For the majority of M1 material. How to study for boards?

[rodmichael82]

I know that the majority of step 1 is Year 2 material but I'm panicking because I don't remember anything from M1 year. I did some Biochem and Physiology Uworld questions and barely got 10 % correct. What do I do at this point? When and how do I go over First year material and how to move forward in M2? Thanks

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[normtheniner]

I know that the majority of step 1 is Year 2 material but I'm panicking because I don't remember anything from M1 year. I did some Biochem and Physiology Uworld questions and barely got 10 % correct. What do I do at this point? When and how do I go over First year material and how to move forward in M2? Thanks

I got a 249 on step 1. Didn't look at M1 year stuff until my dedicated five weeks of studying. Learn M2 stuff as well as you can this year and it'll fall into place.

Phys will come back to you when you learn pathophys this year.

 

[operaman]

While this may not be what you want to hear, the best thing you can do is to relax and enjoy your summer. Anything you learn this summer will be long forgotten by boards time next year, and you run the risk of burning out during ms2 and not getting as much out of it as you should.

If you feel like you must do something, I'd suggest Firecracker and start banking cards that cover your m1 material and try to keep up as best you can as ms2 gets rolling. The thought here is that their spaced repetition algorithm will keep you reviewing the material during the year and thus make you less likely to forget it over time. Any isolated study at this point would be about as useful as prestudying for ms1 would have been.

Pay no attention to your World scores at this point because the questions and answer choices, even for m1 material, presuppose ms2 knowledge. The vignette for a physio question may well contain pathology or pharm concepts even though the actual question tests a physio concept.

For example: (just making this up)

A 54 year old man presents to the emergency department complaining of sporadic syncopal episodes. Vitals at presentation were BP 135/83 Pulse 88 RR 19 T 37.4. Physical exam was remarkable for a ii/vi systolic ejection murmur best heard at the lower left sternal border that grew louder on inspiration. Transthoracic echocardiography revealed a pedunculated mass in the left atrium. Studies performed during a syncopal episode would most likely demonstrate which of the following?

a) increased ejection fraction
b) decreased ejection fraction
c) increased pulmonary capillary wedge pressure
d) decreased peripheral vascular resistance
e) Decreased right ventricular pressure
f) Increased left ventricular peak systolic pressure

This is a basic physiology question, but does presuppose that you recognize a myxoma and know that the pathophysiology of the incidents in question derive from the tumor intermittently obstructing the mitral valve - decidedly 2nd year concepts. Once you know that the mitral valve is obstructed, it's obviously C because mitral pressures will increase just like they would in any other obstructive mitral lesion which would be reflected in your PCWP. A year from now you'll consider this an easy question, but right now has a couple elements that would make it unfair to ask you unless I said "...pedunculated mass in the left atrium sporadically obstructing the mitral outlet" at which point it would be fair game.
[distractors: a&b are wrong because EF wouldn't change; you'd just have less EDV; d is wrong because your body would increase resistance to shunt blood to vital organs during hypotensive episodes; e is wrong because RV pressures would increase due to backing up from the mv obstruction; LV systolic pressures would decrease due to massively decreased preload]

So, save World for next year sometime when you can truly benefit from it and enjoy your summer!

 

[rodmichael82]

Thank you! I already started M2 though, will have my first exam on Friday.

While this may not be what you want to hear, the best thing you can do is to relax and enjoy your summer. Anything you learn this summer will be long forgotten by boards time next year, and you run the risk of burning out during ms2 and not getting as much out of it as you should.

If you feel like you must do something, I'd suggest Firecracker and start banking cards that cover your m1 material and try to keep up as best you can as ms2 gets rolling. The thought here is that their spaced repetition algorithm will keep you reviewing the material during the year and thus make you less likely to forget it over time. Any isolated study at this point would be about as useful as prestudying for ms1 would have been.

Pay no attention to your World scores at this point because the questions and answer choices, even for m1 material, presuppose ms2 knowledge. The vignette for a physio question may well contain pathology or pharm concepts even though the actual question tests a physio concept.

For example: (just making this up)

A 54 year old man presents to the emergency department complaining of sporadic syncopal episodes. Vitals at presentation were BP 135/83 Pulse 88 RR 19 T 37.4. Physical exam was remarkable for a ii/vi systolic ejection murmur best heard at the lower left sternal border that grew louder on inspiration. Transthoracic echocardiography revealed a pedunculated mass in the left atrium. Studies performed during a syncopal episode would most likely demonstrate which of the following?

a) increased ejection fraction
b) decreased ejection fraction
c) increased pulmonary capillary wedge pressure
d) decreased peripheral vascular resistance
e) Decreased right ventricular pressure
f) Increased left ventricular peak systolic pressure

This is a basic physiology question, but does presuppose that you recognize a myxoma and know that the pathophysiology of the incidents in question derive from the tumor intermittently obstructing the mitral valve - decidedly 2nd year concepts. Once you know that the mitral valve is obstructed, it's obviously C because mitral pressures will increase just like they would in any other obstructive mitral lesion which would be reflected in your PCWP. A year from now you'll consider this an easy question, but right now has a couple elements that would make it unfair to ask you unless I said "...pedunculated mass in the left atrium sporadically obstructing the mitral outlet" at which point it would be fair game.
[distractors: a&b are wrong because EF wouldn't change; you'd just have less EDV; d is wrong because your body would increase resistance to shunt blood to vital organs during hypotensive episodes; e is wrong because RV pressures would increase due to backing up from the mv obstruction; LV systolic pressures would decrease due to massively decreased preload]

So, save World for next year sometime when you can truly benefit from it and enjoy your summer!

 

[HoboCommander]

Keep in mind that a lot of the advice given on SDN are from naturally gifted test takers. What works for them might not work for you. Half their class probably has the same study plan that they do, yet those people struggle to break 220.

If you're not as gifted a test taker as some people are, then you just have to work harder.

 

[Locrian]

I got a 249 on step 1. Didn't look at M1 year stuff until my dedicated five weeks of studying. Learn M2 stuff as well as you can this year and it'll fall into place.

Phys will come back to you when you learn pathophys this year.

This.

Keep in mind that a lot of the advice given on SDN are from naturally gifted test takers. What works for them might not work for you. Half their class probably has the same study plan that they do, yet those people struggle to break 220.

If you're not as gifted a test taker as some people are, then you just have to work harder.

Also this.

But even then, it worked out for me studying ahead for MS2 stuff during the summer, stay ahead, keep stress low, saves a lot of pain.

But know your limits.

 

[Anastomoses]

Two things: How did you do on your tests during M1? And are you including questions that combine concepts that we haven't learned yet?

When I do any of the questions that cover things we learned, I am generally surprised by how simple and direct the questions/answers are...the frustration is when they integrate pharmacology or M2 material into the question - of course we're going to get those wrong!

 

[rodmichael82]

Two things: How did you do on your tests during M1? And are you including questions that combine concepts that we haven't learned yet?

When I do any of the questions that cover things we learned, I am generally surprised by how simple and direct the questions/answers are...the frustration is when they integrate pharmacology or M2 material into the question - of course we're going to get those wrong!

All my exams during M1 were mostly in the low 90s.

I actually do remember some of the stuff from Spring (Physio, Immuno, Behavioral Science) but forgot most of the stuff from Fall (Biochem, Genetics, biostat/pop med). Some of the Biochem questions are ridiculous asking about specific enzymes, I don't remember that junk!

 

[paul411]

Some of the Biochem questions are ridiculous asking about specific enzymes, I don't remember that junk!

That's just the nature of material involving very specific biochemistry, genetics, micro, etc. It only stays in your memory for a few weeks at best unless you're actively using the information on a regular basis (which you probably won't during MS2). You've been getting low 90s on class tests, you should be able to pick this material up again quickly during dedicated study time.

If you're still not convinced and feel you have to do something, use Firecracker.

And don't worry about UWorld scores yet, you've got a long way to go. Use UWorld like you're reading a textbook (tutor mode; read full explanations). The key to doing well on UWorld/Step 1 is a combination of both (i) a solid foundation of content and (ii) test-taking skills. You can't start to hone your test-taking skills till you have a strong knowledge base first. I started UWorld in the 50s after MS1, MS2, and a full pass through FA, but I still ended up doing well on Step 1. So don't worry about UWorld scores at this point.

 

[CaptainSSO]

While this may not be what you want to hear, the best thing you can do is to relax and enjoy your summer. Anything you learn this summer will be long forgotten by boards time next year, and you run the risk of burning out during ms2 and not getting as much out of it as you should.

If you feel like you must do something, I'd suggest Firecracker and start banking cards that cover your m1 material and try to keep up as best you can as ms2 gets rolling. The thought here is that their spaced repetition algorithm will keep you reviewing the material during the year and thus make you less likely to forget it over time. Any isolated study at this point would be about as useful as prestudying for ms1 would have been.

Pay no attention to your World scores at this point because the questions and answer choices, even for m1 material, presuppose ms2 knowledge. The vignette for a physio question may well contain pathology or pharm concepts even though the actual question tests a physio concept.

For example: (just making this up)

A 54 year old man presents to the emergency department complaining of sporadic syncopal episodes. Vitals at presentation were BP 135/83 Pulse 88 RR 19 T 37.4. Physical exam was remarkable for a ii/vi systolic ejection murmur best heard at the lower left sternal border that grew louder on inspiration. Transthoracic echocardiography revealed a pedunculated mass in the left atrium. Studies performed during a syncopal episode would most likely demonstrate which of the following?

a) increased ejection fraction
b) decreased ejection fraction
c) increased pulmonary capillary wedge pressure
d) decreased peripheral vascular resistance
e) Decreased right ventricular pressure
f) Increased left ventricular peak systolic pressure

This is a basic physiology question, but does presuppose that you recognize a myxoma and know that the pathophysiology of the incidents in question derive from the tumor intermittently obstructing the mitral valve - decidedly 2nd year concepts. Once you know that the mitral valve is obstructed, it's obviously C because mitral pressures will increase just like they would in any other obstructive mitral lesion which would be reflected in your PCWP. A year from now you'll consider this an easy question, but right now has a couple elements that would make it unfair to ask you unless I said "...pedunculated mass in the left atrium sporadically obstructing the mitral outlet" at which point it would be fair game.
[distractors: a&b are wrong because EF wouldn't change; you'd just have less EDV; d is wrong because your body would increase resistance to shunt blood to vital organs during hypotensive episodes; e is wrong because RV pressures would increase due to backing up from the mv obstruction; LV systolic pressures would decrease due to massively decreased preload]

So, save World for next year sometime when you can truly benefit from it and enjoy your summer!

Good question, except ejection fraction would in fact change.