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Old 01-10-2014
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Experiences 261 in Step 1 (first attempt), my experience

Hi everybody! My name is Nicolas, I graduated last year in Argentina and spent it studying for the step 1. I got my score a couple of weeks ago and I wanted to share the methods I used, basically because reading other's people advice and experiences was tremendously helpful for my preparation and I would like to do the same for others.

First of all, I think that it's important to know that we might be very different people with different thoughts, styles, weaknesses, strengths, prejudices, academic preparation, time available and even different IQs, but there are some general concepts and "rules" that I consider that can be useful for everyone trying to get a high score in step 1. These "keys" are widely spread through the internet in many sites and forums, including this one, of course, but I will try to simplify and summarize them here to make things easier for those aiming to this tough but perfectly possible target.

Before telling which set of books and other materials I did use, I'd like to highlight that our goal is not to use a lot of different materials or to end up reading some books over and over some X number of times (eg: First Aid) but to get the highest mark as possible in the real exam, and we can achieve that in more than one single way. This is important to know to avoid getting frustrated halfway when we can't watch all Kaplan videos, read First Aid 4 times or repeat the whole USMLE World bank. I personally followed the ZumZum Method (the single best study plan that I found most suited for me) and couldn't keep up with it, but it was the base from which I ended up making my own plan, with some additional improvisation, for what I will be always grateful with Dr. ZumZum.

Next, I will summarize in a list the best pieces of advice I found over the internet and some others that I could come up with during the study process:

1) Where do we come from?

Firstly, it is a good idea to take an initial diagnostic test (it could be Kaplan’s Diagnostic Test, which comes with the 12 months subscription, or USMLE World’s Self Assesment 1 and/or 2). If you can avoid getting frustrated by an almost certain low score, it can give you really useful information about where you are starting to study from and maybe which specific areas deserve the most of your attention. I personally didn’t do this, but I would definitely do it had I prepare this exam again. This way you can more effectively evaluate your progress during the process and predict more accurately when you are going to be ready to take the exam.

2) Where are we going?

This may be the most important step to make your study plan. You have to decide which score you pretend to get, or at least the minimum score so all your effort makes sense, and how much time you can and want to invest for that quest. Knowing which specialty you are interested in can be helpful to determine how high your step 1 score should be to avoid having trouble getting interviews. Although some specialties don’t put much weight in step 1 score (eg: psychiatry, the one I’m looking forward to ), a high step 1 passing score can’t hurt anybody!

Don’t underestimate the importance of clearly setting your target score and study time, in the middle of the study jungle it’s pretty easy to get confused and lose perspective. In my case I ended up taking the exam 2 months later than I had planned, with its subsequent higher risk of burnout, because I didn’t have all the relevant information from the beginning. So, I think that the moral is that you better have everything you can analized and decided from the beginning but don’t desperate if you already started studying and have to change something in the way. It’s true that it’s usually better to stick to whatever plan you initially made, but I recommend to be flexible enough to make some changes in your strategy if you have a strong insight about how it can improve your final outcome.

3) Make a list of things to remember in the midway

This is a really tough road and it’s important to always keep in mind certain “rules”. While you are still fresh it’s a good idea to make a list of things that you want to remember when you might be tired and confused in the middle of the study schedule. You can find lots of these key concepts at the beginning of many books (Eg: First Aid, Kaplan QBank, etc.), but I will mention some that were really important to me:

1. This is a perfectly possible project. It is also perfectly normal to feel exhausted and pessimistic halfway, learn to question your own feelings and pessimistic thoughts and think that what is happening to you also happened to many people who finally got a high score. I cannot tell you how many times I felt that I was bound to failure.

2. Remember that nothing’s more important than the final outcome, it’s perfectly fine to do things differently to the advice you get (even this one) as long as you can still get to your target that way. The most objective feedback you can get about it are your USMLE World Qbank score and the NBME forms; getting a high score in them is the best way to know that what you are doing is right.

3. Don’t delay doing question banks, it is strongly emphasized everywhere that all good study plans require making lots of questions in the random timed fashion. Start doing this ASAP, if I had to take this exam again I would start doing UW much earlier in the schedule than I did. I know many cases of people than despite having read tons of books, delaying the practice with question banks was quite detrimental to their performance. On the day of the exam you should not be worried at all about the format or type of questions in the examination. Doing practice questions should be an essential part of your whole study plan.

4. One of the most important things: ACTIVE LEARNING. Try to avoid passive reading or semi-effective study, your time is really important and you should also wisely spend it in having fun and healthy activities. Once you have decided to sit and study, try to keep in mind that everything ends up with a set of multiple choice questions, so try to conceptualize every possible piece of information that way. Paraphrasing, making diagrams and doing many multiple choice questions are some of the best ways towards active learning.

4) Choose materials

Fortunately, there are many excellent review books and other materials and you can find out which are the most popular in the internet. Try to think wisely what type of learner you are and which set of materials you can get the most from. Next there’s a list of what I decided to use and what I did finally use and in the order that I did it:

BOOKS

-First Aid 2013: I would read every section after finishing it in the other books and did 1 reread just before the exam.

-Kaplan USMLE Step 1 Qbook: After each discipline I would do it's respective questions from this book (didn't like it too much).

-Kaplan Lecture Notes 2010: I read Behavioral Sciences, Biochemistry, Histology Section of the Anatomy book, Microbiology and Immunology and Pharmacology.

-Kaplan lecture videos 2010: Could only watch Behavioral Sciences, Biochemistry, Histology and some spared Physiology videos when I needed it to better understand a specific topic.

-High Yield collection (4° ed): I read the Gross Anatomy, Neuroanatomy and Embryology books. I also bought the Molecular Biology one but didn’t read it.

-BRS Physiology: I really liked this book.

-Rapid Review Pathology: A must for many people, I liked it.

-Netter Anatomy Atlas: Just to compliment my anatomy study alongside with my personal skull

-USMLE Medical Ethics 3° ed (By Conrad Fischer): I read this book a couple of weeks before the exam and loved it, but unfortunately I don’t remember answering any ethics question in the real exam using what I learnt from it.

-Bought Clinical Microbiology Made Ridiculously Simple but couldn't read it. Please before buying a book think carefully whether you are gonna read it, I felt pretty stupid doing this (although I was forced to buy it with too much anticipation in order to get someone bring them from USA). Having weaknesses with a certain subject (as in my case with microbiology) doesn't necessarily mean that you must read many books of that subject, you could spent more time studying it or do more of its questions and that could be enough to compensate.

QUESTION BANKS

-Kaplan Qbank: I bought the 12 months subscription to use it between subjects, just as the ZumZum Method recommends. In the end, I did 86% of the questions with a 75% of correct answers.

-USMLE World QBank: The single best question bank, specially for the last weeks of study. I used it as my main source of study for the last 2 months annotating everything I wanted to learn in my First Aid. I did the 100% of the Qs getting a 79% of overall correct Qs, and then redid the wrongly answered ones, having 2 weeks left to review the First Aid and take some NBMEs.

-NBME: I did NBME Forms 15 and 7, getting a prediction of 250 and 252, 2 weeks before the exam.***

-USMLE World Self Assessment (UWSA) 1 and 2: I took them 1 week before the exam and got a prediction of 263 and 265+.

-USMLE Free 150 Questions: Did it 1 week ago and got 94%, which would mean a prediction of 268 +/- 11.

*** I read that NBME Forms may underpredict “conceptual learners” as it is more memoristic than the real exam, and that UWSA and USMLE Free 150 Qs usually overpredict scores. Both things happened with me as I did around 10 points better than NBME prediction and a some points lower than UWSA. Anyway, with some margin of error they all showed to be acceptably accurate. In conclusion, make these tests the final judge of how well prepared you are to take the test!

OTHER RESOURCES

-There are many, almost infinite, resources you can use to compliment your study plan and you can find them all over the internet, the key is to detect which are best suited for you and make your own best plan.

5) Once definitive, stick to your plan!

Even though there’s always place for some modifications, it’s really important that once you decided how much time and how you are going to study, you strongly stick to that. Besides losing time, the greatest risk of getting lost in your own plan is that things stop to make sense and you get in a downward spiral towards lowering your expectations or even giving up. There are lots of places in the internet that can help you to keep things in perspective and have a realistic outlook. Just try to stay away from pessimistic or fanatic concepts and remember that your own path towards success is as valuable as any other, no matter how many difficulties you may have.


Next days I will try to complete and add more things to this post, I hope that someone find this useful and please comment and ask whatever you want to! Good start for everyone in this new year and best of wishes in this exciting fight!

Nicolas
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  #2  
Old 01-10-2014
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congratulations Nicolas..

my eligibility period is from jan to mar 2014..i haven't finished even with my first reading..just watched physiology videos..i know it is impossible for me to write the exam in march at this stage. but i will extend my eligibility period, and i want to do it by end of april or may mid month(and it is not possible for me to do after that,as my wedding is in june)..can u please guide me on how to do the learning fast as i d'ont have any other chance except that..

sometimes i feel that it cant be done..am i wrong on this or right? i am not understanding..

i will be thankful to everyone who can help me on this..
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Great score! How much time did you study for the exam?
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Old 01-10-2014
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congrats on ur score....

its really great

in which mode did u do uworld qbank? and how much time did it take?
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Old 01-10-2014
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Quote:
Originally Posted by drgabhy View Post
congratulations Nicolas..

my eligibility period is from jan to mar 2014..i haven't finished even with my first reading..just watched physiology videos..i know it is impossible for me to write the exam in march at this stage. but i will extend my eligibility period, and i want to do it by end of april or may mid month(and it is not possible for me to do after that,as my wedding is in june)..can u please guide me on how to do the learning fast as i d'ont have any other chance except that..

sometimes i feel that it cant be done..am i wrong on this or right? i am not understanding..

i will be thankful to everyone who can help me on this..
Hi drgabhy!
As I said in the post, I think that it's very important to evaluate where you are standing to better understand your chances. I think that you should take some simulation test in random and timed mode to asses how much study you need to comfortably take the exam. If you can afford it, NBME forms can be helpful, or you can used Kaplan's or UWorld Self Assessments. Remember that it's key to use question banks from the very beginning. If you want to go as fast as possible I would start doing many practice questions in a timed mode and annotate everything you can on First Aid. You can tell me what scores you get and I can try to help you predict and plan as best as possible your schedule. This Score Calculator I found turned out to be quite useful: http://clinicalreview.com/ClinicalRe...alculator.html
To help me understand your particular case please tell me:
1) When did you finish med school?
2) What specialty would you like to chose?
3) What score would you like to get as minimum?
4) Did you take any other step yet? When are you planning to take them?

Best wishes and congrats for your coming wedding!
Nicolas
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Old 01-10-2014
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Quote:
Originally Posted by skeleton View Post
Great score! How much time did you study for the exam?
Thank you! I started studying on March 2013 planning to take it on September but finally took it on November, so there would be around 8 months of preparation. Anyway, I think that it could have been less time if I studied more consistently and better organized! I'm not a really solid student, I think that if it took me 1 more week I would have driven crazy! lol
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Quote:
Originally Posted by shayandokht View Post
congrats on ur score....

its really great

in which mode did u do uworld qbank? and how much time did it take?
Good question! I did it in random timed mode in blocks of 46 questions taking notes of almost everything on FA, and I strongly think that it is the best way to go. It took me almost 2 months to do all Qs and around 1 week to repeat wrongly answered Qs. Sometimes I would take 2 or 3 blocks in a row to try to gain endurance!
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Old 01-11-2014
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Quote:
Originally Posted by Asclepio View Post
Hi drgabhy!
As I said in the post, I think that it's very important to evaluate where you are standing to better understand your chances. I think that you should take some simulation test in random and timed mode to asses how much study you need to comfortably take the exam. If you can afford it, NBME forms can be helpful, or you can used Kaplan's or UWorld Self Assessments. Remember that it's key to use question banks from the very beginning. If you want to go as fast as possible I would start doing many practice questions in a timed mode and annotate everything you can on First Aid. You can tell me what scores you get and I can try to help you predict and plan as best as possible your schedule. This Score Calculator I found turned out to be quite useful: http://clinicalreview.com/ClinicalRe...alculator.html
To help me understand your particular case please tell me:
1) When did you finish med school?
2) What specialty would you like to chose?
3) What score would you like to get as minimum?
4) Did you take any other step yet? When are you planning to take them?

Best wishes and congrats for your coming wedding!
Nicolas
Thanks a lot for your words..and thanks for the wishes..
I finished med school in 2012, I did not give any other steps so far and would like to finish all of them and apply by sept,2015..I am very interested in OBS/GYN and I dont know the score how much I need to get for it..
Can u tell me what is the score I need to get for OBS?
Also, I would like to ask u is there a chance for me to get into OBS???

Thanks
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Old 01-11-2014
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Hey one question, I just did BRS physiolgy and attempted the kaplam Qbook
And I didnt do very well, I felt I didnt knew alot of thing overal just 63% right on both blocks. How was your expierience with it, because really it is quie dishearting for me.
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even though I am interested in OBS..I will go with any and would be satisfied with it,if I get any..

Quote:
Originally Posted by drgabhy View Post
Thanks a lot for your words..and thanks for the wishes..
I finished med school in 2012, I did not give any other steps so far and would like to finish all of them and apply by sept,2015..I am very interested in OBS/GYN and I dont know the score how much I need to get for it..
Can u tell me what is the score I need to get for OBS?
Also, I would like to ask u is there a chance for me to get into OBS???

Thanks
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Old 01-11-2014
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Hi 1st many congrats on a great score buddy 😊i m done with uworld online qbank with commulative score of 61%.....can u plz tell whr do i stand n any suggstn/advice is aporeciated 😊
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Default exam breaks

Quote:
Originally Posted by Asclepio View Post
Good question! I did it in random timed mode in blocks of 46 questions taking notes of almost everything on FA, and I strongly think that it is the best way to go. It took me almost 2 months to do all Qs and around 1 week to repeat wrongly answered Qs. Sometimes I would take 2 or 3 blocks in a row to try to gain endurance!
congrats on sucjh wonderful score .
i would like to ask what was your strategy of taking breaks during real exam?
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Old 01-14-2014
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Quote:
Originally Posted by drgabhy View Post
Thanks a lot for your words..and thanks for the wishes..
I finished med school in 2012, I did not give any other steps so far and would like to finish all of them and apply by sept,2015..I am very interested in OBS/GYN and I dont know the score how much I need to get for it..
Can u tell me what is the score I need to get for OBS?
Also, I would like to ask u is there a chance for me to get into OBS???

Thanks
I think that OBS/GYN mean score is about 220. I think that the best idea is to get the highest score as possible, specially if you want to apply to competitive places. If I had to guess I think that 240 would be a good minimum "safe" score, but as I said before you should aim to the highest possible score. Just get sure that you are having predictions of a score higher than that minimum acceptable score you set. Of course you have chances of getting into OBS/GYN! Your steps scores, clinical experience, research, etc etc are going to determine how easily you can make it and the array of possibilities among which to decide. So get the conviction and put all your effort doing the best that you can with the time you have available!
Remember that if you can't keep studying and you are still getting low scores in UW/UWSA/NBME it's usually better to postpone your exam than taking the risk of passing with a score that is lower than what you would like.
Hope this helps! Keep asking any doubt you have
Nicolas
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  #14  
Old 01-14-2014
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Quote:
Originally Posted by kikoafu View Post
Hey one question, I just did BRS physiolgy and attempted the kaplam Qbook
And I didnt do very well, I felt I didnt knew alot of thing overal just 63% right on both blocks. How was your expierience with it, because really it is quie dishearting for me.
I understand what you mean because something similar happened to me, specially because many of the physio graphs that come up in the banks don't appear in the BRS. Anyway, studying from the question explanations was enough for me to overcome it. What I liked about BRS is that it makes things really simple for a first time reading, it's your task to work on your flaws after that. You could also supplement with other books in those topics that you are having most trouble with when doing questions.
Anyway, don't let your Kaplan QBook or QBank score bother you! I didn't have great scores in neither of them but could learn a lot more and do better when I did UWorld. Remember that, along with NBME, UWorld Score when done at the end of studying is one of the most important "judges". Kaplan QBank and QBank at the beginning of studying can be quite discouraging.
Best wishes and keep fighting!
Nicolas
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Old 01-14-2014
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Quote:
Originally Posted by nerves View Post
Hi 1st many congrats on a great score buddy 😊i m done with uworld online qbank with commulative score of 61%.....can u plz tell whr do i stand n any suggstn/advice is aporeciated 😊
According to this calculator http://clinicalreview.com/ClinicalRe...alculator.html you would be scoring a 225 +/- 18. This prediction is more accurate if you did the whole bank in the timed random mode. Remember to establish your goal and work hard to have a prediction as close to it as possible before taking the exam.
Best wishes!
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Old 01-14-2014
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Quote:
Originally Posted by dr.y View Post
congrats on sucjh wonderful score .
i would like to ask what was your strategy of taking breaks during real exam?
I used the method suggested by Kaplan QBook:
SKIP TUTORIAL, JUST CHECK HEADPHONES
-1st block
(no break)
-2nd block
(5 minutes break)
-3rd block
(5 minutes break)
-4th block
(30 minutes break - lunch)
-5th block
(no break)
-6th block
(10 minutes break)
-7th block

You take 50 minutes of break in order to have 10 extra minutes in case you need them. I couldn't respect the schedule EXACTLY as that (some breaks were longer and others shorter and I finished one block before the 60 minutes) but in the end I ended up having around 8 unused minutes.

Hope it helps!
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  #17  
Old 01-14-2014
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thanks Nicolas..
may I know the score required for Pediatrics???
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Old 01-15-2014
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hi i want to ask what is the minimum target score for general surgery in step 1?
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Old 01-17-2014
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For those asking for the "minimum passing score" for X specialty, unfortunately it doesn't really exist something like that. There's no single factor that can guarantee success nor failure. There are many factors that act in concert besides step 1 score and specialty: intrinsic competitiveness of the residency program, being a US doctor or IMG, med school, clinical experience, research experience, etc.
What you can actually know is the recommended step 1 score to at least avoid being rejected because of it. I think that having a score of more than 250-260 would virtually mean that if you get rejected or can't get an interview is because of a different factor. On the other hand, a score of at least 240 in a first attempt may be just a minimum requisite just to be considered in a competitive program from a competitive place.
There are many websites where you can read some trends by specialty related to step 1 scores among matched US docs and IMGs. I just found this one and looks useful: http://usmlemonster.com/usmle-step-1-scores-and-match-success/
Best regards,
Nicolas
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Congrats on such a brilliant score...!!
Can u give me an idea as to how much in advance should one book the eligibility period or the date to take the exam...
I want to take the exam somewhere in may end or june..i've just started my preparation so i am not sure whether i'll be confident and thoroughly prepared by then..not later than july in any case..so by when (latest) should i book the eligibility period or a date...?
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  #21  
Old 01-18-2014
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Hi everybody! Nicolas

Thank you for your post. I wanted to know how many calculation/probability/genetic questions did you get on the exam? Do you think genetic calculations are high yield?
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  #22  
Old 01-19-2014
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There's another query I'd like to ask u... Is it a good idea to start studying subject wise or organ system wise (as given in FA) ?
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  #23  
Old 01-20-2014
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Originally Posted by shreya.312 View Post
Congrats on such a brilliant score...!!
Can u give me an idea as to how much in advance should one book the eligibility period or the date to take the exam...
I want to take the exam somewhere in may end or june..i've just started my preparation so i am not sure whether i'll be confident and thoroughly prepared by then..not later than july in any case..so by when (latest) should i book the eligibility period or a date...?
You may book the eligibility period as late as some weeks after its beginning, assuming that you already supplied all needed paperwork to NBME or ECFMG. As for the exam date I think that it mainly depends on the prometric center which you are planning to take the exam at. Try to find out how early it gets full and anticipate enough to avoid having to postpone your exam because there are no more available dates in your eligibility period.
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Old 01-20-2014
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Originally Posted by shine4ever View Post
Thank you for your post. I wanted to know how many calculation/probability/genetic questions did you get on the exam? Do you think genetic calculations are high yield?
If I correctly remember I think that I just got a few questions like that. I think that I got one probability question and one question in which I had to choose the sequence of the primers needed for a PCR. What I certainly remember is that I didn't get any Hardy-Weinberg Equilibrium question, but considering the large pool of possible questions I think it's still high yield (unless you have much trouble applying it, which generally isn't the case).
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  #25  
Old 01-20-2014
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Originally Posted by shreya.312 View Post
There's another query I'd like to ask u... Is it a good idea to start studying subject wise or organ system wise (as given in FA) ?
I think that the best way is the one you find most useful and you are more comfortable with. I mostly studied subject-wise just because that's how I studied during university and got used to it, but on the other hand I really enjoyed the "integration potential" that system-wise study provides (eg: in FA).
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  #26  
Old 01-20-2014
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Congrats Nicoloas. Do you remember how many mistakes you counted after you finished the exam during the 3 week period? Since you are 260 hunter, I almost sure you were obsessive to count mistakes. Silly mistakes are killing me
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  #27  
Old 01-23-2014
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Congrats Nicoloas. Do you remember how many mistakes you counted after you finished the exam during the 3 week period? Since you are 260 hunter, I almost sure you were obsessive to count mistakes. Silly mistakes are killing me
Hahaha, interesting question. I actually did a pretty strong effort to avoid obsessive counting the weeks after the exam. I would anyway wake up every morning "reviewing" topics in my mind without even noticing it, but the few questions that I inevitably remembered were fortunately some I thought that I had done correctly, except for one microbiology question (my main weakness) about some parasites that I was almost sure that I had have to guess the answer. Still, I intentionally didn't look for its answer, specially because it's possible that you are remembering a different question from the one that you actually had in the exam. It's important to keep resting times as free as possible from study stuff, so any time you have some of those "mistake" revelations just assume that it was an "experimental question without any value" and go on with whatever you are doing or should be doing at that moment.
Best of luck!
Nicolas
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  #28  
Old 01-23-2015
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Default Step 1 prep

Hi Nicolas! I don`t know if you are going to read this, but I`ll give it a shot anyway. I`m a Med Student also from Argentina and planning to take Step 1 in about 1 yr and a half or so. You prepared it by yourself right? I`ve heard that ISEF/CEAR from Recoleta offers courses.Do you know anything about them?
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  #29  
Old 01-23-2015
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Thanx..it was great help for beginners like me..N congrats on ur score!
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Old 09-22-2015
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Default Greetings

Congrats for your score , please could you explain your order ? did u read the books then the FA ? could u do your timeline
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  #31  
Old 08-17-2016
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Default Please inspire the world

Hello Nicolas,

I'm Chirag from www.medzepam.com

Medzepam.com is a free pharmacology blog for medical students across the globe. I read your success story of USMLE STEP 1 and I feel it will be a great inspiration for the aspirants from all the International Medical Schools.

I kindly request you to share your story on our blog at the following link: (You will be required to login via facebook or google)

http://medzepam.com/forums/forum/usm...ccess-stories/

Thank you

Sincerely,
Chirag
MEDZEPAM.COM
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Old 08-22-2016
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Default Externship program

Hi everyone
Has anybody as IMG ( INTERNATIONAL MEDICAL GRADUATE) taken Externship program before apply for USMLE?
How was your experience?
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  #33  
Old 09-01-2016
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congrats great score
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  #34  
Old 09-03-2016
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congrats
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