I got a 262 on Step 1, ask me anything

[USMLE_Pro]

Hey guys, I've been giving a lot of advice to people on the Reddit thread R/Step1, and SDN has been really helpful to me in the past so I figured I'd post here as well.

Feel free to ask me anything!

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[docsmitty1006]

Hello, I am currently finishing up my first year in medical school. I was looking to begin studying this summer so I can make sure I am fully prepared to take Step 1 after my second year. What do you suggest I should do this summer to prepare? Also, is big or medium robbins enough to study for step?

 

[RhesusPuffs]

What are the resources you used for Step 2CK? I found that for step 1, there is a defined gold standard (UFAP + Sketchy), but for step 2, not so much. Thanks in advance!

 

[CIrcleofWillis504]

Thanks for doing this! What resources did you use and what was your timeline of preparation?

 

[USMLE_Pro]

Hello, I am currently finishing up my first year in medical school. I was looking to begin studying this summer so I can make sure I am fully prepared to take Step 1 after my second year. What do you suggest I should do this summer to prepare? Also, is big or medium robbins enough to study for step?

Unless you have a history of issues retaining information or scored very poorly on the MCAT, I don't think it's necessary for students to start studying for Step 1 prior to medical school. I did not start studying until my 7 week dedicated period after 3rd year (my school takes Step 1 after 3rd year, which I do think is helpful).

I can't speak to Robbins as I never used it. If you want to get your feet wet prior to medical school, I like the book Crush Step 1, which is basically a narrative form of FA and much more readable than FA.

 

[USMLE_Pro]

Thanks for doing this! What resources did you use and what was your timeline of preparation?

I took a dedicated period of 7 weeks during which I studied about 50-60 hours a week and took at least 1 day off a week. I didn't study for Step 1 prior to my dedicated period, but I had already done third year, and I did all the NBME clinical mastery series for each Shelf Exam, and I think this was really helpful to me.

As for resources, I used only Pathoma, First Aid, UWorld, both UWorld SIM forms, and the NBME Comprehensive Basic Science Self Assessments. I made Anki cards based on every UWorld and NBME question I answered incorrectly (and only the questions I answered incorrectly). I spent a lot of time reviewing all 6 current NBMEs to make sure I really understood every question (I took screenshots while I took the exam so I could see the questions I got correct as well).

I did not sit down and read FA until the week before my exam (I essentially read through it that week in the hopes of having some of it in my local memory), but rather cross-referenced sections relevant to questions I got wrong throughout my study period, so I only really read FA in the context of better understanding questions I got wrong. Overall, I really learned from questions rather than FA. For Pathoma I watched the videos and took notes in my book in the standard way.

 

[USMLE_Pro]

What are the resources you used for Step 2CK? I found that for step 1, there is a defined gold standard (UFAP + Sketchy), but for step 2, not so much. Thanks in advance!

I only used UWorld (including the 2 SIM forms) and the NBME CCSSAs as resources during my a 3 week dedicated period for Step 2 CK. During my 3rd year, however, I did UW subject by subject, and also did every relevant NBME clinical mastery series exam for my Shelf Exams. During my dedicated, I redid exactly half of UW in random and timed mode, and did all 3 of the NBME CCSSAs and reviewed them very closely. I didn't make flashcards like I did for Step 1, but I recommend this for others unless you start out scoring very high on practice tests.

 

[neurotransmitter]

Unless you have a history of issues retaining information or scored very poorly on the MCAT, I don't think it's necessary for students to start studying for Step 1 prior to medical school. I did not start studying until my 7 week dedicated period after 3rd year (my school takes Step 1 after 3rd year, which I do think is helpful).

I can't speak to Robbins as I never used it. If you want to get your feet wet prior to medical school, I like the book Crush Step 1, which is basically a narrative form of FA and much more readable than FA.

I took a dedicated period of 7 weeks during which I studied about 50-60 hours a week and took at least 1 day off a week. I didn't study for Step 1 prior to my dedicated period, but I had already done third year, and I did all the NBME clinical mastery series for each Shelf Exam, and I think this was really helpful to me.

As for resources, I used only Pathoma, First Aid, UWorld, both UWorld SIM forms, and the NBME Comprehensive Basic Science Self Assessments. I made Anki cards based on every UWorld and NBME question I answered incorrectly (and only the questions I answered incorrectly). I spent a lot of time reviewing all 6 current NBMEs to make sure I really understood every question (I took screenshots while I took the exam so I could see the questions I got correct as well).

I did not sit down and read FA until the week before my exam (I essentially read through it that week in the hopes of having some of it in my local memory), but rather cross-referenced sections relevant to questions I got wrong throughout my study period, so I only really read FA in the context of better understanding questions I got wrong. Overall, I really learned from questions rather than FA. For Pathoma I watched the videos and took notes in my book in the standard way.

I only used UWorld (including the 2 SIM forms) and the NBME CCSSAs as resources during my a 3 week dedicated period for Step 2 CK. During my 3rd year, however, I did UW subject by subject, and also did every relevant NBME clinical mastery series exam for my Shelf Exams. During my dedicated, I redid exactly half of UW in random and timed mode, and did all 3 of the NBME CCSSAs and reviewed them very closely. I didn't make flashcards like I did for Step 1, but I recommend this for others unless you start out scoring very high on practice tests.

Thank you for doing this!

1. For someone who is now a med student, getting ready for Step 1 this year, but who has barely scraped by so far (so probably lots to learn or review), and who hates First Aid, can Crush Step 1 be a good replacement for First Aid? I like the narrative format much more. First Aid seems just like reading a random list of facts almost.

2. Actually, can I just skip First Aid or Crush Step 1 entirely and only learn from doing questions from UWorld like you said?

 

[USMLE_Pro]

1) I don't think Crush Step 1 is technically a replacement for FA. I think you still need to expose yourself to a fair proportion of FA. But if you want to READ something, I would read crush step 1 over reading FA.

2) That being said, yes, I did learn primarily from questions and this is what I've seen work best for students (and many of my other tutors who are also high scoring took a question-focused approach as well). No one skips FA entirely though, I cross-referenced it when reviewing my wrong answers and incorporated FA screenshots into my flashcards. You still want to at least lay eyes on almost all of FA, but I think all the content can be learned from UW and the NBMEs, if approached the correct way.

 

[USMLE_Pro]

I strongly recommend doing UW as random, timed blocks, even if your test is in August.

I think it creates bad habits to do things by subject (I never did UW for Step 1 by subject, and I think this was advantageous). The test presents things to you in a random order, so you really should learn to answer questions in a random order. Right now, you may or may not be relying on the subject context in order to get questions correct. I also recommend making Anki cards based on the UW questions you get wrong; one reason your baseline NBME score might be low despite having completed an entire qbank is that you aren't retaining the information from the qbank as well as you could if you used a better technique for long-term retention (if you just read the answer explanations, you'll only retain about 5% of that information after 2 weeks).

Based on the information you've given me, the hardest thing for you in reaching a 250+ score might be test-taking skills, if you got a 203 on your first NBME, particularly given that you already did USMLERx. No matter how much content you may have to learn in the next few months, a 50 point jump between baseline and goal score usually isn't just accomplished just by learning content. You need to look critically at each question you get wrong and try to understand WHY you got it wrong. If you aren't already using process of elimination, I recommend doing so on every question.

Please feel free to PM me more details if you want more personalized advice.

 

[DBC03]

Do you think that your school's curriculum (taking Step 1 after clinical rotations) helped? I'm torn between a few medical schools and one school has a similar curriculum (but I need to get off the waitlist). Do you think that a school's curriculum and teaching methods can have a significant impact on its students' step scores? Or do you think that students can self study and do well regardless of curriculum? Also, do you have any techniques or tips you would recommend for retaining information learned during the pre-clinical curriculum in the long term? Thanks for your advice!

 

[USMLE_Pro]

Do you think that your school's curriculum (taking Step 1 after clinical rotations) helped? I'm torn between a few medical schools and one school has a similar curriculum (but I need to get off the waitlist). Do you think that a school's curriculum and teaching methods can have a significant impact on its students' step scores? Or do you think that students can self study and do well regardless of curriculum? Also, do you have any techniques or tips you would recommend for retaining information learned during the pre-clinical curriculum in the long term? Thanks for your advice!

This is a great question! For me personally, I felt taking Step 1 after 3rd year was ideal. I wasn't super motivated to study the first two years of med school because it was pass/fail, but once I was on the wards I learned a lot from my patients and was motivated to study a lot more in the setting of clinical medicine. Some people at my school felt we were under-prepared for the wards, however, and some people struggled significantly with shelf exams (which is problematic if you need great clinical grades because you're eyeing a competitive fellowship). I think the disadvantage of taking Step 1 before third year can be overcome by the right study methods.

Personally, I felt I learned very little in my first two years of med school, but what I did learn I learned in our tutorial discussions. In general, students tend to learn better with active curriculums (tutorials, case-based), versus passive (lecture-based). I do think students can self-study and do well regardless of the curriculum; I think most of the reason certain schools have higher Step averages is that their students were better test-takers (higher MCAT scores) to begin with. You should definitely consider things like location and atmosphere and the culture of the school. How much you enjoy med school depends a lot on your peers, and I've been fortunate to have amazing ones at my school, which I wouldn't have traded for a better curriculum.

For retaining information long-term, active learning and repetition are key. If you made your own Anki cards and reviewed them throughout med school, that would be the ideal way to retain information from the pre-clinical years long-term.

 

[sovereign0]

What kind of scores were you getting on UWSAs and CCSAs? What was your baseline prior to dedicated?

 

[USMLE_Pro]

I didn't do a practice test prior to dedicated, but my first NBME (CCSA 13) a few weeks before the exam was a 230.

My scores on NBMEs and the UWSA ranged from that 230 to as high as a 272 on UWSA2.

 

[GEToutLADYits6AM]

Do you feel like everything you need to know is in uworld? What score would a student who only did uworld twice would get? Thanks

 

[USMLE_Pro]

Do you feel like everything you need to know is in uworld? What score would a student who only did uworld twice would get? Thanks

For step 1, everything you need to know is in UW, FA, pathoma, and the NBME comprehensive basic science self assessments.

How many times you do UW won't predict your score. I only did UW once.

 

[oshanimalia]

For step 1, everything you need to know is in UW, FA, pathoma, and the NBME comprehensive basic science self assessments.

How many times you do UW won't predict your score. I only did UW once.

Unless of course you did uworld throughout the semester and forgot everything lol

Sent from my VS996 using SDN mobile

 

[USMLE_Pro]

That’s why you need to make Anki cards based on the questions you get wrong

 

[BurnedOut]

That’s why you need to make Anki cards based on the questions you get wrong

I am about half way through the review so i could either do a single block per week or 10 qs/day without jeopardizing my study plan. What do you think of doing UW daily - 10q/day/random for about 3 months prior to using it the way most guys do? Is there a minimum number of questions you recommend per session? What are the pros/cons. thanks.

 

[PugsAndHugs]

What so you recommend doing the last 2 weeks after you have finished Uworld + incorrects and NBMEs?

 

[USMLE_Pro]

I am about half way through the review so i could either do a single block per week or 10 qs/day without jeopardizing my study plan. What do you think of doing UW daily - 10q/day/random for about 3 months prior to using it the way most guys do? Is there a minimum number of questions you recommend per session? What are the pros/cons. thanks.

I recommend doing 40 question blocks (random subjects in timed mode, yes, even if you're in pre-dedicated). Better to do them in one sitting to most closely mimic test-day conditions.

 

[USMLE_Pro]

What so you recommend doing the last 2 weeks after you have finished Uworld + incorrects and NBMEs?

Depends on a number of personal factors (e.g., goal scores vs. practice test scores), but it can be good to make study materials (e.g., flashcards) based on the NBMEs and/or read through FA again to have in your local memory.

 

[jimmyd1]

I take step 1 mid june. So about three months away. I have one more system left and classes end around the end of april. I then will have a little over 6 weeks of dedicated. I plan on using UFAP, sketchy, BnB and maybe goljan if I have time. How would y'all suggest I use this last month and a half of school before dedicated to prepare for step 1?

 

[cool93]

Hey guys, I've been giving a lot of advice to people on the Reddit thread R/Step1, and SDN has been really helpful to me in the past so I figured I'd post here as well.

Feel free to ask me anything!

test on March 12. little bit tensed.did nbme 13-17 &19 offline with average score of 88%,uwsa1 78%-251.today did nbme 18 online.depressed with the score-234. low performance in behavioural sc. & stat.any advise to improve my score?

 

[GEToutLADYits6AM]

For step 1, everything you need to know is in UW, FA, pathoma, and the NBME comprehensive basic science self assessments.

How many times you do UW won't predict your score. I only did UW once.

Im only MS1, but do the NBME exams contain answer explanations to the questions? Thanks

 

[USMLE_Pro]

Im only MS1, but do the NBME exams contain answer explanations to the questions? Thanks

No, there are no explanations that come with the tests. Consequently, as tutors we spend a lot of time explaining the NBMEs to our students.

 

[USMLE_Pro]

I take step 1 mid june. So about three months away. I have one more system left and classes end around the end of april. I then will have a little over 6 weeks of dedicated. I plan on using UFAP, sketchy, BnB and maybe goljan if I have time. How would y'all suggest I use this last month and a half of school before dedicated to prepare for step 1?

I think that's a good time to make sure you have all of Pathoma down. It's good to have that as a foundation before you start dedicated.

 

[USMLE_Pro]

test on March 12. little bit tensed.did nbme 13-17 &19 offline with average score of 88%,uwsa1 78%-251.today did nbme 18 online.depressed with the score-234. low performance in behavioural sc. & stat.any advise to improve my score?

Unfortunately, there's not enough info here for me to make a recommendation other than the general advice I've given in this thread. You should look closely at why you're getting q's wrong (knowledge gaps vs. test-taking issue) to help figure out how your approach needs to change.

 

[GEToutLADYits6AM]

No, there are no explanations that come with the tests. Consequently, as tutors we spend a lot of time explaining the NBMEs to our students.

How much are your tutoring sessions?

 

[USMLE_Pro]

How much are your tutoring sessions?

I don't know if I'm allowed to mention it here b/c it might be considered advertising, I'll PM you. The link to our tutoring website is also in my status (and it's literally my username haha).

 

[idkididk]

Hi, I'll be done with 1st pass of all of UFAPS, the Kaplan Qbank, and the USMLE-Rx Qbank before I start 5 weeks of dedicated. My plan for dedicated is to get through a 2nd pass of Uworld, multiple passes of FAPS, couple NBME exams, the 2 uworld exams, and some B&B videos. Is there anything else that you'd recommend?

 

[DBC03]

How much of an impact does a school's curriculum have on Step 1 scores - is it possible to score well even at a school that is not necessarily known for amazing step scores? I hear conflicting opinions on this, but it seems that it is possible to score well if you put in the time, so perhaps a good curriculum will help, but you can still do well despite where you go?

 

[deleted674723]

I don't know if I'm allowed to mention it here b/c it might be considered advertising, I'll PM you. The link to our tutoring website is also in my status (and it's literally my username haha).

Would you recommend starting random UWorld question blocks even if I haven't seen the content in months? I'm starting my dedicated now and it seems like a waste to do questions for say pulmonology when I likely remember maybe 15% of that material from my class and the FA I read at that time months prior. Is it better to wait and review all of the blocks that have long left my memory before starting random question blocks? Thanks bud.

 

[USMLE_Pro]

Hi, I'll be done with 1st pass of all of UFAPS, the Kaplan Qbank, and the USMLE-Rx Qbank before I start 5 weeks of dedicated. My plan for dedicated is to get through a 2nd pass of Uworld, multiple passes of FAPS, couple NBME exams, the 2 uworld exams, and some B&B videos. Is there anything else that you'd recommend?

Sorry for my delayed response! I would say you should do ALL the NBME exams, and multiple passes of FAPS are not necessary. Are you planning to use Anki cards at all?

 

[USMLE_Pro]

Would you recommend starting random UWorld question blocks even if I haven't seen the content in months? I'm starting my dedicated now and it seems like a waste to do questions for say pulmonology when I likely remember maybe 15% of that material from my class and the FA I read at that time months prior. Is it better to wait and review all of the blocks that have long left my memory before starting random question blocks? Thanks bud.

Yes, I would still recommend starting with random question blocks in Timed mode. It's not a "waste" to get questions wrong if you learn from them; in fact, this is the best way to learn! A very common mistake people make is to study by subject, and to delay doing practice questions until they've already been studying in an inefficient way for months.

 

[deleted674723]

Yes, I would still recommend starting with random question blocks in Timed mode. It's not a "waste" to get questions wrong if you learn from them; in fact, this is the best way to learn! A very common mistake people make is to study by subject, and to delay doing practice questions until they've already been studying in an inefficient way for months.

Ok sounds good. I will start doing randoms instead. You asked above if a poster was using anki. Is it reasonable to work through zAnki during dedicated? I'm trying to think of the best way to go through First Aid. I feel like just reading it isn't going to do much, so maybe doing the related Anki is better? What is the best way to go through First Aid and learn the material on top of my Uworld practice questions?

 

[USMLE_Pro]

Ok sounds good. I will start doing randoms instead. You asked above if a poster was using anki. Is it reasonable to work through zAnki during dedicated? I'm trying to think of the best way to go through First Aid. I feel like just reading it isn't going to do much, so maybe doing the related Anki is better? What is the best way to go through First Aid and learn the material on top of my Uworld practice questions?

I do not think it is a good use of time to work through Zanki during your dedicated. There are far too many cards and they are not well targeted to just the facts you need to know to get questions correct.

I advise students to make their own Anki flashcards (based on UW incorrects, cross-referencing FA as you make the cards), as this is much more targeted, and the act of making the cards is one of the best ways to retain information. We've found this is the optimal way to learn FA while also going through UW.

 

[deleted674723]

I do not think it is a good use of time to work through Zanki during your dedicated. There are far too many cards and they are not well targeted to just the facts you need to know to get questions correct.

I advise students to make their own Anki flashcards (based on UW incorrects, cross-referencing FA as you make the cards), as this is much more targeted, and the act of making the cards is one of the best ways to retain information. We've found this is the optimal way to learn FA while also going through UW.

So is it wise to then do UWorld random blocks and when I get to a question I don't know and get wrong, read up on the topic in first aid and make 2-3 anki cards about the topic? I've been doing this but man is it time consuming.

 

[USMLE_Pro]

So is it wise to then do UWorld random blocks and when I get to a question I don't know and get wrong, read up on the topic in first aid and make 2-3 anki cards about the topic? I've been doing this but man is it time consuming.

Yes, but you should only make 1 anki card per incorrect question. You can ask yourself multiple (2-3) related questions on a single Anki card. It's definitely an upfront investment of time, but you'll only have to go through UWorld once, and you'll actually retain the information, so in the end it is far more efficient than other approaches.

 

[pbrocks15]

I've been doing some UWorld Questions each day now and trying to make Anki cards of whatever I got wrong.

I feel as though I might not be really prepared as perhaps other students at the current moment since I feel everyone else is doing Anki + B&B + FA + etc . but I haven't been able to really do much other than UWorld due to a few things coming up and school just being demanding right now.

Do you have any recommendations for me at the moment? Should I just continue my daily UWorld (~15/20 a day) or do something else in the next few weeks before dedicated?

Thanks for doing this.

 

[USMLE_Pro]

I've been doing some UWorld Questions each day now and trying to make Anki cards of whatever I got wrong.

I feel as though I might not be really prepared as perhaps other students at the current moment since I feel everyone else is doing Anki + B&B + FA + etc . but I haven't been able to really do much other than UWorld due to a few things coming up and school just being demanding right now.

Do you have any recommendations for me at the moment? Should I just continue my daily UWorld (~15/20 a day) or do something else in the next few weeks before dedicated?

Thanks for doing this.

How long is your dedicated period? It's okay to go at a slow pace during pre-dedicated as long as your dedicated period is long enough (I personally didn't study in the pre-dedicated period!).

 

[pbrocks15]

How long is your dedicated period? It's okay to go at a slow pace during pre-dedicated as long as your dedicated period is long enough (I personally didn't study in the pre-dedicated period!).

Dedicated is about 6 weeks for me. Then 1 week vacation.

And thank you!

 

[USMLE_Pro]

Dedicated is about 6 weeks for me. Then 1 week vacation.

And thank you!

Do you have a baseline NBME score? Unless it is <200, you are probably fine to do most of UW during your dedicated.

 

[pbrocks15]

I'm going to take a baseline NBME before I start dedicated which is in a 4ish weeks.

At that time I'll have a better idea where I stand I guess.

 

[751866]

No one skips FA entirely though...

I never touched first aid after seeing it's layout. Ignored it completely.

 

[USMLE_Pro]

I never touched first aid after seeing it's layout. Ignored it completely.

I stand corrected, good for you!

 

[harkas]

Hey guys, I've been giving a lot of advice to people on the Reddit thread R/Step1, and SDN has been really helpful to me in the past so I figured I'd post here as well.

Feel free to ask me anything!

Is there anything you recommend doing in the first year of medical school for board prep (other than do well in classes)?

 

[USMLE_Pro]

Is there anything you recommend doing in the first year of medical school for board prep (other than do well in classes)?

I like the book Crush Step 1 to establish a baseline! Otherwise, I would just focus on doing well in your classes (which might include making your own Anki cards for class-related material).

 

[USMLE_Pro]

You can see this NEJM panel for advice from myself and other experts: How to Ace Your Next Standardized Exam on NEJM Resident 360

Please feel free to share to others!

 

[sovereign0]

How much time did you spend reviewing questions you answered correctly on UWorld? I occasionally find that the explanations contain great info for the incorrect answer choices. I'm working towards 3 blocks a day to finish UWorld a few days before my exam, so I'm getting to the point where additional efficiency in reviewing UWorld could be useful.