275 – USMLE Step 1 Experience IMG
Graduation Year – 2015
Time to prepare – 1.5 year
Exam year – Late 2016
Duration – 2 Years
First Aid for the USMLE Step 1
Kaplan USMLE Step 1 Lecture Notes and videos
Rapid Review Pathology by Goljan along with Goljan Audio
Fundamentals of Pathology (Pathoma) along with video lectures
BRS Gross Anatomy (Board Review Series)
High Yield Cell & Molecular biology
High Yield Gross Anatomy
High Yield Neuroanatomy
Conrad Fischer’s 100 Cases on Medical Ethics
High-Yield Biostatistics, Epidemiology, and Public Health (High-Yield Series)
I finished my med school in 2015 and started preparing for USMLE Step 1 after finishing med school. First i had to gather the material and set a goal of the score i wanted to achieve. I set an insanely high score goal and i was not sure if i would be able to make it or not. But i decided to aim for the stars so that i atleast land on the moon. Thankfully i landed on the stars. Though the journey was very tough.
Started with Kaplan Lecture Notes with videos. I used a lot of time reading the lecture notes and seeing the videos but in hind sight i would recommend that the best way to go about this is to just do Kaplan Biochemistry Lecture Notes with videos. For the rest of the subjects merely reading the Kaplan Lecture Notes is good enough. Videos are not of high quality. It took me 3 months to do this but you can do it in 2 months too. It’s not very difficult.
Next i did First Aid USMLE Step 1 with offline UWorld. I did this read very carefully. For anything i did not know i would google it to get more information on the topic. Even the minutest thing i dont know i would google it. Even the smallest thing i had to know what it meant. So i saw wiki, medscape, i googled all the topics which i didnt know. I would google the topic name and then i would add USMLE behind it.. like googling Glioblastoma USMLE and the top results would usually be usmle related websites explaining pseudo-palisading appearance on histology and it would show the other features too. In this way it took me 5 months to do UW Offline + First Aid USMLE Step 1. I also made some Anki cards along the way, and they helped me in the final stages of prep as i used them for rapid review and didnt have to do UW difficult and wrong questions/topics again. Along the way i also did Rapid Review Pathology by Goljan along with Goljan Audio. It helped me a lot as i think i got atleast 7-8 questions directly merely from hearing Goljan Audio while i was bored. While goljan audio was easy and engaging, the book was not. I could not remember everything word for word, but i did the majority and whatever i could not remember i left. I however did the blue color important points on the side margin of the book word for word. It was very high yield for me. While i could not do Goljan entirely, I did Fundamentals of Pathology (Pathoma) along with video lectures for all systems along with in depth understanding. In Pathoma, the explanations of many diseases is done in a very conceptual way. Like even for the skin diseases the exact etiopathogenesis is tied into the signs and symptoms. Like, why pemphigus vulgaris has flaccid bullae and bullous pemphigus has tense bullae. This was explained in completely conceptual manner which i found to be a great way to learn. I would recommend you surely read this book with lecture vids very well as it will get you a hell lot of questions correct on your test.
I started with online UW and also gave the UWSAs (both 260+) but i would not take these UWSA very seriously as many people are getting even 20-30 marks less than the UWSA test in their exam so it has no predictive value. Though the questions are good and worth a read for sure. So I did the UWorld online and got 96% correct (mind you i had already done UWorld offine and i had done it very very meticulously.. so i already knew the majority). This took 1 month. I also did all the books with UW again. This i did because i wanted to start real assessments i.e. NBME after one complete read of basic books. But before that i did BRS Physiology as the up/down arrow questions were really bogging me down and causing a lot of problems for me. So i did BRS Physiology and it’s chapter-wise questions. They were very good. I think i got at least a few questions on my test from the diagrams and up/down arrow questions given in BRS Physiology.
Then i started doing NBME and after every test i would take 2-3 days to go through the answers and explanations with a friend. The reason is doing questions but not understanding what it means is meaningless. You have to actually understand the topics in the NBME questions in depth. I would do the NBME with the explanations and then assess which type of questions i was getting wrong and which type i was getting right by fluke. These weak topics i could work on later on so i kept assessing the subjects i was having issues in. I was a bit weak in : Ethics and Biostatistics i had a lot of problems, Embryology questions, Molecular biology, Some Gross Anatomy and Neuroanatomy. In this way i did all the NBMEs except the last 2. I kept them for last just before my exam so that i understand if using more books to prepare for the subjects i was having issues with worked in improving score or not ?
I did this read for 4 months or so. I read the following extra books for the respective subjects:
Molecular Biology and genetics: Everyone can memorize the list of AR, AD, XR, XD diseases and do some pedigree analysis and Hardy Weinberg principle by reading Kaplan Biochemistry Lecture Notes. However, that is the easy part. In the practice tests and in the exam the more tougher questions are about things like slipped strand DNA mismatch, chimeric mice and knockout mice. High Yield Cell & Molecular biology is the go to book for this. It is pretty thin. Not very difficult to do. I read it and i put a lot of the information from it into my Anki decks which i read later on.
Behavioural Science: While basic behavioural science like operant conditioning etc is easy but the issue i had was almost 50% of my ethics questions were wrong. I used 1-2 days time to read Conrad Fischer’s 100 Cases on Medical Ethics and it helped me a lot because it has a lot of HY info that was on NBMEs and also i think i got a lot of question right in my test because of this. I recommend you to surely check it out and make sure you read it indepth.
I also did UWorld Biostatistics subject review (Its seperate from the regular UWorld). It was very helpful. I also got High-Yield Biostatistics, Epidemiology, and Public Health and it was moderately helpful. I got some important info from it which i would not have got otherwise. So i think it was OK. Though it has mostly theoratical stuff so not as helpful as doing questions. But still if you have difficulty in conceptual stuff then you should surely do this.
Anatomy: Anatomy used to be very tough for me as a lot of the topics are not even given in First Aid USMLE Step 1. So i got 4 things for this: BRS Gross Anatomy (Board Review Series), High Yield Gross Anatomy, High Yield Neuroanatomy, High-Yield Embryology . These books were very helpful. In the test you will get a lot of minutae from anatomy and these books in addition to UW and FA cover everything that you need to know about it. After this i gave the 2 NBMEs i said i had left. That helped me gain a lot of confidence as in first one i got 260+ and second i got 270+.
Finally i decided to wind it all up. I did my UW anki cards which also had some difficult points from NBMEs and also High Yield Cell and Molecular Biology the topics which i was having difficulty in i did once from Kaplan and BRS/HY books and then i got ready for the test. I also read FA on last time in 7 days before exam.
I don’t recall exact scores but i gave NBMEs during my second and third read.
During second read my scores were : 240s
In third read it increased to: 260s and 270s.
In between i worked on the things i was repeatedly having issues in like molecular biology, Anatomy, Biostats, Ethics. That helped a lot to get a good score increase.
Before the exam i was very nervous and i had trouble in sleeping in the last week leading up to the exam. I got only 3 hours sleep and i thought i was doomed. But fortunately in the exam i did not even bat an eye and I was very attentive. I did first 2 blocks back to back and then took a break. Then i did 3rd block and took 5 mins break. After 4th block i ate my lunch. I had got some sandwiches and Red Bull packed with me. I at the sandwiches and gulped down the Red Bull. Then for rest of the blocks I merely took 3-5 mins break between blocks. My exam experience was OK in the sense that i was attentive and i did all the questions correctly which were from the stuff i studied. However, a lot of the stuff i felt like i was facing non-typical scenarios. Like nowhere were they giving direct UWorld questions or anything. So i had to think a lot. Many NBME images were same in exam and also the NBME explanations i had done were very helpful to me as i think i got many questions based on it. Maybe not direct but atleast i was getting similar topics and NBME helped a lot. I had 3 ECG and 2 heart sounds and I recommend you do them well. I had a android app which i would hear the heart sounds and murmurs in before my test in last month. After exam i had a lot of worries about the score. I did not know if i had made it or not. I was having a lot of sleepless nights. Many times i would even wake up in middle of night thinking that i was in middle of test and ws not able to finish paper on time.
Tips and Guidance:
Read as many sources as you can but only if you are sure you will be able to remember. I know lot of people just reading the books but were unable to recall. If you are unable to recall then it is worthless as it doesn’t help in getting better score. I recommend doing as many questions as possible. It will help a lot. The road is tough and long but have faith in your hard work. It will eventually pay off. Best of luck.
– Taken from SDN (2016 end experience)
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