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Hi all! SDN was super helpful to me in the past, so I thought I'd do an AMA here.
Ask me anything!
Ask me anything!
Last edited:
Hi.. congratualtions on your match..
I am an IMG, and i have not taken any of my steps yet, im planning to take step 1 by dec or jan. But i would like to know regarding the effective study material and what question banks/ assessment methods must be followed for step 2 ck and cs both. Also do i need to attend any tutoriols before taking step 2 cs?
Thank you for your time..
Haha, I figured it did not matter as my bio is publicly available at my website listed in my signature!Dude, get your real name off the internet!
Yup.Dude, get your real name off the internet!
*edit Oh wait, Medschoolgurus is like your company. I guess it's ok lol.
Thank you so much!! 🙂Thanks very much!
In general, I recommend active learning through practice questions and spaced repetition as the cornerstones of your learning.
Step 1 Resources
Question Banks
NBME Exams, UWorld, USMLE Rx, and Kaplan.
Studies of USMLE Step 1 scores have shown that the more questions you do, the higher your score will be. I generally recommend doing all the NBMEs you have time for, while doing no more than one NBME every 4 days.
Anki Decks
Spaced repetition through diligent use of Anki flashcards is an effective and efficient evidence based way to retain information throughout your long study period. MedSchoolGurus has developed the MedSchoolGurus Anki Deck as well as curated high yield Anki decks which we recommend that students incorporate into their daily study routine.
Video Resources
The best video based resources are Pathoma and Sketchy Micro. OnlineMedEd has excellent videos for psychiatry.
Textbooks
The best textbooks for boards are First Aid for the USMLE Step 1, and Crush Step 1. First Aid is essentially a bullet point checklist of facts one should plan to study. Crush Step 1 is a great resource if you'd like to read a concise paragraph about how something you don't understand works. Goljan's Rapid Review Pathology is an excellent reference which can be used to supplement areas in which you want more clarification or information.
Biostats
Biostatistics is best covered via First Aid for the USMLE Step 1, UWorld Biostatistics Review, the UWorld Step 1 question bank biostats questions, and the MedSchoolGurus Biostats Anki Deck.
Anatomy
The best resources are First Aid for the USMLE Step 1, Dr. Mavrych's 125 Most Important Anatomical Conceptions, the MedSchoolGurus Anki Decks, and Lippincott's Illustrated Q&A Review of Anatomy and Embryology (contains about 400 USMLE style anatomy questions).
Biochemistry, Molecular Biology, and Genetics.
The best resources are First Aid for the USMLE Step 1, the MedSchoolGurus Anki Decks, and Lippincott's Illustrated Q&A Review of Biochemistry (contains about 400 USMLE style questions).
Step 2 CK Resources
UWorld Step 2 CK.
The best, and most comprehensive, set of questions for shelf and Step 2 review. Includes 2200 extremely high yield questions for shelf exams and USMLE Step 2 CK. Must do.
Anki Decks.
There are a number of extremely high yield Anki decks publicly available for both rotations and USMLE Step 2 CK. The MedSchoolGurus Step 2 CK Anki Deck is a very good paid option and covers all of UW, Online MedEd, the practice NBMEs, and many of the resources mentioned below.
Pestana's Surgery Vignettes.
Outstanding questions for surgery clerkship. High yield for USMLE Step 2CK.
University of Texas Shelf review videos and accompanying slides by Emma Holliday.
Two hour shelf-reviews for Psychiatry, Pediatrics, Surgery, and Medicine. Extremely high yield for shelfs and Step 2 CK. Must do.
Practice NBME Shelf Exams (NBME Clinical Mastery Series).
Official NBME practice shelf exams. I would review your incorrects before Step 2 CK or redo them if you have time. Must do.
Practice NBME USMLE Step 2 CK Exams (Comprehensive Clinical Science Self-Assessment (CCSSA))
Official NBME USMLE Step 2 CK exams. Do each one during your USMLE Step 2 CK review. Must do.
Online Med Ed Videos.
Good for brushing up on areas of weakness for Step 2 CK preparation. Highly recommended.
Step 2 CS Resources
If you are a US allopathic medical student and have completed your clinical year, you should require little to no studying for the CS (just skim First Aid for the USMLE Step 2 CS the day before the exam).
As an IMG, it is harder. Remember, the components of the exam are Spoken English Proficiency (SEP), Integrated Clinical Examination (ICE), and Communication and interpersonal Skills (CIS). I would carefully read First Aid for the USMLE Step 2 CS to maximize your score on ICE. SEP is exactly what it sounds like and can only be improved, well, by improving your spoken English, which is best achieved by immersion in an english speaking country.
CIS is actually pretty teachable. Express interest in the patient as a person. Treat the patient with respect. Say "Tell me more about that" and listen to what they have to say. Assess how the patient's illness has affected his/her daily life. Understand the meaning of patient centered communication. Explain in layman's terms the patient's differential diagnosis and your next steps in management. Comfort and empathize with the patient. Try to pick up on things that make the patient emotional and explore those topics with questions. Use motivational interviewing to help patients change bad habits.
Hope this helps!
Thank you!Congratulations
Did you match before CS exam ?
I need more illustration about Anki please
Hi there !
Thank you so much for your post. So amazing to read about people like you.
I'm an IMG student entering my 3rd year of medical school (so I've done the 2 first years which are all mainly pre-clinical) therefore I should be able to prepare for the USMLE step1. I'm so confused as to where to start ! I've read a lot and most people seem to recommend sticking to First-Aid, UWORLD and sometimes an extra source in order to learn such as Doctors in Training or Kaplan videos. What's your take on this ?
Is there such a thing as studying too in advance for this exam (9months before)?
Sorry for the long message. Cheers, B
Hi B,
That's very nice of you to say. Thank you!
I'd definitely recommend all of the resources I mentioned above. If I had to pick 6 resources "to start with", they would be UWorld, Practice Exams, First Aid, Sketchy Micro, and Crush Step 1. I don't have any personal experience with the Doctor's in Training Videos but my students don't seem to end up sticking with them. I have heard good things about the Kaplan Anatomy videos but think the Kaplan videos are pretty variable. I've tutored dozens of students for the USMLEs, and I'd say about half strongly recommend Boards and Beyond. Most of the students I have who have used Boards and Beyond end up recommending it though, so I think it is worth checking out. Doing additional practice questions such as USMLERx will only help you improve your score.
I personally do not think one can start studying "too early" for the exam. Others will disagree with me on this and encourage you to enjoy yourself before your 2-3 month dedicated study period begins. However, students start their dedicated study period with a different baselines of knowledge and then learn at different rates. I therefore think it is most prudent to begin studying as early as reasonably possible. I think you will have to use your own judgement or meet with someone who can assess your baseline in order to determine when it is reasonable for you to dedicate time each day to USMLE study.
!
Congratulations
I am an IMG and I wish to know if it is possible to get dermatology in USA.
I am yet to take usmle steps.
Hi MedSchoolGurus,
Thank you so much for taking the time to answer me.
Thanks alot doctorThank you!
No, I matched after I took the CS exam.
Here is how to use Anki.
Download Anki
Go to the Anki website and download Anki.
Go to the app store on your smartphone and download the Anki App.
Create an AnkiWeb account
Go to the AnkiWeb website and create an AnkiWeb account.
Link an AnkiWeb account
On your desktop, open Anki. Click sync. Enter your AnkiWeb credentials. Click upload to AnkiWeb. Wait for the sync to complete.
On your phone, open Anki. Click the gear button. Click synching. Enter your credentials. Go back to the Anki home screen. Click synchronize. Click download from AnkiWeb. Wait for sync to complete.
Starting off with a pre-made deck
Many students begin with one of many pre-made decks.
If you're using another deck, you'll want to first suspend all the cards you haven't seen yet. Go to the Anki browser and sort by the date due column. Cards you've seen before will have a due date. Cards you have not seen yet will have a random long number in the due date column. Select/highlight all of the cards you have not yet seen and click suspend. The due date numbers of the suspended cards should now be surrounded by parenthesis. This is a very important step. Do not skip it.
If you're wondering how to import a quizlet deck into Anki, check out this blog post.
Editing the settings of Anki decks
The default settings of Anki decks are not ideal and should be edited as follows. Go to the Anki home screen. You should see a list of your decks. Next to the name of your deck, click the gear button and click options from the dropdown menu. Change the new cards per day limit to 120. Click the reviews tab. Change the maximum reviews per day to 9999. Click ok.
Go back to the home screen with the list of your decks. From the menu bar, click Anki. From the dropdown menu, click preferences. From the second drop down menu, click "Show new cards before reviews".
Using Anki for all new learning
You should use Anki every day to capture all of the new information you learn. Check out our blog posts on which resources to use to prepare for preclinicals and USMLE Step 1 and which resources to use for clinicals and USMLE Step 2 CK preparation. If you just learned a new fact about myosin in the pathology of hypertrophic cardiomyopathy, open the Anki browser on your computer and search for "myosin hypertrop". Note that you don't have to put in complete words for the search function to work. Browse the cards that pop up in the search results. Select the cards you want to study and click suspend. This will unsuspend the cards and you should see that the due date number or date should no longer be surrounded by parenthesis.
You might not always find a pre-made card that corresponds to the information you're trying to learn. That's ok. Make a new card by clicking Add. A good card will test one fact and provide one answer. It's helpful to add screenshots of useful images, tables, or other content, into the back of cards. E.g., if you just made a card asking what the accumulated substance in Tay-Sachs disease is, it'd be helpful to add a screenshot of a table of all the lysosomal storage diseases in the back of the card, just so you can review it if you want at any time after reviewing your card in the future.
Use this process to capture all the new info into Anki, either via unsuspending pre-made cards or creating your own new cards. Pause the video you are watching after learning something new and make sure to capture it into Anki. Take notes in the back of cards if you'd like as well. After getting a question wrong, make sure to capture the key fact you missed into Anki. At the end of your day on wards, look to see what you leaned and see if there's anything worth adding into Anki.
If you're going through a topic for the first time, you'll probably unsuspend or add a ton of new cards a day. Maybe even 300 or so. That's ok. It's hard to commit all of those facts to memory in a single day. The limit of 120 new cards per day is to prevent you from going crazy trying to learn new material. It is equally important to keep up with old reviews as it is to review new information.
Make sure to periodically sync your Anki collection on your desktop once you've added a bunch of new cards on your desktop copy of Anki. Then sync your phone's Anki to make everything up to date.
Using Anki for review
Anki will assign you due cards every day. These are the cards you're most likely to have forgotten, so it's important to do all due cards every day. Typically, students can make it through about 120 review cards per hour and 50 new cards per hour. Completing your daily quota of multiple choice questions is more important than completing every single Anki review, however.
During preclincials and your dedicated USMLE Step 1 review time, try to do at least three hours of Anki review every day and try to make significant progress at completing your reviews every day. During the peak of your dedicated study period, it can take 3-5 hours every day to complete these reviews. Try to finish all of the reviews even if it takes more time.
During wards, try to do at least 1 hour of Anki review every day on wards, and 3-5 hours during weekends/days off.
What to do if your Anki cards are piling up
What if your cards start to pile up and you have 1000+ cards to review? Your main study deck likely has many subdecks for various organ systems and topics. If you click your main study deck and click study now, you will complete these subdecks in alphabetical order. This is fine if you end up completing all the cards, but if you can't complete your daily reviews, you should complete the subdecks that are most important to your review right now. You can do that by clicking the subdeck from the Anki home screen and then clicking study now. For example, if you are really weak in respiratory but haven't been completing this subdeck on a daily basis, click your respiratory subdeck and try to complete all the reviews. Your MedSchoolGuru will help you figure out what to prioritize based on which of your current weaknesses are highest yield to review.
Do not create filtered decks
Anki has the option to create filtered decks which are a quick option to study a bunch of selected cards at once as opposed to doing the cards in the order Anki presents them to you. Don't use filtered decks. Instead, select subdecks and just study those if you want to do a more focused review.
Do not unsuspend a whole subdeck at once
It may be tempting to, all at once, unsuspend a whole subdeck. For example, you may be using a nice pre-made deck while studying hematology. You might choose to select all 700 premade hematology cards and click unsuspend at once. Don't do this. You should review hematology using Pathoma, First Aid, and UWorld, and other resources, and unsuspend facts you don't know as you encounter them. This is a much more manageable and memorable strategy. If you've completed your hematology review and want to see which hematology cards you haven't suspended, go to the Anki browser, click your hematology subdeck, click enter, and search for "-is:suspended". This will show you all of your unsuspended cards in your hematology subdeck. Click through these cards in the browser and see if you find anything that you think is high yield.
Of course! Happy to help 🙂Thanks alot doctor
SDN staff had the same concerns and discussed this extensively with the OP.Since this is an AMA: what is your view of for-profit companies shilling their products via an AMA on a nonprofit website?
Hi MedSchoolGurus,
Thank you so much for taking the time to answer me. You mentioned you help out medical students with USMLE step 1, would you consider taking students from international medical schools or would you feel that IMG should refer to tutors who have also graduated outside the US ? Actually I've read your FAQ on your website, looks like I could possibly discuss this over the phone for 15min. However it doesn't seem to say if IMG are also suited for the tutoring program. Any thoughts ? Best, B
Hi Drpanther,First of all many congratulations for your success. You deserve it. And thanks for giving this opportunity to ask you questions; Can you please guide me for USCE and research especially? I didn’t match last year, I’m done with step-1, step-2 CK and step 2 CS, with low scores, have done Observerships last year but not this year and I’ll be going to USA in a couple of weeks. I will be requiring visa, any inputs for places where I can get a long term research to improve my chances to match? Thanks in advance
Congrats Dude!I would like to consult with you about the feasibility of my plan. How do you think of learning CK especially internal medicine during step1 preparation with the aim of attaining an outstanding score of step1(270+)? The reason I'm considering about this scheme is I've heard that the current step1 is closer to CK in terms of the question style such as more complicated scenario as to making the right diagnosis,next step management.Step1 is becoming more formidable and requires more clinical thinking. If this plan is feasible and rewarding, how should I do to make it to be viable? I intend to use Firecracker CK plus a CK qbank(maybe UW)with or without Kaplan CK on demand course to do that. BTW I'm an IMG and I'm not so time-strapped to take step1 on a fixed scheduled date. I would be very grateful if you could comment on this plan! Thanks very much!
Highly appreciated..thanks a lotThanks very much!
In general, I recommend active learning through practice questions and spaced repetition as the cornerstones of your learning.
Step 1 Resources
Question Banks
NBME Exams, UWorld, USMLE Rx, and Kaplan.
Studies of USMLE Step 1 scores have shown that the more questions you do, the higher your score will be. I generally recommend doing all the NBMEs you have time for, while doing no more than one NBME every 4 days.
Anki Decks
Spaced repetition through diligent use of Anki flashcards is an effective and efficient evidence based way to retain information throughout your long study period.
Video Resources
The best video based resources are Pathoma and Sketchy Micro. OnlineMedEd has excellent videos for psychiatry.
Textbooks
The best textbooks for boards are First Aid for the USMLE Step 1, and Crush Step 1. First Aid is essentially a bullet point checklist of facts one should plan to study. Crush Step 1 is a great resource if you'd like to read a concise paragraph about how something you don't understand works. Goljan's Rapid Review Pathology is an excellent reference which can be used to supplement areas in which you want more clarification or information.
Biostats
Biostatistics is best covered via First Aid for the USMLE Step 1, UWorld Biostatistics Review, the UWorld Step 1 question bank biostats questions.
Anatomy
The best resources are First Aid for the USMLE Step 1, Dr. Mavrych's 125 Most Important Anatomical Conceptions, and Lippincott's Illustrated Q&A Review of Anatomy and Embryology (contains about 400 USMLE style anatomy questions).
Biochemistry, Molecular Biology, and Genetics.
The best resources are First Aid for the USMLE Step 1, and Lippincott's Illustrated Q&A Review of Biochemistry (contains about 400 USMLE style questions).
Step 2 CK Resources
UWorld Step 2 CK.
The best, and most comprehensive, set of questions for shelf and Step 2 review. Includes 2200 extremely high yield questions for shelf exams and USMLE Step 2 CK. Must do.
Anki Decks.
There are a number of high yield Anki decks available for both rotations and USMLE Step 2 CK.
Pestana's Surgery Vignettes.
Outstanding questions for surgery clerkship. High yield for USMLE Step 2CK.
University of Texas Shelf review videos and accompanying slides by Emma Holliday.
Two hour shelf-reviews for Psychiatry, Pediatrics, Surgery, and Medicine. Extremely high yield for shelfs and Step 2 CK. Must do.
Practice NBME Shelf Exams (NBME Clinical Mastery Series).
Official NBME practice shelf exams. I would review your incorrects before Step 2 CK or redo them if you have time. Must do.
Practice NBME USMLE Step 2 CK Exams (Comprehensive Clinical Science Self-Assessment (CCSSA))
Official NBME USMLE Step 2 CK exams. Do each one during your USMLE Step 2 CK review. Must do.
Online Med Ed Videos.
Good for brushing up on areas of weakness for Step 2 CK preparation. Highly recommended.
Step 2 CS Resources
If you are a US allopathic medical student and have completed your clinical year, you should require little to no studying for the CS (just skim First Aid for the USMLE Step 2 CS the day before the exam).
As an IMG, it is harder. Remember, the components of the exam are Spoken English Proficiency (SEP), Integrated Clinical Examination (ICE), and Communication and interpersonal Skills (CIS). I would carefully read First Aid for the USMLE Step 2 CS to maximize your score on ICE. SEP is exactly what it sounds like and can only be improved, well, by improving your spoken English, which is best achieved by immersion in an english speaking country.
CIS is actually pretty teachable. Express interest in the patient as a person. Treat the patient with respect. Say "Tell me more about that" and listen to what they have to say. Assess how the patient's illness has affected his/her daily life. Understand the meaning of patient centered communication. Explain in layman's terms the patient's differential diagnosis and your next steps in management. Comfort and empathize with the patient. Try to pick up on things that make the patient emotional and explore those topics with questions. Use motivational interviewing to help patients change bad habits.
Hope this helps!
Happy to help. While I think that doing more questions can help, I don't think it makes sense to do the Step 2 CK Qbank questions before Step 1 unless you have clerkships before Step 1. I would advise against using advanced resources such as UpToDate as these resources go too far in depth. Remember, Step 1 is designed for second year medical students without much clinical experience.I feel really flattered about your sincere reply Dude,thank you so much!But I'm still a little confused.
Do you think mastering CK knowledge,especially that in the aspects of more clinically-oriented disease manifestation and evidence/clinically based diagnostic algorithms,more clinical thinking(eg.approach a pneumonia patient in a more clinical way like CAP or HAP,typical or atypical,then consider what type of pathogen afterwards) helps with your step1 score?
Is there a situation where the "question Composer" shift a CK practice question into the real step1 qbank to be the WTF step1 question to pick out those gunners with higher "Physician task "performance?That is to say,easy questions in CK could be packaged into the tough ones in Step1
Literally current step1 performance profile does add the EBV/diagnosis/management as the physician task criterion as we can tell.
Frankly speaking as to firecracker,I also dislike its algorithms so I copy its flashcards Q&A to ANKI and I always keep editing these cards via consulting AMBOSS/Dynamed/Uptodate so I can wield anki's splendid spaced repetition algorithms to drill updated CK contents into my head.
I definitely go along with you that I should do as many questions as possible,so is it feasible if I do particular UW CK questions before the Step1 real deal?
Really apologize for badgering you these questions Dude.
Sent from my iPhone using SDN mobile
Hahaha...Since this is an AMA: what is your view of for-profit companies shilling their products via an AMA on a nonprofit website?
is uptodate essential for Step 2 CK , is really worth it ?
For Step 2 CK, only Uworld is enough ??
Are you a US MD candidate, a non-US IMG, or a US-IMG?
US-MD but didn’t do well in my schools OSCE for the ICE part only
Sent from my iPhone using SDN mobile
Your resource list seems fine, though I generally recommend doing Rx before Kaplan (and Kaplan only if you have time, which I'd guess that you do). I'd recommend incorporating Anki if you haven't already. I wouldn't worry about the percent you're getting correct at all. Just make sure you make it unsuspend anki cards (ones that cover the info you didn't know but needed to know in order to get the question right, and info on the distractor you chose so you won't choose it next time you see a similar question) to cover the questions you got incorrect.I’m apart of an inaugural class and would appreciate some input as to how I’m doing. I’m doing FA, pathoma, UWorld, COMBANK (and a few Kaplan questions here and there just because I have access to it through my school.) The material I test myself on is the system we’re on in class. So far (at the end of each system) I’m scoring 60%+ on UWorld and ~60%+ on COMBANK USMLE questions and for COMBANK COMLEX questions I’m scoring 70%+. I don’t have any upper classman to ask about my performance so I guess I’m just not sure where I’m really supposed to be scoring at. I’m ~2.5 months into second year. I’m planning on taking both COMLEX and USMLE. Thoughts?
For CS score release date, do all students get their results at the start of the reporting date? Or is that the group who took it early in the testing period?
Thanks for this post and congrats on those awesome scores. I had a question:
Hypothetically If you didn't have a dedicated period but had 10 months to study, what would you do differently? My school has us take our exam in the middle of rotations. I'll have 2 weeks winter and a few weeks in the summer to study nearly full time, but at no point will I not have to be in school at least from 8-3 (or hours similar to that). My goal score is 240+, but I just haven't seen much advice or experiences of people in this situation.
I made another post about this but I'm nearly 1/2 done with zanki and will do Rx or Kaplan (or both? Which would u do in this case?) And then uworld once or twice. Foundation not great bc PhD courses all don't seem to coincide with ufaps.
Thank you so much for this ama
Thank you so muchHappy to help.
What I'm hearing is that you're currently an MS2, 10m out from Step 1 with no anticipated dedicated, drudging through mandatory events/PhD led lectures 8-3 while studying alongside this with Zanki.
Fortunately, I attended a school where most lectures were not mandatory, and followed a self developed curriculum that paralleled that of my school but was based on the high yield Step 1 resources that I listed above in my first post. Of course, for things like histology, it helped to refer to resources other than those mentioned above (e.g. shotgun histology), but largely, I followed board focused resources, and was overall happy with my results. I did QBanks questions most days and Anki daily during my preclinicals. My school was pass fail preclinical and I typically scored above average (mid-high 80s) without once looking at the PowerPoint slides.
Here are my tips for you (these recommendations may not apply to others). It's a marathon, not a sprint. The goal is to get a good Step 1 score, not to get honors on preclinical courses. Make sure you're managing your time and resources efficiently. Get your anki done daily. Try not to mindlessly memorize and don't blanket-unsuspend a subdeck, especially with Zanki and its 20k cards. Do Rx before Kaplan. Do Kaplan if you have time. Try to finish UW 1x during your preclinical years. Focus on high yield info during preclinicals, not necessarily class lectures (though sometimes there are great lectures and lecturers out there - you probably already know which profs have a great reputation). Make sure you start doing practice tests a bit early in your specific case (maybe the first one 4 months before your exam) as it will be difficult to make time for these (about 10 practice exams total) during your clinical year (they take up the whole morning in terms of taking the test, and can take the rest of the afternoon and even into the evening to review/make/unsuspend ankis).
That's all I have time for at the moment. Hope this helps.
Thank you so much
It depends! Which specialty are you interested in?Thank you for making this thread! I was wondering if you have an advice for IMGs interested in matching into competitive specialities. I know you have to do well in school, get some USCE and get good scores in your USMLEs but you still hear stories about some programs automatically rejecting IMGs because they have enough AMGs to select from. What can we do to make sure that we are considered and do you have any other advice for IMGs?