My Step 1 story.
227 (92)
I would first like to say that I am thankful and pleased with my score. My goal was 230, so I nearly reached it, which I am fine with. My journey was a long one. I studied a good amount in my last quarter of 2nd year and then 6 weeks in the summer. I just would like to put a disclaimer that the advice below is just my opinion. You have to see what works right for you.
My resources/opinions in order of importance:
1) Goljan Rapid Review Pathology & audio
2) First Aid
3) NBME practice exams (all four)
4) Qbank
5) Goljan Rapid Review Step 1 book (question book)
6) High Yield Series: Molecular & Cellular Biology, Gross Anatomy, Neuro
7) BRS Physiology
1) Goljan: This guy is the man. Most who use him, swear by him. I will have to attest to that. Why do I like him? Simply put, because he makes you understand medicine. He emphasizes the why mechanisms how things work, which is what medicine is all about and the boards. You have to understand that this exam is not the way most of our tests are in med school, where we just regurgitate our notes. This test wants you to integrate everything youve learned and see if you can put it together, which is what you do in real life. His book is phenomenal when accompanied with his audio lectures, where the former buy from Amazon/Barnes and the latter from eBay or get from someone you know. I really believe his book will supercede BRS path as the standard for pathology. Dont get me wrong, you can still do well on this exam with BRS path, but I think you will learn a more clinical aspect with Rapid Review Path. His audio lectures are very thorough and entertaining. I would recommend listening to the lectures throughout your second year 3-4 times and once in the last month of studying (FYI, there are almost 37 hours of audio). Concerning test day, he only directly helped me on 5-6 questions, which were almost verbatim, but most importantly he gave me the conceptual knowledge to tackle plenty of difficult questions. Lastly, if you think he helps you just for Step 1, Im in my medicine rotation right now and a lot of the questions I get pimped on from my attending (e.g. what is the significance of the Batson plexus?), I answered them correctly b/c of Goljan and leave a room full of residents and interns dumbfounded. You can imagine I got a good evaluation. Enough said, I think you get my drift on how helpful Goljan is. (Note that the second edition of his book is coming out later on this year, so you might want to wait and just buy that one, its up to you. Also, you can attain his high-yields that he mentions in his audio, online as well, however, I actually didnt find this that great of a study tool, but by the end of my studying from his book/audio, I knew most of what was in the high-yields.).
2) First Aid is pretty much the universal resource that all med students use, but not all people know how to use. You have to take First Aid as an outline that you need to expand upon. It does not really give you reasons or understanding behind its info, but its up to you to annotate from your other resources into the book and understand the why. There are also plenty of little facts that you also need to know. As much as I specify this exam is about understanding, you also need a good core of straight knowledge. First Aid accomplishes this, especially in the more fact-oriented subjects: biochemistry, micro, etc.
3) NBME practice tests: There are four of them. Buy all of them. Dont be cheap and sell yourself short. This is the best way to test yourself. The style of questions are the most similar to how representative it is to the real thing. It is best to do one early in your studying so you can see how they ask questions. On test day, I actually got about 5 questions straight from these tests, but more importantly, I wasnt psyched out by the test b/c I knew how they asked the questions, and with all the stress on test day, this preparation really calmed me.
4) Qbank: To be honest, I was disappointed in Qbank. While Im not saying you shouldnt get it, I am saying use it with caution and the right perspective. It seems to me that it tests more on minutiae (e.g. FAB classifications) than on actual thinking questions. The real exam is much more thinking based like I said earlier, while Qbank is full of fact-based questions on material that is so esoteric. I, for some reason knew a lot of this minutiae garbage and it gave me a slight sense of false security as I was doing quite well on Qbank. I have to admit that the interface of the program is quite good though. Bottom line: buy it for a month, dont do all of it, dont get discouraged if your score fluctuates as this happens to everyone, and most importantly, use it to expand your approach to answering questions.
5) Rapid Review Step 1: These are 7, 50 question tests, in written format, by Goljan. The CD has more questions, but some of them are repeated from the book, but the CD program is not great at all. I did the written questions and I thought they were very good. I have to admit though, I dont think the distribution of questions (e.g. biochem, biostats, anatomy, etc.) were split accordingly, but these questions really do make you think. If you have the time and the money, get this book to do more questions. However, if you had to choose between this book and the Rapid Review Pathology, get the Path book for sure.
6) High Yield Series: These series are pretty good. They have a book for each of the low-yield subjects that most of us hate (molecular, embryo, etc). I would get a book if you have a significant problem with one of these low yield subjects, but keep in mind, these low-yield subjects are really low-yield. You would be surprised, some people memorize all there is to know about biochem, and then it turns out they were only asked 10 questions on the whole thing, of which 7 they probably already knew from First Aid. Therefore, I would only recommend a light read, as you need to spend more time on the bigger subjects. The ones I used, which most use are: Cell/Molecular, Anatomy, Neuro.
7) BRS Physiology: As many people know, this is a very good physiology book. I liked it for physiology too, but thats just it. Step 1 does not test physiology, but pathophysiology! If there were one thing I would change in my study curriculum would be to invest in a good pathophys question book. A typical pathophys question on the exam involves hormones. They will have give you a case and then ask you the changes with arrows (up, down, or no change). This may seem easy, and I thought my pathophys was good before going in, but when they ask you about 5 perturbations and you know all of them except one, and they have every different possibility so you cant use process of elimination, this gets hard and frustrating. Bottom line: know your pathophys well and possibly invest in a book.
General comments:
1) Stick to a select few books that you like. Dont get a book for every freakin subject like most people. Its better to know a few very well.
2) Do questions to test yourself
3) Always ask yourself why. You will remember it better.
4) The journey is hard and sucks, but try to keep yourself motivated and your life balanced. In the beginning of my studying I wouldnt take days off and then by the end of each week I would feel burned out and then stop for the day. I would then feel guilty because I didnt satisfy my goal. I quickly learned then to set goals and limits. Set a time to study and a time to play. That way when you are on your break, you feel like youve earned it and will also be rested.
In closing, I feel very satisfied with my journey and test. I feel like I did the most I could do and reached my maximum potential. Just because I didnt get a 260 doesnt mean the above advice is worthless. I hope this helps many people as I have received help from many others.
