Just took the beast! Here are my pearls

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exmike

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Wow, just finished that monster of an exam. I'm so stoked to be done and totally wired on caffeine, but I want to share my experience before I forget to much.

I cannot emphasize this enough. This has been said before but it cannot be understated. KNOW THE NBME exams INSIDE AND OUT. There are IDENTICAL questions from the NBMEs on the real Step 1, and many many similar questions. More importantly, the test structure, depth, and concepts, and difficulty (more or less) is virtually identical. You cannot go wrong using the NBMEs as a basis for study. Doing all four exams (and studying every question afterwards) is by far the best $180 you can spend for Step 1.

Qbank is way too detailed. The exam covers broad concepts with minor details interspersed. If you know your broad concepts down cold, you will do well on the exam. This leads me to Goljan and his emphasis on mechanisms. If you understand how the mechanisms work, you will be able to mix and match parts of the mechanisms to come to the correct solution. For example, there are hundreds of possible questions and permutations of those questions on the concept of "shock". You dont need to know every permutation. You just need to know the mechanism down pat, and then apply it to different situations. That is probably far more high yield than memorizing the JAK/STAT pathway.

On to the details. There was very little anatomy on my exam, and most of it was basic stuff that you would either remember from MS1, get from qBank, or just plain guessed correctly. This is especially true of brain slices. The neuro questions almost ALWAYS include a slice of brain/brainstem. This makes studying for lesions MUCH MUCH easier. Just know where the structures are and you're golden. Don't waste time memorizing "wallenberg syndrome". If you know the structure of the brainstem, you dont need to know the collection of symptoms that is "wallenberg".

Biochem was likewise very straightforward. Seriousy, FA was enough for biochem. I probably had 15 on the whole test.

There was tons of pathology and pathophysiology on my test. But again, they were often very broad concepts. If there were any overrepresnted subjects on my test, I would say they were Cardiology, Endocrine, and Arachidonic acid derivatives (????).

There was TONS of molecular and cell bio on my test. I was really suprised. I'm not really sure what is the best resource for this becacuse HY MCB wasnt THAT great. There must be a better written resource out there.

Biostats was really straightforward

I really thought they wouldn't test me on EKG stuff, but they did! Here is my advice, MEMORIZE the EKG abnormalities you would see with certain ischemic events. KNOW what each branch of each cardiac artery supplies, and what would show up on EKG if it was occluded. And i'm not talking about simple stuff like axis deviation. I'm talking about which leads would show invert/change, and what would happen to the T wave. I seriously had like 5 questions on this tiny tiny topic.

Another biggie was steroid hormone pathways (different congenital adrenal hyperplasias, steriods in the gonads) All I can say is learn them. There were nearly 10 questions on it on my test.

This might seem really odd, but I had many questions on arachidonic acid derivatives. KNOW inside and out what leads to the production of each AA derivative and its function. If there was one part on my test that was unxepected for me, this was it.

There were a lot of "what do you do next" behav. sciences questions. I think I got rocked on those. It was my worst section on the NBMEs and I felt really unsure about much of it. I'm not really sure whats the best resource because even after reading HY behavioral sciences, I was still scratchign my head over these. Someone just n eeds to come up with a giant list of every single ethical situation and what to do in those situatoins.

Low yield for me. Very very little GI on my test, very few cancer stuff. Nothing on HLA types, only one question on tumor genes. No bone stuff, very little infectious disease stuff. Oh yeah, pharm was really straightforward. FA was really enough for pharm.

So what books/learning tools would I recommend following this experience? First Aid is your backbone for facts. GOLJAN audio is excellent for integration and big picture stuff that this test is chock full of. Listen to GOLJAN, you wont regret it. Robbins Review of pathology was suprisingly useful for pathology questions. BRS path was decent, but too detailed in many respects. For lack of a better book, us HY MCB. There is just too much of this junk on the test. And a lot of it is either you know it or you dont.

Non test stuff: The monitors suck and flicker a lot. Its freaking cold so dress like its winter than remove clothes. Studying during the breaks doesnt work (at least for me). Drive there ahead of time to make sure you know where it is (I got lost during the test drive). Once you show up, they start you, so if your test is at 9 and you show up at 8, you'll probably start at 8.

Overall I think there was about 5-10% that I was just like WTF!?! 2/3 was straight forward that I am pretty sure I got right. The rest I'm just not really sure of so I have no idea how I did. They were a little harder than the NBMEs but not too much harder.

Finally.
Qbank last 300: 78%
NBME Free 150: 88%
NBMEs in order
Form 3: 410/195 before studying 8 weeks prior
Form 1: 560/232 five weeks prior
Form 4: 580/236 three weeks prior
Form 2: 670/252 one week prior

Step 1: we'll see...

ok i'm so pooped. i'm out of here. pm if anyone has specific q's

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hey exmike... i was just wondering if i should spend time doing robbins review of pathology, were the questions level of hardness compared to it? Thanks
 
shiv said:
hey exmike... i was just wondering if i should spend time doing robbins review of pathology, were the questions level of hardness compared to it? Thanks
I thought it was about the same, and thus is a great study tool.
 
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exmike said:
I really thought they wouldn't test me on EKG stuff, but they did! Here is my advice, MEMORIZE the EKG abnormalities you would see with certain ischemic events. KNOW what each branch of each cardiac artery supplies, and what would show up on EKG if it was occluded. And i'm not talking about simple stuff like axis deviation. I'm talking about which leads would show invert/change, and what would happen to the T wave. I seriously had like 5 questions on this tiny tiny topic.

Non test stuff: The monitors suck and flicker a lot. Its freaking cold so dress like its winter than remove clothes. Studying during the breaks doesnt work (at least for me). Drive there ahead of time to make sure you know where it is (I got lost during the test drive). Once you show up, they start you, so if your test is at 9 and you show up at 8, you'll probably start at 8.

About the EKG stuff -- my exam did not have a single question about even basic EKGs. When someone tells you that their exam had a lot of questions on a certain type of question, take it with a grain of salt -- it definitely doesn't mean every test will have a lot of questions on that topic. Also, we don't know how many of the OP's EKG questions were experimental -- maybe 3 or 4 were, maybe none. Tailoring your studying to a specific, small topic because someone had it prominently on their exam may be a mistake. Likely, your exam will have an overrepresentation of another specific topic -- leukemia or biochemistry or metabolic disorders, for instance.

Also, the test room may be cold in some places, although this a matter of personal taste. You don't want to overdress, though, even if you wear layers. The rules in the testing room are very strict, and you are not allowed to remove or mess with your clothing in the room -- you aren't even supposed to put your hands in your pockets. So let's say you wear several layers, and are too hot -- you'll have to wait and use some of your break time to remove a layer. So plan for whether cold or hot bothers you more...
 
RustNeverSleeps said:
The rules in the testing room are very strict, and you are not allowed to remove or mess with your clothing in the room ...

This policy is utterly psychotic.

Judd
 
RustNeverSleeps said:
About the EKG stuff -- my exam did not have a single question about even basic EKGs. When someone tells you that their exam had a lot of questions on a certain type of question, take it with a grain of salt -- it definitely doesn't mean every test will have a lot of questions on that topic. Also, we don't know how many of the OP's EKG questions were experimental -- maybe 3 or 4 were, maybe none. Tailoring your studying to a specific, small topic because someone had it prominently on their exam may be a mistake. Likely, your exam will have an overrepresentation of another specific topic -- leukemia or biochemistry or metabolic disorders, for instance.

Also, the test room may be cold in some places, although this a matter of personal taste. You don't want to overdress, though, even if you wear layers. The rules in the testing room are very strict, and you are not allowed to remove or mess with your clothing in the room -- you aren't even supposed to put your hands in your pockets. So let's say you wear several layers, and are too hot -- you'll have to wait and use some of your break time to remove a layer. So plan for whether cold or hot bothers you more...


you're right. we dont know what is going to be on a given test. but if i got a bunch and if someone has time, it behooves them to study it!
I didn't know about the clothing thing. They didnt say anything at my test
 
What you have to realize is that Rusty was trying to take his pants off. That is, in fact, not allowed.
 
(nicedream) said:
What you have to realize is that Rusty was trying to take his pants off. That is, in fact, not allowed.


Hey Brother...

Luckily I was too busy speeding through the test to notice the temperature or remove my pants. Since my testing center was so strict about behavior in the exam room, I had to take off my pants during a break instead. :)
 
Seagal said:
The Q-bank keeps repeating staging questions. How important is it to know? :eek:
the basic idea what = a certain stage of a cancer i.e 1-4 is always a useful thing to know
 
exmike said:
Wow, just finished that monster of an exam. I'm so stoked to be done and totally wired on caffeine, but I want to share my experience before I forget to much.

I cannot emphasize this enough. This has been said before but it cannot be understated. KNOW THE NBME exams INSIDE AND OUT. There are IDENTICAL questions from the NBMEs on the real Step 1, and many many similar questions. More importantly, the test structure, depth, and concepts, and difficulty (more or less) is virtually identical. You cannot go wrong using the NBMEs as a basis for study. Doing all four exams (and studying every question afterwards) is by far the best $180 you can spend for Step 1.

Qbank is way too detailed. The exam covers broad concepts with minor details interspersed. If you know your broad concepts down cold, you will do well on the exam. This leads me to Goljan and his emphasis on mechanisms. If you understand how the mechanisms work, you will be able to mix and match parts of the mechanisms to come to the correct solution. For example, there are hundreds of possible questions and permutations of those questions on the concept of "shock". You dont need to know every permutation. You just need to know the mechanism down pat, and then apply it to different situations. That is probably far more high yield than memorizing the JAK/STAT pathway.

On to the details. There was very little anatomy on my exam, and most of it was basic stuff that you would either remember from MS1, get from qBank, or just plain guessed correctly. This is especially true of brain slices. The neuro questions almost ALWAYS include a slice of brain/brainstem. This makes studying for lesions MUCH MUCH easier. Just know where the structures are and you're golden. Don't waste time memorizing "wallenberg syndrome". If you know the structure of the brainstem, you dont need to know the collection of symptoms that is "wallenberg".

Biochem was likewise very straightforward. Seriousy, FA was enough for biochem. I probably had 15 on the whole test.

There was tons of pathology and pathophysiology on my test. But again, they were often very broad concepts. If there were any overrepresnted subjects on my test, I would say they were Cardiology, Endocrine, and Arachidonic acid derivatives (????).

There was TONS of molecular and cell bio on my test. I was really suprised. I'm not really sure what is the best resource for this becacuse HY MCB wasnt THAT great. There must be a better written resource out there.

Biostats was really straightforward

I really thought they wouldn't test me on EKG stuff, but they did! Here is my advice, MEMORIZE the EKG abnormalities you would see with certain ischemic events. KNOW what each branch of each cardiac artery supplies, and what would show up on EKG if it was occluded. And i'm not talking about simple stuff like axis deviation. I'm talking about which leads would show invert/change, and what would happen to the T wave. I seriously had like 5 questions on this tiny tiny topic.

Another biggie was steroid hormone pathways (different congenital adrenal hyperplasias, steriods in the gonads) All I can say is learn them. There were nearly 10 questions on it on my test.

This might seem really odd, but I had many questions on arachidonic acid derivatives. KNOW inside and out what leads to the production of each AA derivative and its function. If there was one part on my test that was unxepected for me, this was it.

There were a lot of "what do you do next" behav. sciences questions. I think I got rocked on those. It was my worst section on the NBMEs and I felt really unsure about much of it. I'm not really sure whats the best resource because even after reading HY behavioral sciences, I was still scratchign my head over these. Someone just n eeds to come up with a giant list of every single ethical situation and what to do in those situatoins.

Low yield for me. Very very little GI on my test, very few cancer stuff. Nothing on HLA types, only one question on tumor genes. No bone stuff, very little infectious disease stuff. Oh yeah, pharm was really straightforward. FA was really enough for pharm.

So what books/learning tools would I recommend following this experience? First Aid is your backbone for facts. GOLJAN audio is excellent for integration and big picture stuff that this test is chock full of. Listen to GOLJAN, you wont regret it. Robbins Review of pathology was suprisingly useful for pathology questions. BRS path was decent, but too detailed in many respects. For lack of a better book, us HY MCB. There is just too much of this junk on the test. And a lot of it is either you know it or you dont.

Non test stuff: The monitors suck and flicker a lot. Its freaking cold so dress like its winter than remove clothes. Studying during the breaks doesnt work (at least for me). Drive there ahead of time to make sure you know where it is (I got lost during the test drive). Once you show up, they start you, so if your test is at 9 and you show up at 8, you'll probably start at 8.

Overall I think there was about 5-10% that I was just like WTF!?! 2/3 was straight forward that I am pretty sure I got right. The rest I'm just not really sure of so I have no idea how I did. They were a little harder than the NBMEs but not too much harder.

Finally.
Qbank last 300: 78%
NBME Free 150: 88%
NBMEs in order
Form 3: 410/195 before studying 8 weeks prior
Form 1: 560/232 five weeks prior
Form 4: 580/236 three weeks prior
Form 2: 670/252 one week prior

Step 1: we'll see...

ok i'm so pooped. i'm out of here. pm if anyone has specific q's



Hey what's up man. Sounds like to me you did well. I was wondering where you get the NBME's? I know you get the 150 from the web site, but what of the rest of them?

Thanks.
 
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