If you knew everything on First Aid USMLE Step 1

[Medstart108]

If you knew absolutely everything in the book for First Aid USMLE Step 1 2013 and absolutely nothing else (nothing from medical school), how would you do on the Step 1?

Would you be able to pass?

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[Phloston]

Probably in the 230s.

(that's if you literally just read FA and didn't do any practice questions)

 

[Jorje286]

People really underrate first aid. There's actually so much material in there that USMLE World doesn't come close to testing.

I think if you knew first aid cover to cover and did practice questions you are guaranteed a 250. In fact, most people at my school just do this with no review books and some are scoring in the 260s.

 

[withrye]

People really underrate first aid. There's actually so much material in there that USMLE World doesn't come close to testing.

I think if you knew first aid cover to cover and did practice questions you are guaranteed a 250. In fact, most people at my school just do this with no review books and some are scoring in the 260s.

Memorizing FA gives you the last step in terms of answering a given question. More often than not, you're going to have to interpret a tricky presentation, figure out a diagnosis, figure out a common treatment, and then come up with a common side effect (or how to avoid that side effect, in some cases). This is a skill that takes practice, and one that isn't honed in any way by memorizing FA. Questions from good question banks are the most reliable way to get this practice. This is why people always say FA+UWorld = [insert score here].

P.S. Yes, FA includes all the step by step info to answering tricky multi-step questions, but the integration is much more difficult if you haven't seen a few hundred/thousand examples of how that's done.

 

[thecalccobra]

People really underrate first aid. There's actually so much material in there that USMLE World doesn't come close to testing.

I think if you knew first aid cover to cover and did practice questions you are guaranteed a 250. In fact, most people at my school just do this with no review books and some are scoring in the 260s.

'Most people' who you're referring to were good students who worked hard during the first 2 years. In essence, they built a solid foundation from the start and then used UW and FA to get 250s.

 

[Jorje286]

'Most people' who you're referring to were good students who worked hard during the first 2 years. In essence, they built a solid foundation from the start and then used UW and FA to get 250s.

Those 2 years are only good in so far it makes memorizing first aid easier. But if you get it done in whatever way, then this is pretty much 90%+ of all the knowledge that you will need to ace the exam. And yes obviously knowledge base isn't the only thing you will need to score really high, and I didn't suggest that.

 

[MLT2MT2DO]

If you knew absolutely everything in the book for First Aid USMLE Step 1 2013 and absolutely nothing else (nothing from medical school), how would you do on the Step 1?

Would you be able to pass?

You wouldn't really have any knowledge base to put all the random enzymes/words/pictures/mechanisms etc to tie those into.

I would say they'd be lucky to pass, simply because one or two words that would differ from FA to an actually test question would throw the test taker for a loop.

Now if they knew and understood everything from FA that's a different story

 

[GalenAgas]

It's pretty much impossible to learn everything in FA without understanding it... well for me anyways.

 

[JShephard]

If Step 1 was an open book exam with First Aid? I think you'd do VERY well.

 

[g8orlife]

You wouldn't really have any knowledge base to put all the random enzymes/words/pictures/mechanisms etc to tie those into.

I would say they'd be lucky to pass, simply because one or two words that would differ from FA to an actually test question would throw the test taker for a loop.

Now if they knew and understood everything from FA that's a different story

Cosign.

I've been told that the point is to understand the concepts behind the FA facts.

 

[Greenbayslacker]

.

 

[chronicidal]

But how well?

Here's why I ask.

I want to dump a ton of knowledge into Anki, my knowledge management system, alongside the time I am going through the curriculum. I will review all that knowledge on a spaced repetition schedule so I retain it in a year and a half with >90% efficacy. I can't bank everything we're fed or that I read, because doing all those flashcards every day would take too long. There must be a criterion for what's high-yield enough to merit inclusion into my Anki database. And then for those, say 10,000 factoids found in First Aid, I will know down pat. If I can accomplish that, and do an average number of Qbank questions, what kind of score can I expect?

Or if my criterion for inclusion into Anki were that a factoid was mentioned in FA OR UWorld, what is the incremental cost-effectiveness ratio?

Or if my criterion for inclusion were FA OR UWorld OR BRS Physio OR RR Path, what is that cost-effectiveness?

Phrased differently, how could one craft an database of knowledge such that one can minimize the time spent reviewing but also achieve say, a 260, if one took Step 1 "open-book" with that database.

 

[JShephard]

But how well?

Here's why I ask.

I want to dump a ton of knowledge into Anki, my knowledge management system, alongside the time I am going through the curriculum. I will review all that knowledge on a spaced repetition schedule so I retain it in a year and a half with >90% efficacy. I can't bank everything we're fed or that I read, because doing all those flashcards every day would take too long. There must be a criterion for what's high-yield enough to merit inclusion into my Anki database. And then for those, say 10,000 factoids found in First Aid, I will know down pat. If I can accomplish that, and do an average number of Qbank questions, what kind of score can I expect?

Or if my criterion for inclusion into Anki were that a factoid was mentioned in FA OR UWorld, what is the incremental cost-effectiveness ratio?

Or if my criterion for inclusion were FA OR UWorld OR BRS Physio OR RR Path, what is that cost-effectiveness?

Phrased differently, how could one craft an database of knowledge such that one can minimize the time spent reviewing but also achieve say, a 260, if one took Step 1 "open-book" with that database.

Understanding, test taking, and intuition will be as important as memory.

Knowing all the facts in FA is enough. Understanding and problem solving is a different skill.

Boards obsession is tempting during M1. Honestly, I would focus 110% on class until 4-6 months out. That's PLENTY of time to do as we'll as you want.

This question depends on your background. Some subjects I'm strong in, FA memory is more than enough. Weaker subjects, I need supplements.

Learn class material cold then before the test come back and strategize.

 

[CDI]

Understanding, test taking, and intuition will be as important as memory.

Knowing all the facts in FA is enough. Understanding and problem solving is a different skill.

I didn't realize how big of a factor this was till very late in my prep. Looking at the exam in this way (like another standardized test that you can crack open) definitely helped improve my studying.

 

[Transformers]

NOPE...First aid is a good skeleton, but once u see the integrations with each little box in FA (i.e.- through using UWorld) you start to appreciate what you learned in med school, as obvious as it sounds, is interconnected and merits the time to break down what first aid means...perfect example is cool FA micro which lists a bunch of cool facts and diseases that a certain bug causes....but do you have the understanding to tell the story of a virus for example, from the its reservoir-->transmission--> pathology on different levels (genetic, cellular, tissue, systemic) --> how you diagnose and maybe differentially dx it and treat it? Thats a bit over the top but the ultimately that is what UNDERSTANDING first aid means, can you tell the story...Med schools cool in that they teach you everything subject-wise, but its up to you to make the links with what you see in a given subject with other subjects aka THINKING

 

[Mdard]

I don't think FA is enough. It's a review of high yield facts, and even those facts require that you have a good grasp of the topic. 2 examples from a well known Q bank:

1) The stem was Burkit's lymphoma. I looked for t(8;14)...but it wasn't there. The correct answer was t(2;8). FA12 pg 390. If you know that word for word...you would still not have enough information to get it right. If you understand what's on those chromosomes, which FA doesn't really explain, you would understand the concept behind t(8;14) and t(2;8) causing the same disease.

2) A stem had bleeding esophageal varices. The correct drug therapy was octreotide. We hadn't gone through endocrine drugs yet in class, so I literally didn't know any of the drugs listed. If you knew word for word FA12 pg 334...you would not get it right. If you knew the concept of how the drug works to treat uterine hemorrhage...which is in FA, you could begin to answer it.

I think those questions are fair game and reflect topics we should know for Step 1. Therefore I think FA is a great framework and will definitely guarantee a lot of right answers, but it is probably not enough to do exceptionally well.

And of course, 3 months out, I know nothing except that this test is going to be a b#$%

 

[CDI]

I don't think FA is enough. It's a review of high yield facts, and even those facts require that you have a good grasp of the topic. 2 examples from a well known Q bank:

1) The stem was Burkit's lymphoma. I looked for t(8;14)...but it wasn't there. The correct answer was t(2;8). FA12 pg 390. If you know that word for word...you would still not have enough information to get it right. If you understand what's on those chromosomes, which FA doesn't really explain, you would understand the concept behind t(8;14) and t(2;8) causing the same disease.

2) A stem had bleeding esophageal varices. The correct drug therapy was octreotide. We hadn't gone through endocrine drugs yet in class, so I literally didn't know any of the drugs listed. If you knew word for word FA12 pg 334...you would not get it right. If you knew the concept of how the drug works to treat uterine hemorrhage...which is in FA, you could begin to answer it.

I think those questions are fair game and reflect topics we should know for Step 1. Therefore I think FA is a great framework and will definitely guarantee a lot of right answers, but it is probably not enough to do exceptionally well.

And of course, 3 months out, I know nothing except that this test is going to be a b#$%

Was that first question by any chance from Kaplan?

The second question: That's just something you should know regardless of whether you read FA or not, but just by being in med school. That is considered a gimme question.

I don't think anyone is saying you can literally go on vacation for 2 years and show up 3 months prior to Step 1 and crush it by memorizing FA. We are saying that if you at least showed face and got the basics you can probably sit down with FA, memorize it verbatim, and score in the 220-230 range.

My guess would be its because there are (supposedly) straightforward/auto-click questions on the exam, which if you actually memorized it verbatim - you'd theoretically answer all of those correctly. Obviously thats a lot easier said than done and no one is doing that.

The integrations also will happen as you go through FA more, you may not realize it but eventually you will start picking up on things and want to flip back to check something and realize the integration.

 

[JShephard]

Was that first question by any chance from Kaplan?

The second question: That's just something you should know regardless of whether you read FA or not, but just by being in med school. That is considered a gimme question.

I don't think anyone is saying you can literally go on vacation for 2 years and show up 3 months prior to Step 1 and crush it by memorizing FA. We are saying that if you at least showed face and got the basics you can probably sit down with FA, memorize it verbatim, and score in the 220-230 range.

My guess would be its because there are (supposedly) straightforward/auto-click questions on the exam, which if you actually memorized it verbatim - you'd theoretically answer all of those correctly. Obviously thats a lot easier said than done and no one is doing that.

The integrations also will happen as you go through FA more, you may not realize it but eventually you will start picking up on things and want to flip back to check something and realize the integration.

There will obvious be people in both camps. No one is saying you could have an M1 memorize words in FA and they could score a 250. You need to go to medical school and be a decent student for this to work.

I guess I have no idea about other med schools, but pretty much any average student at my school would do amazing having memorized FA. You can often eliminate wrong answers too when FA wasn't enough. Getting questions down to 50/50 with FA only is great.

Whenever you need background, Wikipedia is great. Wiki + FA + UW does enough to match into any specialty in medicine. If you want to do better than that? I wouldn't know what sources you need.

 

[Phloston]

Whenever you need background, Wikipedia is great. Wiki + FA + UW does enough to match into any specialty in medicine. If you want to do better than that? I wouldn't know what sources you need.

Hah, you know the good sources out there, JS.

 

[GluteusMaximus]

You wouldn't really have any knowledge base to put all the random enzymes/words/pictures/mechanisms etc to tie those into.

I would say they'd be lucky to pass, simply because one or two words that would differ from FA to an actually test question would throw the test taker for a loop.

Now if they knew and understood everything from FA that's a different story

This is fairly consistent with the advice I got when I decided to write step 1. I made a thread on this after I got my results. Basically to sum that up, I am 5th year resident from Canada, 7 years removed from my preclinical years at a school that was definitely not very relevant to step 1 material. I decided to write this exam and took the first available writing. I ended up having just under a month to prepare while working full time and attending fellowship interviews. My ONLY source was FA (I didn't even make corrections or review the lengthy list of errata, just used what's actually printed in the 2012 edition). I got through it almost 3 times. NO other souces. NO practice questions, not even the free 150. So on exam day I really had no idea what the format was like. Trust me, I made lots of stupid mistakes that I realised almost immediately after ending a block. I know for fact I made lots of mistakes that are straight from FA. Anyhow, I wrote the exam on Dec 3, 2012. My score - 233. So, I think if you truly memorized FA front to back you could score much higher than what I did (250-260's sounds realistic).

 

[chronicidal]

1) FA 2013 now includes octreotide for treating esophageal varices. However, the point is well taken that FA will inevitably miss some things.
2) Octreotide for treating varices is an off-label usage. Even if it's commonly used, would the USMLE test off-label usages?

 

[johnstoops2005]

1) FA 2013 now includes octreotide for treating esophageal varices. However, the point is well taken that FA will inevitably miss some things.
2) Octreotide for treating varices is an off-label usage. Even if it's commonly used, would the USMLE test off-label usages?

A lot of the treatments for various protozoa in First Aid are off-label as well. So off-label use is probably fair game if its off-label but still included in clinical practice guidelines.

 

[Greenbayslacker]

.

 

[notcool]

This is fairly consistent with the advice I got when I decided to write step 1. I made a thread on this after I got my results. Basically to sum that up, I am 5th year resident from Canada, 7 years removed from my preclinical years at a school that was definitely not very relevant to step 1 material. I decided to write this exam and took the first available writing. I ended up having just under a month to prepare while working full time and attending fellowship interviews. My ONLY source was FA (I didn't even make corrections or review the lengthy list of errata, just used what's actually printed in the 2012 edition). I got through it almost 3 times. NO other souces. NO practice questions, not even the free 150. So on exam day I really had no idea what the format was like. Trust me, I made lots of stupid mistakes that I realised almost immediately after ending a block. I know for fact I made lots of mistakes that are straight from FA. Anyhow, I wrote the exam on Dec 3, 2012. My score - 233. So, I think if you truly memorized FA front to back you could score much higher than what I did (250-260's sounds realistic).

That's amazing! But isn't it still a huge advantage to have all that clinical knowledge and experience as a 5th year resident for Step 1 (even if you've forgotten most of your basic sciences), while an MS2 would have a lot less clinical knowledge and experience in comparison?

 

[thehundredthone]

If you actually knew absolutely everything in FA2013? You'd do well. If you had only memorized the words? Probably not so well.

 

[ShireCheshire]

Yeah, there's a difference between "knowing everything in FA" and actually understanding it. FA is largely just a book big of facts, providing little to no framework for organizing them all. Memorizing FA front to back would not help much in putting things into context, which is critical for doing well on Step 1.