USMLE Step 1 Experience – 271 – Dr. Yakub

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BACKGROUND: Average/Above-Average student in medical school. Scored usually in top 25 percentile but never in top 20 percentile. My background was average but still i was able to get 100 percentile score. So i think if i could do it then anyone can do it. I am going to give my step by step method on how i made it to this score.


I started basic USMLE prep while still in medical school and gave my exam after medical school was over. I started with Rx videos and Rx qbank. The videos and qbank were very helpful to me in building a solid foundation of FA which I took forward into my dedicated prep. Now I must also inform you that during this time I was also listening to goljan audio during my drive.. I have a motorcycle and I live in south east Asia.. so you can imagine the amount of time I waste in commute. My city is known for traffic jams. So what I did is I would have goljan audio downloaded in my phone and I had an app which would keep the audio playing even when I did not have the screen on. I would keep the phone in my pocket and then earphones beneath my helmet and would listen to lectures on the go. Whether you are in a car, bike or public transport. I recommend you to do this method as it will increase your productivity even during time that would other wise be wasted.

I also would do the Pathoma chapter with videos during this time. I would go over the Pathoma stuff with whichever topic was covered in my medical college.

So that’s all i did in pre-dedicated : FA + RX videos + RX qbank + Goljan Audio + Pathoma (Vids + Book)

Also, during this phase i would also make my own anki cards of everything i thought i needed help retaining. I did not like the premade cards as they did not feel HY enough for me. The decks people use even had stuff like what enzyme does Aspirin inhibit ? Thats obviously COX and i dont need a flash card to tell me that. So i made my own ones and i recommend that you do it. Oh and by the way, Anki on Iphone is a paid app and i had to pay for it. Boohoohoo..Lol. That was the only thing i paid for. I got the videos of Rx for free and also pathoma and goljan. I didnt pay for anything at all for my entire USMLE prep. In the next phase you will see that i did not buy even UWorld and i did it offline only. I did not have a ton of money to spend and hence i just got the downloadable version for free and i didnt buy it. So only thing i bought was Anki Iphone app. Apart from exam fees this is all that i bought.


I now started dedicated prep and used the “XYZ + USMLE” method. I went through UWorld offline and Pathoma & FA in this way. What i would do is, I would do Uworld systemic and Pathoma System with it and then i would do FA system. Anything i did not have a good understand of i would google it in the “XYZ + USMLE” method. What that means is that i would take a topic and let’s say i dont understand “focal nodular hyperplasia” then i would do google search “focal nodular hyperplasia USMLE”. In this way the search results would be reduced to those which are USMLE relevant. If i search just focal nodular hyperplasia in google what happens is i get stuff which is beyond the scope of USMLE. Like i would get really indepth info about FNH which those who are doing fellowship in Hepatology would need to know. Such an extreme level of indepth learning is not needed for USMLE Step 1. So i suggest you do the “XYZ + USMLE” method which is searching in google using the USMLE post-fix to your search query. I read a high scorer did this and say how he used it to get more info on topics he did not understand..i read his experience and i used it. I am sharing this here to help you guys out so you also dont waste your time.

While going through UFAP i would go through every minute detail in the book and anything i did not understand i would google it, find it and then i would put it into anki to remember forever…and you know what guys on the real test also i got a lot of questions whichever not in FA..not in Usmle World.. not in any world and were totally out of this would. Those things i was able to get ONLY because of “XYZ + USMLE” method of searching and finding relevant info in tons of sites online.

Ok.. so that was the stuff i used and the books and qbank i used. That’s all for that part. Now onto the assessment part:

I did all NBME and UWSA. UWSA is not good for assessment despite it’s name. It overpredicted me by 20-25 points. There is a flawed score predictor on Reddit which says that UWSA2 is most predictive. I think those people may have been bought off by Uworld or something because their “so called” predictor of UWSA2 is not at all predictive. Do whatever you deem fit but i would say that use UWSA both as practice questions and not as a means of assessment.
I used all NBME as a learning & assessment tool. I started this from 1st day of dedicated prep and my dedicated was 3 months. Each and every Saturday and Sunday 2 days were NBME days for me. I would do 2 NBMEs back to back to simulate a real testing scenario. I would do that every Saturday and then on Sunday i would go through the NBME blocks.. one after the other all 8 blocks of 2 NBMEs. Sometimes i would not be able to do all 8 blocks in 1 day then  would use Monday also to go over the answers and explanations of the blocks. The way i would do this is i would go through the correct and incorrect option choices and go over word for word everything. I would find the answers and explanations of correct and incorrect options the NBME forms one after the other. This way i would know my strengths and weaknesses and how to improve my score.

At this juncture i need to inform you about what is called the “NBME titration method”.

So the way it works is at follows:


See the diagram properly and understand what has to be done to use this method successfully. I used this to improve my score by 45 points from my first NBME through all the NBMEs to my final exam score.

— 1. Take an NBME to see where you stand

— 2. After giving it.. do the correct as well as incorrect questions along with all answer choices ===> Thus using NBME as a learning tool.

— 3. Now go through only the incorrect questions and analyse.. Why did i get this wrong ? Which subjects am i weak in ? What textbook/qbank for which subject could i have done to get this question correct ? In this way ask yourself what you have done wrong and understand how to rectify your mistake ===> Thus using NBME as an assessment tool.

— 4. Now go back to your books and qbanks and do those things you are lacking in. Improve on your weaknesses..

— 5. Now again do Step 1. Take another NBME.. and see the difference.. You will find many things which you were performing poorly  in the past.. You will start performing well now.

So why is this called “NBME TITRATION  METHOD” ?

It is called so because remember in chemistry class we used to do titration ? Titration means you keep modifying it little by little till you get perfection. In chemistry class we used to pour drop  by drop one liquid into second liquid till the color of second liquid disappears.

The above is image of TITRATION. The thing about titration was slowly with each drop of fluid from above of liquid 1… slowly the color of liquid 2 would disappear and become lighter and lighter and lighter. Just like that we will give NBME after NBME and in the intermediate time period between 2 NBME we will improve on our weaknesses. Thus slowly like the color of the liquid disappears so to shall all our weaknesses of preparation disappear. Now this may seem like a simple technique but most do not do this. If you want to do well on your test then use this technique.

Guy’s stop taking this test lightly and give NBME from the outset. NBME is the same organization that makes USMLE actual test. These questions are so high yield that i think i got at least 50 on my test right from here.. from NBME. So i urge you to do NBME from DAY 1 of dedicated period. You are not gonna be able to do NBME later on as you wont have time near the exam. Start NBME weekly and give it one at a time and your score will drastically improve in just few months. Use the NBME Titration method.

Post Exam feeling:

After the exam i felt i did good but wasnt sure. I am damn sure i recall at least 4 silly mistakes. In a few days i started doubting more and more questions. Eventually i was on the verge of a mental breakdown.. However, i asked one of my good seniors what he would do in this situation and he told me that dont worry…everyone second guesses themselves after the test.. because you dont have actual test question in front of you.. you cant say for sure if what you had attempted was right or wrong. Hence, we must trust our NBMEs. I was wary of that. I didnt know if i will get as much as NBME. But i was very presently surprised. Alhamdulillah, I have got fruit of my labor of many many many months and probably years.

October 10, 2019
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