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med28 Step 1 Experience: 275

83K views 107 replies 52 participants last post by  kalel 
#1 ·
In the following text I will be describing my preparation plan. It is actually nothing more than the compilation of advice given by lots of students in this forum, to whom I am really grateful. Because many of you sent me personal messages asking for personal advice, I will highlight the fact that what worked for me may not work for you.

That being said, I consider it important to describe my background. I just finished the 4th year of a 6-year medical degree in a European medical school. I took the test in May 2013, having started my preparation in September 2012. At that time I had just completed the first 3 years of my school, which in my country cover the preclinical subjects. So while preparing for the Step 1, I was also doing my first rotations in internal medicine and surgery. That turned out to be really helpful, given the increasingly clinical orientation of the exam, as I got familiar with the basic signs and symptoms of diseases. However, I had already bought some usmle-style books in the earlier years, to help me tackle my university exams. For example, I had already studied Microbiology Made Ridiculously Simple and Lippincott's Pharmacology, but not with the purpose of preparing for the step 1.

My preparation
I started my preparation in September 2012. I tried to study 5-6 hours a day until January, when I completed the first pass of the material I had bought for my preparation. For each subject I would first read a review book and annotate the missing information into First Aid. I would then do all the questions in uw ( I had a 6-month subscription starting in November) on each subject (subjectwise-timed/unused mode) and add notes in FA. At that time, I would not bother about my scores or memorizing information. It was all about understanding mechanisms, getting familiar with the topics covered in usmle AND annotating in FA. Guys, I think this was the most important thing I did in my early preparation. I would annotate all mechanisms, new drugs etc mentioned in review books in first aid, so that I would not have to go over those books again. I never made notes in these books, nor read them a second time. By January, I had my first aid stuffed with extra information, but I knew that all I had to do was learn everything in this book and practice questions. It is much easier when you have one book, rather than a series of review books. So starting in February 2013, I started reviewing FA over and over again. Having concentrated a huge amount of info in just 500 pages, I was able to go over the material 4-5 times until April. I would study 8 hours a day, splitting my time in 5 hours of FA studying and 3 hours of practicing question banks. In my case, memorization requires repetition. I have really moderate memorization skills, but after reading the same material 4-5 times I could remember every single page on my first aid book. There were only 2 exceptions to this method: one was Goljan RR, I would not bother annotate it into FA, but what I did was annotate interesting points in the blue margins so that I would later be able to go over it just by reading those margins. The second were the Microcards, which I used instead of the microbiology section in first aid.
During the last 4 weeks, I studied as much as I could each day (10-12 hours) and divided my time equally between studying FA and doing practice questions.

Books used
FA: the absolute guide to USMLE step 1. it is not enough if you are aiming for a high score, but you d better know every single piece of information in it if you want to ace the exam.

Pathology: I spent a whole month studying this subject. For each chapter of Goljan's RR I would first watch the Pathoma videos, then listen to the audio lectures of dr Goljan and then finally read the chapter. I found this approach really useful, but it is indicated only if you have lots of time and a weak background in pathology.

Behavioral science: As a foreign student, this was by far my weakest area. I used BRS pathology. A great book but didnt really help me as far as the ethics questions are concerned. Luckily a few weeks before the exam, a friend recommended the «Kaplan medical ethics: the 100 cases you are most likely to see on the exam». The questions under this topic are not really hard, but require some experience that you gradually acquire after doing lots of questions.

Biochemistry: I used Lippincott's Illustrated Reviews, a lengthy book but with nice text and tables. However, as I mentioned, I never read those books twice, but on the contrary I made annotations into FA

Physiology: I used BRS Physiology. short, concise, but you may need something with longer explanations if you are weak in this subject

Molecular Biology: I used HY cell and molecular biology. Maybe the worst book of the HY series I used. It has trivial information and most topics are also covered in other subjects eg biochemistry, immunology...

Pharmacology: I used Lippincott's Illustrated Reviews. It is a nice book, but not suitable for step 1 preparation. I made some annotations into FA, but ended up learning only the stuff already mentioned in FA and that worked fine.

Microbiology: During my Microbiology classes I had used CMMRS, which is an EXCELLENT book. After the first reading, you can use the summarizing tables found at the end of each chapter. However, I used instead the Microcards. Those cards are AMAZING! They have wonderful algorithms and trees and are the most useful tool in memorizing bugs.

Immunology: I used HY Immunology. Not a great book, but didnt find anything better. Not sure if you really need something more than the first aid immunology section. Do not forget to create a list with all the important CDs, these are frequently tested!

Anatomy/Neuroanatomy/Embryology: I used the HY series. I found those books great, especially the one for Neuroanatomy. (do not worry about anatomy, it is a huge subject and HY gross anatomy may also be a little too detailed. But a quick read of this book, in combination with the anatomy info in FA is all you need)

Question banks/ NBMEs:
Doing a massive amount of questions is probably what can boost your score more than anything else. These help you adapt and use your knowledge. It doesn't matter if you know everything in first aid by heart, if you cannot recognize the buzzwords in the question stems or apply the info learned to a clinical vignette. That's where question banks come in.

I used 3 question banks, UW, Kaplan and USMLERx.

UW is by far the best of the three! Excellent questions, wonderful explanations, it is a major LEARNING tool. Do not use it as an assessment tool! Read the whole explanation in order to learn, even if you got the question right. I first did it subject-wise after finishing each review book and had an overall score of 84%. I also used it during the last 3 weeks, doing 3-4 blocks a day as by that time I had forgotten most of the questions (94%). But as i said, do not worry about your scores, especially at the very beginning. Those questions are really harder than the real test, so do not use them to predict your performance.

KaplanQBank: a very good qbank, definitely use it if you have the time and the money. I made an one-month subscription around April (one month before my exam) and completed 3-4 blocks a day. Overall score=92%

USMLERx: I subscribed for one month in February. It may help you consolidate the info in First Aid, but other than that it is worth neither the time nor the money. I used it because I wanted to practice some questions, while still in the beginning of memorizing first aid, after having a done the first pass of UW.

NBME: Those are the only accurate predicting tools! I took the following:

NBME 6: 650 (2,5 months before the exam date) =259
NBME 7: 700 (2 months <<) =268
NBME 12: 700 (1,5 month <<) = 268
NBME 15: 710 (3 weeks <<) = 271

The rest can be also found offline, but it is up to you, because they are neither legal nor predictive.

I would personally recommend doing all NBMEs but If I were to choose only one, I would choose NBME 15, as it had longer questions stems and was more similar to my real exam. But all of them are quite accurate in predicting your performance from what i hear.

The real exam
The hardest part of the exam is trying to maintain your concentration and focus for 8 hours in front of a computer screen. Stupid mistakes are inevitable but there are some ways to minimize them. These are: practice, practice, practice! Try to simulate the exam at home using a question bank or an nbme exam. I simulated a 7-block exam at least twice so that I would increase my stamina and learn how to cope when my mind gets tired. Try to save energy: when facing a long question stem, first read the last sentence to see what it is all about. Sometimes the long stem is just a distractor. Never spend much time on a question you do not know. Guess an answer, flag the question and come back later once you finish all other questions. Practice will help you read through stems quickly, finish the block with some minutes to spare and go once again over the marked questions. I usually marked 8-9 questions per block, but in most cases what seemed to be a weird hard question, turned out to be a simple question addressed in a complicated way. Even in hard questions I was almost always able to narrow down to 2 choices and then take a good guess. USMLE is nothing more than a test, so a good test-taking strategy is as essential as having the appropriate study material.
Pathology /pathophysiology dominated my exam but all other topics were relatively equally represented in my exam. There were a lot of tables and graphs, CTs and CXR for Anatomy, simple ethic questions, lots of immunology, but as every single exam is unique I don't see a point in going further into detail.

Finally, here are some bullet points with the most important conclusions drawn from my experience:

• Set a goal early in your preparation. Even choose an exam date early in advance. Establish a program and a daily routine and stick to it! You do not have to sacrifice other things, such as friends and family, if you organize your time properly. You will also never feel fully confident to take the test, so delaying your exam is not always a good idea.
• Try to annotate information from various sources into a major one (eg FIRST AID) . This may be time consuming in the early beginning, but you will recognize its value later on, as you will be able to cover a huge amount of information in a short space of time.
• Do questions, questions, questions: online Qbanks, Qbooks, Nbmes, although expensive, are definitely the most useful preparation material together with the first aid book.
• Always try to understand the underlying mechanism of disease! Always ask your self "why is this happening?" when studying. Pure memorization is not so frequently needed, it is your understanding that they want to test.
• use your question banks to learn and nbmes to predict your performance!
• Feel confident, it is totally doable once you set your goal and work for it!
 
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#51 ·
WOW is the Word.....:)

Hey med28...

Congrats on d wow score....change yur name 2 medwow275 now....:D

I was a bit concerned about the increasing amount of immunology and molecular biology that is being asked now......and neither HY Mol bio nor Kaplan can apparently prepare you for them.......are the 3 q banks in yur opinion sufficient to cover these topiks....???

Can you just tell some important trending topiks in yur view in subjects like emryology or immuno-molecular-genetics......coz every1 knows about the imp topics in patho pharma and micro....but not much in crazy genetics and molecular bio......!!!!

Thanks :)
 
#53 ·
Hey med28...

Congrats on d wow score....change yur name 2 medwow275 now....:D

I was a bit concerned about the increasing amount of immunology and molecular biology that is being asked now......and neither HY Mol bio nor Kaplan can apparently prepare you for them.......are the 3 q banks in yur opinion sufficient to cover these topiks....???

Can you just tell some important trending topiks in yur view in subjects like emryology or immuno-molecular-genetics......coz every1 knows about the imp topics in patho pharma and micro....but not much in crazy genetics and molecular bio......!!!!

Thanks :)
about immunology: i have read that lots of people study the immunology pages from levinson's book (Review of medical Microbiology and Immunology). i have no idea, as i have never seen the book, but you could check out if it suits you. my immuno preparation was based on HY immuno, FA, QBanks and the respective pages from Goljan's RR. HY is badly written and has lots of info presented in a hard to memorize way. however as i said, i didnt search for a different book. the qbanks were as always very useful. you can/should also make annotations from the immuno found sparsely in Goljan's RR.

about molecular biology/genetics: FA pages are a must! some topics (replication, transcription...) are analyzed nicely in LIR biochemistry. HY on the other hand wasnt very helpful for me. if you can find a free copy, you can read it in a single day but it doesnt really offer much. Goljan's genetics chapter is also very useful (i didnt use a separate book for genetics, just FA, Goljan and QBanks). I think i already had a strong background in these subjects so i cannot give you useful advice. My only advice is that anything in FA is important, so definitely know these pages cold before sitting the exam.

about embryology: i think i only had one or two questions in my exam, simple things, covered in fa. HY embryology is a nice book but in my case FA would have been enough.
 
#54 ·
hey i have another question you said you didnt take your exam in summeri
in easter vacancy (15days) before the exam what did you do ?and what do you recomend ? since i have your same situation only 15 days what should i do in those 15 days only fa? and practice for endurance?
 
#55 ·
exactly. what i did was study FA and redo some uw questions, mostly to gain some pace and endurance for the exam day. do not try to learn anything new or read new material, it will probably confuse you and make you anxious. just try to consolidate what you have already learnt, mostly what's already in FA.
 
#59 ·
messed up!! is this a proper plan??

i did my first read of kaplan LN few months back (skipped micro and behavioural sciences) but i could not continue with my preparation.. now i can continue with it but i really dont remember anything from my first read... i decided to give 3 months to my next read and annotate kaplan LN to FA this time... i am so much messed up with few questions;
1- how should i annotate kaplan LA to FA? space is too little toa accomodate evrything???

2-there are so many topics that are not written in FA, so should i learn them as well because if i make FA as my ultimate book with some additions then i will be forgetting those non written kaplan LN topics by then...

3-from which subject should i start now??

4- now somebody told me about DIT, so how to manage this alsoin 6 months preparation???

freaking out!!!!!! plz help....... :scared:
 
#61 ·
i did my first read of kaplan LN few months back (skipped micro and behavioural sciences) but i could not continue with my preparation.. now i can continue with it but i really dont remember anything from my first read... i decided to give 3 months to my next read and annotate kaplan LN to FA this time... i am so much messed up with few questions;
1- how should i annotate kaplan LA to FA? space is too little toa accomodate evrything???

2-there are so many topics that are not written in FA, so should i learn them as well because if i make FA as my ultimate book with some additions then i will be forgetting those non written kaplan LN topics by then...

3-from which subject should i start now??

4- now somebody told me about DIT, so how to manage this alsoin 6 months preparation???

freaking out!!!!!! plz help....... :scared:
1. annotating doesn't mean you have to copy anything you read in uworld. try to use your own words and abbreviations, and write down facts that are new and you have not seen before. sometimes i did not annotate anything for a particular question, and my notes for each question were usually no longer than a sentence long. i think i cannot help you anymore on this, each person is different, and you have to find what suits you best.

2. i dont know what to say. it's up to you. the more you study, the more you ll score. but from my personal experience, it is better to spend time practicing questions, than studying obscure topics.

3.i dont know, maybe start with your weakest subject. it s your decision.

4. i didnt use DIT, so i cannot give you any useful advice..
 
#62 ·
i am no exception, i have no idea how the system with the experimental questions works. my personal understanding however is the following: people expect that experimental questions are the hard ones. from what i read, any question is first introduced as experimental, so that the examiners test how the students respond to this question: is it too easy, too hard? so given the fact that any question can be experimental, i cannot comment on how many such questions are in the real exam. my personal opinion is that you should not be worrying about those things, your goal is to try to answer every single question. if there is one lesson to learn, then that is that you should not spend much time on questions you dont know, just mark them and go on.
 
#65 ·
what to do?

hey med28 owesome score and experience well written

i have to ask u something
i have just enough time either to do kaplan qbnak and uworld once or do uworld once and then revise it

so what do u think i shud be doing?:confused:
 
#68 ·
hey med28 owesome score and experience well written

i have to ask u something
i have just enough time either to do kaplan qbnak and uworld once or do uworld once and then revise it

so what do u think i shud be doing?:confused:
i think it s better to do two qbanks. the reason i revised uworld was that i had done it early in my preparation, so by the time of my exam i had forgotten most of the questions. so imo there is no need to revise it right after you finish your first time. and ALWAYS keep in mind that you have to read the explanations, that's what qbanks are for. it's better to read all the explanations in uwrold carefully, than do 2 qbanks without paying attention to the detailed answers. but if you have enough time to do that for each qbank, then do both.
 
#69 ·
Hi med28! It has been a while on this thread :)

I'm scheduled to appear for exam in about 2.5 months. I have finished one round of all subjects along with FA and KQB except gross anatomy and microbiology. I have a few queries:

Should I skip separate review of microbiology (MRS) and gross anatomy (?) and encounter them directly in UW? I want to finish UW with FA, then UW incorrect and finally NBMEs before the test. I feel their separate review would take quite some time and it might not be productive. How is the idea of reviewing them from just FA & DIT before UW? Please give me some suggestion.
 
#70 ·
as far as gross anatomy is concerned, there is no point in reading a separate book for this subject at this point, study FA+QBanks and you should be ready to tackle most of the questions on the exam. just remember to take a look at some xrays, CTs and be able to recognize the main structures. even if you read HY Gross Anatomy, there is no guarantee that you will be able to answer all questions, so use your time wisely.

about microbiology: well it all depends on your background. if you have a solid background, then go with FA. but CMMRS does a wonderful job of presenting all the bugs with mnemonics, images etc so if you are weak in this subject, CMMRS will be a high-yield source, far better than the short-summarizing tables of FA. (still, as i already said, i personally used the microcards, instead of the FA pages). microbiology questions are quite straightforward, once you learn the different algorithms (gram+, gram-, rna viruses etc..) and some basic stuff about each bug, you are ready to tackle 95% of the questions. but anatomy on the other hand is a wide subject, it would be low-yield to dedicate more time.

i havent tried DIT, so i cannot comment on it.
 
#71 ·
Pathology

Hello there friend .. First congrats on ur score ,,
I want u to know that me and my Fiance are following ur guide word by word .. Thx
One Q :about Goljan u annotated the interesting facts to the blue margins , u did'nt read FA and only went through the notes and margins in every revision ? is this right or should I do something else?
I'm intending to read goljan and listen to the audios..
Any answer would be much appreciated ..
Thx
 
#72 ·
Hello there friend .. First congrats on ur score ,,
I want u to know that me and my Fiance are following ur guide word by word .. Thx
One Q :about Goljan u annotated the interesting facts to the blue margins , u did'nt read FA and only went through the notes and margins in every revision ? is this right or should I do something else?
I'm intending to read goljan and listen to the audios..
Any answer would be much appreciated ..
Thx
Thanks! i hope that it is working for you. just be careful, this is not exactly a guide, it s more a description of my experience. for example i may have used Lippincott's for pharmacology but imo this book is an overkill. if i were to do things again, i would not have chosen it, but i would have gone with a briefer review book.
about pathology: as i said, i annotated some important facts in the blue margins, but i also went through the FA pathology pages, where i had also made annotations from the Usmleworld questionbank. the FA pages are a MUST, they may be incomplete, but it is nice having some high-yield facts all put together on a few pages. reading those pages cant be time-consuming, especially when you have already studied goljan's book. i hope i answered your question :)
 
#73 ·
Thx Dr

You are absolutely right ...

For Path first I'm going to read some FA pages then read corresponding goljan pages focusing on blue margins annotating IMP facts to the blue margins and marking other explanations , so when I revise I would go over them more efficiently , but as u said annotating the entire Goljan book to FA is time consuming and unnecessary, if wt I described is similar to ur experience plz tell me and If u have other notes on this approach or any other I would appreciate the insight ..

Again Thx for sharing and sorry to bother .. :)
 
#74 ·
congratulations on such a wonderful score !
I have been preparing for step 1 since 6 months,Now i am doing UWorld and will repeat it afterwords.
As you and many people say that two third paper is going to be from patho , so i am thinking to revise GOLJAN(TRY TO FINISH IT IN A WEEK ,as i have read it once with lectures) four weeks before exam.Is it a good idea ?:(
looking forward for your reply .Thnkyou
 
#75 ·
pathology is definitely the most important subject in the exam, but i think that it includes 25-35% of all questions, not two thirds. so do not neglect all other subjects, such as pharmacology, microbiology etc..
i cant really answer your question. if you can go through goljan's book in a week, then it will surely help you. but if you already score high in pathology uworld questions, but low in other important subjects, then dedicate more time to those subjects rather than pathology. people tend to focus so much on pathology, but there are a lot of easy points coming from micro,pharm,behavioral questions etc, that you should not miss if you plan to score high.
 
#84 ·
Hey Med28

so i am impressed by the way you prepared . !

i am really confused at one point in my preparation and really need your help and my question is :

my exam is almost 40 days away and i jus gave nbme 11 and got 220 .

i want to increase my score so what should i do further ?
i did uworld once have notes , read half and will do marked questions
but i have a thought about kaplan qbank as well but i really dont know that will increase my score

tell me what should i do other than FA in last 40 days ?
i am planning to give more exams like 7 13 15 as well but to increase my score what should i do ?
 
#85 ·
so i am impressed by the way you prepared . !

i am really confused at one point in my preparation and really need your help and my question is :

my exam is almost 40 days away and i jus gave nbme 11 and got 220 .

i want to increase my score so what should i do further ?
i did uworld once have notes , read half and will do marked questions
but i have a thought about kaplan qbank as well but i really dont know that will increase my score

tell me what should i do other than FA in last 40 days ?
i am planning to give more exams like 7 13 15 as well but to increase my score what should i do ?
kaplan qbank won't increase your score much, as it frequently tests obscure topics and this can be stressful at this point. were the topics tested in the nbme questions you missed mentioned in fa? fa alone should help you score 240, so my guess is you're not yet familiar with all the info in this book. my advice is to study FA + redo UW questions. definitely know fa cold before you take the exam, i keep highlighting this fact, but it is reaaally important. nbmes should reflect your progress.
 
#86 ·
Hey med28

I finished all the books same as your way and annotate them to FA, except for patho i used pathoma.
Then finished FA for the first time , then doing UW subject wise first time .. Score 87 % 300 q and stil on it
Myexam is end of march .. Planing to revise fa and Q more and more
What do u think ?????
 
#87 ·
I finished all the books same as your way and annotate them to FA, except for patho i used pathoma.
Then finished FA for the first time , then doing UW subject wise first time .. Score 87 % 300 q and stil on it
Myexam is end of march .. Planing to revise fa and Q more and more
What do u think ?????
i believe you are doing great. just one question: if you have already finished all the books, why don't you do UW in random mode rather than subjectwise?
 
#91 ·
@med28
How much did the NBME exams help u in preparing for the USMLE ?
If I use my question banks to create tests to simulate the exam , would that substitute for the NBMEs - they are expensive !!!

Thx
nbmes didnt help me prepare for the exam. I did use them however to evaluate my progress and estimate my score. as no answers are provided (although most can be found in the usmle online forums), they are of little value for your preparation, but they offer a very accurate (rather than precise ;) ) prediction of where you stand. that being said, you can just do one or two nbmes around 1-2 weeks before your exam, and decide, depending on the grade, whether you feel ready to sit the exam or prefer to delay it.
question banks on the other hand are of variable difficulty and there is no official/standard formula to calculate a predicting score.
 
#94 ·
Thx again for the advice ...
regarding pharma : is reading KLN + videos & FA , enough ?
also Behavioral (BRS) and biostat (HY) , are they good sources? ...

ur opinion will be much appreciated ...
in my first post, i mention all the sources i used, so don't expect me to comment on books i have never tried. as i said, regarding pharma, lippincott's is an overkill, FA is enough, so if you supplement FA with KLN, that will cover you for most of the questions. BRS is a nice book, nothing great though. I didn't study a separate book for biostats, i just used BRS behavioral + FA + Qbanks. Good luck!
 
#95 ·
Congratz for ur great score!!

I would like to do a qbank alnong with my first read of FA, do u recommend uw or usmle rx?

And how can i use UW subject wise, if im doing each chapter in FA along with its corresponding chapter in the supplemental book (I guess this was ur way too)?

Thank you :D
 
#98 ·
hey, i recently took my Step 2 ck exam. I have been waiting for my results, but it seems the ECFMG has sent a request for verification of medical student status to my school. So i guess i will be waiting for a while longer. I had the feeling that step 2 ck was way harder than step 1, many vague questions, a lot of stupid mistakes that i had managed to avoid in step 1, or maybe I didn't have the time to prepare as well as for step 1. i was unsure about almost 10 questions in each block, whereas in step 1 it was 2 or 3 per block. I had a really bad feeling after the test, but from what i read in the forums this is quite common among ck exam-takers. I am gonna post my experience when I get my scores. I have been waiting for almost 2 months...
 
#99 ·
Patho

@med28....You had a great score in Step 1.

I want to know how should I prepare for Patho in addition to cool FA and UW. As you have written in your experience that the review books were not very helpful and if you have to prepare for step 1 again you will do kaplan. I want to know about Goljan, how many times did you read it. And also how many times you heard Pathoma videos and Goljan audios. Kindly please tell how important is Goljan in the prep. Is it a must read ? Also did you read Pathoma book also ? Kindly tell how useful are Goljan audio lectures ?
Thanks
 
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