M1; Focus on Class or Step?

[greentealeaves]

---

Members don't see this ad.

I go to a school with a traditional curriculum and am an M1. I read Costanzo, unlock relevant Zanki cards, do a first pass at watching lecture videos, and do relevant Qbank questions when I can. If I engage more with the school material (make a bunch of customized flash cards for each lecture) then I can score really high on school made exams. If I don’t engage as much (I spend more time unlocking relevant Zanki cards and doing Qbank questions) I perform about average on class exams. My school is P/F. What do you think is the optimal strategy for obtaining the highest Step 1 score?

 

[AnatomyGrey12]

My school is P/F. What do you think is the optimal strategy for obtaining the highest Step 1 score?

Does your school still rank?

With a P/F curriculum I would just do more Zanki and practice Q’s personally. If your school ranks then just do both.

 

[greentealeaves]

School doesn't rank for preclinical. Only clinical years.

 

[AnatomyGrey12]

School doesn't rank for preclinical. Only clinical years.

Then this isn't even a question. Hammer Zanki/FA/BnB/Sketchy and practice questions all day and grind for that 250.

 

[Sleepingdoc]

As long as you do not fail, no one cares about it... make sure you do not fail though... Those performance committees can be tough.

 

[deleted600623]

Then this isn't even a question. Hammer Zanki/FA/BnB/Sketchy and practice questions all day and grind for that 250.

Practice questions as in Qbanks? Or from a textbook like costanzo?

 

[Laradd]

Always study for step. just make sure u don't fail

 

[efle]

Step >> doing better on unranked, pass/fail curriculum

 

[ExplodingUlcers]

Practice questions as in Qbanks? Or from a textbook like costanzo?

I would ask the second years at your school who know how the professors tests. If you get administered NBME exams then regardless Rx, Kaplan and Amboss are your best bet.

For example, the second years at my school recommended doing Guyton-Hall/BRS Constanzo practice questions. They said if you can do those then you can answer anything the professors ask.

Sent from my SM-G955U using SDN mobile

 

[deleted600623]

I would ask the second years at your school who know how the professors tests. If you get administered NBME exams then regardless Rx, Kaplan and Amboss are your best bet.

For example, the second years at my school recommended doing Guyton-Hall/BRS Constanzo practice questions. They said if you can do those then you can answer anything the professors ask.

Sent from my SM-G955U using SDN mobile

Good point. I don't believe we get NBME exams so I'll probably buy Costanzo for when we start systems to study for tests. I have Rx already that I've kinda used as I've finished my foundations block and micro/immuno block so I'll probably start doing those a few weeks to start getting used to board style questions.

 

[ExplodingUlcers]

Good point. I don't believe we get NBME exams so I'll probably buy Costanzo for when we start systems to study for tests. I have Rx already that I've kinda used as I've finished my foundations block and micro/immuno block so I'll probably start doing those a few weeks to start getting used to board style questions.

Nice. What was your impression of Rx? I heard the questions are a little too redundant if you do Zanki pretty regularly.

Sent from my SM-G955U using SDN mobile

 

[deleted600623]

Nice. What was your impression of Rx? I heard the questions are a little too redundant if you do Zanki pretty regularly.

Sent from my SM-G955U using SDN mobile

It's not bad. I just want to get through as many questions as possible before Step. I plan to use Rx to reinforce FA as I go through systems and then get into AMBOSS or Kaplan in the summer/fall for better questions before I start UWorld. Zanki is good obviously but I'm finding that I tend to really rely on recognition from cloze deletions than pure recall to go through cards and it hasn't been that effective. But it's really the only resource for long term retention so that's why I'm sticking with it.

 

[Matthew9Thirtyfive]

I would ask the second years at your school who know how the professors tests. If you get administered NBME exams then regardless Rx, Kaplan and Amboss are your best bet.

For example, the second years at my school recommended doing Guyton-Hall/BRS Constanzo practice questions. They said if you can do those then you can answer anything the professors ask.

Sent from my SM-G955U using SDN mobile

Honestly we do nbme and prof exams. I did almost exclusively zanki, BnB, Robbins, and usmle rx to prepare and did very well in both types of exams. As long as you glance over the professor powerpoints a few times before the exam to pick up any extra details, studying for step is enough to at least pass the prof exams if not do well.

 

[Matthew9Thirtyfive]

It's not bad. I just want to get through as many questions as possible before Step. I plan to use Rx to reinforce FA as I go through systems and then get into AMBOSS or Kaplan in the summer/fall for better questions before I start UWorld. Zanki is good obviously but I'm finding that I tend to really rely on recognition from cloze deletions than pure recall to go through cards and it hasn't been that effective. But it's really the only resource for long term retention so that's why I'm sticking with it.

I have been using zanki and rx together. I used zanki to “learn” the material, and then rx reinforces it in context and makes sure I have it actually in there. Then the reviews on zanki keep it there.

 

[Chromium Surfer]

I go to a school with a traditional curriculum and am an M1. I read Costanzo, unlock relevant Zanki cards, do a first pass at watching lecture videos, and do relevant Qbank questions when I can. If I engage more with the school material (make a bunch of customized flash cards for each lecture) then I can score really high on school made exams. If I don’t engage as much (I spend more time unlocking relevant Zanki cards and doing Qbank questions) I perform about average on class exams. My school is P/F. What do you think is the optimal strategy for obtaining the highest Step 1 score?

How have you optimized finding the relevant anki cards to unlock? Do you search for the relevant cards by using keywords associated to the concept or something else? Also do you do this after going to class or do you just look at the PowerPoints without going through class.

Also for anyone else in a traditional curriculum please chime in on how you optimize finding the relevant AZ kind card that aligns with what you are learning in classes. Thanks so much!

 

[greentealeaves]

@Chromium Surfer For searching, you just enter in all the key words from a given lecture. If your physiology class has Costanzo readings then you're in luck for unlocking physiology. I don't know of a more efficient way to do this, but if anyone has ideas I'm all ears.

 

[OnePunchBiopsy]

Go hard on STEP

C=MD

250 = Publicity

 

[DameJulie]

I have been using zanki and rx together. I used zanki to “learn” the material, and then rx reinforces it in context and makes sure I have it actually in there. Then the reviews on zanki keep it there.

Can you share your flow on how to do this?? And do you make additional flashcards on your Rx wrong ones?

 

[Matthew9Thirtyfive]

Can you share your flow on how to do this?? And do you make additional flashcards on your Rx wrong ones?

BLUF: I do zanki, then the BnB videos for the topics we are on and the video quizzes right away. I do about half of the Rx questions for each topic maybe once a week or so to save some for right before the exam.

I don’t make additional cards for them. I just look over the explanations for all the ones I get wrong and right (to make sure I got it right for the right reasons).

——-

Basically I have all my zanki cards for the module suspended and unsuspend them as we cover the topics in class. If we don’t cover something, I unsuspend it at the end so I still get it. I figure our how many cards I need to do per day to hit them all by the exams, then do that many new per day and all my reviews.

Then I watch the BnB videos for the lecture topics we have that day and do the quiz questions for them. I follow along and annotate FA while watching the videos. If there’s not a great video or I feel like I need more info, I see if there’s a sketchy video and watch it (I try to watch as many of the sketchy videos for the topics as I can, but I don’t always have time because I also have a family and I don’t study when I get home or on the weekends besides doing zanki).

Once or twice a week I will do Rx questions on the topics we hit that week. We also get formative quizzes at our school that don’t count for anything so I get questions that way too. I don’t usually do all the questions on a topic in Rx so I can save a few for the days before an exam.

The days before the exam I will also redo all the BnB quiz questions. We do NBME exams too, and so far I have found BnB to be super helpful even if I’ve already seen the questions. I also do all the Robbins questions during the week before the exam.

 

[slowthai]

BLUF: I do zanki, then the BnB videos for the topics we are on and the video quizzes right away.

You're like the first person I've seen that watches BnB AFTER Zanki, lol. There's this dogmatic statement going around that you MUST watch BnB/Pathoma before you do cards. You don't watch lecture either, right? If so, we've got a somewhat similar workflow, lol.

 

[Matthew9Thirtyfive]

You're like the first person I've seen that watches BnB AFTER Zanki, lol. There's this dogmatic statement going around that you MUST watch BnB/Pathoma before you do cards. You don't watch lecture either, right? If so, we've got a somewhat similar workflow, lol.

Yeah I don’t watch lecture. The only ones I watch are like the ones on reading imaging and stuff like that. We have an oral radiology final this module, and the lectures on imaging are given by a radiologist so I try to watch those lol.

I actually do zanki first because I take the train to school and it’s a decent train ride, so I can get in almost all my cards just on the train ride. But I prefer it that way because doing cards is active learning. Even with annotating, watching a video is still pretty passive.

 

[slowthai]

Yeah I don’t watch lecture. The only ones I watch are like the ones on reading imaging and stuff like that. We have an oral radiology final this module, and the lectures on imaging are given by a radiologist so I try to watch those lol.

I actually do zanki first because I take the train to school and it’s a decent train ride, so I can get in almost all my cards just on the train ride. But I prefer it that way because doing cards is active learning. Even with annotating, watching a video is still pretty passive.

I see. And exactly. I like to start my day off pounding cards. Then I "relax" by watching BnB, then I ramp it up again with endless questions. Also, seeing those cards gives me a good base for actually knowing what Dr Ryan's talking about, lol. It just works well for me.

 

[FindersFee5]

Yeah I don’t watch lecture. The only ones I watch are like the ones on reading imaging and stuff like that. We have an oral radiology final this module, and the lectures on imaging are given by a radiologist so I try to watch those lol.

I actually do zanki first because I take the train to school and it’s a decent train ride, so I can get in almost all my cards just on the train ride. But I prefer it that way because doing cards is active learning. Even with annotating, watching a video is still pretty passive.

I always found that watching the video before I did cards helped provide a broader framework to fit the cards into. Doing cards alone before the video made me feel like I was stumbling around in the dark and it would take longer than normal to learn everything.

 

[Matthew9Thirtyfive]

I always found that watching the video before I did cards helped provide a broader framework to fit the cards into. Doing cards alone before the video made me feel like I was stumbling around in the dark and it would take longer than normal to learn everything.

Different strokes for different folks. Whatever gets the info in your brain most efficiently.

 

[ExplodingUlcers]

You're like the first person I've seen that watches BnB AFTER Zanki, lol. There's this dogmatic statement going around that you MUST watch BnB/Pathoma before you do cards. You don't watch lecture either, right? If so, we've got a somewhat similar workflow, lol.

I think it depends on how conceptual the content in question is. With that said, I wouldn't recommend this method if you're learning cardio/pulm/renal physiology because that will leave you prone to fall into the trap of simply memorizing the cards without understanding the concepts. This happened to me at the beginning of last block and I paid the price lol.

If you can make this method work then kudos to you! I definitely need a first pass material through Costanzo, sketchy or boards and beyond before hitting Zanki cards.

Sent from my SM-G955U using SDN mobile

 

[Matthew9Thirtyfive]

I think it depends on how conceptual the content in question is. With that said, I wouldn't recommend this method if you're learning cardio/pulm/renal physiology because that will leave you prone to fall into the trap of simply memorizing the cards without understanding the concepts. This happened to me at the beginning of last block and I paid the price lol.

If you can make this method work then kudos to you! I definitely need a first pass material through Costanzo, sketchy or boards and beyond before hitting Zanki cards.

Sent from my SM-G955U using SDN mobile

Starting CPR tomorrow, so we’ll see lol. It’s worked for me so far but I’m always willing to change things up if they stop working.

 

[slowthai]

I think it depends on how conceptual the content in question is. With that said, I wouldn't recommend this method if you're learning cardio/pulm/renal physiology because that will leave you prone to fall into the trap of simply memorizing the cards without understanding the concepts. This happened to me at the beginning of last block and I paid the price lol.

If you can make this method work then kudos to you! I definitely need a first pass material through Costanzo, sketchy or boards and beyond before hitting Zanki cards.

Sent from my SM-G955U using SDN mobile

I really think it's on the individual to make sure that they're not just memorizing cards. I do several things to ensure that I'm truly understanding concepts.

1. Constantly ask why the answer to the card is true. This should become automatic. It's especially important for the phys/pathophys cards.

2. Watch BnB and relate what he is saying to what you already know from the cards. Pause the video or go back if you don't understand everything he is saying.

3. Do practice questions.

 

[Matthew9Thirtyfive]

I really think it's on the individual to make sure that they're not just memorizing cards. I do several things to ensure that I'm truly understanding concepts.

1. Constantly ask *why* the answer to the card is true. It should become automatic. This is especially important for the phys/pathophys cards.

2. Watch BnB and relate what he is saying to what you already know from the cards. Pause the video or go back if you don't understand everything he is saying.

3. Do practice questions.

Exactly. The practice questions are more active learning and making sure you’re synthesizing the material. I also make sure I read and understand (and can recite) the extra material on all the zanki cards.

 

[slowthai]

Exactly. The practice questions are more active learning and making sure you’re synthesizing the material. I also make sure I read and understand (and can recite) the extra material on all the zanki cards.

Agreed. But wait, you actually memorize the entire extra section on every single card?? I tried doing that but it just took soooo long. I was making connections with things left and right, but I found that I was going down rabbit holes when I'm supposed to be running through these cards, lol. With the method I use, I find that I effortlessly make connections with other facts/concepts, but only with material/cards that are the most related, instead of just random facts popping into my head, like "Oh yeah, this and this and this disease have this symptom too."

 

[ExplodingUlcers]

Starting CPR tomorrow, so we’ll see lol. It’s worked for me so far but I’m always willing to change things up if they stop working.

Good luck! If it works for you then keep at it. I'll probably revisit your method out when I hit my msk block.

Sent from my SM-G955U using SDN mobile

 

[Matthew9Thirtyfive]

Agreed. But wait, you actually memorize the entire extra section on every single card?? I tried doing that but it just took soooo long. I was making connections with things left and right, but I found that I was going down rabbit holes when I'm supposed to be running through these cards, lol. With the method I use, I find that I effortlessly make connections with other facts/concepts, but only with material/cards that are the most related, instead of just random facts popping into my head, like "Oh yeah, this and this and this disease have this symptom too."

I don’t place too much emphasis on it. I read it each time I do the card and try to remember it when I do them. If I don’t get it exactly right but I get the card right, I just move on. I just try to get the general context and concept.

 

[Matthew9Thirtyfive]

Good luck! If it works for you then keep at it. I'll probably revisit your method out when I hit my msk block.

Sent from my SM-G955U using SDN mobile

We just finished MSK, and it worked great for me.

 

[slowthai]

I don’t place too much emphasis on it. I read it each time I do the card and try to remember it when I do them. If I don’t get it exactly right but I get the card right, I just move on. I just try to get the general context and concept.

Same. But I can't lie, I do skim/skip the the parts of the extras that have just a list of symptoms, lol.

 

[Matthew9Thirtyfive]

Same. But I can't lie, I do skim/skip the the parts of the extras that have just a list of symptoms, lol.

Lol me too tbh. I don’t find memorizing lists of symptoms to be too helpful.

 

[bananafish94]

My pre-clinical grades went way up when I started studying from Pathoma and Anki and using class materials as a supplement for the details that might show up on the test. The meat and potatoes is all going to be the same and frankly it’s going to be taught better by Pathoma. Then once you fill in the blanks from class material you should be good to go.

 

[DrStephenStrange]

Class vs Boards

WHAT'S THE DIFFERENCE?

Sent from my SM-G973U using SDN mobile

 

[efle]

My god, people are now memorizing Anki cards cold before even watching any kind of lecture package to give the factoids any context?

We're truly reaching the singularity. I pity the students of 2025 if they keep current Step1 scoring!

 

[Matthew9Thirtyfive]

My god, people are now memorizing Anki cards cold before even watching any kind of lecture package to give the factoids any context?

We're truly reaching the singularity. I pity the students of 2025 if they keep current Step1 scoring!

My God, it’s almost as if different ways of learning work for different people!

 

[efle]

My God, it’s almost as if different ways of learning work for different people!

I'm not criticizing man. I'm pointing out that if the system rewards people for blindly memorizing flashcards they don't even have context for, the system is busted. You're doing exactly what you ought to, I'm hating on the game not the player.

 

[Matthew9Thirtyfive]

I'm not criticizing man. I'm pointing out that if the system rewards people for blindly memorizing flashcards they don't even have context for, the system is busted. You're doing exactly what you ought to, I'm hating on the game not the player.

You're assuming that we are just blindly memorizing facts without context. If you actually read our posts, we are talking about doing cards for the day before watching the videos and going through FA--the same day. Like I do my cards for the day, and then literally the next thing I do is watch the videos. We're not just memorizing zanki with no context. For me personally, after storing those facts in my brain, watching the videos becomes more of an active process for me. Otherwise, it's just passive watching.

 

[efle]

You're assuming that we are just blindly memorizing facts without context. If you actually read our posts, we are talking about doing cards for the day before watching the videos and going through FA--the same day. Like I do my cards for the day, and then literally the next thing I do is watch the videos. We're not just memorizing zanki with no context. For me personally, after storing those facts in my brain, watching the videos becomes more of an active process for me. Otherwise, it's just passive watching.

No no I understand you end up adding the context later. I still think the system has its priorities backwards where this approach works, because the brunt of mental effort shouldn't be on memorization of discrete factoids.

Like imagine we were talking about a different field or subject. I tell you I've been kicking butt in physics or math or computer science, with my first and foremost study tool being flashcards and often not even watching lecture. That should strike you as very wrong, and tell you something is amiss about my exams. We ought to feel that way about medicine too

 

[Matthew9Thirtyfive]

No no I understand you end up adding the context later. I still think the system has its priorities backwards where this approach works, because the brunt of mental effort shouldn't be on memorization of discrete factoids.

Like imagine we were talking about a different field or subject. I tell you I've been kicking butt in physics or math or computer science, with my first and foremost study tool being flashcards and often not even watching lecture. That should strike you as very wrong, and tell you something is amiss about my exams. We ought to feel that way about medicine too

I majored in math, coincidentally. You could study with flashcards if you wanted to, but it really wouldn't be an efficient use of your time. Medicine (at least what I've experienced so far) is not like math. You can (and should) learn concepts, but there are a lot of things you just have to memorize, which isn't really true of mathematics (at least not higher division math). Part of it is just because there is such a vast amount of material to learn, but much of the material just lends itself to that sort of study.

I think the system seems messed up if you just think of it like that, but at least at my school, what I'm seeing is that we memorize things that seem like random discrete factoids, but then we get a small group exercise where an MD puts all the random factoids into context, and we get to make the connections using cases.

 

[Ho0v-man]

Meh. The most time-intensive part is memorizing the BS. So I just did it first by memorizing the Zanki cards first. More time up front but way less time needed right before the exam.

it’s just the difference between top-down vs bottom-up processing.

 

[efle]

I majored in math, coincidentally. You could study with flashcards if you wanted to, but it really wouldn't be an efficient use of your time. Medicine (at least what I've experienced so far) is not like math. You can (and should) learn concepts, but there are a lot of things you just have to memorize, which isn't really true of mathematics (at least not higher division math). Part of it is just because there is such a vast amount of material to learn, but much of the material just lends itself to that sort of study.

I think the system seems messed up if you just think of it like that, but at least at my school, what I'm seeing is that we memorize things that seem like random discrete factoids, but then we get a small group exercise where an MD puts all the random factoids into context, and we get to make the connections using cases.

Yeah I think at the end of the day I'm bitter because I thought medicine would be a mix of quantitative reasoning + fund of knowledge, and it turned out to really be 95% fund of knowledge, at least on boards/shelves. The fact that a math major starts his daily medical studies by cold memorizing flashcards is just a symptom of that.

 

[Hi_I'mPaul]

Focus on both! Class material should be STEP prep (for the most part).

My approach:
In-house lectures (our lectures mirror high yield STEP materials veryyyy well which is nice) -> in-house Anki cards made by someone in the classes before me (based on lecture slides; hate making my own cards so this is optimal for me) -> B&B + Physeo + Sketchy (whichever is relevant at the time; match these vids with what I'm learning in lecture to spend a little more time on the STEP materials) -> Books (e.g. Costanzo, Thieme, etc.) -> Zanki. Rinse and Repeat throughout the week. Take one day off per week.

I'm in the group that uses Anki purely for review and not primary learning. Will start using QBanks in M2. Score near top of class on exams and feel like I'm adequately preping for STEP. But as people point out, people's approaches will differ and that's fine. If you want to focus on STEP material, know your in-house scores may slip. It's really up to you and what you're happy with.

 

[slowthai]

You're assuming that we are just blindly memorizing facts without context. If you actually read our posts, we are talking about doing cards for the day before watching the videos and going through FA--the same day. Like I do my cards for the day, and then literally the next thing I do is watch the videos. We're not just memorizing zanki with no context. For me personally, after storing those facts in my brain, watching the videos becomes more of an active process for me. Otherwise, it's just passive watching.

Exactly. Furthermore, the Zanki cards of today are lightyears (lol) ahead of the OG deck. We've got FA, Robbins, Pathoma slides, Goljan, Step Up to Medicine, etc as context in the cards themselves. Plus there's the Amboss add on, which is like a pop up dictionary linked to the Amboss database that's based on FA and other high yield sources that adds even more context.

 

[Matthew9Thirtyfive]

Yeah I think at the end of the day I'm bitter because I thought medicine would be a mix of quantitative reasoning + fund of knowledge, and it turned out to really be 95% fund of knowledge, at least on boards/shelves. The fact that a math major starts his daily medical studies by cold memorizing flashcards is just a symptom of that.

I knew what I was getting into. The former associate dean of our school and I had a conversation about it. Do I wish I could spend more time just focusing on a few things I find really interesting? Yeah. But if I did that, I'd be getting a PhD, not an MD.

 

[slowthai]

Meh. The most time-intensive part is memorizing the BS. So I just did it first by memorizing the Zanki cards first. More time up front but way less time needed right before the exam.

it’s just the difference between top-down vs bottom-up processing.

Exactly. I see the trees first (Zanki) and then zoom out to be able to see the forest (BnB/practice qs).

 

[ExplodingUlcers]

Exactly. Furthermore, the Zanki cards of today are lightyears (lol) ahead of the OG deck. We've got FA, Robbins, Pathoma slides, Goljan, Step Up to Medicine, etc as context in the cards themselves. Plus there's the Amboss add on, which is like a pop up dictionary linked to the Amboss database that's based on FA and other high yield sources that adds even more context.

Have you tried this fabled Amboss add-on? I've heard so much about it but would like to know how it fits into doing Zanki regularly.

Sent from my SM-G955U using SDN mobile

 

[Thesimplelifeofamyloid]

Yeah I think at the end of the day I'm bitter because I thought medicine would be a mix of quantitative reasoning + fund of knowledge, and it turned out to really be 95% fund of knowledge, at least on boards/shelves. The fact that a math major starts his daily medical studies by cold memorizing flashcards is just a symptom of that.

Medical school doesn't equal practicing medicine