- Joined
- Dec 28, 2010
- Messages
- 4,955
- Reaction score
- 5,988
The purpose of this thread is to reduce repeat threads on SDN.
The target audience is starting M2s in a traditional curriculum (and now starting M1s!).
I wrote an abbreviated version of this in the Step 1 Scores thread.
------------------------------------------------------------------------------------------------------------
DISCLAIMER: I make a lot of major decisions based on my opinions, biases, and circumstantial evidence. I try to explain myself and some of the longer explanations are given separately after the guide.
-------------------------------------------------------------------------------------------------------------
Guide for Starting Step 1 Prep during Thansgiving of M2 or that Holiday Break + See Post 35 for [New] 2018 update that allows you to start Step 1 Prep in Year 1!
1. Your School's Curriculum:
Don't start with UFAP. Commit to your curriculum and do your best on class exams. It will teach you to think, as opposed to memorize HY information. The only tool you should consider as equal to your curriculum is UWorld.
2. Pathoma:
When Pathology starts, start Pathoma by using it as a primer (see exp. 1) and then watch class lectures. No need to make ANKI flashcards or memorize anything from it. Just listen and understand. During dedicated, review sections you need to see again. I recommend the Intro chapters, Heme/Onc, GI, Reproductive, and Dermatology. These are the subjects where there's lots of straight pathology. He does a great job with other sections, but they're not comprehensive.
3. UWorld:
I would wait until Winter break to start and use UWorld as your primary bank (see exp.2). Go in Organ System/Tutor Mode. The order doesn't matter, but coordinating with your curriculum is ideal. Complete 40 q/day during this time period. Once school starts up, complete 20q/day if you start dedicated in May. If your school starts dedicated anywhere earlier than April, consider starting UWorld earlier. If your curriculum beats you to the next unit, use that to your advantage and create mixed blocks with all previously learnt organ systems. This encourages spatial repetition. You should be finished by UWorld by dedicated, but don't panic if you're not. During dedicated, redo UWorld in random/timed mode and calculate your pace needed, but I feel 80q/day is ideal. If you realize you won't finish, prioritize the Pathology (vs. Physiology, Pharmacology, etc.) content because these I felt were the toughest. Many say to prioritize incorrects but I felt I knew the incorrects very well, but make your own call there. Aim to finish one week prior to your exam.
Lastly and most importantly is that UWorld is a teacher, not an assessment. It will teach you everything you need to know about Step 1. Focus on doing it at your own pace and understanding from it. If someone organized it in the form of a textbook, it'd be a lot of information. Never let it scare you. Also, never think that you need more time reading review books (BRS, Clinical Micro Made..., etc.) before you hit UW.
4.) First Aid:
During your first pass, keep USMLE First AID next to you on a book stand (https://tinyurl.com/y6vbhqxk) and write a max of 1 abbreviated sentence (approx. 5-6 words) per question while still reading each answer and explanation of Uworld carefully (see explanation 3). I believe tackling First Aid should start during dedicated after you've annotated UWorld into it once (see explanation 4). During your last 4 weeks now that your brain is in cram mode, watch a lecture series. It should carry more meaning now and try to remember back to questions you did in UWorld. I personally recommend a video series to make it easier. First AID RX vs. DIT vs. Beyond the Boards (something new I don't know too much about) are your options as they follow First Aid well. Then the week before the exam, you can just straight up focus on reading FA. If you believe in ANKI, there's Brosephelon's deck and there's a new one called Zanki which I've read is more comprehensive, but has its own quirks.
--------------------------------------------------------------------------------------------------
Explanations:
1. Pathoma gives a general CONCEPTUAL overview, Sattar provides great ways of thinking about things, but the source lacks comprehensiveness as a whole. Start with it to get an understanding of what's important in your head so you can focus on collecting other facts during lectures. I honestly believe that if you stream it with classes and only refer to it as needed during dedicated, it's fine. No need to go hardcore and memorize every sentence of it. It's there more to promote a conceptual framework or level of understanding all of us liked so much in undergrad classes.
2. RX is pretty much the same stuff as Uworld but made in a laughably basic way that correlates with First Aid, but requires minimal board thinking that Uworld or the real test requires. Many use it for the sake of tradition and because they think the more questions the better, but I frankly think Uworldx2 is all the questions you need. Your study time is important! Get right to the meat! There's never a point you'll feel ready, just jump right in.
3. I initially felt editing FA is a waste of time because of the constant page flipping and searching but I think if you commit to it, it'll get faster (mark chapters with stickynotes). You should also to read peripheral tid-bits here and there (for example, if you get a hypoglycemic baby with LDH, helatomegaly, you may want to read about all the Glycogen Storage diseases instead of just Von Gierke. Many opt to take First Aid to Kinkos and put it in a binder so they can stick pages between, but I think once you start doing that your creating a work of art rather than studying for Step 1. (A large theme for me about Step in general was the more unorganized I felt, the more efficient I was).
4.) Why hold READING First Aid (obviously still reference it) until dedicated? The idea is that First Aid is a memory jogger. The book basically a list of condensed notes from Uworld, shelf exams, and possibly leaked real exam questions and shelf exam questions written in the form of tables/memory devices. The point of it is to look at and be like...oh yeah, I remember that from a Uworld question or a lecture from class...oh and to be complete, what was the male analogue of this structure... *flip a page*...oh yeah, now I get it! I see it as a course pack for the summer that you memorize in the time after you spend doing Uworld. Also, for circumstantial evidence, all my friends who did better than me did Uworld during class, had 240+ on their first diagnostic NBME before dedicated without touching FA, proceeeded to drill first aid over the dedicated period, and then killed Step 1. To me, this just feels like the right way.
----------------------------------------------------------------------------------------------------------------
Other sources:
USMLE Step 1 Secrets: A cute little book with great explanations. I see it as Uworld explanations without the MCQs. It's a great pre-read before lecture but not required.
Robbins: A great comprehensive source but I believe too much to handle on top of classes.
Goljian: A very popular Pathology source pre-Pathoma (it is more comprehensive compared to Pathoma but it's full of very low yield details). Also, it's hard to read and there's no one there to talk you through significantly lowering the chance you'll get thru it.
Lange Flash Cards for Pharm/Pathology: Don't waste your time. A lot of the stuff they bold is non-specific and applies to lots of drugs/pathologies and it gets confusing.
HY Books: Don't waste your time. If you're going thru your course packs of your curriculum, you will learn more than what's in these books.
-------------------------------------------------------------------------------------------
Common Worries/FAQs:
1.) OMG, I don't remember Anatomy/Biochem/Neuroanatomy/Embryo and haven't covered it in ages...Do I need review book?
No. Trust UWorld and your curriculum to repeat the most highly tested concepts in these areas repeatedly. There are like 8 things (exaggerating) UWorld tests in anatomy and they are basic things like the Peroneal nerve, Gluteus Medius Innervation, Abdominal Blood Supply, Cranial Blood Supply, Brachial Plexus, and Reflexes/Dermatomes/etc. You'll see them come up on Uworld over and over. As for the real exam, yes there may very well be 1-2 extremely low yield anatomy Qs on it but that's where you rely on recalling small details from your school's curriculum, not reading an entire review book passively.
2.) Everyone says the exam is a lot harder now. I need to do something extra.
No, this is a lot like the MCAT where everyone post exam was like OMG, the real exam was harder than AAMC 11 and that exam was hard as ****, remember the Ebola passage MD C/O 2018? The real exam is a mix of Uworld style questions, NBME style questions, and a bunch of stuff from left field.
3.) My class work is too overwhelming and I can't study for Step at the same time.
I already said this but this bears repeating...focus on the classwork then and try to get as many Uworld questions done on the side. If you do this schedule right, you shouldn't have trouble knocking out 20Q a day. If you can't afford to take your eyes of the school course pack you are doing something wrong there and need to take more breaks or get thru the school material faster. While spending 12-16 hours a day on just the course pack is not as bad as only using Pathoma and FA, it'll hurt you in that you won't be doing Uworld.
4. First Aid/Pathoma/Uworld is boring, nothing is sticking and nothing stands out to me anymore.
You're burnt out. Take a break and come back to it tomorrow. If you want, use a video series to help you with FA.
5. I don't feel ready for questions just yet, I want to do something that comprehensively covers the material or else I'll just be wasting questions and time.
You just have to start Uworld somewhere and my advice is to jump right in at Winter break. Uworld can either be a scary assessment and cramming tool under the constraint of 5-6 weeks or it can be a spatial learning source, textbook, and formative feedback tool that you use throughout M2. I don't know about you but I prefer the latter option. As for the notion of not being ready for questions yet, everyone thinks like this but it's a bad mentality because you aren't going to have time to read a chapter of a review book and do classwork on top of it. There's only enough time to do Uworld and it's structured. You'll know you accomplished your goal for that day if you finished 20 questions. It's ok to start with consistent low scores. I started with 40s-50s and worked my way up to 60s-70s after a few weeks and then even days before my exam I was still somewhere in the 70-80s even after seeing the questions once before.
6. Everyone on SDN is emphasizing FA, UWorld, Sketchy, Pathoma, Goljian, etc. and to skip school resources and they're posting 270s on SDN. I know plenty of these people in person and on SDN and they're all annoying and loud on this forum and are probably still regulars on the USMLE Step 1 experience thread despite taking it 2+ years ago. They probably also killed the MCAT and are naturally gifted at taking MC exams and are using that as a platform to endorse this "UFAP-is-life, 270-is-goalzzz" religion. This guide is more or less meant for typical medical student who wants to live a more or less normal medical student life and still score above average by good margin. I would say if you take this advice, you should set yourself up for at least a 240 (which sounds bad, but it will get you into almost every specialty).
The target audience is starting M2s in a traditional curriculum (and now starting M1s!).
I wrote an abbreviated version of this in the Step 1 Scores thread.
------------------------------------------------------------------------------------------------------------
DISCLAIMER: I make a lot of major decisions based on my opinions, biases, and circumstantial evidence. I try to explain myself and some of the longer explanations are given separately after the guide.
-------------------------------------------------------------------------------------------------------------
Guide for Starting Step 1 Prep during Thansgiving of M2 or that Holiday Break + See Post 35 for [New] 2018 update that allows you to start Step 1 Prep in Year 1!
1. Your School's Curriculum:
Don't start with UFAP. Commit to your curriculum and do your best on class exams. It will teach you to think, as opposed to memorize HY information. The only tool you should consider as equal to your curriculum is UWorld.
2. Pathoma:
When Pathology starts, start Pathoma by using it as a primer (see exp. 1) and then watch class lectures. No need to make ANKI flashcards or memorize anything from it. Just listen and understand. During dedicated, review sections you need to see again. I recommend the Intro chapters, Heme/Onc, GI, Reproductive, and Dermatology. These are the subjects where there's lots of straight pathology. He does a great job with other sections, but they're not comprehensive.
3. UWorld:
I would wait until Winter break to start and use UWorld as your primary bank (see exp.2). Go in Organ System/Tutor Mode. The order doesn't matter, but coordinating with your curriculum is ideal. Complete 40 q/day during this time period. Once school starts up, complete 20q/day if you start dedicated in May. If your school starts dedicated anywhere earlier than April, consider starting UWorld earlier. If your curriculum beats you to the next unit, use that to your advantage and create mixed blocks with all previously learnt organ systems. This encourages spatial repetition. You should be finished by UWorld by dedicated, but don't panic if you're not. During dedicated, redo UWorld in random/timed mode and calculate your pace needed, but I feel 80q/day is ideal. If you realize you won't finish, prioritize the Pathology (vs. Physiology, Pharmacology, etc.) content because these I felt were the toughest. Many say to prioritize incorrects but I felt I knew the incorrects very well, but make your own call there. Aim to finish one week prior to your exam.
Lastly and most importantly is that UWorld is a teacher, not an assessment. It will teach you everything you need to know about Step 1. Focus on doing it at your own pace and understanding from it. If someone organized it in the form of a textbook, it'd be a lot of information. Never let it scare you. Also, never think that you need more time reading review books (BRS, Clinical Micro Made..., etc.) before you hit UW.
4.) First Aid:
During your first pass, keep USMLE First AID next to you on a book stand (https://tinyurl.com/y6vbhqxk) and write a max of 1 abbreviated sentence (approx. 5-6 words) per question while still reading each answer and explanation of Uworld carefully (see explanation 3). I believe tackling First Aid should start during dedicated after you've annotated UWorld into it once (see explanation 4). During your last 4 weeks now that your brain is in cram mode, watch a lecture series. It should carry more meaning now and try to remember back to questions you did in UWorld. I personally recommend a video series to make it easier. First AID RX vs. DIT vs. Beyond the Boards (something new I don't know too much about) are your options as they follow First Aid well. Then the week before the exam, you can just straight up focus on reading FA. If you believe in ANKI, there's Brosephelon's deck and there's a new one called Zanki which I've read is more comprehensive, but has its own quirks.
--------------------------------------------------------------------------------------------------
Explanations:
1. Pathoma gives a general CONCEPTUAL overview, Sattar provides great ways of thinking about things, but the source lacks comprehensiveness as a whole. Start with it to get an understanding of what's important in your head so you can focus on collecting other facts during lectures. I honestly believe that if you stream it with classes and only refer to it as needed during dedicated, it's fine. No need to go hardcore and memorize every sentence of it. It's there more to promote a conceptual framework or level of understanding all of us liked so much in undergrad classes.
2. RX is pretty much the same stuff as Uworld but made in a laughably basic way that correlates with First Aid, but requires minimal board thinking that Uworld or the real test requires. Many use it for the sake of tradition and because they think the more questions the better, but I frankly think Uworldx2 is all the questions you need. Your study time is important! Get right to the meat! There's never a point you'll feel ready, just jump right in.
3. I initially felt editing FA is a waste of time because of the constant page flipping and searching but I think if you commit to it, it'll get faster (mark chapters with stickynotes). You should also to read peripheral tid-bits here and there (for example, if you get a hypoglycemic baby with LDH, helatomegaly, you may want to read about all the Glycogen Storage diseases instead of just Von Gierke. Many opt to take First Aid to Kinkos and put it in a binder so they can stick pages between, but I think once you start doing that your creating a work of art rather than studying for Step 1. (A large theme for me about Step in general was the more unorganized I felt, the more efficient I was).
4.) Why hold READING First Aid (obviously still reference it) until dedicated? The idea is that First Aid is a memory jogger. The book basically a list of condensed notes from Uworld, shelf exams, and possibly leaked real exam questions and shelf exam questions written in the form of tables/memory devices. The point of it is to look at and be like...oh yeah, I remember that from a Uworld question or a lecture from class...oh and to be complete, what was the male analogue of this structure... *flip a page*...oh yeah, now I get it! I see it as a course pack for the summer that you memorize in the time after you spend doing Uworld. Also, for circumstantial evidence, all my friends who did better than me did Uworld during class, had 240+ on their first diagnostic NBME before dedicated without touching FA, proceeeded to drill first aid over the dedicated period, and then killed Step 1. To me, this just feels like the right way.
----------------------------------------------------------------------------------------------------------------
Other sources:
USMLE Step 1 Secrets: A cute little book with great explanations. I see it as Uworld explanations without the MCQs. It's a great pre-read before lecture but not required.
Robbins: A great comprehensive source but I believe too much to handle on top of classes.
Goljian: A very popular Pathology source pre-Pathoma (it is more comprehensive compared to Pathoma but it's full of very low yield details). Also, it's hard to read and there's no one there to talk you through significantly lowering the chance you'll get thru it.
Lange Flash Cards for Pharm/Pathology: Don't waste your time. A lot of the stuff they bold is non-specific and applies to lots of drugs/pathologies and it gets confusing.
HY Books: Don't waste your time. If you're going thru your course packs of your curriculum, you will learn more than what's in these books.
-------------------------------------------------------------------------------------------
Common Worries/FAQs:
1.) OMG, I don't remember Anatomy/Biochem/Neuroanatomy/Embryo and haven't covered it in ages...Do I need review book?
No. Trust UWorld and your curriculum to repeat the most highly tested concepts in these areas repeatedly. There are like 8 things (exaggerating) UWorld tests in anatomy and they are basic things like the Peroneal nerve, Gluteus Medius Innervation, Abdominal Blood Supply, Cranial Blood Supply, Brachial Plexus, and Reflexes/Dermatomes/etc. You'll see them come up on Uworld over and over. As for the real exam, yes there may very well be 1-2 extremely low yield anatomy Qs on it but that's where you rely on recalling small details from your school's curriculum, not reading an entire review book passively.
2.) Everyone says the exam is a lot harder now. I need to do something extra.
No, this is a lot like the MCAT where everyone post exam was like OMG, the real exam was harder than AAMC 11 and that exam was hard as ****, remember the Ebola passage MD C/O 2018? The real exam is a mix of Uworld style questions, NBME style questions, and a bunch of stuff from left field.
3.) My class work is too overwhelming and I can't study for Step at the same time.
I already said this but this bears repeating...focus on the classwork then and try to get as many Uworld questions done on the side. If you do this schedule right, you shouldn't have trouble knocking out 20Q a day. If you can't afford to take your eyes of the school course pack you are doing something wrong there and need to take more breaks or get thru the school material faster. While spending 12-16 hours a day on just the course pack is not as bad as only using Pathoma and FA, it'll hurt you in that you won't be doing Uworld.
4. First Aid/Pathoma/Uworld is boring, nothing is sticking and nothing stands out to me anymore.
You're burnt out. Take a break and come back to it tomorrow. If you want, use a video series to help you with FA.
5. I don't feel ready for questions just yet, I want to do something that comprehensively covers the material or else I'll just be wasting questions and time.
You just have to start Uworld somewhere and my advice is to jump right in at Winter break. Uworld can either be a scary assessment and cramming tool under the constraint of 5-6 weeks or it can be a spatial learning source, textbook, and formative feedback tool that you use throughout M2. I don't know about you but I prefer the latter option. As for the notion of not being ready for questions yet, everyone thinks like this but it's a bad mentality because you aren't going to have time to read a chapter of a review book and do classwork on top of it. There's only enough time to do Uworld and it's structured. You'll know you accomplished your goal for that day if you finished 20 questions. It's ok to start with consistent low scores. I started with 40s-50s and worked my way up to 60s-70s after a few weeks and then even days before my exam I was still somewhere in the 70-80s even after seeing the questions once before.
6. Everyone on SDN is emphasizing FA, UWorld, Sketchy, Pathoma, Goljian, etc. and to skip school resources and they're posting 270s on SDN. I know plenty of these people in person and on SDN and they're all annoying and loud on this forum and are probably still regulars on the USMLE Step 1 experience thread despite taking it 2+ years ago. They probably also killed the MCAT and are naturally gifted at taking MC exams and are using that as a platform to endorse this "UFAP-is-life, 270-is-goalzzz" religion. This guide is more or less meant for typical medical student who wants to live a more or less normal medical student life and still score above average by good margin. I would say if you take this advice, you should set yourself up for at least a 240 (which sounds bad, but it will get you into almost every specialty).
Last edited: