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  #1  
Old 09-14-2016
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Default How I Scored 260.

Hey everyone,

I promised I would do this once I finished doing Steps 1, 2CK and 2CS. 18 months later, I finally get my 2CK results and here we are! Please see my 2CK post as well (I scored 263).

SO, many people ask me a lot of the same questions...how long did you study? what books did you use? did you get a tutor/Skype partner? what questions did you use? what was your study plan? Here are my thoughts:

1) The materials for the theory
I ONLY used First Aid for all 3 exams. A lot of people seem to think it isn't enough and I agree to a certain degree. First Aid is designed to have all the necessary information in the most compressed form possible. As such, you need to understand that you must learn the book cover-to-cover without missing any information (this include the pictures and the captions of the diagrams). Now, whilst First Aid had around 90% of what I needed, it did not have everything. The other 10% came from going through USMLE World for Step 1 and 2CK (I only used First Aid for 2CS) and the First Aid Q&A books. In the explained answers, there were certain nuggets of information that I knew was not in First Aid. I knew this because I started doing USMLE World after I had read the book 5-6 times. Once I found a nugget I would add it to the corresponding section in First Aid. Therefore, the next time I read First Aid i would also come across an extra bit of information. As such, First Aid would evolve to have nearly 100% of what I knew I needed.

2) My Study Plan
Being an IMG in my final year of medical school (I go to Cambridge Uni in the UK) I had the benefit of a bit more flexibility in when I took the exam. However, I did not want to set aside too much of my life to these exams. Step 1 took me 8 months to study for, 2CS around 1.5 months and 2CK was 5 months.

Now, I did not have a study plan set in stone. All i knew was that i needed to memorise First Aid and I would do as many read-throughs until i got there. I made a checklist of all the chapters and ensure i read each chapter (not in order, but in the order I felt would be most interesting --> least interesting). For Step 1, this was around 9 read-throughs, Step 2CS around 3 read-throughs and Step 2CK around 9 read-throughs. This is physically and mentally demanding. I would wake up at 5am and study until 7-8pm with a 10 minute break for lunch and that was it. I took no other breaks. My friends did not understand where I got my energy from as I was off caffeine the whole time! i guess it was fear more than anything that drove me.

3) Do not waste your time
The USMLE is a monster and you need to understand this. Now, for my medical degree i have always loved to work with others, but with this there was just too much too learn. I found it more high-yield to work alone. If i spent 5 hours with a tutor/skype partner I could maybe get through 2-3 topics (e.g. for the CVS I could get through anatomy, physiology and maybe a bit of pathology such as HTN). However, if i were to work alone I could get through double, maybe triple that amount. i know it can be isolating, but I just wanted to get through it. Do not waste your time delving deeper into topics First Aid only touches on. If First Aid does this it is for a reason...because it is unlikely to come up in the exam in a lot of detail. I know this can make you feel like your knowledge is patchy (as if you were patching a boat that had many holes with tape), but this is all you need for the exam

4) Questions
Use USMLE World. That is all you need

5) The exam itself
a) Week before
By this point i had First Aid memorised. I cast it aside at that point and went through USMLE World alone. I did maybe 10-12 blocks of 44 questions a day, along with looking through the answers. I could get through the entire bank by the end of the week.
b) Day before
I was used to working 15 hour days by this point. However, the day before i finished after I made sure to finish 5 hours early so I could unwind, have a good dinner (Dominos pizza...nomnom) and get to bed early.
c) The exam day
I did not plan any breaks. I think that following this kind of pre-planned rota is silly. If you feel you can continue, do it. If you need a break, take it. That was the way I worked on the exam day. For both Step 1/2CK i ended up doing the following - 3 blocks, 10-15 min break, 1-2 blocks, 10 mins break, 1-2 blocks, 10 mins break, 1 block, toilet break, 1 block, done. I did not eat during this day because i a) I was not hungry b) eating makes me sleepy. This is a marathon, not an exam. I did everything i could to stay focused. I had a bottle of water and 2 ProPlus tablets (each with 50mg of caffeine) on standby as i knew my caffeine sensitivity would be crazy high. I ended up needing to take 1 tablet during the entire day to stay sharp. I did not get jittery, it just helped me focus.

I hope this helps. If you need any help, please message me on FaceBook (search Simon Arda Metin) or Twitter (@smetin92).

Best of luck!!

Simon Metin

Last edited by smetin92; 09-18-2016 at 03:32 AM.
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The above post was thanked by:
accelerate (09-16-2016), arohi (09-19-2016), CleverFOX (09-14-2016), Ella (10-05-2016), EMR Constantine (09-14-2016), Ganymede (09-14-2016), Rathi Crispa (09-19-2016), sujith0906 (09-14-2016), thelostsoul (09-14-2016)



  #2  
Old 09-14-2016
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  #3  
Old 09-14-2016
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Thank you for posting your experience and congratulations.

Reading through your post, it sounds like your studying method is quite similar to mine. I am only done with Step 1 so far though, and appearing for Step 2 CS in a week's time.

As a fellow IMG, could you give me some tips for CS? Anything at all would be helpful
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  #4  
Old 09-14-2016
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Smile congratulations

thats a very good score!
congratulations. i am an IMG too from India. i want to know that apart from first aid for step 1 which books did you use? and did you do any elective in usa?

Quote:
Originally Posted by smetin92 View Post
Hey everyone,

I promised I would do this once I finished doing Steps 1, 2CK and 2CS. 18 months later, I finally get my 2CK results and here we are! Please see my 2CK post as well (I scored 263).

SO, many people ask me a lot of the same questions...how long did you study? what books did you use? did you get a tutor/Skype partner? what questions did you use? what was your study plan? Here are my thoughts:

1) The materials for the theory
I ONLY used First Aid for all 3 exams. A lot of people seem to think it isn't enough and I agree to a certain degree. First Aid is designed to have all the necessary information in the most compressed form possible. As such, you need to understand that you must learn the book cover-to-cover without missing any information (this include the pictures and the captions of the diagrams). Now, whilst First Aid had around 90% of what I needed, it did not have everything. The other 10% came from going through USMLE World for Step 1 and 2CK (I only used First Aid for 2CS). In the explained answers, there were certain nuggets of information that I knew was not in First Aid. I knew this because I started doing USMLE World after I had read the book 5-6 times. Once I found a nugget I would add it to the corresponding section in First Aid. Therefore, the next time I read First Aid i would also come across an extra bit of information. As such, First Aid would evolve to have nearly 100% of what I knew I needed.

2) My Study Plan
Being an IMG in my final year of medical school (I go to Cambridge Uni in the UK) I had the benefit of a bit more flexibility in when I took the exam. However, I did not want to set aside too much of my life to these exams. Step 1 took me 8 months to study for, 2CS around 1.5 months and 2CK was 5 months.

Now, I did not have a study plan set in stone. All i knew was that i needed to memorise First Aid and I would do as many read-throughs until i got there. I made a checklist of all the chapters and ensure i read each chapter (not in order, but in the order I felt would be most interesting --> least interesting). For Step 1, this was around 9 read-throughs, Step 2CS around 3 read-throughs and Step 2CK around 9 read-throughs. This is physically and mentally demanding. I would wake up at 5am and study until 7-8pm with a 10 minute break for lunch and that was it. I took no other breaks. My friends did not understand where I got my energy from as I was off caffeine the whole time! i guess it was fear more than anything that drove me.

3) Do not waste your time
The USMLE is a monster and you need to understand this. Now, for my medical degree i have always loved to work with others, but with this there was just too much too learn. I found it more high-yield to work alone. If i spent 5 hours with a tutor/skype partner I could maybe get through 2-3 topics (e.g. for the CVS I could get through anatomy, physiology and maybe a bit of pathology such as HTN). However, if i were to work alone I could get through double, maybe triple that amount. i know it can be isolating, but I just wanted to get through it. Do not waste your time delving deeper into topics First Aid only touches on. If First Aid does this it is for a reason...because it is unlikely to come up in the exam in a lot of detail. I know this can make you feel like your knowledge is patchy (as if you were patching a boat that had many holes with tape), but this is all you need for the exam

4) Questions
Use USMLE World. That is all you need

5) The exam itself
a) Week before
By this point i had First Aid memorised. I cast it aside at that point and went through USMLE World alone. I did maybe 10-12 blocks of 44 questions a day, along with looking through the answers. I could get through the entire bank by the end of the week.
b) Day before
I was used to working 15 hour days by this point. However, the day before i finished after I made sure to finish 5 hours early so I could unwind, have a good dinner (Dominos pizza...nomnom) and get to bed early.
c) The exam day
I did not plan any breaks. I think that following this kind of pre-planned rota is silly. If you feel you can continue, do it. If you need a break, take it. That was the way I worked on the exam day. For both Step 1/2CK i ended up doing the following - 3 blocks, 10-15 min break, 1-2 blocks, 10 mins break, 1-2 blocks, 10 mins break, 1 block, toilet break, 1 block, done. I did not eat during this day because i a) I was not hungry b) eating makes me sleepy. This is a marathon, not an exam. I did everything i could to stay focused. I had a bottle of water and 2 ProPlus tablets (each with 50mg of caffeine) on standby as i knew my caffeine sensitivity would be crazy high. I ended up needing to take 1 tablet during the entire day to stay sharp. I did not get jittery, it just helped me focus.

I hope this helps. If you need any help, please message me on FaceBook (search Simon Arda Metin) or Twitter (@smetin92).

Best of luck!!

Simon Metin
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  #5  
Old 09-14-2016
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thanks for the message. As i said, i only used first aid. i did not do an elective in the USA and am deeply regretting it. do it if you can.
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  #6  
Old 09-14-2016
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thank you. i will be going for elective at FIU next year.
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  #7  
Old 09-15-2016
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You just need to go through the 2CS cases as many times as possible. make sure you have memorised the Differentials for a given complaint and their respective tests. DO NOT feel you need to supply 3 DDx for a given condition in the real thing (i did not give more than 2 in any) as you are more likely to lose marks if you suggest irrelevant/barely tenuous conditions. Also, enjoy the free lunch!

Quote:
Originally Posted by Ganymede View Post
Thank you for posting your experience and congratulations.

Reading through your post, it sounds like your studying method is quite similar to mine. I am only done with Step 1 so far though, and appearing for Step 2 CS in a week's time.

As a fellow IMG, could you give me some tips for CS? Anything at all would be helpful
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  #8  
Old 09-16-2016
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OMGGG! You are such a big fat liar, smetin92. You mentioned in another forum that you didn't even use uworld and only used FA Q&A book instead.
What a LIAR!

Quote:
Originally Posted by smetin92 View Post
Hey everyone,

I promised I would do this once I finished doing Steps 1, 2CK and 2CS. 18 months later, I finally get my 2CK results and here we are! Please see my 2CK post as well (I scored 263).

SO, many people ask me a lot of the same questions...how long did you study? what books did you use? did you get a tutor/Skype partner? what questions did you use? what was your study plan? Here are my thoughts:

1) The materials for the theory
I ONLY used First Aid for all 3 exams. A lot of people seem to think it isn't enough and I agree to a certain degree. First Aid is designed to have all the necessary information in the most compressed form possible. As such, you need to understand that you must learn the book cover-to-cover without missing any information (this include the pictures and the captions of the diagrams). Now, whilst First Aid had around 90% of what I needed, it did not have everything. The other 10% came from going through USMLE World for Step 1 and 2CK (I only used First Aid for 2CS). In the explained answers, there were certain nuggets of information that I knew was not in First Aid. I knew this because I started doing USMLE World after I had read the book 5-6 times. Once I found a nugget I would add it to the corresponding section in First Aid. Therefore, the next time I read First Aid i would also come across an extra bit of information. As such, First Aid would evolve to have nearly 100% of what I knew I needed.

2) My Study Plan
Being an IMG in my final year of medical school (I go to Cambridge Uni in the UK) I had the benefit of a bit more flexibility in when I took the exam. However, I did not want to set aside too much of my life to these exams. Step 1 took me 8 months to study for, 2CS around 1.5 months and 2CK was 5 months.

Now, I did not have a study plan set in stone. All i knew was that i needed to memorise First Aid and I would do as many read-throughs until i got there. I made a checklist of all the chapters and ensure i read each chapter (not in order, but in the order I felt would be most interesting --> least interesting). For Step 1, this was around 9 read-throughs, Step 2CS around 3 read-throughs and Step 2CK around 9 read-throughs. This is physically and mentally demanding. I would wake up at 5am and study until 7-8pm with a 10 minute break for lunch and that was it. I took no other breaks. My friends did not understand where I got my energy from as I was off caffeine the whole time! i guess it was fear more than anything that drove me.

3) Do not waste your time
The USMLE is a monster and you need to understand this. Now, for my medical degree i have always loved to work with others, but with this there was just too much too learn. I found it more high-yield to work alone. If i spent 5 hours with a tutor/skype partner I could maybe get through 2-3 topics (e.g. for the CVS I could get through anatomy, physiology and maybe a bit of pathology such as HTN). However, if i were to work alone I could get through double, maybe triple that amount. i know it can be isolating, but I just wanted to get through it. Do not waste your time delving deeper into topics First Aid only touches on. If First Aid does this it is for a reason...because it is unlikely to come up in the exam in a lot of detail. I know this can make you feel like your knowledge is patchy (as if you were patching a boat that had many holes with tape), but this is all you need for the exam

4) Questions
Use USMLE World. That is all you need

5) The exam itself
a) Week before
By this point i had First Aid memorised. I cast it aside at that point and went through USMLE World alone. I did maybe 10-12 blocks of 44 questions a day, along with looking through the answers. I could get through the entire bank by the end of the week.
b) Day before
I was used to working 15 hour days by this point. However, the day before i finished after I made sure to finish 5 hours early so I could unwind, have a good dinner (Dominos pizza...nomnom) and get to bed early.
c) The exam day
I did not plan any breaks. I think that following this kind of pre-planned rota is silly. If you feel you can continue, do it. If you need a break, take it. That was the way I worked on the exam day. For both Step 1/2CK i ended up doing the following - 3 blocks, 10-15 min break, 1-2 blocks, 10 mins break, 1-2 blocks, 10 mins break, 1 block, toilet break, 1 block, done. I did not eat during this day because i a) I was not hungry b) eating makes me sleepy. This is a marathon, not an exam. I did everything i could to stay focused. I had a bottle of water and 2 ProPlus tablets (each with 50mg of caffeine) on standby as i knew my caffeine sensitivity would be crazy high. I ended up needing to take 1 tablet during the entire day to stay sharp. I did not get jittery, it just helped me focus.

I hope this helps. If you need any help, please message me on FaceBook (search Simon Arda Metin) or Twitter (@smetin92).

Best of luck!!

Simon Metin
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  #9  
Old 09-16-2016
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Thank you for the reply. May i ask where I posted this so I can correct it please? I have nothing to prove here and am only trying to help. Please grow up a bit and realise this. What an amazing doctor you will become with an attitude like this.

Quote:
Originally Posted by Eddie320 View Post
OMGGG! You are such a big fat liar, smetin92. You mentioned in another forum that you didn't even use uworld and only used FA Q&A book instead.
What a LIAR!
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  #10  
Old 09-16-2016
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Congratulations on your score and study plan!
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  #11  
Old 09-16-2016
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Great score congrats
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  #12  
Old 09-16-2016
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Yeah, sure!! U're trying to help by giving inaccurate and misleading information.
You better STOP lying on the forums!


Quote:
Originally Posted by smetin92 View Post
Thank you for the reply. May i ask where I posted this so I can correct it please? I have nothing to prove here and am only trying to help. Please grow up a bit and realise this. What an amazing doctor you will become with an attitude like this.
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  #13  
Old 09-16-2016
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Wonderful, thanks for not answering my question. You stay being an immature and unhelpful delinquent. I will continue to be happy and willing to help others with their revision. Riddle me this, what exactly would I gain by spending my own free time to post advice other than hoping others may do well? I'm sorry you are as frustrated as child who didn't get what they want for Christmas but I do hope you find a way to grow up. It's embarrassing to think you may become a doctor!

Quote:
Originally Posted by Eddie320 View Post
Yeah, sure!! U're trying to help by giving inaccurate and misleading information.
You better STOP lying on the forums!
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  #14  
Old 09-17-2016
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STOP bullying others as well, you anorexic LIAR!

I will post the screenshot of your misleading post soon.


Quote:
Originally Posted by smetin92 View Post
Wonderful, thanks for not answering my question. You stay being an immature and unhelpful delinquent. I will continue to be happy and willing to help others with their revision. Riddle me this, what exactly would I gain by spending my own free time to post advice other than hoping others may do well? I'm sorry you are as frustrated as child who didn't get what they want for Christmas but I do hope you find a way to grow up. It's embarrassing to think you may become a doctor!
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  #15  
Old 09-17-2016
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Excuse me whilst I go and cry in a corner...sure thing, post whatever you want. I think I can deal with someone who feels like they have power with their keyboard. Best of luck to you!

Quote:
Originally Posted by Eddie320 View Post
STOP bullying others as well, you anorexic LIAR!

I will post the screenshot of your misleading post soon.
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  #16  
Old 09-18-2016
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Quote:
Originally Posted by smetin92 View Post
Excuse me whilst I go and cry in a corner...sure thing, post whatever you want. I think I can deal with someone who feels like they have power with their keyboard. Best of luck to you!
You are such a disgrace to the medical community. It is better for you to shut your mouth and stop bullying others.

You should get out of all the forums you LIAR!
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  #17  
Old 09-18-2016
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Excellent, thank you for that. I will correct it. You are such a troll it is unbelievable. Its funny that you live behind a veil of anonymity to denounce others. I have nothing to hide, so what you say doesn't really bother me. I don't see how I am bullying others. I have met cowards like you all my life and the fact you think it bothers me is hilarious. The fact of the matter is, I am sitting in a room with a beautiful view of the King's College chapel in Cambridge with my friends whilst you are most likely alone in a room with the only the sound of your own anger to keep you company. I feel sorry for you.

I honestly hope things get better for you and i am more than happy to help you in any way I can. If you would like me to speak to you please feel free to contact me here as I have learned that holding grudges and hate is wrong. I managed to forgive the bullies that caused my eating disorder and I would be more than willing to do the same for you. If you instead wish to reply with something along the lines of "Get off these forums, you Anorexic bastard!" then please don't think for a minute you are causing me any degree of sadness.

Quote:
Originally Posted by Eddie320 View Post
You are such a disgrace to the medical community. It is better for you to shut your mouth and stop bullying others.

You should get out of all the forums you LIAR!
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  #18  
Old 09-18-2016
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So you are now admitting the fact that you lied?!

You honestly do NOT deserve to be a physician.



Quote:
Originally Posted by smetin92 View Post
Excellent, thank you for that. I will correct it. You are such a troll it is unbelievable. Its funny that you live behind a veil of anonymity to denounce others. I have nothing to hide, so what you say doesn't really bother me. I don't see how I am bullying others. I have met cowards like you all my life and the fact you think it bothers me is hilarious. The fact of the matter is, I am sitting in a room with a beautiful view of the King's College chapel in Cambridge with my friends whilst you are most likely alone in a room with the only the sound of your own anger to keep you company. I feel sorry for you.

I honestly hope things get better for you and i am more than happy to help you in any way I can. If you would like me to speak to you please feel free to contact me here as I have learned that holding grudges and hate is wrong. I managed to forgive the bullies that caused my eating disorder and I would be more than willing to do the same for you. If you instead wish to reply with something along the lines of "Get off these forums, you Anorexic bastard!" then please don't think for a minute you are causing me any degree of sadness.
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  #19  
Old 09-18-2016
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Ok, I really do not understand why you are so angry about this. Please could you elaborate on why this bothers you so much? Please be specific because I am concerned I have caused you harm in some way. The fact is for this post I wanted to submit a generalised study plan for steps 1 and 2ck. For Step 1 I did not use Uworld, but I wish i had. for step 2ck I did use Uworld and I posted about it. I wanted to submit a generalised study plan for tackling these exams rather than say what I did specifically for each exam. On some days i only studied 8hours instead of the usual 15. I was tired on those days. Would you like me to disclose that too? Again, I am sorry if I have hurt you in some way. Please feel free to message me if you would like to chat.

Quote:
Originally Posted by Eddie320 View Post
So you are now admitting the fact that you lied?!

You honestly do NOT deserve to be a physician.
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  #20  
Old 09-18-2016
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Enough is enough. But you are still lying!!!

Quote:
Originally Posted by smetin92 View Post
Ok, I really do not understand why you are so angry about this. Please could you elaborate on why this bothers you so much? Please be specific because I am concerned I have caused you harm in some way. The fact is for this post I wanted to submit a generalised study plan for steps 1 and 2ck. For Step 1 I did not use Uworld, but I wish i had. for step 2ck I did use Uworld and I posted about it. I wanted to submit a generalised study plan for tackling these exams rather than say what I did specifically for each exam. On some days i only studied 8hours instead of the usual 15. I was tired on those days. Would you like me to disclose that too? Again, I am sorry if I have hurt you in some way. Please feel free to message me if you would like to chat.
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  #21  
Old 09-18-2016
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Ok then, whatever you say. Again, I am sorry if I have hurt you in the past. You may not accept my apology and you may not want to reveal yourself as you seem to prefer to remain hidden. I am ok with this. I honestly wish you the best of luck in the Match and hope you do well in the future.

Quote:
Originally Posted by Eddie320 View Post
Enough is enough. But you are still lying!!!
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  #22  
Old 09-18-2016
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Quote:
Originally Posted by smetin92 View Post
You just need to go through the 2CS cases as many times as possible. make sure you have memorised the Differentials for a given complaint and their respective tests. DO NOT feel you need to supply 3 DDx for a given condition in the real thing (i did not give more than 2 in any) as you are more likely to lose marks if you suggest irrelevant/barely tenuous conditions. Also, enjoy the free lunch!
Thank you for your advice.

I also have one other query.

I keep running out of lines while practicing the PN on the official website.

Is it okay to write different subheadings in the same line to save space?

For example, write the history portion of PN as :

"HPI : .....
ROS : As in HPI, Allergies : NKDA, PMH : None, PSH : None, FH :...
"

Instead of

"HPI :....
ROS : As in HPI
Allergies : NKDA
PMH : None
PSH : None
FH : ....
"

I know the second way looks nicer, but I keep running out of lines if I do it that way :/

Did you have this issue too? If yes, how did you overcome it?
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  #23  
Old 09-18-2016
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Hey!

I initially had this problem but then I practised a lot. I went through the First Aid book and attempted to write my own history and compared it to the model answers. I think it would be a good idea for me to see an example of your writing style. Could you post a reply with an example of your patient note for one of the cases in first aid? Pick any of them and I will let you know how i would save space. to answer your question though, it can be a good idea to write some subheadings on the same line - e.g. HPI + ROS on the same line, then PMH+PSH on the next line etc... however, if you find that you are still constrained then you are most likely including too much irrelevant info. remember, stick to the presenting complaint!


Quote:
Originally Posted by Ganymede View Post
Thank you for your advice.

I also have one other query.

I keep running out of lines while practicing the PN on the official website.

Is it okay to write different subheadings in the same line to save space?

For example, write the history portion of PN as :

"HPI : .....
ROS : As in HPI, Allergies : NKDA, PMH : None, PSH : None, FH :...
"

Instead of

"HPI :....
ROS : As in HPI
Allergies : NKDA
PMH : None
PSH : None
FH : ....
"

I know the second way looks nicer, but I keep running out of lines if I do it that way :/

Did you have this issue too? If yes, how did you overcome it?
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  #24  
Old 09-18-2016
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Quote:
Originally Posted by smetin92 View Post
Hey!

I initially had this problem but then I practised a lot. I went through the First Aid book and attempted to write my own history and compared it to the model answers. I think it would be a good idea for me to see an example of your writing style. Could you post a reply with an example of your patient note for one of the cases in first aid? Pick any of them and I will let you know how i would save space. to answer your question though, it can be a good idea to write some subheadings on the same line - e.g. HPI + ROS on the same line, then PMH+PSH on the next line etc... however, if you find that you are still constrained then you are most likely including too much irrelevant info. remember, stick to the presenting complaint!
I am mostly having a problem with line limit (which is 15 lines), not the character limit

Here's a PN I just practiced. Here too, I did not run out of characters but had to write several subheadings in the same line in order to fit everything within 15 lines.

HPI : 66 yo M with dizziness X 2 days, decreased hearing in left ear X 2 days. The dizziness occurs 2-3 times in a day, lasts for 20-30 mins each time, is aggravated by standing or sitting up, not alleviated by anything and has no diurnal variations. No h/o falls, otalgia, tinnitus, tingling, numbness, paralysis, blurred vision, aural fullness, otorrhea, etc. Pt has diarrhea X 3 days, which is watery, non bloody. Dizziness is also associated with nausea and a few episodes of vomiting, but no changes in appetite, weight, no head trauma or headaches.
ROS : As in HPI
PMH : HTN X 7 years, PSH : Appendectomy
Meds : Captopril, Furosemide
Allergies : NKDA, FH : Non contributory
SH : Pt is sexually active with wife, is an executive director of an insurance firm, drinks 2-3 beers/week, CAGE - 0/4, no tobacco or illicit drug use.
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  #25  
Old 09-18-2016
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Quote:
Originally Posted by Ganymede View Post
I am mostly having a problem with line limit (which is 15 lines), not the character limit

Here's a PN I just practiced. Here too, I did not run out of characters but had to write several subheadings in the same line in order to fit everything within 15 lines.

HPI : 66 yo M with dizziness X 2 days, decreased hearing in left ear X 2 days. The dizziness occurs 2-3 times in a day, lasts for 20-30 mins each time, is aggravated by standing or sitting up, not alleviated by anything and has no diurnal variations. No h/o falls, otalgia, tinnitus, tingling, numbness, paralysis, blurred vision, aural fullness, otorrhea, etc. Pt has diarrhea X 3 days, which is watery, non bloody. Dizziness is also associated with nausea and a few episodes of vomiting, but no changes in appetite, weight, no head trauma or headaches.
ROS : As in HPI
PMH : HTN X 7 years, PSH : Appendectomy
Meds : Captopril, Furosemide
Allergies : NKDA, FH : Non contributory
SH : Pt is sexually active with wife, is an executive director of an insurance firm, drinks 2-3 beers/week, CAGE - 0/4, no tobacco or illicit drug use.
Here is how i would have wrote it:

HPI : 66 yo M with dizziness + decreased hearing in L ear X 2 days. Dizziness occurs 2-3 times/day, lasts 20-30 mins, aggravated by standing/sitting up, no alleviating factors. Associated with nausea and a few episodes of vomiting. Also, watery diarrhea X 3 days, which non bloody. No headaches, falls, otalgia, tinnitus, numbness/weakness, blurred vision. No changes in appetite, weight and no h/o of head trauma.
PMH : HTN X 7 years; PSH : Appendectomy
Meds : Captopril, Furosemide; Allergies : NKDA
FH : Non contributory; SH : Pt is sexually active with wife, is an executive director of an insurance firm, drinks 2-3 beers/week, no tobacco or illicit drug use.

Why i made these changes:

- For the HPI you should do a complete run-through of each symptom before you go on to talk about things that wasnt there. so for the dizziness, you describe it, then say it is associated with N/V. You save space by doing this as you do not need to write "Dizziness is also associated with nausea and a few..." but you can continue with "Also associated with...".
- For the HPI, you need to talk about pertinent positives before negatives. So the diarrhea goes above your Neuro ROS.
- For the Neuro ROS, you do not need to mention all the negatives. "tingling" is not an essential negative symptom if you mention "no numbness" - also a better word for tingling is paresthesias. Symptoms like aural fullness are very specific to vertiginous symptoms so you dont need to mention it if you think it is dizziness vs vertigo.
- There is no need for a separate "ROS" sub-header if you have included it in the HPI. It is wasted space and would annoy your examiner.
- I was told to put semi-colons between the sub-headers if you chose to put them on the same line.
- Dont include CAGE if the person doesnt drink >1 drink/day (women) or >2/day (men). it is wasted space and shows a lack of knowledge for when you apply the CAGE questions. it would lose you marks.
- Save space by using dashes - so 2/3 times in a day = 2/3 times/day.
- Avoid unnecessary language - "lasts for 20-30 mins each time" = "lasts 20-30 mins". it conveys the same amount of info with less wasted space.
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The above post was thanked by:
Dhakshi (09-19-2016), Ganymede (09-19-2016)



  #26  
Old 09-19-2016
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Quote:
Originally Posted by smetin92 View Post
Here is how i would have wrote it:

HPI : 66 yo M with dizziness + decreased hearing in L ear X 2 days. Dizziness occurs 2-3 times/day, lasts 20-30 mins, aggravated by standing/sitting up, no alleviating factors. Associated with nausea and a few episodes of vomiting. Also, watery diarrhea X 3 days, which non bloody. No headaches, falls, otalgia, tinnitus, numbness/weakness, blurred vision. No changes in appetite, weight and no h/o of head trauma.
PMH : HTN X 7 years; PSH : Appendectomy
Meds : Captopril, Furosemide; Allergies : NKDA
FH : Non contributory; SH : Pt is sexually active with wife, is an executive director of an insurance firm, drinks 2-3 beers/week, no tobacco or illicit drug use.

Why i made these changes:

- For the HPI you should do a complete run-through of each symptom before you go on to talk about things that wasnt there. so for the dizziness, you describe it, then say it is associated with N/V. You save space by doing this as you do not need to write "Dizziness is also associated with nausea and a few..." but you can continue with "Also associated with...".
- For the HPI, you need to talk about pertinent positives before negatives. So the diarrhea goes above your Neuro ROS.
- For the Neuro ROS, you do not need to mention all the negatives. "tingling" is not an essential negative symptom if you mention "no numbness" - also a better word for tingling is paresthesias. Symptoms like aural fullness are very specific to vertiginous symptoms so you dont need to mention it if you think it is dizziness vs vertigo.
- There is no need for a separate "ROS" sub-header if you have included it in the HPI. It is wasted space and would annoy your examiner.
- I was told to put semi-colons between the sub-headers if you chose to put them on the same line.
- Dont include CAGE if the person doesnt drink >1 drink/day (women) or >2/day (men). it is wasted space and shows a lack of knowledge for when you apply the CAGE questions. it would lose you marks.
- Save space by using dashes - so 2/3 times in a day = 2/3 times/day.
- Avoid unnecessary language - "lasts for 20-30 mins each time" = "lasts 20-30 mins". it conveys the same amount of info with less wasted space.
Thank you again. I am going to keep your advice in mind.

I do think it is vital to include aural fullness in the history though, because the patient clearly displays several symptoms which point towards Meniere's, and thus the absence of aural fullness would be a pertinent negative.
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  #27  
Old 10-05-2016
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Default congrats

all the best !!
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  #28  
Old 10-05-2016
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Thank you so much buddy for posting your experience! You're such an inspiration! Congratulations on your score! Simply amazing!
Also i was reading the conversation between you and the anonymous guy and I must applaud your patience. You will definitely become a great physician that patients will be comfortable with as well. Good luck with everything and God bless!




Quote:
Originally Posted by smetin92 View Post
Hey everyone,

I promised I would do this once I finished doing Steps 1, 2CK and 2CS. 18 months later, I finally get my 2CK results and here we are! Please see my 2CK post as well (I scored 263).

SO, many people ask me a lot of the same questions...how long did you study? what books did you use? did you get a tutor/Skype partner? what questions did you use? what was your study plan? Here are my thoughts:

1) The materials for the theory
I ONLY used First Aid for all 3 exams. A lot of people seem to think it isn't enough and I agree to a certain degree. First Aid is designed to have all the necessary information in the most compressed form possible. As such, you need to understand that you must learn the book cover-to-cover without missing any information (this include the pictures and the captions of the diagrams). Now, whilst First Aid had around 90% of what I needed, it did not have everything. The other 10% came from going through USMLE World for Step 1 and 2CK (I only used First Aid for 2CS) and the First Aid Q&A books. In the explained answers, there were certain nuggets of information that I knew was not in First Aid. I knew this because I started doing USMLE World after I had read the book 5-6 times. Once I found a nugget I would add it to the corresponding section in First Aid. Therefore, the next time I read First Aid i would also come across an extra bit of information. As such, First Aid would evolve to have nearly 100% of what I knew I needed.

2) My Study Plan
Being an IMG in my final year of medical school (I go to Cambridge Uni in the UK) I had the benefit of a bit more flexibility in when I took the exam. However, I did not want to set aside too much of my life to these exams. Step 1 took me 8 months to study for, 2CS around 1.5 months and 2CK was 5 months.

Now, I did not have a study plan set in stone. All i knew was that i needed to memorise First Aid and I would do as many read-throughs until i got there. I made a checklist of all the chapters and ensure i read each chapter (not in order, but in the order I felt would be most interesting --> least interesting). For Step 1, this was around 9 read-throughs, Step 2CS around 3 read-throughs and Step 2CK around 9 read-throughs. This is physically and mentally demanding. I would wake up at 5am and study until 7-8pm with a 10 minute break for lunch and that was it. I took no other breaks. My friends did not understand where I got my energy from as I was off caffeine the whole time! i guess it was fear more than anything that drove me.

3) Do not waste your time
The USMLE is a monster and you need to understand this. Now, for my medical degree i have always loved to work with others, but with this there was just too much too learn. I found it more high-yield to work alone. If i spent 5 hours with a tutor/skype partner I could maybe get through 2-3 topics (e.g. for the CVS I could get through anatomy, physiology and maybe a bit of pathology such as HTN). However, if i were to work alone I could get through double, maybe triple that amount. i know it can be isolating, but I just wanted to get through it. Do not waste your time delving deeper into topics First Aid only touches on. If First Aid does this it is for a reason...because it is unlikely to come up in the exam in a lot of detail. I know this can make you feel like your knowledge is patchy (as if you were patching a boat that had many holes with tape), but this is all you need for the exam

4) Questions
Use USMLE World. That is all you need

5) The exam itself
a) Week before
By this point i had First Aid memorised. I cast it aside at that point and went through USMLE World alone. I did maybe 10-12 blocks of 44 questions a day, along with looking through the answers. I could get through the entire bank by the end of the week.
b) Day before
I was used to working 15 hour days by this point. However, the day before i finished after I made sure to finish 5 hours early so I could unwind, have a good dinner (Dominos pizza...nomnom) and get to bed early.
c) The exam day
I did not plan any breaks. I think that following this kind of pre-planned rota is silly. If you feel you can continue, do it. If you need a break, take it. That was the way I worked on the exam day. For both Step 1/2CK i ended up doing the following - 3 blocks, 10-15 min break, 1-2 blocks, 10 mins break, 1-2 blocks, 10 mins break, 1 block, toilet break, 1 block, done. I did not eat during this day because i a) I was not hungry b) eating makes me sleepy. This is a marathon, not an exam. I did everything i could to stay focused. I had a bottle of water and 2 ProPlus tablets (each with 50mg of caffeine) on standby as i knew my caffeine sensitivity would be crazy high. I ended up needing to take 1 tablet during the entire day to stay sharp. I did not get jittery, it just helped me focus.

I hope this helps. If you need any help, please message me on FaceBook (search Simon Arda Metin) or Twitter (@smetin92).

Best of luck!!

Simon Metin
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  #29  
Old 10-07-2016
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Congrats on such a great score!
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  #30  
Old 10-07-2016
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congrates its awesome
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