Hi. I took step 1 a few years ago. I wanted to give some advice to the 2nd year students. I know about getting adequate sleep the night before and so forth, but I'm interested in strategies for actually approaching and working through the questions. Anyone have any ideas? Thanks!
Read the last line first... what is the question?
Then read the answers. What are they are talking about? What is the purpose? What is the "hinge." Then, as you go back through the vignette (for the first time) you have a better sense of what is relevant. You can tease out the important details.
Slightly counter to the above point is the
no curveballs. Both Step 1 and Step 2 have no curveballs. So, anything they include is relevant and important. Think about it, they dont have infinite space. So, if they take the time to say something is positive, thats huge. If they don't mention it, its usually safe to assume that it is negative. BUT, if they take the time to actually say SOMETHING IS NEGATIVE, thats mega ultra. They don't have 475 lines to say all the things that ARENT there, so if they say something is negative, they want you to realize that it is NOT one of the potential diagnosis you considered.
Finally,
hinge. To do well on the test you must realize that each question has a hinge. Reading the vignette gets you oriented. You have to know what the diagnosis is, what biochemical pathway, what type of organism it is before you can even begin to answer the question. After all, if you haven't identified the bug as gram negative, how can you answer a question about LPS, Cell Wall Inhibitors, Antibiotic Choice, or Gram Stain appearence? So the vignette tells you "probably gram negative rod" then the hinge pushes you to one of the basic science principles. This is the reason for number 1... hone yourself in on what the vignette is going to be about.
