Advice to Current 2nd Years (+Any Questions You Have)

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JP2740

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Honestly, you should focus on your classwork this year. If you focus on your classes and study really hard for those and try to do as well as possible, FA + Uworld + NBMEs +/-pathoma +/-goljian is more than good enough to get an excellent score during your dedicated period. It's reasonable and not overly ambitious. A lot of people get really complicated with their study schedule and really modify the hell out of it as they go along and would really benefit from simplifying things. You don't have to study for step 1 during your school year. 35-40 days is enough time to study for step 1. You'll find that if you focus on classes, your foundation of knowledge will be excellent. There are a ton of cases of people being successful this way and it takes off stress from you figuring out how best to prepare for this thing during the year while juggling your classes. I'm grateful to my upperclassman mentor giving me good advice on this stuff. He got 270+, and I did pretty well too. Not saying that'll be the case for everyone, but I can make a case that you can be successful with how I did it too. I made this thread because I thought my post was pretty good (not saying it's better than others' advice) and buried in the step 1 experiences thread. I can also answer any questions you guys might have and kinda have this be a good spot for advice that's not cluttered in the current step 1 thread amidst all the other talk. Fire away 2nd years.

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This is my post from the step 1 experiences thread:


Ok guys, I made a post after my test, and I PMed a guy who asked me a question, so I have a lot of material for a post so I figured I might as well do one. Fire away with any questions and I promise to check periodically. Try to keep it in this thread though and not my PM box. A common theme is striking a good balance between being thorough and wasting too much time. It is easy to annotate a ton, but the benefits diminish the more thorough you are. The balance will be up to you, I cannot tell you how to balance it. I even think I wasted too much time being thorough, although it helped me a lot, I could've spent less time doing things. In hindsight, it worked out, and I do not regret wasting the time, but you get the overall point.

Make sure you sleep at least 7 hours a day. Often times, I went up to 10 hours a day. That's excessive. But at least 7 guys. Don't hurt yourselves on this exam. Lots of sleep + having confidence and only the right amount of anxiety (not excessive) does more wonders than any of you will allow yourselves to believe. Please listen to this. You probably won't if you already break some of these, but I promise you it will help you no matter how much you think you might be wasting time/have too much to do/omg low uworld score kill self and dog.

The main key to my success*********For all you rising MS1ers. Study hard for your classes and do not focus on boards until study period (mine was 40 days). Honestly, you won't have to get exotic with your study sources if you do this, you may honor most if not all your classes, as well as guaranteed to have a great baseline for step 1. As you read below, you'll see I practically did nothing before my study period, and I attribute my success to going hard on my classes the first two years. I know a lot of people who do this and score extremely well. I highly suggest it. My med school is not top 20 or any of that fancy stuff before you ask. Even if you completed MS1 and didn't work hard, work your ass off for MS2 classes and do little step 1 stuff. Maybe hit the intro stuff before the study period during winter/spring break. That's all though.

Test Scores
NBME 7, 11, 12, 13, 15 average = 260 (forgot the individual scores)
UWSA 1 and 2 = 260+ (forgot the scores, less than 265).
Actual score = 260

About the exam itself:
Pholston's advice of hitting biochem, embryo, micro, and pharm in the last few days helped me. I had 0 embryo questions it seemed though unfortunately lol. His plan still helped me on a lot of Q. But honestly they can hit on anything. Biochem questions were really, really simple but a couple I got right only because I reviewed it the last week (yay for pholston).

Goljian's audio for some reason was in my head. It wasn't in my head during uworld q bank or during the NBMEs but for some reason in the high stress situation I heard things he said in my head and got questions right because of him. Could you get it right without his audio? Of course, I have no idea if I would have reasoned through it without him, I'm just saying he helped me net questions.

Pharm for some reason had a lot of questions on the differences between drugs within the same class. I had no idea... just go w your best guess I suppose. It wasn't in 1st aid. Kinda freaked me out lol

It wasn't heavy on neuro or anatomy thank god.

All in all, I'm glad I didn't spend too mcuh time on neuroanatomy or gross. Maybe it was just my exam though.

Behavorial sciences was so stupid and ambiguous. I hate NBME. It's so stupid. Very difficult.

I reiterate what others said about "what's the next step". Stupid questions, ambiguous, not important in clinical medicine IDGAF what anyone says.

All in all guys. You're gonna be going with your intuition A LOT. I had it down to 2 choices often. No sources would've helped more. Not pathoma or anything like that. It came down to intuition. An open book exam would not have helped me. Stop using the words "high yield". There is no more high yield. The vignette had most of what you needed but there was little high yield stuff. Yea there were some gimmies, but not enough to net a good score in my opinion. You need intuition.

I felt like on my NBMEs every question was easy. I got 260+ with being half asleep. I was not nervous on this exam. I was in a good mindset. Good review past few days. But it was 100x harder than NBMEs. There is a lot of intuition. I think the wildcard for me are those questions as well as behavorial sciences which were stupid and ambiguous (ended up doing ok in hindsight-from an old post). Don't be scared because of this. Just go in there with the correct mindset. It's not as easy. Take it 1 quesion at a time and give your best go. It's a constant battle in there. I'm happy as **** to be done. Your score will be based on your intuition past a certain point. Not based on if you know aortic dissection is ripping chest pain to the back or w/e.

I hope you all do well. I don't know what my score will be. Also, try your best to focus because a lot of times I was wondering between 2 and my eyes somehow caught something in the vignette that clued me in. And listen- I think you should avoid looking at marks when you practice because you're probably going to be tight on time in the real thing moreso than any practice. Give it your best go and move on (seriously, saving the time of clicking the mark button 15 times on a question set might give you extra seconds on the last Q). Even if you have a little time I still just clicked next section because you get tired of the exam. And yes, I think Fa+uworld+nbmes is good enough for the exam, the rest is up to your brain power. I thought I could've done anywhere from 245-260.

Materials/Strategy
Summary of materials- First aid latest version, uworld, NBMEs (do all the extended feeds), pathoma, goljian audio, UWSAs
Before my study period began- I listened to the pertinent goljian audio along with the year 2 class at the time. Renal audio ~ renal unit. I read first aid following each exam for pathophys ONLY. Likewise renal first aid after renal year 2 exam. So that means I didn't read any intro sections before my study period, but I did complete every goljian audio before study period.
My typical day-
1. Read a first aid section
2. Do 1 uworld set/go over explanation; Do a second uworld set/go over explanation
3. Listen to goljian before bedtime and annotate (1 a day, when he would go over something slowly I would just start reading stuff in first aid next to where I annotate, great review at the same time)
+/-4. If have more time, read a section in pathoma, highlight stuff I don't remember from first aid or weren't in first aid. So read the first aid section before the pathoma one to do this. If you have time at end of your study period you can hit up the highlights. It was a tremendous and quick review of all of path in less than 1 day at the end of my study period to do this.

I woke up and would read a section of first aid (the intro sections would take me multiple days though). I didn't always get to finish a section but I tried. I would then do 2 qbank 46 questions uworld TIMED and RANDOM and NOT focused (you will see a topic many times over a longer period of time and thus store it in your long term memory better). When I reviewed, I had first aid by me and would HEAVILY annotate into first aid from uworld on things I thought were important. This could be tricky as you may waste a lot of time doing this if you stray from important details. I took up more time than I thought ended up being useful, but a few things I annotated into the intro sections I reviewed at the end of my study period when I hit the intro sections up again, and a few were on my exam.

FIRST AID- - I completed this source 1x (+referring to it during using ALL other sources + 1x pathophys sections during year 2)
Before study period, I would read a section after my year 2 exam. For ex, after my renal pathophys exam, I would read the section in first aid - quick because I just took an exam on it- and annotate any helpful charts, information, clarifications, ETC. from my class notes into first aid. It was not a heavy annotate, but helped in the end for sure. Not much more to say. Just read it with a focus on understanding what you're reading as well as memorizing pertinent information. The exam focused more on your understanding and intuition, but there were plenty of memorization to go around. Strike a good balance and don't waste too much time. Having a pdf version as welll as hardcopy saved me a tremendous amount of time when I was doing annotating to ctrl+find the topic to write something into from uworld, etc.

UWORLD - I completed this source 1x.
1- if you get a Q wrong, always put in the summary into first aid. Like the 1-2 sentence learning objectives. You don't have to put the whole thing, but get it into first aid if it's not in there in some shape or form.
2- Only review a question extensively if you had no idea, or if you want to know when a different choice would be correct. Like if the answer was pleural effusion, but choice A was pneumothorax and you want to know when pneumothorax would be right, read that. Otherwise, don't feel the need to read EVERYTHING or you'll waste time. This is one of those balance things. You just don't have the time to read everything.
3- Use your discretion on the 2 above on what to annotate and what not to annotate to maximize time and putting in good points. I did not only annotate the summary lines, although I know friends who did this and did very well. I annotated some things from the explanation too.
4- You likely won't be able to read through all your annotates at the end but it will help you learn by writing it down, or reading the relevant FA section at the time. For example, at the beginning I remember little about biochem. So every uworld section with biochem I would go through the pathway in FA to learn it (and annotate into it), and I would hit some pathways like 5+ times over the course of a month and thus remember it better. Study from FA at the same time is great.
5. This is kinda lame, but I kept a word document going of strategy. Like in uworld I would often overthink too much, so I put that down in the word doc. Or I would remind myself to make sure I completely understand the question. For example: Anatomy Q- what nerve is cut v.s. the nerve feeding the muscle likely injured as described in the vignette is (your answer can be different based on the vignette). So make sure you know the question well. Also things like make sure that for picture questions, your answer fits the clinical scenario > what the picture shows as youre more likely to get a correct answer (in my opinion). Stuff like that, and your word doc will look different than mine.
6. Every question you get wrong, read aloud the learning objective at the end, and kind of explain the concept to yourself like you're teaching it. Helps in retention and making sure you're understanding. This was important to me.
7. MAKE SURE you know why you got every single question wrong. Things to ask yourself: Why did I get this question wrong? How could I have gotten it right EVEN WITHOUT KNOWING more knowledge? (This is huge, not every question you'll know the answer to, but you can make an educated guess, and so challenge yourself on Q you get wrong to see how you could've got it right). FOR EVERY QUESTION YOU GET WRONG DO THIS WITH NO EXCEPTION KTHXBYE
8. Read learning objective for every question, even the ones you get right. If you got a question right in the bank and basically had absolutely no problem with it, it's safe to skip the long explanation (not the short one though, but go with your own discretion on that. You have less time than you think in the end you'll see lol

That's all I can think of for uworld right now.

PATHOMA - I completed this 1x + reviewing my highlights
pathoma after you down first aid (I did it along with it as said above, but I think it would be better to do it completely after. Refer to first aid on things you want a refresher on from pathoma. Still do the highlighting, and reviewing the highlighting after). Good source but overrated. I didn't feel like pathoma was needed beyond first aid for the questions I saw. It's still a very good and helpful source especially if you're weak in pathophys, which I made sure I wasn't during year 2.

GOLJIAN AUDIO - I completed this 1x (+1x during year 2)
I listened to all his lectures during year 2 whenever I had to drive for the particular unit his audio pertained to. I made absolutely sure I was listening to every word too lol. Ex. During renal unit I would like to his renal lectures. Kinda helped on some exams for year 2. I listened. to goljian audio 1 hour a day during study period (you can listen at 1.4x speed, which was a good change of pace and he helped me with quite a few questions on test day. I annotated hardcore what he said, which reinforced the info, and I would read along in first aid anything that was around where I annotated if he would go off on a tangent. Guys, it's not that much time everyday. It was weird because I generally didn't think it was AMAZING (it was helpful for sure) on NBMEs but on the real deal when **** hit the fan, I remembered his words playing in my head lol (no joke).

NBMEs - Did all extended feedback except for 6 (in hindsight, you might as well do 6 as well)
Save the NBMEs for after FA/uworld ONLY if you have time to hit all the NBMEs with extended feedback. Basically what I mean is, make sure you do all the NBMEs with extended feedback no matter what. Go over the wrong questions, and then hit the wrong questions in the last 1-2 days of studying. I got a question right because I did that and happy that I did. 1 question can be the difference in your score in the end. And it won't take that much of your time.

Kaplan qbank????If you have time after your year 2 exams in pathophys, do this qbank. Like if your exams are generally on fridays, do this on the weekend. Only add the sections you've already done during year 2, and honestly don't really start using it until pathophys. If you're a daring individual, go ahead and use it during winter break/on down time during micro and pharm. But don't get burned out. Other than that, don't feel the need for a 2nd qbank. Follow what I said above and you really don't need one. I did do the kaplan anatomy qbank in the final week, and it helped me on 1-2 questions on the real deal, which was cool. So kaplan is probably useful, but I wouldn't bother annotating from kaplan unless it's something really profound and really clinical. It will waste too much time IMO. Just use it as a throw away during year 2, and if you're rocking the materials above during your study period and want something more, throw in kaplan qbank, but also weigh that with hitting up another source again. Honestly not necessary, but can help (I won't know for sure because I completed like 600 Q - only anatomy during study period, some pathophys **** during year 2). Not necessary.

USMLE Rx????????I did not buy this or use this. I heard it's pretty much asking questions directly from info from first aid. I honestly don't see the use of doing that. I know it obviously reinforces FA material. But you're trying to save time here. Focus on class work + doing uworld questions +possibly kaplan is MORE MORE than good enough. You do not need something to ask you directly out of FA. Uworld will often do that alone. And the good thing is asking things not really presented the same way in FA. This thing is obviously in my opinion the least important qbank, and not worth doing. Many will disagree on this board, so don't bitch at my post just because of this paragraph. Seriously, don't bitch at this post just bc of this opinion.
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Don't correlate uworld to your predicted score. Just keep getting better and the outlier score you might get (on the low end), just use it as a learning experience. Use the NBMEs to know where you're at, but do them later on because that's more predictive and more time efficient in reviewing answers (you'll get more right later).

In the last week, go over all the intro sections of FA + pharmacology chapter + pharm of every pathophys chapter. This helped me a lot on test day.

At the most, besides FA + uworld + pathoma + goljian audio, the most you should do is high yield neuroanatomy mainly for the IMAGES. If you're especially weak on this like during your MS1 class, then maybe read it (I wasn't weak on it though). I didn't even look at it and was fine, as well as an anatomy resource for images mainly. The thing is, these subjects, especially anatomy that is, is so vast that you'll be lucky to cover everything enough times to master it. But some people say they got a lot, I didn't. What you have to do on these questions on the real deal is use your logic to make the best educated guess and youll usually get it. Making a concerted effort to know these subjects can take away your understanding of other subjects, but at the most those sources can be hit up, nothing more. My friends told me some questions they got, and honestly if you calm down and use logic, don't freak out because it's anatomy, a lot of them can be guessed right.

After you finish FA, reassess your time left. You need to absolutely finish uworld and NBME. So see if you could finish uworld BEFORE NBME, if not start NBME and do uworld on your time when not doing NBME. Take your last NBME ~ 4 days before your exam (not a day later, avoid question burnout).

A lot will depend on how much time you assess that you have left at certain key points.

Goals- Do FA/uworld at the same time
-When finish FA, reassess time and see if you can do uworld before NBMEs
-When finish FA + uworld, do NBMEs + pathoma.

I studied the whole last day up to the very end. I got 6 hours of sleep and hardly rested. In hindsight, I wish I did rest for like at least half a day but it didn't hurt me during the exam. I was fresh and all that. But I think try to tie up what you want to do before that last day. I know it's hard because there's always something to do, but you never know subconsciously how much better your brain performs if you give it a little rest. It can definitely work.
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That's all folks. I feel like I was as all inclusive as my memory could allow for now. Feel free to ask questions.
 
👍👍👍

Cheers for the awesome post. I'll read it again when it isn't 3:38 AM.
 
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Great advice here. I would just like to second the part about focusing on your classes and acquiring a solid base of knowledge. Everything really is fair game for this beast, even those touchy-feely seemingly boards-irrelevant lectures. The people who killed Step 1 in my class (>260) are the same ones who honored most everything they touched and really knew their stuff.

I knew a number of people who thought that anything not in FA wasn't really boards material, but that didn't turn out to be true. The same people who said, "biochem/anatomy/stats/behavioral/whatever isn't really that high yield for boards" were the same ones who said, "damn, my exam was really anatomy/biochem/stats/behavioral/whatever heavy!" Everything is testable. While you wouldn't want to waste limited time during dedicated study on lower yield topics, if you're currently a first or second year, you have plenty of time to cover all of it and set yourself up for a very high score. Don't forget: if you add up all the low yield topics, you end up with a heft number of questions.
 
Did you guys go over the 'lower yield' M1 subjects outside of FA(or FC in your case, Operaman)+Qbanks during the 2nd year at all? Or was the work you put in during the course enough?
 
Did you guys go over the 'lower yield' M1 subjects outside of FA(or FC in your case, Operaman)+Qbanks during the 2nd year at all? Or was the work you put in during the course enough?

Short answer: no I did not go over the lower yield M1 stuff during year 2. Coursework + dedicated period was good enough for me.

Long answer: It's kind of like opportunity cost. Spending time during year 2 on those M1 subjects means your taking time away from year 2 subjects that are extremely important. That's why I stressed keeping it simple. Continually hitting up your coursework is important and will help retain. The work I put into the course was enough + FA and uworld during the dedicated period. I think if you want to study during winter and spring break (probably better to rest your mind here) then you can hit biochem and/or micro in FA. I realllly don't think you need to know any biochem outside of FA and uworld. And micro is too vast of a subject to really consult an outside source on your free time. I think micro made simple is probably a good book but you won't retain much because you can't sit there and really spend your time on a 400+ page book.

Alternatives based on how much you're motivated is gross and neuroanatomy. I did not review these during year 2. I felt like doing well in classes was good enough. But I think micro and biochem in FA is good enough, and gross and neuro anatomy are the only subjects I would consider adding an outside source although not necessary. I would only consider hitting this stuff during winter and spring break, but you probably won't have enough time to do damage on them anyway. You'll get a heavy dose of biochem and micro during your dedicated period, so maybe try gross and neuroanatomy.
 
I was just wondering if you have any particular opinion regarding using and annotating Firecracker alongside MS2 classes as a substitute for First Aid? Since I already have most of the MS1 topics banked and I absolutely hate First Aid with a passion, I was hoping that this would be a viable alternative since many of the topics seem to go more in-depth than First Aid (which I hope I'll only need to skim through once before dedicated studying). Overall, which method do you think would be a more effective way to consolidate material: annotating into Firecracker or annotating into First Aid?
 
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As Goljan would say " this is probably the best rendition " of Step 1 experience.
Especially the part about the feeling that you can't answer many questions even with an open book and the only thing which helps is your intuition/instinct which you develop over years of doing well in school including knowing low yield stuff.

Also, operaman is "right on money" about the HY material.

IMHO, everything you don't know becomes HY because when the day comes it comes back to haunt you!
 
Did you guys go over the 'lower yield' M1 subjects outside of FA(or FC in your case, Operaman)+Qbanks during the 2nd year at all? Or was the work you put in during the course enough?

I had some of the lower yield M1 material come up in my FC review queue during the year, but made no real effort to go over it. The work during the course was really enough and dedicated study functioned mostly as a review. We had one of our biochem professors do boards review sessions during step 1 time where he basically went through FA biochem supplemented with selected slides from lectures so as to cover all the UWorld biochem as well, plus anything else he felt might be testable. That was the only time I even looked at biochem during study period or M2, and I'm fairly certain I didn't miss any on the real deal. Again, I REALLY busted by ass during M1 to learn this stuff really well, not just memorize the words on the slides without deeper understanding - the prevailing strategy of many.

I probably did review some relevant M1 material as the corresponding pathology came up during M2, but never with the thought of boards study. My thinking was always that I would forget anything I learned by reviewing in Oct/Dec/Feb/etc anyhow, so why waste my time.

Concepts are everything. Concepts are how you are going to pick the right answer for those ambiguous could be 1 of 2 answers questions that make up the bulk of step 1.
 
Thanks guys.

Edit: @Redsoxist: I'm always paranoid that if, for some reason, FC shuts down or something happens to my account, all those annotations would be lost. I annotate onto good old paper. You could, of course, first type into a word file, and then copy-paste onto FC.
 
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MS1 here. I understand the value of focusing on coursework during the school year, but what do you suggest doing in situations where foundational stuff simply isn't taught in the curriculum? For example, we do physio during MS1 then pathophys MS2 and quite a bit of stuff that is in FA hasn't shown up in the corresponding block of our curriculum. And while FA isn't everything you need to know, I'm under the impression that you do need to know everything in FA.

So I'm torn because focusing on school and ignoring FA/Step1 resources would have made me miss a good amount relevant info. And while MS1 is much lower yield relative to MS2, if I get in the habit of incorporating board study with school study now it will be easier to do next year in the event that my curriculum is lacking.
 
As much as I appreciate the philosophy and would love to follow it, I'm not sure it applies to everyone, not me at least. I'm not the smartest person in the world. Realistically, I probably work twice as hard as the average student to get the same average test scores. I can bust my butt off to try to memorize/learn everything from every lecture, but I just don't think it's worth the time for someone like me. I'm not trying to shoot for a 260+ on step 1. My goal is 240. Heck, it might even become just to get average. I figure I can spend several hours trying to learn my class lectures inside and out for the slight chance that some of the details will be asked on Step–except that I know I won't even remember the details in the first place. Neither is my memory good enough for that kind of stuff, nor do I make connections fast enough to be even able to apply those details in critical thinking questions if they were to be asked. I'd rather spend those same hours pounding the most important stuff into my head over and over again, stuff which I know has a MUCH higher chance of showing up, and which I am much more capable of recalling and applying to questions.
 
Great post and run down of everything. I'm shooting for 250+. I was a "B" student first yr, "A" student so far during 2nd yr. So I'm hoping that my goal is feasible.
One question, so far I have been annotating FA2014 as I go along with our classes and using it to study for the NBMEs that are administered at the end of our blocks in addition to our in-house exams. All the annotations have been from robbins/pathoma/Kaplan/goljan etc(ie no class notes). I think they have helped tremendously for the NBMEs.

My question is, should I scrap these annotations or copy them into FA2015. I'm worried I'll run out if space or my pages will become too cluttered if add these old annotations PLUS UWorld.
 
Private Message: I wanted to personally thank you for a very detailed account of your step1 experience. One of the things that was mentioned in your post, and in many others on SDN, is how step1 is much more difficult than practice NBME's and UWORLD and how it comes down to picking between two choices. I realize there are limits to how much information you can provide post-exam, but could you find the time to give me an example of how a step1 question may be presented? I'm not asking for material from your exam, but perhaps a novel example that gets the point across. I would really appreciate your help.

Answer: It's honestly very hard to represent the difference. You honestly come out of Step 1 in a blur. I made that post shortly after my Step 1 and it's hard to recall the differences. But even though it's harder and a bit different, the best sources remain. Everyone will experience these differences. The most important reason to highlight the difference in difficulty is to recognize that when you get into the test after all your prep, don't get boggled down by how hard it is. Remain calm, use your intuition, and answer each q to the best of your ability and you should score where you're abilities lie regardless of the increased difficulty.

Feel free to PM again if you have more q or just post here.
 
I keep trying to follow the "just focus on classes" advice, but then my professors don't teach things like glaucoma (not mentioned once in neuro), inhaled anesthetics (wouldn't even know these existed if I wasn't studying outside resources), any of the vasculitides (srs) or the hyperlipidemia drugs, or important details like amiodarone causing pulmonary fibrosis. The only way I know about any of those things is because I learned them from Pathoma, KLN, FA, Goljan, etc. So for me it's a constant struggle to even trust my curriculum and professors. I'm always fact checking the things they say and making sure they haven't left anything out or taught something incorrectly.

If you were in my position (i.e. going to a school with a curriculum that clearly leaves out important things) what would you do?

Edit: I am an MS2 at a US MD school.
 
Private Message: What's your advice for studying for boards in M1 summer? Provided a person is trying hard to master the curriculum during the school year. Debating doing research versus reviewing M1 material via board resources.

Answer: This question has been brought up on SDN many times in the past, and the unanimous answer including mine is don't study for step 1 in the summer. There's really no point to. I would never, NEVER, advise somebody to study less. I am one of those students who overdid it for everything. You will forget most of what you study, and it doesn't benefit you. In 2nd year, the way the material will be presented is that you will be learning new stuff in a way that rehashes the old stuff. Believe me, don't study. You also need to be well-rounded. Do the research, everyone asked about mine on interviews. Furthermore, even if you didn't do research, I would rather you be well rested for 2nd year which will be super intense.
 
Great post and run down of everything. I'm shooting for 250+. I was a "B" student first yr, "A" student so far during 2nd yr. So I'm hoping that my goal is feasible.
One question, so far I have been annotating FA2014 as I go along with our classes and using it to study for the NBMEs that are administered at the end of our blocks in addition to our in-house exams. All the annotations have been from robbins/pathoma/Kaplan/goljan etc(ie no class notes). I think they have helped tremendously for the NBMEs.

My question is, should I scrap these annotations or copy them into FA2015. I'm worried I'll run out if space or my pages will become too cluttered if add these old annotations PLUS UWorld.

At a certain point, you kinda start skipping over your annotations. If you're really anal about it, you could go through your annotations and hand pick the ones you want to keep. However the bare bones of FA + uworld annotations will be more than good enough. Too much annotating can just result in a lot of clutter. You're doing well on NBMEs - good - that's one indicator that you will be well prepared for your step 1 studying. You're building a good foundation.

There's no right answer here. You have 2 choices - just scrap them because there's likely not going to be too much that's missing from when you annotate uworld or go through them and add the stuff you think you would need to see another time at this point (factoids you don't already know). Kaplan annotations are no biggie to me. Pathoma you can get by without annotating. Later in step 1 studying, you'll be so good at pathophys that you can tear through pathoma alone quite quickly, and I think that is better than reading stuff from pathoma that you annotated into First Aid (all in my opinion of course).
 
I keep trying to follow the "just focus on classes" advice, but then my professors don't teach things like glaucoma (not mentioned once in neuro), inhaled anesthetics (wouldn't even know these existed if I wasn't studying outside resources), any of the vasculitides (srs) or the hyperlipidemia drugs, or important details like amiodarone causing pulmonary fibrosis. The only way I know about any of those things is because I learned them from Pathoma, KLN, FA, Goljan, etc. So for me it's a constant struggle to even trust my curriculum and professors. I'm always fact checking the things they say and making sure they haven't left anything out or taught something incorrectly.

If you were in my position (i.e. going to a school with a curriculum that clearly leaves out important things) what would you do?

Edit: I am an MS2 at a US MD school.


You didn't learn about statins in year 2? What the ****?

I didn't have glaucoma mentioned either. Some things aren't going to be mentioned in year 2. You will pick them up in your study period and know them. It's a tested fact that studying hard for classes will allow you to do well. However, it doesn't mean that you cannot succeed otherwise. This is just my viewpoint and the viewpoint of many others before me who have succeeded. Really though, when you guys talked about amiodarone, no one mentioned side effects?
 
You didn't learn about statins in year 2? What the ****?

I didn't have glaucoma mentioned either. Some things aren't going to be mentioned in year 2. You will pick them up in your study period and know them. It's a tested fact that studying hard for classes will allow you to do well. However, it doesn't mean that you cannot succeed otherwise. This is just my viewpoint and the viewpoint of many others before me who have succeeded. Really though, when you guys talked about amiodarone, no one mentioned side effects?

Our amiodarone side effects consist of "smurf skin and torsades".

No hypothyroid, no photosensitivity, no pulm fibrosis, no p450 inhibition, no digoxin interaction, no hepatic necrosis, no corneal deposits, nothing.

And no, statins aren't taught. Unless "read lange statins" counts.
 
Our amiodarone side effects consist of "smurf skin and torsades".

No hypothyroid, no photosensitivity, no pulm fibrosis, no p450 inhibition, no digoxin interaction, no hepatic necrosis, no corneal deposits, nothing.

And no, statins aren't taught. Unless "read lange statins" counts.

This is completely out of the norm...
 
At a certain point, you kinda start skipping over your annotations. If you're really anal about it, you could go through your annotations and hand pick the ones you want to keep. However the bare bones of FA + uworld annotations will be more than good enough. Too much annotating can just result in a lot of clutter. You're doing well on NBMEs - good - that's one indicator that you will be well prepared for your step 1 studying. You're building a good foundation.

There's no right answer here. You have 2 choices - just scrap them because there's likely not going to be too much that's missing from when you annotate uworld or go through them and add the stuff you think you would need to see another time at this point (factoids you don't already know). Kaplan annotations are no biggie to me. Pathoma you can get by without annotating. Later in step 1 studying, you'll be so good at pathophys that you can tear through pathoma alone quite quickly, and I think that is better than reading stuff from pathoma that you annotated into First Aid (all in my opinion of course).
Great, thanks man. I think in going to continue annotating in FA2014 and leave 2015 for just UWorld.
 
Private Message:
Wanted to follow up with you to see what is the best way to learn FA. I realize focus should be on learning concepts. But everyone says to memorize FA. What's the best approach?

Similarly, how should one approach learning from Pathoma and Uworld? How should one emphasize learning concepts versus memorizing? Is it a good use of time to reference detailed sources such as Robbins? Or are books like BRS better for step 1?


Answer:
Concepts are always more important. The way that Step 1 is structured is that you will have the obvious gimmies - Pt has blood in stools, they did colonoscopy and found pseudopolyps, what does the pt have or what do you think the pathology report showed? On real step 1, these questions are a lot rarer than on qbank. More often than not it'll be a long passage and you narrow it down to 2 choices. You have to use your intuition/conceptual understanding of the material to give the best answer. I kinda talked about this in my long post too. However, yes, you still need to memorize for the same reason I said before. Look at that question, it's pure memorization and you'll get those questions too.

A lot of people liked listening to Pathoma and annotating but I never found that helpful. I did it for like 2 sections. I used pathoma during my dedicated study after I had read first aid. And I just read it. It's a great review source if you just read it, and you won't be missing anything from not listening. It'll help you touch up on concepts and hammer in points. I mentioned a little bit about this in my post too. Uworld, take a look at my post. I would definitely do random, timed (timing is an issue on exam). And when I was done I would read every explanation, right or wrong, the entire text. I had a pdf of first aid that I would ctrl+search to find a page number where a concept was being talked about and where I wanted to annotate things I found high yield or if a concept was being discussed in a different way I hadn't considered. It took me a long time to do all of uworld because I was really comprehensive with annotations until the end. You'll get to the point where you have a feel of what you want to annotate and what you don't want to, and if you really need to read every little line of text. By the end 80% of my annotations were useless because I knew them already, and 60% of statistics are bull****.

I don't like using robbins, brs, or any of that. The less resources the better. If you actually manage to master uworld and first aid you're in damn good shape. Then you can pepper in pathoma and goljian audio. If you manage to master those you're in really, really good shape. If you're going more than that, I really don't see how you can master em all. Robbins is just inefficient. BRS would be redundant.
 
Private Message:
Wanted to follow up with you to see what is the best way to learn FA. I realize focus should be on learning concepts. But everyone says to memorize FA. What's the best approach?

Similarly, how should one approach learning from Pathoma and Uworld? How should one emphasize learning concepts versus memorizing? Is it a good use of time to reference detailed sources such as Robbins? Or are books like BRS better for step 1?


Answer:
Concepts are always more important. The way that Step 1 is structured is that you will have the obvious gimmies - Pt has blood in stools, they did colonoscopy and found pseudopolyps, what does the pt have or what do you think the pathology report showed? On real step 1, these questions are a lot rarer than on qbank. More often than not it'll be a long passage and you narrow it down to 2 choices. You have to use your intuition/conceptual understanding of the material to give the best answer. I kinda talked about this in my long post too. However, yes, you still need to memorize for the same reason I said before. Look at that question, it's pure memorization and you'll get those questions too.

A lot of people liked listening to Pathoma and annotating but I never found that helpful. I did it for like 2 sections. I used pathoma during my dedicated study after I had read first aid. And I just read it. It's a great review source if you just read it, and you won't be missing anything from not listening. It'll help you touch up on concepts and hammer in points. I mentioned a little bit about this in my post too. Uworld, take a look at my post. I would definitely do random, timed (timing is an issue on exam). And when I was done I would read every explanation, right or wrong, the entire text. I had a pdf of first aid that I would ctrl+search to find a page number where a concept was being talked about and where I wanted to annotate things I found high yield or if a concept was being discussed in a different way I hadn't considered. It took me a long time to do all of uworld because I was really comprehensive with annotations until the end. You'll get to the point where you have a feel of what you want to annotate and what you don't want to, and if you really need to read every little line of text. By the end 80% of my annotations were useless because I knew them already, and 60% of statistics are bull****.

I don't like using robbins, brs, or any of that. The less resources the better. If you actually manage to master uworld and first aid you're in damn good shape. Then you can pepper in pathoma and goljian audio. If you manage to master those you're in really, really good shape. If you're going more than that, I really don't see how you can master em all. Robbins is just inefficient. BRS would be redundant.

Great write up. I'm really hoping that mastering UW will be the gold standard for at least one more year. I've been hearing from students who took it this year and some last year that there was a lot on their step 1 form that wasn't in FA or UW. Obviously there are also the rumors floating around that the test writers are looking through UW, FA, and pathoma and purposely testing things that aren't in those 3 sources. Idk if it's true, but I don't think it's that unreasonable of a rumor.
 
Great write up. I'm really hoping that mastering UW will be the gold standard for at least one more year. I've been hearing from students who took it this year and some last year that there was a lot on their step 1 form that wasn't in FA or UW. Obviously there are also the rumors floating around that the test writers are looking through UW, FA, and pathoma and purposely testing things that aren't in those 3 sources. Idk if it's true, but I don't think it's that unreasonable of a rumor.

So, making the test tougher to keep scores from going up?
 
Private Message: Please clarify if 5-6 weeks dedicated is really enough time to learn uworld, FA and pathoma well along with NBMEs. I'm usually a slow learner, do I'm nervous about leaving HY stuff till the end if I focus on classes only during the year.
As far as classes, I feel I master things for exams, but then just forget stuff as the year goes along. Any advice for retention? I've been scoring around late 80's on class exams, sometimes 90's.



Answer: Well, here's the thing. At my school (which is not on the radar for top schools. isn't listed as a top 50 school for that matter), this principle has been tested and proven for many many students at different ages. However, in that thread some dude said that in 2nd year they didn't even teach him about ****ing statins which blows my ****ing mind. I've posted enough on this board to know that there are a TON of posters who only studied for classes and waited for most (there are some small things I did before dedicated study if you read my thread) of their studying at the end who did phenomenal. It builds this awesome foundation that cannot be matched by review books. I would've been really worried (and I was a little worried actually still) if my mentor wasn't a couple years ahead of me and got in the 270's and was right about every advice he had given me up to that point.

Everyone feels they forget as they go along. You damn well better believe I did too lol. It's there, you just don't know it and neither did I. You'll pick it up quickly, believe me. And you won't know everything at the end and that's normal too because you'll know enough to give educated guesses which is actually really ****ing important and a huge distinguishing factor in this test as I talk about in my original post. You could use ur breaks in the school year to go over micro and/or biochem which was weirdo sections that take longer to learn/memorize. I think you'll be fine otherwise. Of course follow your heart on this and talk to other students to gauge their opinion. It might not work for everyone or for you or for the guy who wasn't taught statins, but it worked for everyone I know who really dedicated themselves big time to classwork.

I'm not trying to sell you a book or anything. All I can say is that plenty have done it and succeeded, plenty have felt they were losing info just as you are
 
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Great write up. I'm really hoping that mastering UW will be the gold standard for at least one more year. I've been hearing from students who took it this year and some last year that there was a lot on their step 1 form that wasn't in FA or UW. Obviously there are also the rumors floating around that the test writers are looking through UW, FA, and pathoma and purposely testing things that aren't in those 3 sources. Idk if it's true, but I don't think it's that unreasonable of a rumor.

Read my original post again. These things were being said when I took this 2 years ago too. They may be doing that. My test felt harder and more complex than both FA and UW, but they both prepped me the best. It's hard to explain, but yes, you said it yourself. "master" UW does not equal "memorize" UW. You have to understand what's going on to understand curveballs and to differentiate between 2 good answer choices because you know just a little bit more about the topic that allows you to make a good intuitive choice that 1 makes more sense than the other. The result is you walk out of the test center not knowing how the **** you did and that no source was really on point. And then you get your score and it's the average of your NBMEs, and you don't know how. Sometimes I get a suspicion that they hunt down your nbme scores and just give you that grade. There are outliers, but it's something that holds relatively true lol.
 
I feel like I really learned the information well during the last two years (M2--preparing for dedicated) and feel like I have forgotten almost everything. I've done way beyond my expectations (Honors or High pass for every core).. I'm not trying to do a subtle brag here, because I seriously feel like I've forgotten everything. I really don't know how some people can remember these things for so long, since you have a brick of paper you need to learn in 2-3 weeks, test, another brick of notes.. I was looking at the free 150 the other day and didn't know a lot of them, which worries me... But I also thought to myself that I knew these at one point, so I hope that counts for something. Nice to see somebody else (referring to whoever sent the PM above) feels like they've forgotten a lot of things and that this seems to be a norm.

I have a question JP... In class I go through my slides several times (write out notes, diagrams, flow charts, etc.).. If it weren't for repetition I think I'd be screwed.. Which worries me for step 1 Are you able to go through things multiple times or is it more or less you need to learn it the first time you review it, because you won't have time to review it again?
 
I feel like I really learned the information well during the last two years (M2--preparing for dedicated) and feel like I have forgotten almost everything. I've done way beyond my expectations (Honors or High pass for every core).. I'm not trying to do a subtle brag here, because I seriously feel like I've forgotten everything. I really don't know how some people can remember these things for so long, since you have a brick of paper you need to learn in 2-3 weeks, test, another brick of notes.. I was looking at the free 150 the other day and didn't know a lot of them, which worries me... But I also thought to myself that I knew these at one point, so I hope that counts for something. Nice to see somebody else (referring to whoever sent the PM above) feels like they've forgotten a lot of things and that this seems to be a norm.

I have a question JP... In class I go through my slides several times (write out notes, diagrams, flow charts, etc.).. If it weren't for repetition I think I'd be screwed.. Which worries me for step 1 Are you able to go through things multiple times or is it more or less you need to learn it the first time you review it, because you won't have time to review it again?


FWIW I found reviewing previously learned material to be a much different beast than learning new material. At the end of MS2 first semester we took an NBME subject exam of the systems we covered and in preparation for that I did some qbank blocks on random, flipped through FA, pathoma, and some other things just as I kind of plan to do during dedicated time. You hear it here all the time, but the information really does come back to you pretty painlessly. I constantly found myself thinking "oh duh, I knew that" or "I can't believe I forgot about that". But very rarely was I thinking "oh **** I've never seen this before".
 
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