USMLE Step 1 Experience – 270 – Roberto



Preparation started: Jan 2019

Exam: Sept 2019

Preparation Time: 8 months


First Aid USMLE Step 1

Pathoma (Fundamentals of Pathology) by Hussain Sattar




NBME (all 20)

Other Stuff:


Preparation methodology & Journey:

My strategy was to use limited resources but to ace them. Many people go after 1000 resources and then they are not even able to memorize one of them. Just think about it..what is actually gonna be in your mind during the exam ? 50 books done very superficially or  books done perfectly word to word. So that was my plan. I used only UFAP and NBME in my preparation and while i did a ton of googling along with it to understand it, i knew that when exam day comes i will have limited resources i have to read and hence the situation will be under control. So i started with the general section of FA which includes: Biochemistry, Microbiology, Immunology, Behavioural Science, Pharmacology(general) and pathology(general). Once i was done with these, i did the systemic part of First Aid USMLE Step 1 along with Pathoma lectures + Pathoma videos. So while i was doing First Aid in this way i looked up a lot of stuff that i did not understand like the swiss cheese model or small monoclonal antibodies for which there is not much info in FA and it is merely mentioned in FA but it is not explained well. I made sure that i knew first aid like the back of my hand. Each and every line, even the errata i knew which mistakes they had made.. lolz. It was like i was married to FA :p . Uworld is a beast. I started Uworld after i finished FA and Pathoma. I thought that Uworld would be a breeze..but was i mistaken. It is a mammoth… almost 3-4 times the data in FA is in Uworld. It is unbelievably dense because the thing is people just rote memorize the right answers and see the superficial explanations..but guys the meat of the material is in the explanations. We have to do the entire explanation of the correct answer along with that of the incorrect one. I did this also in the same manner that i did First Aid.. i read it cover to cover and anything i could not understand i would do it from wiki and medscape and would be all over google for that topic. I also learnt a nifty little trick along the way.. when you are searching for let’s say a topic like swiss cheese model as i described above. The way to search it effectively in google is to put in “Swiss Cheese Model USMLE”. Make sure you put a USMLE behind it. The reason you should be doing this is that when you put a USMLE modifier to the search query the results displayed will be only links relevant to USMLE. When you put in just swiss cheese model you will get a general description as this statistical model is also important for nuclear power plants and steel factories and many other things. So i suggest you to put in USMLE word behind the topic name and you will get only the relevant results. Now after i did all the stuff from UFAP i had to take on the final ultimate beast and that is NBME. This questions are so high yield.. i can’t even overestimate it’s importance..they are that important. The NBME questions have to be done with answers and explanations. Make sure you do these both online and offline. What i mean is that not all NBME forms are available online. SO those tests that aren’t there is a pdf has all the NBME..each and every NBME is in it. So make sure you get it and do the answers and explanations.

So that’s method is do less resources but do them well and it worked. The score speaks for itself.

I have to highlight at this point that the resources i used were insufficient for media questions and hence i did the following from google images/wikipedia/webpath/wayne state radio/etc resources and apps. Just google and do the topics from wherever you find:

Most commonly asked ECG patterns

Most commonly asked Heart Sounds and Murmurs

X-Ray, CT Scan, MRI, contrast vascular stuff– angiography, venography.

Gross Pathological specimen and histopathological images of diseases which have been mentioned throughout the course in UFAP.

NBME Scores:

I did all NBMEs in sequence from NBME 1 to 24. They are called NBME 1 to 24 but actually there is no NBME 8,9,10,14. So there are just 20 NBMEs which are 4000 questions

Offline NBMEs:

NBME 1: 224

NBME 2: 248

NBME 3: 235

NBME 4: 229

NBME 5: 238

NBME 6: 243

NBME 7: 250

NBME 11: 244

NBME 12: 253

NBME 13: 259

NBME 15: 255

NBME 16: 257

NBME 17: 255

I used a score convertor which has like a decimal fraction you can multiply your score with in order to get the 3 digit score.

NBME 18 – 250
NBME 20 – 259
NBME 21 – 264
NBME 22 – 273
NBME 23 – 264
NBME 24 – 271

You might be wondeering how you got 270 on final test but still had only 224 from your initial test. The method is popularly called “NBME TITRATION METHOD” in my group.. Actually this is a phrase a high scorer had in his experience who was from my medical school and then we started using this phrase and it caught on.
It’s simple:
Give NBME —> Analyse NBME score —> See the incorrect questions & THINK –> What could i have done to get this right ? Should i have read the question better ? Should i have done FA better ? Was i not alert ? Was it analytic issue ? Think what was the error —> then next you have to mitigate this issue —> if you are not getting the question right because you did not read FA well then do FA well —> If you did not get this correct because you had issue with not doing enough questions then do more questions —> Next NBME you should improve your score by doing what was lacking —> Then again next NBME you should see what you got incorrect and analyse like this again —> eventually after a few NBMEs you will start getting a grip on it and scores will improve. So that’s all you have to do.. Read basic books ( + Pathoma + UW (UFAP)) word to word.. then do NBME TITRATION METHOD and you will score well.

October 10, 2019
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