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Well I just took the test yesterday and here is how I prepared. I want to thank everyone who has posted on this board, which I checked compulsively during the past few years, and good luck.
First of all I clipped all the advice from this forum regarding Step I preparation over the last two years and asked for help from some well known posters on this board (Dr. Cuts, Geek Medic and others, who were really helpful, so listen to them when they say something)
So I got all the review books from day one of medical school and used them in my class as study tools. As for hardcore studying, I studied for about 4 to 5 weeks, using a stop watch for 6-8 hours a day. I'm a big time slacker so this was a major challenge, so I would take frequent breaks, switch studying locations, do different subjects in a day. For example, I would study
8:00-9:00 questions - 15 min break
9:15-10:15 review of question - then 30 min break
10:45-11:45 - 1st hour of 2 hour study - 15 min break
12:00 - 1:00 - 2nd hours of 2 hours study - 1 hour break
So four hours study, with 2 hours break, then restart routine at 2:00
Now, nothing is set in stone, so if you don't feel like studying and cant concentrate or aren't being productive, then do something else like take a nap or work out or whatever.
As for the specific subjects, this is what I used
PHYSIOLOGY - Used First Aid & BRS Physiology during the first year Physio course and also to review relevant physiology whenever we were doing path for that specific section. During the USMLE prep days, I used only BRS Physiology, then did the question in the back of each chapter. By this time I had read the book about 4 times. As for the equations (i.e CO, or Clearance of substance X, etc), I had some difficulty but once you understand the equation and know how to manipulate it around, its not that hard. On the USMLE, I had 3 or 4 problems with equation.
PATHOLOGY - Used BRS Path during all of second year and read all of robbins path during the course. Used WebPath during the year, and did all the questions for the system that we were studying at the time. Finally, I did all of the web path question again at the end along with rereading BRS Path several times.
PHARMACOLOGY - Used Lippincot Pharm for the class, and Simultaneously Used High Yield Pharm and First Aid, to keep track of the main drugs and their toxicity. At review time, I used first aid exclusively, however my first aid was scribbled with notes or other information from lippioncot or high yield pharm which I felt was important
MICROBIOLOGY - Used Micro Made Ridiculously Simple (one of the best books ever written) during class and Medical Micro & Immuno by Warren, Md, Phd Levinson, this book has a really go section on immunology, which I felt was not covered well by first aid. Micro in first aid was sufficient. MM&Immuno also has a really good section of quick review of all medically relevant bugs. At the review time, I read MMRSimple Once and read the immunology section of MM&Immuno once and did board like question as the back of MM&Immuno book. Finally if anything important was missing in first aid, I added it to micro section. Know you IL (1-10, etc) and immunodeficiency diseases (Burtons, etc). I had lot of questions on these from Immuno.
BIOCHEMISTRY- Not really my favorite subject. Used Lippincot Biochem during the course. Forgot everything over the summer and second year. Surprisingly a lot of it came back during review time. Used BRS Biochem which I read once (without doing the question), then read high yield Biochem twice, and finally just read the Biochem section of first aid & BIOCHEMICAL TECHNIQUES SECTION OF BRS BIOCHEM ( once every day for 4 weeks). Surprisingly I had very little Biochem on my test (go figure), but I did get tested on PCR and some other lab stuff that I cant remember. If you have limited time. Then I would just study First Aid 2003 and look up unfamiliar concepts Lippincot.
BEHAVIORAL SCIENCE - Used High Yield Behavioral Science during the course. During review, I also purchased High Yield Bio-Stats, because a lot of people of people who just took exam said that the emphasis on biostats had increased recently. In the end I had read high yield biostats and high yield behavioral science twice (but, I read the patient physician relationship section everyday for 4 weeks, and it paid off big time, all the question were like, "what would you say to this patient", so emphasize this section and defense mechanism, and Sleep stages). This section is easy points, so don't ignore it. I didn't study first aid behavioral science, because I think it was too simplified.
ANATOMY/EMBRYOLOGY/HISTO - Hated all of these subject, barely passed and failed Neuroanatomy Course (which I repeated, and a lot of it showed up on Step I, so I was ready). First Aid is more than enough for Step One. I didn't' really study any embryology, overall I had about 2 or 3 embryo, and about 10-15 anatomy and few histo questions(mostly on junctions). In the last few days, just skim over (key word) some radiology atlas and histo/path atlas.
QUESTION BANKS - You can get your hands on tons of questions, but since you have a limited amount of time. Here's what I would recommend in order of importance.
1. USMLE Released Questions - Very similar to the real thing. The questions were similar with a lot more graphs and interpretation of research experiments. I did not get a chance to do the online assessment from NBME, so I cant say anything about that. ALSO, DO THE TUTORIAL on the USMLE CD, so you are familiar with the format.
2. QBANK - Good source, although somewhat more detailed with HLA and other suff. Don't pay too much attention to details, just try to learn the main concept being tested. When simulating tests, always construct the test with ALL SUBJECTS & UNUSED QUESTIONS. I started out with 44%, which was kind of depressing but was mostly due to genetics/anatomy. However towards the end, I was consistently scoring in the 70-75%. I also did the IV QBANK - which is also really good source, but I would do it in the end (after QBANK & Qbook), when you have all the knowledge to integrate everything.
3. QBOOK - Also a good source of questions, especially behavioral science questions. I didn't get chance to finish it. But this is definitely helpful, so make sure you go through this.
4. WEBPATH - Best preparation for path questions of the exam. I would read the BRS Path chapter on a system and then do the corresponding web path questions. I felt that path was my strongest subject.
5. NBOME/COMLEX RELEASED QUESTIONS - People who write comlex questions have a 200 question booklet that you get which I felt was about 90% similar to comlex exam. If you are from MD school, I still suggest this because, you can just skip the OMM (Which I hate) but still do other questions, which I felt were really quality questions. This book is like 15 dollars. .
5. MEDREVU - I did about 1000 questions, but most of the questions were not that good and the explanations are long and difficult to read. I would not recommend these, unless you have a lot of time and would really like just practice questions.
I took both COMLEX/USMLE in same week and I want to say a little bit about COMLEX. Just study for the USMLE and use the Blue book by Saverese for the OMM component and you'll get most of the omm questions. Comlex is more exhausting because its 800 question and its two days with the paper and pencil format.
As for the USMLE Step I, the test was an interesting experience. Remember, USMLE is a test of concepts and fundamental principals. Its not direct recall test. So during my prep I would pick a concept or topic and tried to explain it to somebody, so that I really mastered it. But there is always some esoteric question that you just mark at move on.
During the last week, I just used first aid and did not do any questions. Secondly, I started getting up early in the morning and sleeping early to get back regular sleep cycle. A few days before the exam, I visited the center where I was going to take the exam, and to get familiar with directions and alternative routes. The day before test, I had backup transportation and backup alarm clock to make sure I would make it to the test center in time. Although I couldn't' really sleep the night before. Just kept thinking about stuff I still wanted to learn and had all kinds of negative thoughts. So, just go watch a movie or read something and its OK to be nervous.
Finally got to the test center and there were some people sitting there reading First Aid, so I stayed as far away from them as I could , to avoid being stressed out. Finally, they call you in and seat you. Just request to be seated far away from the door, so people who take breaks don't distract you, because there are always people coming in and out of the test room. Also make sure you have a good breakfast.
As for the test, it took a few question to get into the rhythm of everything. With the above listed question sources, I felt that I had seen about 70-80% of the questions in some form before.
Most of the questions, I could narrow it down to two choices. Don't' dwell on question that you cant answer, mark and more on, and come back to it if you have time.
Overall, the test is really fair and not that difficult (besides stupid research questions). Remember you may get like 10 hard questions in a row, so don't panic, just keep going.
Well, its all over now, and for those who still have to take it, good luck. For those who took, I hope everybody passes. If you have any question or comments, please feel free to post. Good Luck, and I didn't really proofread this.
First of all I clipped all the advice from this forum regarding Step I preparation over the last two years and asked for help from some well known posters on this board (Dr. Cuts, Geek Medic and others, who were really helpful, so listen to them when they say something)
So I got all the review books from day one of medical school and used them in my class as study tools. As for hardcore studying, I studied for about 4 to 5 weeks, using a stop watch for 6-8 hours a day. I'm a big time slacker so this was a major challenge, so I would take frequent breaks, switch studying locations, do different subjects in a day. For example, I would study
8:00-9:00 questions - 15 min break
9:15-10:15 review of question - then 30 min break
10:45-11:45 - 1st hour of 2 hour study - 15 min break
12:00 - 1:00 - 2nd hours of 2 hours study - 1 hour break
So four hours study, with 2 hours break, then restart routine at 2:00
Now, nothing is set in stone, so if you don't feel like studying and cant concentrate or aren't being productive, then do something else like take a nap or work out or whatever.
As for the specific subjects, this is what I used
PHYSIOLOGY - Used First Aid & BRS Physiology during the first year Physio course and also to review relevant physiology whenever we were doing path for that specific section. During the USMLE prep days, I used only BRS Physiology, then did the question in the back of each chapter. By this time I had read the book about 4 times. As for the equations (i.e CO, or Clearance of substance X, etc), I had some difficulty but once you understand the equation and know how to manipulate it around, its not that hard. On the USMLE, I had 3 or 4 problems with equation.
PATHOLOGY - Used BRS Path during all of second year and read all of robbins path during the course. Used WebPath during the year, and did all the questions for the system that we were studying at the time. Finally, I did all of the web path question again at the end along with rereading BRS Path several times.
PHARMACOLOGY - Used Lippincot Pharm for the class, and Simultaneously Used High Yield Pharm and First Aid, to keep track of the main drugs and their toxicity. At review time, I used first aid exclusively, however my first aid was scribbled with notes or other information from lippioncot or high yield pharm which I felt was important
MICROBIOLOGY - Used Micro Made Ridiculously Simple (one of the best books ever written) during class and Medical Micro & Immuno by Warren, Md, Phd Levinson, this book has a really go section on immunology, which I felt was not covered well by first aid. Micro in first aid was sufficient. MM&Immuno also has a really good section of quick review of all medically relevant bugs. At the review time, I read MMRSimple Once and read the immunology section of MM&Immuno once and did board like question as the back of MM&Immuno book. Finally if anything important was missing in first aid, I added it to micro section. Know you IL (1-10, etc) and immunodeficiency diseases (Burtons, etc). I had lot of questions on these from Immuno.
BIOCHEMISTRY- Not really my favorite subject. Used Lippincot Biochem during the course. Forgot everything over the summer and second year. Surprisingly a lot of it came back during review time. Used BRS Biochem which I read once (without doing the question), then read high yield Biochem twice, and finally just read the Biochem section of first aid & BIOCHEMICAL TECHNIQUES SECTION OF BRS BIOCHEM ( once every day for 4 weeks). Surprisingly I had very little Biochem on my test (go figure), but I did get tested on PCR and some other lab stuff that I cant remember. If you have limited time. Then I would just study First Aid 2003 and look up unfamiliar concepts Lippincot.
BEHAVIORAL SCIENCE - Used High Yield Behavioral Science during the course. During review, I also purchased High Yield Bio-Stats, because a lot of people of people who just took exam said that the emphasis on biostats had increased recently. In the end I had read high yield biostats and high yield behavioral science twice (but, I read the patient physician relationship section everyday for 4 weeks, and it paid off big time, all the question were like, "what would you say to this patient", so emphasize this section and defense mechanism, and Sleep stages). This section is easy points, so don't ignore it. I didn't study first aid behavioral science, because I think it was too simplified.
ANATOMY/EMBRYOLOGY/HISTO - Hated all of these subject, barely passed and failed Neuroanatomy Course (which I repeated, and a lot of it showed up on Step I, so I was ready). First Aid is more than enough for Step One. I didn't' really study any embryology, overall I had about 2 or 3 embryo, and about 10-15 anatomy and few histo questions(mostly on junctions). In the last few days, just skim over (key word) some radiology atlas and histo/path atlas.
QUESTION BANKS - You can get your hands on tons of questions, but since you have a limited amount of time. Here's what I would recommend in order of importance.
1. USMLE Released Questions - Very similar to the real thing. The questions were similar with a lot more graphs and interpretation of research experiments. I did not get a chance to do the online assessment from NBME, so I cant say anything about that. ALSO, DO THE TUTORIAL on the USMLE CD, so you are familiar with the format.
2. QBANK - Good source, although somewhat more detailed with HLA and other suff. Don't pay too much attention to details, just try to learn the main concept being tested. When simulating tests, always construct the test with ALL SUBJECTS & UNUSED QUESTIONS. I started out with 44%, which was kind of depressing but was mostly due to genetics/anatomy. However towards the end, I was consistently scoring in the 70-75%. I also did the IV QBANK - which is also really good source, but I would do it in the end (after QBANK & Qbook), when you have all the knowledge to integrate everything.
3. QBOOK - Also a good source of questions, especially behavioral science questions. I didn't get chance to finish it. But this is definitely helpful, so make sure you go through this.
4. WEBPATH - Best preparation for path questions of the exam. I would read the BRS Path chapter on a system and then do the corresponding web path questions. I felt that path was my strongest subject.
5. NBOME/COMLEX RELEASED QUESTIONS - People who write comlex questions have a 200 question booklet that you get which I felt was about 90% similar to comlex exam. If you are from MD school, I still suggest this because, you can just skip the OMM (Which I hate) but still do other questions, which I felt were really quality questions. This book is like 15 dollars. .
5. MEDREVU - I did about 1000 questions, but most of the questions were not that good and the explanations are long and difficult to read. I would not recommend these, unless you have a lot of time and would really like just practice questions.
I took both COMLEX/USMLE in same week and I want to say a little bit about COMLEX. Just study for the USMLE and use the Blue book by Saverese for the OMM component and you'll get most of the omm questions. Comlex is more exhausting because its 800 question and its two days with the paper and pencil format.
As for the USMLE Step I, the test was an interesting experience. Remember, USMLE is a test of concepts and fundamental principals. Its not direct recall test. So during my prep I would pick a concept or topic and tried to explain it to somebody, so that I really mastered it. But there is always some esoteric question that you just mark at move on.
During the last week, I just used first aid and did not do any questions. Secondly, I started getting up early in the morning and sleeping early to get back regular sleep cycle. A few days before the exam, I visited the center where I was going to take the exam, and to get familiar with directions and alternative routes. The day before test, I had backup transportation and backup alarm clock to make sure I would make it to the test center in time. Although I couldn't' really sleep the night before. Just kept thinking about stuff I still wanted to learn and had all kinds of negative thoughts. So, just go watch a movie or read something and its OK to be nervous.
Finally got to the test center and there were some people sitting there reading First Aid, so I stayed as far away from them as I could , to avoid being stressed out. Finally, they call you in and seat you. Just request to be seated far away from the door, so people who take breaks don't distract you, because there are always people coming in and out of the test room. Also make sure you have a good breakfast.
As for the test, it took a few question to get into the rhythm of everything. With the above listed question sources, I felt that I had seen about 70-80% of the questions in some form before.
Most of the questions, I could narrow it down to two choices. Don't' dwell on question that you cant answer, mark and more on, and come back to it if you have time.
Overall, the test is really fair and not that difficult (besides stupid research questions). Remember you may get like 10 hard questions in a row, so don't panic, just keep going.
Well, its all over now, and for those who still have to take it, good luck. For those who took, I hope everybody passes. If you have any question or comments, please feel free to post. Good Luck, and I didn't really proofread this.
