Compiled Step one Experiences

[Jalby]

---

Members don't see this ad.

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.

 

[Doc Ivy]

Hmm, I'm guessing from the oseltamavir controversy that this was a "experimental" question that going to be thrown out anyway so I wouldn't worry about it: Pt had past hx of MI, high chol, renal faliure, on a statin, anti HTN, diuretic, and bblocker, may some other things-- got exposed to the flu from her grandson
The exact question was which factor is a reason not to use oseltamavir in this patient:
renal insufficiency (I chose this)
Age
Gout
Immunocompromise (she wasn't)
there might have been other choices but I can't remember

 

[HiddenTruth]

Hmm, I'm guessing from the oseltamavir controversy that this was a "experimental" question that going to be thrown out anyway so I wouldn't worry about it: Pt had past hx of MI, high chol, renal faliure, on a statin, anti HTN, diuretic, and bblocker, may some other things-- got exposed to the flu from her grandson
The exact question was which factor is a reason not to use oseltamavir in this patient:
renal insufficiency (I chose this)
Age
Gout
Immunocompromise (she wasn't)
there might have been other choices but I can't remember

ok, so she wasn't a diabetic? That's definately not it then. As a side note, if she was diabetic, I think that is an immunocompromised state in and of itself. (But yea, I don't think that's it either). Wierd question. Such open ended.

 

[Bounty]

ah yes...have in my notes that the active drug is excreted renally...

 

[jennie 21]

anyway, wouldn't oseltamavir prophylaxis be even more important in an immunocompromised patient who's been exposed to the flu? seems to me like renal insufficiency is the only viable answer of the ones that were listed.

 

[Samoa]

jennie, they're not sure it works in immunocompromised patients. otherwise you're absolutely right.

 

[LovingItAll]

I enjoy reading everyones "decompress" from their Step 1 experience. I'd be curious to know what everyone's experiences were in terms of question types. The notion of "steps in an question" has been discussed before:

Which type of questions predominated your exam:

PATH: (SLH = symptoms/lab abnormalities/histologic abnormalities)
- They give you SLH, you pick the correct disease
- They give you a disease name, you pick expected SLH
- They give you SLH, you pick likely additional SLH.

PHARM: (AE=adverse effect, MOA=mechanism of action, DOC=drug of choice)
- They give you a disease name, you pick the DOC
- They give you a disease name, you pick the MOA of the DOC
- They give you a disease name, you pick the AE of the DOC
- They give you SLH, you pick the DOC
- They give you SLH, you pick the MOA of the DOC
- They give you SLH, you pick the AE of the DOC
- They give you a drug name, you pick the MOA
- They give you a drug name, you pick the disease its used for.
- They give you a drug name, you pick the AE
- They give you a drug name, you pick the MOA
- They give you a drug name and an AE, you pick an alternative drug without the MOA.

Any thoughts from those who have gone through it?


And yes, I have OCD. why...you don't?

 

[Stevens Johnson]

I know nothing about the NBME tests except from what I have read on the forums. A friend and I were both planning on taking one of the tests next week.

Is there any way that a cheapskate like me could get around the system and save some money on the test? perhaps just one of us could pay, but both of us to have access to the exam? can anyone help me with a scheme.

thanks from a poor student with only one shoe because he had to eat the other one for food,
stevens johnson

 

[HiddenTruth]

Is there any way that a cheapskate like me could get around the system and save some money on the test? perhaps just one of us could pay, but both of us to have access to the exam? can anyone help me with a scheme.

I haven't taken it, but I know the general format--but really, it depends on what you're trying to get out of by taking the test. If it is for score correlation--then you both can't take it for obvious reasons--you submit ONE exam! However, if you just want to take it for the sake of practice questions, then I suppose you can do it. There are 4 sections (each 50 q's each); you can take it in the untimed mode, which will give you 4 hrs/section. So, you both can take it one at a time for each block. The second person that takes it can submit the answers. Do that for each block--only one of you will get a score correlation though. So keep that in mind!

I suppose if you wanted to get a ROUGH ESTIMATE of your score--you both can copy your answers elsewhere, and then make a rough comparison based on what one person gets. Really really skewed correlation, however.

 

[eunice]

I looked a couple things up during breaks - I got a couple physiology questions on the same (rather major topic) that I wasn't sure on, so I checked on it just in case I got a third.

Thanks for sharing w/ us.

JUst wondering, do people usually do this?? bring their FA and check answers during breaks?
I didn't even think about it, b/c i think it would make me super bummed... after each block, looking up the questions I missed...

i heard it's best to not think about the ones you 'probably' missed the last block, so that you don't stress yourself out for the next block.

BUT, if they do repeat concepts, then maybe it is good to look it up?

what do people do usually?
Bring FA to the test or not? what's your vote?

thanks!

 

[SkidRow]

Took it today.. I have a bone to pick. The survey at the end of the new FRED software does not work. Any question that has check more than one option is not recognized and left as incomplete no matter what you do. I told the prometric people and they said not to worry since survey is optional. Made me think about the rest of the exam. That was a little uncomforting to see that happen. Other than that, ill wait for the result, but overall very equally distributed test without much low yield material. FA is definitely the book to memorize once you go through your other sources. Anyone else have a problem with the survey??

 

[Pox in a box]

Took it today.. I have a bone to pick. The survey at the end of the new FRED software does not work. Any question that has check more than one option is not recognized and left as incomplete no matter what you do. I told the prometric people and they said not to worry since survey is optional. Made me think about the rest of the exam. That was a little uncomforting to see that happen. Other than that, ill wait for the result, but overall very equally distributed test without much low yield material. FA is definitely the book to memorize once you go through your other sources. Anyone else have a problem with the survey??

If the survey's your biggest complaint, you must have rocked that baby! Congrats! I do agree that I'm a bit hesitant in putting 100% faith into this new FRED software.

 

[SkidRow]

the FRED software was actually EXTREMELY USEFUL. it was great to highlight and due to this feature i did not mark a single question, i did them as they came. I didn't have any problem with time. I finished my first section with 35 min remaining, and the rest of the blocks about 20 minutes remaining. I'm not saying anything about the difficulty of the exam b/c it was very spread out EVENLY. It had everything on it. The survey though did me in. I was expecting the testing delivery to be flawless is that too much to ask? Overall finished in 5 1/2 hours, including about 5-10 min breaks. High Yield exam mostly. Hopefully i passed! (and hopefully the rest of the exam wasn't like the survey)

 

[eunice]

what's this survey?

the FRED software was actually EXTREMELY USEFUL. it was great to highlight and due to this feature i did not mark a single question, i did them as they came. I didn't have any problem with time. I finished my first section with 35 min remaining, and the rest of the blocks about 20 minutes remaining. I'm not saying anything about the difficulty of the exam b/c it was very spread out EVENLY. It had everything on it. The survey though did me in. I was expecting the testing delivery to be flawless is that too much to ask? Overall finished in 5 1/2 hours, including about 5-10 min breaks. High Yield exam mostly. Hopefully i passed! (and hopefully the rest of the exam wasn't like the survey)

 

[omarsaleh66]

Hey familys:

Just took the Step man on monday, I cant beleive its over. I had a hard ass test; it might have been easy for some but it wasnt for me. sunday nite i couldnt sleep, (i even took Ambien and still coudlnt sleep!) So i just spent all nite listening to 80's music and Penn Masala trying to fall asleep. But once I got there, I wasnt tired at all, I ate a healthy breakfast and drank alot of coffee. I took a thermos of coffee w me and some Starbucks doubleshot drinks and after each block i made sure I would go outside and drink some coffee and my 1 L water. I also ate some peanuts M&Ms and balance bars to stay energized. I even took some tylenol w me just in case I wouldnt get a headache. I was the only one that was taking breaks after each block. Everyone else was going thru it. I think the breaks helped me and kept me from getting too tired.

As far as the test:

Anatomy: I had a lot of anatomy. First Aid is ok, but not enough. I only used Platinum Vignette for Anatomy and Embry and First Aid. I had to guess on alot of anatomy questions, and some I just remembered from reading in Moore's during my MS1 year!!

Path- I guess i had a lot of path, Goljan audio was defineitly high yield. First Aid is good too. That's all I did. I didnt have time to go over BRS path. But I used BRS path and a bunch of other pathology review books and questions thru the year so I felt kinda confident.

Pharm - First Aid was enough for most questions. I got like 3-4 that were not in First Aid and I had to guess on. Pharm questions very incredibly easy to like super hard where i had to make up drugs and their mechanisms to answer the question. I got a lot of pharm questions.

Micro - Easy, nothing hard here. First Aid is defineity enough.

Phys- Hard to say what is Phys and what is path-phys. It's all a blur. Alot of arrow questions -and these were hard. I got alot of endocrine!

Biostats- I had alot of biostats. I suck at biostats. These questions are easy for most people; pretty staraightforward i guess; not for me though. First Aid is enough here. Know the relationships between sensitivy and specificity. and some basic calucations

Genetics - I usd HY molecular bio; It made me confident but I dont think I could easily answer these questions. Maybe cuz i read it a week ago and forgot it.

Histo - I dont remember any histo questions. Maybe a few and they were easy.

Neuro - I got a couple pics straight from Haines atlas. I didnt use Haines atlas and kinda wish i did. I got quite a bit of neuro and happy I used HY Neuro.

Biochem- Most biochem questions were easy. First Aid is all u need. I got maybe 10-15 biochem. Maybe 2-3 were not in First Aid.

Behavoarila science - easy, qbank + First Aid is good prep.

This is what i did to prepare. I had 5 weeks. I did Appleton and Lange. about 30% of qbank. HY molec, HY neuro, HY histo, Platinum Vignette for anatomy & embryo. I did about 50% of NMS and averaged 66% but never went over the answers (no time !!). I listened to goljan and did First Aid for the last couple of days.

The things I felt that helped me the most was Goljan audio and First Aid. I did not use goljan 36 page HY notes but I skimmed thru them today and a bunch of stuff from these notes was on my test, so I highly recommend it. Goljan tells u what is on the test, and guess what? it was showing up everywhere! I had a big advantage listening to him cuz I was able to answer some really difficult questions cuz he explains it to u. Really High Yield. It was coming up everywhere. I would listen to goljan while I ate, maybe u guys can try that. First Aid is the other big help. If i had mastered this book, maybe could have gotten some more right. But it did save me on alot of stuff. Glad i spent time on First Aid. what else helped? Believe it or not, SDN helped. I got tested alot on what questions are asked here. Look at some of Pox's, Hidden's or Ramoray's questions - > they all showed up.

Another great study aid was the NBME 1 and 2 test. These questions were showing up on my exam. If not the same word for word, they were testing the same concept in a different way. I was able to discuss some of the NBME questions with some friends and luckily the same concepts were popping up on my test. For the most part, this test was HY. U should know it from being in medical school. I walked out of that test not feeling confident. I missed alot of easy questions just due to poor preperations and I dont know if everyone feels this way or what. But I dont even care; I'm just glad it's over.

Even though i think I didnt prepare right for this test, what probably helped me was that over the 2nd year I have probably done 3000-5000 questions. That is the best prep. Now I wish i could have done even more (like add qbank, NMS, BSS) but also using review books during the first 2 years was a good idea. What else? well i walked out of that test feeling that I knew some stuff but I guessed on alot - usually narrowing down to 2-3 choices. Or 2 choices. I hope everyone feels this way cuz i didnt know alot!
Gluck everyone

Later
Omar

 

[Pox in a box]

Hey familys:

Just took the Step man on monday, I cant beleive its over. I had a hard ass test; it might have been easy for some but it wasnt for me. sunday nite i couldnt sleep, (i even took Ambien and still coudlnt sleep!) So i just spent all nite listening to 80's music and Penn Masala trying to fall asleep. But once I got there, I wasnt tired at all, I ate a healthy breakfast and drank alot of coffee. I took a thermos of coffee w me and some Starbucks doubleshot drinks and after each block i made sure I would go outside and drink some coffee and my 1 L water. I also ate some peanuts M&Ms and balance bars to stay energized. I even took some tylenol w me just in case I wouldnt get a headache. I was the only one that was taking breaks after each block. Everyone else was going thru it. I think the breaks helped me and kept me from getting too tired.

As far as the test:

Anatomy: I had a lot of anatomy. First Aid is ok, but not enough. I only used Platinum Vignette for Anatomy and Embry and First Aid. I had to guess on alot of anatomy questions, and some I just remembered from reading in Moore's during my MS1 year!!

Path- I guess i had a lot of path, Goljan audio was defineitly high yield. First Aid is good too. That's all I did. I didnt have time to go over BRS path. But I used BRS path and a bunch of other pathology review books and questions thru the year so I felt kinda confident.

Pharm - First Aid was enough for most questions. I got like 3-4 that were not in First Aid and I had to guess on. Pharm questions very incredibly easy to like super hard where i had to make up drugs and their mechanisms to answer the question. I got a lot of pharm questions.

Micro - Easy, nothing hard here. First Aid is defineity enough.

Phys- Hard to say what is Phys and what is path-phys. It's all a blur. Alot of arrow questions -and these were hard. I got alot of endocrine!

Biostats- I had alot of biostats. I suck at biostats. These questions are easy for most people; pretty staraightforward i guess; not for me though. First Aid is enough here. Know the relationships between sensitivy and specificity. and some basic calucations

Genetics - I usd HY molecular bio; It made me confident but I dont think I could easily answer these questions. Maybe cuz i read it a week ago and forgot it.

Histo - I dont remember any histo questions. Maybe a few and they were easy.

Neuro - I got a couple pics straight from Haines atlas. I didnt use Haines atlas and kinda wish i did. I got quite a bit of neuro and happy I used HY Neuro.

Biochem- Most biochem questions were easy. First Aid is all u need. I got maybe 10-15 biochem. Maybe 2-3 were not in First Aid.

Behavoarila science - easy, qbank + First Aid is good prep.

This is what i did to prepare. I had 5 weeks. I did Appleton and Lange. about 30% of qbank. HY molec, HY neuro, HY histo, Platinum Vignette for anatomy & embryo. I did about 50% of NMS and averaged 66% but never went over the answers (no time !!). I listened to goljan and did First Aid for the last couple of days.

The things I felt that helped me the most was Goljan audio and First Aid. I did not use goljan 36 page HY notes but I skimmed thru them today and a bunch of stuff from these notes was on my test, so I highly recommend it. Goljan tells u what is on the test, and guess what? it was showing up everywhere! I had a big advantage listening to him cuz I was able to answer some really difficult questions cuz he explains it to u. Really High Yield. It was coming up everywhere. I would listen to goljan while I ate, maybe u guys can try that. First Aid is the other big help. If i had mastered this book, maybe could have gotten some more right. But it did save me on alot of stuff. Glad i spent time on First Aid. what else helped? Believe it or not, SDN helped. I got tested alot on what questions are asked here. Look at some of Pox's, Hidden's or Ramoray's questions - > they all showed up.

Another great study aid was the NBME 1 and 2 test. These questions were showing up on my exam. If not the same word for word, they were testing the same concept in a different way. I was able to discuss some of the NBME questions with some friends and luckily the same concepts were popping up on my test. For the most part, this test was HY. U should know it from being in medical school. I walked out of that test not feeling confident. I missed alot of easy questions just due to poor preperations and I dont know if everyone feels this way or what. But I dont even care; I'm just glad it's over.

Even though i think I didnt prepare right for this test, what probably helped me was that over the 2nd year I have probably done 3000-5000 questions. That is the best prep. Now I wish i could have done even more (like add qbank, NMS, BSS) but also using review books during the first 2 years was a good idea. What else? well i walked out of that test feeling that I knew some stuff but I guessed on alot - usually narrowing down to 2-3 choices. Or 2 choices. I hope everyone feels this way cuz i didnt know alot!
Gluck everyone

Later
Omar

Sounds like you did pretty well omar. Congrats for being done.

 

[4424]

congrats on finishing. i take mine next week. did you have a lot of pictures on your exam? i have trouble with the pictures on qbank and other question sources if they answer isn't in the question stem 👎

 

[Kluver_Bucy]

Hey familys:

Just took the Step man on monday, I cant beleive its over. I had a hard ass test; it might have been easy for some but it wasnt for me. sunday nite i couldnt sleep, (i even took Ambien and still coudlnt sleep!) So i just spent all nite listening to 80's music and Penn Masala trying to fall asleep. But once I got there, I wasnt tired at all, I ate a healthy breakfast and drank alot of coffee. I took a thermos of coffee w me and some Starbucks doubleshot drinks and after each block i made sure I would go outside and drink some coffee and my 1 L water. I also ate some peanuts M&Ms and balance bars to stay energized. I even took some tylenol w me just in case I wouldnt get a headache. I was the only one that was taking breaks after each block. Everyone else was going thru it. I think the breaks helped me and kept me from getting too tired.

As far as the test:

Anatomy: I had a lot of anatomy. First Aid is ok, but not enough. I only used Platinum Vignette for Anatomy and Embry and First Aid. I had to guess on alot of anatomy questions, and some I just remembered from reading in Moore's during my MS1 year!!

Path- I guess i had a lot of path, Goljan audio was defineitly high yield. First Aid is good too. That's all I did. I didnt have time to go over BRS path. But I used BRS path and a bunch of other pathology review books and questions thru the year so I felt kinda confident.

Pharm - First Aid was enough for most questions. I got like 3-4 that were not in First Aid and I had to guess on. Pharm questions very incredibly easy to like super hard where i had to make up drugs and their mechanisms to answer the question. I got a lot of pharm questions.

Micro - Easy, nothing hard here. First Aid is defineity enough.

Phys- Hard to say what is Phys and what is path-phys. It's all a blur. Alot of arrow questions -and these were hard. I got alot of endocrine!

Biostats- I had alot of biostats. I suck at biostats. These questions are easy for most people; pretty staraightforward i guess; not for me though. First Aid is enough here. Know the relationships between sensitivy and specificity. and some basic calucations

Genetics - I usd HY molecular bio; It made me confident but I dont think I could easily answer these questions. Maybe cuz i read it a week ago and forgot it.

Histo - I dont remember any histo questions. Maybe a few and they were easy.

Neuro - I got a couple pics straight from Haines atlas. I didnt use Haines atlas and kinda wish i did. I got quite a bit of neuro and happy I used HY Neuro.

Biochem- Most biochem questions were easy. First Aid is all u need. I got maybe 10-15 biochem. Maybe 2-3 were not in First Aid.

Behavoarila science - easy, qbank + First Aid is good prep.

This is what i did to prepare. I had 5 weeks. I did Appleton and Lange. about 30% of qbank. HY molec, HY neuro, HY histo, Platinum Vignette for anatomy & embryo. I did about 50% of NMS and averaged 66% but never went over the answers (no time !!). I listened to goljan and did First Aid for the last couple of days.

The things I felt that helped me the most was Goljan audio and First Aid. I did not use goljan 36 page HY notes but I skimmed thru them today and a bunch of stuff from these notes was on my test, so I highly recommend it. Goljan tells u what is on the test, and guess what? it was showing up everywhere! I had a big advantage listening to him cuz I was able to answer some really difficult questions cuz he explains it to u. Really High Yield. It was coming up everywhere. I would listen to goljan while I ate, maybe u guys can try that. First Aid is the other big help. If i had mastered this book, maybe could have gotten some more right. But it did save me on alot of stuff. Glad i spent time on First Aid. what else helped? Believe it or not, SDN helped. I got tested alot on what questions are asked here. Look at some of Pox's, Hidden's or Ramoray's questions - > they all showed up.

Another great study aid was the NBME 1 and 2 test. These questions were showing up on my exam. If not the same word for word, they were testing the same concept in a different way. I was able to discuss some of the NBME questions with some friends and luckily the same concepts were popping up on my test. For the most part, this test was HY. U should know it from being in medical school. I walked out of that test not feeling confident. I missed alot of easy questions just due to poor preperations and I dont know if everyone feels this way or what. But I dont even care; I'm just glad it's over.

Even though i think I didnt prepare right for this test, what probably helped me was that over the 2nd year I have probably done 3000-5000 questions. That is the best prep. Now I wish i could have done even more (like add qbank, NMS, BSS) but also using review books during the first 2 years was a good idea. What else? well i walked out of that test feeling that I knew some stuff but I guessed on alot - usually narrowing down to 2-3 choices. Or 2 choices. I hope everyone feels this way cuz i didnt know alot!
Gluck everyone

Later
Omar

Omar thanks for the great reply. Can you explain what sections of anatomy were high yield? Also the breakdown of gross anatomy on your exam, upper trunk, lower trunk, pelvis&perineum, abdomen, thorax. If you had to guess roughly what percentage were these sections (abdomen 60%, 10% rest etc?

Also, did you have cross section or CTs of upper trunk, lower trunk, pelvis, abdomen, and thorax. If so which part of the body is the highest yield for CTs besides head and neck. After taking the exam, how would you study for the anatomy questions if you had a 2nd chance.

Thanks a bunch.

 

[eunice]

so nobody has any thoughts on this matter?
should you bring your FA to the test to look up answers during breaks?

it may be helpful to get you a few questions.. but it may also be kinda discouraging, you know?

what do you guys think?

thanks!

 

[Gumshoe]

so nobody has any thoughts on this matter?
should you bring your FA to the test to look up answers during breaks?

it may be helpful to get you a few questions.. but it may also be kinda discouraging, you know?

what do you guys think?

thanks!

Definitely do not do that. It just doesn't matter.

My feelings of the test were that (I took it yesterday) it wasn't easy, wasn't crazy hard, but you get all types of questions. I felt like there wasn't as much time, however, at the end of each section left for me to have breaks that were really as long as I wanted them to be ... finished each section with 5 minutes left, max ... then lunch is only like 45 ... i think they should give you more break time. Still, I finished, and it's over. I was more pharm heavy, with questions on every subject. All tests are different, it doesn't matter, just go in and get it done. QBank is just like it, just different questions

Gumshoe

 

[omarsaleh66]

so nobody has any thoughts on this matter?
should you bring your FA to the test to look up answers during breaks?

it may be helpful to get you a few questions.. but it may also be kinda discouraging, you know?

what do you guys think?

thanks!

I took about 5-10 minute breaks after each block to drink coffee, bathroom, eat - no time for First AId really. I really didnt have time for First AId. Finished last in my group. I really took breaks just to chill and get fresh air.

 

[snman31]

Here's the rundown from my test last Friday (I did a little travelling right after the test, hence the delay in posting.)

I took Step I at the Boston Prometric Testing center, which was nice, quiet, and had decent computer screens. Overall I'd say the conditions at the testing center had no effect on my performance. I did arrive early, and they let me start right away, which was nice.

I lightly studied through March and April, essentially just going through PharmCards and MicroCards until I knew them faily well. I also read First Aid once through during this time. Come May, I started to do Q-Bank a lot, finishing it one week before the exam. I did several blocks per day, always one timed and the rest untimed, and always repeating any questions I got wrong until I got them right. I also did both NBME tests, electing to do them self-paced, but timing myself so that I didn't change any answers after one hour, but still had time to review my answers to make sure I understood the questions. The numbers from various tests were as follows:

Q-Bank (cumulative) = 69% (50%-78%)
NBME Released Items = 80%
NBME CBSSA1 (4 days before exam) = 500 (219)
NBME CBSSA2 (2 days before exam) = 560 (236)

As mentioned before, my preparation was pretty much just First Aid and Q-Bank, with a little BRS Path thrown in when First Aid didn't explain things quite as well as I wanted. My target score was 230, so if CBSSA is any indication, I think that preparation was good enough.

As for the actual exam: it was a beast. I thought it did not really resemble anything that I had studied, but I guess everyone feels that way. There was a lot of random stuff, such that I thought I could have taken it a month ago and done pretty much the same. I'll post the final score when I get it. Hope the info helps.

 

[samyjay]

DONE WITH THE BEAST!!! WAHOO!!! My post is going to be relatively short, but for the most part, i think the test was fair....definitely a lot of tough questions, i did have a good number of behav and biostats but if you read high yield behav, you can make an educated guess...for the most part the most important thing i thought today was to see the test as 7 mini tests of 50 questions...it is easier that way, i took a break after each section, talk to the workers, talked to the other students...DONT BRING FIRST AID or any study materials, and another thing is that if you do not know a questions, dont dwell over it, i have a tendency to do that, but my motto was this "think simple and that they are not going to try to trick me" Kaplan biochem was really helpful, i thought qbank was awesome, if anything it taught me how to GUESS in time pressured situations...My test seemed to be composed of everything, not too much embryo, good number of path, biochem, and lot of physio, esp a lot of up down arrow questions, the prob with those is that i always got it down to two, then just guessed from there, on the whole, i think if you have been doing timed qbanks, and have confidence, you will do awesome...time to party for me

 

[Wrigleyville]

I finished up this afternoon at three -- I still feel the urge to read books and study... it's like I'm going through withdrawal.

As for the exam:

Micro -- I had no worms or wierd bugs of any kind. The most exotic thing was a soldier who got bitten by a sandfly, and you didn't even need to figure out what kind of Leishmaniasis he had, just that that was what he was infected with. There were a couple of fungus questions, one was a guy who kept getting infected with a fungus from his dog, and the other was an aspergillosis infection in a tuberculosis cavity. The rest were basic questions on bug identification based on the culture (oxidase +, lactose -, etc.)

Pharm -- Most questions were straightforward. Drug interactions and contraindications were the order of the day. There was one question where I had literally never heard of any of the answer choices. I wish I remembered, because I almost laughed out loud when I saw them. Hopefully that was an "experimental" question.

Physiology -- My test was dominated by arrows and graphs as far as the physiology questions are concerned. Nothing too hard.

Path -- No HLA types, no translocations, none of that crap. Most of the questions were long physical exam finding question stems to help you identify the disease, and then they'd ask you something about the disease process.

Anatomy -- I only had one or two peripheral nerve questions. They were stupidly easy. I had TONS of CTs, MRIs, angiograms, etc. At least 20-25. Many were neuroanatomy questions. They'd give you a clinical scenario, and you'd have to point at what was broken. Or they'd show you a tumor, and you'd have to choose a structure out of a list that the tumor was impinging upon. Those kinds of things. In no way was First Aid sufficient, but High Yield was plenty.

Stats -- good lord, there were plenty of stats questions. Some were very easy, others took time to figure out. There were several questions about types of studies, their relative advantages, etc.

Histo -- I had zero pure histology questions as far as I can remember. There were a handful of cell biology questions.

Good luck to the rest of you still studying for this beast. It's Miller Time for me.

 

[HiddenTruth]

fungus from his dog, .

congrats Wrigley!
But, a fungus from a dog? You're not talking abt protozoan are ya, Leptospira, or tape worm?

 

[idq1i]

congrats Wrigley!
But, a fungus from a dog? You're not talking abt protozoan are ya, Leptospira, or tape worm?

tinea barbae

 

[Long Dong]

tinea barbae

How about micorspurim canis (not sure of spelling) under woods light.

 

[HiddenTruth]

How about micorspurim canis (not sure of spelling) under woods light.

yea, actually i was just thinking that after i wrote it-- is that the only one, of the dermatophytes that can be a reservoir in animals?

 

[Samoa]

so, yeah, I took step 1 today...I got the insanely hard test, wouldn't you know? And the first block was the absolute hardest. Seriously, I just about got up and walked out half way through, and that's not at all like me. I was so rattled I had to take a break and regroup before moving on to the next section.

The rest of it ended up being at least doable, and really there were a fair share of easy questions. There were also several questions that were just a matter of reasoning. So maybe it'll turn out OK.

I got questions on a lot of things that aren't in FA. And I got plenty of cytokines. No chromosomal translocations, but I did get HLA alleles and anti-whatever antibodies. And some pharm drugs that I only know of because I'm a pharmacist (and please don't ask me what they're for). So that was a barrel of fun.

My test seemed heavy on anatomy, and it was all stuff that Qbank didn't cover, and FA didn't cover, and BSS didn't cover, and that wasn't in HY Gross Anatomy either. Sadly, not a single brachial plexus question. Yep, that sucked. Some of the neuroanatomy questions were also pretty obscure.

There were plenty of statistics and pharmacokinetics, including 2 or 3 questions where I really did need a calculator. Study design and behavioral science were also pretty well represented. Those didn't seem too bad to me, although I do think they were intended to be difficult.

In terms of straight pathology, my test seemed skewed toward skin and musculoskeletal diseases. Which was particularly fun, as I had studied mainly cardiovascular and renal and pulmonary and heme. 🙄

The micro wasn't too bad. There were usually a number of clues in the question stem, any one of which would lead you to the right answer.

All I have to say is, thank God I studied the way I did, or I'd have been toast. (I may still be toast, but I'm pretty sure I at least passed.) So here's what I did:

I cut the binding off my FA, and had it spiral-bound with a blank sheet of paper between each book page. This was someone else's idea, but I shamelessly stole it and I feel no remorse for having done so. 😛 Then I went through BRS physio and annotated heavily. Did the same with HY Gross Anatomy, and my class notes from micro. Same with BRS Biochem. I looked through the figures in my class text for cell bio, and copied down anything that looked high yield.

QBank, of course. I did about 1/3 of the questions before classes were over, and from that point on, I did about 2 sets of 50 questions per day, random and timed. Annotated FA some more from the explanations. Finished Qbank a week ago.

I had the five-book set of Board Simulator Series. I did most of the two basic science books, and one test each out of the organ system books. Not as much as I would have liked, but those books are time-consuming, and I was getting short on time.

Something else I did, which I think helped more than anything, was to make flashcards. Lots of flashcards. I made cards for every major disease in Goljan's STARS Pathology, and cards for everything in FA's pharm section. Then I sat down and drilled myself on each card until I could remember it.

During the school year, I was also a notetaker for my school's noteservice, and there were about 5-10 questions on the exam that I could answer ONLY because I had had to learn the material well enough to write clear explanations for my classmates.

So it ended up being kind of a hodgepodge of study techniques, but hopefully it served me well. I still may not do well because it was such a hard test, but I don't know how else I could have studied for the test I got.

next on the agenda: making my liver work hard instead of my brain...

 

[C-GAR]

Took the test today and I have never felt so great to be done with a test in my whole life!!! I will share what I found to be the best things for my studying later, right now I am going to spend some well deserved quality time with my wife!

 

[greenpink]

hey!!!
step 1 is ovah!!!!
I'm either a genious (which I am most certainly not), or my test was very fair and relatively painless.
How I studied: FA, BRS path and phys, HY series, Qbank, scattered Robbins questions, Goljan audio lectures.

I had PLENTY of behavioural science and biochem. Nearly no pharm (which sucked in a way, because I was freaked about it and so memorized the FA pharm section COLD). There were a fare share of give-a-ways (a person who has protracted vomitting -- what is their major acid base imbalance?). I was shocked how straightforward some of the questions were. My stat questions were tough, though, and I found myself baffled at how to solve them (though I had memorized all the equations, and took a year of stats as an undergrad).

Here's question I remember: in which scenario is it contraindicated to give epinephrine with lidocaine in repairing a laceration? a) fingertip b) popliteal fossa c) over zygomatic process d) over the cervical spine (I picked d cause I figured the epi might mess with the cervical ganglions? i just guessed). Not hard stuff (this question is typical) -- this test really wants to check out your reasoning processes.

The 2 days before the test -- spent 90% of time my time listening to the Goljan audio -- something I am grateful for having done. I cannot believe how many questions went from his mouth right onto my computer screen. That blew me away.

I had 1 question re: HLA antigens -- each answer choice gave a long list of HLA antigens and asked which choice represented the person with the highest chance of remaining healthy).
Only 1 lysosomal/glycogen storage disease (another thing I went mad about memorizing).

Many questions gave normal values in the stem -- and the ones that didn't, I found that it was rarely necessary to look them up (not essential to answer question).
An alarmingly large # of questions were only a through d (sometimes only a through c !). It was the exception to have an a --> j type question -- and usually for those, the stem was straightforward. Like "blah, blah, broad-based budding...la la la...which is the most likely causative organism?" duh!! No problem!

I did three sections --> 10 minute break --> 2 sections --> lunch (wanted to be more than 1/2 way done before lunch....also, I was so happy during lunch that I was almost done that I just took about 25 minutes to eat, and then went back in) --> last 2 sections.

The good news:
real thing seriously easier than qbank (i was averaging around 74% on qbank)
though there will be some insanely tough questions, they will be the minority\
it'll be over before you know it
I studied for 32 days -- and that was plenty

The bad news:
you may get a test like samoa's.
sorry.

I love to give details -- so please email me if you have any nitpicky questions or anything.

oh ya -- also -- i was so nervous last night that I only got 3 hours of sleep (normally I get at least 8 or 9) -- but don't stress out if this happens to you. Just accept it, and know that your adrenaline will carry you through the test and the lack of sleep will be managable until your test is oveZZZZZzzzzzzzzzzz

 

[idq1i]

Here's question I remember: in which scenario is it contraindicated to give epinephrine with lidocaine in repairing a laceration? a) fingertip b) popliteal fossa c) over zygomatic process d) over the cervical spine (I picked d cause I figured the epi might mess with the cervical ganglions? i just guessed).

I believe this question was asking about minimizing the risk of ischemic necrosis. I would have picked "finger" - less collateral circulation

 

[joshua_msu]

No use of epi on nose, ears, digits, and penis due to poor collateral circulation as noted above.

 

[heelshmeel]

No use of epi on nose, ears, digits, and penis due to pore collateral circulation as noted above.

exactly, that was what I was taught - "toes, nose, fingers, and 'hose'..." 😉

 

[Stevens Johnson]

thanks greenpink! as far as the HLA questions goes, do you remember what you picked?

Going by the list of hla subtypes in FA p277 (2005) they all look pretty nasty to me. I remember a qbank question that said that DR2 reduces risk of DMtype1 which would make me choose that if i was given the list on p277 as choices. however if i were to answer this question, i would probably choose a choice that was not in this list if given one.....what do you all think?
-------

I had 1 question re: HLA antigens -- each answer choice gave a long list of HLA antigens and asked which choice represented the person with the highest chance of remaining healthy).
Only 1 lysosomal/glycogen storage disease (another thing I went mad about memorizing).

 

[Ologist]

Correct me if i'm wrong, but aren't the tests curved based on the actual questions that show up and their level of difficulty. In other words, wouldn't a very difficult exam have a nicer curve since most of the people who have had those same questions probably had a tough time as well on them? So, theoretically, wouldn't an "easy" test have a curve that wasn't as nice?

Or am i getting this all wrong? It just doesn't sound fair if people are curved against different tests w/ different level of difficulties. Didn't someone post once that each question is "curved" based on all the responses to that same question on other past exams?

Can anyone shed some light on this?

 

[greenpink]

hi again
firstly,

i feel like such a huge airhead. no epi in a fingertip. doh!!!
what was i thinking.
anyway. i hope that lapse in my wee little feeble brain was a singular event.

ok, re: HLA stuff.
The question I was referring to was insane. Each answer choice listed about 8 or 10 HLA antigens. I looked for ones that were familiar to me, and tried to see if they were grouped together in one particular answer choice. No such luck. Unless there is some magical antigen that I should have known about (aside from the diabetes, RA, psoriasis stuff in FA) -- I have no idea how this question should have been answered.

Also -- good question about the curve for these tests. Maybe you are luckier if you get a tough one. Who knows. All I am going to do now is pray that I got a decent score, and try not to worry too much.

Here's something else. Which incidentally is random, I think:
I had a grand total of 2 embryo questions. 2!! I memorized all those friggen arches and pouches, and what's from ectoderm, crest, etc, etc. One of questions I got asked something about which embryological derivative remained patent in the adult? Can't remember what I chose.

OK.
Trying to figure out why I'm up so early (7am).
Going back to sleep.
Goodnight.

pink.

 

[Samoa]

Well, I hope that's true. My very first question on the first section has been driving me crazy since yesterday, and I finally found the answer. It was an obscure paraneoplastic syndrome that wasn't mentioned in any of the review books, and big Robbins devotes one fairly short paragraph to it, and doesn't even give it its own heading. But I remembered a case discussion by one of our professors on a patient with a very similar presentation, at a club meeting early in my first year, where there was a very clear explanation of what was going on physiologically. I don't recall ever formally learning about it in any of my classes, but because of that case discussion, I kinda thought I knew the diagnosis. Of course, the question wasn't asking that (no, that would be too easy 🙄 ). It asked what test would you do to confirm the diagnosis. That relied on knowing enough hematology to remember another disease that would have similar lab findings, and to pick the lab test for that disease.

There is absolutely no way to study for that kind of question. But after finding the little paragraph in Robbins, I'm pretty sure I got it right.

Edit: I should note that the case discussion only helped me understand what process was at play. We were not given the answer to this question, even in a roundabout way.

 

[HiddenTruth]

Well, I hope that's true. My very first question on the first section has been driving me crazy since yesterday, and I finally found the answer. It was an obscure paraneoplastic syndrome that wasn't mentioned in any of the review books, and big Robbins devotes one fairly short paragraph to it, and doesn't even give it its own heading. But I remembered a case discussion by one of our professors on a patient with a very similar presentation, at a club meeting early in my first year, where there was a very clear explanation of what was going on physiologically. I don't recall ever formally learning about it in any of my classes, but because of that case discussion, I kinda thought I knew the diagnosis. Of course, the question wasn't asking that (no, that would be too easy 🙄 ). It asked what test would you do to confirm the diagnosis. That relied on knowing enough hematology to remember another disease that would have similar lab findings, and to pick the lab test for that disease.

There is absolutely no way to study for that kind of question. But after finding the little paragraph in Robbins, I'm pretty sure I got it right.

DIC with prostatic adenocarcinoma?

 

[omores]

About the HLA question. I had it too. Can't remember the details exactly, but I do remember having an "aha" moment when I realized that what they were testing was basic genetic principles rather than HLA types. Sorry to be cryptic; don't want to be descended upon by NBME goons for revealing too much. Greenpink: PM me if you want.

 

[idq1i]

DIC with prostatic adenocarcinoma?

I bet it was hypertrophic osteoarthropathy

 

[bobbybee22]

hey!!!

The 2 days before the test -- spent 90% of time my time listening to the Goljan audio -- something I am grateful for having done. I cannot believe how many questions went from his mouth right onto my computer screen. That blew me away.

Like what? Do you remember what parts from Goljan were on?

 

[nutmegs]

took mine yesterday, pretty happy with the way it went. as people have said the questions are VERY straightforward for the most part. I read almost all of BRS path, about half of first aid, used some clinical micro made simple, did about half of qbank and qbank IV, used some path and pharm recall, and laid HY neuroanatomy under my pillow one night while I slept. there were DEFINITELY things I didn't know, definitely things I guessed on, but I was quite comfortable taking the exam as compared to how much I was freaking out about how much I hadn't gotten to review the day before. so take deep breaths, kids. if I had to pick some things to know
-the names and actions of all the cholinergic/adrenergic drugs, because they love to use them in experiments
-the translocations, because they are a very easy way to get those questions right
-the cytokines and immune cell markers
-the HIV drugs
-which senses travel where in the spinal cord
-how to tell the carrier frequency given the disease prevalence
-cerebral blood supply, including angiograms


good luck!!

 

[jojo14]

Finished! Today! Thankfully, I think my test was more like greenpink's, less like samoas. It was completely doable. There were maybe two questions that I completely guessed on, like just chose C and moved on, and perhaps I should have known them. I felt a lot like I did when I took form 1/2, which I am praying will translate into their predictions. At no point did I feel absolutely clueless, which how I used to feel when taking a random block of Qbank 50.

Prep: MEMORIZE FA. Every question went back to it. I even used the silly mnemoics. Pharm in FA is more than adequate. HY Molec Bio and Histology are fantastic books. And I think I probably did 2500 q's, mostly QBank. This probably had a lot to do with my feelings of ease, although I don't know how to quantify how it helped. I had a fair amount of path and physiology q's, but usually they didn't hinge on you knowing everything to get the q right. I did have a lot of Biochem/Genetics, some Anatomy/Embryo, but nothing was not in FA. Micro-I thought there would be more. And I did actually get a q on NADPH oxidase deficiency after posting a thread about it last night. And I did get buzzwords. Blue sclerae did appear on my exam.

As far as studying the day before- do it. There were so many things that I had and I got right because I looked it over yesterday/ this morning.

Not that I am genius people, I know I didn't ace this, but it is not impossible! I am trying to be positive (wait, trying? did i forget what it feels like to be happy?). We will see how I really did in 6 weeks...

 

[Qwest]

Correct me if i'm wrong, but if you get a really hard test, then your performance will be compared to those who also took the same test, not the total population at large. Right?

 

[Gumshoe]

Correct me if i'm wrong, but if you get a really hard test, then your performance will be compared to those who also took the same test, not the total population at large. Right?

I believe roughly 20K take it per year. I also believe that you are judged on how people did on that same test over the past year (Because there are a lot of people to base it on) ... and that sets the "curve"

Good luck to all!

Gum

 

[Stevens Johnson]

2005 FA, p269 says polyarteritis nodosa is NOT assoc with ANCA, but in older editions it says it is is assoc with P ANCA.

any thoughts if this is a misprint or if it is a new discovery?

 

[allylz]

polyarteritis nodosa is definitely associated with P-ANCA, but not nearly to as great a degree as wegener's is associated with C-ANCA. according to the most recent article i could find, only about 20% of people with PN have P-ANCA, and there's a fairly high correlation with C-ANCA too. i dunno. maybe my articles are wrong, but my 2004 FA definitely says PAN=P-ANCA, and goljan definitely hammered it home. if i saw P-ANCA on a test, i'd definitely be thinking polyarteritis nodosa!

on another note, i think this message belongs in the '2005 First Aid Errata' rather than 'Step 1 Experiences' thread.

 

[katieb]

http://www.usmleasy.com/2005_FA_Step1_Errata_Sheet.pdf

 

[HiddenTruth]

http://www.usmleasy.com/2005_FA_Step1_Errata_Sheet.pdf

Nice, I like how ONE of ONLY two mistakes that the errate sheet lists is of a missing contributor. 🙄 How about the 2-3 dozen others? Maybe Bushan can quit being lazy and do something worthwhile besides making a crap load of money 1. from every med student, and 2. from being a radiologist

 

[Pox in a box]

Nice, I like how ONE of ONLY two mistakes that the errate sheet lists is of a missing contributor. 🙄 How about the 2-3 dozen others? Maybe Bushan can quit being lazy and do something worthwhile besides making a crap load of money 1. from every med student, and 2. from being a radiologist

I'm the one that pointed out the mistakes that they actually noted (like the PAN contradiction). They sent me the errata sheet and I got excited when I saw the title but just junked it because it told nothing. I hope you guys are on the West Coast because your posts seem to be coming at 3, 4, and 5 o'clock in the morning.