Yash Senghani – USMLE Step 1 Experience – 263



INTRODUCTION Hi, I’m an Indian IMG. In the final(4th) year of M.B.B.S. at B.J.Medical college,Ahmedabad.I’ve heard about USMLE since the 1st year in my medical college from fellow colleagues. During the last few months of my 2nd year(2016) I started thinking about usmle and by the end of the year I made a decision to give step 1 during 3rd year(2017)…YASH SENGHANI The Beginning On 5th Feb.2017 my 2nd year University exams ended and at once I started gathering the information and study material for step 1 with the some help from seniors & fellows pursuing career in usmle…against the advice of many I was still obsessed with collecting everything that is available for step 1… searching,downloading,purchasing,borrowing,printing and wasting my time and energy… A MISTAKE So ‘n so begins my 3rd year of mbbs and the usmle prep.(15th Feb.2017)Starting with Physiology – BRS,Kaplan video+notes… Then Microbiology & immunology- kaplan…I was going very slowly…trying to understand & remember everything…without any deadline…without any goal… MISTAKE AGAIN I bought the First Aid 2017 and divided every system of the book in separate spiral bound books… MISTAKE Cont.Lack of seriousness and planning only made it worse…Wasted the April,May & June by watching Seasons ,reading other books and surfing through Social media… Big MISTAKE.And I gave up the idea about giving step 1 in 3rd year…Then around the end of June there comes the score of my senior Dr.Harsh Patel securing in step 1… who had attended the step 1 in his Final year… and there comes the hope that it is possible to take step 1 even in the final year. I read the Experience and contacted for the advice…262USMLEProcrastination [ if you’re short of time then skip to page 4.Title “ How I cracked…” ]

 

Once again I started reading in June…targeting for the Rest of Kaplan and for Pathology- pathoma along with FA …June,July,August…And came the interruption !during all this time I haven’t focused or thought about my 3rd year and here comes the schedule for Prelims exam of college in October & Date of University exams in December… with impending fear of failure…So once again I abandoned the usmle and started preparing for 3rd year…Besides me two of my friends also had started preparing in February for usmleAnd were done with step 1 by the end of September…except me…1st JUNEAgain there was a problem… now I cannot focus even on my preparation of college exam because the thoughts about step 1 kept nagging me and the vicious cycle of doubts,overthinking,anxiety and fear continues on and on…And then came the solution… on the day of 20th Sept.2017 I put aside my books for a while and decided to make everything straight forward…I wrote my Pros and Cons,abilities and drawbacks and problems…I made a Checklist, a timetable, setting the deadline and the goal…I enlisted everything to be achieved and done along with a timeline and a deadline.Starting from 1st October & ending on 1st JUNE…and hence named…From now on I only focus on one thing at a time according to checklist…And here are few important checkpoints like[1.] College exam – 25 days [4.] remains of Pathoma and FA – 15 days[5.] application for ECFMG certi. – November [8.] University exam – 1.5 months [10.] application for step 1 – December [16.] UW online- February [24.] USMLE step 1 – 25 April [25.] Score – 16 MayIn short there were 31 tasks ending on 1st June…You may note that many numbers are missing because either they are very small & less important or personal matters…

 

GOALOn the very first day of “1st June” plan I fixed my goal…I’ve seen the score reports mentioning about that most scores falling between 140 and 260. So anything above 260 is best in accordance…And so I fixed 270 as my Target as never in my career I’ve achieved 100 % of whatI wanted or what I aimed… there were always shortcomings considering the Human nature and circumstances in account…The Final yearUniversity exam ended on 23 December…took a week off…And thus on January 2018 once again I was back on track of Step 1…At that point of time I had done with 1st reading of all kaplan,pathoma,FA,BRS physio with almost a year passed since I started first… I felt totally Blank as without any revision everything seems like first time reading…But I’ve already applied for step 1 in December and done with all the formalities of application process, So there was no going back this time and the only way out was through and through…How I cracked …I realised late that the popular method of learning by video watching & hearing is a waste for me so now I started focusing only on learning by Reading…So here is how I prepared… Dedicated study in 2018.> From January to 14 February… 1.5 month> FAid + UsmleRx Qbank + internet FA has more than 700 pages but the majority of content is covered in about 600 pages so I planned to read 15 pages per day system wise… I read in day and solve Qs at night… Being a Night Owl my day begins at 12 pm noon and ends at 5 am morning… I start reading at 1 pm and about 8 pm I finish reading FA and take a break for dinner… 1st. Reading with Questions I just go through the one line of FA page and close my eyes and try to remember it by simple questioning… e.g. SER – Site of steroid synthesis and detoxification of drugs and poisons. Q. What is SER?, What are its two functions?,what it makes and what it breaks?Quadruple Reading…

 

2nd. Reading with Associations & Comparisons Here I focus on every word of line and try to find its meaning and some associations…almost every topic of FA can be associated with some other topic from different systems in FA…e.g SER – why it’s called smooth and not rough?, what is difference between endoplasm and cytoplasm?,what is difference between reticulum and retinaculum?,What are some steroid hormones?,what are some drugs & poisons detoxified? How can I ralate & associate this topic with other systems, case scenario where this facts can be asked in usmle…3rd. Reading Online with Internet -A highly effective method for me… Here I open the chrome and type the topic name and put “ USMLE STEP 1 “ behind it and hit the search…e.g. type “ cystic fibrosis USMLE STEP 1 “ and Google it…there were many websites & forums related to it…Like Websites ~Medbullets- a thoroughly organised information with some free practice Qs at end.Stopmonstep1- good explanationsBlogs ~Medicowsome- Ikan…she always has something interesting… Mynotes4usmle – Ranata…always with some extra info. and images…Forums ~ many anonymous Geniuses…Usmle-forms – bebix,Sabio,novobiocine,xpaxez…Usmleforum – cardio,psychmledr…Studentdoctornet – phloston…Prep4usmle…And many others…I just go through them and note down important stuff…PLEASE beware of spoilers Many people on internet discuss about NBME & UW so if you’re planning to use nbme & uwsa as practice assessment test then you must identify & avoid them…4th. Reading with RxOnce I complete a system I start the 15 pages of next system and do the Qs. of previous systems from Rx at night…Rx has its pros & cons…The explanations are sometimes boring & unnecessarily stuffed with low yield materials…though they provide the reference page of FA & its no. to identify the line or topic from which the Qs. was derived which helps you to localize and get familiar with FA… I took tons of useless notes from Rx and stuffed my FA with it… A mistake… because of it I’ve to make separate notebooks for UW notes…

 

By 14 Feb. I was done with FA ,Rx and most of Internet searching for FA topics except for Biochem,Micro & Neuro. because of some interruptions in my timetable…Gave nbme 11 on Feb 15 …25 wrongSo it was a good start and I know that the method is working…UWORLD Bought the 3 month subscription on 16th Feb.Started with Endocrine- System & Subject wise Timed Tutor modeI generally try to complete 2 blocks of 40 in a day… but mostly reach up to 60 because constant staring at screen strains eyes much…Once again I read FA in a day and when complete a system I start Qs. of previous system and FA read of next system…Strategy was :I read the last line of every case vignette to get the idea what the Qs. is asking and make a mental note about it… like it is a Anat,embryo,physio,patho or pharmac Qs from cvs,endo,msk,psych,micro…. system. Then rapidly skim through answer choices and then go to top of the Qs. and read through it to find information,clues,hints,buzzwords… considering the Age,gender,residency,sign &symptoms of patient… and make a choice & hit the answer…Although not all Qs. are like this but the general process is somewhat similar…Now if I got it wrong then I try to find out what piece of information I was missing that made my answer wrong… what mistake I did…what clue,hint I missed,weather it was given in FA or not ,if yes then where it is in FA… etcThe explanations of UW are very good and informative…which helps to clear the confusion…And if I got it right then I try to find whether my chain of thought is in accordance with the UW explanations or not , had I just guessed & got lucky…?, like wise…Also that doesn’t complete the Qs. I go through the explanations of every wrong choice and try to figure out in which case scenario this choice could be the right answer and why it is wrong in this case…Lastly I read educational objective…And then I rapidly go through that topic in FA for quick revision & to identify missing info…along with the topics of wrong choices.

My score reports…Nbme 11 – 25 wrong (240~245 predicted)Nbme 1-7 ,12-17 – 12 to 20 wrong (252~264)UWSA 1 – 279 (8 wrong) a totally over predicted test… and I did the mistake here,Overconfidence & Ignorance are the human factors which lead to failure of many men… and I was no exception…Soon I know about uwsa1 ‘s over hyped score and I was back on track once again…
 
Then I gave rest of the exams at 1 week intervals…UWSA 2 – 275 ( 6 mistakes)nbme 19 – 273 ( 3 mistakes)Boom !! I was soaring at seventh sky… with every bit of confidence…I let down all my guards,became very relaxed,timetable destroyed,revision left aside, lost my focus on step 1 and started daydreaming about life after step 1… A New Huge MISTAKE in 2018 after my series of mistakes back in 2017… there happened nbme 18 – 267 ( 8 mistakes)And then I realised that my scores are going like Cardiac Action potential…After the overshoot depolarization & plateau…it is actually going down towards re-polarization phase 3…And 24th May was approaching near…And fearing that the score might go further down I started reading as fast as possible…I completed the remaining marked UW Qs. Once again I fall short of time… it seemed that I might not complete it by 24th and hence in hurry I delayed exam with penalty… I wanted the 31st May but it was packed so the next date I could get was after 1st June… I tried everything I could but still it further got down and on 11th July it came out the Final Score 263…The day before I went through some biochem tables,biostat formulas, FA rapid review,Heart sounds & murmur & EKGs…And in the free 120 tutorial I got 90 % (12 wrong)Went to bed at 10 pm but got about only 5 hours of sleep… my only fear was about going down the graph further…The Day of ExamMy Father arrived the day before at my student Hostel and he dropped me at the exam centre wishing all the best & advising about not to worry and you had done your part at best…
 
The Center & staff were all good…I checked the headphones & earmuffs & started my 1st block around 8 am…And just after few Qs I realised about One more Mistake…The Brightness of pc was at 100 % , I never work on my laptop above 20%…and I there was no key for brightness adjustment on keyboard…The block was easy but it strained my eyes much…Took a break to relax and adjusted the brightness with help of staff assistant…2,3 block again normal & monotonous…Still I mark about 10-12 Qs per block and almost 15 mins were left before I finish block & 2-3 min. before I finish review marked…I took break after every block as planned…Now the Game was On and I anticipated it… the 4,5,6 block marked about 13-15 Qs. And Yes there were some very long cases and also WHAT THE HELL !! Qs. of which I have no idea what are they asking about…The last one was bit easy with short Qs. Total 280 Qs.I came out of exam blank without any feeling or fear…the only thing bugging me was the decline in performance graph…The ScoreAs it was more than 6 months of my verification of student status the ECFMG had sent the reverification form of which I was totally unaware until my senior told me about that…the score was already delayed as per website info. and it arrived as expected on the 11th July…263 it says… and I’m proud of it… The whole Family is rejoicing, Friends demanding the party,Parents are proud and celebrating ,many unknown medicos approaching for advice all around the globe ,many congratulating,many being jealous and many blessings ….And I’m here still trying to complete my 1st JUNE checklist…Writing the EXPERIENCE of step 1 was 26th checkpoint…And still 5 more tasks left to make 31 complete…
 
Summary Resources usedKpln – 1 ( it got evaporated by 2018) FA – 5 times ( I had 2017 edition hence I had to Find out the changes in 2018 edition) Rx- 1 (2017 version, A 2nd revision of UW would be better than Rx)Pathoma- 3 (2013 edition) (videos only once)100 cases by conrad.did it During January ( do it once… it helped somewhat)BRS physio – 2 ( it is very much stuffed with unnecessary info. but I’ve read it once in 2017 so for the sake of revision I did it again)UW – 1 online + 2nd marked & wrong ( I also tried the offline but couldn’t complete it) try to do the 2nd revision… it will benefit much…All NBME,uwsa,UW Biostat.Unused Material – I collected everything but never find the time to read it…Goljan- bought but not even opened single page, gifted it to my friend…LOLSketchy- not my cup of tea/coffee as I like it…Becker,DIT,B&B,PreTest,High yield,BRS any many more…Just focus on FA ,UW ,Pathoma properly …it covers most …And learn from my every mistakes…Inspiration & motivation I found these things as temporary but necessary…there were times when I lost the motive ,everything seems uninteresting,going through long Qs & explanations feels tiring & exhausting … the only thing that kept me going was the 1st June… cracking step 1 was not a Dream…it was a Plan with Dedication & some procrastination,Deadlines & delays,hopelessness to overconfidence,Beginning to the En…. nahhhh it is not over yet… Word of ThanksAs step 1 is achievement of my own and I’m the one who gets the most of benefit but many people were with me along the path…You can be the captain of ship but you can’t sail it only by yourself…My parents & Family- I had decided to not go home until I’m done with step onewhich took me more than 5 months but they kept visiting me & daily phone calls kept reminding that at least there is someone who cares without expectations…
 
My friends & Seniors – their support helped me a lot…Mentors & tormentors – many guided me and yet many tried to demotivate me, One made the path clear and one made me strive harder…Homework I love reading extra books and the quotes…Here are some I keep on my desk…> “Only those who seek shall find…”> “The Journey of thousand miles begins with a single step.” ( literally the distance from India to USA is more than 7000 miles and to be a Doctor there you have to take the step 1)> “Per Aspera Ad Astra…” ( find the meaning of this latin one & remember it… helps me a lot)…— Wish you ALL THE BEST for your journey… Hope you will do better than me…of course by avoiding mistakes… It is Difficult but Possible…and I believe in You…Gracias & Au Revoir.


September 24, 2019
%d bloggers like this: