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I got a 262 on Step 1, ask me anything

Discussion in 'Step I' started by USMLEpro, Feb 19, 2018.

  1. sovereign0

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    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.
     
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  2. OP
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    I usually did 2 blocks per day, but sometimes 3. My schedules vary considerably for my tutoring students, but 3 is too much for a lot of people. I think it's more important to review the blocks properly than to do multiple passes of UW.
     
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  3. pbrocks15

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    How much time did each block take you on average?
     
  4. OP
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    Review time really varied from block to block for me (and varies even more from student to student). For me, usually no more than 2 and a half hours (time decreased as I got closer to my test and was getting more questions right).
     
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  5. pbrocks15

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    Understandable. I feel like I struggle with 3 - 4 hours review when I could be more efficient. Anyone to hone in on this maybe? Should I keep it at where I'm at right now?
     
  6. sovereign0

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    I'm not OP, but I was taking anywhere from 3-5 hours per block when I was first starting, because I was running into things that I really needed to review or never got familiar enough with in the first place (spent a lot of time on biochem, especially). I'm about 50% of the way through now and it takes me 45min to answer and 2 hours to review.

    3 hours to review really isn't bad imo. If there's a subject that you find yourself frequently having to review, you could step away from UWorld to reinforce that material from a content review source.
     
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  7. sovereign0

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    1.) How much time/effort did you spend reviewing questions you answered correctly? Just reading explanations, or actually taking notes/making flashcards?

    2.) Do you find UWorld first pass %correct to be a decent predictor of performance? Do you recall your first pass %?
     
  8. OP
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    1) I skimmed the entire explanation for the ones I got correct. I did not take notes or make any flashcards for my corrects.

    2) No, it is absolutely not a good predictor of performance. Do not read into your UW percentage, mine was somewhere in the 70s.
     
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  9. sharkbyte

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    Do you have a recommendation for when to start taking the NBMEs? This coming Friday will mark 8 weeks out from my exam and 3 weeks out from dedicated. So far I have taken my school's CBSE, and my school is also administering a full-length Kaplan practice test in a couple weeks. Should I just wait until dedicated to do the NBMEs, or should I work through some of the earlier ones now?
     
  10. robbierob

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    For the life of me, I could not keep my biochem straight. There's a biochem poster called 'doctors notes medical biochemistry poster' -- And it's a godsend for anyone looking to improve their biochem knowledge quickly and efficiently for Step 1.
     
  11. OP
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    Sorry for my delayed response, have been extremely busy tutoring!

    I like to have people do NBME 13 right at the start of dedicated, or even early. In my experience, as much as 3 months before your test date can be appropriate, but it depends on the student. In your case, take NBME 13 ASAP!
     
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  12. OP
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    My take is people attempt to learn TOO MUCH biochem and this is why they struggle. There is actually a fairly discrete set of facts the NBME likes to test, so my approach was to just memorize those facts, and that's been working really well for my students!
     
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  13. sharkbyte

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    No worries, I appreciate the help. I took NBME 13 right when dedicated started, which ended up being a nice coincidence with your post. I also took NBME 15.
     
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  14. sab3156

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    Thanks for this thread.

    Do you think the questions you got wrong on Step 1 was due to lack of knowledge or just difficulty of the questions, or both? In other words, with the resources you used, do you feel that you could have gotten a 100% if the test had been "open-note"?
     
  15. Mark 313

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    First pass of first aid with usmle rx is good? Average student..
     
  16. 073116

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    Aren't there like more than 19 NBMEs? To do all of them it will take about 40 days even if I try to take NBME every other day. Some of us have only 3-4 weeks dedicated time. Kaplan prep and even FA have subject by subject material presentation - this is how many of us build core of our knowledge, a baseline if you will. It greatly helped me to reinforce each subject by corresponding questions from Qbank and UW. And yet you say to do random questions?! I mean what good is it going to do if I'm learning specific subject or going over one subject in FA, to start doing some random not related to material I'm studying questions?
    Furthermore, without knowing your baseline score - it makes little sense to give advise to us, as for example it's not like you improved from 170 to 260 in 7 weeks. You said first test you took several weeks before exam was 230 already - I mean that's almost national average to begin with lol.
    Then it becomes even more interesting, you say you studied 50-60 hours a week. That's about 8 hours per day lol. I mean come on, even laziest of us study more. In dedicated mode - people tend to do about 10-12 hours per day. Something is not right here and I might know what. There were numerous threads on forum by people who scored 260+ and in 9 out of 10 cases - they had high baseline to begin with. Their secret was not how to study or what materials to use, not how to take questions random mode or not lol, their main secret was that they busted their ass during MS1/2 years and had a solid foundation and good retention. It all comes down to that.
    This is like a Porsche 911 will be teaching Dodge Grand Caravans how to sprint 1/4 mile lol.
    I would like to ask questions to a average student who started from low to average baseline (180-200) and then progressed to 250-260 within 7 weeks. Now that would be interesting and useful as it will relate to majority of us and could teach us how to progress and study to get from low to high score, not from high to even higher like in your case. Forgive me my style of writing, I mean no disrespect, but I feel like too many 260+ scorers and loads of students asking them questions are forgetting that it's not you who we need to really ask (you guys did nothing extraordinary, you basically improved on your already good skills and material knowledge), but it's those who started like us (from depth of hell) and managed to score high. I've yet to see those folks to post, but for some reason they tend to not post.
     
  17. OP
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    I would think it was mainly lack of knowledge of fairly obscure facts, but of course this is a subjective assessment.
     
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  18. OP
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    I would suggest UWorld over USMLE Rx, and making Anki flashcards of your incorrects. It will also be important to do the active NBMEs (13-19).
     
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  19. OP
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    I mean the active NBMEs, 13 to 19. There is no reason to do the older ones.

    My baseline score was a 230, but most of my advice comes to working with students who start as low as 150 on NBME 13. People often ask me for my personal experience, but the thing that informs my advice the most is my experience as a tutor and someone who oversees the work of 25 other Step 1 tutors.

    Being a good test-taker is not a disadvantage when it comes to advising people, because test-taking skills can be learned. Most people who scored a 260 say it's all about working insanely hard, but that wasn't my personal experience, and that hasn't been my experience with my high scoring students. How you study and how you approach questions is far more important than how many hours you study, because unfortunately the large majority of students are studying relatively inefficiently doing things like trying to memorize First Aid. Of course it takes many more hours a day of studying to memorize FA, but that just isn't helpful or necessary compared to other strategies.

    I appreciate your perspective but I would warn against telling people that it's more useful to get advice from someone whose only basis for advice is their own personal experience. Just as you wouldn't advise patients on an N of 1, you should be cautious of taking Step 1 advice from someone only with personal experience, as the specific of what works well for different students varies reasonably widely. Unfortunately, this setting only allows me to give relatively generic advice, which is why I provide my phone number to people who PM me.
     
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  20. shaolinr4

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    Hi there, I've been reading your posts and firstly, thank you for taking the time to provide advice.

    I have a question in regards to my own progress. I, like yourself, began dedicated with a 230, however I dropped to a 225, and my recent NBME was a 228. My UWorld % correct is at 72 (random/untimed), and I make flashcards for all of my incorrect questions, as well as my NBME's. However, a good amount of the q's I got wrong on my last 2 NBME's (15 and 16), were due to question interpretation (14/33 on NBME 15, and 11/32 on NBME 16). Yes, I had content gaps, but I am more concerned with getting questions wrong due to test taking.

    Do you have any advice in regards to my circumstances? I finish my blocks with 30 minutes left because I get anxious when i have unseen questions, but perhaps I should be going slower? How did you pace yourself throughout NBME's? It is just very frustrating to have had a solid baseline and to be getting questions wrong I am fully capable of answering correctly if I give my brain time to think.

    Thanks!
     
  21. moh16us

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    Hey guys!

    I am dental school graduate and I am taking the CBSE this August. So I have about 45 days. Unfortunately, I have no medical background. I have access to Pathoma, B&B, First Aid, UWORLD and Doctors in Training!

    I have read a lot of suggestions, however, they're all either for medical students who are already taking classes in medicine or for those who have a lot of time to study.

    What is your advice to someone in my situation?

    Thank you!
     
  22. Treebeard

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    @USMLEpro do you suggest doing Uworld on random with all topics even earlier in the year, before I have learned those topics? Or do you recommend not using it at all until dedicated anyway?
     
  23. OP
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    I always do 2 passes--I go through once quickly and mark the ones that I am not confident about, then go back to my marked ones. This might work for you if you feel anxious about un-answered question. Unfortunately, there aren't great resources to improve test-taking skills, and my usual recommendation for this issue (which you seem to have correctly diagnosed) is to work with a study buddy or tutor. Your anxiety may also be more significant than you think--if it's not giving you trouble in other areas of your life, exercise and/or guided meditation (I have many of my students use Headspace) can be helpful.
     
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  24. OP
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    Best resources: Pathoma, UWorld, First Aid, AND the NBME practice tests (comprehensive basic science self-assessments. Take NBME 13 and let me know your score (can PM) and I can give you more specific advice based on that.

    I don't use and don't recommended B&B or DIT for my students. Not worth your time or money in my opinion.
     
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  25. OP
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    It depends. What did you score on your MCAT (score and percentile)? For some students, only one pass of UW is needed. For others, a slow first pass by subject, followed by a more intense second pass on random, can be ideal.
     
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  26. Treebeard

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    518 (97th percentile on the MCAT). Re: step, I'd like to do well obviously, but I am not interested in any wildly competitive fields (interested in IM, FM, neuro, maybe peds). If I got a 250 I'd be thrilled.


    Let me broaden my question a bit. I just started 2nd year this week. I am in a traditional curriculum, so my current cardiovascular block is my first organ system block, unless you count neuroscience. What should I be doing now and what should I be doing in January-April? In my dedicated time (April-May) I know I need to do a butt load of practice Qs.
     
  27. sandhu11

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    i am starting studying for step 1 from scratch i am an IMG and finished med school 3 years ago

    are kaplan videos necessary to learn the basics or can i start with first aid/uworld/pathoma

    if i want to give it by the end of this year what would be the best way for me to start, i am willing to put in all the effort and time required for prep but i feel the kaplan videos are too time consuming and i dont know any basics
     
  28. OP
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    I would start with Pathoma, going with relevant videos for the subject you're studying. You can also do subject-specific UWorld blocks in timed mode if time allows. I've found that most of the score is determined by what one does in the dedicated period if you're a good test-taker already, but laying a good groundwork will always help to some degree.
     
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  29. OP
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    No, I never recommend Kaplan videos to my students. Pathoma is often a good place to start, followed by UWorld, making Anki cards from incorrects while cross-referencing first aid, and doing each NBME practice test thoroughly.
     
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  30. Treebeard

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    So basically, focus on studying for my classes, and use pathoma/q-banks (in part) to do so? AND, do not explicitly worry about doing lots of step 1 questions at this point?

    I definitely have good test taking skills, but that doesn't give me much comfort regarding the beast that is step 1.
     
  31. shaolinr4

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    Thanks for your response. I realized that I was simply moving way too quickly. I slowed down during my blocks, and my last 2 practice exams (NBME 17 and UWSA1) were a 244, and 245, respectively. I am happy that I figured out what my issue was, but I am still upset that I am not breaking into the 250's due to some careless mistakes. I think meditation is an excellent idea, and I sometimes do it before my blocks.

    Do you have any suggestions for what to do in my last week to bump my score? In particular, do you have any strategies to identify weaknesses based off of my UWSA1 and how to attack them? I use Anki and I have been making flashcards for all q's I get incorrect, but I have quite a bit of reviews that have built up due to skipping days. I got 8 questions wrong in Pharmacology and another handful in Behavioral Science/Psych on my UWSA1 (today). I feel like Pharm and Behavioral are fortunately easy topics to crush in a short amount of time, but what do you think? Do you think a 250+ is reasonable to expect on Game day? Thanks for your insight!
     
    #81 shaolinr4, Jul 20, 2018
    Last edited: Jul 20, 2018
  32. OP
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    Yes. You can also do a first pass of UW using sets of questions that are relevant to the subject you are studying at the time.
     
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  33. OP
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    The most high-yield thing for you to do is to review ALL the NBMEs very closely. You should be very familiar with all that content and understand every single question (we spend hours and hours reviewing these exams for our tutoring students). Currently, you are a bit off from a 250, you are more in the 235-245 range; the major reason people hit a plateau in the 240s is test-taking skill, so you should try to focus on questions/content in the context of questions, rather than purse content. If you get in the 260s on UWSA1, you are more in range to score 250+ on test day.
     
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  34. OP
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    How did your test go? I'm always curious how accurate my predictions are since I typically have a pretty good track record :)
     
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  35. Treebeard

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    @USMLE_Pro - which NBME practice exams do you recommend? I don't take the test until May and am still early-ish in my prep, but starting to think ahead about my dedicated time. I'd like to do as many as will be helpful.
     
  36. OP
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    Just the current NBMEs! You can also do the free 120 for extra practice. I always have people start with NBME 13 (mainly because the curve becomes increasingly harsh). Even 6 months before your test isn't too early to take NBME 13, in my experience. You want to know early how much progress you need to make and plan your studying accordingly.
     
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  37. Dr. Meliodas

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    Just curious, any particular reason you don't recommend B&B? Do you think the content it covers is not enough or too in depth or not what is needed for the STEP?
     
  38. OP
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    I find the quality of the explanations to often be poor, and it is not a good use of your time relative to the true gold-standard resources. Pathoma is so well-done that I think it is reasonable to watch videos to lay some foundation and gain familiarity with histopathology, but in general, watching videos is too passive. You will forget at least 50% of what you watch in a video after 2 weeks. The reinforcing questions help address this slightly, but still videos are an inferior way to study compared to other more active methods. Using the spaced repetition of Anki, doing practice questions, and other more active learning approaches (like making your own Anki cards) result in better long-term content retention. Watching videos can feel less painful and unpleasant, so it can be appropriate if you can't get yourself to study in more efficient ways, but most med students are sufficiently motivated if not already burnt out from other inefficient and ineffective study methods. BnB will not teach you to answer questions more strategically, and I have found that the limiting factor for many students is in the realm of test-taking skills, and these students are better off doing practice questions and critically reflecting on them to identify systematic patterns of test-taking error. This can be difficult to do on your own, but this more mindful approach, in my experience, is better than watching videos.

    Mostly, I have worked with/supervised people who have worked with many people who have struggled and wasted time on B&B, and later succeeded with approaches that did not include B&B. In this way, my view on it is mostly empirical (I say empirical rather than anecdotal as it's a N of a few hundred students).
     
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  39. Aerus

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    The only problem with this is that you need to build a knowledge base before being able to do questions. From what it looks like on SDN, the highest scores seem to be people who are already getting 80%+ on qbanks, which means they aren't using the qbanks to learn the concepts or else those numbers would be a lot lower. Boards and Beyond is one way to learn the material without relying on inefficient ways like lectures and textbooks since not everyone can learn from Anki, especially as a first time pass.
     
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  40. Yorick

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    What do you recommend someone do in their last ~2 weeks of prep? I finished all the NBMEs, UWorld, and UWSA1/2 - ending with 266 on UWSA2 and 255 on NBME 19 taken yesterday. I don't really have any weak areas standing out. I still have a Kaplan Qbank subscription with about 600 questions left, but I can knock those out, but otherwise I'm thinking I should just reread First Aid, make sure I didn't miss anything, review the NBMEs again and reread Uworld explanations.

    The scores should give me confidence, but I feel like it's still so easy for Step to test something I don't know, even in areas I feel strong in.
     
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  41. OP
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    The most high-yield thing to do in this time is to review the NBMEs very, very closely. You can cross-reference First Aid as you review questions you've gotten wrong. I dont' recommend spending time on Kaplan. You look like you are in a pretty good position based on your practice test scores. If you've used flashcards, this is a time to really review them (I have my student doing a lot of Anki card review during this period). Good luck!
     
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  42. OP
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    I disagree with this, and thinks its too narrow a view of "being able to do questions". People are afraid to get questions wrong, so they think they need to wait until they can do well on the blocks to use questions. This is not an efficient use of time or productive mindset--it is okay if you get every single question wrong if you are learning from them.

    I was getting around 50% (and sometimes below 40%) when I first started doing UW blocks 6 and a half weeks before my exam. I used UW as my primary resource and learned from the questions I got wrong. I also disagree that "not everyone can learn from Anki". I agree plenty of people would be overwhelmed by trying to do all of Anki, but I think many people can be shown how to use it effectively. I agree with you that lectures and textbooks are ineffective, but I don't view BnB to have that much value over a standard lecture (other than the reinforcing questions), although it is certainly better than trying to memorize FA by reading and taking notes.

    In general, I think medical students approach Step 1 studying with too much of a fixed mindset, i.e., some people are good test-takers and others aren't, some people have great memories, some people are able to focus, etc. etc. Studies have shown, again, and again, that many of the qualities we view as fixed (even I.Q.) can be improved with effort and the right approach. I think it's discouraging and misleading to tell people that only "certain" people can start with Q-banks or use Anki well. It's an understandable and really common view, but my experiences with students have made me a lot more optimistic to believe that anyone who can get into medical school can really improve their score if they are willing to put in the effort and depart from the conventional approach to things. They may need to dramatically change the way that they approach test-questions and study, but this can be done. I think people need to stop using the same study method almost everyone else does, that leads some people to success (in spite of this method) and others to relative failures that are in no way reflective of their potential.
     
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  43. Aerus

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    What is your opinion on the fact that many of the top scorers on Step 1 on this forums are doing over 70% (some over 80%) on UWorld and all other qbanks that they do? Are they all just anomalies?

    I do agree Qbanks are the most efficient way to learn material, but after a foundation of knowledge has been established. It is very inefficient to learn material for the first time from qbanks.

    Not everyone CAN learn from anki. It is a separate list of discrete facts. I can agree that Anki can be useful for everyone, but as a primary resource? Absolutely not. Some people are top down learners and need to see the bigger picture BEFORE memorizing the discrete facts. I am one of those people who has tried using Anki has a primary resource before. It was very very ineffective and a waste of time until I used some video resource prior.

    I don't deny all this, but I don't agree with your closed mindset that Boards and Beyond is not a good resource because it is passive learning, since there needs to be some way for the person to learn the material the first time. Sure, retention is horrible for videos, but it is processed by the brain subconsciously and I have ALWAYS found that Anki cards were infinitely easier to go through after having watched the relevant videos for that section.
     
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  44. OP
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    I think there is a selection bias for people who tend to post these things, and an average score is not the same as the score when you first start out. I know others who scored similarly to me and started similarly low on UW.

    Hopefully, you would have been at least exposed to the material in medical school, but even if not, my experience has been that it is effective to learn from qbanks. But if this doesn't appear to work for you, and something else does, of course, you can stick with the thing that is working for you.

    I disagree, I think everyone can. But if you don't want to, and if you find something else easier and can expend the time and effort on it without burning out, go ahead and and use that.

    Not sure of the evidence behind "processed by the brain subconsciously", but sure, use it if it works for you.
     
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  45. sadsoul

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    Thank you for sharing all your thoughts with us @USMLE_Pro! For someone who has never been exposed to the material in med school, because I'm coming from a med school in the UK where the basic sciences aren't stressed as much as in the US, do you think it is still effective to learn from qbanks (UWorld)? Would you say it is possible to learn from UWorld alone and using absolutely no other resources - not Pathoma, not even First Aid? I honestly dislike reading through FA and I start to fall asleep even if I force myself to push through. (At most I can only see using FA as a reference - maybe, a very uncertain maybe.) In other words, is it possible to learn and do well (hoping for around a 230 if possible) only using UWorld but taking the time to read through and analyze everything in UWorld, right and wrong answers and explanations, plus making and constantly reviewing concise Anki flash cards for things I got wrong from UWorld? I have about 3 months. Thank you!
     
    #95 sadsoul, Jan 13, 2019 at 10:21 PM
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  46. Aerus

    Aerus Elemental Alchemist
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    Fair enough.

    It's actually quite rare, if not impossible, for a school to expose their students to everything needed to know for Step 1. The problem with doing only qbanks is that you miss a lot of concepts and facts that may be necessary to know in order to eliminate choices on the test. Of course I understand that you don't need to know all the content in order to score extremely well, but there are many schools out there who do quite a poor job at teaching Step 1 content that there may be serious deficiencies in content knowledge that would require a primary video resource just to get the first pass of the knowledge down.

    There are two ways to do poorly on UWorld in the beginning: (1) Not know how to take the test (Doing tons of Qbanks helps remedy this) and (2) Not even having a basic understanding of what the question is asking you (Doing tons of Qbanks is necessary but not sufficient to fix this efficiently)

    Sure everyone can in the same way that everyone can also master the material by rewriting everything a million times from memory. But it's definitely not the most efficient way for everyone. Many people memorize more efficiently with anki if they have at least seen the material once before.

    That concept is exactly why Anki and spaced repetition works so well. There would be no need for the "spaced" part and we can jump straight to just the repetition if our brains didn't learn subconsciously.
     
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    #96 Aerus, Jan 14, 2019 at 1:02 AM
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  47. OP
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    Hey, don't want to waste more of your time in a back and forth if you're still in med school. A lot of what you're saying doesn't match my experience with students and high-scorers, but I'm glad your approach is working for you. Good luck!
     
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  48. OP
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    Hey, I do think it is possible to learn A LOT of what you need from UW, but you won't retain the information well if you just read the UW explanations. I used FA as a referencing when I made my Anki cards based on my UW incorrects, so I still got exposure to FA. I would recommend starting with Pathoma, it is a very well done, high yield resource, particularly if you are out of touch with pathology. Reading through FA is a very inefficient way to study (the only time I think this is okay if is if you're skimming through it the week before your test to lay eyes on anything you might have missed--you won't retain this long-term, so it doesn't make sense to do unless it's very close to the test).

    I think sticking with UW, FA, Pathoma, AND the NBMEs can work for you. You need to review each NBME very, very thoroughly. The challenge will be making good Anki cards--I have seen people spend lots of time making essentially useless cards, so that's something to watch out for, that you're really making cards to memorize the 1 or 2 facts you actually need to know cold to get a question right. Good luck!
     
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