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  #1  
Old 06-02-2011
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Info Step 1 finished. My thoughts

June 1, 2011

Here are some of my thoughts on the beast that is USMLE Step 1. My results aren't out yet and so this could be an exercise in vain. I will however try to be objective so this applies to anyone who reads it. I am writing this note before my results are out because it is true that the longer I wait to put my thoughts on paper, the slimmer my chances of capturing my precise observation.

DISCLAIMER:
1. I have been out of medical school for 5 years and had to go through the books at a slower pace than others might.
2. I have a hard time mugging facts. I find it much easier to remember concepts. So, contrary to the usual belief of relaxing on exam eve, I went through a self-made list of topics that I need to go through.
3. What follows is my opinion based on my preparation and the exam experience.

So, here goes to nothing.

THE PREPARATION:
What needs to be done - Kaplan books with lectures, Goljan audio, Goljan notes, First Aid, USMLEWorld (UW) questions, NBME 4-hour tests.

What I did -
1. Kaplan notes and lectures were good for the most part in explaining the concepts. Use all lectures for study except for Pathology, which should be entirely Goljan.
2. First Aid (FA) turned out to be an extremely useful asset, but only during the last few days. I find mugging hard and so it took me some time to reconcile with the book. I actually picked up FA once I was done with one complete UW read (all 2000+ questions). This helped me in understanding the bigger picture of the bite-sized facts FA seemed to provide. Also, important is the fact that once I started using FA, I rarely opened my Kaplan books.
3. I also did Kaplan's MedEssentials. I think FA is the book that hits the key things useful for the exam and so this book could be avoided altogether. The online practice questions that go with the book do not follow the book's pattern of study.
4. Kaplan QBook can be ignored based on the fact that you will be doing better and more focussed questions from other sources.
5. Goljan lectures. I put it in my iPhone and listened to them on my way and back from work all through my preparation. I converted them into audiobooks in iTunes and listened to them @2X speed.
6. Goljan notes. There is a 100 page note, a 36 page note and a 5-day lecture note. I did the 100 page note. It is helpful, but only during the last stages of your preparation as you need to know the stuff beforehand to correlate and learn the bullets in the notes. Use 36 page if short on time. I think the 5 day note was the one that gave me confidence. It is a write-up of all that Goljan says verbatim. Again, I love concepts and some of the things he taught were amazing. I think it is important to learn these topics from the 5 day notes: Anemias, Nephrotic and nephritic syndromes, Oxygen hemodynamics, reproductive system.
7. UW. The holy grail of questions for all USMLE exams. I took extensive notes for all explanations by hand, and they were of great help in preparing in the last few days. A revision of wrong answers is important too.
8. 'Things you need to know for USMLE Step 1'. These supposedly have been compiled from previous exams and Garam Masala (!) notes. I used these to practice all the high yield material with a study partner. It was a good confidence booster.
9. NBME practice tests. I gave 3 of them and did 3 more offline. Scored pretty low on all, the highest score being 380. I guess I will only know of these tests’ reliability once the results are out. So, I will withhold my judgment on these.
10. Last minute revision topics. In the last week of studies I started to make a list of all the topics I felt I needed to give a quick look 1 day before the exam. On the exam eve, this list had about 40 topics big and small. And it did really help. During the exam I kept thinking about how I had read this topic yesterday.

I did not find any need for any other books or practice materials.

THE EXAM:
It is a long 8 hour stress-fest. But it's do-able. Here are my impressions in a nutshell -
1. Breaks: What best suited me was the first break after 3 sections (of 1 hour and 46 questions each), second after 2 sections. Thats it.
2. During my practice tests at home (timed and untimed), I realized that the less nervous, stressed, sleepy, tired I was the better my score was. And this is what I practiced in the exam. Even if I didn’t know the answer or felt that the entire section hadn’t gone as I had hoped, I would tackle each new question as if I was starting the test afresh. I told myself constantly that I had to keep going. In fact, I wrote my favorite mantra 'Keep Calm and Carry On' on the provided rough sheets.
3. The first three sections went well. There were a bunch of things I was sure of and some in which I was reasonably certain I had gotten to the right answer. I felt confident and calm during my first break.
4. The 4th and 5th sections were average difficulty, but there definitely were questions I had no clue about.
5. The final 2 sections proved to be harder than I thought. Now that could also be because I felt nervous or was very tired. But once I was out of the exam I felt that the questions in those sections were definitely longer and harder. Too many histo images, CT, MRI. Again, this could be just my impression because I was tired already.
6. There were ECFMG reports that the pattern of questions in the exam is changing. There were rumors that the new exam would contain more of Immunology. This proved to be true. I had a tough time answering some of those questions. I distinctly came back with the impression that there were too many Immunology questions. Again, this could be because although there were reasonable amount of Immuno qs, I found them hard and so in the end those were the questions I spent most of my time on and hence came back thinking there was a lot of Immuno.

Could I have done better? Based on the fact that I was doing a full time job at Harvard and was out of med school for a good 5 years, I feel like I gave my best that I could. And I am happy about that, I have no regrets. If that's not good enough, then so be it. But for now, I revel in the fact that I could undertake this daunting task at this stage of my life and career and come out on the other side pleased with the effort. I thank everyone on this forum who wrote. It really helped more than you think!

And if you have any questions, I will be happy to answer. Hope this WAAAAAYY too long note helps you in understanding what you will be tackling. Thanks again people!!
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Old 06-02-2011
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great article..but i have a qs..which book do u think is the best for immuno??
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Quote:
Originally Posted by earthpole View Post
great article..but i have a qs..which book do u think is the best for immuno??
Earthpole,

I did Kaplan Immuno + FA only, but I did it thoroughly. Made my own notes and revised constantly. I have heard BRS immune is also good. Pursue it if you have time. I have not read it at all.

I heard of the change in format only a few days before my exam. So, instead of getting a new book to read immuno, I just revised again and again from Kaplan and FA.

Also a bunch of Leukemia and lymphoma questions - but mostly fairly easy and solved by Goljan audio and FA.
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Default Congrats!

Congrats on being done. I am sure the hard work will pay off.
In your thread you mentioned about a book "Things you need to know for USMLE Step 1", would it be possible for you to pass it to me if you have it in a pdf or word file.
Thanks for your help.
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Excellent job and post. God bless the good people like you. Goodluck in your match!!
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Thank you for sharing, congratulations! God bless your heart.
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Smile Thanks and some help

Hey guys,

ApplicantGuide and usluipek,

Thank you so much for the kind words. I want you to know that it means a lot to hear encouragement and optimism from others. During some of the 'bad' days these words keep me moving.

Again, thanks.

I have got a request from several people about the Things You Should Know for Step 1 that I have mentioned in the write-up above. The document can be found at - http://d.pr/YwEZ

To reiterate, it has high yield bullets and topics collected from previous test takers. It is NOT essential to go through them for the exam. 95% of all things mentioned in the note would have already been covered by your study. So, my opinion is that you do it only if you have enough time. I think its 20 pages long and should not take very long to finish. 1-2 hours per day should finish it in a week or so.

You can either do these with a study partner where you read the topics out loud to each other and then speak all you both can recall OR you can do it alone - read the topic name and try to speak out loud as much a you know about the topic - this will adequately measure your hard knowledge on the high yield stuff.

Hope it helps.
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Old 06-03-2011
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Congratulations!!! God willing you aced that test. You posted a great experience and I thank you for such good writing. Thanks also for the "should know list". I would also like to know 2 things: how long did it take you to prepare (how many hours per day) since you work and all...and just out of curiosity (you can just disregard this one) do you do medical related things at Harvard? Congratulations again on your success, indeed hard work should pay off. Thanks again! God Bless!
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Quote:
Originally Posted by tootsie View Post
Congratulations!!! God willing you aced that test. You posted a great experience and I thank you for such good writing. Thanks also for the "should know list". I would also like to know 2 things: how long did it take you to prepare (how many hours per day) since you work and all...and just out of curiosity (you can just disregard this one) do you do medical related things at Harvard? Congratulations again on your success, indeed hard work should pay off. Thanks again! God Bless!


Tootsie, (I love that movie )

Thank you for the kind words. So, I work full time (7:30am - 4pm) in a research setting, which can be rather taxing at times. In total, I took around 7 months or so of concentrated study. Some days were good and I could sneak 5-7 hours a day, while others were bad and I was so tired that I couldn't pick any book. So, On an average I would say it was 3-4 hours a day of studying. And I revved it up during the last 2 months averaging 5 hours a day at least. I took the last 2 weeks before the exam off to study for 8-10 hours/day.

I think my schedule is erratic and might not be of much help to most people. I should also mention that I moved my exam date 'by a significant amount' twice because I didn't feel confident. I think what I will advice is - read read read as much as you can and test test test as much as you can. Only go the exam if you are stuck with a time constraint or your scores have steadily improved in UW.

As for the second question, yes, I am involved in a medical research project under 3 different physicians.

Thanks for writing in! Good luck with the studies!
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Quote:
Originally Posted by abeworld View Post
June 1, 2011 .....Thanks again people!!
best preparation u did & hope your hard work ll give you big achievments..
so do you think kaplan immuno lec notes was not sufficient for exam?? in fact there is detail immuno in kapaln..
2ndly hw was genetics ,biochem & pharma question?? i covered these subjects from kaplan lec notes...is it sufficient...
you mention many histo slides,CT, MRI were in exam...so wat sources you covered histopatho slides, CT,MRI ?
3rdly..can you post me 5days goljan notes & list of 40 big topics in pdf ?? i shall b thank full..
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Old 06-03-2011
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hey thanx for the gr8 post...nd thjanx for sharing the doc file...can u tell me goljan notes vs goljan rapid review..?? also regarding goljan notes i have the 59 pages path secret bye goljan i .e. the words of goljan in lectures ...r u talkin abt the same notes , or r they different..
thanx in advance
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Congratulations on finishing the exam. and good luck with the result. I'm sure ure going to do well.
1. Could you tell me from where to so Neruanat sections? also,
2. which 100 page notes r u talking about? I have the path secret file and those bullet points and USMLE scenario Goljan files. what am I missing?
3. how many times should I do uworld? I am almost done with it but im taking the exam in august. should I extend the subscription? I took down extensive notes in my first aid itself..so instead I should just read those notes for the next 1.5 months? which is the better option?
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Congrats dude!
Your guidelines are very helpful. Your hard work will certainly yield you good results.
Thanks for taking time to share your experience.
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wat job u dng at harvard ,u havent got your residency as yet..so??
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Old 06-04-2011
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Quote:
Originally Posted by marrium View Post
best preparation u did & hope your hard work ll give you big achievments..
so do you think kaplan immuno lec notes was not sufficient for exam?? in fact there is detail immuno in kapaln..
2ndly hw was genetics ,biochem & pharma question?? i covered these subjects from kaplan lec notes...is it sufficient...
you mention many histo slides,CT, MRI were in exam...so wat sources you covered histopatho slides, CT,MRI ?
3rdly..can you post me 5days goljan notes & list of 40 big topics in pdf ?? i shall b thank full..



Thank you for the kind words.

I do think that Kaplan lectures and notes ARE sufficient for the exam. However you need to remember everything from it and make sure you supplement it with UW questions. Again, my test had a good number of immuno questions, but I have seen other people's experience too and they say that their exam had a normal amount. So, Kaplan + UW is enough and just to be on the safe side, revise it one extra time and you will be fine. Pathophysiology still has the maximum number of questions - focus on that.

Genetics, biochem and pharmac - I did Kaplan + FA + UW and I think that should be more than adequate. There were certainly questions on Hardy Weinberg and inheritance and genetic diseases, as expected. Pharmacology was definitely tested more that genetics or biochem.

I did not specifically do histo, CT, MRI from any source and I did not feel that I had to rely on these to solve the questions in the exam. I did look up the appendix of FA and I also had Goljan Rapid Review book - if there was a question in UW regarding am image, I would go back to Rapid Review and see the images in all the related topics.

I had all the notes on an external hard disk which I gave to a friend after finishing the exam. Will try to get her to post them here. In regards to the 40 big topics - those were just some things that I wanted to revise on the last day because I find it hard to cram stuff. I wrote down those 40 Qs while giving UW tests. That was just a note and once I was done I threw it away. You should not pay attention to that. If you like the idea of having a small set of things to look at one day before the exam, make a list in a note book and keep it with you. Mine had a bunch of small things that I kept forgetting, like the Gram +ve and -ve labs, nephrotic and nephritic syndromes, gall and kidney stones, UC and Crohn's, etc. I knew these things but I realized that they were very important for the exam and I need to see them right before the exam so that they are fresh in my head.

Hope this helps.
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Quote:
Originally Posted by drnirajmavani View Post
hey thanx for the gr8 post...nd thjanx for sharing the doc file...can u tell me goljan notes vs goljan rapid review..?? also regarding goljan notes i have the 59 pages path secret bye goljan i .e. the words of goljan in lectures ...r u talkin abt the same notes , or r they different..
thanx in advance


I think Goljan's rapid review is too big and notes are enough. You need to stay focussed on what's required in the exam.

I am not aware of 59 page notes, but I think if these notes are exactly what Goljan is saying the lectures, then you have got the right one. I remember mine said 'Goljan 5 day lecture notes' on top. But it shouldn't make any difference - the idea is to have written notes so that its easier to follow Goljan's incredible lectures and revise it when needed.
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Quote:
Originally Posted by kjain View Post
Congratulations on finishing the exam. and good luck with the result. I'm sure ure going to do well.
1. Could you tell me from where to so Neruanat sections? also,
2. which 100 page notes r u talking about? I have the path secret file and those bullet points and USMLE scenario Goljan files. what am I missing?
3. how many times should I do uworld? I am almost done with it but im taking the exam in august. should I extend the subscription? I took down extensive notes in my first aid itself..so instead I should just read those notes for the next 1.5 months? which is the better option?



KJain,

Thanks for the wishes.

1. I did neuroanatomy from Kaplan and saw the figure of Cranial Nerves origin in the brain from Neuroanatomy RoadMap - but you can read that from anywhere. Just make sure it is sufficiently descriptive. I wasn't overwhelmed by the amount of Neuroanat in the exam.

2. The 100 page pdf note I read said 'Goljan's high yield notes' on top and had ALL the subjects in it. I do not know of the pdfs you have mentioned here. The idea nevertheless is to go through a quick high yield revision, wherever you do it from. These notes are very old anyway and I dont know how helpful they are in the exam. But they are excellent source of a quick 5 day revision and that really helps during the last few days.

3. I did UW once thoroughly and then did the wrong answers only. The important part is understanding questions and taking notes. As long as you learn the fact in the question and read the entire explanation you should be good to go. Oh, and I do think you should extend the subscription. You need to be doing questions till the very last day. It really helps to be in that 'mode' of answering questions. Start the whole UW QBank again if you are done with it. But DO NOT stop doing questions EVERYDAY once you started.

Hope this helps.
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Quote:
Originally Posted by rahul usmle View Post
wat job u dng at harvard ,u havent got your residency as yet..so??


Rahul,

I hope you don't mind but I would like to keep a certain things a little private (not that going a little Sherlock Holmes on my profile won't give away everything hehehe)

I am not a resident, just involved as a scientist. I hope you understand. Send me a PM if you have questions and I will try my best to answer.
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Old 06-08-2011
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Thank you so much for post! Congratulations on finishing the exam. With all the hard work you did, Im sure you will get a very excellent score

I would like to ask you a few questions:
1.) How many audio/video questions did you come across the exam? Did you use any review materials for these? What topic should we focus on to prepare for such questions?

2.) Were there a lot of graph interpretations? computations? Is BRS enough for Behavioral Science? Or do you think Kaplan is better?

Thank you so much for your reply. Goodluck on the results and on your future endeavors
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congratulations....wish you all luck for a great score
can you plz enumerate the important topics to be done from goljan rapid review
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Old 06-09-2011
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Quote:
Originally Posted by angelina vivien View Post
Thank you so much for post! Congratulations on finishing the exam. With all the hard work you did, Im sure you will get a very excellent score

I would like to ask you a few questions:
1.) How many audio/video questions did you come across the exam? Did you use any review materials for these? What topic should we focus on to prepare for such questions?

2.) Were there a lot of graph interpretations? computations? Is BRS enough for Behavioral Science? Or do you think Kaplan is better?

Thank you so much for your reply. Goodluck on the results and on your future endeavors


Hey Angelina,

Thank you for the wishes. I am so nervous!

1. As far as I can recall I didn't have many audio/visual questions. Infact I can only remember 5, dealing with heart sounds and murmurs. (I am not including CT/MRI/Histo in this category). I did not read anything special. Just went through the UW questions that had these questions + First Aid. I think murmurs are very important. You can google and listen to those murmurs to get used to them. Plus it is important to know the areas of the heart where heart sounds and murmurs are heard.

2. Again, I recall only a few graphs - I certainly did not come back with the impression that there were an overwhelming number of charts and graphs. Though the standard ones were all there. I don't want to divulge explicitly which graphs I encountered but I can say all of them are in Kaplan books physiology section. There were a couple of Hardy Weinberg calculations and a three biostat ones. Know your sens/spec/PPV/NPV/OR/RR/AR by heart and do a few questions from somewhere. I had some of my best scores in Behavioral Science while doing UW and so, I did not do a lot of it. I only studied Kaplan. I think BRS is more extensive and hence definitely should be more than enough, IMO. If you follow Kaplan lectures with the Kaplan books, all questions can be solved. I tried reading BRS and did not enjoy it. Like I said before - I like explanations more than bullets. If you like quick and fast mugging, BRS is great. In short, both books are enough individually - find whatever suits you.

Hope this helps and was not that confusing. I am a little tired today
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Quote:
Originally Posted by usmlemydream View Post
congratulations....wish you all luck for a great score
can you plz enumerate the important topics to be done from goljan rapid review



usmlemydream,

I used Goljan Rapid Review for only important images. I think you will find better understanding of the pathologies from a combination of UW questions and FA and Goljan audio lectures and notes.

Maybe someone who has done the book thoroughly can assist more and comment.
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Old 06-09-2011
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Quote:
Originally Posted by usmlemydream View Post
congratulations....wish you all luck for a great score
can you plz enumerate the important topics to be done from goljan rapid review
There isn't an "imp topics list", you need to read everything, after your first read (or once you're done understanding), than you can stick to only the blue margin notes.
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Hope this helps and was not that confusing. I am a little tired today [/QUOTE]




Thank you so much, abeworld! That helped and enlightened me a lot! Again thank you and goodluck on your results! Im pretty sure you did so well so dont be nervous. God bless!
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What is "Garam Masala' questions?
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Quote:
Originally Posted by maitribhandari View Post
What is "Garam Masala' questions?


maitribhandari,

Garam Masala is supposed to be a note listing all remembered topics from previous exam-takers. But this is an old note and so I would suggest use it if only you have some extra time. They can be used as a quick revision tool.
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