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Discussion Starter · #1 ·
Note: originally posted on SDN

I found out earlier this week that I scored a 272 on Step 1, and as you might imagine, I'm still in shock. But, I want to pay this forward and be of help to anyone still studying, so I thought I would share a few details of my studying, strategies, etc.

To begin, a disclaimer: our school has us take Step 1 after our major clinical year (i.e., halfhway through MS3, as we have 1.5 years preclinical), which I feel puts us at a big advantage in terms of already being very familiar with NBME question style (having already prepared for and taken a year's worth of Shelf exams).

In brief, I had a 6 week dedicated study period after clerkship year, in which I did all of UW and about half of the Kaplan QBanks, both UWorld mock exams, First Aid, Pathoma, a smattering of Sketchy Micro, most of Brosencephalon's Anki deck, and NBMEs 15-18.

I was dealing with some life issues while in that 6 week period so I didn't actually have a pristine study schedule, but in general I just prioritized quizzing myself as much as possible - e.g., covering up a table in First Aid and asking myself what would be in each block before even looking at it the first time, asking myself why each incorrect answer choice in UW was wrong before looking at the explanations, etc. In addition, I did UW entirely on untimed tutor - I tried to focus on making sure I was learning from every single question rather than constantly timing myself, though I took the NBMEs and UW practice exams with realistic time constraints.

That said, I have never been one to take a long time on exams (and finished each block on test day with > 20 minutes remaining), so this may not be the most appropriate strategy for those who have issues with finishing in time -- though I would still recommend focusing on identifying specific facts from each explanation and quizzing myself on them. It can be easy to lapse into passive studying when reading through the reams of text on UW question explanations or just skimming through FA, but I have a feeling my success on the exam owed in large part to having tested myself in so many small ways all throughout my study period.

Re: NBMEs and UW practice tests, I was really nervous/afraid of how I would do, so I (probably foolishly) didn't take one until 12 days before the exam. But for those who are interested:

  • UW %: 94
  • UW Form 1: 282 (which I think must be a gross overestimate comparing the # incorrect from UW to NBME), 12 days out
  • NBME 15: 262, 11 days out
  • NBME 16: 268, 9 days out
  • UW Form 2: 269, 7 days out
  • NBME 17: 270, 6 days out
  • NBME 18: 270, 4 days out
  • Step 1: 272 (evidently I don't yet have enough posting privileges to upload a screenshot of the score report, but I would be happy to send the screenshot to anyone who would like verification; but anyway, what incentive would I have to lie to strangers about my score?)

I am sorry if this comes across as braggy - that's really not my intent (and I am not interested in revealing personally identifying information, because everyone at my school is getting their results around now, and I do NOT want to shove this in anyone's face). Instead, I know how stress-inducing this exam is for everyone who takes it, and want to be a resource to those who would like advice. Feel free to post here or send me a private message!

PS - a note on wellness - I took 45 minutes to 1.5 hours every day during my dedicated study time to exercise, stretch, do yoga, take a walk outside, whatever...I think I would have burned out and done more poorly if I hadn't made that a priority, even on the days I hadn't done as much UW, FA, or whatever else as I had hoped.

Edits: summary of the smatterings of advice I have given either in replies or in PMs:

  • Know what you do and do not know going into your dedicated study time - personally I knew the biochem, micro, immunology, anatomy, and embryology were (a) not taught well at my school and (b) much farther from me in chronologic terms (i.e., learning Micro for the first time in September '14 and taking the exam in February '17.) Once you know what you're weak on (either from preliminary QBank results or just your own intuition, don't feel so chained to the notion that you have to "get through" everything in equal proportions, but instead repeat the subjects you're unfamiliar with early and often throughout your studying period.
  • Re: efficiency, I would say the most important thing is to focus on actually learning from a resource rather than just trying to force yourself to get through it to feel like you've accomplished your study task for the day. I always pushed back plans for how much I would cover when I knew I couldn't cover it all and actually understand and retain the material. Do not fall into the trap of buying more and more materials just to say you made it through them all - it would serve you much better to know UW, FA, and Pathoma cold than to "just get through" Kaplan, UW, FA, Pathoma, Sketchy Micro, Picmonic, BRS Physiology, etc. etc.
  • As much as possible, use UW as an excuse to do forced recall of topics you've studied on previous days in First Aid - so let's say you looked over the mechanisms and indications and side effects for diuretics 2 days ago and ostensibly memorized them - so then when you get a question on where the thiazide diuretic acts, this is your excuse to force yourself to recall where loop (and osmotic, and K-sparing, blah blah diuretics work in addition to their side effects and indications). In generally, the more mentally taxing something is, the more frustrating it is to study, but the more likely you are to retain it.
  • When you are reading questions, try to ask yourself "what unambiguous entity is this question trying to get me to identify?" Because remember that for whatever question, the answer must be universally agreed upon by a panel of experts (unlike many med school exams that try to trick you up). So, particularly for the questions that are more than just rote memory (what cell secretes IFN-gamma?) try to look for patterns instead of taking each detail as a separate data point. For instance, when you hear diabetes, HTN, HLD, and smoking, you should be thinking "what are they about to ask me about atherosclerotic vascular disease, from CAD to cerebrovascular disease to mesenteric ischemia to peripheral vascular disease to renovascular hypertension 2/2 bilateral renal artery stenosis" before even looking at the answer choices.
  • Similarly, when reading a stem on, say, cirrhosis, you should start to bring to mind all the etiologies you can think of (alcohol, hepatitis B and C, autoimmune hepatitis, Wilson's disease, A1AT deficiency, hemochromatosis) and begin thinking of how examiners could unambiguously identify one of these for you - neuropsychiatric manifestations with Kayser-Fleischer rings for Wilson's, early-onset emphysema for A1AT, bronze diabetes, cardiomyopathy, and arthralgias for hemochromatosis, Wernicke-Korsakoff, aspiration pneumonia, and macrocytic anemia for EtOH, and history of immigration from an endemic region vs. IVDU for Hep B/C...and THEN you should start thinking about how you could test for each of those things, AND the underlying pathophysiology of each.
  • The key is making connections as often as possible so that each question becomes a mini-review of every possible topic. Once these webs start to interconnect in your brain, "retention" will become less rote and more facile because your brain remembers why one factoid is relevant in distinguishing one disease entity from another and in allowing you to corral your knowledge base into more organized chunks.
 

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Wowww

That is huge!!!!
Congratulations!!!
Note: originally posted on SDN

I found out earlier this week that I scored a 272 on Step 1, and as you might imagine, I'm still in shock. But, I want to pay this forward and be of help to anyone still studying, so I thought I would share a few details of my studying, strategies, etc.

To begin, a disclaimer: our school has us take Step 1 after our major clinical year (i.e., halfhway through MS3, as we have 1.5 years preclinical), which I feel puts us at a big advantage in terms of already being very familiar with NBME question style (having already prepared for and taken a year's worth of Shelf exams).

In brief, I had a 6 week dedicated study period after clerkship year, in which I did all of UW and about half of the Kaplan QBanks, both UWorld mock exams, First Aid, Pathoma, a smattering of Sketchy Micro, most of Brosencephalon's Anki deck, and NBMEs 15-18.

I was dealing with some life issues while in that 6 week period so I didn't actually have a pristine study schedule, but in general I just prioritized quizzing myself as much as possible - e.g., covering up a table in First Aid and asking myself what would be in each block before even looking at it the first time, asking myself why each incorrect answer choice in UW was wrong before looking at the explanations, etc. In addition, I did UW entirely on untimed tutor - I tried to focus on making sure I was learning from every single question rather than constantly timing myself, though I took the NBMEs and UW practice exams with realistic time constraints.

That said, I have never been one to take a long time on exams (and finished each block on test day with > 20 minutes remaining), so this may not be the most appropriate strategy for those who have issues with finishing in time -- though I would still recommend focusing on identifying specific facts from each explanation and quizzing myself on them. It can be easy to lapse into passive studying when reading through the reams of text on UW question explanations or just skimming through FA, but I have a feeling my success on the exam owed in large part to having tested myself in so many small ways all throughout my study period.

Re: NBMEs and UW practice tests, I was really nervous/afraid of how I would do, so I (probably foolishly) didn't take one until 12 days before the exam. But for those who are interested:

  • UW %: 94
  • UW Form 1: 282 (which I think must be a gross overestimate comparing the # incorrect from UW to NBME), 12 days out
  • NBME 15: 262, 11 days out
  • NBME 16: 268, 9 days out
  • UW Form 2: 269, 7 days out
  • NBME 17: 270, 6 days out
  • NBME 18: 270, 4 days out
  • Step 1: 272 (evidently I don't yet have enough posting privileges to upload a screenshot of the score report, but I would be happy to send the screenshot to anyone who would like verification; but anyway, what incentive would I have to lie to strangers about my score?)

I am sorry if this comes across as braggy - that's really not my intent (and I am not interested in revealing personally identifying information, because everyone at my school is getting their results around now, and I do NOT want to shove this in anyone's face). Instead, I know how stress-inducing this exam is for everyone who takes it, and want to be a resource to those who would like advice. Feel free to post here or send me a private message!

PS - a note on wellness - I took 45 minutes to 1.5 hours every day during my dedicated study time to exercise, stretch, do yoga, take a walk outside, whatever...I think I would have burned out and done more poorly if I hadn't made that a priority, even on the days I hadn't done as much UW, FA, or whatever else as I had hoped.

Edits: summary of the smatterings of advice I have given either in replies or in PMs:

  • Know what you do and do not know going into your dedicated study time - personally I knew the biochem, micro, immunology, anatomy, and embryology were (a) not taught well at my school and (b) much farther from me in chronologic terms (i.e., learning Micro for the first time in September '14 and taking the exam in February '17.) Once you know what you're weak on (either from preliminary QBank results or just your own intuition, don't feel so chained to the notion that you have to "get through" everything in equal proportions, but instead repeat the subjects you're unfamiliar with early and often throughout your studying period.
  • Re: efficiency, I would say the most important thing is to focus on actually learning from a resource rather than just trying to force yourself to get through it to feel like you've accomplished your study task for the day. I always pushed back plans for how much I would cover when I knew I couldn't cover it all and actually understand and retain the material. Do not fall into the trap of buying more and more materials just to say you made it through them all - it would serve you much better to know UW, FA, and Pathoma cold than to "just get through" Kaplan, UW, FA, Pathoma, Sketchy Micro, Picmonic, BRS Physiology, etc. etc.
  • As much as possible, use UW as an excuse to do forced recall of topics you've studied on previous days in First Aid - so let's say you looked over the mechanisms and indications and side effects for diuretics 2 days ago and ostensibly memorized them - so then when you get a question on where the thiazide diuretic acts, this is your excuse to force yourself to recall where loop (and osmotic, and K-sparing, blah blah diuretics work in addition to their side effects and indications). In generally, the more mentally taxing something is, the more frustrating it is to study, but the more likely you are to retain it.
  • When you are reading questions, try to ask yourself "what unambiguous entity is this question trying to get me to identify?" Because remember that for whatever question, the answer must be universally agreed upon by a panel of experts (unlike many med school exams that try to trick you up). So, particularly for the questions that are more than just rote memory (what cell secretes IFN-gamma?) try to look for patterns instead of taking each detail as a separate data point. For instance, when you hear diabetes, HTN, HLD, and smoking, you should be thinking "what are they about to ask me about atherosclerotic vascular disease, from CAD to cerebrovascular disease to mesenteric ischemia to peripheral vascular disease to renovascular hypertension 2/2 bilateral renal artery stenosis" before even looking at the answer choices.
  • Similarly, when reading a stem on, say, cirrhosis, you should start to bring to mind all the etiologies you can think of (alcohol, hepatitis B and C, autoimmune hepatitis, Wilson's disease, A1AT deficiency, hemochromatosis) and begin thinking of how examiners could unambiguously identify one of these for you - neuropsychiatric manifestations with Kayser-Fleischer rings for Wilson's, early-onset emphysema for A1AT, bronze diabetes, cardiomyopathy, and arthralgias for hemochromatosis, Wernicke-Korsakoff, aspiration pneumonia, and macrocytic anemia for EtOH, and history of immigration from an endemic region vs. IVDU for Hep B/C...and THEN you should start thinking about how you could test for each of those things, AND the underlying pathophysiology of each.
  • The key is making connections as often as possible so that each question becomes a mini-review of every possible topic. Once these webs start to interconnect in your brain, "retention" will become less rote and more facile because your brain remembers why one factoid is relevant in distinguishing one disease entity from another and in allowing you to corral your knowledge base into more organized chunks.
 

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Discussion Starter · #4 ·
The UW QBank should obviously be your first priority, but if you've exhausted that (including re-doing the questions you got wrong), I would say absolutely go for more unique questions over just doing UW twice, for instance. The exam itself will have novel questions, so you should be as unperturbed as possible by them.
 

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Discussion Starter · #5 ·
i.e., just re-doing old questions can give you a false sense of security regarding your knowledge base, so beware of that.
 

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i.e., just re-doing old questions can give you a false sense of security regarding your knowledge base, so beware of that.
but does kap qbank cover some unique points, not covered in UW?
and BTW if one wants score like yours, is every word in UW gold?
i mean in some explanations they even have muscle insertions and some details that i just can't imagine being tested
 

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Congratulations... Amazing score!

I burned out 2 years ago and I was not able to take the test. Now after graduating I'm back on my study routine and I don't want to make the same mistakes.

Do you have any recommendations for study schedule?

I am studying from FA and Kaplan videos. Do you recommend other resources? I will add Qbanks later on (because of monetary situation).

Good luck on your career! Best wishes!
 

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Discussion Starter · #8 ·
but does kap qbank cover some unique points, not covered in UW?
and BTW if one wants score like yours, is every word in UW gold?
i mean in some explanations they even have muscle insertions and some details that i just can't imagine being tested
I'm not sure how much is unique so much as assessed in a different way - or for a question type with, say, 6 options, 3 of the options would show up as correct answers to UW questions, and maybe 2 unique ones in Kaplan. So, it's not as though the information isn't there in UW, just that you can't possibly be asked a unique question about every answer explanation present in UW.

And no, some of the answer explanations are way overboard. You should read them for your edification and understanding, but focus on a depth of knowledge that would allow you to answer the question - and differentiate each of the incorrect answers. More than that is (generally) overkill.
 

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Discussion Starter · #9 ·
I burned out 2 years ago and I was not able to take the test. Now after graduating I'm back on my study routine and I don't want to make the same mistakes.

Do you have any recommendations for study schedule?

I am studying from FA and Kaplan videos. Do you recommend other resources? I will add Qbanks later on (because of monetary situation).

Good luck on your career! Best wishes!
I'm sorry to hear that you burned out, but having been close to burnout myself, I understand the stressful and anxiety-provoking situations that may have brought you up to that point. I hope you have found ways - friends, family, exercise, meditation, relaxation, hobbies, whatever - to find some balance and joy in each day, even as you've rededicated yourself to studying medicine.

Re: schedule, as I alluded to in the post, I was in the middle of a depression flare while in my dedicated study period so I really could not stick to a rigid schedule (because there were certain days where I just could not force my brain to focus enough to study, no matter how hard I tried), so I'm actually not the best resource for specific schedule planning. The most important item in planning will be to figure out how much of UW you need to do per day to finish ~1 week before your test to go over the ones you missed or marked.

Getting through the other content...the most important is to make sure you actually know what you're studying. For me, videos are too passive a form of studying, so I learned best from flashcards and regurgitating FA onto pieces of notebook paper the day after I studied them. Find what works for you and helps you retain the information for longer than just a few days after reading it or watching it. If videos work well for you, then great, but for many people they are too passive to promote long-term retention.
 

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Thanks for your words

I'm still trying to find the balance before starting my dedicated study time. I feel the same way about videos. I need to challenge my brain to retain the information.

"To find some balance and joy in each day, even as you've rededicated yourself to studying medicine" Your words have been an inspiration. Thanks for sharing your experience.
 

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Discussion Starter · #14 ·
Also, a few people have PM'd me, but evidently I don't yet have the # of posts to respond. So if you reached out to me, I'm so sorry I haven't responded, I just haven't been able to do so! If you feel comfortable, I would be happy to respond in public on this thread; just let me know.
 

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Note: originally posted on SDN

I found out earlier this week that I scored a 272 on Step 1, and as you might imagine, I'm still in shock. But, I want to pay this forward and be of help to anyone still studying, so I thought I would share a few details of my studying, strategies, etc.

To begin, a disclaimer: our school has us take Step 1 after our major clinical year (i.e., halfhway through MS3, as we have 1.5 years preclinical), which I feel puts us at a big advantage in terms of already being very familiar with NBME question style (having already prepared for and taken a year's worth of Shelf exams).

In brief, I had a 6 week dedicated study period after clerkship year, in which I did all of UW and about half of the Kaplan QBanks, both UWorld mock exams, First Aid, Pathoma, a smattering of Sketchy Micro, most of Brosencephalon's Anki deck, and NBMEs 15-18.

I was dealing with some life issues while in that 6 week period so I didn't actually have a pristine study schedule, but in general I just prioritized quizzing myself as much as possible - e.g., covering up a table in First Aid and asking myself what would be in each block before even looking at it the first time, asking myself why each incorrect answer choice in UW was wrong before looking at the explanations, etc. In addition, I did UW entirely on untimed tutor - I tried to focus on making sure I was learning from every single question rather than constantly timing myself, though I took the NBMEs and UW practice exams with realistic time constraints.

That said, I have never been one to take a long time on exams (and finished each block on test day with > 20 minutes remaining), so this may not be the most appropriate strategy for those who have issues with finishing in time -- though I would still recommend focusing on identifying specific facts from each explanation and quizzing myself on them. It can be easy to lapse into passive studying when reading through the reams of text on UW question explanations or just skimming through FA, but I have a feeling my success on the exam owed in large part to having tested myself in so many small ways all throughout my study period.

Re: NBMEs and UW practice tests, I was really nervous/afraid of how I would do, so I (probably foolishly) didn't take one until 12 days before the exam. But for those who are interested:

  • UW %: 94
  • UW Form 1: 282 (which I think must be a gross overestimate comparing the # incorrect from UW to NBME), 12 days out
  • NBME 15: 262, 11 days out
  • NBME 16: 268, 9 days out
  • UW Form 2: 269, 7 days out
  • NBME 17: 270, 6 days out
  • NBME 18: 270, 4 days out
  • Step 1: 272 (evidently I don't yet have enough posting privileges to upload a screenshot of the score report, but I would be happy to send the screenshot to anyone who would like verification; but anyway, what incentive would I have to lie to strangers about my score?)

I am sorry if this comes across as braggy - that's really not my intent (and I am not interested in revealing personally identifying information, because everyone at my school is getting their results around now, and I do NOT want to shove this in anyone's face). Instead, I know how stress-inducing this exam is for everyone who takes it, and want to be a resource to those who would like advice. Feel free to post here or send me a private message!

PS - a note on wellness - I took 45 minutes to 1.5 hours every day during my dedicated study time to exercise, stretch, do yoga, take a walk outside, whatever...I think I would have burned out and done more poorly if I hadn't made that a priority, even on the days I hadn't done as much UW, FA, or whatever else as I had hoped.

Edits: summary of the smatterings of advice I have given either in replies or in PMs:

  • Know what you do and do not know going into your dedicated study time - personally I knew the biochem, micro, immunology, anatomy, and embryology were (a) not taught well at my school and (b) much farther from me in chronologic terms (i.e., learning Micro for the first time in September '14 and taking the exam in February '17.) Once you know what you're weak on (either from preliminary QBank results or just your own intuition, don't feel so chained to the notion that you have to "get through" everything in equal proportions, but instead repeat the subjects you're unfamiliar with early and often throughout your studying period.
  • Re: efficiency, I would say the most important thing is to focus on actually learning from a resource rather than just trying to force yourself to get through it to feel like you've accomplished your study task for the day. I always pushed back plans for how much I would cover when I knew I couldn't cover it all and actually understand and retain the material. Do not fall into the trap of buying more and more materials just to say you made it through them all - it would serve you much better to know UW, FA, and Pathoma cold than to "just get through" Kaplan, UW, FA, Pathoma, Sketchy Micro, Picmonic, BRS Physiology, etc. etc.
  • As much as possible, use UW as an excuse to do forced recall of topics you've studied on previous days in First Aid - so let's say you looked over the mechanisms and indications and side effects for diuretics 2 days ago and ostensibly memorized them - so then when you get a question on where the thiazide diuretic acts, this is your excuse to force yourself to recall where loop (and osmotic, and K-sparing, blah blah diuretics work in addition to their side effects and indications). In generally, the more mentally taxing something is, the more frustrating it is to study, but the more likely you are to retain it.
  • When you are reading questions, try to ask yourself "what unambiguous entity is this question trying to get me to identify?" Because remember that for whatever question, the answer must be universally agreed upon by a panel of experts (unlike many med school exams that try to trick you up). So, particularly for the questions that are more than just rote memory (what cell secretes IFN-gamma?) try to look for patterns instead of taking each detail as a separate data point. For instance, when you hear diabetes, HTN, HLD, and smoking, you should be thinking "what are they about to ask me about atherosclerotic vascular disease, from CAD to cerebrovascular disease to mesenteric ischemia to peripheral vascular disease to renovascular hypertension 2/2 bilateral renal artery stenosis" before even looking at the answer choices.
  • Similarly, when reading a stem on, say, cirrhosis, you should start to bring to mind all the etiologies you can think of (alcohol, hepatitis B and C, autoimmune hepatitis, Wilson's disease, A1AT deficiency, hemochromatosis) and begin thinking of how examiners could unambiguously identify one of these for you - neuropsychiatric manifestations with Kayser-Fleischer rings for Wilson's, early-onset emphysema for A1AT, bronze diabetes, cardiomyopathy, and arthralgias for hemochromatosis, Wernicke-Korsakoff, aspiration pneumonia, and macrocytic anemia for EtOH, and history of immigration from an endemic region vs. IVDU for Hep B/C...and THEN you should start thinking about how you could test for each of those things, AND the underlying pathophysiology of each.
  • The key is making connections as often as possible so that each question becomes a mini-review of every possible topic. Once these webs start to interconnect in your brain, "retention" will become less rote and more facile because your brain remembers why one factoid is relevant in distinguishing one disease entity from another and in allowing you to corral your knowledge base into more organized chunks.
Congratulations!
 
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