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- Jun 15, 2003
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My turn to give feedback to the forum--I took my Step 1 exam on June 4.
Study Strategy: Started reviewing in January, about 1 hour a day. Started with my weakest areas: Gross Anatomy, then Embryology; then started reviewing First Aid from cover to cover. Had used First Aid in my coursework. Signed up for Kaplan Early Bird QReview in December of 2002, and used the Organ System question set to review for my class exams second semester. Used my spring break to go through QBank questions in pharm, micro, biochem, behavioral sciences. By the time second semester was over, I had gone through all the QBank questions at least once. Then I started going through the Clinical Vignettes in 50-question test blocks. For both QBank and Clinical Vignettes, I used "tutor mode" for the first go-around (reading both correct and incorrect explanations), then took 50-question test blocks and would review incorrect first, then went through all to reinforce correct answers.
My initial scores were 65-75% in both QBank and Clinical Vignettes, which improved as I went through the questions multiple times. The week before my test date, I was pretty familiar with the Bank questions, and would score 90-100%.
Study Resources: High Yield Embryology, Neuro, Gross, Behavioral Sciences; BRS Path; Lippincott's Biochem; First Aid. I didn't feel the need to review much path, as we had path second semester and it was fresh in my mind. Didn't review Histology except with QBank, nor physiology. Mainly used First Aid for micro and biochem, along with QBank. Would spot-review concepts/issues as I felt I needed.
Practice/Simulated Exams: Took the Kaplan in-center simulated exam three weeks before my test date. Took notes as I went on all material I felt I needed to review. Scored a 72%. Went through the answer key and added to my notes. I used this feedback to further bone up on my weak areas.
Through the USMLE website, signed up to take the half-length practice test at the Prometric Test Center where I was scheduled to take my exam (cost $42, but it was definitely worth it for me). Took the USMLE practice exam one week before my real exam. This got me familiar with the test center staff, procedures, computer room (scoped out which carrel I wanted on exam day), white boards, etc.) Scored a 72% on that one, too. I printed out the explanations from the Kaplan website, and reviewed them the day after the practice test. Took the practice test off the website and scored 95%, and felt comfortably familiar with the questions.
Day Before Exam: I followed First Aid's and Kaplan's advice and didn't study the day before the exam. I decided to try and suppress all thoughts about the exam and let my unconscious mind "consolidate" while I did something unrelated. I went to the garden center, bought a tree and 5 shrubs, and spent the day planting them like a mad woman in the pouring rain. It worked. I hardly thought about the Step 1 all day. That evening before going to bed (9:30 pm), I went over my own review sheets I'd made with the info I never remembered no matter how many times I went over it (HLA's, chromosome translations, glycogen/lysosomal diseases, etc.). I laid out my clothes, made a lunch, got my papers together,etc., so I wouldn't have to think about anything in the morning.
Day of Exam: Got up early enough to make eggs and coffee for breakfast, shower, and make sure I had everything I needed. Got to the test center at 8:00 am (half hour early). Requested and got the seat I wanted. Started the exam around 8:20, skipped the tutorial to get more break time.
Followed Kaplan advice about breaks: did blocks 1 and 2, then took a 5-minute break and drank a protein shake. Did block 3, took a 5-min. break. Took a 1/2 hour break after block 4, ate a sandwich, drank 2 cups of coffee and went on a walk. Returned, did blocks 5 and six, took a 10 min. break, then did block 7. It was hard to keep focused towards the end, so that 10 minute break really helped refresh my brain.
Test Content: Unlike some of the posts I've read, my test seemed pretty well-balanced, with no obvious emphasis. Aside from a few questions that I had absolutely NO CLUE about, most of the questions covered material I had reviewed. Many were second- or third-order type, e.g., a clinical description giving the diagnosis at the end, then question asking the mechanism of action of the drug of choice for the disorder. So, you didn't need to come up with the diagnosis, but you did need to know the DOC and, additionally, the MOA. A path example would be asking the histology after giving you a clinical description with the diagnosis at the end. Or, no diagnosis, so you had to know both the disorder and the histology. My slides and graphs were clear, legible and sufficiently sized.
Pathology: Not much cardiology or GI. Neoplasms, renal, pulmonary, diabetes seemed more common. Had a venous return/cardiac output vs. atrial pressure graph, EKG, pulmonary function test diagrams, too. A lot like QBank.
Pharm: First Aid was pretty sufficient for pharm, except for a couple of wierd ones that weren't even covered in my pharm course. They seemed pretty straight forward--either I recalled or I didn't. Emphasis on clinically-relevant drugs, not the obscure ones.
Micro: Not much on bugs--viruses emphasized more. A few "gimme" questions on the commonly encountered bacteria and how distinguish them. Again, First Aid seemed sufficient for micro.
Embryology: A number of expected developmental questions regarding what structural precursors were where on a diagram at a particular stage of fetal development, pharyngeal cleft/pouch-derived structures, etc. High-Yield Embryology and QBank should prepare you well for these if you get questions like mine.
Gross: Not many questions. First Aid was sufficient, although I needed to review the High Yield and Netter's of the arms, legs, buttocks, abdomen, etc. a few times before I felt I retained the First Aid info. My personal weak area, so take this with a grain of salt...
Behavioural Sciences: A few questions on developmental stages, whether certain behaviors were normal for a certain childhood age, appropriate response to a patient. I felt that QBank and Clinical Vignettes were good preparation for these. The High Yield Behavioral Sciences was excellent prep, also.
As for stats, I got an odds ratio question and a "what happens to false negative/positive rate" when you change 2 x 2 table numbers. For those of you who intuitively get this kind of thing, it was easy. For those of us who don't, I felt that it was necessary to have really worked through the QBank examples and those in the High Yield book to think through a couple of these on exam day. They weren't exactly like any question I'd done, so they bent my brain a bit. Hopefully I got them right for all the time I invested in them.
Test Taking Strategy: I gave myself a 60-second limit on each question. I would read the last line first, review the answers, then read the full question, and focused on the info I'd need to answer it. Most of the time, this was the most efficient way to approach them. If I didn't know the answer in 60 sec, I would eliminate those I knew were incorrect, made my best guess among those remaining, marked the question, and moved on. Usually I got through the block with 10-15 minutes to spare, so I had time to go back and think through the ones I'd marked. I then went through all of the questions, looking for gross mistakes (like misreading the question or answer choices). I NEVER changed my answer if it were a guess. I stayed with my first hunch.
Overall, I think that Step 1 is kind of like the MCAT--you can maximize your score if you work out HOW to take the test that's best for you. I used this strategy for the GRE's and MCAT, and it felt efficient for me. I would advise you to consciously formulate and refine your "attack strategy" in the couple of weeks before the test so that you feel in control on test day.
After the Test: I walked out with no idea how well I scored, but felt pretty sure I'd passed, judging from how I'd felt after the practice tests. I hope I'm right, but am plagued, like just about everyone, with fears that I might have failed. With the score reporting delay, looks like we'll have to wait until mid-July for our reports. In the meantime, let's all leave it behind us and enjoy our friends and family in the Outside World while we can!
Hope this was helpful. Feel free to ask me any questions you might have.
Study Strategy: Started reviewing in January, about 1 hour a day. Started with my weakest areas: Gross Anatomy, then Embryology; then started reviewing First Aid from cover to cover. Had used First Aid in my coursework. Signed up for Kaplan Early Bird QReview in December of 2002, and used the Organ System question set to review for my class exams second semester. Used my spring break to go through QBank questions in pharm, micro, biochem, behavioral sciences. By the time second semester was over, I had gone through all the QBank questions at least once. Then I started going through the Clinical Vignettes in 50-question test blocks. For both QBank and Clinical Vignettes, I used "tutor mode" for the first go-around (reading both correct and incorrect explanations), then took 50-question test blocks and would review incorrect first, then went through all to reinforce correct answers.
My initial scores were 65-75% in both QBank and Clinical Vignettes, which improved as I went through the questions multiple times. The week before my test date, I was pretty familiar with the Bank questions, and would score 90-100%.
Study Resources: High Yield Embryology, Neuro, Gross, Behavioral Sciences; BRS Path; Lippincott's Biochem; First Aid. I didn't feel the need to review much path, as we had path second semester and it was fresh in my mind. Didn't review Histology except with QBank, nor physiology. Mainly used First Aid for micro and biochem, along with QBank. Would spot-review concepts/issues as I felt I needed.
Practice/Simulated Exams: Took the Kaplan in-center simulated exam three weeks before my test date. Took notes as I went on all material I felt I needed to review. Scored a 72%. Went through the answer key and added to my notes. I used this feedback to further bone up on my weak areas.
Through the USMLE website, signed up to take the half-length practice test at the Prometric Test Center where I was scheduled to take my exam (cost $42, but it was definitely worth it for me). Took the USMLE practice exam one week before my real exam. This got me familiar with the test center staff, procedures, computer room (scoped out which carrel I wanted on exam day), white boards, etc.) Scored a 72% on that one, too. I printed out the explanations from the Kaplan website, and reviewed them the day after the practice test. Took the practice test off the website and scored 95%, and felt comfortably familiar with the questions.
Day Before Exam: I followed First Aid's and Kaplan's advice and didn't study the day before the exam. I decided to try and suppress all thoughts about the exam and let my unconscious mind "consolidate" while I did something unrelated. I went to the garden center, bought a tree and 5 shrubs, and spent the day planting them like a mad woman in the pouring rain. It worked. I hardly thought about the Step 1 all day. That evening before going to bed (9:30 pm), I went over my own review sheets I'd made with the info I never remembered no matter how many times I went over it (HLA's, chromosome translations, glycogen/lysosomal diseases, etc.). I laid out my clothes, made a lunch, got my papers together,etc., so I wouldn't have to think about anything in the morning.
Day of Exam: Got up early enough to make eggs and coffee for breakfast, shower, and make sure I had everything I needed. Got to the test center at 8:00 am (half hour early). Requested and got the seat I wanted. Started the exam around 8:20, skipped the tutorial to get more break time.
Followed Kaplan advice about breaks: did blocks 1 and 2, then took a 5-minute break and drank a protein shake. Did block 3, took a 5-min. break. Took a 1/2 hour break after block 4, ate a sandwich, drank 2 cups of coffee and went on a walk. Returned, did blocks 5 and six, took a 10 min. break, then did block 7. It was hard to keep focused towards the end, so that 10 minute break really helped refresh my brain.
Test Content: Unlike some of the posts I've read, my test seemed pretty well-balanced, with no obvious emphasis. Aside from a few questions that I had absolutely NO CLUE about, most of the questions covered material I had reviewed. Many were second- or third-order type, e.g., a clinical description giving the diagnosis at the end, then question asking the mechanism of action of the drug of choice for the disorder. So, you didn't need to come up with the diagnosis, but you did need to know the DOC and, additionally, the MOA. A path example would be asking the histology after giving you a clinical description with the diagnosis at the end. Or, no diagnosis, so you had to know both the disorder and the histology. My slides and graphs were clear, legible and sufficiently sized.
Pathology: Not much cardiology or GI. Neoplasms, renal, pulmonary, diabetes seemed more common. Had a venous return/cardiac output vs. atrial pressure graph, EKG, pulmonary function test diagrams, too. A lot like QBank.
Pharm: First Aid was pretty sufficient for pharm, except for a couple of wierd ones that weren't even covered in my pharm course. They seemed pretty straight forward--either I recalled or I didn't. Emphasis on clinically-relevant drugs, not the obscure ones.
Micro: Not much on bugs--viruses emphasized more. A few "gimme" questions on the commonly encountered bacteria and how distinguish them. Again, First Aid seemed sufficient for micro.
Embryology: A number of expected developmental questions regarding what structural precursors were where on a diagram at a particular stage of fetal development, pharyngeal cleft/pouch-derived structures, etc. High-Yield Embryology and QBank should prepare you well for these if you get questions like mine.
Gross: Not many questions. First Aid was sufficient, although I needed to review the High Yield and Netter's of the arms, legs, buttocks, abdomen, etc. a few times before I felt I retained the First Aid info. My personal weak area, so take this with a grain of salt...
Behavioural Sciences: A few questions on developmental stages, whether certain behaviors were normal for a certain childhood age, appropriate response to a patient. I felt that QBank and Clinical Vignettes were good preparation for these. The High Yield Behavioral Sciences was excellent prep, also.
As for stats, I got an odds ratio question and a "what happens to false negative/positive rate" when you change 2 x 2 table numbers. For those of you who intuitively get this kind of thing, it was easy. For those of us who don't, I felt that it was necessary to have really worked through the QBank examples and those in the High Yield book to think through a couple of these on exam day. They weren't exactly like any question I'd done, so they bent my brain a bit. Hopefully I got them right for all the time I invested in them.
Test Taking Strategy: I gave myself a 60-second limit on each question. I would read the last line first, review the answers, then read the full question, and focused on the info I'd need to answer it. Most of the time, this was the most efficient way to approach them. If I didn't know the answer in 60 sec, I would eliminate those I knew were incorrect, made my best guess among those remaining, marked the question, and moved on. Usually I got through the block with 10-15 minutes to spare, so I had time to go back and think through the ones I'd marked. I then went through all of the questions, looking for gross mistakes (like misreading the question or answer choices). I NEVER changed my answer if it were a guess. I stayed with my first hunch.
Overall, I think that Step 1 is kind of like the MCAT--you can maximize your score if you work out HOW to take the test that's best for you. I used this strategy for the GRE's and MCAT, and it felt efficient for me. I would advise you to consciously formulate and refine your "attack strategy" in the couple of weeks before the test so that you feel in control on test day.
After the Test: I walked out with no idea how well I scored, but felt pretty sure I'd passed, judging from how I'd felt after the practice tests. I hope I'm right, but am plagued, like just about everyone, with fears that I might have failed. With the score reporting delay, looks like we'll have to wait until mid-July for our reports. In the meantime, let's all leave it behind us and enjoy our friends and family in the Outside World while we can!
Hope this was helpful. Feel free to ask me any questions you might have.
