Compiled Step one Experiences

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Jalby

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Hey guys. This is a thread to post individual step 1 experiences. Like what was on it, how you felt going into it, what books you used, what was helpfull, what was not. Basically anything you think would be helpfull to other students. Post your own thread so that you can get the congratulations you deserve and answer any questions, but please just cut and paste that experience onto this thread so it will be around for years. Thank you very much.

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i got it from amazon...

here



sweet n sour said:
joe

thanks for sharing ur experience..I was wondering about the goljan rapid review u mentioned..the one i bought is a book by goljan that came out in 2004..it has 100 questions in the end n it comes with a CD with 350 questions! can u please tell me where u got this other book or CD from?
 
I've lurked on SDN a little, but having recently gotten my Step 1 scores I just wanted to post one thing:

First Aid is not required for Step 1

Almost everyone here recommends FA, and I'm sure it's an excellent help. But I've never been able to study effectively from that sort of outline-list format, so I made the decision early on that I wasn't going to waste time trying to force myself against my instincts.

Instead, I used a combination of outline-sentence format (HY series) and paragraph format (Lip. Pharm, Micro Made Ridiculously Simple), tailored to fit my needs, and was able to cover a lot more ground than I would have with FA. And I did very well -- I guess I'm not supposed to post my score, but I'll say that if I could've gone back and done anything differently, there's nothing I'd change.

A couple general insights:

1. As above, pick whatever books work for you. By far the most important thing is not to lose momentum. If you can't make headway in some book, ditch it and either (a) try another subject entirely and come back later, or (b) find a different book. I spent a couple days doing nothing but looking at books to decide what worked for me, and considered it time well spent.

2. Remember that you'll never learn everything, the important thing is that you get the best yield for your time. Note especially that you don't have to learn every subject to the same level; a question is worth the same no matter what subject it comes from.

3. QBank I thought was great. I'm not sure that it predicts Step 1 scores -- I was getting around 75 - 80% on QBank by the end, FWIW -- but the post-test analysis helps you find relative weak spots. (I also used it to find strong spots and not waste time studying them...and not waste time doing QBank questions on them either.) QBank questions are definitely longer and more complex (in the exam, I had maybe five questions that didn't fit on one screen), and a bit subtler, but I'd still recommend them if for no other reason than to make the Step 1 questions seem straightforward by comparison (good for self-confidence).

4. Think about the order you study in. I purposefully did a lot of my clinical studying early on, and saved biochem etc for the end, because I find it easy to retain clinical material, whereas biochem would have been pushed out and forgotten had I done it early.
 
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I took my test in Feb 05' and got my results this week, so I thought I'd share.


MCAT: 27
Kaplan full-length: 65%
Qbank: 65-70% (just before step 1) on fresh mixed sets
NBME 1: 570
NBME 2: 550
Step 1: 232

My experience on this test was that they didn't test deep, abstract information. It was mostly the basics of each subject approached from odd/different ways. They made a lot of connections (between subjects) that I had not considered. I highly recommend studying foundational things like cardio and renal pharm., diabetes, AIDS/HIV. This may sound obvious but I know a good number of people who focused on abstract details of obscure diseases/meds that did not pay off. I studied for a good 1.5 months. I studied 4-5hrs/day for the first month, and kicked into serious studying (10hrs/day) for the final 2 weeks. I was very near burnout in the end.

The review books I used included FA and Kaplan for Pharm, Goljan audio and Rapid Review for Path, FA for Micro, Kaplan alone for the rest. I read Robbins, Harrisons, Katzung, Bern & Levy, and Moore for classes and only used them as references during test prep.

I made a two day rapid review, done the same way before each practice test and the real deal.

I give all the credit for my Step 1 score to God above, to whom I owe everything.
 
shalom2u said:
I took my test in Feb 05' and got my results this week, so I thought I'd share.


MCAT: 27
Kaplan full-length: 65%
Qbank: 65-70% (just before step 1) on fresh mixed sets
NBME 1: 570
NBME 2: 550
Step 1: 232

My experience on this test was that they didn't test deep, abstract information. It was mostly the basics of each subject approached from odd/different ways. They made a lot of connections (between subjects) that I had not considered. I highly recommend studying foundational things like cardio and renal pharm., diabetes, AIDS/HIV. This may sound obvious but I know a good number of people who focused on abstract details of obscure diseases/meds that did not pay off. I studied for a good 1.5 months. I studied 4-5hrs/day for the first month, and kicked into serious studying (10hrs/day) for the final 2 weeks. I was very near burnout in the end.

The review books I used included FA and Kaplan for Pharm, Goljan audio and Rapid Review for Path, FA for Micro, Kaplan alone for the rest. I read Robbins, Harrisons, Katzung, Bern & Levy, and Moore for classes and only used them as references during test prep.

I made a two day rapid review, done the same way before each practice test and the real deal.

I give all the credit for my Step 1 score to God above, to whom I owe everything.


Congratulations!

Are NBME 1 and NBME 2 the NBME 200qs comprehensive exam??????? Where can I find it and take it???????

Thanks!
 
Yes, the tests I mentioned were the 200Q practice exams. Go to NBME.org and look for the Comprehensive Basic Science
Self-Assessments
. They are $45 each, but well worth it.
 
shalom2u said:
Yes, the tests I mentioned were the 200Q practice exams. Go to NBME.org and look for the Comprehensive Basic Science
Self-Assessments
. They are $45 each, but well worth it.




I got it.

I would like to buy "Rapid Review for Path", you can email me at [email protected]

Thanks!
 
First off, I have to say that SDN is a great place to ask your questions and get (usually) straight forward answers from people who have actually "been there and done that". It's so encouraging to know that there are so many students across the world who experience the same fears and concerns as you do.

That being said, I'm hoping to get some great advice from fellow med students. I'm a US FMG currently studying in India. I'm graduating in 6 months after which I will start preparing for the USMLE. I'm completely out of touch with the basic sciences because I took my exams back in Sept '03. So by the time I start studying it will have been TWO YEARS since I had direct contact with the basic sciences. Unfortunately, the system here is geared towards Indian exams or at most UK exams, so they don't give us any time to prepare for the USMLE.

What I want to know is, WHAT SHOULD I DO NOW? I plan on joining Kaplan once I get back home, but how long of a course should I take? The site is so confusing and I dont want to end up taking something too short, or too long. How much time should I give myself to prepare THOROUGHLY for the exam. I really wanna kick butt but I don't want to spend a year studying either. Because I'm an FMG, I know how important step 1 is for me, and I don't want to screw it up. If there is anyone out there who has been in my shoes, or knows someone who has, or just has some good advice, I'd appreciate any and all input. You can reply on the thread or PM me. Thanks. :oops:
 
Joe Joe on da Radio said:
i took my exam last week and it was not as difficult as i had anticipated it to be. i don't know about other versions out there, but i really felt that the exam i took served up to its billing as a competency exam. they're not trying to trick you, but see if you have the basics down, and if you do, there isn't much that they can hurt you with. i used the following resources over 6 weeks (3 weeks of which were completely off from classes):

1) BRS Path (it is essential to understand everything in this book; used WebPath along with it)
2) BRS Physio (i felt the exam was much more about pathophysiology than pure physiology)
3) First Aid (sufficient for biochem, behavior, anatomy, pharm)
4) Appleton & Lange Micro & Immuno (a high-yield condensed version of clinical micro made ridiculously simple; i would highly recommend this book instead)
5) BRS Neuroanatomy (chapters on spinal cord tracts/lesions and brainstem lesions only; reviewed a neuro atlas on brainstem sections)
6) HY Molecular Bio (made me less anxious about the subject matter after reading it)
7) Q Bank
8) Goljan Rapid Review USLME Step 1 Question Book (much more in line with the real exam than Q bank in my opinion; and it was only $40 with a CD of 1050 additional questions with 350 in the book itself; i wish i had knew about this book before i spent >$300 on Q bank b/c it would have been more than sufficient!)

as for the exam, i found it helpful to read the question stem first before i read the vignette's as some of them were quite long. i could focus on what to pick out of the vignette knowing what the question was asking for already.

good luck and study hard!

--joe
Great information. I'm using nearly the exact same books and I'm liking all of them. Sticking to Clinical Microbio made red simple because I'm infatuated with it and it made memorizing everything in microbio including the pharm antibiotics so much easier.
 
OK... I am kinda recovering after the Step 1. I took it today. It was weird.

Basically I want to know if there is anyone around here who had the same feelings after the exam.

Most of the questions seemed extraordinary different from anything I had ever done during the prep period. That includes Kaplan, Goljan RR, USMLEasy, Robbins Review, Kaplan / LWW BSS etc etc. Most of the questions were written in such a way that, it seemed to me, they tried to eliminate any buzz words, or giveaways, even the smallest ones: everything was rephrased and strange appearing. I think I managed to understand most of them, but cannot be sure at all. For instance, they didn't name enzymes by name, but rahter they were using alternate language describing the enzyme's function in less common words. They didn't use typical phrases that are usually used to describe typical morphologic changes, but rather loads of synonims, so to say. No eponims in the entire test! :)

Another thing that baffled me was the huge number of questions that "happened" in an experimental setting: cell cultures, mice, monkeys, isolated receptors, imaginary stuff, genomic libraires, obscure genes (some stems actually implied that I wasn't supposed to know anything about those genes, rather they gave me all the needed information and they were interested in where I was able to go from there). I don't want to go into details because I do not want to be in breach of the rules I accepted there.

There were, obviously, many questions that were more "reasonable" and common and within my reach, but the problem is that I feel incredibly unsure. I cannot say for a fact that my performance was indeed poor, or average, or as expected, or SOMETHING, anything!

Another remark would be that, almost always, they gave you the most unexpected set of choices for a particular stem. Also, most "vignette type" questions, were exquisitely particular, there were very few "generic" questions. Almost no "pure recall" questions (I appreciated that, actually). Somewhere close to half of them where... how should I put it? they simply seemed far more "intelligent" than any questions I used in my training. Recognizing the disease process, or the particular concept involved was not barely enough to even start deciding on the right answer. I needed to build bridges over huge cognitive gaps that separated the stem from the answer choices. Do I make any sense? The same principle holds, indeed, in answering Kaplan questions (among all my training material they were the closest match, not necessarily in terms of aspect or phrasing, but in terms of thought processes involved). However, Kaplan questions, on the average, required significantly less "bridging".

Behavioral questions, on the other hand, were totally different from most anything I did. My guess is that review materials are totally off on this one. Really. They were stated in such a way that I cannot even verify my answers. There's no way to go to some source (book, qbank, whatever) and see if my answers were correct. Regarding Behavioral, I had a constant feeling that at least two of the choices were "jus as correct", and I have no real sound argument to justify my ultimate pick! :( BTW: I always got the highest scores in behavioral during my prep, and I am particularly knowledgeable in Psych apart from my USMLE preparation.

All in all, I wasn't expecting to be so confused now. I feel like I could expect ANYTHING on that score report. I can't even honestly say if I passed or not... I can't say anything! It's very frustrating, but I can't even blame the test: it felt very professional and balanced and beautiful and fascinating and all that. I really am speechless regarding the exquisite rigorousness of the Prometric test center staff (I took it here, in my home country, and I was expecting at least some tiny slip of their part :) ). The problem is, in part, that my experience doesn't really fit the general pattern of other test takers' shared experiences that I have read on various forums.

Thanks for 'listening'.


PS: my performance in Behavioral was quite high during prep, but in the CBSSA it was, indeed, rather poor... :confused:
 
bigfrank said:
TAKE A BREAK BETWEEN EVERY BLOCK EVEN IF YOU DON'T FEEL LIKE YOU NEED TO (YOU WILL BY QUESTION #25 ON THE NEXT BLOCK ANYWAYS)

Just wanted to point out that I learned the true value of this piece of advice the hard way. It is a very, very important point in my oppinion. There is a very slim chance to run ouyt of break time.
 
HYJunkie said:
OK... I am kinda recovering after the Step 1. I took it today. It was weird.

Basically I want to know if there is anyone around here who had the same feelings after the exam.

Most of the questions seemed extraordinary different from anything I had ever done during the prep period. That includes Kaplan, Goljan RR, USMLEasy, Robbins Review, Kaplan / LWW BSS etc etc. Most of the questions were written in such a way that, it seemed to me, they tried to eliminate any buzz words, or giveaways, even the smallest ones: everything was rephrased and strange appearing. I think I managed to understand most of them, but cannot be sure at all. For instance, they didn't name enzymes by name, but rahter they were using alternate language describing the enzyme's function in less common words. They didn't use typical phrases that are usually used to describe typical morphologic changes, but rather loads of synonims, so to say. No eponims in the entire test! :)

Another thing that baffled me was the huge number of questions that "happened" in an experimental setting: cell cultures, mice, monkeys, isolated receptors, imaginary stuff, genomic libraires, obscure genes (some stems actually implied that I wasn't supposed to know anything about those genes, rather they gave me all the needed information and they were interested in where I was able to go from there). I don't want to go into details because I do not want to be in breach of the rules I accepted there.

There were, obviously, many questions that were more "reasonable" and common and within my reach, but the problem is that I feel incredibly unsure. I cannot say for a fact that my performance was indeed poor, or average, or as expected, or SOMETHING, anything!

Another remark would be that, almost always, they gave you the most unexpected set of choices for a particular stem. Also, most "vignette type" questions, were exquisitely particular, there were very few "generic" questions. Almost no "pure recall" questions (I appreciated that, actually). Somewhere close to half of them where... how should I put it? they simply seemed far more "intelligent" than any questions I used in my training. Recognizing the disease process, or the particular concept involved was not barely enough to even start deciding on the right answer. I needed to build bridges over huge cognitive gaps that separated the stem from the answer choices. Do I make any sense? The same principle holds, indeed, in answering Kaplan questions (among all my training material they were the closest match, not necessarily in terms of aspect or phrasing, but in terms of thought processes involved). However, Kaplan questions, on the average, required significantly less "bridging".

Behavioral questions, on the other hand, were totally different from most anything I did. My guess is that review materials are totally off on this one. Really. They were stated in such a way that I cannot even verify my answers. There's no way to go to some source (book, qbank, whatever) and see if my answers were correct. Regarding Behavioral, I had a constant feeling that at least two of the choices were "jus as correct", and I have no real sound argument to justify my ultimate pick! :( BTW: I always got the highest scores in behavioral during my prep, and I am particularly knowledgeable in Psych apart from my USMLE preparation.

All in all, I wasn't expecting to be so confused now. I feel like I could expect ANYTHING on that score report. I can't even honestly say if I passed or not... I can't say anything! It's very frustrating, but I can't even blame the test: it felt very professional and balanced and beautiful and fascinating and all that. I really am speechless regarding the exquisite rigorousness of the Prometric test center staff (I took it here, in my home country, and I was expecting at least some tiny slip of their part :) ). The problem is, in part, that my experience doesn't really fit the general pattern of other test takers' shared experiences that I have read on various forums.

Thanks for 'listening'.


PS: my performance in Behavioral was quite high during prep, but in the CBSSA it was, indeed, rather poor... :confused:


Are you an IMG? How did you prep for the Step 1? Has it been a while since you took the courses? Thanks for the detailed info!
 
Yes, I am an IMG. I didn't take any prep courses, if that's what you are asking. I graduated last year. It wasn't that easy for me to go back and study first and second year subjects, but I feel I did as much as I could. I pretty much did everything in a way as old fashioned as possible :) (reading, writing, drawing and doing MCQs). I tried listening to audio material, but felt too time consuming. I listened to Goljan, mostly. I gave up listening to some bootleg Kaplan mp3s after a (very) short while. I posted my study material in the books thread.
 
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ok well i just took this beast yesterday and boy did it suck.

in preparing for this test, you should do qbank in front of a crappy low-contrast screen with a lot of flicker, because that's what you're going to be doing on the real test. also, that crappy software that comes with the 150 free questions is what i had, though this is supposed to change in the next month.

in terms of questions there was nothing really too far out there. they just hammered in the basics in a million different ways. overall i think it's more important to know the basics in great detail than to know a little about a lot. there were many times where i felt that a natural curiosity for "why, how" would have come in handy in preparing for this. the "pimp each other" thread does a good job of this. seek to understand the mechanisms, because first aid is no secret, and the holes can and will be exposed.

repro/endocrine - extremely high yield on my particular test... tons and tons and tons of questions asked from left field right field, every which way possible. FA/BRS phys is good enough for endocrine, not enough for reproduction. best prep for repro was m2 year, unfortunately. basically every question possible about women's health was asked on my test.

immunology - has its grubby hands everywhere on this damn thing. you must know the general concepts, think outside the details and understand how an antibody works, etc. of course you have to know everything else as well. very high yield, huuuuuge part of this test.

molecular biology - as many many people reported, this is a huge part of the test. most were very simple but presented in intimdating ways. we're talking full page DNA/RNA/AA sequences. AP biology material was fair game, apparently.

neuro - HY neuroanatomy is the greatest book on the face of the planet. so extremely unbelievably high yield, i can't say enough good things about it.

behavioral science - very odd questions, many of which were discussed in great detail in m2 small group sessions but not well represented in HY or FA. you must know how to deal with subtleties in regards to "what would you say next" questions. they won't make it black and white for you, many distractors to sift through.

micro - one parasite question, very common. questions about bacterial consisted completely of secondaries and tertiaries. they know that everyone studies bacteria the most and will not make it that easy. also had tons of viruses. ugh.

cardio/renal/GI/resp - huge part of the test obviously. there are some things you should know from m2 year, as part of a physical exam, but is not really covered in review books, especially for cardio. nothing really too out there, just know the big stuff VERY well. obscure crap in BRS was not there at all, or maybe i just didn't recognize them. either way it's useless to me. :)

anatomy - some ridiculously simple, some i couldn't figure out after looking it up netters. nuff said.

histology - stuff you should know after m1 year, very common stuff. but can trip you up if you didn't review at all.

embryo - FA was more than adequate.

pharm - recurring theme. know the big drugs very well. ask "how" questions often in your review.

biochem - understand the pathways as a whole system. knowing the regulating steps is the highest yield but by no means adequate.

overall i think this test is no harder than the finals i've had as an m2. there are holes in review books that simply cannot be filled without recalling stuff from college/m1/m2 year. that's expected - the review books only gives you the highest yield material... in theory. i hate to say this but building a solid foundation in m2 goes a long way in preparing for this thing.

review materials: highest yield: FA, HY neuro.
low yield: HY anatomy, HY embryo (great book but doesn't add much to FA), qbank. in fact most of the HY books don't really add much IMO.

i didn't get the impression that goljan was the golden goose. he's good but don't idolize him. in the end he's just one source out of many.
 
automaton, did you use Goljen? or have you just heard from other test takers...i'm in the midst of his (lots) notes now and i'm looking for feedback from test takers.
thanks, streetdoc
 
automaton said:
review materials:
highest yield: FA, HY neuro.
low yield: HY anatomy, HY embryo (great book but doesn't add much to FA), qbank. in fact most of the HY books don't really add much IMO.

qbank low yield? could you expand on why you thought this. was it the material, the type of questions, the format, the length, the substance etc.?
 
automaton - thanks for your post! Do you have any suggestions for sources for immuno and molec bio?
Thanks again and i hope you kicked some booty.
 
conure said:
qbank low yield? could you expand on why you thought this. was it the material, the type of questions, the format, the length, the substance etc.?
ok low yield was kind of harsh. just that the upperclassmen told us qbank was awesome, which was far from the case. qbank tests you on rat facts. don't get me wrong, you need to know a lot of details, but like i said, you really need to know the details about the main things, not random eponyms. by the way i had 1 eponym show up out of 350 questions.

so example of what i mean...
i'm going to use an example that i just made up so as to not violate anything. something that is very common are corticosteroids. everyone should know corticosteroids are used for inflammation, you might know that you use it to rev up surfactant, etc. but that's not enough. you have to know HOW corticosteroids work, where in each step that it has its effects, and what those effects are. this is an example of something that is incredibly widely used, but that most people sort of know something about but not in great detail.

example of why i think qbank sucks...
qbank would have answer choices of 5 eponyms. that's ridiculous and NOTHING like the real test. qbank will have 5 answer choices of cell markers, and they're not main things like CD3, CD4, CD8, CD19... they're like CD100 or whatever. really random and pointless. qbank has less than 20 molecular biology questions and 200 anatomy questions. those proportions are probably way different on the real test in general.

basically what it comes down to is that the USMLE is both a conceptual and detail oriented test. but the thing is that (IN MY OPINION) the details are NOT about random pathology you'd find on a footnote... it's very much a bread and butter test that requires you to know a lot about the truly important things. again, please realize this is one test taker's opinion out of thousands, and there are countless versions of exams, so take my words with a grain of salt. but if i had to do this all over again, i wouldn't take too much stock in qbank and their obsession with trivia, eponyms, and gross anatomy.
 
streetdoc said:
automaton, did you use Goljen? or have you just heard from other test takers...i'm in the midst of his (lots) notes now and i'm looking for feedback from test takers.
thanks, streetdoc
i've used the rapid review pathology book, the 100 page HY, the USMLE question CD, and a lot of the audio. i think the rapid review book is much better than BRS... i was using BRS all throughout m2 year but ditched it once i got rapid review. he explains things very well and the book is excellent. my only point is that he's not a miracle worker that's going to tell you about 349 out of 350 things you'll see on the test. he is very good though and i would use his materials again without hesitation. please god let me only be talking hypothetically.

oh by the way, like some other people mentioned warned me about... i ran out of time on many of my sections... not in terms of "i didn't answer half the questions" but more like "i need more time to think about these things i'm not sure about but i don't have time for it"
 
congrats man--for being done. I am sure you're pretty relieved.

so, is FA as "godly" as everyone makes it, in terms of the material that was represented from it on the test?

what did u use for molec bio and immuno? was it adequate?

i notice u emphasized knowing certain subjects in great detail, beyonjd the scope of what's covered in the review book. So, would u reccommend reading certain big ch. like renal/cardio in robbins? Like, what is the best way to approach this? Our m2 path was only 3.5 months, and i basically learnt squat. So, I spent over 5 weeks just "learning" path, but obviously it was from multiple REVIEW books, and not robbins (while i did use it to clairfy certain subjects).

and what do u mean secondary, tertiary stuff in micro--you mean obscure stuff, beyond the normal, typical presentations?

and sorry, one last question: did u find any qusetion souce to be very helpful?--by that i mean, better than qbank, and more representative of the actual test?

thanks man--keep us posted on the sciZore and its correlation with cbssa/b
 
thanks automaton,
i was curious which of his sources you used.
he pulls a lot of things together from micro/pharm/phys and path. seems helpful so far. but like you said, i'm going to have to work on all those subjects independently as well. i also tried my qbank out tonight and was a little less than impressed. it seemed a whole lot easier then my M2 exams/finals which my school tries to tailor to be "board like."
anyone else have ideas on qbank and the real USMLE?
streetdoc
 
HiddenTruth said:
congrats man--for being done. I am sure you're pretty relieved.

so, is FA as "godly" as everyone makes it, in terms of the material that was represented from it on the test?

what did u use for molec bio and immuno? was it adequate?

i notice u emphasized knowing certain subjects in great detail, beyonjd the scope of what's covered in the review book. So, would u reccommend reading certain big ch. like renal/cardio in robbins? Like, what is the best way to approach this? Our m2 path was only 3.5 months, and i basically learnt squat. So, I spent over 5 weeks just "learning" path, but obviously it was from multiple REVIEW books, and not robbins (while i did use it to clairfy certain subjects).

and what do u mean secondary, tertiary stuff in micro--you mean obscure stuff, beyond the normal, typical presentations?

and sorry, one last question: did u find any qusetion souce to be very helpful?--by that i mean, better than qbank, and more representative of the actual test?

thanks man--keep us posted on the sciZore and its correlation with cbssa/b
when i say it's good to know things in great detail, i'm not really talking about reading robbins or anything crazy like that. i'm just talking about studying the details that are there already in FA or goljan or whatever. i guess this applies mainly to "big picture" oriented people that tend to blow off a lot of details.

for immunology i think FA had all the details i needed... concepts are another story, but that's something you should get from m1/m2 year anyway. for phys and path i would learn BRS phys and goljan path very well for the major things. rule of thumb - the more obscure it is, the less you have to know about it. the more common it is, the more you have to know. that means if it's extremely common you gotta know a lot of picky details. again, it's not about "beyond the scope." it's not a matter of MORE detail, it's simply a matter of seeing the detail that's there. i.e. not blowing it off as minutiae.

i dunno, maybe that's obvious to high achieving medical students who memorize everything and are never satisfied with superficial explanations to anything, but i don't normally function that way.

anyway, about the books, i read HY immuno twice. the reason i read it twice is because the first time i was just wasting time and reading passively because i got lazy. second time was because i couldn't leave that damn book without at least a few highlights on it. that's pretty much it. i'm not really sure what i got out of it. all the factoids i remembered during the test were details i memorized from first aid. i read HY molecular once. it was good for understanding how some of the lab tests worked, i think. i'm not sure that translated to getting more questions right. i read these books once or twice just to kind of make myself feel better about it but i'm not sure that it added too much to my score. that's just me. i remember bigfrank said he thought HY molecular was great, so obviously different people have different impressions.
oh and question source. i think qbank is annoying but there are enough good questions in there to ultimately make it worth trudging through. i used goljan's USMLE CD and thought it was pretty good but the software was absolutely terrible. obviously NBME was good at helping me strategize my study plan but it doesn't have any answers so it was kind of lame as a study tool.

also, i just want to say again this is just MY personal experience with my own biases. there are many different versions of the test - yours might be completely different. i'm not even saying i did particularly well. honestly i have no clue how i did because i took only one NBME and that was after one week of studying when i got bored and felt like seeing how much studying i had to do... and that was like 5 weeks before step1. i just know i didn't enjoy those 8 hrs staring at a flickering monitor, and i had a few things that i thought prepared me well for some questions, some things i wished i'd studied more, and some i wish i'd spent less time on. oh, and having taken an actual test doesn't make me an expert on the subject, by any means. just my personal opinions and observation, that's all. beware of sample size.
 
wow. i cant believe that after lurking on this USMLE forum for two years i am finally posting on the step1 experience thread....

took the test yesterday, was a little underwhelmed but by no means did i find the test straightforward. some things i learned:

first off, if you are looking for a 220-230, the ONLY things you need are FA, Qbank (annotating FA with Qbank "pearls" and reviewing during the last week), and a couple hours a day of goljan audio. thats it. serious. get through Qbank once during the year and once again during your review time. take notes in FA!! and nothing else. nothing.

okay but i will presume since you are still bothering to read this that you might be interested in a bigger score. well, i highly doubt that i will be anywhere near a "big score" but i feel i am just as qualified as the smart people to tell you what i would have needed to study to do better. if you read this and think to yourself "i already know MCB like the back of my hand" well, congrats because on my version of the test you get a 250+. on the other hand, if you remember little else about first year other than beerpong tricks or the first season of the apprentice (tha don), you will need to spend time going over the basic of the basics from first year. you know which subjects im talking about, they are whatever your particular weaknesses are. or as my buddy likes to say "the subjects that make you feel crappy when you study them". let me be perfectly clear: these are NOT high yield subjects and are NOT an effecient use of your time. In fact, the question/hour of study time ratio is horrible if you do choose to head off and memorize HY gross anatomy or HY cell bio. but i honestly feel that this is what it takes to push your score into the higher brackets. i am talking mainly about cell bio in my particular case, but in general this also includes functional anatomy, neuroanatomy or whatever other subject that makes you feel like crap when you study it. i doubt everyone will agree, but i thought that i would give my own opinion after reading hundreds of these myself in the past year.

some words about BRS path/phys: NOT worth the hype. stop. put down the highlighters. what i find semi-ironic (yes i just made that word up) is that i saw some kids in my class that literally worked over BRS path until the pages were ratted and falling out and yet come test day were still baffled by straightforward pathology questions. stop it. what would i use then for my path review? glad you asked, PATHOPHYS for boards&wards. this is undoubtably the book to know - shorter, physical diagnosis based (the way boards questions are asked) and even has a review of BASIC immunology and neuroanatomy with pictures of brainstems that you will see on exam day. and for those of you wondering about the goljan rapid review pathology book... it is even worse than BRS and it is WAY to much info about WAY too many diseases (sorry goljan). just stick to his audio.


Qbank: despite the many nitpicky questions and shortcommings in CMB and immuno, it is by far the best quesiton source out there. by far. it is also the best cure for passive studiers who think that they just reviewed a concept only to have it twisted around and thrown back at them. this is so key on the real exam since you only have a very limited time to "figure it out" and life is a lot easier if you have "figured it out" at some point beforehand. by the way i will claim Qbank expertise as i went through it three times completely.

NBME: i spent umpteen hours on various discussion boards looking at people's NBME practice test scores and what they ended up getting on the real deal. ill let you know once my scores come in if they worked for me.

i think that the common theme seems to be that regardless of what subject people say was more represented in one test vs. another (a notion that i dont buy into - if you really think about your test you will always come to the conclusion that it was balanced), the common thread is that knowledge of the basic subjects from first year are the questions on step1 that play a big role in the higher score ranges. of course i am far from an expert, but to give an example from my exam: each time i finished a block with 20-25min left, i would go back through the marked questions and realize that out of the 15 or so that i marked, the vast majority were not path or pathophys. further, i would say that even though i spent way too much of my studying time on path (about 3 of 5 weeks), i was getting questions that i had to rely far more on my memories from class than anything i saw in a review book this month. i wont claim to have known the answer to every path question, but i will tell you that i sure spent a heck of a lot more time working out the biochem/CMB questions on my exam. by the way, based on my "feeling" and looking up about 20 questions that i could remember, i am probably headed for the 220 range. just to let you know where i'm coming from. on test day i was a completely mountain dew intoxicated freak and i spent ten minutes on my last quesiton of my last block trying to remember which antibiotic causes ototoxcicity. i am not what you might consider a good test taker. basically you might say i'm more of a "mini corn dog" than a "big frank". or maybe one of those mini microwave pretzels stuffed with cheese.... mmmm

anyway, good luck to all of you and ill keep my fingers crossed for a decent score. i guess i will post back when it arrives and then you can decide if i am an idiot or not and how much of my advice is complete rubbish.
:luck:
 
Thanks for the info mattie!

yikes...is this increase in molec bio a new thing? If not, kaplan should have caught on and written some more questions! Anyone know of a question source for that stuff - it is definitely a weak subject for me (ie studying it makes me feel like crap) - mattie, that phrase is so accurate!
 
Wow, just finished the test. And I have to say the two above have it right dead on. What did i think about when i was taking it....


The first block went smooth until I realized i was taking the real USMLE in QBANK tutor mode speed and had 10 questions left in the block with only 9 minutes left on the timer......got a little freaked but finished on time...barely. During the second block i remember thinking at about question 30, when i was kinda stressed.....I wish i could take a break right now. MORAL: Take breaks.....even if you don't need them when you start you will need it at about question 35.

Took about a 10 minute break after the second test block.

Was dumb eenough to not take a break between the next two blocks and found myself once again freaked out and stressin at about question 25 on the 4th block. Once again ......TAKE BREAKS even if you don't feel like it.


Took a 15 minute break after the 4th block and felt better about 5th, 6th, and 7th block because i took BREAKS inbetween them.

By the way, did you two guys above think that some test blocks were easier than others?

Other notables about the big quiz. Mattie it right, as far as my test was concerned it was very well rounded. I know this becuase i wasn't swayed by one topic being harder than the others.....i don't know a lot about a lot of things so I was able to see the well roundedness of the questions i didn't know the answer to.

mattie is also right about books...you really only need FA, BRS path, I know he liked that other phys book but BRS phys is good also, you just have to apply you knowledge to questions. Qbank was useful, but unfortunately i only got through about 50%.....once.

Anatomy and embryo you only need FA for they are straight out of FA except for some off the wall anatomy ones.......Oh, and the same goes for pharmacology.....only need FA..but make sure youknow it backwards, i didn't and i was so pissed at some points becasue I know the answer was sitting in first aid and i didn't bother memorizing it becuase I didn't think theyd ask...yep, i'm a ******.

I though there was a good amount of immuno on the test, some hard, some easy.

Pictures of things look like sh1t and the screen flickers.

A dude next to me would take breaks and came back smelling like a damn chimney.

The markers for the dry erase board were all dried up themselves.

should have known first aid better.

Got a 410 (~195) on NBME on both tests so only hoping to pass. Was getting between 55-65% on Qbank (random, all subjects) before the test. Only went to dental school, never medical school so i only hope to pass. Already in my residency so i don't care if i only pass. My co-resident found out he passed last week, so i will look even more dumb if I fail.

I'll post my step1 results when i get them.

Good luck to you all and PS:

I hate all of you smart people who made the curve high and this damn test so hard.
;)
 
north2southOMFS said:
Only went to dental school, never medical school so i only hope to pass. Already in my residency so i don't care if i only pass. My co-resident found out he passed last week, so i will look even more dumb if I fail.

I'll post my step1 results when i get them.

Good luck to you all and PS:

I hate all of you smart people who made the curve high and this damn test so hard.
;)


Only went to dental school??? Red flag? :confused:
 
Pox in a box said:
Only went to dental school??? Red flag? :confused:


I assume he's a oral-surgery / maxofacial whatchacallit surgeon, in residency. They often do 2nd year of med school and have to pass step 1 as part of their residency. Gotta 3 really great ones in my class here at UF.
 
Ya, usually oral surgery residents get to do the second year of med school but not here at LSU, we get thrown in at 3rd IF we pass step 1. Little worried about that.......
 
hi guys
well my exam got over on 6th. had another exam today so free only now. so now for my experience:

well the most striking thing is that its very fatiguing.. way beyond anything i had experienced in my life.. almost like a mental marathon. u have to scare at the screen for ages. i took 5-15 mins breaks btwn the blocks initially 5, and 15 on the last 2 (approx). skipped the tutorial so that helped - so its better to be familiar with the testing interface - same as qbank 4 me (the prometric software and not fred)
Now well the exam went fine, cant really predict coz lot of application was involved. the questions are around 35% straight forward, and the rest are multiple jumping pattern, for eg, they give a clinical scenario and ask for the drug of choice etc.
the toughest questions are from molec bio and cell bio - some i had never heard of b4

I did 1200 qs in qbank - 82%. stopped doing my strong areas after 900 or so as time was short. completed the areas i was weak in like histo, cell bio, behavioral, immunology etc

read kaplan for physio, biochem, anat, behavioral and immuno. micro - MMRS. patho - goljan stars and brs. goljan better for systemic and brs for general path. pharmac - CNS, CVS and Autonomic from lippincotts, rest first aid. did first aid for pharmac, histo and embryo.
feelin gr8 now that its over :D
 
Confronted Step 1 yesterday, for the first and -- I hope -- last time. This was a test I'd been dreading: it's been three years since I've been in basic science classes, and there was much to fear. Here at Duke, we get one long year of basic science, then hit the wards in our second year. Following that is a year of research during which cram in some studying (aka "totally relearning") when we can. To make things extra challenging for myself, I went and had a baby during my research year -- a beautiful girl who is possibly one of the worst sleepers on the planet. I'm currently wrapping up research year number two.

I'd been studying off and on since New Year's, but only really went into high gear for the last three weeks. Postponed the test three times as well. I kind of enjoyed the day when I realized that I was no longer able to postpone without re-registering. Gave me a nice sense of inevitability.

* * *​

The sign-in process at my local Prometric bears a disconcerting resemblance to being remanded into custody. You and your ID card are scrutinized with a look of extreme scepticism, as if they know you're trying to get away with something but they can't quite prove it. You're grudgingly allowed to proceed. All your belongings go into a bitty little locker, and your even have to empty out your pockets for them. At least they didn't insist upon a body-cavity search. I had brought a wool stole to wrap around myself in case it got chilly, but was informed that this was a Prohibited Item. Why? Do they think I've somehow managed to knit secret notes into the fabric? Or are they afraid I'm going to hang myself with it if things don't go well?

Either way, they needed have worried.

The test, as it turned out, felt surprisingly OK. There were one or two rough blocks, but most of the questions felt very straightforward. The emphasis was absolutely on Big Concepts rather than minutiae -- and that was great. Some subject areas are of necessity more detail-oriented than others, however, so here's a subject-by-subject breakdown.

Anatomy
Q-bank had led me to expect the worst, but this topic was welcomely under-represented on my test: 5-10 questions max (including embryology). Some were straightforward vascular or nerve Qs; some were integrated with pathology (you had to identify the condition first) +/- radiology (identify the affected area on a CT scan). The embryology ones were interestingly concept-y: description of an obscure developmental anomaly, speculate upon what it might have caused it or what it might be associated with. Not something you'd find in First Aid, or on Q Bank, for that matter, but something that drew upon concepts that you'd find in both those sources.

Behavioural Sciences
Very QBank-esque. Predictable biostats Qs, and the usual scenarios -- for each one, you were given the option of insulting your patient or referring her to your more knowledgeable colleague as well as the (presumably correct) warm and empathetic "tell me more about..." response. A few oddball questions that you just had to guess at.

Biochemistry
Another unexpectedly scanty topic. Few questions; all of them (the ones I remember) were in a clinical context: we were given a case presentation, then asked to choose which enzyme wasn't functioning or which substrate was missing. If you could recognize the disease, it was pretty easy to determine the answer, since the enzymes would be from completely different metabolic pathways.

Cell/molecular biology
Basic stuff, some of it coming from Bio101 rather than med school (wish I'd reviewed some of those notes instead!) A few things you had to guess at -- guessing at the function of cousins of genes you'd run into in other contexts, for example.

Micro
Again (this is my theme, I guess), the principles were more important than the details. I had quite a few questions about how bugs make us sick, none that required me to know whether a capsid was helical or icosahedral. Also quite a few standard-issue we'll-describe-the-disease-and-you-pick-the-pathogen questions. Basic immuno questions, though often cloaked in such a way that you didn't recognize them at first.

Pathology
Pathology was everywhere! It was the rare question that didn't have a pathological flavour to it. So much of my test involved recognizing the salient s&s of a disease (based on its gross or micro appearance or a description of a patient with the condition), then picking out the likeliest presenting symptom, or the major risk to the patient, or the correct treatment. Missing, but not missed, were any questions on HLA type or chromosome number. Nor did that horrendous FAB leukemia classification system show up -- the one that's everywhere in QBank. And not a single eponym.

Physiology
The physio questions on my test were exactly like QBank. Had quite a few of those godawful ones that make you choose one of eighteen possible combinations of up or down arrows for seven different physiological parameters, and you get seasick trying to find the right answer. I'd spend about five seconds deciding what the answer should be, then another three minutes actually locating it among all the other almost-identical-looking ones. I was sorely tempted to use my dry-erase marker right on the computer screen in order to keep track of the answers I'd already rejected, but I figure that might have constituted an "irregularity."

Pharmacology
Basic, though sometimes they'd get tricky with those basics -- make you think that they wanted you to pick out which drug was a p450 inhibitor, when really they were after something altogether different. On my exam, mercifully, I encountered only the major representatives of each class o' drugs. None of the more obscure poly-wolly-sylabic sulfonureas, for example, just good ol' glyburide.

* * *​

Added more in separate post below.
 
omores said:
Confronted Step 1 yesterday, for the first and -- I hope -- last time. This was a test I'd been dreading: it's been three years since I've been in basic science classes, and there was much to fear. Here at Duke, we get one long year of basic science, then hit the wards in our second year. Following that is a year of research during which cram in some studying (aka "totally relearning") when we can. To make things extra challenging for myself, I went and had a baby during my research year -- a beautiful girl who is possibly one of the worst sleepers on the planet. I'm currently wrapping up research year number two.

I'd been studying off and on since New Year's, but only really went into high gear for the last three weeks. Postponed the test three times as well. I kind of enjoyed the day when I realized that I was no longer able to postpone without re-registering. Gave me a nice sense of inevitability.

* * *​

The sign-in process at my local Prometric bears a disconcerting resemblance to being remanded into custody. You and your ID card are scrutinized with a look of extreme scepticism, as if they know you're trying to get away with something but they can't quite prove it. You're grudgingly allowed to proceed. All your belongings go into a bitty little locker, and your even have to empty out your pockets for them. At least they didn't insist upon a body-cavity search. I had brought a wool stole to wrap around myself in case it got chilly, but was informed that this was a Prohibited Item. Why? Do they think I've somehow managed to knit secret notes into the fabric? Or are they afraid I'm going to hang myself with it if things don't go well?

Either way, they needed have worried.

The test, as it turned out, felt surprisingly OK. There were one or two rough blocks, but most of the questions felt very straightforward. The emphasis was absolutely on Big Concepts rather than minutiae -- and that was great. Some subject areas are of necessity more detail-oriented than others, however, so here's a subject-by-subject breakdown.

Anatomy
Q-bank had led me to expect the worst, but this topic was welcomely under-represented on my test: 5-10 questions max (including embryology). Some were straightforward vascular or nerve Qs; some were integrated with pathology (you had to identify the condition first) +/- radiology (identify the affected area on a CT scan). The embryology ones were interestingly concept-y: description of an obscure developmental anomaly, speculate upon what it might have caused it or what it might be associated with. Not something you'd find in First Aid, or on Q Bank, for that matter, but something that drew upon concepts that you'd find in both those sources.

Behavioural Sciences
Very QBank-esque. Predictable biostats Qs, and the usual scenarios -- for each one, you were given the option of insulting your patient or referring her to your more knowledgeable colleague as well as the (presumably correct) warm and empathetic "tell me more about..." response. A few oddball questions that you just had to guess at.

Biochemistry
Another unexpectedly scanty topic. Few questions; all of them (the ones I remember) were in a clinical context: we were given a case presentation, then asked to choose which enzyme wasn't functioning or which substrate was missing. If you could recognize the disease, it was pretty easy to determine the answer, since the enzymes would be from completely different metabolic pathways.

Cell/molecular biology
Basic stuff, some of it coming from Bio101 rather than med school (wish I'd reviewed some of those notes instead!) A few things you had to guess at -- guessing at the function of cousins of genes you'd run into in other contexts, for example.

Micro
Again (this is my theme, I guess), the principles were more important than the details. I had quite a few questions about how bugs make us sick, none that required me to know whether a capsid was helical or icosahedral. Also quite a few standard-issue we'll-describe-the-disease-and-you-pick-the-pathogen questions. Basic immuno questions, though often cloaked in such a way that you didn't recognize them at first.

Pathology
Pathology was everywhere! It was the rare question that didn't have a pathological flavour to it. So much of my test involved recognizing the salient s&s of a disease (based on its gross or micro appearance or a description of a patient with the condition), then picking out the likeliest presenting symptom, or the major risk to the patient, or the correct treatment. Missing, but not missed, were any questions on HLA type or chromosome number. Nor did that horrendous FAB leukemia classification system show up -- the one that's everywhere in QBank. And not a single eponym.

Physiology
The physio questions on my test were exactly like QBank. Had quite a few of those godawful ones that make you choose one of eighteen possible combinations of up or down arrows for seven different physiological parameters, and you get seasick trying to find the right answer. I'd spend about five seconds deciding what the answer should be, then another three minutes actually locating it among all the other almost-identical-looking ones. I was sorely tempted to use my dry-erase marker right on the computer screen in order to keep track of the answers I'd already rejected, but I figure that might have constituted an "irregularity."

Pharmacology
Basic, though sometimes they'd get tricky with those basics -- make you think that they wanted you to pick out which drug was a p450 inhibitor, when really they were after something altogether different. On my exam, mercifully, I encountered only the major representatives of each class o' drugs. None of the more obscure poly-wolly-sylabic sulfonureas, for example, just good ol' glyburide.

* * *​

Out of time -- will add more later.


Thanks. This was really helpful! Hope to hear more later.
 
More blather:

Overall, the test struck me as quite fair, both in terms of the balance of subjects but also in terms of the big picture : picky detail ratio. That said, it was still very challenging in a few ways.

First (obviously) was the scope of material with which you need to be familiar. It's a huge amount of stuff to cram into your head, and not just that, it has to be readily accessible too. Many posts on this board are concerned with which review books are best, but in my opinion, what matters most is which books help the material stick in your mind. I started with the ever-popular brs pathology, but quickly found that the material exited my brain nearly as quickly as it entered it. What seemed to work better was using a combo of QBank and the Robbins question book to de-rust my memory and identify holes in my understanding, and then move to Big Robbins or online sources to help fill in those gaps. I noticed fairly quickly that what really helps things lodge in my skull is either a lovely nasty graphic description or a nice gruesome full-colour picture.

Second, as many others have mentioned, the test can require you to make quite a few mental leaps in order to get the right answer. One thing that helps is to realize that the NBME folks have their favorite conditions. Certain diseases are classics either because they're common (diabetes, hypertension), or because, although they're not so common, they illustrate a key metabolic or physiologic process gone awry (Lesch-Nyhan, Goodpasture's syndrome). Create some mental cue cards for yourself that hit the highlights of the conditions that you think will be favorites. Take diabetes. How might the NBME folks describe someone with Type II DM? (Obese 65yo with a h/o hypertension and a rising creatinine level?) What images could they show you to illustrate the pathology? (Kidney with K-W nodule and hyaline arteriolosclerosis?) What problems might they want you to associate with the condition? (vascular disease --> proliferative retinopathy, lower extremity vascular insufficiency, renal insufficiency). And what would they choose to illustrate the consequences of those conditions? (Blindness, ulcers/gangrene, dialysis/transplant.) Then be prepared to do the whole thing backwards without the intervening steps. That way, when they show you the picture of the hairless leg with the missing toes and ask you to identify its most likely owner, you'll head straight for the chubby polyuric senior citizen in the answer choices.

Another problem is that answer choices often seem to contain a few technically correct answers; you're required to pick the "most likely" or "most common" one. This requires not just a breadth of knowledge but also a strong sense of salience. Problem is, it's exceedingly difficult to develop that sense in the classroom. Personal or clinical experience helps a great deal. The next best thing is probably to do lots and lots and lots of practice questions from multiple sources until you're well aware of the material's recurring themes. When you're taking the real Step 1, you'll notice that a whole lot of questions feel familiar to you -- you'll know exactly what the NBME folks are after. Then, if you're like me, you'll narrow your answers down to two choices and pick the wrong one.

One thing I can tell you for sure, though: if you're spending your final week loading up on practice questions, make sure you read the explanations too. You'll learn alot from doing so, but it'll also make the real thing seem so much nicer by comparison. There's something wonderful about clicking END, taking a break, and moving on to the next session instead of having to slog through all those explanatory paragraphs. Kinda like eating dinner and not having to do any dishes afterwards.

Best of luck everybody.
 
mattie113 said:
the common thread is that knowledge of the basic subjects from first year are the questions on step1 that play a big role in the higher score ranges. of course i am far from an expert, but to give an example from my exam: each time i finished a block with 20-25min left, i would go back through the marked questions and realize that out of the 15 or so that i marked, the vast majority were not path or pathophys. further, i would say that even though i spent way too much of my studying time on path (about 3 of 5 weeks), i was getting questions that i had to rely far more on my memories from class than anything i saw in a review book this month. i wont claim to have known the answer to every path question, but i will tell you that i sure spent a heck of a lot more time working out the biochem/CMB questions on my exam.

So spending 10 days (out of a 6 week schedule) on biochem/molecular bio, anatomy, embryo, histo, and neuro isn't a huge waste of time? I'm about to hit my head against the wall feeling like I shouldn't have spent so much time on these low-yield subjects, but first semster of first year is definitely where my grades were lower.
 
Thanks, Omores!

I know exactly what you mean about dish doing!
One more week left for me, and then you all get to hear about my experience... =O
 
Ok, so my time has come to share my experience on the “The Beast: Part I” After reading such great posts by BigFrank, Idiopathic and many many others (Thanks to all!) I will like to share my experience.

I tried to post the resources I used after the discussion of my experience with the 7 major test topics. First Aid was the foundation for my USMLE studying. Studied for about 5 weeks.

Registration at test site
Very courteous staff. Make sure that you bring your IDs and that you look similar know to how you did on your ID years ago. Very prompt start, cracked the first question by 8:45 after reading the tutorial.

Anatomy
I probably got an embryo/anatomy/neuro intensive exam as I recounted about 30 questions after I got out of the exam. Some things were very common, anatomy of heart, anatomic landmarks, and some questions reminded me of QBank although by No means as straightforward as in QBank. I feel that FA did a decent job on hitting some points but if you just read FA without really thinking about the topic you probably won’t have been able to answer the questions. Some nit picky stuff from HY Neuro that despite picky it is relevant. Most of my questions had MRIs, diagrams of SC/medulla, CTs associated to them. BTW for neuro, whatever they point out on the right/they will point on the left side
Resources used: FA, HY Anatomy, HY Embryo, HY Neuro, notes from neuro class

Behavioral Sciences/Stats
I think that most of the topics for my exam (with the exception of the What would you say next type of Q) were covered in Q Bank or in the sources used for studying. Only remember doing math for one biostat question. Had a couple of questions on study design an the applications of statistical tests/power.
Resources used: FA, HY BS, UCV Behavioral

Biochemistry/Mol Bio/Genetics
Ranged from basic to “WTF” type questions. There were various questions asked in very “intelligent” ways that with some reasoning you could get them right (or at least that’s how I feel). Insulin effects on metabolism was another good hit on my particular exam. Some strange dzs (not in FA or Lippincot’s) you just can not prepare for. Nutrition and the importance of vitamins in metabolic pathways were very well represented on my test. I probably should have read HY mol bio to refresh on nit picky Mol Bio stuff represented on my exam.
Resources used: FA, RR Biochem, UCV Biochem

Microbiology/Immunology
I expect this to be one of my strongest subjects (knock on wood). I had very comprehensive courses on both of these topics in med school (plus major in undergrad). Questions usually will pose many organisms that can cause a particular dz and you will have to decide on the most common one based on clinical presentation/pt hx. Know how the same bug can affect many organ systems, mechanisms of toxin toxicities, how to differentiate bugs. I didn’t have a single question on HLA associations. They asked a good bit about cytokine and T/B/NK cell effector functions.
Resources used: FA, really good review prepared by a TA (During the course I read AL MI + Bugcards)

Pathology
I felt that pathology was somewhat underrepresented in the exam. Don’t get me wrong here. I just feel that they pick some systems and really asked questions left and right about them. Make sure you understand well the control and consequences of hormones as you will have panels of 3-4 hormones/electrolytes with arrows going up/down in every single combination possible. So if you just knew a little bit about a bunch of stuff they could have easily show you who’s your daddy. I didn’t feel I have any really unheard off dz besides the ones related to biochem.
Resources used: FA, BRS Path

Pharmacology
Here I have to say that the first aid is the heavy weight champion. I can’t recall any single question that wasn’t on my first aid. However most of the questions focused on mechanism, interactions, teratogenesis, side effects and not really on what would you use to treat X dz. Know FA and go beyond the short explanations on FA cold and you probably would be able to get away with this. You will also see charts of kinetics, drugs effects on BP/HR/PP, t1/2, etc so understanding is a must.
Resources used: FA annotated with Katzung & Trevors

Physiology
The favorite system on my exam was the respiratory so I got many questions around this some similar to Qbank, some things from BRS, and others I just had no idea. Know the formulas and how to use them as I had to do some math for lung/renal physio.
Resources used: FA, BRS Phys

Test taking strategy
Did 100 questions straight, then took a break after every single block (about 5 min each, 20 mins for lunch after the 4th block). Had a drink of soda/water and something else to get a sugar fix. I probably finish every block with 10-20 minutes to spare. Because I noticed that in Qbank I had trouble with picking the right answer because I didn’t read the question well, I went back and checked out my answers to the questions that had diagrams (especially neuro) and went again over the ones I had marked. I marked between 10-20 questions in each block to go through again.

Overall impression
I think that the test is “fair” and does a good job to make sure you understand what you should know and not just that you have a good memory. I agree with people that in previous posts have commented that if you pushed yourself hard during the first two years of medical school and do a reasonable review you should have no problem on passing the test. I agree with Omores post above. Think of the diseases that are more common on the US (HTN, diabetes, lung CA) and try to go beyond what’s written in the review book to understand and integrate the anatomy/path/physiology/etc. Although I felt well after taking the exam I have no idea on what to expect for a score. I guess I’ll have to patiently wait for a few weeks.

Good luck to all of you that have your exam in the coming weeks. You’ll feel sooo good once it is done.
If you have any questions, just let me know.

Regards,
RetroMan
:D
 
Just got my scores back…249/99 – obviously very happy and glad to have this over. First I want to say that doing well on Step 1 is much more about hard work than pure intelligence (because I’m not the smartest kid around). My best piece of advice is a reiteration of something Big Frank said awhile back…treat your step 1 prep like a marathon. I don’t think there’s any substitute for working hard during second year and using First Aid throughout so that you already are very familiar with it come study time.

In terms of test content I’m not sure that I can say much that’s very helpful. Everybody’s test is so different that it’s not smart to focus on one area at the expense of the other (in terms of the big boys: pharm, path, micro…embryo probably is never going to be real high yield for anyone). My test for example was loaded with pharm and neuro and luckily I had done a 3 day pharm crash course right before my test because I knew it was one of my weaker areas. The path/pathophys I received was pretty easy overall (and I thought a little underrepresented). First aid was excellent for everything, and with few exceptions all I needed for anatomy, embryo, micro, and behavioral science. It was very close to all I needed for pharm but it is a little weak in some of the conceptual areas – I used Lippincott’s and pharm cards (sparingly!) to fill in some of the holes.

I had about 4 weeks to study. The first two weeks I reviewed the books below and added anything to my first aid that was missing (used the 2003 FA which had been with me since the beginning of school). The last two weeks I spent going through FA as many times as I could in addition to finishing Qbank (got all the way through…73% average on all timed, mixed sets but I started out with some pretty low scores so don't let Qbank get you down). In addition to First Aid (which is really the foundation for doing well in my opinion) I used the following:

1. Path – BRS, RR Path, Goljan Audio…Goljan is a great teacher (I was skeptical at first but since SDN is basically Goljan worshiping grounds I thought I’d give it a try and he really does know step 1)…I thought RR path filled in a lot of gaps in BRS…especially in cardiovascular path.
2. Rapid Review Biochem – very good for clearing up concepts not explained in FA
3. Micro Made Rediculously Simple – used this more during my micro class…not so much come study time (First aid was sufficient for almost every question)
4. High Yield Nuero – great book…saved me on a lot of questions
5. High Yield Embryo and Anatomy – spent half a day at most on these two combined and that was too much…First Aid is great (but know it cold)
6. BRS Behavioral Science – pretty good but Qbank is better as a question source
7. High Yield Molecular and Cell Bio – another book that I saved for the end of my studying that made a big difference (thanks here to Big Frank for his advice)…I had a lot of cell signaling questions and this really helped me out
8. Robbins Review of Path – great book but a lot to get through…for those of you with time use it during classes…it helps cement a lot of important concepts (none of my path questions were any more difficult than the questions in this book)
9. BRS Physio – I had very little pure physio questions and not a single calculation (which surprised me but this means nothing as I know calculation questions are out there)
10. Appleton and Lange Review for Step 1 – I really only used the pharm section which was a good kick in the butt for how little I knew…didn’t really use the other sections as I ran out of time
11. QBANK – besides First Aid this was my most valuable resource…started doing questions about 3 months out, 50 timed questions per night, going through each right and wrong question afterwards to learn from the answers…anything I didn’t know I annotated in First Aid…on test day I felt like I had seen a lot of questions before and the real test basically felt like a watered down version of qbank
12. NBME practice test – took form A at the beginning of my studying to see where I was at and got a projected 228 or something like that…it motivated me knowing my baseline was decent but that I had work to do to meet my goal.

Hope this is helpful. To summarize, First Aid and Qbank are golden…for those of you still a year out work hard second year and make first aid a part of your study – it will make a big difference come crunch time.

Good luck to you all…again, this test is not to identify the geniuses out there…I’m far from it but feel like my score is solid – set a goal and work hard…it’s definitely attainable :)
 
Pox in a box said:
What do you mean RetroMan?

Thanks for the 411.


I mean that they might say the person has a deficit of temp/pain sensation on the left side and then point to the same tract on the left/right of SC....so that you also have to remeber if the fibers crossed already for that pathway, etc, etc.
 
RetroMan said:
Anatomy
Most of my questions had MRIs, diagrams of SC/medulla, CTs associated to them.

How do we prepare for these, besdies what's in FA and HY? Any other sources u used that were helpful? Thanks
 
RetroMan said:
Biochemistry/Mol Bio/Genetics
Some strange dzs (not in FA or Lippincot’s) you just can not prepare for. :D

I like Pox's idea from the other thread of telling us "certain" biochem diseases so we can be moe intelligent physicians :) So, why not tell us 5 molec diseases, esp some that we are not aware of, so we can all become smart, eh??
 
HiddenTruth said:
How do we prepare for these, besdies what's in FA and HY? Any other sources u used that were helpful? Thanks


I think that HY did a decent job. You just need to make sure that you are reading actively. Think like this...pain in the toe, what nerve-follow the tract in SC-follow the decussations-Medulla-thalamus-Sensory Homunculus in brain.

I didn't use any other resources besides what I mentioned on the post above.
 
r_dubbs said:
To summarize, First Aid and Qbank are golden… :)

I totally agree however I didn't open FA or Qbank til the month prior to my test. I would suggest taking a month to study hard core, however keep things that are important to you in your life (for example, I used the Gold Standard CDs every day while I worked out at the gym) :) Took Step 1 in Feb (my school ends basic sciences early). Had a 29 MCAT so was worried, but ended up very pleased with my score. Feel free to PM me for details ...
 
Does anyone every feel good after they walk out that exam?

I agree with the above posters that the exam is definitely "fair" but there is just no conceivable way to feel prepared. I thought I had a decent mixture of everything with more molecular biology than I would have cared to seen. I am terrible at that stuff.


Pharm..very straight forward on the exam I thought. Possible one of the easieast sections and if you know FA you will handle it with few problems. I had one drug that I had never heard.
Resources: FA and Kaplan Pharm

Molecular Bio/Biochemistry....I thought the molecular bio was the most difficult aspect of the exam, but I am terrible at it too. I thought I prepared well for it, but it didn't seem to matter. There were things on there that I might have covered in undergad. but definitely not in medical school. I was able to answer around 50% of those with some certainity. The other 50% were just pure guesses. The biochemistry was straight forward and not very difficult. If you have decent understanding of the major pathways and enzymes you will be golden on the biochem. stuff.
Resources: BRS biochem, HY molecular bio, Kaplan biochem.

Anatomy/Neuroanatomy/Embryo....These were straight forward if you knew what the vessel was or what nerve innervated it. My test was heavy on pelvis/LL vasculature and LL innervations. There were some easy label this kind of stuff with cranial nerves and of course there were sections of the brainstem and you had to know where the cranial nerves went and what was affected if they were damaged. Know your blood supply to the brain, probably had 5 q's on that alone. I had maybe 3-4 embryo questions and they were hit or miss. FA is definitely not enough for these sections if you want to do well on it. I probably had around 30-40 q's total on anatomy and Neuroanatomy.
Resources: FA, Kaplan anatomy/neuroantomy HY embryo

Micro/Immuno.....Micro was the easiest part of the test and if you know FA you will not miss a question on micro, same for immuno. I only had a couple of esoteric micro things and those are easily answered from FA.
Resources: FA, Kaplan micro/immuno, MMRS

Pathology.....It seems you really never get any, "this symptom, what is the disease, type questions." Everything is third layer. You will be reading the question and in your mind you know what the person has but when you look down that isn't what they are after. So know BRS path cold so you can reason out the third and fourth level type questions. You do not need the pictures to answer the questions. Every question I had could easily be answered by the text alone. I also thought I had more bone questions than I care to recall. It also seemed like I would get the the question down to 2 and have to guess from there. I felt like I was doing this often throughout the exam.
Resources: BRS path, Kaplan path, FA

Physiology.....Lots of endocrine phys and they love the kidneys. Very little respiratory phys or cardio phys. There were all the basic graphs and arrow questions...we take this away, what goes up and what goes down, etc. Again, knew some, get some down to 2 and guess. I guess that's part of the game though. BRS phys was excellent for this part of the test, know it well.
Resources: BRS phys.

That's all I can think of for now. I definitely don't feel good about it that's for sure. I finished Qbank w/a 73% average, but I don't feel Qbank was very representative of the difficulty of what I had on the USMLE. I scored a 460 on the NBME A 6 weeks ago and a 600 on NBME B 2 days before the exam. I will let you know how all this correlates when I get my scores...let's hope I passed at this point in time.

Any questions..just ask!
 
Since u appeared for the exam today and according to the USMLE website info FRED was supposed to be implemented from today was just wondering if ur exam used the fred software ?
thanks
 
moonface said:
Since u appeared for the exam today and according to the USMLE website info FRED was supposed to be implemented from today was just wondering if ur exam used the fred software ?
thanks

Yes, I had the FRED software. Everything went off without a hitch..well, except for the actual test questions :scared:
 
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