students to acquire license to practice their profession. However before students can acquire their medical license, they need to go through residency programs.
Nowadays, med students go through a stringent screening process primarily because either slots in residency programs have decreased or the number of applicants increased. The situation has forced the hand of program directors to be extremely selective. Getting passing scores on your USMLE STEP 1 and 2 are not enough to get you admitted on your preferred specialty program. To increase your chances of being selected, your scores needs to go beyond the average.
According to the 2009 study by Green and others, STEP 1 comes second to studentsí third year grades as the most important factors in determining who gets in residency programs. You have more reason to target better than a passing grade in your USMLE STEP 1 if you are interested to pursue Emergency Medicine, Neurosurgery, Ophthalmology, Otolaryngology, Surgery, Urology, Anesthesiology and Obstetrics and Gynecology as residency programs in these specialties put a lot of weight in an applicantís score.
The same study also rated ENT, plastic surgery and orthopedic surgery as the most competitive specialties while the least competitive were internal medicine, neurology and family medicine. The research stated that ďthe average USMLE score increased in relation to specialty competitiveness.Ē
Now, this study only reinforces what most med students already know: a huge part of your future depends on your STEP 1 performance. Your entire medical career can either be sidetracked or propelled by your STEP 1 score. Therefore, it is of utmost importance to be clear with your target score so you can organize your study in a way that will enable you to achieve or go beyond your goal.
Benefits of Setting a Clear Goal
If you are starting to feel the pressure of performing well, take that energy and use it to be crystal clear with your goal. Once youíve written the magic number, you will definitely experience a few benefits including:
1. Focus Ė When the mind is clear on what it needs to do, people tend to only consider behaviors that can help them reach their goal. Every hour is spent towards the attainment of the objective. Youíll wake up in the morning with a sense of direction and your actions will be aligned that what you want to achieve.
2. Purpose Ė The spirit responds once the mind is focused. Itís easy to have a sense of purpose when every single aspect of your life is directed towards the completion of a goal. You will feel uplifted and confident. Inspiration will be your state of being.
3. Motivation Ė As the mind and spirit work together, your emotions will eventually join the party. You will have the energy to complete your daily tasks and then wake up the next day still feeling the same intense drive. When the objective is unambiguous, it will feel as if every single cell of your body is alive and ready to perform to the highest level to accomplish the goal.
At this point, you should take a few moments or a few days to identify your preferred specialty and the score you need to be sure youíll get in the program. You can have all the best resources in the world at your disposal but if you donít know specifically where you are headed, you might find yourself in a place where you donít want to be in.
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Remove Distractions and Stay on Track


Once your goal is set and you are ready to move forward, you need to remove distractions, especially those which you think are harmless. Social media, mobile phone, and TV can be accessed by just lifting a finger which makes them treacherous for people who are focused on achieving a goal. You may convince yourself of taking a few minutes off to relax but the next thing you know, youí spent more time than you can afford indulging on these devices.
Even though you have the willpower to resist temptation, itís better not to take chances. Here are tried and tested tips you can use to minimize distraction.
Start the Day without Social Media
Before the internet invaded every American home, people were productive as soon as they opened their eyes. They prepared breakfast, showered, prayed, or ran. Nowadays, it is not uncommon to hear young people spending 30 minutes to one hour skimming through Facebook updates before they got out of bed. For someone who has a clear and challenging goal, you canít afford to start your day distracted. Skip this addictive social media morning ritual and begin your mornings like most Americans did more than two decades ago.
Avail of Useful Apps
Itís so easy to click on your Facebook, Instagram, and Twitter bookmark whenever boredom strikes. Social media is highly accessible so if you donít want to fall inside a time-consuming quicksand, download browser-based apps that can block websites for a certain period of time. LeechBlock is available for Firefox users while Chrome users can get their hands on Nanny for Google Chrome. Both apps are great in limiting which sites you can access so you can go through Qbank questions without delay. Donít worry because your friends will still be there.
Activate Do Not Disturb Mode
Even if you activated apps that can restrict access to certain sites on your computer, you still have your latest mobile phone or tablet where you can access blocked sites or receive messages or notifications as soon as they are available. Protect yourself from further distraction by turning on the Do Not Disturb feature on your mobile device. If you are worried about emergency calls, you can modify the settings so calls coming from the same number within three minutes will not be silenced.
Watch TV Shows Later
When your favorite TV series is in conflict with your study schedule, the logical choice is to stick with the plan because with todayís technology, you can always play catch up. Nowadays, people record TV shows all the time. If the technology is not available in your country, there are many websites offering free live-streaming services. Stick to your study schedule and perhaps you can allot your rest day for a TV series marathon.
Eliminating any form of distraction is crucial if you want to maximize your study time. With the two to three month window, itís safe to say that time is very much of the essence, especially if your target score is higher than the norm.
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Accountability with the Help of Family and Friends


Some people like to keep their cards close. They do not want others to know what they are thinking and where they are going. While keeping secrets will give you an air of mystery, scientific research tells us sharing your goal with other people increases the likelihood of success.
A study conducted by Dr. Matthews in 2009 revealed that those who clearly stated their goals in writing, shared the details with someone close, and sent updates on a weekly basis were 33 percent more successful on average in attaining the goal in comparison to those who simply formulated the goal on their head. According to Matthews, his study provides evidence on the effectiveness of commitment, accountability, and writing goals on paper.
Needless to say, this book encourages you to share your goals to friends and family members. You can even send them weekly progress reports. Once you share your goals to other people, thereís no turning back. For sure, you will feel the pressure but you will also enjoy these benefits.
Accountability
You just donít share your goal to a friend or a family member who has very little care for your progress. That would be cheating. You want to tell it to someone who will not think twice to call you out whenever your actions are misaligned to your objectives. Ponder on your choices and select a few close souls who deeply care for you. You might have to put up with nagging from time to time but thatís just tough love. At the end of the day, every person in your support group wishes you nothing but success.
Transparency
When you share your goal to someone close, this person will most likely see if you are aiming too high or too low. For example, letís say you want to pursue dermatology. To be able to do that, you set your mind on achieving a score of 221 for STEP 1. According to Dr. Cohen, however, your target score only gives you a shot at an interview. If you share the information, a true friend will not hesitate to let you know your number is not enough. Do you want an interview or do you want to seal the deal? This line of
questioning is what you should expect from people who hold you accountable to your goal.
Reference
Believe it or not, fishes do not know they are living and swimming in water. They are not aware what water is because water is the only point of reference they have. You can never have a complete view of your progress if you are on your own because like the fishes in the sea, you are only swimming on your own thoughts.
However, your progress may be clearer with the input of other people who have the capacity look at information objectively. They are the ones who will most likely see adjustments you have missed. Feedback about your progress is critical, especially since you have very little time to prepare for STEP 1. You need people to tell you what improvements you can still make as you move forward.
Bond
When you sincerely share a part of yourself to other people, an everlasting bond is created. You may think trying to involve others will just add more burden to their already busy lives but if your chosen people are truly concerned about your success, they will feel nothing but appreciation. They would be more than happy to be part of your coaching staff, your board of directors, or your alpha team. You will rely to them for advice and in return, you will make them proud by achieving your dreams. Give and take relationships last for a very long time.
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Effective Study Habits


*** ďPerseverance is the hard work you do after you get tired of doing the hard work you already did.Ē - Newt Gingrich
Now that you have a study schedule plus a list of all the resources you will need, the next step is to build habits that will make you successful. The habits that you will learn go more than doing the same thing over and over again. This book will teach you how to think in the right direction so you can build habits tailored for your lifestyle and learning style.
In this chapter, you will understand how to integrate resources together so you can create a study habit that will keep your mind engaged and stimulated. You will also learn valuable tips on how to enhance focus while studying and how to make studying fun. Lastly, you will understand why itís important to take breaks but if you feel like you are biting more than you can chew, the chapter also offers valuable tips on how to manage stress.
How to Integrate Information and Own STEP 1
The common way people prepare for STEP 1 is predictable. They spend countless hours trying to memorize facts they find in reviewers like First Aid. When they feel ready, they open the computer and tackle Qbank questions. If they score well, they study the next section but if not, they go back to studying and passively watching videos.
While some people can easily digest information by following this simple method, many tend to lose focus because letís face it, First Aid is not the most organized reviewer. If you were given a compilation of facts, absorbing information will take a lot of effort and concentration. This book offers an alternative approach, one that will enable you to integrate information seamlessly and keep you engaged at the same time.
Identify Areas of Weakness First
In chapter two, templates were provided to help you break down different topics and activities so you can come up with a realistic study schedule. Also in that chapter, it was emphasized that you plan your schedule around your weaknesses. In this section, you will understand why.
Instead of creating a schedule around the idea of going through a certain section of First Aid, you can create a better one with your areas of weakness in mind. In order to do so, you need to answer Qbank items first. From there, you can identify which topics you need to work on. If you follow this advice, you will have a much more fruitful study time.
If you begin with Uworld before consulting First Aid, the most likely scenario is that youíll make a lot of mistakes. Donít worry about percentages for now because these figures do not actually matter. Whatís important is you identify what you do not know so you can use First Aid to better understand the explanations provided by Uworld.
You might be wondering why itís not better to first study First Aid, answer Uworld questions, and then go back to First Aid. The primary reason is time. Studying for two to three months only gives you so many hours and you have to make those hours count. The next reason has a lot to do with how First Aid is created which the next subtopic will cover.
Get to Know the Roots of First Aid
Itís not uncommon to hear people recommending that STEP 1 examinees should digest every bit of information from First Aid like they are participating in a massive eating contest. While those experts will tell you what to eat, they wonít tell you how. This book gives you more than the how. It also offers the why.
In the previous chapter, Iíve mentioned that STEP 1 is predictable and that foreseeable aspect of the exam has always been exploited by proponents of First Aid through a surprisingly simple method. Iíve heard rumors that researchers representing First Aid get material by approaching students who have just finished taking STEP 1 and collecting questions they could recall.
At first, I thought the rumor was unlikely but when I opened my own copy of First Aid, I discovered something that would support the story. Under the ďHow to Use This BookĒ page, thereís a section where users are encouraged to review the book immediately after the exam. The emailís content should notify creators what was ďtruly high and low yield.Ē If First Aid has online contributors, it wouldnít surprise me if they have people farming questions on site.
In light of this information, I began to understand the purpose of First Aid. The resource is not the most organized reviewer because the objective is to point students to the right
direction. First Aid is a collection of facts that will enable users to answer questions that will most likely appear in STEP 1. In other words, First Aid is the answer key.
Now that you are aware of your weaknesses plus you know First Aidís purpose, the next step to integrate information so the facts begin to make sense.
Use First Aid for In-depth Study
Having the keys to the castle gives you an edge but those keys wonít matter if you donít know which doors they open. The book has already given you why First Aid is organized through a chaotic collection of facts. The how comes next.
Once you have identified your areas of weakness with the help of Uworld, write down those subjects on a list and then use First Aid to know which concepts about a particular topic would show up on the exam. For instance, myocardial infarction is one area you need to work on. Open First Aid and find what about the heart condition would likely appear on the exam. Do this for all the items in your list.
Following this method will allow you to study items that are considered high yield in greater depth, as opposed to memorizing low yield facts coming from multiple sources. Although this approach may be a couple of steps slower than the usual ďIíll go through Pathology today,Ē you can be sure that your time and effort are invested in material that you will most likely encounter in the exam. It may take a while before you match the keys to the right doors but when you do, you have access to rooms that contain the kingdomís treasures.
Connect the Dots Knowing facts is good, but understanding how these facts are related is better. STEP 1 is not like any exam youíve encountered before. The objective of the test is not to measure the amount of facts youíve stored inside your brain. Its purpose is to measure how well youíve integrated those facts and your ability to apply what youíve learned.
Therefore, having intelligence on which questions will appear on the exam is crucial because it will enable you to identify which topics you should focus on wisely. You no longer need to spend tremendous amounts of resources to shell the enemy with the hope that youíll hit the target. With First Aid, you essentially have the enemyís battle plan and all you need to do is to concentrate fire on areas of vulnerability.
For you, that means you need to ask the right questions so all those facts that seem so random can finally come together and make sense. If I was a doctor and a patient came in for consultation, I can only provide sufficient information about a disease if I know:
 What is the pathogenesis of the disease?
 What is its presentation?  How are the two related?
For example if a patient wants to learn more about myocardial infarction, I should know what happens inside the body before a heart attack. Also, I should be able to describe the symptoms of a heart attack. More importantly, I must elegantly explain how the causes (pathogenesis) lead to the effects (presentation).
By asking the right questions, the connections between facts are revealed. Ultimately, learning is a process of discovery as opposed to mere memorization of facts.
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Ways to Effectively Manage Stress and Keep Your Mind Healthy as You Study


Most articles or books will tell you stress is something you should avoid. These experts claim that stress is the enemy but in reality, stress or the feeling of stress is your best friend. The human race has always been under tremendous pressure but somehow and some way, we survived, thrived, and moved forward. Genetically speaking, you have within you all the resources you need to tackle any stressor head on.
To effectively manage stress, you have to think of it as a powerful ally instead of an enemy in the shadows, biding its time and waiting for the opportunity to strike. Biologically, the feeling of stress is your bodyís reaction to a threatening stimulus. The presence of a stressor activates the primitive fight or flight response. In other words, your body is offering the necessary resources to deal with the stressor.
Only true friends can say directly in your face that something is off and offer a hand in case you need it. You can either ignore the warning because you perceive the pressure as something negative or you can listen to stress, deal with it, and grow from the experience. The former offers no reward but convenience; the latter, on the other hand, offers strength and growth. If you havenít noticed, the three step formula mentioned above has enabled the human race to go from hiding inside dark and hideous caves to exploring the wonders beyond our solar system.
Humans have always thrived on stress. Without it, we would stagnate.
As a medical student, you are on the path to making a difference in your own ways. Nevertheless, the road is not easy and there are many obstacles along the way. Before you take another step in your journey, treat stress as a friend you respect and never fail to listen to. Itís alright to have your friend say a thing or two to you once in a while. What you donít want is to have that friend breathing down your neck. Therefore, you need to listen to stress before it becomes a real issue.
Studying for several years to earn your medical license is not the primary stressor. Pressure usually rears its ugly head once students begin to understand whatís at stake.
You immediately feel your heart race, lips turn dry, and blood pump through your veins in a frenetic pace once you think about how one exam can ruin your chances of the future youíve always dreamed of.
At this point, your friend is telling you to bring nothing less than your A game. It will not go anywhere and it will know if you offer anything less than your best. I have dedicated a significant part of this chapter with the hope that you will change your views on stress because so many people crumble under pressure whenever they go through life changing events. As you prepare for the USMLE, here are tips you should consider to help you manage stress.
Create a Study Plan and Religiously Stick to It
Many students experience stress whenever they feel something is beyond their control. The good news is your performance on the USMLE will largely depend on your preparations. With the help of this book, you are provided with workable study schedules, ideal resources, and tried and tested study strategies.
You have the ammunition and the correct approach to conquer the exam. If you are committed, you will have no reason to be worried. Stress will be happy to stay on the sidelines. However as soon as you deviate from the plan, you can expect your friend to conjure up troublesome thoughts. Embrace the counsel and make up for lost time. If you listen to stress instead of resisting it, you only improve your chances of hitting the target score.
Take Care of the Body and the Mind
Your friend, stress, knows that to do well on an exam of this magnitude requires your 100 percent. That means your mind and body should be in great shape. You have 24 hours every day, 8 of which you will presumably dedicate to study. The 16 hours left should be wisely spent on activities that support your campaign including:
1. Sleep Ė Experts recommend you slumber for 7-8 hours daily. Lack of sleep makes learning difficult and which makes it counter-productive to stay up late just to read and digest a few more pages. Therefore, do yourself a favor and sleep like a baby every night so you can keep stress at bay. 2. Exercise - Spend 20 or 60 minutes of your day running, lifting weights, or assuming yoga positions. Exercise keeps the body healthy and boosts the immune system. Moreover, physical activity promotes learning and consolidation of memory. Stress has one less reason to interfere if you keep your body and mind healthy. 3. Follow a Healthy Diet Ė Eat foods that are good for both brain and brawn. Abstain from toxic substances that can impede your momentum like alcohol. You miss one day of study due to intoxication and you will hear subtle whispers of regret.
4. Love Yourself Ė If you took a step back on your study due to an emergency or you caught a nasty bug, donít put too much pressure on yourself to catch up. Give yourself time to recover. More importantly if you feel fatigue setting in, be kind to yourself. Tell yourself that everything is fine and that you are more than capable of dealing with any situation.
Enjoy the Company of Your Loved Ones
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Bad Study Habits You Should Never Commit

If you look at the big picture, it is obvious how the room for error is too small for you to feel comfortable. If youíve chosen to follow the many suggestions provided, you will now have the resources, strategy, and time frame to effectively tackle an exam of this magnitude. While you have everything that you need at the palm of your hand, it should never occur to you to slack off. You have to start strong and finish stronger. Along the way, weed out any bad study habits that you might have developed during your younger years. Studying with No Sense of Purpose Students usually begin their review with the vague notion that they have to study section X of First Aid and do Y number of questions. They go through each page and question as if they are compelled by a powerful force to render service. This mediocre level of involvement may have worked for you in the past but if you want to achieve a competitive score, you need to study with a sense of urgency. Before you begin you day, ask yourself why you bother to take such a heavy burden that is the USMLE on your shoulders. Remind yourself day in and day out your ultimate purpose for going through this journey. Renew the fire everyday and notice the difference in your study in terms of vigor and focus. Cutting Classes to Review In the past, you may have skipped a few lectures and used the time to study for an exam. If you employ the same strategy for STEP 1, you are doing more harm than good. Keep in mind, STEP 1 is designed to assess your abilities to integrate and apply knowledge that you should have learned in your preclinical years. Therefore, attending
classes is the better option because it is in these lectures where you will encounter little details that will help you understand and interpret concepts presented in First Aid. Using Rote Learning At the risk of sounding like a bootlegged CD, STEP 1 was constructed to test how well you are able to synthesize and apply knowledge youíve learned in med school. Early years of education may have conditioned you to study like a parrot, repeating what was stated by the instructor and the book. The same strategy is no longer applicable at this level. If you find yourself unconsciously memorizing facts, snap out of it and then focus to understanding how the facts are connected. Studying Until the Wee Hours of the Morning One of the reasons why you need to create a sound study schedule is to follow your bodyís natural rhythm. Working in the morning until the sun sets is a healthy and sustainable study schedule. Reviewing until the sun rises is not. Studying way past midnight is never recommended. At this point, your brain is already drained of energy it needs to effectively store information. Furthermore, staying up late compromises your immune system and robs you of the energy you need to perform efficiently the following day. Stick with your study schedule and never let procrastination get the best of you.
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Effective Habits that Will Take Your Study to the Next Level


Your years of education prior to med school have programmed you to follow certain habits without questioning them. For instance, many students are so used to memorizing facts that the first instinct when preparing for STEP 1 is to employ rote learning. Others have been so successful putting off work up to the last minute because they are under the impression that procrastination still has a room in med school. If you are guilty of such behaviors, itís time for you take the extra mile. Study at a Higher Level This book has already established how memorization of facts is not enough to ace the USMLE. You need to step up and study like you never did before. According to Bloomís taxonomy, the first three levels of educational learning involve knowledge, comprehension, and application. Recollection and application of information were the strategies you are very familiar of since college exams were designed to measure studentsí ability to recall and understand information. However, your current journey requires you to absorb information and more. Remember, questions in STEP 1 are presented through clinical vignettes. In order to
successfully deal with each case, you need to have a good grasp of relevant medical concepts and theories plus the ability to analyze, synthesize, and evaluate information. In college, it might have been sufficient to memorize and identify parts of the midbrain. For STEP 1, you need to understand the significance of each part as this increases your ability to deduce solutions. For example, what happens if cells in the substansia nigra die? How would it affect the entire body? Asking these questions enables you to effectively analyze and evaluate information so you can arrive at the correct answer. More importantly, your study strategy no longer relies on force feeding information through repetition until it is digested by your brain. You would be more focused on making connections based on the available information and your sound medical background. Study with Intense Focus for Short Periods of Time Studying for long periods of time will only give you the illusion that youíve successfully accomplished the dayís goal. You may have answered 100 + questions in Uworld during your 8-hour review marathon but are you confident that you can apply and integrate everything that youíve learned? In college, so many students fail because they think cramming knowledge for extended periods of time is equivalent to weeks of dedicated study. Such is not the case because when you study continuously for 8-10 hours every day, the concern is about quantity of information, not the quality. While many experts believe that preparing for STEP 1 is like running a marathon, I think it is more of a 3-5 km daily sprint. You study with intense focus for a maximum of 90 minutes and then take 30-60 minute breather before the next run. The end result is a cycle where your performance is always at its peak because your energy levels are replenished again and again. At the end of the day, you can tell yourself with conviction that you can apply and integrate the concepts youíve learned. Pretend the Case is Real The usual practice is to take each clinical vignette like itís a hypothetical scenario. The fact of the matter is the cases you are studying now are the cases that you will encounter in the future. Therefore, it is only right to view each case as if a patient is suffering from the disease. If you come across a question about cardiac ischemia, approach the item like you are profiling a patient. What might be the personís lifestyle and what does the disease tell you about the patientís history? Once the profile is complete, it is easier to understand what occurs in the myocardium because you are dealing with people, not just facts. From this perspective, you are studying to treat patients, not just pass STEP 1. This
simple shift in thinking keeps you engaged because of the awareness that the life of a patient is in your hands.
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Tips to Enhance Focus and Improve Study


Now if youíve been following the suggestions provided in this book, you know very well that you have 1 and a half hour for each study session. With so much information that needs to be digested, the time given seems inadequate. I also had the same impression before but if you immerse yourself to nothing but unadulterated study, 90 minutes is an eternity. Of course, the trick is to keep your study untainted and free from distractions. To do so, you need to follow these four basic instructions. Eliminate Distractions Before you start doing Uworld questions, be sure that your work area is free from clutter. Only the necessary resources should be on top of your desk. No leftover meal from last night, no distracting electronic gadgets, and no other review materials. Block sites that have the potential to capture your attention and keep your phone in silent mode. If you are inside your room, put up a sign that says you cannot be disturbed. For 90 minutes, dedicate your entire being to study. Extend Your Focus The Buddha once claimed, ďThe mind that perceives the limitation is the limitation.Ē Initially, intense focus is difficult to sustain but just like muscle and cardiovascular endurance, all can be improved with consistent practice. At first, you will feel your efficiency to process information drop after 50 minutes. Research claims itís normal to feel restless after an hour of studying; however, you can build mental fortitude by staying vigilant. Muster your mental energy when you feel like you are losing focus and go back to reading that Uworld explanation. The key is to direct your attention consciously whenever your mind begins to wander. For 90 minutes, fight for your concentration. With enough practice, your mind would be drifting less and less. Focus on One Task Itís extremely difficult to get into a flow if during your dedicated study time, the mind is invaded by worrisome thoughts such as next monthís rent. Once you clock in, nothing else matters but your study. Concentrate on the task at hand because you will always have the time to deal with the mundane but necessary aspects of living. Answer Uworld questions and use the explanations to make sense of the concepts provided in First Aid. For one and a half hour, this is the most important thing in your life. Everything else should fade into the background.
Stay Present There are days when you will feel agitated or exhausted even before you start. It happens to the best of us. However, the best do not allow their feelings to interfere with their goals. Many take the time to take a step back and give themselves the room to breathe. If today you are feeling a little down, give yourself a few minutes to reclaim your mind. Meditate and focus on the air that you inhale and the air that you exhale for 10 to 20 minutes. The simple practice refreshes your body and more importantly, it takes your mind away from the origins of your worries by rooting your attention to the here and now. Once you achieve presence through meditation, continue the practice by devoting all of your attention to the task which is studying. In this state of being, the mind is clear and you are in a better position to learn, analyze, and synthesize information.

Make Study Fun and Keep Your Mind Engaged

While study is a mentally draining task, it doesnít have to be dull to the point that digesting information becomes unpalatable. Unlike in universities where lectures and activities are structured to follow policies, your preparations for STEP 1 are unhindered by bureaucracy. You donít to stay in one place all the time and you donít have to follow any schedule other than your own. This leaves you with a lot of creativity to play around with your study so if you want your review sessions to be stimulating, here are ideas you can consider.

Change Scenery


Thereís nothing wrong with holding your study sessions inside your room but if you are going to prepare for the USMLE for 60 to 90 days, changing the environment is a surefire way to keep your mind engaged.
Perhaps within a day, you can move from one place to another each time you finish one study run. Coffee shops are perfect spots to stimulate your senses early in the morning. In the afternoon, you can bring your fully charged laptop at the park where the setting sun is in the background. If you still plan to hold one study session at night, you can do so in the patio where the night sky is your companion. Again, novelty arouses the brain which you can use to keep your mind engaged.

Draw Images

One way to ensure that you have fully grasped a concept is to tap your artistic side. When I was studying the anatomy of the brain, it always helped if I drew a certain part like the brainstem. I also found that using different colors to identify specific parts facilitated learning. According to the study conducted by Schmeck and others, engaging in drawing activities while learning improves performance. So if you are learning about the Krebís cycle for the first time, do yourself a favor by illustrating the entire process.

Create a Presentation

Answering questions and understanding the provided explanations will definitely help you retain information. However if you are still unable to connect details after a couple of attempts, perhaps putting yourself on the spot might do the trick. Gather willing friends and family members and ask them to stand as your audience. If there are none, pets and toys also make wonderful listeners.
Use this opportunity to create a PowerPoint presentation complete with relevant texts and images as if you are giving an academic lecture. The goal of the activity is for you to understand concepts to the point that you can convey them elegantly to your listeners. The presentation can be time consuming but if it enables you to fully understand a disease or a theory, I would say you have invested your time well.
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Improving Oneself


*** Carl Jung, a prominent figure in psychology said, ďWho looks outside, dreams; who looks inside, awakes.Ē In the previous chapters, this book has provided practical tips on how you can effectively prepare for the USMLE. In this chapter, I am encouraging you to also take time to improve yourself from within. A tree is only as strong as it roots and if you are getting ready to dance with such an intimidating partner like STEP 1, you need to be stable, perfectly grounded.
Though for 2-3 months most of your time will be dedicated to study, I cannot stress the importance of spending time to take care of yourself. More often than not, students neglect their emotional and spiritual needs during the preparation period because they are so deeply immersed with studying. However, keeping your eyes fixated on the prize alone is never healthy.
This chapter encourages you to look within by helping you elevate your self-confidence, improve discipline, and develop perseverance. You will also learn what to do when motivation cannot be found, how to meditate, how handle information overload, and why you should rejoice at the achievement of the smallest victories. Also after reading this chapter, you will be able to identify signs of burnout so you can prevent it before it rears its ugly head.
Move in the Direction of your Dreams with Confidence
Through my personal reflections, I realized that tasks which we view as difficult are difficult not because of the set of actions that needs to be done in order to complete the job. They are grueling and challenging because we have to step out of our comfort zone, eliminate convenient habits, and develop new habits that will make us successful.
From an objective point of view, preparing for the USMLE is not very tricky. You only need to dedicate a certain amount of time and employ the right strategy to successfully achieve the target score. However if you are the one studying for the exam, you know how difficult it is to stay focused, completely ignore distractions, and be disciplined throughout the experience. This is where self-confidence comes in; you need to have faith in yourself to able to withstand the pain and demands of growth.


Why Quiet Confidence is Necessary

Even if you have the time and the correct strategy to ace STEP 1, the journey will be met with frustration after frustration if you lack confidence. If you doubt your ability to stay focused, chances are you will always find a way or a reason to be distracted. If you are uncertain of your ability to integrate and apply information, you will freeze under tremendous pressure. Needless to say, what you think about yourself becomes real.
However if thereís no doubt in your mind, then good things are bound to happen. First, you are resilient and external events do not crush your spirit. For example, less than confident students may lose heart and become intimidated after discovering in Uworld or NBME that they have numerous areas of weakness. Those who have complete faith in themselves will be more than happy to see the list of weaknesses because the information can be used to develop their strategy.
Second, confident people are happy people. When they are faced with a demanding task, they see it as a challenge rather than a threat. This simple shift in mindset allows confident people to perform at their best. Unfortunately, the same cannot be said to people who second-guess themselves. When they encounter a difficult task, they see it as something dangerous to their well-being. They then become defensive, withdrawn, and inefficient. They would rather make excuses than find solutions.
Lastly, people who display confidence are less vulnerable to burnout because they handle stress well. If they feel like the situation is becoming too much to handle, they use positive coping strategies like exercise or meditation. They do not lock themselves inside a room to shun the rest of the world. Also, they do not turn to quick-fix solutions like substance abuse to escape their issues. Deep inside, they know that they are capable of dealing with any problem and this awareness shields them from forming destructive habits. If you are preparing for STEP 1, drinking yourself to sleep because you cannot handle the pressure and anxiety is a definite no-no.
Things You Can Do Now to Build Confidence Knowing the importance of confidence and actually having confidence are two separate sides of the coin. Itís great to be aware of the benefits of fully trusting yourself but if you are one those people whose first instinct is to second-guess or over think, you need pointers on how to be self-assured. You can start by taking action, allowing room for mistakes, and by seeing a task as a challenge. 1. Do It - I read an article before that talked about courage. The author said that you get courage after youíve done the task that you are afraid of, not the other way around. Confidence works the same way. You only develop confidence after you tackle the task head on. If the thought of taking STEP 1 turns your stomach
upside down, then use resources like the NBME and Uworld more often to build confidence. Doing questions from the safety and comfort of your own home will give you enough room to build confidence. 2. Accept the Possibility of Making Mistakes Ė Some students feel anxiety creeping inside their system when they forget the answers to several questions during their review. Sometimes, the pressure to hit the target score can be overwhelming that students think they cannot afford to commit errors. Ironically, if you are aiming for perfection, then you are setting yourself up for failure. As you review, be gracious when you are making mistakes. Remember, many who took STEP 1 felt like they did not do well but still, they made it. So as you move on with your preparations, always remind yourself that slip-ups are okay. 3. See the Task as a Challenge Ė Nothing builds your confidence faster and better than a slight shift in perspective. According to the Biophysical Model of Challenge and Threat, if a task is viewed as challenging, blood pressure remains the same and the individualís performance is most likely to be proficient. On the other hand when the task is perceived as a threat, blood pressure spikes and performance declines. If you get a little bit shaky at the thought of the USMLE, perhaps it is because you see it as something dangerous. If thatís the case, look at it as an opportunity to prove your brilliance and capabilities. Just this tiny change in your thought process is enough to alter your state of mind from negative to positive.
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Strengthen Your Willpower and Accomplish Your Goals

If you are about to take the USMLE in a few months, that must mean you are smart enough to finish college and enter medical school. However if you are relying on your intelligence alone to get you over the hump known as STEP 1, you might want to rethink your strategy.
Duckworth and Seligman recently wrote an article about self-discipline and IQ in the Journal of Psychological Science. According to the authors, self-discipline is a better predictor of academic success than IQ. Even if you have superior intelligence, your brain can only process information it knows. Hence, you still need to punch the clock and get your hands dirty if you want to pass STEP 1.
Cultivating your willpower is no easy feat. If you have very little discipline before, you wonít wake up one day and magically possess willpower comparable to spiritual sages, business tycoons, and elite athletes. Like muscle, self-discipline is something you can improve with practice. Below are tips to harness your willpower so you can develop it as you prepare for STEP 1.

Eliminate Sources of Temptation

If your body is out of shape and one day you decide to hit the gym, you canít expect your pectoral muscles to perform like seasoned body builders or youíll risk injury. The same is true for developing self-discipline; it will be extremely tough for you to consistently ignore ringing mobile phones or say no to video games in the beginning. If you leave yourself vulnerable to distraction, chances are youíll give in sooner than later.
You can start cultivating your self-discipline by removing any form of temptation. Make sure that video games and your mobile phone are out of sight before you start doing UWorld questions. Eliminating sources of temptation is a must for those who are aware that discipline is not one of their strongest traits.

Think Long-Term


Another way you can develop self-discipline is by sacrificing the rewards of the now for the greater rewards in the future. If you invest your time checking for social media updates instead of making sense of the information in First Aid, then the feeling of being updated is the best you will get. Think like a long-term investor who waits more than five years before locking-in massive gains. If you sacrifice the pleasures that you can have today for a greater purpose, then youíll develop self-discipline and achieve a sweeter reward in the future.

Practice on Small Tasks


Probably the most effective way to develop self-discipline is by flexing your willpower muscles on mundane tasks. If your study schedule starts at 7:00 am, then wake up at around 6:00 am so you can eat breakfast, meditate, and take a quick shower before doing questions. If you intend to run for 2 km and walk for 1 km as your daily exercise, then stick to the plan. If you need to study for 90 minutes without distraction, then focus on your study and muster all your willpower to ignore your internet-ready devices. By following through even with your smallest intentions, you are giving your willpower its much needed exercise to develop.
Remembering Your Purpose When You Want to Quit
Dale Carnegie said, ďMost of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all.Ē During your 60 Ė 90 days of preparation when you do the same thing over and over again, there will come a time that you will hit the wall. When that happens, the thought of abandoning your purpose will enter your mind. Iíve been through the same situation, more than once. The only thing that kept me going was the pain of letting go of my purpose.

The Only Reward of Quitting


Whenever you feel like you want to call it quits, you have to understand that the ultimate prize of quitting is relief, nothing else. You will feel elated because a huge burden that is the USMLE has been lifted off of your shoulders. The world would be more vibrant and the pressure that once lurked inside your system would be banished. For a few days, you will feel like you are the happiest person on the planet.
However, the euphoria will begin to subside once regret starts creeping in. Of course, your family and friends who supported you will understand your decision but a part of you will feel that youíve let them down. The worst will come once you realize that you have given up your shot at greatness, your shot at making a significant difference. You could be saving lives and bringing hope to those in despair but instead, you chose the easy way out. Think about this scenario before making a life-changing decision.

Recollect Your Reasons


When you want to close up shop, go back to the very reason why you began this journey. Why do you want to be physician? Are doing for the prestige, money, or power? Or are you doing it because you have a grand purpose, one that is between you and yourself alone? Are you ready to desert your purpose because you think youíve had enough?
Only you can answer these questions. Itís easy to tell you to move forward, to hang on, or to grind it out more. However at the end of the day, you alone could only determine your lifeís course. This book is here to tell you that at some point, the thought of quitting has entered the mind of students preparing for STEP 1. Hitting the wall is just a phase which you could deal with by packing up for a weekend retreat.
You could be in despair because even if you tried your best, you just canít seem to turn the corner. If thatís the case, take a step back and remember your purpose. Once you do, ask yourself these questions, ďAre you the type of person who quits when the going gets tough, or are you the type who keeps trying even when there seems to be no hope at all?Ē

What to Do When You Lose Motivation


Perhaps days or weeks before the thought of quitting intruded your mind, the enthusiasm that once reined your state of being was nowhere to be found. You woke up every morning dragging your feet to the kitchen only to bombard your brain with caffeine so you can have the energy to get started. When you do questions, you find your mind drifting off to places youíd rather be in. Although you can finish the dayís task, you go to bed dreading that you have to do the same thing all over again the next day.
If any part of the previous paragraph somehow resonates to you, then itís safe to assume that you lost the fire within. There are many reasons why your motivation has
disappeared but the most common for students preparing for the USMLE is exhaustion. Sometimes, self-studying for 8 hours every day for 8-12 weeks can drain a person mentally, physically and emotionally. Aside from the daily demands of study, students also have to deal with the pressure of hitting their target score. Thereís no shame in running on an empty fuel tank. What you need to do is to follow certain techniques that will keep the fire burning.
Use Visualization Techniques
Before you start your day, find a quiet place where you can be alone and free from any distraction. Make yourself comfortable and sit up straight. Close your eyes and envision yourself successfully completing your mission.
How does it feel to finally earn the right to be called ďDoctorĒ? How does it feel to command the respect of your friends, family and peers? If this newly-licensed physician was to go back in time, what would it say to the past version of you?
Iíve used this powerful technique every time I felt lost and Iím happy to say that the future version of me has always been a great source of inspiration. Sometimes, the best help that you can get is from yourself.

Be Part of a Pride


Lions are dangerous predators not because of their strength, speed, or ferocity. They are one of the most feared animals on the planet because when you notice one stalking you, rest assured there are others waiting for you to make a mistake.
Thereís nothing wrong if you want to travel on your own but if you desire to light up your motivation, then itís time for you to walk with the right people. Find others who will stop at nothing to achieve the same goals that you have and once you do, something magical happens.
The coming together of like-minded people produces massive amounts of positive energy. When you are feeling down, your support system is there, ready to pick you up. When you fail to see something, your group will give constructive criticism. So stop studying on your
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Make Changes in Your Environment


You may not be aware of it but your environment can subtly affect your state of mind. Sure, you have the willpower to ignore external factors like clutter or temperature. However, why waste precious energy working against your environment when you can alter your surrounding so that it works for you?
Scan your workplace and look for factors that can hamper your productivity. Is your workstation filled with pizza boxes, mugs, plastics, and paper? Do you have sufficient lighting? Does your room smell unpleasant? Itís difficult to study when unconsciously, your system rejects the immediate environment. Changing your environment can impact your motivation levels. Take time to clean your room and eliminate any unpleasant odors. Open the curtains and allow light to come in. Print out quotes that will keep you motivated and post them around your room. Make sure your desk is always free from clutter. Inspiration and motivation come easier when your environment is set up for productivity.
Meditation: A Healthy Workout for the Brain
It is widely accepted that the brain is something that you can consciously alter. Neuroplasticity is the concept that refers to the brainís ability to create neural connections based on changes of the personís environment, behavior, or thinking process. This means that at any time of your life, you can rewire your brain to serve your purpose.
Meditation is one of the best ways to change the neural connections in your brain. For students, the benefits of daily meditation are tremendous. Meditation training facilitates learning by enabling you to better control alpha rhythms. It also helps both hemispheres of the brain work harmoniously, and it stimulates brain areas associated with learning.
Meditation Enhances Focus
Throughout the day, your brain goes through various measurable states such as beta, theta, delta, and alpha. Among these different waves, alpha rhythms are known to enhance learning and recall. Based on the study published in the Brain Research Bulletin, meditation helps individuals control alpha waves. As a result, people who regularly meditate are more focused and are more capable of ignoring distractions.
Meditation Helps in Brainwave Synchronization
In the past, numerous studies have revealed that successful people had elevated degree of whole brain synchronization. In other words, the left and right hemispheres of their brains work harmoniously together.
If you are having trouble finding success in your studies lately, perhaps meditation training can help you get back in the zone. Itís been scientifically proven that daily mediation helps a person achieve brainwave synchronization. So review your schedule and find a perfect time when you can be on your own to meditate.
Meditation Stimulates Certain Areas of the Brain
One last reason why you should meditate every day even after you pass STEP 1 is that it fires up parts of the brain associated with storage (hippocampus) and retrieval of information (frontal lobe). Whenever you meditate, neurons in these areas are stimulated which improves your ability to consolidate and recall information. For 20 Ė 30 minutes a day, you give your brain the workout it needs to effectively organize and store huge sums of information which is perfect for your STEP 1 preparations.
Celebrate Your Wins
During your few months of preparation, expect there would be days when youíll feel less enthusiastic. The brain does not find repetition very attractive and thatís why itís imperative you create an illusion that will keep your brain stimulated. One way to do that is by celebrating your wins, those little but measureable progress you make.
When you consciously notice your victories, you effectively withdraw your mind from the difficulty of your UMSLE journey. By focusing on what you were able to accomplish for the day, you keep your spirits up, you are motivated to try again the next day, and you build your confidence.
You are Flooded with Positivity
At the end of the day, reflecting on the tasks youíve completed can only make you feel elated. For example, you were able to answer 50 Uworld questions and you did your best to read and make sense of the explanations for the day. This is a cause for celebration because today you faithfully completed your duties.
You could have been slacking off, checking your social media account, or playing your favorite video games but you didnít. Instead, you buckled down and went to work. If you think of your victories in this manner, you canít help but smile and feel good about yourself.
You are Motivated to Move Forward
If you always look at whatís ahead, the only emotion that you will feel is dread. The USMLE is a long and arduous road that begins with STEP 1, STEP 2 CS and CK, and finally STEP 3. Itís tough to keep your zest for study burning if your eyes are never on the present moment.
The alternative, however, offers something better. If you appreciate what you did for the day, you are telling yourself that you are making measurable progress. You are giving
yourself the permission to soak up the happiness that you truly deserve. As a result, youíll be energized to do the same thing again tomorrow.
You Walk With Confidence
How would you feel if so many people admired you because you are on way to becoming a responsible doctor? How it make you feel if strangers on the street congratulated you because of your relentless dedication? Itís impossible not to feel confident.
People who are truly confident do not need the approval of others; they only need the approval of themselves. So instead of waiting for others to give you the thumbs up, go ahead and sing praises to yourself. Raise your fist vigorously whenever you completely grasp a difficult concept or principle as if you just scored a game-winning basket. Whenever you finish doing questions for the day, go out and give your roommate or your sibling a heartfelt high five. Treat yourself to a sumptuous dinner after you accomplished your tasks for the week. If you continue to give yourself approval, eventually your confidence level will skyrocket.
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Resist Procrastination and Watch Your Production Soar



Have you ever given in to procrastination? If you never had, then you have my admiration. For those who have delayed work in favor of momentary pleasures, let me tell you that you are not alone. Millions of students procrastinate everyday because they can still afford it. However for someone preparing for the USMLE, habitually putting of work for later may come at the expense of your career.
Studies have revealed that people who are masters at delaying gratification experience more success than those who are in the habit of giving in to procrastination. Fight this unproductive habit by preparing yourself mentally, dividing large tasks, and taking action.
Prepare Your Mind
If you are a sports fan, you will notice that players make a lot of preparations before the game begins. Prior to the game, all players follow their pre-game rituals and do stretching exercises plus warm up drills. They prepare their mind and body to get into a state where they are ready to compete.
When you have a huge task ahead of you, it wonít help if you start the day surfing the internet or playing video games. If you do, you will be distracted and it will be extremely difficult for you quit playing and start working. Instead, get into the habit of warming up your mind as soon as you wake up. Say no to distractions and meditate to clear your
head. If you want, you can also follow pre-game rituals like pumping your chest or saying a little prayer. If you do these little practices, you are consciously sending your brain the message to get ready to work.
Break Down Tasks into Bite-size Chunks
Primarily, students tend to procrastinate because the task at hand seems overwhelming. If you think about it, doing more than 100 Uworld questions for the day is not appealing. The idea of having to answer complicated medical questions and the fact that you have to read detailed explanations are daunting. Thinking about the uphill climb can make anyone hesitant to take the first step.
The perfect solution to this problem is to divide tasks into small and manageable chunks. For example, instead of planning how to conquer 100 questions today, just think about the 10-15 questions that you need to do for the next hour. The job is small enough for you to get started. Do the same for the next seven hours and at the end of the day, you will be surprised at how much you were able to accomplish.
Act
Superstars know that sometimes, thinking can be the greatest enemy. If they try to analyze a situation, they risk freezing up or choking when the opportunity presents itself. Instead, they hit the ground running and intuitively react to every development.
After your pre-game preparations, go ahead and start doing questions. You may start slow but if you continue to move forward, you will gather enough momentum to finish the task. Think of an airplane taking off. It needs a lot of land and energy to get those wheels of the ground but once it reaches a certain altitude, the flight enters cruise control. You may need to summon all of your strength to take off but once you do, youíll be a man on a mission.
Handle Information Overload and Keep Your Mind Laser Focused
With the amount of information that you have to absorb in your preparations for STEP 1, you have to be judicious to where you put your attention to. If you try to consume everything thrown at your feet, you might leave yourself susceptible to the negative effects of information overload. According to Shenk, the effects include anxiety, trouble in storing and recalling information, and decreased attention span.
Manage the information that you digest by focusing on hi-yield information, choosing quality over quantity, and never multi-tasking.
Set Your Eyes on Whatís Important
In stock market investing, you increase your chances of making profits by minimizing risks and maximizing rewards. This means, ignoring risky moves like investing on penny stocks and only betting on stocks of fundamentally sound companies known as blue chips.
The same can be applied in your STEP 1 preparations so you donít have to suffer the consequences of information overload. Fix your eyes on hi-yield information only. Read and fully absorb information from a number of select and reliable resources. Spend most of your time, if not all, on must know information. Details that are nice to know can be revisited when times are no longer hectic.
Aim for Quality
In basketball, teams create plays that enable players to take high quality shots. In the process, more time is consumed in creating space and setting screens to make sure a player gets an open shot. If applied throughout the game, aiming for better quality shots drains the opponentsí energy and increases the teamís chances of success.
When preparing for STEP 1, it is recommended that your time be spent on internalizing quality information. Instead of doing as many questions as you can within a day, it is better if you take a lot of time understanding the explanations and connecting the concepts to the information provided in First Aid. You may not progress as fast as you would like but you can be sure that the progress you are making is legit. More importantly, your brain doesnít suffer from information overload.
Focus on a Single-Task
In business, employees are much more satisfied with their job if the duties and responsibilities are clearly defined. They get to focus on their expertise and they know the limits of their job. Their mind has a singular purpose which leads to increased productivity and job satisfaction.
Now if you are doing questions while chatting with a friend, your brain will not get into a state where itís ready to learn. So instead of trying to do two things at once, settle down and focus only on a solitary task. Remove distractions like mobile phones when itís time to study. Condition your mind to follow a singular purpose. If you do, the brain will be able to manage the influx of information without dampening your productivity or leaving you vulnerable to the unsavory effects of information overload. 3 Ways to Prevent Burnout and Keep Moving Forward
Whenever you step out of your comfort zone in an effort to tackle a herculean task such as the USMLE, burnout is a possibility. While stress helps us grow, too much of it for a
certain period of time can lead to physical, mental, and emotional exhaustion. The effects vary but according to Psychology Today, a person may experience impatience, paranoia, depression, psychosomatic illnesses etc.
Although the journey is long and unpredictable, you can protect yourself from burnout by having a ďmeĒ time, relying on your support system, and by practicing self-awareness.
Take Care of Yourself
The USMLE is a three-headed behemoth. If you want to slay a monster of this size, time is your ally. You will need it to device a clear strategy, collect weapons, and gather information. More importantly, you need time to make sure you do not hurt yourself in the process.
Many people are so eager to make the cut that they somehow cut themselves out of the equation. Keep in mind, you are taking the USMLE for yourself and therefore, it is only right that you look after your well-being while you pursue your dreams. In your daily schedule, spend 1-2 hours doing the things that make you feel good. Run, read your favorite book, or cook sumptuous meals under the night sky. Do the things that remind you are a person, not just another examinee, and you will be better protected against mental and emotional exhaustion.
Sit Down With Your Support System
In pre-historic times, humans survived the nastiest environmental challenges by sticking together. During the day, they worked as a team to bring down prey more than 10 times their body weight. At night, they sat down together around a bonfire to tell their stories of success and sometimes, tragedies.
We are social creatures and during times of distress, we rely on other people to lift our spirits. If you are beginning to feel the weight of the USMLE, set a get-together with your inner circle and blow off steam. Share stories, laugh, and have a blast. Doing this regularly takes the edge off which makes you more resilient to long-term stress.
Know Thyself
Thereís nothing esoteric about being alone and assessing your lifeís direction. When the demands of daily living becomes too much to handle, the person reacts to the situation instead of dictating outcomes. In other words, the person becomes powerless and life assumes control.
In your preparations for the USMLE, you have to ask if you are still the one in the driverís seat. Does your study overwhelm you to the point that you are confused and
uncertain on what to do next? Considering the available time, can you still reach your target score or are you rushing because of pressure from peers and family? These questions will lead you to discernment of who is in command. If somehow the factors in your life have conspired to overthrow you, thereís always time to regain
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Study Strategies ***


ďAll men can see these tactics whereby I conquer, but what none can see is the strategy out of which victory is evolved.Ē
- Sun Tzu
Millions of years ago, our ancestors roamed the wide African Savannah. Smaller than todayís average human, the pre-historic men walked on two feet cursed with nothing but physical disadvantages against his prey. He had no massive claws or teeth to defend himself against wild animals. Moreover, walking on two feet will not save him from the powerful jaws of quicker predators. From an evolutionary perspective, our ancestors should have been written off, easy.
But they werenít. Instead, they survived and thrived until they gave birth to a species that would dominate the planet and venture beyond our solar system. How could it be possible that a species so physically weak would eventually be the most dangerous of all? Truth is our supremacy began when we started studying our environment. Our ancestors spent hours and hours watching the behaviors of both their prey and predator. They used the information they collected to formulate strategies that would make them efficient hunters. Fast forward to the modern era and the formula is still intact: gather information and create strategies. If youíre preparing for STEP 1, thereís no reason for you to deviate from a tried and tested blueprint.
This bookís mission is to collate the information you need to be successful. I have done that in the previous chapters and you will know more. For this chapter, I will help you with the strategy part. You will understand why doing Qbank questions is the primary strategy to acing STEP 1. You will also learn about other effective study strategies like group study and review classes in addition to taking your courses seriously. At the end of the chapter is a reminder of what you should know about STEP 1.

Question Banks Are Masters


Throughout human history, skills are passed from one generation to another via the student-mentor relationship. The student comes to the master for apprenticeship and service and the master teaches fundamental skills plus trade secrets. Itís a mutually beneficial relationship that allows the student to grow and in time, teach the same to the next generation.
In your journey to become a physician, your first mentor will not come in the form of a well-respected doctor. Instead, the first master that you will encounter is an online
question bank. It will teach you essential knowledge through application and integration as opposed to passive reading and memorization. Furthermore, Qbanks expose your weaknesses, allowing the opportunity for improvement. Last and certainly not the least, Qbanks provide extensive explanations. In essence, the more questions you do, the better!
Qbanks are Avenues for Application
Reading books are great if you want to know information. However if you want to apply that knowledge in the context of taking an exam, you need a better strategy. For STEP 1, knowing is not enough. You need to learn information through application. Qbanks are the perfect platform for that purpose.
Think of it this way. If you are reading a martial arts book, you will definitely know the name of the moves and the theory behind the system. Nevertheless, your book knowledge wonít come in handy in case of an altercation. Naming techniques wonít save you from your attackerís vicious punches.
Now when you do questions, you are gaining knowledge and experience useful in the testing arena. You become familiar with the language used in questions, and you are immersed to the experience of test-taking. Itís as if you are practicing your moves against a sparring partner so when danger is looking at your face, you are ready to defend yourself. Going back to Qbanks, this means the more questions you do, the more ready you are.
Qbanks Bring Weaknesses to Light
Some people find a Qbankís lack of organization as a weakness. I beg to disagree. The chaos that you experience while doing questions should be taken advantage of as it opens up the opportunity for you to identify areas that need work.
When you are focused on reading books, you waste time by re-reading concepts that you are already familiar with. Moreover, theories or principles that you are unfamiliar with are not given sufficient attention. More often than not, you read the page like any other and you move on to the next.
When you do questions, mistakes indicate concepts that you need to learn. With the detailed explanations, your weaknesses are corrected. At the end of the day, the more questions you do, the more you get to uncover and correct your weaknesses.

Qbanks Explain All Choices


Itís no secret that my favorite Qbank is Uworld. It provides the explanation why a particular choice is right and why the others are incorrect. What others donít usually notice is that Uworld explains very well when the incorrect choices would be correct.
The implications of the last statement are huge, especially when test questions are presented through clinical vignettes. First, explanations solidify knowledge on a particular concept by providing critical information on when the concept is applicable. Second, you also learn about other details related to the concept which facilitate integration and depth of information. For these reasons, and I cannot stress this any further, the more questions you do, the better!
Group Study
While doing questions on your own will help you achieve the target score, it is better to break the routine sometimes. Nobody said you have to go through this journey alone, even if you are introvert. When youíve been holed up inside your room for weeks and you are dying to get out, one way to get your breath of fresh air without ruining your schedule is by setting up a group study.
Before you dismiss the idea, participate in one first. You will notice how a small group of people can lift your spirits, reduce procrastination, and provide valuable feedback.

Morale Boost


Staring at your laptop and books for 8 hours every day can take its toll, mentally and emotionally. Humans are social creatures and as much as we deny it, we crave for the company of other people. When studies drain you and thereís not much time for a bit of rest and relaxation, call some colleagues and schedule a study session.
While some might reject your offer, there are those who also feel the sting of reviewing alone. Meet in a public place like a coffee shop where thereís lot of light and air. Break the monotony and enjoy the moment. You can also talk about your struggles for the past weeks. The best part of it is that social facilitation suggests that you will review better in the company of other people.
No Room for Delay
If you tell yourself that you will study first thing in the morning but then you always find yourself lost on the internet, having a small get together might be the wake-up call that you need.
Once you sit down with a group of dedicated students, the sense of urgency is palatable. No one has the luxury of time to regularly check whatís new; everyone gets down to business. The serious atmosphere of the group will make you question your work ethics and perhaps after the meeting, youíll get an idea of the type of work you need to put in to pass the exam.
Chance for Constructive Criticism For me, hearing constructive feedback of other students is the best take-away from participating in group study. Since you are taking the USMLE for the first time, you have no idea if the rate of your progress is ideal or not. Sitting down with other students allows you to discuss matters about your study strategy and schedule. Others would be more than happy to provide their input as well as their progress which you can use as benchmark. At the end of the session, you have gathered sufficient information to know whether you need to make adjustments or not. Participating in a study group is a productive way to review while socializing with your friends and colleagues. Itís beneficial to all those involved as long as business comes first. Take Coursework Seriously Some students would rather study on their own terms rather than sit through a lecture. This strategy is wrong on so many levels. First, the focus of STEP 1 is to test your ability to apply and integrate knowledge that you should have learned during your preclinical years in med school. Second, lectures are your building blocks towards mastery. Remember, the Holy Grail is to become a licensed physician, and not just pass STEP 1 convincingly. Dedicated Study Pays Off If you look at things objectively, you will realize that the USMLE is based on the concepts that were discussed in the first two years of medical school. You may groan at the amount of information being fed in your classes, but this level of detail is necessary. Mastery of information presented in your courses is imperative as it will serve as your background when you prepare for STEP 1. If you study diligently, you are exposed to details that you might have missed because you thought lectures are boring. Consequently, you are in a better position to eliminate wrong choices and come up with the correct one. Coursework is the Foundation Classes in medical school are rigorous because you are exposed to the basic sciences that serve as the stepping stones of your profession. During the first two years, your coursework ensures that no stone is left unturned by providing information down to the very last detail. At first, mastery may seem impossible but if you want to become a qualified physician, you need to employ a strategy that will allow you to absorb huge chunks of information. As I mentioned, the end-game is to become a doctor. Passing the USMLE is just a milestone.
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Originally Posted by sashabeliimd View Post
Maybe a lot of information, but very good explaned , what you need, what to do, and what thing will increase your mood, your power, and long preparation, found this article if can say , but want to be visible for all...
Best wishes for all people who choice to follow this long journey...
Good luck...
Like for the Romanian flag!
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Foods that Boost Brainpower
Every organ in the body needs energy to function and the brain is not an exception. You may not be aware of it but the quality of your study will ultimately affect your score on the test. Performing at the highest level possible begins with the food that you eat while you prepare for the USMLE.
1. Fatty Fish Ė Have you ever studied after eating a hearty meal of Japanese cuisine? I have and it felt like I could absorb material without getting exhausted. Thatís because cold water fishes like salmon and tuna are loaded with omega-3, an essential fatty acid that nourishes the mind. Your cell membranes are virtually made up of fats, including omega-3 and a steady supply of this fatty acid keeps
cell membranes elastic. Furthermore, omega-3 helps improve blood circulation in the brain.
2. Cruciferous Veggies Ė Eating vegetables will not only help keep your body in great shape, it will also boost your brainpower. If you eat salads, make sure it contains cruciferous veggies like broccoli, cauliflower and cabbage. These veggies are rich in antioxidants such as vitamin C and carotenoid, a compound known to protect the brain. With your brain never shutting down, it creates a lot of waste products known as free radicals. These unstable atoms or group of atoms seek stability by destroying other cells. Antioxidants are the perfect weapons against free radicals as they target and destroy these atomic groups, keeping your brain and body healthy.
3. Chocolate Ė Who says you canít have a good time eating healthy foods? Dark chocolate is rich in flavonoids, another antioxidant that can keep your brain in great shape. Moreover, eating chocolate stimulates production of dopamine, a neurotransmitter known to boost retention and learning. So the next time you feel the need to get your sweet fix, ditch sugary candy bars and stick to dark chocolate.
4. Whole Grains Ė When you eat refined carbohydrates like bread, your body experiences an energy rush which is followed by a crash. The energy spike may help in getting your study started but youíll certainly pay for it as you would feel drowsy and lethargic within an hour or so. Do not make the mistake of building your study schedule around this spike and crash cycle by only consuming whole grain foods like oatmeal and brown rice. Whole grain foods keep the blood sugar levels steady and without the crash, you will be able to study longer.
5. Berries - These little fruits are big in antioxidants that protect your brain from free radical damage. Add them to your daily cereal or oatmeal to minimize the effects of age-related damage to your brain. You can also munch on berries while you study instead of wolfing down inordinate amounts of greasy chips.
6. Water Ė Many people would rather drink soda than water to quench their thirst. They erroneously think that the sugar they consume will help keep them up and running for their study. Do not follow the example because keeping yourself hydrated with water can definitely help improve your performance. A study conducted by researchers in Ohio University revealed that people who were sufficiently hydrated performed significantly better on brainpower tests in comparison to those who drank inadequately.
7. Coffee Ė Moderate caffeine consumption can improve reaction time, attention span along with other brain skills. However, overdosing on caffeine can backfire and make it difficult for your brain to process information.
From this list, you can create a daily diet plan with the intention of feeding your brain with the nutrition it needs to perform at its peak. Although some of these foods are quite expensive, look at it from an investment point of view. At this point of your life, you are not only investing on your health but on your career as well.
great advise
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sounds like a very good plan.thanks
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what wonderful advise! thank you!
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