USMLE Step 1 – 263 Experience

USMLE Step 1 - 263

USMLE Step 1 – 263

Hi guys, How do you do? Most of you probably don’t know me as I’m not online that often.
I’m an IMG from India, doing my third year medical school. Gave my STEP 1 exam on 30th September. Because of some verification process pending in my med school, I got my score late, on 19th November, but it was worth the wait. When I saw 263 written in my mail, I had to check 5 that I was not reading it wrong. At the same time my third year exams also started so was caught up in that, didn’t get a chance to write.
First of all, I want to thank all members of forums, for helping me out. This experience is just an advice. No offense intended.

Planning: Plan ahead. Find out what score you want to achieve, prepare a path of your own , with the help of others.
I made my plans first, it took three whole days. I searched forums, experiences as USMLE was totally unknown to me & designed a plan. But then I stuck to it. I didn’t go on searching what in need to do in this and that.
Don’t just keep reading on forums what others keep saying, you will be diverted, as everyone have their own methods. It is good to use forum/community. But use precisely, only on which points you need help. It’s not like “the more you try to find out how to prepare /read, the more you score”. So yes, get help from other, but not try to be others. Make your own plan and stick to it. Make small adjustments as needed timely but Don’t deviate. Discussing in group in one thing (good thing) , but being deviated by it is another. Every now and then I opened forums to find out about my specific problem or see if any important update has come out about exam. I saw many who were just confused what to do by different answers on forums, & just wandering searching for answers, posting questions, discussing idiotic things. In my opinion, if they had spent that time in reading, man, they would have scored higher then me.
So if you are reading this after starting your prep, don’t be confused by what I say.

Prep timing: Average 8 hour a day, 5-6 days a week, for total of 8 months.

As an IMG, it was hard to make the decision of giving STEP 1 in 3rd year of medical school, as most of seniors & other guys gave/are giving in Internship/post-intern. It becomes hard to study as most of your friends in 3rd year are enjoying, while you have to stick to reading constantly!! Besides, you don’t have experience in medicine, ophthal, surgery, etc. while examiners are asking a few ques related to that!!! But everyone says if you can do it in third year, you should do it. You get lot of time to read & you save the time of internship in which you can do clerkship & rotations. So I did it. It was hard, but it’ll be hard to study constantly no matter whenever you give the exam. So it depends on you, what is aim, how much you are dedicated. If you think you can read seriously in 3rd year, then no problem.

I used to study for 10-12 hours initially, but soon I burnt out. I’d go watching movies without reading for a week or so. Then I started reading for 8-9-10 hours. Moreover, initially I read without any break, continuous for 10-14 days, then I would burn out & wont be able to read for a few days.
So my advice would be, don’t take load. Know your capacity to read “efficiently”. Plan in advance and stick to it. Don’t go reading like an idiot. Work smart. And take a break a day in a week or so, voluntarily. Do the things of your hobby, like I did movies, piano, visit friends & families. Otherwise those days are going to be wasted anyway involuntary, as you will be fatigued & won’t be able to read at all (happens for most of us).

Prep Materials: 
Kaplan: Videos and Lecture notes for all subjects except patho.
Pathoma videos + Goljan book:
Qbanks: Kaplan 2010 version and Uworld of 2013.

Timeline:
First read: 5 months (as my basics were good)
Anat->Biochem->Physio->Patho->Behavioral->Pharmac & Micro
[note: I had no idea about what USMLE is & no plan of giving it upto 2nd year. But I had done Kaplan Micro and Pharmac videos in 2nd year and Anat Physio in 1st year medical school just to make my concepts brighter. So it was easy for me to do these subjects now. You may need more time.]

I saw videos of Kaplan, annoting & highlighting on the book. This way I would finish a subject in week or so & would do Qbank blocks for that subject (I had Qbank in subject wise, block wise manner).

Physiology: I did Kaplan first, but it was not satisfying. So I just read through BRS Physiology. It is good. I read it in a day. After Physio, I did Patho. So it would complete my Pathophysiology. Moreover, when starting a particular patho chapter, I would read physiology of it briefly.

Pathology: Most important subject. I mainly did Goljan Rapid Review, 4th edition. I only used Pathoma videos when I found the chapter boring or hard to memorize. Goljan is all you need to know. No pressure on memorizing minor/sharp details. But know practically or exam relevant information. You can find out what you need to know by doing some blocks of Qbank questions in advance. Every chapter is important, as the exam covers all topics, from medicine to environment to nutrition to genes and senescence. The Plus point is, the info which you need to know about medicine surgery pedia etc is given in Goljan. Goljan is a sort of bridge between patho & medicine. Pathoma is not enough, in my opinion. Basic knowledge of pathoma is good, but “Patho” for concept of our exam does not only mean pathology, but overall understanding of a disease.

Making notes: Make a lots of notes, because you will remember not the things you read but the things you understand and make a schematic or map of that in your mind. Make schematics, tables, acronyms, whatever you want to make, thus it becomes not merely facts but your own creation & understanding. I inserted 1 blank page in between two pages of goljan, so I could write, or make a diagram of relevant info on that page. You can make a separate book for that.

What to focus on: Concepts are important. Although I also put much effort in memorizing, it was not necessary. In starting, just do a subject & then Qbank block, you will understand how much you need to memorize. Otherwise don’t just go on memorizing, as kaplan and goljan has so much info that might not be necessary. If you can memorize , good. Do it, as it may come handy in some ques. I got maybe 10 -20 ques based on memory or specific info, e.g. which type of cyp is inhibited by a particular drug. Don’t put much effort in that, as this type of que may come out of anywhere, there’s no way to avoid it. I had que that a girl decreased her diet by *** calories, how much weight would she lose in how much time?? So avoid overworking on this datas etc & don’t be frustrated if you encounter a que like this. They are just for this sole purpose, to frustrate you.
Instead place your focus on concepts and visualizations, basics, as most of ques are from that. Even by working on that only, you can get your score as high as you want.
[Some guys have been saying “I just do FA & by only that I got good score. FA is most important blah blah…” But to score very high, that guy must have good basic concept, good knowledge and understanding. So don’t go blindly, know the concepts. FA is good ,compact (I did few chapters of it). ]

Revision and Qbanks:
In second phase I started doing Qbanks. Half the day I would revise a subject and then do 3-4 blocks of Uworld. Thus 3-4 days for each subject, based on your need. I completed Micro Pharmac in 1 day. But for patho i needed 7-8 days to revise, as I revised goljan in detail, not just highlights.
Do questions in blocks, timed manner. Look the answers for each questions carefully.
I completed Uworld in 15 days. Took screenshots of the questions or concepts which were unknown to me, to revise later.
REMIND: Many guys Qbank very slowly & depend on it for concepts. But for me concepts were from Kaplan. So Qbank went very fast. Don’t spend too much time, as it contains limited number of concept. And nowadays the exam questions are not similar to Uworld. It is monopoly of Uworld that everyone says it is must. In my opinion, if you want to “just pass” then only uworld is okay, as it contains most important ques & in exam you can pass on most important. But if you want to score high, do all the concepts of Kaplan & Goljan. It’s like Kaplan Goljan are textbook, and Uworld and FA are “most imp” to do in short time near exam.

Utilization of Uworld is that you can simulate exam like situations, exam like stress on you & when looking at answer, you can think of the technique in which you have to answer. You can develop tactics for tackling a particular question. You’ll have the knowledge and concepts from Kap+Gol , but you will need to learn how to understand what is asked, how to think/process a question, reach to an answer with certainty. Notice the mistakes you make, & decide/think how you will not make the same mistake in future. This is what you learn from Qbanks.

Then I thought what were my week points and gave special attention to it , revised it thoroughly.Then I did the Kaplan Qbank 46 blocks for which I got more than 40 corrects for each block. I did it in 7 days! Some would say impossible, but I did 7 blocks each day, just like in exam, continuous, from 8 AM to 4 PM. In 4 hours I would check all the answers and would only give more attention to the ques , which I got wrong/new concept. {6-10 questions per block}.

I relaxed, get determined.
Last month: I was relaxed, as I had done what I needed to. I did 1 NBME per day offline, but in exam like situation, and then wud solve that NBME:
My correct answers out of 200 were…
1=183
2=187
3=196
4=194
5=183
6=191
7=189
11=187
12=191
13=191
15=191
I didn’t do any of them online but from screenshots. I cud not predict my score as I did nothing online, So I lacked confidence of what score I might get. I didn’t do NBME 16 , which was a big idiotness, as it is most near the exam. I saw some questions of it afterwards. E.g. I was asked 2-3 questions about incontinence, which were on 16, but I got them wrong!!!!!
Each NBME has 3-4 controversial questions, to which answers are not known. Don’t focus or discuss them. Let them go. Even on exam, learn to let go question. Don’t get hyped or worried. As I said earlier, there’s no way to avoid them from being asked. So just avoid them from your mind, keep them in your blind spot.

Exam advice: Be relaxed. Don’t freak out. Don’t do new material. Keep your focus and peace together. Keep smiling.

RELAX: It is not necessary to do everything. It’s not like “the more material you do, the more you score”!!!!!! You will find some guys doing all the DIT,FA, Kaplan, Rx, studying for 12 or even more month, but it doesn’t guaranteed high score. Just know yourself & decide what you need. FOCUS!!!!

I did not buy/ use any material online, for which I am guilty. So you all can start judging me. But I had no other way around. I can afford none of them, even paying for STEP 1 was hard.

Thank you. Keep helping…. May be I’ll meet some of you in US

Good luck to all of you for your bright future.

If you liked this experience, check out the following experiences:

Dr. Moumina – USMLE Step 1 Experience – Despite all odds

USMLE Step 1 Experience – 258 – Abdulmunaim Eid

My USMLE Step 1 Experience 245 – Review by Dr. Sarah Brum

December 13, 2017
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