'Old' IMG (2006), working full/part time, Score 243 - USMLE Forums
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  #1  
Old 04-08-2013
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Smile 'Old' IMG (2006), working full/part time, Score 243

Experience of an ‘old’ IMG who was also working while preparing for the USMLE Step 1.

USMLE Step 1 - Score 243 ; Exam March 2013

Background
Graduated in 2006; Did clinical work till 2008; MPH in 2009 and working in Global health since then. So no clinical work/exposure for almost 4 years. Working full time currently. Total study time 7 months. Studied for 4 months while working full time. Then took partial leave (working from home about 2 days a week) for 3 months to focus on preparation. Luckily I requested for leave during Dec-Feb when the office workload is low.

Target Score:
I was initially aiming for 240 but the initial NBME's that I took dampened my expectations and I decided I would take the exam if my NBME score became 220+. But by the end I was scoring higher in the UWorld assessments which made me hopeful again. Then I decided on a target ‘range (220-240). [dancing with joy with anything above 240, but anything above 220 will still be a welcome relief. Less than 220 I'll just go hide somewhere]

Here are my scores:
- Dec 24 - NBME11 - 204
- Jan 24 - NBME 12 – 207 (no change in NBME score for one month! So changed study strategy, read below)
- Feb 8 - UWorld Self Assessment Form 1 - 242
- Feb 22 – Prometric Practice Test – 93%
- Feb 24 – Uworld Self Assessment Form 2 – 252
- Feb 24 – NBME Form 7 – 231
- March 1st - exam date

Study Materials
- Kaplan Videos + Lecture Notes (once, very rapidly)
- Pathology videos from www.pathoma.com (I did not use Kaplan for Pathology)
- First Aid (main review book, did it thrice, almost knew it cover to cover by the end)
- Uworld Qbank (did it twice)
- Kaplan Qbank (did half - about 1000 qs)
- Flash Cards Microbiology – “Illustrated Microbiology Memory Cards: MicroMnemonics” (helped me memorize things I found difficult in a very fun, memorable way)

Study Schedule
 Aug 1st – Nov 30th 2012: Kaplan videos and books. One week per subject, some subjects like Pathology took around 2 weeks. I was working full time (9 – 6 pm) during this time. So I studied in the evenings (average 1.5 hrs/day) and entire weekends.
 Dec 1st – Jan24th: Completed UWorld Qbank (scoring 60% average on random blocks) + FA in bits and pieces
 Jan 24th –Feb 8th: Did FA chapter wise + subject wise questions from Kaplan Qbank. (scoring 70% on subject wise blocks) (Did not complete Kaplan qbank, did only about 1000 qs)
 Feb 8th – Feb 21st – First Revision of FA chapter wise and repeated all of Uworld subject wise in timed tutor mode. (scored around 80% this time).
 Feb 24th – Feb 28th – Completed “intense” subject wise second revision of all of FA + did the leftover/incorrect/marked questions from UWorld.

Day before the exam - Feb 28th
Only studied Biochem from FA in the morning and reviewed 4 pages of written notes from UWorld and did two remaining blocks of marked questions from UWorld. Was very relaxed while studying (not intense), and also stopped studying around 4 pm. Went out to lunch. In the evening I prepared food and laid out clothes and packed bag for the next day. Did the exam tutorial from the USMLE site. Meditated and went through exam day in my head (explained later). Watched Greys Anatomy, had a heavy dinner (helps to make you sleepy) and slept on time (10:30 pm).

Exam Day – March 1st
Woke up at 6 am. Reached exam centre by 7:30 am. Started exam at 8 am. Exam centre was only a 5 minute drive from my place and I had requested a friend to drop me there. Had a good breakfast with eggs and toast and coffee. Felt reasonably relaxed. On arrival. I put my cards/money/keys/phone in the locker. Rest of my bag I left on the floor, next to the locker so it would save me time in accessing my things. Put my coffee mug and water bottle on top of the lockers for quick access. You may have to check whether the staff at your exam centre are ok with you leaving your things outside the locker. Went to the restroom before starting. In the tutorial I went straight to the ‘sound’ tab and ensured my headphones were on and clicked ‘end block’. This got me an additional 14 minutes of break time. I am restless so I took a break after every question block (some friends I know did 2-3 blocks at a stretch, so it’s a personal choice no hard rules here). I had packed some lunch but in the end I only ended up eating bananas.

Exam day - break schedule
Break 1 – 5 minutes, stretched, took a sip of water
Break 2 – 10 minutes – Ate banana, had coffee, went to restroom and looked up something in FA
Break 3 – 5 minutes, stretched, water/coffee
Break 4 – 15 minutes – Ate banana, coffee, restroom, read some FA and even switched on phone to google
Break 5 – 5 mins – stretched, water/coffee and a piece of chocolate
Break 6 – 10 mins –ate banana, looked up FA, restroom
Break 7 – 5 mins. Stretched.

Tips
1. Watch Kaplan videos at 1.5x or 2x speed. You will find this option in most video players including windows media player and VLC player.
2. Do Uworld twice. You will be surprised to see how much you have forgotten just doing it once.
3. Take UWorld for 6 months atleast because you will be redoing all the questions and will need to reset your questions. There are strategies for redoing all the questions on a shorter subscription without resetting but I think it’s best to pay a little more and keep it simple.
4. FA is hard initially but it gets easier the more you do it. And it will really be the best last week review book. Try to go through it thrice before the exam.
5. I found subject-wise review and timed tutor modeto be most helpful for learning.
6. Do the prometric centre practice test if you are willing to pay for it. I found it very helpful. It is only 3-4 blocks so does not simulate the length of the real exam but familiarizes with the centre etc.
7. Do a full day simulation. I used NBME 7 + USWA 2 for this. Keep a sign in/sign out sheet like in the real exam. And pack lunch/ coffee like you would for exam day. This lets you know whether you can do blocks at a stretch and whether you need breaks etc.
8. If you have a high target score then listen to Golijan. I did not listen to all of it but did it in bits and pieces and there were atleast 3 questions on my exam that I was able to answer because of Golijan. I would strongly recommend listening to all of them. But I think they are most useful if done closer to the exam. Maybe one month before the exam.
9. If possible fine 3-4 supportive people (friends/family) particularly those who have taken the steps. It helped me to call them when I was feeling low and needed motivation. Stay away from non-supportive people.
10. Try to enjoy learning. We are privileged to have access/opportunity to such knowledge. Malala Yousufzai’s story motivated me. Also, not to sound cliché but you are learning to save lives, so respect that and be grateful.
11. You will need a lot of what you are studying for Step 2 CK also so don’t throw away your study materials once you are done with Step 1.
12. Make sure that you fix your sleep/wake habits. At the minimum you should be sleeping by 11 pm and waking up by 7:30 am every day for 2 weeks prior to the exam. If you can sleep/wake earlier (10 pm/6 am) even better. Use multiple alarms, ask roommates/parents to help. Do whatever works. This is important.
13. Don’t nap in the afternoon! I used to nap in the afternoon and was unable to fix my sleeping habits. When I stopped napping I was able to fix my sleeping. I don’t usually drink coffee but it helped me to stop napping when I was initially fixing my schedule.
14. Exercise for atleast 30 mins twice a week. Try free yoga videos online – google yogayak free videos, or get dumbbells and do some simple weight exercises at home, or go out for a run. Go for walks to refresh yourself. Exercise for me is critical to making me feel happy and motivated.
15. Make an ‘After exam list’ – whenever there is anything you think of doing, that is distracting you. Put it on the after exam list and forget about it for now.
16. The day before the exam do some meditation. Find a soothing video on youtube with a meditative, pleasant soundtrack and play it. As you are relaxing yourself, imagine your exam day from opening your eyes, dressing up, leaving for exam centre, feeling confident, imagine yourself taking each of your breaks, eating, drinking water, going to the restroom and imagine the end of the exam. This is a powerful exercise, one thing it does is it will remind you if you are forgetting anything to take/plan, but most importantly you will feel much more confident during exam day because in your mind you have already been through the whole day before, it will not be new!

For ‘old’ IMG’s who are working full-time
1. You can do this no matter how ‘old’ you are. I know of people who graduate 20 years ago and scored in the 250s on the Step 1. Although it may be more challenging for those of you who have work and kids. But it can be done.
2. I would recommend taking atleast 2 months either completely off or atleast flex-time/part time before the exam. Especially if your target score is about 230. (I had three months of flextime/part-time)
3. You will need to go through the Kaplan videos/notes to refresh your memory. But do this quickly and don’t get boggled down and think you don’t know enough. Trust the process, you may not know everything perfectly in your first round but repeated rounds of revision will get you there.
4. If possible find someone who gave the exam as an ‘old’ IMG and keep communicating with them for motivation/guidance. I was lucky to have a friend who had been in a similar situation as me and given the exam one year before me. He ‘understood’ and was very supportive and encouraging. It is difficult to relate to IMG’s fresh out of medical school and studying for this full time, or AMG’s who usually give this during medical school and need only 6-8 weeks to prepare.
5. Strongly recommend doing Step 1 before CK. I am now studying for CK and it feels so much easier because it feels like I already know half the stuff. You can give CK first BUT in that case studying for CK will be a struggle and studying for Step 1 after that will be a struggle. If you do Step 1 first then although it will be a struggle, studying for CK will be much smoother.
6. Motivation/momentum and perseverance are KEY. It will be a bit of a struggle at times to push yourself through. Don’t stop, stick to it and you will get through.

Having said all this, there is a lot of advice out there, do what feels right to you, find your own path. You can contact me if you have any questions. I do not promise that I will be able to reply though.

I also hope to upload a more detailed study plan for the working ‘old’ IMG. I call it the ‘onion method’.

All the best!
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  #2  
Old 04-08-2013
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congrats can you post the onion method please
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congratulation and thanks for the detailed motivating experience
I would like to ask you doing the tutorial from usmle web side, I tried to down load the Fred software but failed and there is error always, did you face this problem, any idea how to do it.
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Quote:
Originally Posted by sami trailer View Post
congratulation and thanks for the detailed motivating experience
I would like to ask you doing the tutorial from usmle web side, I tried to down load the Fred software but failed and there is error always, did you face this problem, any idea how to do it.
I did not have any trouble using Fred. Try doing it on another laptop or computer. Also Fred is not Mac compatible so you need to use a computer with windows on it.
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Old 04-08-2013
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Default congratulations!

congratulations for a great score!
i see that everyone here says about FA being crucial for the step 1 , i have done the reading twice but my score in nbme 6 which was the latest one i took offline was only about 203. i have been going through kaplan books many times but its not helping either. can you please advice me how i can improve my score? i have done 70% of the kaplan qbank and average score is 64%. should i keep going through FA again?
and youve said that u looked up FA in the breaks too...do they allow that?
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Old 04-17-2013
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hey nice experience, I'm a IMG fro the Caribbean graduated on 2010, working full time from 7-4pm. It's hard study and work at the same time, but im focus on this and I spend my study time when i get home, take a bath and eat something. Usually i start studying from 7:30 to 10pm and sometimes 10:30.. weekends i spend like 5-6 hrs

I did Kaplan videos( behavioral, Biochem, Physio, Pharm) and im doing Pathoma rite now with FA. Im gonna buy Uworld after this read probably for 6 months subcription. Im refreshing my self on the material because this is my second attempt for step 1, i took it on august 2011 but fail .
This is the reason that i decide to work ( i need to pay bills, lol)

I remember a lot of thing but also i forget some details.. im doing the trial from kaplan qbank and rite now im in the 69% overall.. so i think its not bad...
I will appreciate some tips that u can give me or advice. I looking for a passing score of 210-215..
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Old 04-17-2013
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Hi, granulation s for the awesome score!
I am 2006 graduated too, I was doing pediatric surgery in my country. And now I am preparing step1. I would like to know what is the chance to be matched as an old Img?
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Old 04-18-2013
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Quote:
Originally Posted by Drsouheyla View Post
Hi, granulation s for the awesome score!
I am 2006 graduated too, I was doing pediatric surgery in my country. And now I am preparing step1. I would like to know what is the chance to be matched as an old Img?
It's a million dollar question. No body can stick out the head and say the percentage. But the truth is u still have good chance.
Not only do they look at ur year of graduation but also whether u have been in clinical practice u get me? Get good scores etc
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Old 04-18-2013
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Default thank you for your motivation

I really want to tell you thank you , because I am an old INM. I study two years ago everything , iam scoring on Usmle-world 65%, I did NBME 7 and i scored too low 290 changing it with the test score it came like 190 , When I found that two of my friends who were scorigng higher than me did the test and they did not pass i got frustrated and i stop studying, . I work 8-9 hours per day and iI amnot going to be able to stop working part time , but I will study night time two , three hours per night , plus weekends 4 -5 hours , I decided to go back to my goals, and I am going to start studying again , but I found kaplan notes which I already did was too bored and it took me too long to finish it, and I already did USMLE WORLD twice in 2009 , once off line in 2010 , I do not know if i t is going to be convenient to do it again and just focuse on First aid . I will like to give me an advice , thank you for your post and good luck with the next step test too
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Old 04-18-2013
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Quote:
Originally Posted by nsesereso View Post
It's a million dollar question. No body can stick out the head and say the percentage. But the truth is u still have good chance.
Not only do they look at ur year of graduation but also whether u have been in clinical practice u get me? Get good scores etc
Thanks for your encouragement ,I am very depressed since I ve read articles about old IMG who didn't get matched ,and they have been waiting many years for the match!?
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  #11  
Old 04-18-2013
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Congratulations! your thread has motivated the heck out of me!
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  #12  
Old 04-18-2013
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Quote:
Originally Posted by Drsouheyla View Post
Thanks for your encouragement ,I am very depressed since I ve read articles about old IMG who didn't get matched ,and they have been waiting many years for the match!?
Don't mind those statements, the truth is that the match procedure is multifactorial. I have seen several old grads matching. In fact my study partner is a 2007 graduate and I know he would match.
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Old 04-20-2013
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Default I need Kaplan videos and lectures notes

Hi I am IMG

I need Kaplan videos and lecture notes... Where can I get these which I can speed up when viewing?

Please advise, thanks

P.s: your testimony has been very encouraging...

Thank you once again.
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Old 04-22-2013
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Quote:
Originally Posted by Drsouheyla View Post
Hi, granulation s for the awesome score!
I am 2006 graduated too, I was doing pediatric surgery in my country. And now I am preparing step1. I would like to know what is the chance to be matched as an old Img?
If you are planning to apply to surgery you need to work very hard and get high scores. It is tough (but possible) for IMGs to get surgery. Check out other threads.
Good Luck!
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  #15  
Old 05-05-2013
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I heard old IMG who graduated 5 or more years ago are not eligible is this true?
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  #16  
Old 05-07-2013
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Quote:
Originally Posted by Dr.Albert View Post
I heard old IMG who graduated 5 or more years ago are not eligible is this true?
U heard from where, who and how? What is ur source. Yeah evidence based information. If no evidence then disregard it.
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  #17  
Old 05-07-2013
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Quote:
Originally Posted by nsesereso View Post
U heard from where, who and how? What is ur source. Yeah evidence based information. If no evidence then disregard it.
Sorry I was misinformed and now stand corrected and motivated.
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  #18  
Old 05-19-2013
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Default Advice

quaintlee, can u give me any advice in my previous post. ( 4 weeks ago)
Thx
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Old 05-19-2013
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Thank You very much . Your post is highly motivating .
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Old 07-12-2013
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Help THanks from an old IMG

Quote:
Originally Posted by quaintlee View Post
Experience of an ‘old’ IMG who was also working while preparing for the USMLE Step 1.

USMLE Step 1 - Score 243 ; Exam March 2013

Background
Graduated in 2006; Did clinical work till 2008; MPH in 2009 and working in Global health since then. So no clinical work/exposure for almost 4 years. Working full time currently. Total study time 7 months. Studied for 4 months while working full time. Then took partial leave (working from home about 2 days a week) for 3 months to focus on preparation. Luckily I requested for leave during Dec-Feb when the office workload is low.

Target Score:
I was initially aiming for 240 but the initial NBME's that I took dampened my expectations and I decided I would take the exam if my NBME score became 220+. But by the end I was scoring higher in the UWorld assessments which made me hopeful again. Then I decided on a target ‘range (220-240). [dancing with joy with anything above 240, but anything above 220 will still be a welcome relief. Less than 220 I'll just go hide somewhere]

Here are my scores:
- Dec 24 - NBME11 - 204
- Jan 24 - NBME 12 – 207 (no change in NBME score for one month! So changed study strategy, read below)
- Feb 8 - UWorld Self Assessment Form 1 - 242
- Feb 22 – Prometric Practice Test – 93%
- Feb 24 – Uworld Self Assessment Form 2 – 252
- Feb 24 – NBME Form 7 – 231
- March 1st - exam date

Study Materials
- Kaplan Videos + Lecture Notes (once, very rapidly)
- Pathology videos from www.pathoma.com (I did not use Kaplan for Pathology)
- First Aid (main review book, did it thrice, almost knew it cover to cover by the end)
- Uworld Qbank (did it twice)
- Kaplan Qbank (did half - about 1000 qs)
- Flash Cards Microbiology – “Illustrated Microbiology Memory Cards: MicroMnemonics” (helped me memorize things I found difficult in a very fun, memorable way)

Study Schedule
 Aug 1st – Nov 30th 2012: Kaplan videos and books. One week per subject, some subjects like Pathology took around 2 weeks. I was working full time (9 – 6 pm) during this time. So I studied in the evenings (average 1.5 hrs/day) and entire weekends.
 Dec 1st – Jan24th: Completed UWorld Qbank (scoring 60% average on random blocks) + FA in bits and pieces
 Jan 24th –Feb 8th: Did FA chapter wise + subject wise questions from Kaplan Qbank. (scoring 70% on subject wise blocks) (Did not complete Kaplan qbank, did only about 1000 qs)
 Feb 8th – Feb 21st – First Revision of FA chapter wise and repeated all of Uworld subject wise in timed tutor mode. (scored around 80% this time).
 Feb 24th – Feb 28th – Completed “intense” subject wise second revision of all of FA + did the leftover/incorrect/marked questions from UWorld.

Day before the exam - Feb 28th
Only studied Biochem from FA in the morning and reviewed 4 pages of written notes from UWorld and did two remaining blocks of marked questions from UWorld. Was very relaxed while studying (not intense), and also stopped studying around 4 pm. Went out to lunch. In the evening I prepared food and laid out clothes and packed bag for the next day. Did the exam tutorial from the USMLE site. Meditated and went through exam day in my head (explained later). Watched Greys Anatomy, had a heavy dinner (helps to make you sleepy) and slept on time (10:30 pm).

Exam Day – March 1st
Woke up at 6 am. Reached exam centre by 7:30 am. Started exam at 8 am. Exam centre was only a 5 minute drive from my place and I had requested a friend to drop me there. Had a good breakfast with eggs and toast and coffee. Felt reasonably relaxed. On arrival. I put my cards/money/keys/phone in the locker. Rest of my bag I left on the floor, next to the locker so it would save me time in accessing my things. Put my coffee mug and water bottle on top of the lockers for quick access. You may have to check whether the staff at your exam centre are ok with you leaving your things outside the locker. Went to the restroom before starting. In the tutorial I went straight to the ‘sound’ tab and ensured my headphones were on and clicked ‘end block’. This got me an additional 14 minutes of break time. I am restless so I took a break after every question block (some friends I know did 2-3 blocks at a stretch, so it’s a personal choice no hard rules here). I had packed some lunch but in the end I only ended up eating bananas.

Exam day - break schedule
Break 1 – 5 minutes, stretched, took a sip of water
Break 2 – 10 minutes – Ate banana, had coffee, went to restroom and looked up something in FA
Break 3 – 5 minutes, stretched, water/coffee
Break 4 – 15 minutes – Ate banana, coffee, restroom, read some FA and even switched on phone to google
Break 5 – 5 mins – stretched, water/coffee and a piece of chocolate
Break 6 – 10 mins –ate banana, looked up FA, restroom
Break 7 – 5 mins. Stretched.

Tips
1. Watch Kaplan videos at 1.5x or 2x speed. You will find this option in most video players including windows media player and VLC player.
2. Do Uworld twice. You will be surprised to see how much you have forgotten just doing it once.
3. Take UWorld for 6 months atleast because you will be redoing all the questions and will need to reset your questions. There are strategies for redoing all the questions on a shorter subscription without resetting but I think it’s best to pay a little more and keep it simple.
4. FA is hard initially but it gets easier the more you do it. And it will really be the best last week review book. Try to go through it thrice before the exam.
5. I found subject-wise review and timed tutor modeto be most helpful for learning.
6. Do the prometric centre practice test if you are willing to pay for it. I found it very helpful. It is only 3-4 blocks so does not simulate the length of the real exam but familiarizes with the centre etc.
7. Do a full day simulation. I used NBME 7 + USWA 2 for this. Keep a sign in/sign out sheet like in the real exam. And pack lunch/ coffee like you would for exam day. This lets you know whether you can do blocks at a stretch and whether you need breaks etc.
8. If you have a high target score then listen to Golijan. I did not listen to all of it but did it in bits and pieces and there were atleast 3 questions on my exam that I was able to answer because of Golijan. I would strongly recommend listening to all of them. But I think they are most useful if done closer to the exam. Maybe one month before the exam.
9. If possible fine 3-4 supportive people (friends/family) particularly those who have taken the steps. It helped me to call them when I was feeling low and needed motivation. Stay away from non-supportive people.
10. Try to enjoy learning. We are privileged to have access/opportunity to such knowledge. Malala Yousufzai’s story motivated me. Also, not to sound cliché but you are learning to save lives, so respect that and be grateful.
11. You will need a lot of what you are studying for Step 2 CK also so don’t throw away your study materials once you are done with Step 1.
12. Make sure that you fix your sleep/wake habits. At the minimum you should be sleeping by 11 pm and waking up by 7:30 am every day for 2 weeks prior to the exam. If you can sleep/wake earlier (10 pm/6 am) even better. Use multiple alarms, ask roommates/parents to help. Do whatever works. This is important.
13. Don’t nap in the afternoon! I used to nap in the afternoon and was unable to fix my sleeping habits. When I stopped napping I was able to fix my sleeping. I don’t usually drink coffee but it helped me to stop napping when I was initially fixing my schedule.
14. Exercise for atleast 30 mins twice a week. Try free yoga videos online – google yogayak free videos, or get dumbbells and do some simple weight exercises at home, or go out for a run. Go for walks to refresh yourself. Exercise for me is critical to making me feel happy and motivated.
15. Make an ‘After exam list’ – whenever there is anything you think of doing, that is distracting you. Put it on the after exam list and forget about it for now.
16. The day before the exam do some meditation. Find a soothing video on youtube with a meditative, pleasant soundtrack and play it. As you are relaxing yourself, imagine your exam day from opening your eyes, dressing up, leaving for exam centre, feeling confident, imagine yourself taking each of your breaks, eating, drinking water, going to the restroom and imagine the end of the exam. This is a powerful exercise, one thing it does is it will remind you if you are forgetting anything to take/plan, but most importantly you will feel much more confident during exam day because in your mind you have already been through the whole day before, it will not be new!

For ‘old’ IMG’s who are working full-time
1. You can do this no matter how ‘old’ you are. I know of people who graduate 20 years ago and scored in the 250s on the Step 1. Although it may be more challenging for those of you who have work and kids. But it can be done.
2. I would recommend taking atleast 2 months either completely off or atleast flex-time/part time before the exam. Especially if your target score is about 230. (I had three months of flextime/part-time)
3. You will need to go through the Kaplan videos/notes to refresh your memory. But do this quickly and don’t get boggled down and think you don’t know enough. Trust the process, you may not know everything perfectly in your first round but repeated rounds of revision will get you there.
4. If possible find someone who gave the exam as an ‘old’ IMG and keep communicating with them for motivation/guidance. I was lucky to have a friend who had been in a similar situation as me and given the exam one year before me. He ‘understood’ and was very supportive and encouraging. It is difficult to relate to IMG’s fresh out of medical school and studying for this full time, or AMG’s who usually give this during medical school and need only 6-8 weeks to prepare.
5. Strongly recommend doing Step 1 before CK. I am now studying for CK and it feels so much easier because it feels like I already know half the stuff. You can give CK first BUT in that case studying for CK will be a struggle and studying for Step 1 after that will be a struggle. If you do Step 1 first then although it will be a struggle, studying for CK will be much smoother.
6. Motivation/momentum and perseverance are KEY. It will be a bit of a struggle at times to push yourself through. Don’t stop, stick to it and you will get through.

Having said all this, there is a lot of advice out there, do what feels right to you, find your own path. You can contact me if you have any questions. I do not promise that I will be able to reply though.

I also hope to upload a more detailed study plan for the working ‘old’ IMG. I call it the ‘onion method’.

All the best!
Thanks for detail info, I am an old IMG graduated in 2004, and since 2007, I am away from clinical practice. I am currently working in UN, planning to write my step 1 exam in coming November , I am following your plan, but need a thorough guidance on Patho, I just finished Physio from Kaplan and started Patho, which is really annoying, hap hazard discussions and lectures are not good, I am now skipping it and I am starting anatomy and will finish rest of Kaplan subjects and will do Patho from Goljan rapid review at the end, and finally will do pharma. I have heard of pathoma but ....... My heart is saying go for Goljan. I am in almost same position like you we're in 2012, the only diff is I am two years old IMG..... Your help appreciated
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, I am an old IMG graduated in 2004, and since 2007, I am away from clinical practice. I am currently working in UN, planning to write my step 1 exam in coming November , I am following stated plan by quar..r , but need a thorough guidance on Patho, I just finished Physio from Kaplan and started Patho, which is really annoying, hap hazard discussions and lectures are not good, I am now skipping it and I am starting anatomy and will finish rest of Kaplan subjects and will do Patho from Goljan rapid review at the end, and finally will do pharma. I have heard of pathoma but ....... My heart is saying go for Goljan. I am in almost same position like you we're in 2012, the only diff is I am two years old IMG..... Your help appreciated
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, I am an old IMG graduated in 2004, and since 2007, I am away from clinical practice. I am currently working in UN, planning to write my step 1 exam in coming November , I am following stated plan by quar..r , but need a thorough guidance on Patho, I just finished Physio from Kaplan and started Patho, which is really annoying, hap hazard discussions and lectures are not good, I am now skipping it and I am starting anatomy and will finish rest of Kaplan subjects and will do Patho from Goljan rapid review at the end, and finally will do pharma. I have heard of pathoma but ....... My heart is saying go for Goljan. I am in almost same position like you we're in 2012, the only diff is I am two years old IMG..... Your help appreciated
Goljan is gold but voluminous. Pathoma is concise and has almost all the high yield. His vedios are excellent. God bless the dude who introduced me to pathoma. After pathoma u would realised that u would know almost everything in Goljan and can work out from basic concept what is in Goljan but not in pathoma.
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, I am an old IMG graduated in 2004, and since 2007, I am away from clinical practice. I am currently working in UN, planning to write my step 1 exam in coming November , I am following stated plan by quar..r , but need a thorough guidance on Patho, I just finished Physio from Kaplan and started Patho, which is really annoying, hap hazard discussions and lectures are not good, I am now skipping it and I am starting anatomy and will finish rest of Kaplan subjects and will do Patho from Goljan rapid review at the end, and finally will do pharma. I have heard of pathoma but ....... My heart is saying go for Goljan. I am in almost same position like you we're in 2012, the only diff is I am two years old IMG..... Your help appreciated
Honeslty .....bearing in mind that you have around 4-5 months of dedicated prep during which you have to work also .... i see that for you doing Goljan is unrealistic ....i don't know how well you have the previous basic sciences imprinted in your mind but after being away from the clinical practice for a good 6 years .... i think things would be quite fuzzy and you will need more time to cope with the stuff .... so in my point of view pathoma is best for you ...because normally for an average reader takes 2 months of time to get through goljan judging by how extensive it is and still one in the end is uncertain how much he retained because the info is extensive ...and one feels he has actually wasted time .....because it doesn't matter how much you read it depends how much you retain ..... Goljan is best utilized when you are doing your basic sciences course in your med school and you opt this book to review with your main course books .....

so for you KLN except pathology ..... pathoma ....UsmleRx and UW qbanks ....remember doing as many questions is the key for you .....
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Thank you npktun. You couldn't have said it better!
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Honeslty .....bearing in mind that you have around 4-5 months of dedicated prep during which you have to work also .... i see that for you doing Goljan is unrealistic ....i don't know how well you have the previous basic sciences imprinted in your mind but after being away from the clinical practice for a good 6 years .... i think things would be quite fuzzy and you will need more time to cope with the stuff .... so in my point of view pathoma is best for you ...because normally for an average reader takes 2 months of time to get through goljan judging by how extensive it is and still one in the end is uncertain how much he retained because the info is extensive ...and one feels he has actually wasted time .....because it doesn't matter how much you read it depends how much you retain ..... Goljan is best utilized when you are doing your basic sciences course in your med school and you opt this book to review with your main course books .....

so for you KLN except pathology ..... pathoma ....UsmleRx and UW qbanks ....remember doing as many questions is the key for you .....
thanks for thorough reply, it will really help me, I was good in basic sciences in school, but I am away from medical studies for quite a long time and regaining that inertia will be time consuming, I will do my best what ever I can for Patho as it is a big cake in box, Will do pathoma instead of Goljan and some time I fear that I might extend my eligibility, but honestly I don't want to extend if I finish pathoma and all others that u suggested I will stick to my schedule.
thank you once again for informative reply,,,God bless you
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thanks for thorough reply, it will really help me, I was good in basic sciences in school, but I am away from medical studies for quite a long time and regaining that inertia will be time consuming, I will do my best what ever I can for Patho as it is a big cake in box, Will do pathoma instead of Goljan and some time I fear that I might extend my eligibility, but honestly I don't want to extend if I finish pathoma and all others that u suggested I will stick to my schedule.
thank you once again for informative reply,,,God bless you
Hello Jav2013! Which subjects have you done?
Only physiology and now on pathology or you have done some reading of some other subjects. Am also working full time and studying as well. Lets motivate ourselves man!
Good luck.
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Hello Jav2013! Which subjects have you done?
Only physiology and now on pathology or you have done some reading of some other subjects. Am also working full time and studying as well. Lets motivate ourselves man!
Good luck.
dear, I gave huge time to physio, I went through Kaplan DVD and lectures, then BRS for neuro, finished Kaplan q bank and UW for physio, then added important stuff in FA organ system. Took me 4 weeks almost. I have done half of Patho, yesterday I skipped that and I have started anatomy. it is tough, I can can not leave job, I have applied for leave without pay, let's see if they approve.... But I think it is possible to study in Job...
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dear, I gave huge time to physio, I went through Kaplan DVD and lectures, then BRS for neuro, finished Kaplan q bank and UW for physio, then added important stuff in FA organ system. Took me 4 weeks almost. I have done half of Patho, yesterday I skipped that and I have started anatomy. it is tough, I can can not leave job, I have applied for leave without pay, let's see if they approve.... But I think it is possible to study in Job...
Very impressive! Keep it up.
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Very impressive! Keep it up.
when r u intending to write you step1? And where are you at this point, I mean which subjects from which books you covered?

WR
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when r u intending to write you step1? And where are you at this point, I mean which subjects from which books you covered?

WR
Yet to receive my ecfmg confirmation and permit. My eligibility period is oct - dec. still am on my first read. Done anat, phys, bioc, micro now on patho.
Am working full time. So kind of slow motioner!
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Yet to receive my ecfmg confirmation and permit. My eligibility period is oct - dec. still am on my first read. Done anat, phys, bioc, micro now on patho.
Am working full time. So kind of slow motioner!
me too still waiting my ecfmg confirmation and my eligibility is oct-dec
coincidence

lets keep in touch!
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Yet to receive my ecfmg confirmation and permit. My eligibility period is oct - dec. still am on my first read. Done anat, phys, bioc, micro now on patho.
Am working full time. So kind of slow motioner!
Have got confirmation of my eligibility period that Sep to Nove, if I. Do one time extension, I know they will give next consecutive months.
y Qis next eligibility period would be Nov-Dec?
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me too still waiting my ecfmg confirmation and my eligibility is oct-dec
coincidence

lets keep in touch!
Hey guy! Good to see u here.
What subjects have you done now? Have u done any qbanks?
Good luck to you.
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Have got confirmation of my eligibility period that Sep to Nove, if I. Do one time extension, I know they will give next consecutive months.
y Qis next eligibility period would be Nov-Dec?

Wow!
Congrats on the ecfmg confirmation.
But is it a must that they give u the next eligibility period or u have the right to choose the three month block of ur choice as far as it's within 12 months from the time u submitted your online application?
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Wow!
Congrats on the ecfmg confirmation.
But is it a must that they give u the next eligibility period or u have the right to choose the three month block of ur choice as far as it's within 12 months from the time u submitted your online application?
They submit my scheduling permit for earlier mentioned eligibility period. However it is upto candidate if he wish to extend. but only one time extension, further extension are charged if one wish to extend. t is a volunteer procedure.. I mean candidate wish.....
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Experience of an ‘old’ IMG who was also working while preparing for the USMLE Step 1.

USMLE Step 1 - Score 243 ; Exam March 2013

Background
Graduated in 2006; Did clinical work till 2008; MPH in 2009 and working in Global health since then. So no clinical work/exposure for almost 4 years. Working full time currently. Total study time 7 months. Studied for 4 months while working full time. Then took partial leave (working from home about 2 days a week) for 3 months to focus on preparation. Luckily I requested for leave during Dec-Feb when the office workload is low.

Target Score:
I was initially aiming for 240 but the initial NBME's that I took dampened my expectations and I decided I would take the exam if my hNBME score became 220+. But by the end I was scoring higher in the UWorld assessments which made me hopeful again. Then I decided on a target ‘range (220-240). [dancing with joy with anything above 240, but anything above 220 will still be a welcome relief. Less than 220 I'll just go hide somewhere]

Here are my scores:
- Dec 24 - NBME11 - 204
- Jan 24 - NBME 12 – 207 (no change in NBME score for one month! So changed study strategy, read below)
- Feb 8 - UWorld Self Assessment Form 1 - 242
- Feb 22 – Prometric Practice Test – 93%
- Feb 24 – Uworld Self Assessment Form 2 – 252
- Feb 24 – NBME Form 7 – 231
- March 1st - exam date

Study Materials
- Kaplan Videos + Lecture Notes (once, very rapidly)
- Pathology videos from www.pathoma.com (I did not use Kaplan for Pathology)
- First Aid (main review book, did it thrice, almost knew it cover to cover by the end)
- Uworld Qbank (did it twice)
- Kaplan Qbank (did half - about 1000 qs)
- Flash Cards Microbiology – “Illustrated Microbiology Memory Cards: MicroMnemonics” (helped me memorize things I found difficult in a very fun, memorable way)

Study Schedule
 Aug 1st – Nov 30th 2012: Kaplan videos and books. One week per subject, some subjects like Pathology took around 2 weeks. I was working full time (9 – 6 pm) during this time. So I studied in the evenings (average 1.5 hrs/day) and entire weekends.
 Dec 1st – Jan24th: Completed UWorld Qbank (scoring 60% average on random blocks) + FA in bits and pieces
 Jan 24th –Feb 8th: Did FA chapter wise + subject wise questions from Kaplan Qbank. (scoring 70% on subject wise blocks) (Did not complete Kaplan qbank, did only about 1000 qs)
 Feb 8th – Feb 21st – First Revision of FA chapter wise and repeated all of Uworld subject wise in timed tutor mode. (scored around 80% this time).
 Feb 24th – Feb 28th – Completed “intense” subject wise second revision of all of FA + did the leftover/incorrect/marked questions from UWorld.

Day before the exam - Feb 28th
Only studied Biochem from FA in the morning and reviewed 4 pages of written notes from UWorld and did two remaining blocks of marked questions from UWorld. Was very relaxed while studying (not intense), and also stopped studying around 4 pm. Went out to lunch. In the evening I prepared food and laid out clothes and packed bag for the next day. Did the exam tutorial from the USMLE site. Meditated and went through exam day in my head (explained later). Watched Greys Anatomy, had a heavy dinner (helps to make you sleepy) and slept on time (10:30 pm).

Exam Day – March 1st
Woke up at 6 am. Reached exam centre by 7:30 am. Started exam at 8 am. Exam centre was only a 5 minute drive from my place and I had requested a friend to drop me there. Had a good breakfast with eggs and toast and coffee. Felt reasonably relaxed. On arrival. I put my cards/money/keys/phone in the locker. Rest of my bag I left on the floor, next to the locker so it would save me time in accessing my things. Put my coffee mug and water bottle on top of the lockers for quick access. You may have to check whether the staff at your exam centre are ok with you leaving your things outside the locker. Went to the restroom before starting. In the tutorial I went straight to the ‘sound’ tab and ensured my headphones were on and clicked ‘end block’. This got me an additional 14 minutes of break time. I am restless so I took a break after every question block (some friends I know did 2-3 blocks at a stretch, so it’s a personal choice no hard rules here). I had packed some lunch but in the end I only ended up eating bananas.

Exam day - break schedule
Break 1 – 5 minutes, stretched, took a sip of water
Break 2 – 10 minutes – Ate banana, had coffee, went to restroom and looked up something in FA
Break 3 – 5 minutes, stretched, water/coffee
Break 4 – 15 minutes – Ate banana, coffee, restroom, read some FA and even switched on phone to google
Break 5 – 5 mins – stretched, water/coffee and a piece of chocolate
Break 6 – 10 mins –ate banana, looked up FA, restroom
Break 7 – 5 mins. Stretched.

Tips
1. Watch Kaplan videos at 1.5x or 2x speed. You will find this option in most video players including windows media player and VLC player.
2. Do Uworld twice. You will be surprised to see how much you have forgotten just doing it once.
3. Take UWorld for 6 months atleast because you will be redoing all the questions and will need to reset your questions. There are strategies for redoing all the questions on a shorter subscription without resetting but I think it’s best to pay a little more and keep it simple.
4. FA is hard initially but it gets easier the more you do it. And it will really be the best last week review book. Try to go through it thrice before the exam.
5. I found subject-wise review and timed tutor modeto be most helpful for learning.
6. Do the prometric centre practice test if you are willing to pay for it. I found it very helpful. It is only 3-4 blocks so does not simulate the length of the real exam but familiarizes with the centre etc.
7. Do a full day simulation. I used NBME 7 + USWA 2 for this. Keep a sign in/sign out sheet like in the real exam. And pack lunch/ coffee like you would for exam day. This lets you know whether you can do blocks at a stretch and whether you need breaks etc.
8. If you have a high target score then listen to Golijan. I did not listen to all of it but did it in bits and pieces and there were atleast 3 questions on my exam that I was able to answer because of Golijan. I would strongly recommend listening to all of them. But I think they are most useful if done closer to the exam. Maybe one month before the exam.
9. If possible fine 3-4 supportive people (friends/family) particularly those who have taken the steps. It helped me to call them when I was feeling low and needed motivation. Stay away from non-supportive people.
10. Try to enjoy learning. We are privileged to have access/opportunity to such knowledge. Malala Yousufzai’s story motivated me. Also, not to sound cliché but you are learning to save lives, so respect that and be grateful.
11. You will need a lot of what you are studying for Step 2 CK also so don’t throw away your study materials once you are done with Step 1.
12. Make sure that you fix your sleep/wake habits. At the minimum you should be sleeping by 11 pm and waking up by 7:30 am every day for 2 weeks prior to the exam. If you can sleep/wake earlier (10 pm/6 am) even better. Use multiple alarms, ask roommates/parents to help. Do whatever works. This is important.
13. Don’t nap in the afternoon! I used to nap in the afternoon and was unable to fix my sleeping habits. When I stopped napping I was able to fix my sleeping. I don’t usually drink coffee but it helped me to stop napping when I was initially fixing my schedule.
14. Exercise for atleast 30 mins twice a week. Try free yoga videos online – google yogayak free videos, or get dumbbells and do some simple weight exercises at home, or go out for a run. Go for walks to refresh yourself. Exercise for me is critical to making me feel happy and motivated.
15. Make an ‘After exam list’ – whenever there is anything you think of doing, that is distracting you. Put it on the after exam list and forget about it for now.
16. The day before the exam do some meditation. Find a soothing video on youtube with a meditative, pleasant soundtrack and play it. As you are relaxing yourself, imagine your exam day from opening your eyes, dressing up, leaving for exam centre, feeling confident, imagine yourself taking each of your breaks, eating, drinking water, going to the restroom and imagine the end of the exam. This is a powerful exercise, one thing it does is it will remind you if you are forgetting anything to take/plan, but most importantly you will feel much more confident during exam day because in your mind you have already been through the whole day before, it will not be new!

For ‘old’ IMG’s who are working full-time
1. You can do this no matter how ‘old’ you are. I know of people who graduate 20 years ago and scored in the 250s on the Step 1. Although it may be more challenging for those of you who have work and kids. But it can be done.
2. I would recommend taking atleast 2 months either completely off or atleast flex-time/part time before the exam. Especially if your target score is about 230. (I had three months of flextime/part-time)
3. You will need to go through the Kaplan videos/notes to refresh your memory. But do this quickly and don’t get boggled down and think you don’t know enough. Trust the process, you may not know everything perfectly in your first round but repeated rounds of revision will get you there.
4. If possible find someone who gave the exam as an ‘old’ IMG and keep communicating with them for motivation/guidance. I was lucky to have a friend who had been in a similar situation as me and given the exam one year before me. He ‘understood’ and was very supportive and encouraging. It is difficult to relate to IMG’s fresh out of medical school and studying for this full time, or AMG’s who usually give this during medical school and need only 6-8 weeks to prepare.
5. Strongly recommend doing Step 1 before CK. I am now studying for CK and it feels so much easier because it feels like I already know half the stuff. You can give CK first BUT in that case studying for CK will be a struggle and studying for Step 1 after that will be a struggle. If you do Step 1 first then although it will be a struggle, studying for CK will be much smoother.
6. Motivation/momentum and perseverance are KEY. It will be a bit of a struggle at times to push yourself through. Don’t stop, stick to it and you will get through.

Having said all this, there is a lot of advice out there, do what feels right to you, find your own path. You can contact me if you have any questions. I do not promise that I will be able to reply though.

I also hope to upload a more detailed study plan for the working ‘old’ IMG. I call it the ‘onion method’.

All the best!
when u r going to post O method, as I am in almost same situation, old IMG, non clinical job.
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Carolina_USMLE (08-23-2013)
  #37  
Old 07-15-2013
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Quote:
Originally Posted by nsesereso View Post
Hey guy! Good to see u here.
What subjects have you done now? Have u done any qbanks?
Good luck to you.
just finish first read from kaplan currently doing FA (first time to maintain what i learn from kaplan) and Uworld ...what about u good luck BTW
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  #38  
Old 07-15-2013
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Quote:
Originally Posted by muse View Post
just finish first read from kaplan currently doing FA (first time to maintain what i learn from kaplan) and Uworld ...what about u good luck BTW
Stil on my first read no qbanks yet
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  #39  
Old 07-21-2013
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Hi
Do upload the onion method , U have inspired me !
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  #40  
Old 07-02-2016
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Can you please give more detail explanation about your day to day schedule. Like how many questions you did per day while you where working full time. And how many hours did you dedicated to whatching the videos? Also did you do notes?
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  #41  
Old 07-03-2016
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Well done, great score!
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  #42  
Old 07-05-2016
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need onion method..
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  #43  
Old 07-20-2016
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Hi thanks for the brilliant post. I am wondering what happened to all the other 'old imgs' who posted in this page since 2013? I hope you are all settled doing some kind of residency in the US . I myself have graduated in 2006 and worked for many years until recently decided to move to the US.

I recently posted something asking if you are stuck in btween two matches for instance if one misses the 2017 match and going for the 2018, what can a doctor do in btween career wise?

I am studying full time since I am moving to the US I have stopped working and concentrating on studying but unfortunately I don't think I would be able to do a match for 2017 -can't finish all three steps by the end of this year> need more time to study.

I somehow feel its a career assassination if I don't work in between these two matches as a doctor ie on the whole almost 2 years of no permanent job is it a disaster? ( I am basing it on the Uk system to come to these conclusion).

I hope you can please advice me as I am loosing hope.
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  #44  
Old 09-04-2016
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congratulations.
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  #45  
Old 09-04-2016
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This is very inspirational!
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Old 09-04-2016
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I heard Golijan some time back. Have exam block in approx 2 months. I think Pathoma 2011 edition will be a better way to revise pathology. What is everyone's opinon???
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Old 09-09-2016
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Helpful post.
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  #48  
Old 10-29-2016
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Hi and thanks for your post. I am in the exact same intuition and would love to speak with someone who went through it. Img, working full time with minimal support systems. I had a uworld average of 68%.I've been too scared to take a self assessment because the last ones I did were really low and my depression makes me stop studying completely. Pls send me details of how to proceed. Right now I'm doing 2nd round of first aid and u world. I've done pathoma video and notes once but feel like I've forgotten everything. Help!???
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