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Old 05-27-2013
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Smile Studying Experience - Step score 0f 211

I have been visiting this forum for quite a while and the wonderful people here are among the many to whom I owe my success. As I was inspired by the many stories presented here by students far more talented than me, I hope that this helps others. From the get go, please know that I am not one of those all-star students. I have failed more times than I dare admit and I even once failed Step 1.
I got a score of 211 on my second attempt which was, although far below my aim, yet gives me a chance to fight on. But while studying, I realized quite a few things that if realized far before, would have resulted in a far better life in med school for me. So here is my experience, the good and the ill, which I leave to your own judgement and learning.

1) To get a good score in Step 1 (or in any subject really), the first thing you need is the WILL TO STUDY. All the tutors, mnemonics or guidebooks in the world will not help you learn something if your heart is not in it. You may have realized this during end-stage cram sessions. If your mind is receptive to the information, it will automatically make a serious effort to learn something by making memory aids (such as linking that information to a funny person you may have met). It is this linking that helps improve learning, memory and recall.
One cannot learn if one’s mind is thinking about the next Game of Thrones episode or simply cursing the material for its length. Take the long lists in portions that you can digest. For example, if you try to memorize the vasculitis list in one go, it will result in a brain crash (and possible loud cursing at the creators of the exam). Instead, break it down into portions according to the size of the endothelial vessel affected. Same goes if you are trying to remember reproductive tumors such as ovarian or breast tumors. Break them down into malignant vs non-malignant (this alone helps you learn the general characteristics shared by many tumors). Then, further categorize them in a logic map based on infiltration, epidermal changes, pain, swelling, histology, etc.

2) No one will deny that Step 1 is considerably about memorization. In all my life, I have never hated sentences that start with the phrases “Just remember..” or “You need to remember..”.

a. Note: memorization is made easier when you understand. So if you do not understand, hit Wikipedia or your primary text (Goljan for me) and learn it first! If your basic science course was weak or spent on facebook, I highly recommend you hit Dr. Najeeb’s lectures or the Kaplan video lectures (for physio and pharmacology especially) and learn the basic concepts. It will not only save you precious time from cramming an otherwise easy concept but will also avoid considerable headache (literally!)

b. Basically, strong memory is from 2 things: reinforcement/repetition and linking.

c. Linking, as I mentioned before, is when you attach a fact to memory aids. Take Raynaud’s disease as an example. It affects the extremities in cold climates and is also called White, Blue and Red tumor due to the sequence of color change on extremities (which also happen to be the colors of the French flag!). So while you are reading, you imagine a French flag carrier feeling cold in his hand and feet on a cold morning. You HAVE to use this analogy every time you think about the disease and with repetitions, you will not have to. That mental image was one link. You make additional links when you attempt questions on the topic, hand-write its extra info to your First Aid, look up the image on internet, talk to a patient whom you know to suffer from it and so on. All these links will light up when you see the disease in any form. That being said, you also have to manage your time and not spend an entire day on one disease. NEVER UNDERESTIMATE THE POWER OF A PICTURE. It really can be worth a thousand words. Tip: When you are trying to make sense of lipid/cholesterol processing, look it up from Kaplan Biochem notes.

d. Moving on to repetition, you have to repetitively visit those disease/topic links you have in your master notes (I’ll talk about it later) on a regular basis. Specifically, target the chapters that you know to be weak (from an NBME evaluation or your med school exam scores) and devote more frequent repetitions to it. Aim to finish a repetition in a reasonable amount of time such as Biostatistics formulae in two hours maximum or 25 pages of First Aid minimum in one day.

e. Together, linking and repetition will solidify your memory to such degree that you will less and less time to cover a set amount of material in one sitting.

3) Make a master copy of your notes. You can use Kaplan notes if you prefer it since they are all encompassing. But personally, I would advise the following plan. Unbind your First Aid (definitely from Staples, Kinko’s, etc.) in the beginning of your second year or at the beginning of your prep time for Step 1. Get Kaplan Notes/Videos also if you are weak in your pharmacology, anatomy or physiology (preferably from someone who has just finished their exam). When you study a chapter at day, try to read ahead from Goljan Rapid review and watch its video/image on Youtube/Google Images respectively. Then, add that information to an adjoining blank page next to where its mainly mentioned in First Aid. This way, not only are you making a quick study source in the last month or so before your Step 1, you are also focusing on main topics during your Basic Sciences and making those memory links from the get go! It is this master copy that you must study from in the last 1-2 months before Step 1 and where you can also add information from UsmleWorld or Kaplan Qbank which have excellent tables in their answer sections. I also highly recommend adding charts from Kaplan Biochemistry energy metabolism chapters and images from Kaplan/High Yield Neuroanatomy.

4) Overall, I used the following resources:
a. Goljan Rapid Review (Read it at least twice thoroughly at a pace 1-2 days per chapter). It will reinforce both physio and pathology. I also found its first seven chapters on wound healing and its hematology chapters very helpful. If you have bought a new copy (you will if you are taking Falcon review courses), its own 100-200 question bank is very good for pathology.
b. BRS Physiology- this is your ultimate source for physio!
c. Kaplan Biochemistry
d. – This website is based on First Aid. It is an awesome source if you want to quickly review any single disease/ topic in its entirety. Bear in mind though that its search function is very strict about the correct name of the disease/topic.
e. First Aid (do check regularly for errors and mnemonics from their website) – has excellent mnemonics and I suggest you read through its topic before making your own. You will save time that way.
f. High Yield Neuroanatomy
g. USMLEWorld Qbank first and then, Kaplan Qbank. Do NOT use these as primary learning tools. If so, you WILL end up memorizing the answers and it will falsely inflate your average and the perception of your preparation standing. I was scoring approximately 45-55% average in both qbanks when I started and 60-65% before my Step 1 exam. Do NOT be discouraged if you have received low average in your question sets. Instead of blindly going through more questions, try to read up on the chapter before attempting its questions so that when you look at it, you can remember the page in your First Aid/Master copy where you saw it. Again, it is all about making memory links!
h. ******Anyone who says that all your need is First Aid and UWorld for Step 1 prep is either misguided or already has a very good foundation in basic sciences. First Aid and pretty much every other review course out will only help filter out what is important and WHAT you need to know. It is up to you to add the relative information for the diseases from the sources I have listed above (a-g) in the process I listed above (#3). Basically, HOW you learn is still up to you in terms of mnemonics, memory aids and so forth.******

5) In terms of review courses, do not go to Falcon or Kaplan expecting a magic class where someone will just pump information into your head. They can only highlight what to study and how to study but NOT HOW YOUR REMEMBER IT. A better way can be to borrow the notes and videos from someone who took their course and has just finished their Step 1. Use a disciplined study plan for a month or two and learn from the same notes/videos and use them to add to your master notes/videos. Try giving an NBME or use a UWORLD/Kaplan Qbank to assess your standing, and after that, if you feel that you do need to improve your standing, you can take a review course. Basically, review courses do have an unspoken expectation that you are at least familiar with the basics or the topics mentioned in the First Aid. Another alternative is to look for a private tutor in your area.

6) You do NOT need an army of decent study partners if you DO have ONE really good study partner. Ideally, it should be someone from your own class, someone who is at the same learning stage as you or someone who is giving the exam at the same time as you. But for me, this was my dad. He is a veterinarian so he has the relative medical background in basic sciences. He is my ultimate study partner not because he has all of First Aid in his head, but rather because he is willing to stay with me through the entirety of the preparation and push me towards my goals. The ultimate study partner is someone who will:

a. keep you on track,
b. ask you questions regularly (even at the dining table)
c. will not hesitate to embarrass if it means helping you learn
d. will encourage you when you suffer a breakdown (and trust me, many students do!)
e. look up topics on the internet and help you learn the extra info missing in First Aid
f. call you out on bullsh** answers
I can say with assurance that if it were not for my father, I would have probably failed the Step 1 exam yet again. So I would like to take this opportunity to thank my father and if you are reading this, do thank your studying partners for sticking through the process with you!
As for the exam itself, I cannot add anything else that others have mentioned on this forum.
Do NOT take more than 6 months for your studying preparation. Use your first two months to view the videos/notes/primary texts and collate your information, especially on your weak areas, into your unbound First Aid. Do use the first few months to go through Goljan Rapid Review twice. Your typical preparation day should include at least 12 hours of fast-paced study time (not including breaks, meals or workouts). During this time, also make a list of forgettables that you should focus on for repetitions. You should also study in well-lit areas that mimic the conditions you will have on exam day. So try to take -10 min. meal/bathroom breaks at the end of the hour after hour study long sessions.
Then, once you have approximately two months left, set up a studying plan whereby you are covering your master notes at least 4-6 times overall or 25 pages min. per day. In the same late time period, go through UWorld and Kaplan Qbanks twice each in random timed mode. If you are short on time, go with UWorld only.
On the day before the exam, try to remain calm and stick the list of forgettables and Rapid Review items at the end of First Aid if you really want to study something. Do pack light snacks(chocolates, juice boxes, grapes) that can be consumed readily (remember that you a 5 min. break), get your directions and call early to see if your appointment if still available. The most important factor though is to get enough sleep. Try to start getting enough sleep from 2 days before the exam.
On exam day, do reach the exam day an hour early. Do not talk to anyone or go through notes during breaks since you want to give your brain some rest.
I had taken NBMEs and UWSAs long before my exam but I was scoring in a similar range as my actual score +/- 10 points.
My hope is that these lessons that I wish I learned far earlier would serve as an early warning and guide to those who still have time.

Good Luck with your exams and I hope you achieve your goals.
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Old 05-27-2013
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Congrats for the score ... the first aid notes (forming a master book) and linking diseases through silly pictures, i think you pretty much nailed that ..... i am surprised to see your score after seeing how much you have put it in and how smartly you went about it....thanks for the tips and good luck for step 2 ... i know you will score big and will match to your desired residency ...

Your dad must be really proud of you
256/262/passed/237/2016/need Visa/ 3 months USCE/ 1 Pub

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Old 05-28-2013
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Thank you and Congratulations. Thanks for compiling all these wonderful thoughts and ideas and helping others. I am sure you will do Marv on Step 2 and reach your goals in Life. Good Luck
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Old 05-28-2013
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Default Hello :)

Wow!! Your post is an inspiration and an ultimate guide for any directionless USMLE step 1 aspirant. Thank you isn't enough.
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Old 05-29-2013
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Thank you so much for posting this; i really needed this right now at the time of peak demotivation stage and giving up stage i'm facing right now...i feel i'm doing so many mistakes which your post has helped me correct now!

Congratulationsss on your step 1 score; you are truly determined and all your hard work has really payed off; i'm so happy for you! I'm sure you will do awesome on step 2 and get an amazing residency!

Good luck
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Old 05-29-2013
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Default Thank you!

Excellent post. I'm currently studying and will take your advices. I LOL with the Game of Throne statement
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