all you need to know is in first aid

[VeggieGal]

Is it really true that everything we need to know is in first aid? I keep hearing this over and over again from 3rd and 4th years, but am not sure if I buy into it. For example, if a drug side effect is not in first aid, should we not know it? or if a drug is not in there, but we learned it during classes, does that mean it's not likely to be on the boards?

There are also some bacteria we learned in class that aren't listed in first aid as well. i know we are supposed to go through and annotate first aid with the topics already listed, but what about adding new topics?

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[Terpskins99]

Is it really true that everything we need to know is in first aid? I keep hearing this over and over again from 3rd and 4th years, but am not sure if I buy into it. For example, if a drug side effect is not in first aid, should we not know it? or if a drug is not in there, but we learned it during classes, does that mean it's not likely to be on the boards?

There are also some bacteria we learned in class that aren't listed in first aid as well. i know we are supposed to go through and annotate first aid with the topics already listed, but what about adding new topics?

To pass? Possibly.
To score the national average? Unlikely.
To crack 240? No way.

Just as an experiment, I'm curious to see how someone would do using nothing but First Aid.

 

[Pinkertinkle]

I think having done reasonably in your classes all you need to PASS is in first aid.

If you're shooting for average or higher it certainly isnt enough.

 

[Law2Doc]

Is it really true that everything we need to know is in first aid? I keep hearing this over and over again from 3rd and 4th years, but am not sure if I buy into it. For example, if a drug side effect is not in first aid, should we not know it? or if a drug is not in there, but we learned it during classes, does that mean it's not likely to be on the boards?

There are also some bacteria we learned in class that aren't listed in first aid as well. i know we are supposed to go through and annotate first aid with the topics already listed, but what about adding new topics?

FA is a collection, basically in outline form, of what student contributors over the years feel is the highest yield info. So if you know everything in FA, you probably have the basics. But it is not all inclusive, nor meant to be. Most people use it as a barebones outline on which you annotate pearls you glean from other resources. If you read nothing but FA, and knew nothing but what was in there I don't actually think you'd necessarilly pass.

 

[osli]

If you knew everything in FA cold, absolutely perfectly, and could apply it without error, chances are you'd pass. If you were a good student you might even make average. Hell, maybe even better depending on how good of a student you are. Most questions are probably in FA somewhere. The problem is that it is near impossible to remember every detail in any one source, much less be able to actually apply some factoid in a chart to a "thinking" question. The raw material might be there, but your conceptual and applied understanding isn't.

That's why multiple sources (within reason) are probably important. The extra "detail" in more subject specific sources may or may not be on the exam, but they will likely help you understand what is going on, and will also likely help you remember important details (even ones in FA that you might otherwise forget).

And it is probably highly dependent on the student... some can probably digest and integrate extremely dense information from FA into their fund of knowledge and conceptual framework established in their first two years... while for others a dense chart or list may not do them much good on the exam even if the raw information is there to answer the question. Why do you think some people here say memorizing a couple of pages of micro in FA is all you need for the boards, while others read and recommend the 300+ page CMMRS book for the same material? The key is probably evaluating your own scope of understanding and deciding which subjects are strong (i.e., you only need to re-memorize lists of details and factoids to fill in the blanks - Neuroscience for me) and which are weak (i.e., you only memorized loose word-associations the first time around in school and barely passed that section - Biochem for me).

 

[osli]

BTW, keep in mind that the vast majority of US med students are not SDN members. They don't come here and read the good advice available. They rely on either their own guesses, advice from the faculty, and/or advice from upper-levels in their program.

Some of that advice is likely to be good... some not so good. At my own school (DO, hmm... maybe that means something ) I've heard numerous classmates say something like "John took the USMLE last year and said all you need to know is FA to pass." Others add Goljan audio to FA as all you need. And then I see many other classmates buying huge boxes of used board books that they will probably never get through even a fraction of (whole Kaplan book sets, plus the whole BRS series, and a few RR and HY books bought from other upper-levels "just in case"). And about half my class is confident that the Kaplan lectures on campus will be their ticket to a great board score. Maybe so. And then our faculty hosts their own "board review lecture series" for a month for all students that wish to attend (most students go to a few that they think will help them in a specific area, and self study most of the time or do Kaplan). If you ask our administration, they'll say "all you need is to go to our review series."

So advice varies widely. Only on SDN can you search through a hundred threads giving advice, try and place your own study style and understanding level in the context of the people giving advice, and then assemble a study strategy that you think will give you the best chance of success.

I honestly think that if everyone in the country was an avid SDN user/reader the average would be much higher... and I am thankful they are not. I have two good friends who don't know SDN from a hill of beans, and the advice I've passed on to them from SDN seems like divine revelation to them. A 1999 HY book? Some weird dude's audio lectures? RR Path... what's that? There are question banks other than Kaplan?!?

 

[Law2Doc]

I honestly think that if everyone in the country was an avid SDN user/reader the average would be much higher...

LOL, actually I think if that happened, instead of seeing threads entitled "How hard is it to get 240+", you would see threads entitled "How hard is it to get 220+". SDN readers get a warped view of reality. Seems like everyone on here gets 35+ MCATs and ultra-high board scores. Wouldn't be the case if the board was populated by a bigger cross section of future members of the profession. Suddenly the national average would also be the SDN average.

 

[osli]

I see your point, and agree, but I think there is reciprocation. While SDN is a self-selective community (in who joins, who posts, and who discloses their scores), I think the advice available here also plays a role in helping some members achieve good scores.

I look at myself and my two good friends I mentioned... if I were not an SDN member, the three of us would be pretty lost for board review. No one else has given any of us the type of advice available here. About the best we would have is "get step-up or FA or something like it, and there are some audio path lectures out there, and probably get the Kaplan books or course."

I think the Kaplan part would be the only thing saving our hides! I would have never heard of Goljan, or RR path, or the 1999 HY cell/molec book, or CMMRS, or known that BRS physio is fine (even at a quarter the size of the Kaplan physio), etc. etc. etc. Those resources guarantee nothing, but I wouldn't have even heard of them. I would have done like many of my classmates... walked into our book store, and on advice of the lady there purchased step-up. And then perhaps bought a load of used review books having no real clue which ones were worth the time to read. Boards would have been a big mysterious black hole looming on the horizon, I would probably not have had any idea of a reasonable study plan, and thus would not have organized and managed my time nearly as well, and ultimately would have been much less prepared than I will be. If I manage a 200 now, I would have probably failed without SDN.

It is sad, but I know many of my classmates who think Kaplan is just making money off students and doesn't teach them anything they can't teach themselves (they are right, about that last part I mean), and think that reviewing class notes and buying step-up is going to get them an average or better board score (I hope they are right).

 

[lord_jeebus]

I think good strategy is key and many non-SDN users miss out on this.

Your two years of study set a ceiling for how high you can score in optimal condition. There is no substitute.

However, your boards strategy determines how close you get to this ceiling.

I know many people who did much better than me in classes (I only got Honors in two preclinical courses, both first year.) but fell into the trap of weak strategy (reading only First Aid, deciding that molecular bio, biochem and anatomy wouldn't be on the test, and/or doing QBank very slowly and only getting through a third of it). These are very bright and dedicated people who scored 20-40 points below their potential because they got some bad advice.

 

[Law2Doc]

I see your point, and agree, but I think there is reciprocation. While SDN is a self-selective community (in who joins, who posts, and who discloses their scores), I think the advice available here also plays a role in helping some members achieve good scores.

I agree SDN is helpful, but the boards are set up such that everyone is presumably scored (curved) against each other, aren't they? The same number of people will get 240+ even if everyone who took the exam got 10% more questions correct thanks to SDN or otherwise. The average stays the average. So a lot more people on SDN would only pull the board's average down.

 

[lord_jeebus]

I agree SDN is helpful, but the boards are set up such that everyone is presumably scored (curved) against each other, aren't they? The same number of people will get 240+ even if everyone who took the exam got 10% more questions correct thanks to SDN or otherwise. The average stays the average. So a lot more people on SDN would only pull the board's average down.

My understanding is that it is not curved.

 

[Terpskins99]

My understanding is that it is not curved.

For some reason, I was under the impression that it is scaled on a rolling basis with either the previous years' results (or even the previous 3 month block's results) influencing the scale for the next group of examinees.

 

[osli]

Who knows. Well, who on SDN knows.

 

[lord_jeebus]

Well, as a licensing exam it should be possible for everyone to pass, and for everyone to fail.

 

[Terpskins99]

Well, as a licensing exam it should be possible for everyone to pass, and for everyone to fail.

And for everyone in SDN to qualify for Mensa.

 

[DwyaneWade]

From what I have heard (and agreeing with lordjeebus) I think it depends on how well you learned material the first two years.


I know a student in the year ahead of our class who just focused on really understanding the concepts her first two years and then spent 5-6 weeks just with First Aid and broke 250. What she told me is that she would read First Aid and she would remember all the additional concepts not included that she had learned over two years. Then you have people who needed to use 10-12 books but also broke 250. Each to their own.

 

[Law2Doc]

Well, as a licensing exam it should be possible for everyone to pass, and for everyone to fail.

If everyone failed we'll have one heck of a healthcare crisis.
However they do it, about the same percentage of people pass each year, and the average stays within a point or two of the prior years. There aren't years where a glut of people score 240, notwithstanding that entering stats at med schools have gone steadilly up for about a decade. I suggest that the scores are calculated (whether by curve, scale or other algorithm) such that the distribution is about the same year after year. Thus only a fraction will ever score 240+ in any given year, even if everyone prepared smarter thanks to SDN input.

 

[jdig]

all this begs the question:
why the raise in the passing score over time?

 

[Law2Doc]

all this begs the question:
why the raise in the passing score over time?

I agree that if they massage the numbers the way I've suggested to get the desired distribution, they could either change the scaling to adjust the distribution or just move the threshold, and get the same results. Might as well move the threshold -- that way they don't have to change the algorithm.

 

[lord_jeebus]

all this begs the question

Public Service Announcement

 

[jdig]

law2doc, good point..
lord jeebus, lol
allow me to raise the question then

 

[osli]

However they do it, about the same percentage of people pass each year, and the average stays within a point or two of the prior years. There aren't years where a glut of people score 240.... I suggest that the scores are calculated (whether by curve, scale or other algorithm) such that the distribution is about the same year after year.

Ran across this old thread looking for some other info. I found this post particularly interesting in light of this year's several point jump in the average with little/no effect on standard deviation. It does seem as though more people scored higher this year, and the NBME didn't "curve" it back down. Perhaps adjustments will be made in future years to keep this inflation in check (I'm certain they will), but this highlights the point that no one should get caught in the trap of thinking that they have to beat half of the other students taking the test to score above the median score. It is possible for everyone taking the test in the spring of a certain year to do very well. You are scored based on the difficulty (based on past student performance) of the questions on your particular exam, not against students currently taking the exam. The NBME would just include this performance data into the statistical analysis, making it hell on future test takers.

And just for L2D and his stream of posts over the past months/year warning that half of all test takers are below average, including some very good students, so "don't get your hopes up prematurely..." I set a goal, found the advice on SDN to help me achieve it, and got the score I wanted. I don't see any reason not to encourage everyone to do the same.

 

[highyield]

I honestly had FA memorized cold, nearly every page word for word. Other than that, i looked at the BRS phys respiratory and cardiac sections, but didn't memorize them, not even close. I also did 80% of UW and spent time reading and understanding the answers. Spent about 10-12 hours/day on 100 questions. unused, timed, random cumulative 70% last 250 questions. 73%

I got a 235 and was insanely disappointed but understand why. Someone, possibly BRS, needs to come up with a review book that is strictly pathophysiology. Especially if each section had arrows to describe the systems.

So you can pass using just FA, but don't expect to rock it!

 

[UditNarayan]

if you learn through understanding, then FA is not so good of a choice. i didnt even use it much...some people on this forum go thru it like 4-5 times and i didnt even get thru it twice...i knew that looking at FA would be like staring at words on a page because they simply dont give me much info. some of my friends who are memorizers liked it but since i learn thru mechanism im glad i didnt spend much time on it. figure out what works for you and then stick with it. you will do much better sticking with solid resources than freaking out about how others are using something else, etc.

 

[GMDMD]

To pass? Possibly.
To score the national average? Unlikely.
To crack 240? No way.

I disagree. It depends on the person. I have no doubt most of the 260 scorers here could have easily busted 240 with just FA. Most of them scored at or above the national average before starting studying.

I hit 247 on an nbme 4 weeks in mainly studying FA (probably spent about 70% of my studying during the first 4 weeks with FA) plus a few other resources (mainly I lightly read through Rapid Review from cover to cover, for example, plus referenced microbes made easy. former i might argue overwhelms you with details while the latter i'm not sure how high yield it was during board review). At that point I had only gone through FA once and estimate I knew only about 65% of it hardcore. I don't think I ever knew more than about 80% of FA cold when all was said and done.

I don't know that my score at 4 weeks in would have been all that much lower if I had allocated all of my time instead to knowing FA 95% cold within that time interval. FA is pretty damn high yield. If you know all of FA there are few holes in your game.

That being said, knowing does not equal memorizing. To KNOW FA is to understand the concepts behind the facts.

I would say if you're going for a 240+ and you aren't scoring at or near the national average prior to starting studying, your knowledge base is too weak to rely mainly (90% focus) on FA.

But why handicap yourself like that? If you can get a 240 with just FA... why not use the right resources and get a 260??

 

[ACSurgeon]

I disagree. It depends on the person. I have no doubt most of the 260 scorers here could have easily busted 240 with just FA. Most of them scored at or above the national average before starting studying.

I hit 247 on an nbme 4 weeks in mainly studying FA (probably spent about 70% of my studying during the first 4 weeks with FA) plus a few other resources (mainly I lightly read through Rapid Review from cover to cover, for example, plus referenced microbes made easy. former i might argue overwhelms you with details while the latter i'm not sure how high yield it was during board review). At that point I had only gone through FA once and estimate I knew only about 65% of it hardcore. I don't think I ever knew more than about 80% of FA cold when all was said and done.

I don't know that my score at 4 weeks in would have been all that much lower if I had allocated all of my time instead to knowing FA 95% cold within that time interval. FA is pretty damn high yield. If you know all of FA there are few holes in your game.

That being said, knowing does not equal memorizing. To KNOW FA is to understand the concepts behind the facts.

I would say if you're going for a 240+ and you aren't scoring at or near the national average prior to starting studying, your knowledge base is too weak to rely mainly (90% focus) on FA.

But why handicap yourself like that? If you can get a 240 with just FA... why not use the right resources and get a 260??

Because you only have 5-6 weeks of prep time... I could probably master (memorize/understand) First Aid in 5-6 weeks, but would only be able to casually read 10 review books (with little memorization) in the same period of time... So where does one draw the line between spreading them self too thin by having more sources than can be mastered and mastering too few sources to cover a broad enough base of knowledge?

 

[UditNarayan]

I disagree. It depends on the person. I have no doubt most of the 260 scorers here could have easily busted 240 with just FA. Most of them scored at or above the national average before starting studying.

I hit 247 on an nbme 4 weeks in mainly studying FA (probably spent about 70% of my studying during the first 4 weeks with FA) plus a few other resources (mainly I lightly read through Rapid Review from cover to cover, for example, plus referenced microbes made easy. former i might argue overwhelms you with details while the latter i'm not sure how high yield it was during board review). At that point I had only gone through FA once and estimate I knew only about 65% of it hardcore. I don't think I ever knew more than about 80% of FA cold when all was said and done.

I don't know that my score at 4 weeks in would have been all that much lower if I had allocated all of my time instead to knowing FA 95% cold within that time interval. FA is pretty damn high yield. If you know all of FA there are few holes in your game.

That being said, knowing does not equal memorizing. To KNOW FA is to understand the concepts behind the facts.

I would say if you're going for a 240+ and you aren't scoring at or near the national average prior to starting studying, your knowledge base is too weak to rely mainly (90% focus) on FA.

But why handicap yourself like that? If you can get a 240 with just FA... why not use the right resources and get a 260??

Good points GMDMD...I also felt why should I handicap myself with FA? my mock board was a 240 12ish weeks out of the test without having done much board studying during the year (in fact I had done none until a couple months before classes ended, where I started to lightly follow along with Goljan and FA for my path/pharm class). If you have a good knowledge base, you don't need to waste your energy trying to decipher some of the FA sections - instead, I spent my time trying to hammer down Goljan RR and the other sources that helped me to sharpen my knowledge. If I had instead spent this time with FA, I would not have gotten as much out of it, just because I felt that there wasn't all that much that could help me in FA. FA pharm, microbio, and biochem I thought were pretty good and I even read thru those sections twice by the test, but there were entire parts of the book that I basically skimmed/lightly read through.

So all in all, don't sweat it if you don't think it's not for you. I felt ok with my knowledge base from med school and decided to stick with the same study style I used while in med school: I studied the way I thought would help me, not because it has been shown to work for others. Was I scared before the test? Hell yea! I hadnt memorized FA (which others said was going to kill me) but in the end, it turned out well (266/99). Good luck, and stay true to what has worked for you...

 

[GMDMD]

[/b]

Because you only have 5-6 weeks of prep time... I could probably master (memorize/understand) First Aid in 5-6 weeks, but would only be able to casually read 10 review books (with little memorization) in the same period of time... So where does one draw the line between spreading them self too thin by having more sources than can be mastered and mastering too few sources to cover a broad enough base of knowledge?

My advice would be to use FA as a reference framework for "**** you ought to know". Go through FA, memorize the minutiae that has long faded away (germ cell tumors, breast cancers, etc) and when you run across stuff you don't understand that well, look it up in the appropriate supplementary text. Spend time in FA so you know what to focus on. If you find yourself in another text going into too much depth about a particular topic that FA covers in 1 sentence, maybe back off a little.

I think many people on this forum would agree: Know FA, BRS Phys and BRS Path (or Rapid Review) damn well and you can rule the world. KNOW 80% of that material cold and supplement with 1000 UWorld questions and you are good for a 250. Throw in some goljan audio during your drives/workouts and maybe you'll hit 260

 

[JeffLebowski]

My advice would be to use FA as a reference framework for "**** you ought to know". Go through FA, memorize the minutiae that has long faded away (germ cell tumors, breast cancers, etc) and when you run across stuff you don't understand that well, look it up in the appropriate supplementary text. Spend time in FA so you know what to focus on. If you find yourself in another text going into too much depth about a particular topic that FA covers in 1 sentence, maybe back off a little.

I think many people on this forum would agree: Know FA, BRS Phys and BRS Path (or Rapid Review) damn well and you can rule the world. KNOW 80% of that material cold and supplement with 1000 UWorld questions and you are good for a 250. Throw in some goljan audio during your drives/workouts and maybe you'll hit 260

I agree. I mean I think each person should tweak this based on their strengths/weeknesses (a few HY books, more questions, NBME's, etc.), but this is a good way to put a solid study plan into 1 sentence.

 

[peter90036]

if you learn through understanding, then FA is not so good of a choice. ...looking at FA would be like staring at words on a page

yes. FA was useless for 2CK and i'm not too keen on FA for step 1 at this point, ain't feeling much help from it unless you stare at it and memorize the words.

 

[phase12007]

If you use it as a secondary book after going over the material as you go along, FA becomes easier to read. Once you understand major concepts, FA becomes easier to understand, therefore easier to read, and summarizes all the facts needed to be reinforced.

The step up authors believe this can do the same, perhaps you may want to look into this book, if you do not like FA.

 

[jey2283]

Is it really true that everything we need to know is in first aid? I keep hearing this over and over again from 3rd and 4th years, but am not sure if I buy into it. For example, if a drug side effect is not in first aid, should we not know it? or if a drug is not in there, but we learned it during classes, does that mean it's not likely to be on the boards?

There are also some bacteria we learned in class that aren't listed in first aid as well. i know we are supposed to go through and annotate first aid with the topics already listed, but what about adding new topics?

Minus the errors..everything is in there...but i'd add goljan's book to sit pretty.

 

[fatsal]

I've read First Aid 4 times and I didn't do well on the USMLEworld. First Aid teaches you buzz words but it doesn't teach mechanisms. And often times, questions will describe the buzz word but won't use the buzz word itself. For example, First Aid teaches you that clue cells are associated with G. vaginalis. However, a question testing G. Vaginalis will not include "clue cells" in the question stem because that's too easy. Instead of the term clue cells, they will describe it as epithelial cells with bacteria. Or they will say that EBV is associated with the Monospot test but they won't describe the Monospot test and a test question will not have the words "Monospot test" in the question and will instead describe the test.

 

[jey2283]

I've read First Aid 4 times and I didn't do well on the USMLEworld. First Aid teaches you buzz words but it doesn't teach mechanisms. And often times, questions will describe the buzz word but won't use the buzz word itself. For example, First Aid teaches you that clue cells are associated with G. vaginalis. However, a question testing G. Vaginalis will not include "clue cells" in the question stem because that's too easy. Instead of the term clue cells, they will describe it as epithelial cells with bacteria. Sure, this is not a great example and you could still figure this out but hopefully you understand what I'm trying to say. First Aid leaves out information in regards to mechanisms and there is practically no physiology in the book.

The argument could be made that 2 years of medical school doesn't give you a great score on UW. I took Step1, UW is MUCH harder (IN EVERYWAY).

 

[fatsal]

The argument could be made that 2 years of medical school doesn't give you a great score on UW. I took Step1, UW is MUCH harder (IN EVERYWAY).

These types of questions were not just on USMLEWorld. I have seen these in QBank, NMS and the NBME questions.

 

[UditNarayan]

anecdote: my friend (a 3rd yr on her internal med rotation) asked me (who has not been through any of my clinical rotations) a question from the internal medicine shelf practice questions (MKSAP its called). i was pretty surprised to hear the question actually and i answered it right because of studying UWorld (i remembered something about periosteal bone formation and its connection to lung cancer). perhaps the scope of UW is greater than Step 1, but it sure does a nice job teaching you info, because it will definitely stick.

 

[fatsal]

anecdote: my friend (a 3rd yr on her internal med rotation) asked me (who has not been through any of my clinical rotations) a question from the internal medicine shelf practice questions (MKSAP its called). i was pretty surprised to hear the question actually and i answered it right because of studying UWorld (i remembered something about periosteal bone formation and its connection to lung cancer). perhaps the scope of UW is greater than Step 1, but it sure does a nice job teaching you info, because it will definitely stick.

Personally, I've gotten more out of USMLEworld than reading FA 4 times. I learn through understanding so I guess that's why I've gotten more out of it. If you are someone who can memorize something by reading it once and can intuitively apply the information without having seen it done, I think First Aid would be appropriate.

 

[UditNarayan]

Personally, I've gotten more out of USMLEworld than reading FA 4 times. I learn through understanding so I guess that's why I've gotten more out of it. If you are someone who can memorize something by reading it once and can intuitively apply the information without having seen it done, I think First Aid would be appropriate.

well, i consider myself pretty good at applying concepts that have not been drawn out for me, but FA didnt give me enough context to apply some things. it may work for some, but i didnt like it as a review source. sure, just like many high scorers, i spent the last 5 days solely using this source and luckily by that point, i didnt need to rely on FA to "learn" anything else, it was like doing a review with a pretty barebone outline. really dont think it helped me much, but at that time i felt like it at least had to be done. rapid review takes the cake tho for me, i really felt like it clicked for me and did a great job giving mechanistic clarification and pictures/images.

 

[osli]

In the same sense that "everything you need to know for an anatomy practical is on the syllabus checklist" I suppose you can say the same for FA about the USMLE. And just as that structures checklist that you may have had provided to you in anatomy to narrow down the bazillions of structures/nerves/vessels/etc. to just a few hundred or thousand you were responsible for on the exam, so does FA do a pretty good job of narrowing down the bazillions of factoids into a somewhat manageable list that you are responsible for on step 1.

In both cases, no one would suggest that those resources are good for a primary source of learning. They are checklists, useful to both jog your memory and help you keep track of what you have and have not covered. If your primary learning from classes was solid, FA may be a good enough checklist. If your primary learning was not solid, or has faded from memory, you may need a bit more of a jog than FA provides.

 

[hj0517]

You are right osli, revision for step 1 using First aid is meant to be exactly that, revision. For example, being in the UK's equivalent to MS3, I'd completely forgotten about stuff like GTP released in gluconeogenesis is used for PEPCK. First aid and UW helped me trudge up that memory of my biochem professor standing in front of the lecture hall wayyy back in 2004! Distinguishing between 'new learning' and 'revision' I think is key to whether you solely use FA or go into a more comprehensive source.

Enough babbling, back to studying...