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  #1  
Old 11-17-2011
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Arrow 269 IMG experience

I'd like to share my experience, as it may be of help for others, whether IMG or not.
I took a long time to prepare, thatís because I have a job and a family, so not much time to study. All in all, it was almost 18 months.
I believe the more hours in a day you study the better, but also that is not linear, i.e. that you learn more by studying two days 1.5 hours than 3 hours in one day. Following this philosophy I studied every single day, even if it was only 1.5 hours, make it count, concentrate.
I read Kaplan manuals and feel they are pretty good. I have an old edition, but I don't think it's critical to have the latest. It is not a lot that changes.
I read them cover to cover, and read them like I really mean it, not trying to fly over it. On the first read, I recommend going carefully over everything. For some topics this may be the one and only time to read it, so at least have it read carefully.
Microbiology, Immunology, physiology, Genetics, even behavioral, all I felt very well explained in kaplan manuals.
Some topics are a matter on understanding them, those I would recommend especial care in the first read, such as physio, behavioral, genetics. Once you understood what positive predictive value is, that's it, even if you never read it again, you have it (same applies to hardy weinberg, acid/base disturbances, etc)
Other things you may read it 10 times and forget it 10 times, such as what age children reach a certain milestone, which things derive from neural crest, etc. These you can read quickly, because you will read them again.
In fact I would do a list of easily forgettable things that need to be re-read last day, including tumor markers, tumor genes, auto-antibodies, etc.
The only thing I did not read from kaplan was pathology because I saw people recommending goljan so much. This was a mistake, Goljan's book (rapid review path) is poorly written, which makes learning difficult (picture yourself trying to learn the phone book, something like that).
This is not to say that listening to Goljan is no good. Of course there are mistakes, and I know not everybody likes his style, but actually the audio is good, for the time it takes to listen to it.
Ok, after finishing that first read, I would recommend doing an NBME practice exam. No other practice exam is as good as an NBME. It gives you a good estimation of how you're doing and also tells you which subjects you need to go over again.
I read first aid, cover to cover once. Hopefully this should feel like a deja vu experience, if you are reading first aid and feel as if you were reading new material, I would go back to kaplan manuals, especially in big topics.
Here is where I took my vacation days from work, and started studying 10 hours per day (not counting breaks). I planned this final stretch 3-4 weeks before my test date so I could cram and then take it before I forget.
Continue to do NBMEs. I thought initially that if they already asked something they wouldn't ask it again, wrong! They ask over and over the same topics, sometimes even the exact same question. I made a point of reading again about the ones I missed, or that I got right but only by elimination or by chance, especially those that are board's favorites. For example COPD pathophysiology, I would say they put a question per block, it may be a long chapter in the book, but it's worth it.
Because of time costraints, I did not re-read any material cover to cover (I know some people reads first aid like 7 times! I don't know that I would have done that even if I had had the time). Do not try to read every book you can get your hands on. Better read twice from the same manual than from two different manuals, you will remember more. Also Kaplan + FA is pretty much enough, almost anything I missed was because I read it in Kaplan or FA and then forgot, not because it wasn't there.
So next go over Kaplan manuals, reading only three specific things: 1) whatever was highlighted on the first read (I highlight very little BTW), 2) ALL of the clinical correlates (high yield stuff), and 3) most of the chapter summaries (some manuals have crappy summaries, but most).
What to focus on: mechanisms and clinical correlates. Knowing a disease's presentation, diagnosis, prognosis, treatment and epidemiology will not get you far if you don't know the mechanism. Basic stuff such as embryology, anatomy, biochemistry... focus on clinical parts. There may be 20 very interesting chapters in immuno about recombination and such, but you really really have to know the immunodeficiencies by heart.
More NBME practice: notice there are many 'small' diseases. I recommend creating your own list of these diseases, one line for each disease, it's a long list, but there are may be three or four words you really need to remember for each. After all, how much do you think they'll ask about wiskott aldrich, hippel lindau, or lesch nyhan?
Another thing I noticed in NBME: some of the hard questions are from Robbins. I remember one question about something I never heard before in my life, but when I looked it up in Robbins it was mentioned in four different chapters!
I feel it is worth it to read Robbins for big diseases that are very likely they'll ask, such as myocardial infarction or vasculitis. Not so for the small diseases, those read from first aid.
Question bank: I did USMLE world. I did not finish it because of time, did about 60%. I feel it is a very good preparation (harder than the real thing, which is good actually). I read the explanation for the ones I missed. It is important to practice timing, a question per minute is ideal.
Last preparations: make sure you have your Id, permit, granola bars, prometric address loaded in gps, gas in the tank.
Last day read: the easily forgettables, the list of small diseases, the last pages from first aid.
Exam!
Plan to get there with plenty of time, just in case. Take plenty of snack foods and caffeinated beverages.
Time management: I had plan one thing and did something else. I came out every time, ate, drank and peed in almost every break, but quickly. Better to take 5 min breaks early and 10-15 min in the last one if you have them. Don't eat too much at once.
I noticed the first two blocks I had left over time to go over every question again, the next couple of blocks only time to go over the marked ones, the last two blocks I barely made it on time to answer the last question.
You have to pay attention to every word in the stem, many times the give-away clue is right in front of you but they are experts at disguising the give-away clue, so you may miss it. However, you need to read quickly, so that is the difficulty I guess.
In the long-stem questions I glance at the answers or even the last line of the stem, so I know what I'm looking for. It is really frustrating when after ten lines of signs, symptoms, labs, they tell you ... the diagnosis is such, which is the most likely complication...I would say develop your own method for reading questions quickly, but do not improvise on exam day.
Be prepared to have lots of questions about newborns and infants. Embryology (malformations), immunology (immunodeficiencies), and biochemistry (inborn errors of metabolism) are evaluated this way.
Other topics they attack from many angles... alcoholic patient blah blah... question may be Biochem, Path, Behavioral.
As for subject distribution I'd say similar to NBMEs of course (nothing beats NBMEs) but also similar to usmle world (very few histo, few anatomy, lots of path and pharm) except for the behavioral/statistic book, which I felt there were many more relative to usmleworld q bank.
Question with pictures: I would say look first at the pic (quickly), even before reading anything, if you know what it is you can go very fast through the stem, but if you don't know at first glance, then don't waste your time looking at the picture, read the stem and (many times) the picture may be irrelevant, you may be able to answer without the picture. Where to look for pictures to practice for the test? Google images, just google it, usually very good. Another tip for images, the stain may tell you more than the image. Why would they show a silver stain of a bronchoalveolar lavage, other than Pneumocystis? So that has to be it, no matter if they look like hats or whatnot, I will choose pneumocystis. If they show a slide of brain with the brownish looking stain, I may not see tangles, but Iíll say itís alzheimerís, and so on.
Question with sound: I am really bad at this, and felt I did not have the time to learn more, and that I needed all the time I had for higher yield stuff. Fortunately I had only two, and one you could get by carefully reading the stem.
Step two-ish questions: some questions look like simplified versions of step 2 questions (great for those who took step 2 first). For example some ob/gyn scenario, what is the most likely diagnosis? The one thing I want to say about these is that the option that sounds right is right. That of course is many times not the case with the rest of the questions (thereís always one that looks correct at first sight, but after some thought, it is not) but seems to be the case for step two-ish questions.
Questions with buzzwords: Goljan says the boards will not use buzzwords. I say that may be true compared to years back, may be it was all buzzwords at one time. But there are buzzwords still, i.e. the only thing in this universe that Ďrumblesí is mitral stenosis, and I actually donít know what a Ďlancetí looks like, but as far as Iím concerned lancet means Ďpneumococcus-shapedí. So pay attention to buzzwords when preparing.
Other than that is what I said above: mechanisms and clinical correlates. For example for those of us that have been away from medical school for a few years, we have to learn about new drugs that came out in the last few years, but only if they have a distinct mechanism of action.
Score and correlation: again nothing beats NBME. Predictions were 266, 271, and 268, actual score 269. Overall (including offline forms) I got about 96% correct answers in NBME and 89% corrects in usmleworld.
My last piece of advice is to trust your instincts: 1) when you read the stem concentrate on what you think the answer should be, if that is in the options, thatís it. Even if you read the other options and there is another one that looks right, go with your first guess. 2) Many times if you are between two, you can get it right by trusting your gut. This is not luck, it is that you know more than you think you know. Somehow your knowledge makes the right option feel better.
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  #2  
Old 11-17-2011
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Default Congratulations

you sure have lots of patience studying for 18 months
When did u gave the exam and tell me little more of last month preparation my exam is in about a month
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  #3  
Old 11-17-2011
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Default Congrats

wow thats really an awesome score! im really happy for you. thank you for sharing such a detailed experience. i found it quite helpful.

I totally agree with you about Goljan RR Book. I mean i've gone nuts over it for the past more than a month! His audio is really good but the book is just so puzzling! He says some of the stuff is for step 2 and blabla. i wish he had made the syllabus more clear. so i have been skipping some stuff that was not discussed in the audio lecture. now i dont know if the stuff i skipped is important or not. PS .. all those tables??? do people actually memorize them?? Could you guide me on how to use the book?? Thanks in advance .. and congrats onmce again
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  #4  
Old 11-18-2011
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Congratulations!!!

Thanks Patient doctor for your very helpful post.... Best of luck with the rest of the steps...!

Thanks for the tips...

Very inspiring by the way since you are working....
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  #5  
Old 11-18-2011
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congrats and thanks 4 sharing ur experience
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Old 11-18-2011
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Thanks alot for that detailed explanation, avtually I'm IMG and been studying for a year now, because I have to work 4 days a week in an emergency room as a technician, so i get distracted alot, but that's not the case, i study 10 hours of=n my days off, and i started Goljan book and audios about a month ago, and I barely finished half of it right now, the book is really good if you look for the real explanations for most diseases.but it's super big book, I'm kinda confused now if I should continue or should i switch to kaplan!!
If you have any advise here it would be so appreciated.
thanks you all
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  #7  
Old 11-18-2011
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congrats, its an amazing score!!! and thanks for the very detailed preperation description
may i ask what was ur two-digit score?
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  #8  
Old 11-18-2011
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Quote:
Originally Posted by drmirzanaveed View Post
you sure have lots of patience studying for 18 months
When did u gave the exam and tell me little more of last month preparation my exam is in about a month
Thank you. I took it about a month ago. I just got my score this last wed.
My preparation for the last month you can read in the first post starting from when I begun studying 10 hours/day. I would say go over the areas that you are weak in NBME, practice questions (timed!), perhaps re-read first aid quickly (4-5 days).
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  #9  
Old 11-18-2011
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Quote:
Originally Posted by numbndumb View Post
wow thats really an awesome score! im really happy for you. thank you for sharing such a detailed experience. i found it quite helpful.

I totally agree with you about Goljan RR Book. I mean i've gone nuts over it for the past more than a month! His audio is really good but the book is just so puzzling! He says some of the stuff is for step 2 and blabla. i wish he had made the syllabus more clear. so i have been skipping some stuff that was not discussed in the audio lecture. now i dont know if the stuff i skipped is important or not. PS .. all those tables??? do people actually memorize them?? Could you guide me on how to use the book?? Thanks in advance .. and congrats onmce again
Thanks. Honestly I don't know what advice to give you about Goljan's book. I suffered through it, but afterwards I felt that I did not remember much and I don't think it was time well invested. As for how to best use it... if you have a specific doubt, open it, check it, close it. Images are always useful (they are online too if you have the access code in the book). Other than that I don't know. Good luck
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Old 11-18-2011
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Quote:
Originally Posted by ElizabethNYC View Post
Congratulations!!!

Thanks Patient doctor for your very helpful post.... Best of luck with the rest of the steps...!

Thanks for the tips...

Very inspiring by the way since you are working....
Thank you.
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  #11  
Old 11-18-2011
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Quote:
Originally Posted by rideurlife View Post
congrats and thanks 4 sharing ur experience
Thank you very much
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  #12  
Old 11-18-2011
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Quote:
Originally Posted by husseinalaa View Post
Thanks alot for that detailed explanation, avtually I'm IMG and been studying for a year now, because I have to work 4 days a week in an emergency room as a technician, so i get distracted alot, but that's not the case, i study 10 hours of=n my days off, and i started Goljan book and audios about a month ago, and I barely finished half of it right now, the book is really good if you look for the real explanations for most diseases.but it's super big book, I'm kinda confused now if I should continue or should i switch to kaplan!!
If you have any advise here it would be so appreciated.
thanks you all
Like I said, I didn't like it. As for advice, not much, see my answer to numbndumb above. I did read one or two things from kaplan path, testicular tumors I think and something else. I thought it was easier to read and remember than Goljan's.
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  #13  
Old 11-18-2011
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Quote:
Originally Posted by drhma View Post
congrats, its an amazing score!!! and thanks for the very detailed preperation description
may i ask what was ur two-digit score?
Thanks. two digit score I got 91 (doesn't look very impressive with the new scoring system)
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Old 11-18-2011
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Smile Congrats

Thats a real roaring score...!!!!!!..who cares bout d 2 digit one wn u have got such an excellent 3 digit score...WHOA..!!!..Gud luck fr step 2...
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Old 11-19-2011
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patient doctor: congratulations on your score!

Also, which Robbins book were you referring to (there are 4!)?

Thanks
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  #16  
Old 11-19-2011
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Quote:
Originally Posted by mattard View Post
patient doctor: congratulations on your score!

Also, which Robbins book were you referring to (there are 4!)?

Thanks
Thank you. I'm referring to ROBBINS AND COTRAN PATHOLOGIC BASIS OF DISEASE, 8th Edition. I read molecular bases of cancer, vasculitis, and a couple more topics. Unfortunately I did not have time to read more. It is not high yield, in the sense that it takes a long time to read, and it is not very often that you get a question that you wouldn't otherwise have gotten from a more abbreviated syllabus, but I like it, it is written clearly, and like I said, they get some of their difficult questions from there.
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  #17  
Old 12-10-2011
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"This is not luck, it is that you know more than you think you know. Somehow your knowledge makes the right option feel better."

... very well said. I have felt this each and every time i did an NBME and took the USMLEs... This is a great exam, rewards hard work, not easy to score high by "luck", so well done... u must have worked harder than anyone i know.
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