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Old 09-14-2011
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Arrow How I passed Step 1 in 54 days, tips

Hello everyone,

I’d like to share my experience of passing Step 1 in September 2011 at my first attempt, after 54 days of revision. This may not be useful for many of you, as my sole aim was to pass the exam as I have already secured a subspecialty clinical fellowship in ophthalmology in the USA. I did not need a high score.

About me
You may have already read my thread in this forum about passing Step 2 CS after 17 days of revision (How I passed Step 2 CS in 17 days - lesson & tips). For those who haven’t, I am a board certified ophthalmologist in the U.K. I went to medical school in the UK, and graduated 11 years ago. I am of Asian origin and grew up in Asia. I have not done any general medicine or surgery for 10 years - only ophthalmology. I am taking the USMLEs for the reason I have highlighted in the first paragraph.

WHAT USMLE STEPS HAD I TAKEN BEFORE STEP 1?

I took Step 2 CS in June 2011 and passed. I am due to take Step 2 CK shortly.

HOW DID I PREPARE?
I was originally scheduled to take Step 1 just under six weeks following Step 2 CS. This was a very short period of time for the number of subjects that needed to be covered. I used the following RESOURCES:
1. First Aid for Step 1 (2011 edition)
2. USMLE World Qbank (2 months subscription)
3. NBME self-assessment number 5
As I was short for time, I was forced to limit the number of books I used to just 1. I needed to be extremely focused and targeted with my revision. I agree with other forum posts about using more books for a higher score and if you have more time.

THIS WAS MY ACTUAL PREPARATION TIMELINE:
1. Days 1-37:
As it’s been so many years since I did any general basic science work, I decided to revise by organ systems as this generally makes more sense to me as a practising clinician (even though I’m an ophthalmologist and not an internist or general surgeon).

Starting with the cardiovascular system in First Aid, I’d read through a chapter once (1/2 to 1 day), and then did the USMLE World Qbank questions on that system only. It was difficult trying to understand a lot of the First Aid information, as it is heavily summarized and assumes you already have an understanding of the topic from reading of other/larger texts. I took in as much as I could, and the Qbank is extremely helpful in filling in the missing links and with providing detailed explanation (e.g. of biochem pathways, etc etc). I then moved on to the next system. I would spend 3 to 5 days on each system in total. For each system, if there was a Qbank question relating to a basic science topic not covered within the “High Yield Organ Systems” topic, I’d take that opportunity to assimilate the relevant pages within the basic science “High Yield General Principles” in First Aid (e.g. embryology, microbiology, etc).

With regards to the Qbank, I used “tutor” mode only. In total, I did 1750 out of the available 2080-2100 USMLE World Qbank questions. I had the intention to go through all the questions twice, but I didn’t manage to even finish it once.

On average, I spent about 9 hours studying per day (more or less on some days as I was also doing some unrelated lab research at the time)

2. Day 38:
This was 2 days before I was originally scheduled to take Step 1. I did not feel ready, particularly as I still hadn’t revised and done the Qbanks for neurology, reproductive medicine, hematology, psychiatry and dermatology. To be certain, I took the NBME Comprehensive Basic Science Self-Assessment Form number 5. I got a score of 270, which is equivalent to a USMLE Step 1 score of 168, i.e. a fail! I decided to postpone Step 1 by 2 weeks.

3. Days 39-47:
I revised the rest of the topics I hadn’t covered as listed above.

4. Days 48-53:
I read through most of First Aid for the second time – most the Organ Systems chapters, and some of the High Yield General Principles (basic science) chapters.

I would recommend giving yourself at least 2 days more than I had done (I ran out of time) to read through First Aid again – I had to skim through some sections quicker and less thorough than I would’ve liked (e.g microbiology), and did not read some chapters again at all (e.g. embryology, psychiatry)

5. Day 54:
I read through Rapid Review and High Yield Images (in First Aid). This was very useful. This was my first time reading the Rapid Review section, and I wish I had done it once previously.

6. Breaks:
I took 3 full days off completely in those 54 days – days 6, 12 and 32.

EXAM DAY EXPERIENCE:

I took Step 1 in August 2011.

This was undoubtedly the most unprepared I had ever been for an exam. I thought the questions were as tough as, if not tougher than the USMLE World Qbank. I managed to just about finish answering all questions in each of the 7 one hour blocks. However, for 2 or 3 of the blocks, I did not have time to go over any of the questions I had ‘marked’ for my own review. Time was extremely tight, and I wish I had practiced a few timed blocks in USMLE World – the only one I had done was the NBME self assessment (which I failed 2 weeks prior).

This was an absolutely brutal exam, largely because I should’ve been better prepared. There were many questions with which I had absolutely no idea, and just had to guess. After the exam, I was certain I had failed and thus began planning towards to a re-sit.

To my delight and surprise, I passed Step 1 last week!

SUMMARY & CONCLUSION:

Step 1 is an extremely tough exam for those of us who’ve been out of medical school for a few years. However, it’s not rocket science. It simply requires a dedicated amount of time to acquire and retain the sheer volume of knowledge. The syllabus for Step 1 is clear, and there are ample resources. You need to streamline your resources based upon the score you’re aiming for. If your aim is simply to pass, then I am certain the limited resources and plan I used described above will suffice. If however, your plan is to get a high score (as would be the case for most of you), then you need to read around the subject more, add notes to First Aid and revise through that, and do more questions.

I hope everyone who’s about to embark upon Step 1 can glean something useful from my experience. Specifically, regardless of what score you are aiming towards, you can at least be confident of passing with less than 2 months of solid and very focused studying. You can then extrapolate how much extra time you’d need to get a high score.

Good luck!

Last edited by Redreflex; 09-14-2011 at 11:09 AM.
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  #2  
Old 09-14-2011
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What is your score?
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  #3  
Old 09-14-2011
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this is the only post about step 1 taking experience that I have read completely and never puked.

Very promising!

Thank you man!

Good luck with your fellowship!
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Old 09-14-2011
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Best of luck for all the rest
You really have done well
And have guts too
Really good post


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Old 09-15-2011
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DocSikorski and drmirzanaveed

Thank you. The key for me was limiting the number of resources. Good luck to you.
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  #6  
Old 09-16-2011
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Nice and really encouraging post but it would be especially great after explaining it all to say your score or a range
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Old 09-16-2011
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Very inspiring. Just a quick question, why didn't you gave a second NBME before appearing for exam? Were you confident that you'll pass it??
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Old 09-17-2011
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Thanks for the kind comments.

I scored 194/79. Pass mark is 188/75

whocares13 - that's a good question about taking NBME again. When I took it the first time, I failed by about 5-10% after about 5 weeks of work. Thereafter I did an additional 2 weeks of work. I figured I had probably done enough in the extra 2 weeks to be able to get an increase in my score by that margin. Of course I wasn't sure. But on balance, it was more important for me to spend one productive day revising, than taking another NBME which would've probably told me borderline pass/fail, which wouldn't have helped me decide anyway. Plus if I had delayed my exam further, I would've had to take an enforced 10 day revision break immediately (other work-related reasons), i.e. I would've lost some of that short-term memory knowledge and I would've have to re-acquire that - not efficient. I also have my step 2 CK next week, and I'm on a very tight time schedule!!!

So on balance, I thought I had probably done enough and could risk taking the exam, bearing in mind I was only aiming for a pass. I needed every day of revision I could get, thus didn't take NBME again. It was a judgment call.
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  #9  
Old 10-25-2011
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wow... very inspiring... and i'm also soooo jealous of you!!! i'd love to be an ophthalmologist!!!!! but i have to be realistic, since i know noone, i should also apply to other less competitive residencies
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  #10  
Old 10-25-2011
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Quote:
Originally Posted by Chococat View Post
wow... very inspiring... and i'm also soooo jealous of you!!! i'd love to be an ophthalmologist!!!!! but i have to be realistic, since i know noone, i should also apply to other less competitive residencies
Thank you, very kind of you. All the best with your residency application! You may well be pleasantly surprised!
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  #11  
Old 11-25-2014
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Inspiring. Thank you!
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Old 11-11-2016
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Default Similar situation and experience - Practicing MD, just needed to pass

Hi! Thank you for your post. Even if it is a few years old, it is still very relevant and it helped me in my preparation as well. I'm a practicing Canadian anesthesiologist with a fellowship already lined up in the US who also "just needed to pass". I just wrote USMLE Step 1 and found out I passed this week.

I just wrote about my own experience in a separate thread - unfortunately usmle-forum won't let me post a link to it! The title is "Default Canadian practicing MD writing USMLE Step 1" if anyone is interested.

I should have just written it as a response to your thread, since we wrote the exam under very similar circumstances. I'm set to write Step 2 CK next week - thank you for your feedback on that experience as well!
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Old 11-11-2016
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Default Similar situation and experience - Practicing MD, just needed to pass

Not sure why the word "Default" came up when I cut and paste the title of my post. I just noticed it after I posted it! The actual title is just "Similar situation and experience - Practicing MD, just needed to pass". Sorry!
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  #14  
Old 11-13-2016
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Nailed it!
Congratulations!
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