Biggest Mistake Studying for Step 1

[Kluver_Bucy]

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Hello,

I'm just starting to study for Step 1. My exam is on July 2nd. Could some of the people that have taken the exam, or are currently studying for step 1 post some common mistakes people make studying for this exam.

I currently have a B- GPA, so please be kind with advice.

 

[bigfrank]

I wasted time memorizing ALL of the HLA associations associated with autoimmune diseases/phenomena and ALL of the translocations associated with malignancies and got ZERO questions over any of it.

 

[bustbones26]

Studying too much. I tend to want to know everything about everything and in the process of studying, you discover that it is impossible to do so. Thus you can't ever study enough. So focus, study on heavy board hits, things that have classicaly appeared in the past and know that stuff cold!! Also, don't rely on first aid, it is a focused text, but it does not include everything!

 

[neilc]

too many books and resources. it is far better to know everything that is covered in the major review books (ie first aid and boards and wards) vs knowing a little bit out of a bunch of large texts.

find a single solid review book. learn it perfectly. then, move on to more detailed books if you have the time and need the review in a weak subject.

do practice questions, as many as you can.

practice questions and a solid review book! keep it simple

 

[klubguts]

I agree with nelic. If you start supplementing your primary source with too many texts, you can get bogged down, frustrated, and may have difficulty retaining the core information (from FA or whatever you use these days). I found doing questions to be very helpful. Studying too long can be a major problem...serious burnout and apathy tend to set in (it took about 2 1/2 weeks for this to happen to me) relatively quickly. When you are taking the test, try to relax and go with your instincts...Good luck to y'all.

 

[Chandler]

I wasted time memorizing ALL of the HLA associations associated with autoimmune diseases/phenomena and ALL of the translocations associated with malignancies and got ZERO questions over any of it.

BigFrank, I wish you would have mentioned this earlier. I have already stored and wasted precious time with these meaningless associations in my longterm memory via flashcards, and I can't get rid of them. 🙁

CML = 9,22
AML (M3) = 15,17 (trans-retinoic acid)
Burkitt's = 8, 14
Mantle Cell = 11,14
Follicular Lymphoma = 14,18
Ewing Sarcoma = 11,22

 

[automaton]

dude aren't you a first year chandler?

anyway, i would say know the basics inside and out. know everything about them. for the most common stuff you need to know everything because these questions will be multi-layered. otherwise they would be too easy. focus on these before you invest time with the more obscure bugs. that's just my advice after NBME so take it with a huge grain of salt.

eponyms are not as important as BRS or QBank make it seem. think like a clinician seeing a patient because that's how stuff will be presented to you. when you look on a scope you're not going to see something labeled as "orphan annie nuclei" on the slide. you will see it and describe what it looks like. when a patient comes in he's not going to say "doc i have waterhouse-friedrichsen, what can you do about my hyperpigmentation", he's going to tell you a relevant history (neisseria infection) with some symptoms that might suggest hemorrhagic necrosis of the adrenals (darkened area over the skin, feeling tired, etc). again this is just my impression after NBME.

 

[automaton]

wow that score rocks. sorry about the misunderstanding, i was wondering how a first year knew so much.

 

[Chandler]

wow that score rocks. sorry about the misunderstanding, i was wondering how a first year knew so much.

I wouldn't put too much stock in it because I took Idiopathic's advice and took the exam in slow mode so I could think about each question (I tried to think like the testwriter as Goljan mentioned, I tried to think of alternative questions with the same question stem, or think of possible questions for each answer choice without having to worry about the time constraints. The NBME exam measures more application, analyzing data (via tables, charts, up arrow, down arrow, etc), and reasoning than I thought. This surprised me as I thought it would be more of a recall exam of isolated facts. From this experience, if I had to guess, memorizing first aid will not be enough if your goal is above national mean. You have to be able to APPLY and use REASONING to connect the facts given in First Aid. But, what do I know? I haven't taken the USMLE Exam yet. Once I do take the exam, I will post a very thorough Step 1 experience for all of SDN to read.

 

[carrigallen]

I disagree. Certain chromosomal translocations are important. It only takes a few minutes to learn them.

It is important to understand the mechanism of the translocation - ie Mantle cell lymphoma is 11:14 - this replaces the IgH on 14 with cyclin D1 from 11, hence disinhibition of the G1 - S transition.
The same goes for bcr-abl 9:22, c-myc 8:14, etc. This is classic pathophysiology. A question involving this material also has the advantage of being multidisciplinary: it includes elements of genetics, immunology, pathology, hematology.

Remember to take the posts on this board with a grain of salt...especially where certain posters are concerned.
****
Chandler, I looked up some info: Capsaicin depletes and prevents reaccumulation of substance P in peripheral sensory neurons. (drug monograph) Interestingly, capsaicin also comes from hot peppers.
The TNF question seems crazy, considering it does so many things:

Biological activities attributed to TNFalpha include induction of pro-inflammatory cytokines such as interleukin (IL)-1 and IL-6; enhancement of leukocyte migration by increasing endothelial layer permeability; expression of adhesion molecules by endothelial cells and leukocytes; activation of neutrophil and eosinophil functional activity; fibroblast proliferation; synthesis of prostaglandins; and induction of acute phase and other liver proteins. (infliximab, drug monograph)

 

[bigfrank]

Actually, this is not "classic pathophysiology," but study it if you want. But it won't pay off. 😉

 

[Samoa]

Interestingly, they give you a corresponding Step 1 scale after you take the exam.

370 is equivalent to 184
>800 is equivalent to 265+

Thanks for posting that. I took Form 1 as a way to figure out what to study, not predict my score. So I never even bothered to scroll down and see what was at the bottom of the score report. The thing about these tests is that their assessment of my strengths is based entirely on what specific questions they ask. And on this exam, I got easy questions in all my weak areas, and hard questions in all my strong areas. So the assessment says my strengths are exactly the opposite of what I know to be true.

Just as commentary, that test pissed me off, because there were at least a couple of questions where they'd give you risk factors pointing toward one disease process, and a clinical course typical of a different etiology. I wasn't sure whether to go with the risk factors or the clinical course. In real life, either answer would be about equally probable. I went with the clinical course, but we don't get the answers, so I still don't know how to solve a problem like that if I see something similar on the real test. 😡

 

[phoenixsupra]

Biggest mistake

People talk a lot about how much study you can do before becomming totally fried. Well, do almost that much, then take a week off. You'll find that if you do that, you can actually do a whole lot more. 😉

 

[north2southOMFS]

I personally wish the USMLE exam was a 2 day affair like it used to be. .

Your CRAZY!!!!!

 

[phoenixsupra]

Your CRAZY!!!!!

Totally, I mean 2 days isn't nearly enough, is it?

 

[carrigallen]

They should offer a 350 question standard exam, and then instead an optional 700 question, 13 hour exam for people who want to prove their stamina and abilities. The question bank would be the same though.

 

[phoenixsupra]

They should offer a 350 question standard exam, and then instead an optional 700 question, 13 hour exam for people who want to prove their stamina and abilities. The question bank would be the same though.

Ok, but there should be an hour in the middle where we do pressups and jumping jacks, just to weed out the reall slack-asses. I think that'd be ok.

 

[quant]

too many books and resources. it is far better to know everything that is covered in the major review books (ie first aid and boards and wards) vs knowing a little bit out of a bunch of large texts.

find a single solid review book. learn it perfectly. then, move on to more detailed books if you have the time and need the review in a weak subject.

do practice questions, as many as you can.

practice questions and a solid review book! keep it simple

The KISS principle.....(Keep it simple, stupid!)

Never fails!!

Perfectly sane advice with which id agree 100%..............

 

[Pox in a box]

Your CRAZY!!!!!

I think it should be a week long exam in a hyperbaric chamber completely oral with only 2 restroom breaks per day. If you miss a question, you would be shocked.

 

[Samoa]

I think it should be a week long exam in a hyperbaric chamber completely oral with only 2 restroom breaks per day. If you miss a question, you would be shocked.

Ah, but then our professors would test us that way the entire first two years. And by the time step 1 rolled around, everyone would either have all the info burned into their brain (maybe literally) or else would have dropped out of med school entirely.

 

[north2southOMFS]

Ah, but then our professors would test us that way the entire first two years. And by the time step 1 rolled around, everyone would either have all the info burned into their brain (maybe literally) or else would have dropped out of med school entirely.

Yah but think...with all that hyperbaric oxygen you got....what great vacularization you would have by then.

 

[IlianaSedai]

Trying to read too many books! You have 4 (5, 6, whatever) weeks. What makes you dumb enough to think you can really read BRS Physiology in 3 days and BRS Pathology in 4 days? That's what my schedule said, but that's not what panned out!

If I were to do it again, I'd stick to:
1. First Aid
2. BRS Physiology
3. BRS Pathology

and then, spend a couple of days or evenings going through no more than ONE additional book that would be high yield for you. For example, I did High Yield Neuroanatomy because I felt I really needed the neuro review.

 

[phoenixsupra]

Trying to read too many books! You have 4 (5, 6, whatever) weeks. What makes you dumb enough to think you can really read BRS Physiology in 3 days and BRS Pathology in 4 days? That's what my schedule said, but that's not what panned out!

If I were to do it again, I'd stick to:
1. First Aid
2. BRS Physiology
3. BRS Pathology

and then, spend a couple of days or evenings going through no more than ONE additional book that would be high yield for you. For example, I did High Yield Neuroanatomy because I felt I really needed the neuro review.

This and start doing timed questions from the start and you'd have a better program than most.

But remember, that anyone who actually buys that "four weeks" crap is in the second league from the get go. 😉

 

[Pinesinger]

I took Step One last Wednesday, and I was shocked at how many analysis questions were on there. I had more graph-based questions then I had on any practice test, or any test given in school itself. If I had to do it again I would spend a lot more time on things like the stupid Lineweaver-Burk graph, etc. I had been told that enzyme kinetic type questions would be fairly straightforward. They weren't.

 

[peach4me]

Can you give us an insight on how it differs from traditional questions?

I took Step One last Wednesday, and I was shocked at how many analysis questions were on there. I had more graph-based questions then I had on any practice test, or any test given in school itself. If I had to do it again I would spend a lot more time on things like the stupid Lineweaver-Burk graph, etc. I had been told that enzyme kinetic type questions would be fairly straightforward. They weren't.

 

[Kluver_Bucy]

I feel overwhelmed with the amount of material. I am scared to death. Does anyone have any more advice or biggest mistakes that people can avoid?

 

[bigfrank]

This and start doing timed questions from the start and you'd have a better program than most.

But remember, that anyone who actually buys that "four weeks" crap is in the second league from the get go. 😉

this is good advice.

 

[Stinger86]

The biggest mistake I made was spending too much time studying Behavioral Science and Microbiology and not enough time studying Pharmacology

 

[SuitsYou]

Too many textbooks (stupid, i know), too much gross anatomy, not enough renal (my worst area) and should of refined my pharm study to a smaller book.

 

[Kluver_Bucy]

not enough time studying Pharmacology

Stinger, do you mean pharacokinetics/pharmacokinetics content, side effects/drug interactions, or recalling drugs from class?

 

[Stinger86]

Stinger, do you mean pharacokinetics/pharmacokinetics content, side effects/drug interactions, or recalling drugs from class?

Well, just pharmacology in general. My study schedule allowed for 3 days to study pharm, 2 days to study Behavioral, and 3 days to study Microbio. If I were to do it over again and rethink my schedule, I would've spent 1 day on Behavioral, 2 days on Micro, and 4-5 days to study pharm. That may have given me an extra day of break as well.

Most of the questions dealt with MOA, side effects/contraindications, usages (if they were classic), but of course there were several (though a relative minority) that dealt with conceptual stuff and things like cell signalling, so it wouldn't have hurt to spend a little more time with the subject.

Pharmacokinetics was not tested on my exam, but pharmacodynamic stuff was fair game.

 

[caribsun]

what's MOA? thanks

 

[RLMD]

what's MOA? thanks

MOA = mechanism of action

 

[GiJoe]

i'll throw in my 2 cents...


dont open a textbook, its a waste of time...reading out of big robbins is stupid.

dont study for more than 6 weeks otherwise you'll burn out

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

and dont forget to have a life.

 

[Martin25]

Hello,

I'm just starting to study for Step 1. My exam is on July 2nd. Could some of the people that have taken the exam, or are currently studying for step 1 post some common mistakes people make studying for this exam.

I currently have a B- GPA, so please be kind with advice.

I think one of the most important things a person should do to prepare for this exam is to leave at least 5 days at the end of studying to do questions. Q bank I feel is the best resource for this. It gets your mind in the test taking mode and is an excellent way to pinpoint weaknesses last minute and review the material you are subjects you are consistently weak in. AND TAKE THE TIME TO READ THE ANSWERS TO THE QUESTIONS, THE ONES YOU GET RIGHT AS WELL AS THE ONES YOU GET WRONG!!!!

Also with Q bank:
- do questions in 50 Q blocks (as long as you are nearing the end of studying). This doing one question here and five questions there I don't think is that helpful
- try to do mixed tests at the end, it gets you accustomed to constantly switching gears
- don't panick when you get a Question block that you get 58% on. As long as they are the exception to the norm you should do fine.

Also: TAKE BREAKS!!!!

 

[joshua_msu]

But remember, that anyone who actually buys that "four weeks" crap is in the second league from the get go. 😉

Do you mean four weeks of total studying?

 

[p53]

i'll throw in my 2 cents...


dont open a textbook, its a waste of time...reading out of big robbins is stupid.

dont study for more than 6 weeks otherwise you'll burn out

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

practice questions

and dont forget to have a life.

Doing questions without a foundation of knowledge is counterproductive. I agree doing questions is important however, one must have a working knowledge of the material to get the most out of the questions, and make it stick into your mind. Memorizing answers via repetition on QBANK is a recipe for FLUNKING Step 1.

Also, just doing questions will potentially wound a person's psyche because of the realization of how much one doesn't remember.

The best method is to review as much as you can (studying for Step 1 is not to learn new material), and save the last week for just questions so it would be fresh on your mind.

 

[Pox in a box]

Biggest mistake is listening to certain people and believing they were being honest.

 

[bigfrank]

Biggest mistake is listening to certain people and believing they were being honest.

Sounds like there are some issues here...

 

[Pox in a box]

Sounds like there are some issues here...

Sometimes real people can help you make USMLE associations. 👍 Hopefully this person will not need a psych admission because this person fits the description very well.

Narcissistic personality disorder is characterized by self-centeredness. Like histrionic disorder, people with this disorder seek attention and praise. They exaggerate their achievements, expecting others to recognize them as being superior. They tend to be choosy about picking friends, since they believe that not just anyone is worthy of being their friend. They tend to make good first impressions, yet have difficulty maintaining long-lasting relationships. They are generally uninterested in the feelings of others and may take advantage of them.

 

[bigfrank]

Ok

 

[VJWDO]

This and start doing timed questions from the start and you'd have a better program than most.

But remember, that anyone who actually buys that "four weeks" crap is in the second league from the get go. 😉

I may have lost neurons from third day of path review, but what do you mean about the four weeks and second league?

 

[Kluver_Bucy]

Bumpin again for the new test takers. Please give us some good advice!

 

[Kluver_Bucy]

Collecting one more time.

 

[Benzo4every1]

Hello,

I'm just starting to study for Step 1. My exam is on July 2nd. Could some of the people that have taken the exam, or are currently studying for step 1 post some common mistakes people make studying for this exam.

I currently have a B- GPA, so please be kind with advice.

don't goof off. You will have time to goof off later in the fourth year 😉 Or so it's been said to me.

 

[FarEastGrapplr2]

thought i'd bring this TtT for any new advice

 

[bulletproof]

Sometimes real people can help you make USMLE associations. 👍 Hopefully this person will not need a psych admission because this person fits the description very well.

Narcissistic personality disorder is characterized by self-centeredness. Like histrionic disorder, people with this disorder seek attention and praise. They exaggerate their achievements, expecting others to recognize them as being superior. They tend to be choosy about picking friends, since they believe that not just anyone is worthy of being their friend. They tend to make good first impressions, yet have difficulty maintaining long-lasting relationships. They are generally uninterested in the feelings of others and may take advantage of them.

I don't know who you are talking about....but you pretty much described one helluva lot of med students I know. The Med student, generally speaking of course, is partial to his ego.

Anyway, back on topic. The advice I have gotten with respect to Board prep. from those who have gone before me is as follows....
1. Pick your sources early...and stick to them
2. Know all of the common diseases and their atypical/uncommon presentations....alcoholism, SLE, DM, HTN,etc.
3. Do many questions and read ALL answers.
4. Take your breaks and don't feel guilty about them.
5. Take everyones advice with a grain of salt.(mine included)
6. Eat. Sleep. Study. Pray. Repeat.

 

[GenSurg]

Trying to read too many books! You have 4 (5, 6, whatever) weeks. What makes you dumb enough to think you can really read BRS Physiology in 3 days and BRS Pathology in 4 days? That's what my schedule said, but that's not what panned out!

I started reviewing the BRS books during my course work so I was familiar with the material. After taking my finals, I took one day off, studied for 15 days and took Step 1. With prior review, and my ability to keep a schedule, I was able to study every pre-clinical subject (range 1/2 day for psych/embryology to 2 days for pathology and pharmacology). Things ended up working out pretty well for me.

http://www.freeiPods.com/?r=20049323

 

[p53]

This thread is strangely familiar.

Looks like someone loves to steal ideas.

 

[DOCTORSAIB]

This thread is strangely familiar.

Looks like someone loves to steal ideas.

Apparently the previous OP frequents prep4usmle.com as well. THAT's where I got the idea.

Stealing is a very strong word. You should choose your words more carefully boss.