Going from mediocre med student to doing well on the boards

[PlasticC]

Is it possible?

In all the boards advice threads, I see people saying do well in your classes and you'll do well on the boards. But what if the reality is that you didn't? Is there anyone on here that has reformed and was able to do well on the boards?

Maybe I'm looking for a miracle, but what if from this point on, I buckled down and worked really hard, how much can I turn things around?

I haven't done very well in medical school up until this point, for reasons that are beyond the scope of this thread, but am willing to settle down, study hard and do everything I can do learn the information I need to do well. I ended up cramming a lot for classes in med school, and was able to pass, but now I feel like I have forgotten a lot, and don't know some of the basics that are expected of me as a second year medical student. Sad, but true story.

Is there any hope for a student like this?

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[McGillGrad]

Use the Taus method or go with a review class such as Falcon or Kaplan for 8 weeks.

 

[albaloo]

I guess it depends on how much time you have to study... I've seen people mention classmates in the bottom quartile ending up with the highest boards scores in the class, and some self-defined "slackers" talking about their turn around.

The new thing about this test, compared to the SATs or the MCATs, is that it is heavily knowledge based. So, the more you study the better you'll do. Even if you don't find the perfect motivational story on SDN, you might as well give it your all, no? You can be the motivational story for the next year's class!

Go go PlasticC!

 

[ACSurgeon]

Is it possible?

In all the boards advice threads, I see people saying do well in your classes and you'll do well on the boards. But what if the reality is that you didn't? Is there anyone on here that has reformed and was able to do well on the boards?

Maybe I'm looking for a miracle, but what if from this point on, I buckled down and worked really hard, how much can I turn things around?

I haven't done very well in medical school up until this point, for reasons that are beyond the scope of this thread, but am willing to settle down, study hard and do everything I can do learn the information I need to do well. I ended up cramming a lot for classes in med school, and was able to pass, but now I feel like I have forgotten a lot, and don't know some of the basics that are expected of me as a second year medical student. Sad, but true story.

Is there any hope for a student like this?

Well, there is still the second half of second year for you to get your act together. That can be half your step 1 studying right there (or make reviewing that material easy). Also, if you passes, I think you got enough overall. If you crammed and completely forgot certain topics, then you might wanna brush up on those. Details matter little (from my expereince) and it is your ability to think through a problem and see overarching themes that will help you the most.

Once you start reviewing and doing practice questions, you'll get a better idea of how much you know compared to how much you should know. Best of luck!

 

[ZagDoc]

I tell people there's two things about Step 1:
-Your score is much more dependent on how meticulous your review is than how you did the first two years of med school
-The best thing you can do during the first two years to prepare for Step 1 is to do well in your classes

They seem contradictory but let me explain. You could learn all the information in the curriculum 'well' during the first two years of med school, but if you miss that material during your review in the weeks just prior to Step 1, it won't be there in your ready-access memory when you go to the test. By the same virtue, if you don't learn the material well during the first two years of med school, getting through the material during your review period is going to be much more time-consuming and frustrating.

I was a good but not great student my first two years. Top third, not anywhere near the top 10. I scored a 99 on Step 1 and was, as far as I know, the second highest score in my class. The key was the study period. We have a natural tendency to skim subjects we don't enjoy or find frustrating. I definitely found going through subjects I did well in the classes on for Step 1 was easier because it was more 'reviewing' the material than 'relearning' it. The subjects I did poorly on, it sucked to go through that stuff. But I made sure to cover everything, no matter how painful the subject was or how poorly I understood the material.

So, yeah. I think the biggest misconception about Step 1 is people overvaluing long term review and undervaluing the 3-5 weeks before the test. I see it all the time on SDN. People starting to review during MS1, starting question blocks in january when they take the test in June but then either skipping certain things in the weeks prior to Step 1 because they 'already covered it' 2 months ago or being too ambitious during their review period and having to skip things during their review period because there isn't enough time. The key to ANYTHING you do prior to those 3-5 weeks before the test is to increase the efficiency of your studying DURING the 3-5 week period. But those weeks are the key thing. You have to make sure you cover everything, and cover it well enough that you learn it well enough to apply it on the exam. You can compensate for a poor first 2 years with an excellent 3-5 weeks of study. By the same virtue, you can waste 2 years of excellent performance with a shoddy 3-5 weeks of study.

 

[kryptik]

^ good stuff

 

[Cerberus]

I tell people there's two things about Step 1:
-Your score is much more dependent on how meticulous your review is than how you did the first two years of med school
-The best thing you can do during the first two years to prepare for Step 1 is to do well in your classes

They seem contradictory but let me explain. You could learn all the information in the curriculum 'well' during the first two years of med school, but if you miss that material during your review in the weeks just prior to Step 1, it won't be there in your ready-access memory when you go to the test. By the same virtue, if you don't learn the material well during the first two years of med school, getting through the material during your review period is going to be much more time-consuming and frustrating.

I was a good but not great student my first two years. Top third, not anywhere near the top 10. I scored a 99 on Step 1 and was, as far as I know, the second highest score in my class. The key was the study period. We have a natural tendency to skim subjects we don't enjoy or find frustrating. I definitely found going through subjects I did well in the classes on for Step 1 was easier because it was more 'reviewing' the material than 'relearning' it. The subjects I did poorly on, it sucked to go through that stuff. But I made sure to cover everything, no matter how painful the subject was or how poorly I understood the material.

So, yeah. I think the biggest misconception about Step 1 is people overvaluing long term review and undervaluing the 3-5 weeks before the test. I see it all the time on SDN. People starting to review during MS1, starting question blocks in january when they take the test in June but then either skipping certain things in the weeks prior to Step 1 because they 'already covered it' 2 months ago or being too ambitious during their review period and having to skip things during their review period because there isn't enough time. The key to ANYTHING you do prior to those 3-5 weeks before the test is to increase the efficiency of your studying DURING the 3-5 week period. But those weeks are the key thing. You have to make sure you cover everything, and cover it well enough that you learn it well enough to apply it on the exam. You can compensate for a poor first 2 years with an excellent 3-5 weeks of study. By the same virtue, you can waste 2 years of excellent performance with a shoddy 3-5 weeks of study.

I agree with everything said here so far. I wasn't a great student my first two years (not a bad one either, just average). Starting around January I started to go over Goljan audio, do a little review here and there, and most importantly make a plan for the 4 weeks of study time I had for Step I. I highly suggest finding Taus study plan and using it. I made a 248/99 on the real deal.

 

[PokerDoc]

Is it possible?

In all the boards advice threads, I see people saying do well in your classes and you'll do well on the boards. But what if the reality is that you didn't? Is there anyone on here that has reformed and was able to do well on the boards?

Maybe I'm looking for a miracle, but what if from this point on, I buckled down and worked really hard, how much can I turn things around?

I haven't done very well in medical school up until this point, for reasons that are beyond the scope of this thread, but am willing to settle down, study hard and do everything I can do learn the information I need to do well. I ended up cramming a lot for classes in med school, and was able to pass, but now I feel like I have forgotten a lot, and don't know some of the basics that are expected of me as a second year medical student. Sad, but true story.

Is there any hope for a student like this?

amen man, you described me pretty much perfectly to date.. first year, i was typically below average on my exams, sometimes close to the mean sometimes not. This year i started slipping more though, because everyone elses effort went up and i still did 'just enough' to get by.. But i have big dreams and I know i wont achieve them by sitting around and doing 'just enough'. We just had a neuro exam 2 days ago and our grades just came in.. scored top 1/3 on this exam. I know i can do it, just gotta maintain that drive from now till june

 

[dnslay]

Zag,

Would you be able to tell us specifics of your schedule during that 3 to 5 weeks and details about things you did to increase your study efficiency?

I would very much appreciate a breakdown of how you were organized and what your hours were like.

So, yeah. I think the biggest misconception about Step 1 is people overvaluing long term review and undervaluing the 3-5 weeks before the test. I see it all the time on SDN. The key to ANYTHING you do prior to those 3-5 weeks before the test is to increase the efficiency of your studying DURING the 3-5 week period. But those weeks are the key thing. You have to make sure you cover everything, and cover it well enough that you learn it well enough to apply it on the exam. You can compensate for a poor first 2 years with an excellent 3-5 weeks of study. By the same virtue, you can waste 2 years of excellent performance with a shoddy 3-5 weeks of study.

 

[ZagDoc]

Zag,

Would you be able to tell us specifics of your schedule during that 3 to 5 weeks and details about things you did to increase your study efficiency?

I would very much appreciate a breakdown of how you were organized and what your hours were like.

Gotten a couple of PMs about this also. I gave a pretty detailed account of my study schedule, thoughts during the month, and outcome in the Step 1 personal experiences thread. You can check it out here: http://forums.studentdoctor.net/showthread.php?p=8292712#post8292712

 

[McGillGrad]

Gotten a couple of PMs about this also. I gave a pretty detailed account of my study schedule, thoughts during the month, and outcome in the Step 1 personal experiences thread. You can check it out here: http://forums.studentdoctor.net/showthread.php?p=8292712#post8292712

I would also like to note that ZagDoc is a freak of nature and these results are not typical.

There is no doubt that hard, concentrated work will yield results, but expecting to score like ZagDoc is going to be difficult. I have been reading his blog and he has a gift for writing. I suspect that his humanities background has been the 'x-factor' that allows for the 250+ score he earned.

 

[dnslay]

Thanks Zagdoc!

 

[ar2388]

wow Zagdoc, that looks outstanding. thank you!

 

[Noeljan]

congrats zagdoc, and not to take away from your methods but I disagree a little bit. I think a huge portion of how you do is based on how you did in the first two years (more importantly year 2, but depending on your curriculum this can include year 1). The more you learn something and understand it, the more you can recall it at a later date (which I think you also seem to agree with). I don't think there is anything magical about those last few weeks. In fact, many people I know were burned out or in freak out mode or hit a plateau. I myself didn't study much of anything leading up to the last two weeks of the test (nor did I sleep the night before). Honestly, the stuff I got right most likely came from long term thinking and memory. Most (again there are exceptions) people I know that did well on Step 1 did at least above average in the 2nd year. I don't want to discourage anyone who is out of time and has only 6 weeks left (because I firmly believe the more work you put in the higher your score will be no matter your baseline). BUT, if you have many months left start now! Learn as much as you can and try to understand the concepts (and memorize). Really for this test you need both IMO thinking and good memory.

wanted to add: the reason why i think it it best for current med students to start working hard now (as opposed to banking on the 4-10 weeks you may be given) is also to give yourself a cushion. That is what it comes down to. If you cant sleep before it (which happened it seemed to almost everyone I talked to), are burnt out, have an emergency come up around that time, anything, you have knowledge and work to draw upon instead of if things go less than perfect and memorizing all your review books didn't quite happen during board only study time.

 

[McGillGrad]

You are confusing high scores in basic sciences with learning material. Yes, they usually go hand-in-hand but scoring in the top 10% of your class by memorizing the notes actually cheapens your step score when someone in the bottom 10% gets the same score.

That's why clinical evaluations are almost as important as step scores. They differentiate the clutch players from the true talent.

congrats zagdoc, and not to take away from your methods but I disagree a little bit. I think a huge portion of how you do is based on how you did in the first two years (more importantly year 2, but depending on your curriculum this can include year 1). The more you learn something and understand it, the more you can recall it at a later date (which I think you also seem to agree with). I don't think there is anything magical about those last few weeks. In fact, many people I know were burned out or in freak out mode or hit a plateau. I myself didn't study much of anything leading up to the last two weeks of the test (nor did I sleep the night before). Honestly, the stuff I got right most likely came from long term thinking and memory. Most (again there are exceptions) people I know that did well on Step 1 did at least above average in the 2nd year. I don't want to discourage anyone who is out of time and has only 6 weeks left (because I firmly believe the more work you put in the higher your score will be no matter your baseline). BUT, if you have many months left start now! Learn as much as you can and try to understand the concepts (and memorize). Really for this test you need both IMO thinking and good memory.

wanted to add: the reason why i think it it best for current med students to start working hard now (as opposed to banking on the 4-10 weeks you may be given) is also to give yourself a cushion. That is what it comes down to. If you cant sleep before it (which happened it seemed to almost everyone I talked to), are burnt out, have an emergency come up around that time, anything, you have knowledge and work to draw upon instead of if things go less than perfect and memorizing all your review books didn't quite happen during board only study time.

 

[Noeljan]

You are confusing high scores in basic sciences with learning material. Yes, they usually go hand-in-hand but pretending like scoring in the top 10% of your class by memorizing the notes actually cheapens your step score when someone in the bottom 10% gets the same score.

That's why clinical evaluations are almost as important as step scores. They differentiate the clutch players from the true talent.

huh? Not sure what you are saying here. Your sentence makes zero sense. Pretending like scoring in the top 10% of your class by memorizing notes....?????can you complete the thought. I'm just telling the students that have time left to LEARN INSTEAD of MEMORIZE if you reread my post. Waiting to cram until you have 6 weeks is actually memorizing and not learning as efficiently as someone who started learning it a while back. Resist the temptation/defense mechanism/chip on shoulder that the top 10% of the class is just memorizing, while everyone else is "learning." BTW nowhere in my post did I even mention top 10, or 5 etc...Now, from personal experience I did well in classes and I personally felt that helped me score above 255 on step 1 even in the less than ideal situation. I don't think waiting until I had 6 weeks would have gotten me my score. Maybe I am wrong, but from the advice someone gave to our class that did well on the boards before us, step 1 is not the time to prove you are a genius. If other people claim to not study all 2 years and cram for step 1, good for them. Meaning don't play games with your preparation.

 

[McGillGrad]

That may be the problem. You just don't know what people are saying.

huh? Not sure what you are saying here. Your sentence makes zero sense. Pretending like scoring in the top 10% of your class by memorizing notes....?????can you complete the thought. I'm just telling the students that have time left to LEARN INSTEAD of MEMORIZE if you reread my post. Waiting to cram until you have 6 weeks is actually memorizing and not learning as efficiently as someone who started learning it a while back. Resist the temptation/defense mechanism/chip on shoulder that the top 10% of the class is just memorizing, while everyone else is "learning." BTW nowhere in my post did I even mention top 10, or 5 etc...Now, from personal experience I did well in classes and I personally felt that helped me score above 255 on step 1 even in the less than ideal situation. I don't think waiting until I had 6 weeks would have gotten me my score. Maybe I am wrong, but from the advice someone gave to our class that did well on the boards before us, step 1 is not the time to prove you are a genius. If other people claim to not study all 2 years and cram for step 1, good for them. Meaning don't play games with your preparation.

 

[Noeljan]

You are confusing high scores in basic sciences with learning material. Yes, they usually go hand-in-hand but scoring in the top 10% of your class by memorizing the notes actually cheapens your step score when someone in the bottom 10% gets the same score.

That's why clinical evaluations are almost as important as step scores. They differentiate the clutch players from the true talent.

and FYI not sure why you are bringing up clinical evals when we are talking about step 1 and its relation to basic science classes, but from what I have gathered from attendings and residents clinical evals, or ANY grades for that matter are nowhere near as important as step 1. Sad but true. Some specialties don't even read the deans letter before giving inteviews (again sad but true, because I have gotten some amazing and nice comments that I would love to see count for something). Also, many fields only care about letters from their own field (again sad but true, since if you ace a rotation and think you could get a letter some fields dont care). It is the reality. People have told me they were very surprised how much step 1 actually meant once they were on the interview season and trail. Just wanted to add....this could be biased towards certain specialties that I have looked into extensively (like neurosurg and optho) so perhaps in other fields this does not ring true. However, older friends who have applied/are applying in other fields have said they didnt realize how impt step 1 was until then.....I just want to help people. Don't slack off because you think something is not important. Try your hardest and things will work out.

 

[McGillGrad]

Breaks and paragraphs are wonderful things...

and FYI not sure why you are bringing up clinical evals when we are talking about step 1 and its relation to basic science classes, but from what I have gathered from attendings and residents clinical evals, or ANY grades for that matter are nowhere near as important as step 1. Sad but true. Some specialties don't even read the deans letter before giving inteviews (again sad but true, because I have gotten some amazing and nice comments that I would love to see count for something). Also, many fields only care about letters from their own field (again sad but true, since if you ace a rotation and think you could get a letter some fields dont care). It is the reality. People have told me they were very surprised how much step 1 actually meant once they were on the interview season and trail.

 

[Noeljan]

Breaks and paragraphs are wonderful things...

true...

 

[kdburton]

and FYI not sure why you are bringing up clinical evals when we are talking about step 1 and its relation to basic science classes, but from what I have gathered from attendings and residents clinical evals, or ANY grades for that matter are nowhere near as important as step 1. Sad but true. Some specialties don't even read the deans letter before giving inteviews (again sad but true, because I have gotten some amazing and nice comments that I would love to see count for something). Also, many fields only care about letters from their own field (again sad but true, since if you ace a rotation and think you could get a letter some fields dont care). It is the reality. People have told me they were very surprised how much step 1 actually meant once they were on the interview season and trail. Just wanted to add....this could be biased towards certain specialties that I have looked into extensively (like neurosurg and optho) so perhaps in other fields this does not ring true. However, older friends who have applied/are applying in other fields have said they didnt realize how impt step 1 was until then.....I just want to help people. Don't slack off because you think something is not important. Try your hardest and things will work out.

In hindsight some students and residents (even attendings) may think this was true when they were applying for residency, but when you actually look at the data....

http://www.nrmp.org/data/programresultsbyspecialty.pdf

In most cases your clinical grades/evals - including the required clerkships or in your desired specialty - are as important if not more important than standardized exams (and most other measurements). In fact when you look at all specialties averaged out the most important thing that a PD looks at is your grade in a rotation through their specialty.

 

[Noeljan]

In hindsight some students and residents (even attendings) may think this was true when they were applying for residency, but when you actually look at the data....

http://www.nrmp.org/data/programresultsbyspecialty.pdf

In most cases your clinical grades/evals - including the required clerkships or in your desired specialty - are as important if not more important than standardized exams (and most other measurements). In fact when you look at all specialties averaged out the most important thing that a PD looks at is your grade in a rotation through their specialty.

I agree about the letter from the specialty you are going into (ex: NS rotation/letter from NS rotation). However, that most NS programs are done with interviewing before the deans letter even goes out (which is what includes all of your comments/clinical evals from other rotations). I have had NS tell me they could care less really what other rotations say about you more or less. Look on that list you linked again. Step 1 is still the highest percent for deciding factor in interviewing. Apparently grades are less standardized than Step 1 (they don't know how different schools or even different places in each school does things from what they have said). Obviously grades are important (and one shouldn't slack). One also shouldn't slack in preparation for exams. It is all important, and each speciality will differ. Obviously you should try to shine the most in your speciality rotation (you would be silly not to), and try to do your best in all rotations.

Anyways, the point of this thread was about basic science knowledge and step 1. I stand by what I said before someone brought up clinics for some reason. Work hard in medical school (especially year 2) and it will make it easier for you come step 1 alloted time. I wanted to add, I think the problems arise (which is what I try to give advice so people can avoid falling into traps) when people don't work as hard in class, step 1 or even other rotations and think by acing a SubI they are golden bc "that's the most important thing" Or waiting until three weeks before step 1 to hardcore study bc "that is the most important time" I have seen people eat up comments like this and end up really regretting it. I agree with working hard NOW in classes to learn which will help for step 1....it is January there is still time to be had Lets get back on topic.

 

[njbmd]

Is it possible?

In all the boards advice threads, I see people saying do well in your classes and you'll do well on the boards. But what if the reality is that you didn't? Is there anyone on here that has reformed and was able to do well on the boards?

Maybe I'm looking for a miracle, but what if from this point on, I buckled down and worked really hard, how much can I turn things around?

I haven't done very well in medical school up until this point, for reasons that are beyond the scope of this thread, but am willing to settle down, study hard and do everything I can do learn the information I need to do well. I ended up cramming a lot for classes in med school, and was able to pass, but now I feel like I have forgotten a lot, and don't know some of the basics that are expected of me as a second year medical student. Sad, but true story.

Is there any hope for a student like this?

Your first task is to take care of your second-year coursework. It doesn't help your situation to focus on board prep when you have a whole semester of coursework ahead of you. You have already stated that you are "willing to settle down, study hard and do everything I can to learn the information to do well". The thing now is for you to do what you have stated above.

When you are done with your second-year coursework, make a systematic review schedule. You can take a review course, you can use review books or you can use some combination of the two but figure out what you need and make a schedule to get this done. You also want to make sure that you utilize some kind of computer question base (Kaplan or USMLEWorld-type) so that you are totally comfortable with knowing if your missed answers are a "knowledge deficit" or a "procedural deficit". Every question that you do will help you review your knowledge but you have to pay attention to how you approach the questions too.

In addition, drop the "mindset" that because you did the bare minimum to pass in your coursework, you don't have any knowledge base from that coursework. Most students have far more knowledge than they would believe. You don't have to be able to "parrot back" every piece of your pre-clinical coursework word-for-word in order to do well on board exams. You need to have a solid means of problem-solving so that you can maximize the knowledge that you do and will have in order to do well on board exams.

Yes, you can turn your performance around but don't put extra pressure on yourself to "get a certain score" or "get into a specific specialty". Your focus needs to be on each task in a stepwise manner rather than trying to deal with everything at once.

The steps to take now are:

• Start nailing your remaining coursework. Anything that you learn and master now is less to review for boards.
• Start asking for information from upper classmates who have recently taken boards, school administration as to what they may be providing and online searches/evaluations of various USMLE prep methods.
• Stop trying to focus on your entire career at this point but take one step at a time.
• Don't keep "labeling yourself" as "marginal student", "mediocre" and other self-defeating labels.
• Tune out the people that say you can't get this done period.

You may not have been happy with your previous coursework results but you can change what needs to be changed and be quite happy with your ability to review. Put your focus on each task as it comes and resolve to do your best. There is nothing magical or miraculous but good solid work to be done here.

 

[McGillGrad]

In hindsight some students and residents (even attendings) may think this was true when they were applying for residency, but when you actually look at the data....

http://www.nrmp.org/data/programresultsbyspecialty.pdf

In most cases your clinical grades/evals - including the required clerkships or in your desired specialty - are as important if not more important than standardized exams (and most other measurements). In fact when you look at all specialties averaged out the most important thing that a PD looks at is your grade in a rotation through their specialty.

I tried to explain that program directors clearly stated that step 1 is slightly more important than clinical evaluations.

Those who ignore the data are simply making themselves look misinformed.