Took the beast today.
Took off about 7 weeks to study and spent most of it at home in my PJs, only emerging to workout at the gym and on weekends to eat dinner out. Sure, the internet and TV distracted me, but I used them as frequent breaks since I have the attention span of a fruitfly anyway. I got very well-versed in the latest CNN newsbreaks and the newest Bravo reality show episodes.
And I kept up with the primaries! Plus having the convenience of all my books and the contents of my fridge within reach was very comfortable.
And no, I did not gain weight from the aforementioned.
Schedule - Tried fitting myself into the 8-5 schedule, but my nocturnal tendencies prevailed. Would wake up around 11am, study till 4 with a lunch break in the middle, workout/eat dinner/watch TV, resume studying at 8pm and go on till 3am or so. Saturday was supposed to be rest and catch-up day, but I would do an NBME every 2 Saturdays or so.
I used
this and
this to help me plan a schedule. Mapped it in Google Calendar.
I used
FA 2005. My school taught systems-based; I thought I would benefit from using a different approach to review. Plus I think my ADD brain just focuses better in a subject-oriented manner without having to switch topics within an organ system. Annotate into FA from your other books! I started off diligently then slacked off after physio. Hehe.
Started with
biochem and mole bio - 6 days total. Man, just be aware that by the time 6 weeks goes by, you will have forgotten 90% of what lovely metabolic pathways you crammed into your head in the beginning. I realized this little gem when I tried doing biochem questions a week before my exam. Definitely need a refresher closer to the day.
Books RR Biochem and HY Mole Bio (1999 edition -- I think I should sell my copy on ebay for $500
) RR was a little overkill, but I was so rusty I think it helped me get my basics back. HY Mole bio was very basic; I'm not sure what the hype is about. I didn't get too much mole bio on my exam, mainly basics about transcription and translation and
usually integrated with micro or pathology.
Then
Phys - 5 days, using only
BRS Physio. Not much to say, just understand the graphs -- high yield stuff to know: cardiac nodal cells and myocyte membrane potentials, ventricular pressure-volume curves, GI hormones, renal electrolyte balance and endocrine functions.
Path took a huge chunk of time - 10 days. Started
Goljan audio from day 1. Supplemented with
RR Path after each lecture. This formula was great for integrating multiple subjects and solidifying many high yield path concepts. Highly recommended.
Pharm - 2 days I didn't spend as much time on this as I should have; USMLE Roadmap Pharm lulled me into a false sense of security. It was way too basic and didn't explain concepts or mechanisms in enough detail for me to remember anything.
HY Pharm was better, but I think FA is enough. Did antimicrobials last then jumped to..
Micro/Immuno 2 days bacteria, 1 day viruses, 1 day parasites. Used HY Micro to get basics down, but think FA is more than enough for quick and dirty review. I am really weak in micro -- cannot for the life of me remember what bug stains what in what medium and oxidises what. WHO.THE.F.CARES??? Rant aside, FA had more gems that HY didn't and I was able to answer some questions because of that. I only used FA for Immuno, but I had a pretty good background in undergrad.
Anatomy - 2 days HY Gross anat helped with clinical scenarios, but their preamble in each chapter is pure fluff. I skipped through all that. In hindsight, FA was wonderful and I should have just focused on that. However, HY is better for upper and lower extremity, which is very key. They love to ask about innervation there. Also, know your CT cross sectional brains and functional correlations. Pretty much every anatomy question I had could be traced to FA, sometimes with some regretful slapping of the thigh during the exam (quietly!)
Neuro - 1 day This was the exception to the system-based rule. Also neuro was my strong point, so I left it to the end. Neuro phys in BRS is quite overkill (especially the eye and ear stuff.) Learn ANS phys and pharm cold though -- they love that stuff. I had 10 questions just on autonomic agonists and blockers. As said before, know neuroanatomy as relates to pathology cold. Neuropath questions were pretty straightforward.
HY Neuroanat was good for brain slices but don't stress out about minutiae in there, it won't be tested. It was a good book to skim through, for me, and good review for neuropath.
Embryo Err I think I had maybe 2 WHOLE questions in the entire exam and straightforward. Low Low yield -- just use FA. I skimmed through HY Embryo, but nothing was on there that FA didn't have, and in a more concise manner.
Histo+FA pictures - 1 day Blood smears, cancers... Know what different cell layer types epithelial/adeno/myo look like as you will be asked to apply these to pathology.
Behavior - 1 day HY Behavior is great. They have a small section on biostats, which tells you all you need to know; don't get HY Biostats. Psych is big; they like schizophrenia, defense mechanisms and drug side effects. Ethics is also fave -- most of my "quote" questions, i.e. "what will you do if your patient freaks out on you?" were pretty obvious.
Last 5 days -- focused on FA, especially the short-term memory topics Biochem, Pharm and Micro. I only skimmed Anatomy, thus leading to aforementioned thigh-slapping. Relax as much as you can the last day. Light review, no new material. Go to bed early. And try not to let nightbird in you thwart your efforts by waking you up at 1.22am after 10pm lights out and keeping you up till 445am. Sigh. I did ok though. hehe
Day of - Took every break I could. 5 min after 1st block, 10 after 2nd, 15 after third. Break got longer as I got more tired. 20 min lunch break. Went to the bathroom each break. 10 min after 5th, whopping 20 min break after 6th because I was getting very fatigued and sat down for some pseudo shuteye. Then 7th (my hardest block!) and survey yay!! Bring snacks, water and a protein-rich lunch. Try not to talk to fellow step-takers during breaks about test-related material; stresses you out and may get you in trouble! They video
and audiotape the public areas of my test center.
They also videotape you as you're taking the exam and warn you not to take your jacket off, change your hairstyle (verbatim!), put your hands in your pockets or perform any other "irregularity" while you are at the computer.
Qbank USMLEWorld -- most of the questions were way harder. You'll maybe get 5-10 of those
questions on each block in the real thing. I got so frustrated doing uW towards the end of my review that I just did them in tutor format and skimmed the answers, blowing off those that only 17% of people got correct.
However, I have to say that a lot of questions I wouldn't have otherwise been able to answer were thanks to uW. Even some of the pictures were exactly the same!
All in all, uW gives you a great idea of what kind of questions to expect, as well as what is high yield to know (except those annoying 17% answered correct questions, which were too ridiculous for me.) Start doing the questions from day 1 as you will not only retain concepts learned, but will focus your mind when studying to help you take note of concepts you would otherwise have ignored.
I started off with 52% and moved towards 64-74% towards the end, completing ~75% of the questions. My absolute highest was 78% 2 weeks before the test. I freaked out and thought I'd reached my peak too early when my scores started plummeting after.
NBMEs
CBSE 228
#1 - before studying 228 (ha, did I not learn anything new in 1 yr of clinics?)
#4 - 5 weeks before 234
#3 - 2 weeks before 245
free 150 (CBT version) 2 weeks before 87% or 253
#2 - 1 week before 241
#5 and #6 came in right as I was entering my last week of studying, I think I must have seen them when I was buying #2 but plain ignored them (unconsciously... repression?) I thought 2 and 4 were the hardest. 3 was fair and I hope it's representative.
the free 150 were way easier than the real thing.
Overall I probably used too many books and could have studied in a shorter period of time, but I'm done!
Update: 245/99. Exactly the same as NBME #3!