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  #1  
Old 11-13-2013
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Experiences Taming the Beast - DNA105's Step 1 Experience (262)

I've been dreaming of filling this column for weeks and here I am now, with Step 1 behind me, and me trying to give back to this wonderful forum all that I've gained from it; God bless the Internet. So I'll try my best to be helpful here, disclose my study plans of course, but also give some insights and some personal opinions. Apologies if it gets over-detailed.

Preparation -

Duration of prep - 6.5 months, dedicated.

First 4 months - First reading.
I know I took some time for my first reading. But in the end it was worth it. The first reading is the most important part of your prep. It's all about building foundation. Conceptualization has always been my weapon and the USMLE suited it well. This is basic science; try to understand and unravel the intricacies of the mechanisms of health and disease. All that may seem overwhelming but once you actually understand, it's a bliss. Your first reading may take more or less time depending on your background.

Materials used -

For Pathology - One word - PATHOMA. Even though it's not the coolest name for a review course, it is most certainly the best one out there. During my entire life as a medical student, I haven't come across a course more well taught than this. Dr. Sattar is a genius. Pathology was one actually one of my weaker subjects in school. Subscribing for Pathoma was the best decision I made.
I also read Goljan AFTER I read Pathoma; took me around 12 days and I annotated Pathoma with the extra information. Goljan is a good book, no doubt. The good thing about it is the depth of the information provided. It cleared some of the concepts I was confused about for years! But the point is, all that extra information wasn't really tested (as far as I can tell), even though I loved reading it.
Bottomline for Pathology - It is the most important subject for Step 1 as we all know. I swear by Pathoma. If you understand each and every thing it has to offer - you're good to go. IF you have time, you can skim through Goljan and annotate Pathoma. And don't even bother touching Kaplan for Pathology (yes, I tried and it was pathetic.)

For all other subjects - One word again - Kaplan. Seriously, the guys at Kaplan need a pat on their backs. The notes are all that you need to ace the test (except Pathology of course, which is horrible). Complete, conceptual, and even concise (as compared to some of the other reviews in the market). Notes and videos go together. What I did was I made the habit of watching the videos and reading from the notes together. That saved a lot of time. You get a much better idea of what's written in the notes if you watch the videos simultaneously. I recommend watching all the videos except Histology (and Pathology, of course.)

Special note on Behavioral Science -
This was one subject which was the pain in the rear for me. The questions they ask are so ambiguous, often being stuck with 2 choices. This should not be taken lightly (especially by IMGs).
Biostats - It's easy. Know your formulas and apply (Kaplsn is enough). If you're good at Maths, you shouldn't get a SINGLE biostat question wrong in your entire test. I, fortunately have a good aptitude for Maths and I tackled some REALLY twisted Biostat questions in my test. Also, the Kaplan Qbank has some really challenging Mathematical questions for you to practice (will talk about it later.)
Legal questions - You should get most (if not all) of these right. It's like being in law school - know the rules. I read Conrad's 100 Cases - good book, takes less than one day to read.
Psychology - Kaplan is a good book and Dr. Daugherty does a great job in videos.
Ethics and "Next-best-response" questions - you can't do much about these. Common sense may/may not work. Practicing questions is the key though.
I also read BRS Behavioral Science - just a very quick read in 2 days during my FINAL week of prep (not in 4 months). Not absolutely necessary; I did it because I was scoring low in Behavioral. You can read it only if you have time.

So during these four months I read all that material, AND did the UWorld questions for "assessment", subject-wise, after finishing each subject. It gave me an idea of my strengths and weaknesses. I didn't read the explanations or annotate anything.

5th and 6th months -
Revised the entire study material - took me around 20 days.

Read First Aid - Big surprise. Just read it ONCE. First Aid was not at all helpful for my prep. I read it once and annotated the extra information into the Kaplan notes. Now I'm not discouraging anyone against using First Aid but this is for someone like me who feels reading First Aid as the main resource can be terribly painful - you can score well without making 5-6 readings of it.

Reviewed UWorld - This is super-important. UWorld is a top class Qbank. The sheer authenticity of the questions is makes it the best Qbank. I made sure I imbibed the concept offered by every single one of those 2200 questions and annotated the extra information into the notes.

Revised the entire annotated study material 3rd time - took me around 15 days.

Did Kaplan Qbank - Another great Qbank. A must-do if time permits. Strengths vs UWorld - Highly challenging Microbiology, Biostats and Genetics questions.

Finally, did a fourth and final review of the entire study material in the last 15 days (along with a quick read of BRS Behavioral Science, as already mentioned.) I know that sounds excessive but I believe revision is under-rated in USMLE prep. I didn't have time to do the Kaplan Qbank again.

NBMEs and UWSAs -
NBME 7 and 13 - 240 (2.5 months off)
NBME 11 - 250 (1.5 months off)
NBME 12 - 240 (1 month off; was ill)
NBME 6 - 254 and NBME 15 - 250 (15 days off)

UWSA 1 (15 days off) and UWSA 2 (2 days off) - both 265.
The cut-off for 265 in UWSAs is around 85%. I got 85% correct in UWSA 1 and 88% in UWSA2.

Judgement Day -
I slept for around 6 hours, fragmented, the day before. But adrenaline just keeps you going. Try avoiding anxiety though. It's your show, you own it. The test was well, a little bit of everything. I guess I got lucky because all the tough questions were from my strengths - Genetics and Molecular biology. Know your molecules! I have always had a fascination for all those complex signalling pathways etc. All that is high yield. Overall it was a well balanced set of questions.
After the exam. Go get lost in oblivion, at least for a few weeks. Don't analyze anything.

Final words -
Well that's pretty much all I had to rant about. This is just to give you an idea. The best judge is YOU. Know your style, your strengths, your weaknesses, and play accordingly. Make your own perfect plan.

Sorry if I missed anything. I'll try to answer any other specific queries that you may have. Good luck to all you great fellas. Tame the beast!
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  #2  
Old 11-13-2013
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awsome man, you killed it . Now GET SMASHED .
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congratulations you deserve it

did you miss any questions because of lack of time?

and how many mistakes did you remember after the exam?

did you have lot of pathohistolgy slides?
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@cysterna_chyli - Thanks man!

@taher - No I didn't miss any questions. I think I had the strategy of not getting stuck on a question I have no idea about, except if it was a calculation question which is bound to take some time. I had 6-10 minutes for reviewing each block. I have the bad habit of marking too many questions though (some unnecessarily). I marked 8-12 in each block...

You really don't have to worry about pictures. There were quite a few in my test but were MUCH more easy than those in Qbanks and NBMEs. Just have a very basic idea.
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Hey many many congrats on such a superb score......v def need to extract most out of ur experience......😜
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Quote:
Originally Posted by DNA 105 View Post
@cysterna_chyli - Thanks man!

@taher - No I didn't miss any questions. I think I had the strategy of not getting stuck on a question I have no idea about, except if it was a calculation question which is bound to take some time. I had 6-10 minutes for reviewing each block. I have the bad habit of marking too many questions though (some unnecessarily). I marked 8-12 in each block...

You really don't have to worry about pictures. There were quite a few in my test but were MUCH more easy than those in Qbanks and NBMEs. Just have a very basic idea.
was genetics really tough? Even though its your strong subject. I get tripped up on the math sometimes, in the stats questions though. I am a person who needs to be constantly revising FA (exam is next Friday!!), otherwise i just dont seem to retain everything i need to.
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Quote:
Originally Posted by CisternaChyli View Post
was genetics really tough? Even though its your strong subject. I get tripped up on the math sometimes, in the stats questions though. I am a person who needs to be constantly revising FA (exam is next Friday!!), otherwise i just dont seem to retain everything i need to.
Some of it was tough, but not outrageously tough. None of those obnoxious experiment questions we have in NBME. If you've made your concepts clear with Kaplan's notes, you'd answer most questions.

Stats? Well, yeah I had some twisted questions. Eg: Just make sure you know what things like "Number needed to treat/harm" actually mean in practical scenarios, then you would know how to use the Math. Doing maximum questions/revising would be best for you I reckon.

Good luck for your test!
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Congratss on sucha good score!!
How did you find anatomy n biochem in the exam?is kaplan n FA enough for two.
Is going through all of the kaplan for anatomy importana?
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Quote:
Originally Posted by DNA 105 View Post
Some of it was tough, but not outrageously tough. None of those obnoxious experiment questions we have in NBME. If you've made your concepts clear with Kaplan's notes, you'd answer most questions.

Stats? Well, yeah I had some twisted questions. Eg: Just make sure you know what things like "Number needed to treat/harm" actually mean in practical scenarios, then you would know how to use the Math. Doing maximum questions/revising would be best for you I reckon.

Good luck for your test!
yeah i did genetics from both kaplan and HY genetics, so i feel a lot better about the subject, but the kaplan q bank questions on the subject were tough. I am planning to review them again before the exam.
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congrats ..great score..how u studied anatmoy and neuro ?
is exam Q doable after doing kaplan n u world?
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Quote:
Originally Posted by CisternaChyli View Post
yeah i did genetics from both kaplan and HY genetics, so i feel a lot better about the subject, but the kaplan q bank questions on the subject were tough. I am planning to review them again before the exam.
I've 4weeks to go,how did you find HY genetics?how much time did it take you to finish it,is it different than Kaplan n uworld ?
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Wink Congratulations

Thank you for sharing with us your experience
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wait u took nbme 7 and 13 on same day?

and then nbme 6 and 15 and uwsa 1 on same day?

wow that's a lot of questions in one day!
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Congrats & thanks for sharing your experience

My exam is at the end of the month and after reading your post I am not freaking out because I am just finishing my first pass of FA and have followed a similar schedule as yours. Hoping to get a decent score.
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what is the meaning of UWSA
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have u listened to goljan audio??
& have u done highyield videos or DIT??
or any extra videos like dr. najeeb etc..??
cns ct scans etc. from where u have done??
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Quote:
Originally Posted by Irha View Post
Congratss on sucha good score!!
How did you find anatomy n biochem in the exam?is kaplan n FA enough for two.
Is going through all of the kaplan for anatomy importana?
Thank you!

Anatomy was manageable. Kaplan, is enough for ALL subjects (except Pathology). As I already told, I used First Aid as a secondary revision source.

This is my opinion. Some people have suggested they've got some super-tough Anatomy questions lately. Each exam is different but I still stand by the Kaplan notes.

As per your second question, I think the answer is yes. My personal opinion is, if you're aiming for a good score, you should go through the notes AT LEAST once to make solid understanding. Again, do what suits your style of learning.

I haven't read any HY books. Kaplan's Genetics is TOP NOTCH! Good luck man.
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@cysterna_chyli - The Kaplan Qbank's genetics is very challenging. It's good for practice though.

@mysha - Anatomy & Neuro were okay. Neuro was surprisingly easy for me! Kaplan is all that you need. I tried reading HY Neuroanatomy but I didn't like the presentation of that book at all; it has lots of information but it doesn't explain it in an understandable way. Neuroanatomy is a twisted subject. Kaplan's videos are highly recommended. (Especially brain stem questions.)

@mike_usmle - You're welcome. UWSA = UWorld Self Assessment. These are 2 simulationexams offered by Uworld, just like the NBMEs.

@jadej_a - No man! That is certainly NOT recommended. I took them on alternate days. Sorry I didn't make that clear before.

@violet - Lots of luck!

@anoushay - I tried listening to his audio lectures but I didn't like 'em much. Those are very old bootlegs, not easy to listen to, and very time consuming (around 40 hours). I had already done the Pathoma course, so just skimmed through Goljan once. As I said before, Pathoma is the number 1 Pathology course for me.
No didn't feel the need for DIT, HY vids or Dr. Najeeb's lectures after doing Kaplan. All these are exhaustive courses. I wouldn't suggest doing these AND Kaplan. Do just ONE and master that...

Last edited by DNA 105; 11-13-2013 at 10:59 PM.
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Was the exam more like U world Qbank/UWSA or the NBMEs?

Reason i ask is that i was set to take the exam last month, and after getting a 254 on NBME15, i took UWSA1 and bombed it (only managed a 214). A lot of it was due to having a poor grasp of genetics and molecular bio, and to a lesser extent, behavioral science. That really affected me and it kind of wrecked the test for me. So i postponed the exam to this month..

I covered a lot of genetics and some of molecular bio from the high yield series, i thought it was a good review...so i would say HY is worth getting.
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Quote:
Originally Posted by CisternaChyli View Post
Was the exam more like U world Qbank/UWSA or the NBMEs?

Reason i ask is that i was set to take the exam last month, and after getting a 254 on NBME15, i took UWSA1 and bombed it (only managed a 214). A lot of it was due to having a poor grasp of genetics and molecular bio, and to a lesser extent, behavioral science. That really affected me and it kind of wrecked the test for me. So i postponed the exam to this month..

I covered a lot of genetics and some of molecular bio from the high yield series, i thought it was a good review...so i would say HY is worth getting.
Oh that is really unfortunate. Something must have gone terribly wrong for you. I suggest you to take UWSA2. It is slightly easier than UWSA1 and might just give you the confidence.

Well the exam was a mix of everything. The questions were carefully crafted and well balanced; over-all a better standard than the NBME questions I reckon.
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i have 7 weeks to go, started UW getting 60% how to improve? i am doing fa+kaplan again in 16 days total, will it be helpful? i want to take an nbme by the end of nov, exam is end of dec. thanks .
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Oh that is really unfortunate. Something must have gone terribly wrong for you. I suggest you to take UWSA2. It is slightly easier than UWSA1 and might just give you the confidence.

Well the exam was a mix of everything. The questions were carefully crafted and well balanced; over-all a better standard than the NBME questions I reckon.
Well what went terribly wrong was that the questions to me seemed totally wierd, coupled with struggling with the subjects that i mentioned already and then it just ruined the whole thing. I made a lot of silly mistakes; if i hadnt done that, i would have gotten a 230-240 easily on the exam. I honestly found NBME 15 not that tough, other than some wierd stats and genetics problems. Yeah i'll be taking UWSA2 tommorow, after finishing up my neurology review. Good to hear about the question style though; AspiringDoc was saying that the UWSA questions are pretty different and strange compared to the real exam, any truth to that? Or maybe its just personal perceptions.
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hey man great score and a great achievement

my plan and stuff is roughly the same and like you i bank of kaplan notes alot and to me they are the best there is for usmle prep

im aiming for the same score but i dint do kaplan qbank nor have time for it
do u think i can still be able to achieve good score

my last NBME 12 3 mnth before exam was 230
now i have 2.5 months left in exam

and i havent even touched first aid

thnx
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hey, a huge congratulation! u did really fantastic!
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Hi, You earned it man!! congrats
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Quote:
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Well what went terribly wrong was that the questions to me seemed totally wierd, coupled with struggling with the subjects that i mentioned already and then it just ruined the whole thing. I made a lot of silly mistakes; if i hadnt done that, i would have gotten a 230-240 easily on the exam. I honestly found NBME 15 not that tough, other than some wierd stats and genetics problems. Yeah i'll be taking UWSA2 tommorow, after finishing up my neurology review. Good to hear about the question style though; AspiringDoc was saying that the UWSA questions are pretty different and strange compared to the real exam, any truth to that? Or maybe its just personal perceptions.
Well the questions in UWSA were kind of "different" but, you just had a bad day I guess. Don't get disheartened. 254 in NBME 15 is a rock solid score. Try doing more assessment exams and you would get a much more realistic idea of your preparation.
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hey man great score and a great achievement

my plan and stuff is roughly the same and like you i bank of kaplan notes alot and to me they are the best there is for usmle prep

im aiming for the same score but i dint do kaplan qbank nor have time for it
do u think i can still be able to achieve good score

my last NBME 12 3 mnth before exam was 230
now i have 2.5 months left in exam

and i havent even touched first aid

thnx
Hey thanks.
I suggest you do First Aid at least once now. It would be a good revision for you, plus you can annotate your notes with some extra information. I even remember getting one question right on the exam from first aid which wasn't there in any other book.

Since you have 2.5 months to go, I strongly recommend Kaplan Qbank. I assume you have done at least 2 passes of Uworld. It has a good variety of questions and compliments Uworld very well. The idea is to do maximum questions. It makes you feel at home on the big day. It doesn't take much; took me just 12-13 days to finish Kaplan Qbank. Try doing maximum questions per day and build your endurance...
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Congratulations & thank you for sharing your experience!

Can you please share your resource for molecular biology preparation? And is it important to do Goljan after Pathoma?
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Hey thanks.
I suggest you do First Aid at least once now. It would be a good revision for you, plus you can annotate your notes with some extra information. I even remember getting one question right on the exam from first aid which wasn't there in any other book.

Since you have 2.5 months to go, I strongly recommend Kaplan Qbank. I assume you have done at least 2 passes of Uworld. It has a good variety of questions and compliments Uworld very well. The idea is to do maximum questions. It makes you feel at home on the big day. It doesn't take much; took me just 12-13 days to finish Kaplan Qbank. Try doing maximum questions per day and build your endurance...
thnx for the advice mate
but the problem is i jst started uworld and into 2nd read of kaplan so it will take me atleast 1.5 mnths more so i have left fa foe the last month with some imp high yield stuff from all evrything to study with it

leaves me hardly any time for anything else

thts why i asked
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Old 11-14-2013
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Well the questions in UWSA were kind of "different" but, you just had a bad day I guess. Don't get disheartened. 254 in NBME 15 is a rock solid score. Try doing more assessment exams and you would get a much more realistic idea of your preparation.
i have UWSA2 and NBME 12 left to do before my exam next week. I have taken all the other NBMEs, i did 7, 11 and 13 way back before the summer, did awful in all of them so i changed up my whole strategy. Thats what lead me to get a 254 on NBME 15. I also went over those old NBMEs so i am good with those now .
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Old 11-15-2013
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Congratulations & thank you for sharing your experience!

Can you please share your resource for molecular biology preparation? And is it important to do Goljan after Pathoma?
Thank you!

There's no separate source for molecular biology. I mean there may be books but those are just not recommended. It is hidden in subjects like Pharmacology and Pathology. This is something one inculcates inherently. I've always been fascinating by molecular mechanisms. Best example would be the mechanisms of nitrergic vasodilators. This is something you develop a liking for inherently, very early in your prep. Most of my friends got disgusted by that stuff and tried to cram it, I didn't.

It is not absolutely necessary to follow Pathoma with Goljan. You may get 1-2 questions right because of the extra information in Goljan. Again you have to be the judge. If you think you can spare 10-12 days of your crucial prep time, go for it. But there are more important things to do. Eg. If you are to choose between doing an extra Qbank vs doing Goljan after Pathoma; I would definitely choose the first option.

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@anwar - Ah Okay. Well in that case I reckon a good, solid second read of Kaplan and Uworld is much more important that doing an additional Qbank. Many people, including those scoring in 260s, don't do the Kaplan Qbank.

But you can always push yourself and set tough goals. Try to squeeze out just 8-10 days of your prep time and maybe you can buy some time for Kaplan Qbank. Sometimes it's not possible to finish the entire thing. Even if you do 70-80% of it , it would help a lot. Good luck with that!

@cysterna_chyli - Ah, okay. Good luck with those, mate!
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Thank you!

There's no separate source for molecular biology. I mean there may be books but those are just not recommended. It is hidden in subjects like Pharmacology and Pathology. This is something one inculcates inherently. I've always been fascinating by molecular mechanisms. Best example would be the mechanisms of nitrergic vasodilators. This is something you develop a liking for inherently, very early in your prep. Most of my friends got disgusted by that stuff and tried to cram it, I didn't.

It is not absolutely necessary to follow Pathoma with Goljan. You may get 1-2 questions right because of the extra information in Goljan. Again you have to be the judge. If you think you can spare 10-12 days of your crucial prep time, go for it. But there are more important things to do. Eg. If you are to choose between doing an extra Qbank vs doing Goljan after Pathoma; I would definitely choose the first option.
indeed you are right, a LOT of molecular bio is buried within other subjects like Pharm and Pathology (especially the tumor oncogenes and tumor suppressor genes). I think HY Molecular bio is a pretty decent book though, and you can team that up with Kaplan. Kaplan neglects to cover the JAK/STAT pathway though, and little details like how the insulin receptor undergoes dimerization (FA has that little nugget though). Yeah i am doing another review tommorow and then i will take UWSA2. Sunday most likely i will take NBME 12...
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indeed you are right, a LOT of molecular bio is buried within other subjects like Pharm and Pathology (especially the tumor oncogenes and tumor suppressor genes). I think HY Molecular bio is a pretty decent book though, and you can team that up with Kaplan. Kaplan neglects to cover the JAK/STAT pathway though, and little details like how the insulin receptor undergoes dimerization (FA has that little nugget though). Yeah i am doing another review tommorow and then i will take UWSA2. Sunday most likely i will take NBME 12...
Yes. Well that reminds me of another thing. I did have a habit of referring to some standard text books like Robbins. I had read a few chapters of General Path form Robbins during my school days so I just revised and made notes of topics like molecular mechanisms of some tumor suppressor genes which is not covered so well in Pathoma (it covers oncogenes beautifully though). So I'd like to suggest anyone early in their prep to not be afraid of referring to standard textbooks. It's a very good habit and it completes your review. I owe a large part of my success to this.

And as you mentioned, the JAK-STAT pathway is just touched superficially in Kaplan's Biochemistry (& the Pharmacodynamics chapter I guess) but I had to supplement it with Tripathi's Pharmacology (one of the best course books in Pharmacology, a proud Indian author). But those chapters in Kaplan's Pharmacology and Biochemistry are well written and super high yield - GPCRs, insulin signalling, ANP receptor etc. Make sure you know them inside out.

Additional molecular topics which I read from Lippincott's Biochemistry were O-linked and N-linked glycosylations. Not the detailed reactions. What are they, where the reactions occur etc. It has been given superficially in Kaplan Biochemistry but I think it deserves more coverage than that. I even read vesicular trafficking and coat proteins from Harper but that is VERY low yield. (I was just enticed to read it 'cause I had read it once way back and First Aid happened to just mention it somewhere, so I couldn't resist.)

Let me also give you another extras. There are actually 2 types of nuclear receptors for steroid hormones - let's just say Type 1 and Type 2.
The conventional Type 1 receptors are present in the CYTOSOL - bind to the ligand (hormone) - get transported to the nucleus to alter transcription. Eg. Receptors for cortisol, androgen, progesterone and all other steroid hormones EXCEPT thyroxine.
Type 2 receptors are present in the NUCLEUS - bind to the ligand - leading to activation of transcription. So in this case the hormone has to translocate all the way to the NUCLEUS to bind to its receptor and cause signalling. Eg. Vitamin A (RAR) and Vitamin D receptors (VDR) and receptors for thryroxine .
This concept has actually been tested in Uworld and some NBME exam but not given clearly anywhere. I had to resort to Wikipedia to understand it.

Bottomline - To anyone still in med school or very early in their prep - don't restrict your knowledge to the review books. Be curious, hungry and explore additional resources. That will give you an edge from the rest of the world and will make things so much more clearer to you!

P.S. - Good luck to you with your NBME and UWSA. Go hit 'em hard!
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Wow, interesting stuff . How detailed do the questions on second messenger pathways get on the exam? I mean u world was actually pretty straight forward in this area
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Ah yes, Thyroxine has to go all the way to the nucleus itself, to bind with its receptor and start transcription. I do remember the question in U world and its on NBME 15 as well. Its really sneaky, and a lot of people missed it, as evidenced by the discussion on studentdoctor.net.
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Default Receptors

this might be of help...
Attached Files
File Type: pdf Steroid Hormone Receptors.pdf (124.5 KB)
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@CysternaChyli - Well I had some challenging questions but nothing ridiculously scary. Somewhat on the lines of UWorld you can say. There was just ONE nit-picky molecular question based on drug receptor mechanism which I happen to remember luckily, but overall it was cool.

@hardtime - Thanks, those are some well-researched notes.
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@CysternaChyli - Well I had some challenging questions but nothing ridiculously scary. Somewhat on the lines of UWorld you can say. There was just ONE nit-picky molecular question based on drug receptor mechanism which I happen to remember luckily, but overall it was cool.

@hardtime - Thanks, those are some well-researched notes.
ah okay, that sounds fine then . How was neurology on the exam? I know Kaplan gets way into depth on it...
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Old 11-16-2013
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hey..congrats !! happy for u

i had few ques..plz take out time to ans.. thanks alot..

my study plan is almost like u xcept im not doing BRS..only kaplan, goljan & pathoma...for the major organs i did GOLJAN e.g. heart, kidney, lungs, endo, GI rest im dng from pathoma..i really like it too..so ur advise would b to keep dng pathoma? or shd i do goljan as well??

secondly i did beh.sci/biostats from FA & UWORLD only.. did 1st 2 chps from kaplan rest all FA..is this enough??

third.. after my 1st read im planning to do NBME.. i was thinking of starting nbme 1 nd then doing each nbme every week.. is this the fine approach? or shd i jst stick with the imp. nbmes??

plz advise reg these issues.. God Bless.. Good luck with ur future endeavors
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Great experience! Congratulations! Thanks for sharing!
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Would you please once again mention how you go about U world. I have 6 months of time for preparation and been wondering which subscription of U world to subscribe to.
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@cysterna_chyli - Neuro was surprisingly easy. Nowhere near the level of difficulty we get in Qbanks. But that may just be me. Every test is different!

@faith - Hey! Thank you. Goljan is NOT absolutely vital. Knowing in and out of Pathoma is, along with doing maximum questions. Also, even if you're reading Goljan, read it to gain knowledge. Don't try to cram all the irrelevant, extra factual information presented in it. But if you don't have time, you can do without it as well.

As I said, Behavioral Science is crucial. Doing just FA may be enough as some people suggest but it depends. It might be risky I reckon 'cause I personally sought maximum practice in this subject and Kaplan for me is highly recommended. (Dr. Daugherty is a class act.) If you seriously think you don't have the time at all then assess your performance in Qbanks and NBMEs. If you're doing fine in Behavioral then maybe you can do without additional resources.

I did all NBMEs "online" except NBME 5 because they don't provide extended feedback for that. Doing NBMEs online is crucial as only then you can know how exactly are you scoring. You can do NBME 6, 11, 12, 13, 15 in any order you want with at least 2 weeks of gap in between (I reckon). All of them have extended feedback, so you would know which questions you got wrong.

Good luck!



@devareddy - I personally did UWorld, timed, subject-wise after the FIRST read of each and every subject. The first time I didn't read the explanations and didn't annotate my notes; got 75%. Then I did a second pass of Uworld after my second reading of the kaplan notes. Just read through the explanations and annotated notes etc. (Didn't do proper tests.)
Many people do Uworld AFTER they have finished with their first read of the entire course. Some of them don't do subject-wise. Use the technique which suits you best
You can opt for a 6 months subscription from their website. Good luck!
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If you don't mind sharing... how were you doing in behavioural in the NBMEs? Compared to ur actual step performance..
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If you don't mind sharing... how were you doing in behavioural in the NBMEs? Compared to ur actual step performance..

I was doing poor/average till the very last NBME which I gave where I did good. Didn't do anything dramatic to improve, just practiced questions. Reading BRS Behavioral in 2 days during the last week of my prep maybe helped me edge ahead a bit more. I remember getting one tricky question right in my Step 1 because of that. Again, the Psychiatry/Biostats part is OK. It's the ethics part which needs a lot of common sense and practice.
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I've been dreaming of filling this column for weeks and here I am now, with Step 1 behind me, and me trying to give back to this wonderful forum all that I've gained from it; God bless the Internet. So I'll try my best to be helpful here, disclose my study plans of course, but also give some insights and some personal opinions. Apologies if it gets over-detailed.

Preparation -

Duration of prep - 6.5 months, dedicated.

First 4 months - First reading.
I know I took some time for my first reading. But in the end it was worth it. The first reading is the most important part of your prep. It's all about building foundation. Conceptualization has always been my weapon and the USMLE suited it well. This is basic science; try to understand and unravel the intricacies of the mechanisms of health and disease. All that may seem overwhelming but once you actually understand, it's a bliss. Your first reading may take more or less time depending on your background.

Materials used -

For Pathology - One word - PATHOMA. Even though it's not the coolest name for a review course, it is most certainly the best one out there. During my entire life as a medical student, I haven't come across a course more well taught than this. Dr. Sattar is a genius. Pathology was one actually one of my weaker subjects in school. Subscribing for Pathoma was the best decision I made.
I also read Goljan AFTER I read Pathoma; took me around 12 days and I annotated Pathoma with the extra information. Goljan is a good book, no doubt. The good thing about it is the depth of the information provided. It cleared some of the concepts I was confused about for years! But the point is, all that extra information wasn't really tested (as far as I can tell), even though I loved reading it.
Bottomline for Pathology - It is the most important subject for Step 1 as we all know. I swear by Pathoma. If you understand each and every thing it has to offer - you're good to go. IF you have time, you can skim through Goljan and annotate Pathoma. And don't even bother touching Kaplan for Pathology (yes, I tried and it was pathetic.)

For all other subjects - One word again - Kaplan. Seriously, the guys at Kaplan need a pat on their backs. The notes are all that you need to ace the test (except Pathology of course, which is horrible). Complete, conceptual, and even concise (as compared to some of the other reviews in the market). Notes and videos go together. What I did was I made the habit of watching the videos and reading from the notes together. That saved a lot of time. You get a much better idea of what's written in the notes if you watch the videos simultaneously. I recommend watching all the videos except Histology (and Pathology, of course.)

Special note on Behavioral Science -
This was one subject which was the pain in the rear for me. The questions they ask are so ambiguous, often being stuck with 2 choices. This should not be taken lightly (especially by IMGs).
Biostats - It's easy. Know your formulas and apply (Kaplsn is enough). If you're good at Maths, you shouldn't get a SINGLE biostat question wrong in your entire test. I, fortunately have a good aptitude for Maths and I tackled some REALLY twisted Biostat questions in my test. Also, the Kaplan Qbank has some really challenging Mathematical questions for you to practice (will talk about it later.)
Legal questions - You should get most (if not all) of these right. It's like being in law school - know the rules. I read Conrad's 100 Cases - good book, takes less than one day to read.
Psychology - Kaplan is a good book and Dr. Daugherty does a great job in videos.
Ethics and "Next-best-response" questions - you can't do much about these. Common sense may/may not work. Practicing questions is the key though.
I also read BRS Behavioral Science - just a very quick read in 2 days during my FINAL week of prep (not in 4 months). Not absolutely necessary; I did it because I was scoring low in Behavioral. You can read it only if you have time.

So during these four months I read all that material, AND did the UWorld questions for "assessment", subject-wise, after finishing each subject. It gave me an idea of my strengths and weaknesses. I didn't read the explanations or annotate anything.

5th and 6th months -
Revised the entire study material - took me around 20 days.

Read First Aid - Big surprise. Just read it ONCE. First Aid was not at all helpful for my prep. I read it once and annotated the extra information into the Kaplan notes. Now I'm not discouraging anyone against using First Aid but this is for someone like me who feels reading First Aid as the main resource can be terribly painful - you can score well without making 5-6 readings of it.

Reviewed UWorld - This is super-important. UWorld is a top class Qbank. The sheer authenticity of the questions is makes it the best Qbank. I made sure I imbibed the concept offered by every single one of those 2200 questions and annotated the extra information into the notes.

Revised the entire annotated study material 3rd time - took me around 15 days.

Did Kaplan Qbank - Another great Qbank. A must-do if time permits. Strengths vs UWorld - Highly challenging Microbiology, Biostats and Genetics questions.

Finally, did a fourth and final review of the entire study material in the last 15 days (along with a quick read of BRS Behavioral Science, as already mentioned.) I know that sounds excessive but I believe revision is under-rated in USMLE prep. I didn't have time to do the Kaplan Qbank again.

NBMEs and UWSAs -
NBME 7 and 13 - 240 (2.5 months off)
NBME 11 - 250 (1.5 months off)
NBME 12 - 240 (1 month off; was ill)
NBME 6 - 254 and NBME 15 - 250 (15 days off)

UWSA 1 (15 days off) and UWSA 2 (2 days off) - both 265.
The cut-off for 265 in UWSAs is around 85%. I got 85% correct in UWSA 1 and 88% in UWSA2.

Judgement Day -
I slept for around 6 hours, fragmented, the day before. But adrenaline just keeps you going. Try avoiding anxiety though. It's your show, you own it. The test was well, a little bit of everything. I guess I got lucky because all the tough questions were from my strengths - Genetics and Molecular biology. Know your molecules! I have always had a fascination for all those complex signalling pathways etc. All that is high yield. Overall it was a well balanced set of questions.
After the exam. Go get lost in oblivion, at least for a few weeks. Don't analyze anything.

Final words -
Well that's pretty much all I had to rant about. This is just to give you an idea. The best judge is YOU. Know your style, your strengths, your weaknesses, and play accordingly. Make your own perfect plan.

Sorry if I missed anything. I'll try to answer any other specific queries that you may have. Good luck to all you great fellas. Tame the beast!
congrats!!! Thanks a lot for sharing!
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Old 11-18-2013
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thanks for the reply..

u have made me scared regarding BEH.SCI/BIOSTATS :/

i did do 1st 2 chps from kaplan & watched the videos nd i did kaplan qbank nd uworld ques offline nd annotated thm in my FA..

wht other practice ques u will suggest?
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thanks for the reply..

u have made me scared regarding BEH.SCI/BIOSTATS :/

i did do 1st 2 chps from kaplan & watched the videos nd i did kaplan qbank nd uworld ques offline nd annotated thm in my FA..

wht other practice ques u will suggest?
I think that would do. I don't mean to scare you. It's just I've personally had a tough time with it. The only other chapters you can read from Kaplan is "Doctor-patient relationship" and "Legal affairs". Again, assess your performance with more questions...
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Idea! Hey thanks!

Quote:
Originally Posted by DNA 105 View Post
Thank you!

There's no separate source for molecular biology. I mean there may be books but those are just not recommended. It is hidden in subjects like Pharmacology and Pathology. This is something one inculcates inherently. I've always been fascinating by molecular mechanisms. Best example would be the mechanisms of nitrergic vasodilators. This is something you develop a liking for inherently, very early in your prep. Most of my friends got disgusted by that stuff and tried to cram it, I didn't.

It is not absolutely necessary to follow Pathoma with Goljan. You may get 1-2 questions right because of the extra information in Goljan. Again you have to be the judge. If you think you can spare 10-12 days of your crucial prep time, go for it. But there are more important things to do. Eg. If you are to choose between doing an extra Qbank vs doing Goljan after Pathoma; I would definitely choose the first option.

I totally agree with you. I think I'll go for one book and that will be Goljan (cause those extra questions here & there do matter badly ). I'm so glad to have cleared these doubts in my early prep. I'll work on my molecular biology skills! After talking to some buddies, I was planning to go with Kaplan books except Path (Goljan), Physio (BRS), Pharm (First Aid) & Micro (CMMRS). Could you please comment from your experience?
I'll be writing my exam in June & will just be done with Anat (& Neuoanat) from Kaplan (alongside Kap Qbank)...long way to go!

Thank you so much for your quick response! Really appreciate it!
Good luck for the coming Steps!
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I totally agree with you. I think I'll go for one book and that will be Goljan (cause those extra questions here & there do matter badly ). I'm so glad to have cleared these doubts in my early prep. I'll work on my molecular biology skills! After talking to some buddies, I was planning to go with Kaplan books except Path (Goljan), Physio (BRS), Pharm (First Aid) & Micro (CMMRS). Could you please comment from your experience?
I'll be writing my exam in June & will just be done with Anat (& Neuoanat) from Kaplan (alongside Kap Qbank)...long way to go!

Thank you so much for your quick response! Really appreciate it!
Good luck for the coming Steps!
Hey,

Yeah you do have a long way to go, good luck. The plan looks good. I didn't read BRS Physiology so can't comment on that. Kaplan's physiology was fine for me (a bit too detailed maybe but I liked it.) As for Pathology, if you think you have a very strong background knowledge and you can handle dense overy-detailed books, it's okay to go with Goljan. If you're like I was with a weak base then Pathoma is strongly recommended over Goljan. In the long run, it's not the extra information that matters, its how well you've understood the subject which helps you retain stuff - Pathoma does that much better. But again, the final decision is up to you. Again CMMRS is a highly rated book but I haven't read it so can't comment. Micro was fine in Kaplan as well. As for Pharmac, I would suggest reading a book at least once if you have time. Again, that's what I feel the best way to go about is and that's what I've done. It's completely fine if you want to chalk out some of your own plans for some things. Doing what suits YOU is more important!

Good luck!
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Old 11-23-2013
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Good job .
I have my xam in feb ... Can u guide me bit regarding preparation for last 2.5 months as i m gng thru 2nd read of kaplan left with micro,BS,n immuno .. suggestme how shd i move further .. n whn shd i take uworld subscription n nbmes??
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Default Study plan question

Dear DNA 105
Would you mind to give me some advice please?, I'm planning to take my exam on june 2014, I haven't started to study,my plan is to begin next week, I will take kaplan's course, center prep, and the pathoma course along with the books, What should I do first?, Thank you very much for helping other physicians.

Best Regards
Mike
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@doc565 - I suggest you take an NBME right after your revision. Then start off with Uworld and do it religiously. You can think about a third revision (+FA) +/- Kaplan Qbank later, depending on the time you have. Good luck.

@mikeusmle - Hello! Your plan looks perfect, and the amount of time you're putting is more than enough for it. Start off with the first year subjects. I started with Physiology as it's the most fundamental of basic sciences. Strong concepts in Physiology helps you build your entire preparation. I followed it up with Biochemistry as that requires a deep understanding as well. Then when you've used all your enthusiasm figuring out these two, you can start with Anatomy. Then you can do the remaining subjects in any order. Chip in with Behavioral Science when you feel burned out. It's a completely unique subject and would give you a breather. I did Pathology in the end as all the information from the other subjects helped understand it even better. Good luck and keep going!
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  #54  
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Omg, thanks for everything!!

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Quote:
Originally Posted by DNA 105 View Post
Hey,

Yeah you do have a long way to go, good luck. The plan looks good. I didn't read BRS Physiology so can't comment on that. Kaplan's physiology was fine for me (a bit too detailed maybe but I liked it.) As for Pathology, if you think you have a very strong background knowledge and you can handle dense overy-detailed books, it's okay to go with Goljan. If you're like I was with a weak base then Pathoma is strongly recommended over Goljan. In the long run, it's not the extra information that matters, its how well you've understood the subject which helps you retain stuff - Pathoma does that much better. But again, the final decision is up to you. Again CMMRS is a highly rated book but I haven't read it so can't comment. Micro was fine in Kaplan as well. As for Pharmac, I would suggest reading a book at least once if you have time. Again, that's what I feel the best way to go about is and that's what I've done. It's completely fine if you want to chalk out some of your own plans for some things. Doing what suits YOU is more important!

Good luck!
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Old 11-24-2013
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Thanks... But i m not that much confident to do NBME ... As i think i m not still strong .. as i havent read FA completely n have done only once n thats only regions .. after this still u suggest me for NBME .. n whch NBME shd i gve ?
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Thanks... But i m not that much confident to do NBME ... As i think i m not still strong .. as i havent read FA completely n have done only once n thats only regions .. after this still u suggest me for NBME .. n whch NBME shd i gve ?

Only do nbme when u are prepared!
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You're welcome, Subuhi!

@doc565 - Yeah don't take it right now. I was suggesting you take it when you're done with your second read of everything. I suppose you would be confident enough once you're done with it. If not, don't take it. Overall it's a good idea to take an early NBME 'cause it helps you build a baseline score. You can only improve from there. No matter what people tell you, all NBMEs are scored in a standardized way so the score you get is fair. I started with NBME 7.
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Congratulations a great score
I am 2 months away from my exam and I have done Kaplan twice with uworld (offline)...still got 200 in NBME 15 .i m a little frustrated I have done goljan twice should I go for pathoma now..... My aim is to get around 240 250 . Plz Ned some good piece of advise how to utilize my these two months. Thank you.plz help
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Old 11-25-2013
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Quote:
Originally Posted by DNA 105 View Post
@doc565 - I suggest you take an NBME right after your revision. Then start off with Uworld and do it religiously. You can think about a third revision (+FA) +/- Kaplan Qbank later, depending on the time you have. Good luck.

@mikeusmle - Hello! Your plan looks perfect, and the amount of time you're putting is more than enough for it. Start off with the first year subjects. I started with Physiology as it's the most fundamental of basic sciences. Strong concepts in Physiology helps you build your entire preparation. I followed it up with Biochemistry as that requires a deep understanding as well. Then when you've used all your enthusiasm figuring out these two, you can start with Anatomy. Then you can do the remaining subjects in any order. Chip in with Behavioral Science when you feel burned out. It's a completely unique subject and would give you a breather. I did Pathology in the end as all the information from the other subjects helped understand it even better. Good luck and keep going!
Thank you!!!!
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Quote:
Originally Posted by DNA 105 View Post
You're welcome, Subuhi!

@doc565 - Yeah don't take it right now. I was suggesting you take it when you're done with your second read of everything. I suppose you would be confident enough once you're done with it. If not, don't take it. Overall it's a good idea to take an early NBME 'cause it helps you build a baseline score. You can only improve from there. No matter what people tell you, all NBMEs are scored in a standardized way so the score you get is fair. I started with NBME 7.
thank you so much DNA105 .. i really got that what u said .. hope fully i will follow accordingly .. i will think to take NBME aftr gving first read to FA so that i will be confident regarding it n will know my shrt cmngs too .. what says ... ? Thanks alot for such a kind advice
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Quote:
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thank you so much DNA105 .. i really got that what u said .. hope fully i will follow accordingly .. i will think to take NBME aftr gving first read to FA so that i will be confident regarding it n will know my shrt cmngs too .. what says ... ? Thanks alot for such a kind advice
Yep. That sounds perfect. Good luck mate!
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when you say you revise the material you mean you read it all again in 20 days?
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@rainbow28 - Well it depends upon your performance in Pathology. If you're scoring low in Pathology, doing Pathoma would be a good idea since you have 2 months to go and Pathoma wouldn't take more than 10 days of your time. If you're scoring well in Pathology then work on your weak areas, you still have time. Good luck

@szaldivarr - Yes, that's exactly what I meant. The entire thing (notes + Pathoma) top to bottom. It's doable in 20 days really, if you're persistent enough (keeping a target of 3-4 days per subject). And it's very vital too...
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@dna105
Thank you ...
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congrats for you really did it! thanks a lot for sharing your preparation and insights. How long did you subscribe for uworld? did you take it like 6 months or 3+mo.? It would really help me in understanding your approach better.
No more questions for now, as I have yet to go through all your subsequent posts. Please excuse if you have already mentioned the answers.
and thank you sooo much for putting this thread!
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Quote:
Originally Posted by kirparo View Post
congrats for you really did it! thanks a lot for sharing your preparation and insights. How long did you subscribe for uworld? did you take it like 6 months or 3+mo.? It would really help me in understanding your approach better.
No more questions for now, as I have yet to go through all your subsequent posts. Please excuse if you have already mentioned the answers.
and thank you sooo much for putting this thread!
My absolute pleasure, kirparo.

I subscribed for 6 months, yeah. Always useful to keep reviewing back some of the useful questions and concepts from it throughout your prep. Good luck!
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Wow, congrates, wish i had that score too, very badly. But I am really slow at reading,,, now still stuck with biochem,, should I concentrate or just read the notes without having to totally understand everything?
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Wow, congrates, wish i had that score too, very badly. But I am really slow at reading,,, now still stuck with biochem,, should I concentrate or just read the notes without having to totally understand everything?
If you ask me, understanding was everything for me. Each one of us have their own gameplans but that's what works best for me.

More important than speed is how much are you understanding/retaining...
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Embarrassed great!!

wow. congrats my friend. amazing!!!
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thanks for your response dna105 . I have a query regarding the ethics book 100 cases by conrad fischer- did you mean ' Kaplan 100 cases 2nd edition' book? how different are 'kaplan 100 cases 2nd edition' from ' master the boards ethics high yield review 3rd edition' Both by conrad fischer? I found the later as the next edition of the previous book,but no where it is mentioned as '100 cases' in the 3rd edition book! phew
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thanks for your response dna105 . I have a query regarding the ethics book 100 cases by conrad fischer- did you mean ' Kaplan 100 cases 2nd edition' book? how different are 'kaplan 100 cases 2nd edition' from ' master the boards ethics high yield review 3rd edition' Both by conrad fischer? I found the later as the next edition of the previous book,but no where it is mentioned as '100 cases' in the 3rd edition book! phew
I read MTB Ethics. That is basically the 3rd (latest) edition of Conrad Fischer's 100 cases. Just the name is different. Cheers.
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thanks for quick reply. yay! feels good when confusion goes away .. cheers
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  #73  
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text first then video or video first ??
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text first then video or video first ??
I started off with text first but as I progressed through the prep I kinda did them hand in hand, especially for topics I was comfortable with.
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