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Need Advice... Been studying for 6 mos.. Score not Imporving

Discussion in 'Step I' started by dinkey, Dec 20, 2008.

  1. dinkey

    7+ Year Member

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    Hi.. i took the kaplan live lecture about 9 months ago... had to take a three month break... family problems.. etc.. i had to stop studying and then I started again about 6 mos ago... first three mos were kinda haphazard, but then i got my routine.. i've basically done the Kaplan Review Books.. have revised them and have started on UWorld..

    I'm doing FIRST AID as well now..

    I have given two NBME Exams.. I gave the first one about 11 months ago before I started my Kaplan live lecture.. I got a score of below two hundred (correlating to a less than 136 on step 1) on it... the lowest you can get and was pretty off the chart on the lower end..... I regave the NBME about three months ago.. managed to score a 220 (correlating to a score of 140 on step1 )

    My avg on UWorld is at 39%... I have seen a bit of improvement, but not where I need to get to pass... I need to give my exam ASAP as I have waited too long already and am looking for honest advise as to what I need to do to pass the exam as I am in a deep rut here and feel lost...

    I know there are a lot of stellar students on this forum with 99% plus etc..

    Any one with advise on what I need to do to improve my score... studying wise, questions wise, etc..?? What do I need to do differently? What do I need to do again..

    Any advise will be appreciated...
     
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  3. laxman310

    laxman310 TheManWithAPlan
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    With scores in that range, it seems like you lack FUNDAMENTAL understanding of the material. i.e. A fundamental understanding of the material, without knowing minutia, should get you close to a passing score.

    Considering the time your taking, my recommendation would be this:
    Read a chapter of Robbin's basic path (starting with chapter 1), and then do the questions from Robbin's Review of path right after. What I mean by reading is: read a short section (2-4 pages), stop reading, and spend a few minutes trying to recall and go through mechanisms in your head. Look at the pictures to review the mechanisms and cause/effect of conditions. (i.e. why renal insufficiency causes bone problems, what lab values would be off, etc.).
    Do the questions ONE at a time. i.e. Read the question, think about it, pick an answer, check your answer, read the explanation. If you feel like you do not comprehend why the answer given is the correct one, go to the page referenced, and re-read the topic. Do this everyday. You should get through it in a month, or less, depending on how many chapters you read.. Then take one of the assesments you already took, and see how much you improved.

    Considering your assesment tests, you are jumping the gun. It would be equivalent to an MS1 trying to take an assesment test after only completing their first year. They lack a fundamental understanding of the majority of what is tested on the exam (path/mechanisms).

    If you were just trying to pass, and you had a close score, I would say push through a question bank. But right now you have to build a foundation.

    The majority of the test is pathology, and its also the basis for the rest of the test. Come back after you did the above, and
     
  4. doc20

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    i have had friends who study for too long and cant retain the vast amount of material that is required for step 1
    i think you need to pick 4 weeks and go through uworld and step 1 twice during that time and immediately take nbme practice and see how you do, try to put in as much effort in as little time as possible
    and set up a set date to get it out of way it would motivate you
     
  5. laxman310

    laxman310 TheManWithAPlan
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    With NBMEs in the 130s and 140s, he lacks a solid base. Its like trying to read FA without having done any prerequisite work.
     
  6. AmyO

    AmyO Member
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    I think having a strong pathology base and a strong physiology base are probably the 2 most important subjects to have a firm handle on. The USMLE is about why not what (for the majority of the questions - there will be those pure rote memorization ?s like which pharyngeal arch does this structure orginiate from, etc). Have you tried Rapid Review Path by Goljan along w/ listening to his audio (try talking to upper classmen if you don't have it already)? I agree Robbins is very good; however it does take a considerable amount of time to get through just the first few chapters. For physiology (if you need a more in-depth understanding), try Costanzo Physiology. If you don't know the basics, BRS physiology will not give you enough detail, but I think if you read over Costanzo's regular text esp cardio, pulmonary, renal, & endocrine (& repro if you can....they love testing LH, FSH, etc w/ arrows going up or down), then you should see an improvement in your scores if you truly are mastering those 2 subjects. Then, I would hit micro and pharm as these are also pretty high yield. Most of the micro & pharm are adequately covered in FA (certainly enough for passing). At this point, I would concentrate primarily on strengthening your knowledge base versus taking more NBMEs. You can keep practicing USMLE world ?s at night but at least for 2 wks I would work on fundamental principles. Good luck!
     
  7. dinkey

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    thanks for the advice.. i've decided to tackle patho first wid robbins and goljan where permitted.. then i guess i'll progress towards physio.. need to pick up mhy pace a bit.. thanks all
     
  8. DarlynVMD

    DarlynVMD Junior Member
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    dinkey,

    It is in your best interest to cover physiology first and once you've understood normal physiologic functions for each system, then you can move on to pathology. Also, reading robbins is not necessary at all... it's too massive and it's only going to overwhelm you. Give Goljan a shot... read his book in its entirety once along with his audio. For example, give yourself 10 days for pathology... go through it slowly and don't rush anything...and while doing this, try and make connections between what your learned from physiology with the pathologic processes presented in Goljan. If you don't understand something, DO NOT MOVE ON... this is where you'll need a reference text like Robbins or the internet (which is a great resource as you might already know). You're not going to make all the connections right away, not until your 2nd of 3rd read as your fundamental basis is kinda weak as per your post. But like previous posters have suggested... active studying not passive. Ask yourself q's while studying the material....and it sounds like your having difficutly honing in on what's most important with the material, your best bet right now is to understand concepts and leave the minutia for your 2-3 readings. The boards rarely test regurgitable facts, at least on my exam is was mostly on micro, pharm, and biochem... the rest is all about being able to apply previously learned concepts. Also be sure to review previously learned material constantly... you won't retain much by reading it once, you'll most likely forget it 2 weeks into your studies, so reviewing is massively important for this exam... and that's where FA comes into play.
    If you have any specific q's, please don't hesitate to ask, everyone on this forum is extremely helpful and supportive, we're all in the same boat so we're here to help.

    Best of luck.

    D
     
  9. laxman310

    laxman310 TheManWithAPlan
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    I agree that covering physiology is helpful, along with basic immuno, before trying to cover pathology.
    Knowing immunology will help with things like cell injury, inflammation, which is fundamental for understanding. (I.e. knowing which cytokines do what, what cell types are involved in acute vs. chronic inflammation, etc.)
    Physiology will be helpful when you cover organ systems, especially endocrine, renal, cardio, and pulmonology. Knowing phys isnt quite as helpful for neuro, musc/skel, heme/onc.

    As for Robbins, the OP stated he has been taking MONTHS to study. 10 days is not going to teach him pathology. Robbins BASIC path (I.e. middle robbins) is about 800 pages, and at 40 pages/day with questions, should take him less than a month, and its a straightforward routine for active learning, requiring only 2 books which probably covers 50-60% of the test.
     

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