USMLE Step 1 Preparation

Pre-Med & Medical School Pre-Med Topics
1

<p>D is heavily into it, as I know somemom's kid is. My kid's profile/make-up/history is that she will attempt , with some success, to over-power the dang thing. From my reading, this doesn't concern me the same way her MCAT prep did, as this does seem to be a more "cumulative knowledge" test requiring substantial review and maybe less test strategy. In fact, it might well play to some of her strengths. Hoping a pro can comment. </p>

<p>D ended classes a while back. Maybe a month ago. The day after classes ended she had some sort of "practical test". The day after that, her class, as a whole, took a "Shelf Exam"- a 4 hour test that supposedly bore a direct resemblance to the 7 hour Step 1 and , I guess, was intended to be "diagnostic". She scored over what she needed to "pass" the test, but maybe 10 points over which is 40 points under where she wants to be for her residency apps. Not bad, I think, before starting her review.</p>

<p>Last weekend (edit: weekend before last) , she took a full-length test after making it through about half of her review. She improved almost 30 points. (And found some holes in already reviewed material but basically her improvement tracked her study topics. But some results were random and un-explainable) Again. Not bad, I think. </p>

<p>Still has 21 days left before the test. Her plan is to finish her in-depth review (or re-learn ;)) within the next ten days. At the same time, she is going back and dealing with each topic in a mini-review to keep it fresh. And then take another diagnostic exam. Hopefully that exam will produce a score close to what she feels she needs. </p>

<p>She's voicing that she is not trying to kill the test, just do well enough to get to what she feels will be her strongest residency app points (rec's, eval's, etc). IOW, not have a score low enough to be culled before a full review of her app. </p>

<p>Others students at her school and from her UG have a substantially different schedule ( a moderate review, repeated over and over), but she believes her strategy is better for her and she's gonna go with her gut. </p>

<p>My fear as a parent of this particular kid comes from: </p>

<p>a) complete ignorance about the test</p>

<p>b) dis-belief about her study schedule (8-12-15 hours a day, everyday except 1 so far) </p>

<p>c) A history of ignoring strategy and relying on intellectual muscle and work to power through any obstacle</p>

<p>d) A couple of times where she over-did it in high school, over-tried is the most acurate term. Once or twice in high profile athletic competitions where she tried to do too much and once in an academic competition where prior successes led her to "over-try" . Those 3 events are burned into my parental brain. They were ugly. Of course, there were many more events where she performed pretty much flawlessly. Looking back, it's when she demanded and expected a near flawless performance and the event was "high profile" that the problems came in. She does not fear tests and is an excellent test-taker. Confident of her preparation and intellect. She does the work. But these outliers bug me. </p>

<p>So....I have been coaching "realistic expectations". "Balanced life" even while studying. And she is at least listening. She is the type that needs to be calmed down in intensity, not ramped up. (Something her high school coach failed to grasp. lol)</p>

<p>So. Any word from the pros on her approach to the test and my approach to her? If not, hey. I needed to vent something out my stress-pipe, so at least I feel better for typing this. ;) lol</p>

2

<p>Curm- (using my mommy voice)</p>

<p>It has been a long time since she was in high school.</p>

<p>And yes you are the worry-wart Big Daddy. Can’t change that.</p>

<p>But and a BIG BUT, she just needs you to listen, nod, say uh-huh and tell her you love her more than anything.</p>

<p>In 2 years she will be a physician. Yep, a DOCTOR. Sure, still your little girl, that ALWAYS. She will perform to her very best ability on the step 1. She has great teachers, great peers and she herself is the BOMB.</p>

<p>Okay. Carry on Big Daddy, and I would trade your “worrying” self-disciplined daughter for my idiot boy any day. Just let me know when!</p>

<p>Kat</p>

3

<p>Wow, DD does not finish class until the end of this month and takes the exam a month after that. I will be interested to hear the advice, as studying has no really begun, though I did see a Facebook status about the first 10/10 on Qbook ;)</p>

4

<p>Hey. One of her friend’s just got engaged and is buying a condo and has to move out and buy furnishings. Plus study for this dang test. Of course, she made a 42 on the MCAT so…</p>

<p>Yeah. Yeah. I got it. “Chill out, Idiotman.” lol. I’ll try.
But I’ll really be playing against type here. ;)</p>

5

<p>somemom. D takes the test the 30th I think, comes home for a week, and then they have survival week and MS3 starts in earnest.</p>

6

<p>Ew, the last thing I want to be thinking about is Step 1. I’ll take the end of M1 first please :slight_smile: (which, guess what, is FRIDAY!)</p>

7

<p>USMLE World Q bank + First Aid Step 1 and 5 weeks of studying was all I used.</p>

8

<p>ncg, since I don’t know what any of that is, I will have to assume she is using good stuff, too. lol</p>

<p>As I might have mentioned a time or two , I am completely ignorant of just about everything from here on out.</p>

9

<p>norcal, did you follow along review books during the 1st 2 years?</p>

10

<p>Yeah, I think more than 9 hours a day is pretty intense. I studied in 3 hours blocks with an hour in between five days a week, with 2 5 hour days as a break. I didn’t use any review materials before starting my study period, but I did my clinical year first which I feel may have been a leg up despite no formal prep. I used FA as my bible, reading it 3 times total (twice section by section followed by once entirely through during the last few days of my studying). What I did was read a section, then do all of the USMLEWorld questions on that section, annotating as needed. I also included one supplemental material per section to annotate first aid. After annotating a section I read it again and moved on to the next section. This was usually Goljan and for a few I added Constanzo’s BRS physiology book (pulm, cards, and renal). For infectious diseases I read through the charts of Microbiology made ridiculously simple and annotated. For Biochem I started using a BRS book but found it worthless and just stuck with first aid. I didn’t use anything additional for epidemiology or for psych. For immuno I used some random review book I found. I had access through a promotional offer that has since expired to Kaplan’s Qbank. I did a few Qbank questions for things that had little coverage in USMLEWorld (mostly epi), but I found it not to be worth my time over all.</p>

<p>It sounds like she has had a tremendous amount of time to dedicate to this (1 month + 21 days). Her problem will be maintaining all the early stuff. I too studied for a sizable period of time (7 weeks), and what I am really glad that I did was save the whole last week for reviewing first aid all the way through, tearing out all of the hard pages (drugs for me mostly), and reviewing them again and again until I had whittled myself down to 3 pages by test day. I read them on my subway ride over to the center and that was that. Overall, I improved 53 points over my starting score.</p>

11

<p>The “big kids” at my school recommended getting First Aid early, during first year, and using it to review for exams. I use it now and really like it–it’s concise and very “high yield” and has lots of mnemonics (sometimes too many though–harder to remember the trick than the actual thing you’re learning!). I just use the section about organ systems for the most part. It’s nice because for the most part, it’s laid out the same (eg anatomy, normal physiology, pathology, meds) for each organ system, which isn’t always the same for text books. It’s a nice review in that it cuts out all the fluff, and I recommend using it as a review instead of as a starting point.</p>

<p>As far as how it applies to the real test, beats me. I just like having everything in one place.</p>

<p>(Curm: “First Aid for the USMLE step 1” is a review book, kinda like an SAT or MCAT prep book on lots and lots and lots of steroids, and seems to focus more on content review than test-taking strategy)</p>

12

<p>

</p>

<p>No. I don’t think it’s a bad idea though to get First Aid at the beginning of M2 year and follow along. You’ll be going through it multiple times anyway.</p>

<p>I did buy a 6 month subscription to USMLE World. But, I only did ~500 questions during the school year and I did the other ~1700 questions during my 5 weeks of studying.</p>

<p>I bought all the other “recommended” review books: Goljan path, High Yield Neuroanatomy, BRS Physiology, etc. Never used them.</p>

13

<p>

Not sure if it will only be First Aid that last week, but it will be condensed and cover all topics. Really sounds similar. I’ll ask. And probably get yelled at.</p>

14

<p>i also heard that people watch goljan videos and stuff like that. how does anyone have that much time to watch all the videos, read through review books, and do the question banks.</p>

15

<p>I’m currently an MS3 and took the Step 1 at the end of May last year. I bought 1st Aid and USMLE World QBank for a 1 year subscription. For my second year courses, in addition to studying the course material, I would use these two sources to study (very very lightly until after spring break). I did the Step 1 Method and their proposed study plan, which is get through at least 60% of QBank and annotate your First Aid with it by your intensive study period. I had annotated my entire First Aid with my QBank by my intensive study period and spent the intensive period (4 weeks) going through First Aid about 3-4 times and QBank a total of 2.5 times and this was 10-12 hours per day with a half day off one day a week. Though I had other supplemental sources, I never used them (the only thing I did was listen to Goljan when I was in the shower, walking to the library, or needing a break from questions-I went through the audio files once), and my score ended up being extremely impressive and way more than I had ever hoped for. So…I did the same thing for third year for the shelf exams and Step 2 but with much less intensity (no annotating). With that method, I honored all my shelf exams (with the exception of OB/Gyn because that is on Friday!) and am now going to really crack down for Step 2. </p>

<p>If your daughter has found what works for her, then that’s all that matters and she’ll do her absolute best. The test itself is just exhausting because it’s 8 hours of staring at a computer screen and racking your brain. I was a zombie when I finally walked out of the testing center. So my best suggestion is to do a TON of questions to prepare your mind for this experience, and be able to answer the questions quickly.</p>

<p>Hope this is helpful for the MS1’s and MS2’s out there! Best of luck, and don’t forget to eat and take breaks when you need them!</p>

16

<p>bigreddawg- it’s pretty impressive what some people cram into their school year. I think there is a subgroup of folk that basically say “screw studying for my classes, I’m going to just studying this section as it pertains for the step 1.” Being thus free of all school related materials other than attending lectures perhaps, they delve entirely into the wide array of step 1 prep materials out there. I’m not sure that I agree entirely with this method of step 1 prep, but it is most certainly feasible (especially at p/f schools) in terms of passing.</p>

<p>Also, I believe the Goljan materials that you are referring to are the audio lectures. Many people listen to those while traveling, working out.</p>

17

<p>curm:</p>

<p>I’m late to the party, but here’s my 2 cents.</p>

<p>The key to doing well on Step 1 is, I think, doing what works for your D. It’s easy to get caught up in the paranoia and try to do it all - answer all the questions in all the question banks, read all the books, memorize all the flashcards, etc. Your D doesn’t need to do it all. She just needs to do what works for her. </p>

<p>That said, a book like First Aid is key. Depends on your D’s strengths, I’d consider supplementing that book with High Yield Neuroanatomy, High Yield Embryology, BRS Physiology, or High Yield Cell and Molecular Biology. (You can see where I was weak by my book choices.) Books like Goljan’s Rapid Review Pathology are fundamentally good, but they’re so long and details that I found I didn’t have time to read them! </p>

<p>I’d also invent in a good question bank like USMLE World. </p>

<p>Make a study schedule and stick to it. Make sure your D has a few break days tossed in there. Take a break day the day before the test.</p>

18

<p>Thanks much. I am certainly gonna stress the break days. And I’d like to see her cut her daily hours down, too. I know she is using First Aid and has some sort of Q bank. </p>

<p>She was in foul mood yesterday, mad at the world and all of its inhabitants (according to my W). I’d much rather have her a little less prepared and in the right frame of reference, than the other way around.</p>

19

<p>Just like for the MCAT, what works for some students may not work for others for the USLME1. We have something the school calls “The Penn Method” and it seems to be what most Penn students go for (or end up adapting it depending on their individual needs)
I think it is a very useful template that everyone can modify as needed. Here it is:</p>

<p>Books needed:</p>

<p>First-Aid for the Boards - USMLE part 1
Lippincott’s Biochemistry
Lippincott’s Pharmacology
Microbiology Made Ridiculously Simple
Microbiology and Immunology (by Lange…orange and dark grey book)
BRS Pathology
BRS Physiology
High Yield Anatomy
High Yield Embryology
High Yield Neuroanatomy
High Yield Behavioral Sciences
High Yield Histology</p>

<p>Question Sources:</p>

<p>Kaplan’s Q-bank (2500 questions + answers online), 1 month subscription
Appleton and Lange’s USMLE Step 1 (1200 questions + answers, including 2 full-length exams)</p>

<p>Schedule (First 25 days*) - Background Reading</p>

<ul>
<li>These days are meant to get you familiar with the material. Don’t get caught up on trying to memorize every detail. These days are not for memorization.</li>
</ul>

<p>They are just meant for you to see all the material once and to distill out the most testable points in order to take notes upon for further study (see “last 5 days” below). These days are approximately 8-9 hours of studying/day. Make sure you sleep, eat, and work-out during this time. Also, try and relax for 2-3 hours per night (i.e. hang with girl-friend, watch movies, get out of the library).</p>

<p>2 days First-Aid for the Boards (only cursory reading - get a feel for what you are up against)</p>

<p>4 days Biochemistry + 50 biochem questions per night</p>

<p>1 day Histology + 50 histology questions</p>

<p>3 days Microbiology (Micro made ridic simple only) + 50 microbio questions/night</p>

<p>1 day Immunology (Lange’s book) + 50 immuno questions</p>

<p>1 day Embryology + 50 embryology questions</p>

<p>3 days Physiology + 50 physiology questions/night</p>

<p>1 day Anatomy + 50 anatomy questions</p>

<p>4 days Pharmacology + 50 pharmacology questions</p>

<p>1 day Neuroanatomy + 50 neuroanatomy questions</p>

<p>3 days Pathology + 50 pathology questions/night</p>

<p>1 day Behavioral Sciences + 50 behavioral sciences questions</p>

<p>So for each of first 25 days of reading, you review (in 1 hour each morning) the corresponding section from First-Aid. While you are doing your readings for the day, you take all your notes in the margins of First-Aid on the section that relates to that day’s readings. At night, you do 50 to 100 practice questions on the topic (i.e. Biochemistry) that you read about that day and read ALL the explanations for each question at the back of the Book or on the Kaplan Website.</p>

<p>Schedule (Last 5 days*) - “where the men are made and the boys are broken”</p>

<p>*WARNING: last 5 days are the absolute meat of getting the score. Everything you’ve done before this is just a warm-up. These days are approximately 12-14 hours of studying/day. Besides eating, sleeping and working-out, you are doing ABSOLUTELY NOTHING ELSE BUT STUDYING.</p>

<p>· Day 1 - review Biochemistry, Physiology sections of First-Aid
(i.e. deeply study these sections and all the notes you wrote in the margins). This should take approximately 5-6 hours. In the afternoon, do 150-200 questions/answers related to Biochem, and Physiology.</p>

<p>· Day 2 - review all small topics (i.e. Histology, Anatomy, Embryology, Neuroanatomy, Behavioral Sciences) and Pathology sections of First-Aid plus your notes. Do 150-200 questions related to these topics.</p>

<p>· Day 3 - review Pharmacology and Micro + Immuno sections of First-Aid plus your notes. Do 150-200 questions related to these topics.</p>

<p>· Day 4 - review First-Aid sections/notes: Biochem, Physio, Path. Do 1 practice test from Appleton and Lange. Do more questions related to these topics.</p>

<p>· Day 5 (Last Day!!!) - Review First Aid sections/notes: Micro + Immuno, Pharm, and small subjects. Do second test from Appleton and Lange. Do more questions related to these topics.</p>

<p>TAKE THE TEST… GO ON VACATION!</p>

20

<p>Good luck to D., Curm!
I always feel the same. I remind my D. about importance of taking breaks and staying away from “intense” people from “fansy” schools. She got some supporting crowd though…it has helped a lot. We even offerred to drive there, hug and kiss her and go back home…but she has no time for that. This week she is taking exams for their hardest block (according to MS2’s), and she likes some of it more than others, her favorite of this block are kidneys.
She has ordered book(s) for Step 1, I have no idea what.</p>