Compiled Step one Experiences

[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.

 

[Brickhouse]

The worst thing for me was that I made sure I was a brachial plexus expert going into the test.

Guess how many questions I had on it, out of 30 total?

Zero

(not that you shouldn't study it -- but studying is the best way to make sure something doesn't appear on the exam)

LOL - no kidding. At least tell me that Lesch Nyhan was on there.

 

[JayZee]

The worst thing for me was that I made sure I was a brachial plexus expert going into the test.

Guess how many questions I had on it, out of 30 total?

Zero

(not that you shouldn't study it -- but studying is the best way to make sure something doesn't appear on the exam)

LOL
so true.

just toss FA out the window...

 

[lord_jeebus]

LOL - no kidding. At least tell me that Lesch Nyhan was on there.

I got Lesch Nyhan.

But no SLE, Multiple Myeloma, Wegener, Goodpasture, Alzheimer, Meningitis or Encephalitis, Crohn's, Ulcerative Colitis, Osteoarthritis, Bone pathology of any sort, Sarcoidosis, von Hippel Lindau, Tuberous Sclerosis, Tuberculosis, Bipolar disorder, Hodgkins.....

I did get a full range of exotic parasites, all accompanied by handy geographic buzzwords.

 

[BDylan]

That list of no-shows is hilarious and ridiculous. And depressing.

 

[lord_jeebus]

To the NBME's credit, I did get 15-20 good questions just about myocardial infarctions and diabetes.

EDIT: on second thought I overestimated a bit

 

[Brickhouse]

I got Lesch Nyhan.

But no SLE, Multiple Myeloma, Wegener, Goodpasture, Alzheimer, Meningitis or Encephalitis, Crohn's, Ulcerative Colitis, Osteoarthritis, Bone pathology of any sort, Sarcoidosis, von Hippel Lindau, Tuberous Sclerosis, Tuberculosis, Bipolar disorder, Hodgkins.....

I did get a full range of exotic parasites, all accompanied by handy geographic buzzwords.

Wow. It's like noone told them these were high yield. 🙄

 

[gourman]

A poster on this thread reported getting 3-4 hox questions, & I've talked to others who've gotten them before. Beyond the *obvious* clinical value in knowing them, is it worth memorizing the large chart of Hox's in the back of HY Cell & Molecular Bio? Would the Hox questions have been gimmes if you'd memorized the chart or were they figure-it-out/you'll-probably-miss-them-anyway type questions?

 

[woowoo]

i think i would make memorizing the hox genes the last thing on my priority list. could possibly be the lowest yield item on the test. i got a hox question, but it was very easy, and you could have gotten it without memorizing anything.

remember, this test is not interested in how well you can regurgitate factual knowledge. they are more interested in mechanisms and integration. i think that reminding yourself of this and keeping it in mind while taking the test is half the battle. if you will stop overthinking half of the questions, and realize that what they are asking is usually some sort of basic concept, then the test becomes much easier. if you read into every question, there is a good chance that you are going to make the question harder than it really is, and will miss several easy questions that way.

resist any urge to memorize some stupid list consisting of hox genes and their derivations. will you get a question on it? maybe, but it is extremely low yield, and even if you miss it, that is ok b/c you will probably never ever see the word "hox" again.

 

[freddydpt]

What's a hox gene? I'm not kidding...

 

[nykka3]

What's a hox gene? I'm not kidding...

i am not sure of the exact function but hox is involved in development and differentiation of the embryo. retinoic acid (vit A derivative) can disturb the function of hox supposedly and is considered a teratogen.

so i had step 1 yesterday and it was hard but doable. there was a lot of stuff on my test that i know was in FA or something that Golgan said, but everyone's test is somewhat different. i was just so happy and very tired after it was done. if you believe in God or a higher power or just have ppl. who are supportive in your life, it is definitely helpful to rely on esp. that week before your test. i went to the mall after my test and bought some expensive jeans, went to a reggae club and danced the night away. then i got home and threw up. it was a full day for me. but i am glad that step 1 is done and hopefully behind me (as in i hope i did well).
good luck! you have studied very hard for this and there will be stuff on your test that you can answer!

 

[Brickhouse]

What's a hox gene? I'm not kidding...

LOL Fred I just sent an email to Brenn and Ebeth asking that same question! 😕
Minor point left out at our school, I guess?

 

[Brickhouse]

So I just did two of the three free question sets and I'm noticing it is VERY clinical - is the actual test like this? It seems like most people are saying that the test is best represented by these questions so I just want to know if this is what I have in store?

 

[MeowMix]

i think i would make memorizing the hox genes the last thing on my priority list. ..if you will stop overthinking half of the questions, and realize that what they are asking is usually some sort of basic concept, then the test becomes much easier.

absolutely. The point about focusing on basic concepts is really important.

I knew hox might come up and did not spend any time studying it, and I have no regrets. I answered 2 questions knowing nothing about hox other than that it has something to do with where things go during embryonic development. Then the third question needed much more detail and I just guessed.

I got a lot of mileage out of memorizing the alpha/beta/nicotinic/muscarinic agonists and antagonists, because that's one thing where if you don't know it, you can't reason out the question. That's where I'd focus my attention; the big-picture, really important topics.

 

[om207]

absolutely. The point about focusing on basic concepts is really important.

I knew hox might come up and did not spend any time studying it, and I have no regrets. I answered 2 questions knowing nothing about hox other than that it has something to do with where things go during embryonic development. Then the third question needed much more detail and I just guessed.

I got a lot of mileage out of memorizing the alpha/beta/nicotinic/muscarinic agonists and antagonists, because that's one thing where if you don't know it, you can't reason out the question. That's where I'd focus my attention; the big-picture, really important topics.

Great point...Any suggestions on reviewing autonomics/adrenergics? I was planning on reading BRS chapter on Neurophysiology.

Thanks!

 

[MeowMix]

Any suggestions on reviewing autonomics/adrenergics? I was planning on reading BRS chapter on Neurophysiology.

I would suggest a focused review of the G-proteins etc. (mentioned here many times before), exactly how they work (in more detail than FA), and the details of the major adrenergic/cholinergic pathways. The Costanzo BRS phys is pretty good for that; her big blue book has more G-protein details. Do a bunch of questions to test your understanding, do not get demoralized. The NBME exams are a good way to see how horribly detailed some of those questions get.

drugs - I had a table with mnemonics, which I made for a pharm exam. It was the easiest way to go back and re-memorize since it was already organized. I resisted it until 2 days before the exam, then I sat down and wrote it out over and over again until I could reproduce by memory. I skipped the esoteric chemicals and focused on the stuff that kept showing up. I could never remember where alpha and beta were and what they did, but if I saw the drug name (e.g. albuterol) and knew which receptor it targeted, then I could figure out what the receptor did to blood vessels etc. I'm sure a better student would have a much more elegant way of doing this!

 

[Violinrose]

ooh....i got the hox gene question too! 🙂 i took the step 1 exam yesterday. for me there were 2 killer blocks (the 4th and 7th ones) where I had question marks on like half of the questions. I just felt bad that some questions tested some minute subjects that I would never have studied while more than half of what I did study did not even make an appearance on the exam. My test centered on mostly path, genetics and mol bio. I think I at least passed. I hope. 😳

In Goljan's lectures, he once remarked that the test writers put questions on the exam stemming from their own lives. If that is the case, then my exam had a whole lotta writers with erectile dysfunction. After the 5th or so question, it just got to be annoying. BPH came in second. So it would seem older men are writing these questions.

Anyways, after it was all done, I felt it to be anti-climatic. Kind of a what do I do now that this is over feeling and school starts in a couple of weeks. ....At least I get to go vacation in Hawaii next week. Hope everyone else gets a fun break too. Good luck. 🙂

 

[hale-bopp]

well since I obsessively checked this forum to see what other people had to say, I feel like I should contribute my experience. I took it today, and while it's sort of a blur, I'll post what I can remember.

my test seemed pretty fairly divided between subjects. The difficulty of the blocks did not seem even, with the first two and last one seeming harder. (although with the first two, I might not have been warmed up yet)

I had about 5 embryo questions and they were all very easy between first aid and qbank.

The anatomy was a mixed bag. Half of it was stuff that was emphasized in Q bank, half of it was stuff you maybe could have figured out from the image or remembering basics. I think first aid was pretty worthless for anatomy but I wouldn't have used anything more, except maybe spent a little more time (like 20 minutes) going over cross sectional anatomy of the trunk. Probably about 10-15 questions total.

Neuro on my test was really easy. And I am not that good at neuro if it gets tricky. pretty evenly divided between central and peripheral, maybe 3 questions per block. There were an annoying number of questions about cell physiology of neurons which I did not review at all because it's not in first aid or qbank and I had to try to remember from first year. there is a chapter on cell phys in BRS path I could have read and probably would have in retrospect.

I thought the pharm on my test was pretty hard. I was doing pretty well on pharm on Q bank and USMLERx by the end, too, for what it's worth... I might think it's hard because I can only remember a few questions that I really had absolutely NO idea on. I think there might have been a bunch of questions that were really easy too that I've forgotten about. also I got a LOT (probably 5) questions with graphs of different inhibitors and various questions about that, easy if you've practiced it. my test was maybe 10% pharm.

micro was mostly straightforward, no worms, a couple of parasites, very few viruses, a few fungi. mixture of mechanism of some aspect of infection, name the infection, how do you treat it... no idea how many questions, not a ton. Mostly really straightforward and from first aid, a couple I had no idea on (but still could be in first aid).

path/pathophys/phys was the bulk of the test. I think it was more renal and cardio, but pretty even among most stuff. there was maybe one derm question, I think I got every single question about bones wrong. Reproductive was harder than any of the NMBEs too. Overall, there were a couple of case presentations where I had absolutely no idea what was going on, one where I had heard of the random disease mentioned once as an afterthought in class, but not the details of it... hopefully experimental. I thought that path in general was harder than the NBME exams, where I didn't really have a problem with it.

I thought I had sort of a lot of histo/cell bio (not a ton, definitely less than 10 total) and not so much images but descriptions and I did NOT do well on those questions. sometimes I'd figure out the answer like on a break after the next block. stupid. Q bank does not have enough of those questions and first aid only has like a page. that is one thing I would have liked to have spent like 2 more hours reviewing and it would have been really easy points, they were not hard questions. maybe high yield histo would have been a good investment.

Biochem was mostly okay. I spent a LOT of time reviewing it, because I felt the weakest in it. There were a couple of questions about tRNA-type stuff that I had no idea on, but other than that, not too bad. The metabolism questions (which I was terrified of) were really straightforward. like people have been saying, KNOW the signaling of the alpha and beta receptors. Knowing signaling pathways in general was probably good for 5-10 easy questions. (insulin, growth factors...) If you feel weak at all, HY cell and molecular has it all. I thought the immunology on my test was REALLY hard. and I work in an immunology lab. there is NO WAY you would have gotten some of the questions just knowing first aid (like you needed to know multiple names for costimulatory molecules in MHCI vs II presentation of antigen). but maybe the really hard ones were experimental. and there wasn't that much.

Behavioral science questions were way better written than q bank. I had at least 10 what would you says, but 7 were no brainers at least. I got a LOT of questions about epi also (2-3 per block), I'm really glad I reviewed it the day before, and glad that my school DRILLS us with it till we want to die of boredom.

I think there were at least two questions with no answer. one was a biochemical disease where they named an enzyme that causes a disease and asked which disease it causes and then listed 5 diseases, none of which were the one it caused, and the other was a genetics question, where I checked my work like 5 times (although I could still be wrong about that one, I guess.) I guess that's what "experimental" questions are? I think they're just trying to mess with your (my) head, but I can't figure out why. Fortunately, after the disaster that is multiple choice exams at my school, questions with no correct answer don't faze me too much, hahaha.

I thought that the NBMEs were the best source of practice questions, once I had finished reviewing all the material once. they were pretty dead on about some of my weaknesses (information which I used better in some areas than others...) also, I definitely feel less good about this than I did the NBMEs, I'm hoping it's a combination of (a) experimental questions are hard, and (b) on the NMBEs I would go back and check (but not change) my answers so I knew if I had guessed right, whereas now I don't. I'm pretty sure I passed, at least, but I sure don't feel terrific.

also, I had time issues on some blocks of the actual test, which I did not have on the NBMEs, mostly because of a few WTF questions (probably experimental, but you never know) or just forgetting facts that I thought might come to me (sometimes they did). and I am normally a really fast test taker, at school I am one of the first ones done with our tests, I finished some sections on the MCAT like 30 mins early... I got through everything once no problem, but on a few blocks I could really have used a few more minutes to think.

I hope this helps someone, or at least makes you feel better about the test. good luck to everyone who still has to take it. 😳

 

[2008md]

I took about 6 weeks to study. My plan was to get through everything by the end of 4, then focus on questions and rereading FA. I used some old Kaplan books for biochem, micro, and immuno, HY for behavior and cell and molec, and BRS for my systems based path and phys. I think that annotating FA with each of these sources really helped me make sure I focused on the important stuff, as outlined by FA, while fleshing out the details with things from other books. Also, it was nice in my last 1.5-2 weeks to have everything I wanted to look over in one spot. My goal was to have everything I needed to know in FA, while I knew I would never “memorize it.”

I used qbank for questions. I tried to do 50-100 random per day and just used it as a learning tool, rather than use it as a gauge on how I was doing. That said, I did only blocks of 50 to try to get my brain adapted to that time frame.

Some tips:
-Qbank is terrible as a predictor for “what will the test be like.” It is excellent for helping identify the important concepts. Use it as a guide of what concepts to focus on, but don’t memorize all the minutiae. However, it’s helpful to read every explanation.
-You should know the different classes of receptors (tyrosine kinase, G-pns, steroid, etc.), how they work, and what receptors are in each class. I would also know the 3 main classes of Gpns (Gq, Gs, Gi) I made mnemonics for the ones I didn’t know and then scribbled them on my eraser board as soon as I got there. Sure enough, I got 5 or so q’s on these. They were easy if you had memorized them. One of the last chapters of HY cell and molec is really good at this.
-Do the NBME’s, especially 3 and 4. Those 2 were quite similar to my real exam. If you want to go over the answers, just do the self timed mode and take 10 minutes per block to cut and paste all the questions into a word doc. Then you can scrutinize them at your leisure. This should be your guide as to what to focus on.
-If you find yourself starting to do poorly toward the end of a block, take a break and check your answers half way through each block. I found this really helped me and I didn’t get as tired.
-The most important thing you can do for yourself is to know the how and the why of pathology. For this, the first few BRS path chapters were very helpful. This isn’t well covered in FA, but you can reason a lot of things through if you know the basics. If you don’t get something, look it up in Robbins.
-Don’t let people stress you out. I felt I was doing fine on the NBME’s and then a couple friends told me they thought it was way different than any of the NBME’s. This intimidated me and stressed me out, but I realized during the real test that it was quite similar to the NBME’s, at least in the concepts. Just stick to what you are seeing on them and you will be fine.
-For first years: just understand it the first time around and it will be much easier later on. I was amazed at how I would remember random things from path lab during my test.

Anyway, good luck everyone!

 

[RB333]

I'd just like to quickly echo what 2008 said: don't let everyone stress you out.

Expect that there will be questions that are WTF - most people I talk to who studied their a$$es off, scoring well in QBANK etc. but then who thought 'Now I just want to pass' would bring up the same 10-15 questions that were impossible. Then they would go on about how difficult the ENTIRE exam was.

Don't forget there are 350 on the entire test, and chances are, if you don't remember the question it's likely that you answered it in 10 sec because you knew your stuff...essentially, we all remember the questions that made us feel inadequate and we rarely remember those we found easy or had a reasonable answer to.

I don't know how I did, we'll see, but I know that I went in expecting there to be questions I wouldn't know, and I still wouldn't know even if I had three more months of study, and Goljan was my uncle.

My strategy was to skip these types of questions, and keep myself in the zone and thinking with clarity, and then come back at the end of each block. I think this helped and allowed me to work out the difficult, but doable questions that followed.

I'll post my experience when I get my score, good luck everyone.

 

[James20062]

FINISHED TODAY!!! My test wasn’t too bad (I hope). Qbank may not be a good predictor of how you’ll do on the exam, but it was darn good in preparing me to answer the questions. By annotating every explanation for every answer from qbank in my first aid, then reviewing it all at the end, I felt I had enough to answer a VAST majority of the questions for the real thing. I had some questions almost word for word from Qbank, and an EXACT question out of the free released (had to do with auto regulation of flow through capillary bed). Also, High yield molecular… receptors/g-protiens… I had a lot of that on my version. We’ll see how it pans out in a few weeks. Don’t be freaked out if you haven’t taken it yet… everyone around here warned me how bad it was going to be and it scared the poop out of me! 😱

 

[cd1998]

Well, I can hardly believe it but I am finally done. First of all, I really want to send a genuine thank you to everyone in this forum who has posted their experiences-- it was an invaluable resource for planning my study plan and kept me motivated and encouraged these past several months. I took my test today and wanted to go ahead and post my experience for anyone that it may help; i will attach my scores after i get them in about 6 weeks.

I studied for about six and a half months (more concentrated for the last 7 weeks once classes ended), getting through all of the material 4-5 times in total. I first attacked the subjects I was weakest at (physio and path), and then moved on from there. At first it took me at least 1 week to get through each subject, but by the end I could review a subject in a few days or less. I also took the live prep kaplan course in the city where i go to school for 3 weeks (but i skipped the path and most of the phys).

Sources
Physiology-
1)BRS (i was very weak in this subject and i thought the explanations were basic and easy to understand. i read all of the chapters except for the first 2 and i also did all the questions in the back of each chapter.
2)Kaplan webprep videos (cardio and renal only-- i used these to fill in any blanks, things not covered in BRS)
3)i bought a big, detailed physio reference book to read up on anything that i really didn't understand after BRS and Kaplan

Path-
GOLJAN. I followed along in his Rapid Review path book and used this as my sole path source. Personally, this was my weakest subject going in and I felt that these resources brought it up to one of my best. Goljan really worked for me-- he is an amazing teacher and gets down to explaining WHY things are going on, not just the what, which is what the exam really focuses on.

Pharm-
First aid, Kaplan webprep, Kaplan live prep lectures. This is where live prep really worked for me, but most people i talked to just focused on FA. I never used notecards for course work, but i made pharm notecards a few weeks before i took the exam and thought that was a helpful way to learn it. I focused mainly on the cardio drugs, CNS, and antibiotics (cancer drugs are minimally tested).

Micro-
Read micro ridic simple to get a broad overview. Then I really focused on FA. I also took the kaplan micro live prep and thought this was pretty helpful for explaining actions of toxins and replication, but you could prob get the same info from just reading the kaplan micro subject book.

Biochem-
FA and kaplan biochem subject book/kaplan biochem liveprep (used webprep, but it was only minimally helpful for me bc i had a hard time understanding it). I thought this book was great for explaining and pointing out the important enxymes, and liveprep helped with this. For molecular bio, i took the advice from so many on this forum and used HYMolecular Bio-- to my surprise, there were definitely some q's from my test today that i prob got bc of that book.

Anatomy-
Kaplan anatomy subject book and kaplan webprep (for anatomy, neuroanatomy, and embryo). I also read through FA, HY Anatomy, and HY Neuroanatomy and looked at all of the images.

Behavioral Sciences-
Kaplan webprep videas and FA.

Question sources-
#1- QBank (i saved these for the last 6 weeks. scoring in the low-mid 50s at the beginning and low-mid 70s by the end, with the occasional score lower or higher. I stopped doing QBank the last week and so only finished about 86% of the Q's.)
#2- QBook-- all questions except one anatomy test and the path tests. Thought this book had GREAT explanations and helped me to brush up on unclear concepts.
#3- Kaplan Full Length (71%, 3 weeks before my real exam).
#4- 150 USMLE released items (74%, 2 weeks out)
#5- NBME exam #2 (520, 1 week out)

I also used a few questions (about 50-100 max from each) of the blue Lange Q. book and the Rapid Review question book (thought these q's were GREAT, but didn't have time to really incorporate them into my study schedule, i probably should have).

I really tried to push myself and, due to a lot of self-motivation and incredible support from my family and some close friends, i really didn't feel any burn-out until the very last week.

I really hope this helps someone out there still studying or first starting to study for this. I will post my scores when i get them and anything else that comes to mind that could help in the coming weeks. Best of luck to all.

-cd1998

 

[Dunce]

. . . and an EXACT question out of the free released (had to do with auto regulation of flow through capillary bed).

looks like question 89 for my fellow stalkers out there

 

[Tiki]

I took the exam today. Right now my brain feels like it's going to explode, but at least I'm going on vacation in three hours.

Anyway, my test had alot, ALOT of molecular biology, immunology, neuroanatomy and micro. Everyone says that usually the second year material is tested more heavily, but I felt like at least fifty percent of the questions pertained to first year stuff. I had quite a few biochem questions, but they were pretty easy.

I was surprised by the lack of cardio, endocrine, repro, and GI on my test. I had quite a bit of renal (mostly acid-base) and some pulmonary questions. Not alot of straightforward physiology questions though, which surprised me. I spent alot of time with BRS physio, and I ended up getting very few physiology questions. I didn't have one embryology question.

I feel like I had about fifty questions on the manifestations of alcoholism alone. And tons on neuro pathways, neuroanatomy and nerve injuries.

Here are the books I used:
First Aid
BRS Path
BRS Physio
HY Neuro
HY Cell and Molecular biology
Roadmap Gross Anatomy.

Overall, I thought First Aid was adequate for biochem, pharm, micro, and embryology. It wasn't near enough for the cell molecular, neuro and immuno (but HY was fine for Neuro).

I have no clue how I did. I don't think I failed but I don't think I'm the next Big Frank (or Big Frankette in my case ). Before the exam I was hoping for 230+, but I think after taking it, I'll be happy with 220+.

Oh, and I studied about four and half weeks. I averaged 73% on qbank. And I'm one of the rare SDNers who did not take the NBMEs (because I'm poor!).

I am just soooooooooooooooo glad it's over!!!!!!!!! 😀 😀 😀

 

[Catalyst]

just got back from the exam... I'm too tired to post details (I honestly don't remember much anyways from the exam since I poured every ounce of my brain into it), but for those of you taking it next week, make sure you finish and understand the Qbank questions, know First Aid (I cannot stress this enough), and do as many of the NBME exams as you can (I had many questions that were just reworded versions of previous questions)

all in all, not as bad as I expected... guess I got lucky to not receive all the horrific questions I've been reading about here

 

[Arsenic]

Hey guys! OK... in honor of funkless's post the day he took this thing last month, mine will also be typed out as i'm drinking vodka.

OVERALL:

Wow, I just hope I did decent. Like people have said before, probably 10-15% of the questions were so simple you didnt have to think about the answer and 20% were WTF questions. You have at least a chance with the rest... lets just hope I guessed alright. Goljan audio was gold. I must have had at least 5 questions that came directly out of his mouth, makes me wish I had read his notes!!!! I had only listened to the audio and read brs path instead. damn it! I typed out my breakdown below. If you're reading this and your test is coming up in the next few days dont freak out, its totally doable! It all depends on what your breakdown is and what you're strong in. i think the nbme's were better than qbank in terms of style but they still didnt reflect my test that great. If you're reading this with 4+ weeks until your test.... read goljans notes, listen to his audio, and know your micro/pharm cold. The impression I got coming out of that test was that I got stuck with a lot of micro/pharm and that goljan knows what he was talking about for everything else.​

Here's how my exam breakdown was:

Behavioral science (10-15 questions):

Lots of "quote questions", ie what would you say in a particular situation. No biostats questions asking how common a disease was. 2 easy questions right off the first aid formula list at the end of the book, 1 question asking to identify a certain study design. HY behavioral was very good for this section and was a 1 day read.​

Biochemistry/Cell and Molec bio/Genetics/Nutrition (40-50 questions+, no joke):
KNOW YOUR ENZYMES, ie whats the rate limiting enzyme in all the major pathways like gluconeogenesis, glycolysis, etc... I thought the hardcore biochem pathways was one of my weakest areas going into this test but I knew those enzymes cold and just with that I was able to answer A LOT of questions. I think I actually may have survived this section! Hopefully. Other than that there were about 2-3 easy vitamin questions and maybe 3-4 questions on lysosomal storage diseases that werent so easy. Sucks that I spent like 2 and half hours memorizing those yesterday... ahh whatever!!! As for cell/molec bio... maybe like 10-15 questions asking about mRNA, etc. Genetics had about 10 questions... know the inheritance patterns and know how to use math to solve genetics problems. Nothing really TOO bad in genetics.

Embryology: (2 questions! 😀 )
I SERIOUSLY lucked out here... 1 of the 2 questions I wasnt sure on but I think I made a great guess, the other one I know I got right because I heard goljan give the answer on his audio.

Micro and Immuno: (lots and lots and lots)
This was all over my test, not exactly my strongest area. 🙁 I wish I would have studied this more. Mostly bacteria and viruses, maybe 4 questions on fungi. Nothing that I remember on worms. Know the section in first aid COLD and you should do great. I think I just did decent here.

Pharmacology: (too many to count)
WTF... seriously... it felt like 1 in 5 questions was on freaking drug reactions. I couldnt believe it, they wanted interactions for half the questions! 😱 Again... drug interactions/side effects was NOT my best area. F***! I feel like I could have KILLED this test had I known all the drug reactions/interactions cold, not just their mechanisms/applications. Seriously a downer... 🙁 If you have a few weeks before your test I'd really recommend you sit down for an entire week at least and just do pharm. First aid may be enough if you know everything, otherwise get flash cards or road map. I had the flash cards but just didnt have the time to learn them all. I just cant get over how many question there were on this stuff, nothing at all like the NBME exams question distribution for pharm and I took them all. I think I got screwed here.

*sips vodka*

Cardio: Maybe 10 questions. Mostly atherosclerosis and capillary exchange and some drugs thrown in too. Almost nothing on diuretics (the only part of pharm i own3d). Nothing on antiarrhythmics, maybe 1.

Endo: A LOT of questions in the organ systems were endo. Know endo absolutely cold, they try to trick you out a lot here. I think I managed ok.

GI: about 10-20 questions, not too bad. Mostly path and IBD... and drugs for IBD. 🙄

Hem/Onc: about 10, know your carcinogens and cancer drugs. know your neuro tumors and leukemias/lymphomas.

Musculo/Skin: 5-10. mostly path, drugs, and bugs that cause infxn.

Neuro/Psych: 20-30. KNOW YOUR BRACHIAL PLEXUS. woah... i only had about 10 anat questions on the whole test and like 6 were nerves in the arm. the other 2 anat were lower extremities and 2 on hernias. For neuro know your spinal cord lesions and neuroanatomy there cold, including where the signals cross. the rest in neuro was pathology and maybe 4 questions on synapse physiology/drugs. had about 3-5 questions with CT's or MRI's asking to identify. 2 questions on aphasias.... also know your tumors.... i cant remember anything else.

Renal:
Sadly only about 5-7 questins or so. I knew this organ sooo sooo well and I just didnt get asked too much on it. whatever. 👎 know your glomerular apparatus and everything about the renin-angiotensin-aldo systen, including where everything is made. be ready to identify on diagrams. know prostate hyperplasia/cancer and problems arising from it well.

Repro: 10-15 questions on women with abdominal pain and all the lovely things that can go wrong that could have caused it. know your pathology and std bugs/drugs.

Resp: maybe 15-20 questions. know the physiology and pathology well. 1 question involved a calculation.

That its... that was my test. *drinks more vodka*

 

[MadameLULU]

No offense Arsenic, but wouldn't this post be more useful under the Compiled Step 1 Experiences instead of as it's own thread? I would think users would find it easier and are more likely to read through the experiences thread than do a search for every thread started about someone's STEP 1 thoughts.

Hope you're enjoying that vodka.

 

[Arsenic]

No offense Arsenic, but wouldn't this post be more useful under the Compiled Step 1 Experiences instead of as it's own thread? I would think users would find it easier and are more likely to read through the experiences thread than do a search for every thread started about someone's STEP 1 thoughts.

Hope you're enjoying that vodka.

done 🙂

 

[osteomedo09]

Well-- honestly, I thought it sucked. I fell for a lot of the distractors in the answers sections and chose the wrong answers. It is hard to go with my "gut" feeling when there are distractors.

What is the enzyme in homocysteinuria?
They gave distractors with homocysteine and methionine in the name -- so that I forgot it was cystathione synthase.

Confused the treatment for warfarin toxicity with the treatment for heparin toxicity. (Vit K with fresh frozen plasma for warfarin and protamine sulfate for heparin)

Stuff I kinda knew, but didn't when asked because I was operating from a midbrain level of fear.

BIOCHEM
I got a lot of genetic disease presentations in kids -- Patau, Down's, Pompei's, Turner's.

Enzymes and vitamins -- Propionyl CoA --> Succinyl CoA (vitamin B12)
What vitamin is deficient in a person with some skin problem and respiratory infections (zinc?)
Pompei's disease -- what was accumulated

MOLECULAR BIO
Lac Operon
rRNA (where is it made)
experiments with mice

MICRO
EBV- nasopharyngeal ca
pic of broad based bud - blasto
Lots of funguses in my test questions
MOA of amphotericin B -- impairs membrane something

NEURO
Coronal sections -- ID hippocampus?
Brain slices
visual pathway-- what does upper quandratonospia
Autonomic drugs -- tons

ENDO
11-B-hydroxylase
lots of treatment for diabetes qs
--rosiglitizone
--HMG CoA reductase (what doesn't it work in some person with a certain familial type of hypercholesterolemia)

Repro
What stimulates oxytocin during labor?

Respiratory
COPD

Msk
My worst section
x-ray -- what attaches to the calcaneus?
breast cancer patient got surgery to remove lymph nodes near thoracoabdominal mm -- what mm. group is affected.


It's over. Must move on. COMLEX on Wed.

 

[p53]

ooh....i got the hox gene question too! 🙂 i took the step 1 exam yesterday. for me there were 2 killer blocks (the 4th and 7th ones) where I had question marks on like half of the questions. I just felt bad that some questions tested some minute subjects that I would never have studied while more than half of what I did study did not even make an appearance on the exam. My test centered on mostly path, genetics and mol bio. I think I at least passed. I hope. 😳

In Goljan's lectures, he once remarked that the test writers put questions on the exam stemming from their own lives. If that is the case, then my exam had a whole lotta writers with erectile dysfunction. After the 5th or so question, it just got to be annoying. BPH came in second. So it would seem older men are writing these questions.

Anyways, after it was all done, I felt it to be anti-climatic. Kind of a what do I do now that this is over feeling and school starts in a couple of weeks. ....At least I get to go vacation in Hawaii next week. Hope everyone else gets a fun break too. Good luck. 🙂

Sounds as though you had a similar form from my exam last year. I had a handful of questions about sildenafil's mode of action. This is where they asked about cGMP pathway. Also, questions on BPH and prostate CA.

My step 1 theory on the best way to prepare for Step 1 is in this link.

http://forums.studentdoctor.net/showthread.php?p=3803705#post3803705

 

[Kashue]

To those who had parasites on their exams, were these worms or just amebas etc? Any idea where to focus in regards to parasites?

 

[p53]

To those who had parasites on their exams, were these worms or just amebas etc? Any idea where to focus in regards to parasites?

I had Albendazole for Tx for a worm. The rest of the worm sections in low yield.

I would know Amoebiasis cold. Liver cysts, frothy macrophages etc. Listen to Goljan's liver lecture when he talks about parasites. That is all you need.

 

[lord_jeebus]

To those who had parasites on their exams, were these worms or just amebas etc? Any idea where to focus in regards to parasites?

I had

E. histolytica
Leishmania
Enterobius
S. haematobium

So I would cover it all if I had time.

 

[BigRedMachine]

Took mine this morning. Overall not too bad. Not the easiest ofr most fun thing I have ever done. But overall fairly manageabe. Pretty much what I expected. Each block has some questions I knew very easily, Some that I looked at and had no idea what was even going on, and the vast majority were in the middle were I didn't know it outright, but could reason it down to the answer or at least down to 2 choices. I think the biggest thing is to just stay calm. Seems like the people I know who struggled the most on test day are the most tightly wound and those who have been worried the most. Don't study the day before the test. Take a day and relax. Thats my best advice I can offer

 

[Brickhouse]

I had sporothrix tx. 🙁




and I guessed right! 😎




but I think that was the only one I got right..... 🙄

 

[Sharkfan]

Since starting med school I have reverted to "lurker mode", but out of appreciation for the people who posted their experiences, I will post mine. I found it really helpful to read these as my "D-day" approached.

Took the beast yesterday. Not quite sure what to think; most of my classmates have been saying that it was virtually impossible: all 2nd and 3rd level reasoning, super-picky details that smacked of PhD material, and very few that they we sure that they answered correctly. I, on the other hand, am afraid that I got an easy form and will get screwed because of it. Yes, there were some questions I didn't know, but a whole lot were so easy and straightforward I stared at the screen and was like "Are you kidding me?" Examples: What is elevated in the sweat test? What ion is not transported properly in CF? What virus causes mono? What autonomic receptor is blocked in drugs used to treat hypertension and BPH? Now I am worried, mainly because everyone says that if you leave thinking you barely passed you did awesome, and if you think you did fine you barely passed. I thought it was a lot like the path mini-board in terms of difficulty: hard questions were the ones where you had to think a bit and weren't quite sure the answer you put down was right but oh well.

Block difficulties: #'s 1-4 seemed like an even spread, #5 was pretty easy, and #'s 6 and 7 left me feeling haggard and a tad depressed. And I don't think it was because I was getting tired- my school made us take a Kaplan full-length test, and my scores actually went up at the end on that.

Themes: ENDOCRINE, BEHAVIORAL SCIENCE, NEURO, RECEPTORS. Endocrine is just confusing to me no matter how hard I study, so I think the questions were on par with the path & phys mini-boards. Repro & DM seemed to dominate. I thought Kaplan's behavioral questions were pretty convoluted; knowing FA was sufficient. Neuro was also straightforward provided that you understood it to begin with, and mostly anatomy-based. I had a decent understanding of HY Neuro, and felt that most of my neuro questions were slam-dunks. With regard to receptors, I doubt I had a ton of those questions, but go more than enough of them to inwardly groan every time a receptor question came around, which was at least 1-2 per block. I even had a hideous (and confusing) "up down" question of a whole smattering of receptors! (You know, the ones with all the arrows). I don't think HY Molecular really helped all that much; to say the least, know ANY and every receptor possible or be really comfortable making educated guesses.

Biochem was very straightforward IF you put in the time to memorize the main enzymes involved. I had about 5-7 questions on B12 related to alcoholics.

Very little: immuno, devo

For pharm, the overwhelming majority of questions involved SIDE EFFECTS. Very little MOAs, mechanisms, etc. Know your stinking side effects!

Path: I listened to Goljan, bought the Rapid Review for Path, and read through most of his High Yields. (Like everyone says, he's the man.) Maybe that's why I thought the test wasn't that bad? Sadly, only time will tell. I am freaking out now because everyone I know said it was SO hard, and I thought it was doable.

NOTE: Did not pay any money to take the NBME samples. Just couldn't bring myself to do it. I remember reading someone saying that if you know FA really well, answers will seem to jump out at you; I agree. And for those of you who are slow test takers: most questions at the end of a paragraph could have stood alone or are unrelated, and a good number of lab values provided in the stems aren't necessary. Skim the stem, read the question, then go back up if you must. Because time will be short, especially if you like to go back over your work before closing out a block.

So that's it. Time will tell.

**********update!!***********

Score: 252/99
I'm over the moon, to say the least. 😀

****************************

Kaplan Q-bank: final percent was unreliable, since I used it more as a learning tool and less as a testing/assessment tool. I took a few mixed tests towards the end, and was getting 75-85%, but once you've taken enough Q-bank you tend to see questions on the same information, so... yeah.

Books used: Goljan Path Rapid Review, HY Neuro, FA 2004, FA 2006 (used 2004 to review a subject at once, 2006 to review organ systems); and (gasp!) no, I didn't get through all of FA- most of it, especially the biggies, but certainly not all of it. Advice: if you're anything like me... unless you plan your studying out to a tee and give yourself over a week extra for slip-ups, time will get short and things will have to get tossed aside.

 

[SippiGirl08]

sharkfan, i had a very similar experience. all my friends said they felt like **** after it was over, but i felt like it was a breeze -- not even worth studying for. i had tons of path, tons of behavior, very little biochem or micro, and the miniscule amount of pharm on my exam was concentrated on side effects, inhibition/induction of p450, etc.

i studied first aid, step up, and kaplan lecture notes for 5 weeks. i also completed about 75% of kaplan qbank, ending with an overall average of 70%, with most of my last several exams ranging from 65-85%. how's that for consistency?

i took NBME form 1 and scored a 240. we'll see if it really correlates.

 

[freddydpt]

Hi Sharkfan,
Quick question... did you know Goljan's HY cold or did you just read through? I'm taking the 26th and the only HY section I've really gone through and pounded in is Microbio/Immuno... I'm starting on the others. Do you think I should dedicate the rest of my week toward learning his HY?
Thanks!

 

[Dr. Don]

hey peoples so I also took the beast last week and I thought it was brutal!!! Damn, at first I wanted to really kick butt in this exam, but now I'm just hoping I passed.

Out of 7 blocks, I only felt good about 1 of them, where I only marked like 4-5 questions and just made educated guesses on them. The rest of the questions in my block I felt good about. BUT on the other blocks, damn, I probably marked between 10-15 questions each, and the rest of the questions I did not feel as confident about. The last block was the worst for me, because I just wanted to get the f--k out, and I think I marked like half the block because my brain couldn't think anymore and I just wanted hit the other questions that were "supposedly" the easy ones before thinking about the other ones on my last block.

Afterwards I had to check some answers that I made educated guesses on, and I missed some of them, got lucky on a few.... Did anyone who already took the test had a similar experience and still passed? I'm considering IM so getting ridiculously high score is not really a priority to me, but obviously doing pretty decent WAS. Also I'll be taking the COMLEX soon, so just in case it didn't go well with the USMLE, I guess I'll be applying to DO friendly places. Any DO students take the beast recently? How did it feel?

Good luck and let's hope we all at least passed!

 

[Pinner Doc]

hey peoples so I also took the beast last week and I thought it was brutal!!! Damn, at first I wanted to really kick butt in this exam, but now I'm just hoping I passed.

Out of 7 blocks, I only felt good about 1 of them, where I only marked like 4-5 questions and just made educated guesses on them. The rest of the questions in my block I felt good about. BUT on the other blocks, damn, I probably marked between 10-15 questions each, and the rest of the questions I did not feel as confident about. The last block was the worst for me, because I just wanted to get the f--k out, and I think I marked like half the block because my brain couldn't think anymore and I just wanted hit the other questions that were "supposedly" the easy ones before thinking about the other ones on my last block.

Afterwards I had to check some answers that I made educated guesses on, and I missed some of them, got lucky on a few.... Did anyone who already took the test had a similar experience and still passed? I'm considering IM so getting ridiculously high score is not really a priority to me, but obviously doing pretty decent WAS. Also I'll be taking the COMLEX soon, so just in case it didn't go well with the USMLE, I guess I'll be applying to DO friendly places. Any DO students take the beast recently? How did it feel?

Good luck and let's hope we all at least passed!

I may be wrong here, but I think you should feel very good about your hardest blocks only having 10-15 you were unsure about. Even if you got, say, 10 out of those 15 wrong, that still correlates to a very respectable score. Good job.

 

[Dr. Don]

I may be wrong here, but I think you should feel very good about your hardest blocks only having 10-15 you were unsure about. Even if you got, say, 10 out of those 15 wrong, that still correlates to a very respectable score. Good job.

IF I got 10/15 right, wow, that would be a true miracle....I think my problem is that I KNOW I missed some of the easy ones too! 🙁 ie, saturday night's palsy-Radial Nerve, put Axillary, duh! side effect of aminoglycosides-ototoxicity, put gi problem duh! I don't know what happened, maybe I freaked out, and the answer just didn't seem to "come out at me" like some people suggested here.

Also, I've heard that the NBME drops one block completely, is this true? Of course, with my luck, they'll probably drop the only one that I felt good about, and I'm so counting on that one to get me a pass......geez the waiting until I get my score is going to kill me.....

 

[Sharkfan]

Hi Sharkfan,
Quick question... did you know Goljan's HY cold or did you just read through? I'm taking the 26th and the only HY section I've really gone through and pounded in is Microbio/Immuno... I'm starting on the others. Do you think I should dedicate the rest of my week toward learning his HY?
Thanks!

I always run out of time when I am studying for something, and didn't get to the High Yields until the last 3 days before my test and figured I could get away with reading them through just once because I have good recall within a small time span like that. When I did take a look, it turned out that I already knew most if it from his lectures and rapid review. So no, I didn't know them "cold," but definitely did know a lot of it. Hope that made sense.

 

[Sharkfan]

sharkfan, i had a very similar experience. all my friends said they felt like **** after it was over, but i felt like it was a breeze -- not even worth studying for. i had tons of path, tons of behavior, very little biochem or micro, and the miniscule amount of pharm on my exam was concentrated on side effects, inhibition/induction of p450, etc.

i studied first aid, step up, and kaplan lecture notes for 5 weeks. i also completed about 75% of kaplan qbank, ending with an overall average of 70%, with most of my last several exams ranging from 65-85%. how's that for consistency?

i took NBME form 1 and scored a 240. we'll see if it really correlates.

Sounds like we had the same test or two very similar forms. I don't know how or why the NBME can make such a spread of forms- I mean, how can they be sure of accurate assessments if some people get things so crazy they can hardly answer a thing and others don't have a problem? So far there has been a handful of people in my class who had "fair" tests; everyone else said there was very little they weren't guessing on. 😕

 

[friedcfood]

hey peoples so I also took the beast last week and I thought it was brutal!!! Damn, at first I wanted to really kick butt in this exam, but now I'm just hoping I passed.

Out of 7 blocks, I only felt good about 1 of them, where I only marked like 4-5 questions and just made educated guesses on them. The rest of the questions in my block I felt good about. BUT on the other blocks, damn, I probably marked between 10-15 questions each, and the rest of the questions I did not feel as confident about. The last block was the worst for me, because I just wanted to get the f--k out, and I think I marked like half the block because my brain couldn't think anymore and I just wanted hit the other questions that were "supposedly" the easy ones before thinking about the other ones on my last block.

Afterwards I had to check some answers that I made educated guesses on, and I missed some of them, got lucky on a few.... Did anyone who already took the test had a similar experience and still passed? I'm considering IM so getting ridiculously high score is not really a priority to me, but obviously doing pretty decent WAS. Also I'll be taking the COMLEX soon, so just in case it didn't go well with the USMLE, I guess I'll be applying to DO friendly places. Any DO students take the beast recently? How did it feel?

Good luck and let's hope we all at least passed!

man...sound rough. most people feel like shiet after coming out...i know i will...taking it tomorrow. Good luck on the Comlex. Laters trick!

 

[ddmo]

I took it today. After reading this board I was ready to have an M.I. for the last few days leading up to it. I think a lot of this is hype. I felt like if you knew First Aid really well, you could get 50% right off the bat. Another 25% could be narrowed down based on logic etc., down to either the right answer, or one of two answers. The rest were just off the wall stuff that studying an extra year wouldn't have made that much of a difference with, you just had to go with your best judgement.

It's not the end of the world if you have to guess on a few of them each section as most everyone else is and it's statistical. I found the real thing to be very similar to the NMBE exams, although I was definitely more rushed for time. I went down to the buzzer on about 4 of the sections.

If you only have a couple more days, I recommend studying the biostatistics stuff, general pharm, and immuno out of First Aid. That wouldn't take that much time and I found it extremely high yield. Especially the general pharm.

Regardless, I'm done, feel like a million bucks, and am sipping a Bell's Third Coast beer, life is good for the next week before my peds rotation starts.

Good luck and stay calm!

 

[friedcfood]

Took the USMLE today. Did not compare to the NMBE...more like NMBE on steriods!!! I took forms 1,2 and 3...today's test was way harder. They must have some sick people thinking up those questions.

 

[Dunce]

Whew!

I just took it and am one happy guy right now. This may sound crazy, but I really did not think the test was all that bad. I doubt I blew it out of the water, but I feel like I did pretty well -- I guess I'll find out pretty soon, but I am usually very good at having an accurate sense of how I did on a test.

Qbank was way harder. Qbook was more like the questions I had on the real thing. The free released items also seemed fairly similar to the real questions. I did not take any of the $45 NBME exams.

I had what seemed like a ton a ton of super obvious straightforward questions that just seemed like a joke (like this one: you ask a patient to stick out his tongue, what nerve are you testing? I mean WTF?? ). There were about 5-10 with pictures on each block, and they were relatively straightforward. Gross, CT, and Xrays were pretty easy but the histo pics were tricky.
Time was not a concern for me at all. I blew through the test and took only 4 breaks for about 5-10 minutes each. I just wanted to keep pushing on while I had motivation and focus, and I ended up with just over 2 hours of break time available when I was done. Sick! Hopefully, careless errors were not too numerous.

Good luck to everyone who is about to take it. I'll type up some thoughts on my study plan and what I used, but I won't post it until I have an actual score to go along with it.

 

[Dunce]

Last Minute Study Advice:

Biochem:
I got a lot out of devoting a day worth of last minute review to this subject. It was a weak area for me anyway. Fairly high yield stuff. Know glycolysis/gluconeogenesis stuff and those enzymes. Vitamin knowledge is pretty high yield too -- B6, B12. Also know the diseases in the biochem section in First Aid.
I didn't feel like my test was full of biochem like a lot of people have been saying this year, but that's probably because a lot of those diseases and processes that some call "biochem" fall under the category of pathology for me.

Pharm:
My weakest link of 2nd year. This material was not quite as bad as I had expected. Side effects are critical -- my test seemed to have a running theme about ototoxicity/nephrotoxicity. Cardiovascular pharm including diuretics was pretty big on my test.

Path/Pathophys:
This can't really be learned at the last minute, but the best thing to do is sit down and do a bunch of questions with explanations in the last few days leading up to the test.
A strong understanding of BRS Path plus Goljan's review materials is like gold. Thank you Goljan! That guy definitely scored me a few extra points from some of his random factoids. Two days before the test I was listening to one of his lectures where he talked about the possibility of getting a question that included something about neurofibrillary tangles and Alzheimer's not being an answer choice. It was CJD. Definitely got that one!
The Goljan HY handout is ok, but I felt like I knew all of that core stuff by the end of my studying.

Micro/Immuno:
I had a fair amount of immuno stuff on my test. That material is pretty easy and quick to review, so I consider it extremely high yield. You basically just need to spend half a day memorizing the stuff because if you get an immuno question and don't know the answer right away, it can be kind of hard to get it by reasoning through it. Pharm is similar in that aspect.
Bacteria and viruses were fairly straightforward. Know the big players, but be prepared to get some off the wall crap. I had one random question where I narrowed it down and guessed Brucella melitensis -- I had never even heard of that.

That's all for now.
I highly suggest a ton of questions in the last few days. I did somthing like 600+ questions yesterday and the day before, and that really helped to both solidify some key facts and also get me ready as far as stamina was concerned.

 

[Rock514d]

I took the test back in May. I scored a 249/99. My advice for doing well would be this:

Listen to Goljan
Annotate First Aid with Goljan stuff and stuff from BRS books (Path and Physio)
Do all of Q-Bank and read and re-read the explanations (annotate First Aid)
Do All the questions in Robbins Review and read and re-read the explanations
Read Micro Made Ridiculously Simple and annotate First Aid
Use Pharm Cards and annotate First Aid

Use your annotated First Aid only for a week before the test as you continue to do Q-Bank. Take a few days off completely before the test. Try and go in with a clear head.

I thought my test was hard and was sure of probably 30/50 questions on each section. I eliminated as many answer choices as possible and made educated guesses.

Good Luck.

 

[ChoroidPlexus]

Hey,

I just took the exam 2 days ago, and I don't feel too great or confident about it. I was scoring real high on the NBME sample assessments (>=240), but when I got into the real thing, I was taken aback. Things out of left field were being asked, small tiny minutiae not covered in First Aid or any HY I have read. The Behavioral questions were so ridiculous, completely clueless on those. They like to ask stuff that you would'nt even think is important enough to merit studying, that's what sucks the most. Does anyone else who took the exam feel like they bombed it afterwards? I am hoping the curving helps me out.

 

[friedcfood]

Hey,

I just took the exam 2 days ago, and I don't feel too great or confident about it. I was scoring real high on the NBME sample assessments (>=240), but when I got into the real thing, I was taken aback. Things out of left field were being asked, small tiny minutiae not covered in First Aid or any HY I have read. The Behavioral questions were so ridiculous, completely clueless on those. They like to ask stuff that you would'nt even think is important enough to merit studying, that's what sucks the most. Does anyone else who took the exam feel like they bombed it afterwards? I am hoping the curving helps me out.

ditto that!