It was tough but at the same time I thought it was doable if I had like 80 min per block. Almost EVERY TEST IS DIFFERENT!!! I went in to the test with the advice of upper classmen, whom all said watch your time, do the ones you know first (this really helped for me but may not help others so practice each method on qbank and see how you do), and expect to see about 5-7 ?s of things you have never heard of.
In general my test emphasized the 4 Ps (Pharm, Physiology, Pathology, Patho/Phys) as do most peoples test. The Phys and Patho/Phys was heavy in Cardio (Cardiac Vascular function curve, cardiac cycle, MI complications, evolution of MI, enzymes, etc
) and Pulm (Spirometer, even one question on helium dilutional method for measuring TLC). Lots of graphs and tables and experiments you have never heard of but can figure out. The Path was all over the place and covered almost every organ system.
I had a lot of pharm questions about autonomic drugs (just like in qbank where they give you drug X and a graph, drug Y and a graph, and then drug X and drug Y). Probably had like 8-10 questions on autonomic drugs. Few questions on Neuro drugs, mostly side effects and MOA (Love the depressed cheese eating guy who suddenly gets HTN). Know your side effects of Cancer drugs and immunosuppressants, had a few of those. Antimicrobials are important usually MOA, side effects, which to avoid for a girl whose knocked up (Im terrible).
Now for the rest of the subjects I just thought I would go thorough each section briefly and tell you what I thought about each one
Behavioral Science
Had a lot of what would you do next, say next, or advise this patient type of questions, at least 10. Some were tough and I usually could narrow them down to at least 2 and just picked one (this was a general theme on my test for the harder questions, narrow it down to 2 choices and then pick). Had a few on the Bell shaped curve so make sure you know where each Standard deviation is and what percentage of people fall in that population (i.e. 1 SD = 68%). Know your table and all the sensitivity, specificity PPV, NPV, odds ratio, relative risk, prevalence, etc
all that crap! Those NBME practice tests always had a developmental milestone question and the real thing did too! Had one ? on ego defenses. I thought this section was about straight memorizing the info because they just asked me to regurgitate it on the test.
Biochem
One word for my test: VITAMINS!!! Know this **** cold, Goljan does a good job I like him. Enzyme Kinectis pretty easy. Know your Collagen synthesis. Believe it or not I had stain question about Vimentin. I actually didnt have a lot of metabolic stuff on my test besides def in vitamins or cofactors and what substance would accumulate because of that deficiency. Like Goljan says know your rate limiting enzymes for metabolism. One Lysosomal storage disease question. I had a few questions on dyslipidemias and I wish I went over that a little more. Know your heme synthesis. This section again was memorizing information and just spitting it out, only a few ?s required actually thinking. Know your fu%&^# vitamins!!
Cell Biology/Molecular biology
Thank god I took 2 semesters of biochem in college. As some people have mentioned earlier this is being tested on quite frequently. I did buy that HY book everyone was talking about but I flipped through about the first 7 chapters when I had extra time. I had at least 7 questions in this subject. Really random but not well covered in First Aid for sure!! Lots of logical thinking here.
Embryology
Lets see, I looked at it twice throughout my studying and the second time was about 4 days before the test and im so glad I did. Just memorize and spit that info out when they ask it, nothing else.
Micro/Immuno
This subject is very very long!! Stupid Micro. Anyway, I had some really picky questions from this subject especially the micro part but on my exam I probably got like a total of 8 questions for my entire *#!#%$% exam, and I studied it so hard. I used made ridiculously simple because they had stuff in there that wasnt in First Aid. Know your Immunodef. Know your cytokines. I got a question about cell surface proteins (pg 186). Heard a lot of different things from people in my class so my advice is to know this section because of the volume of info they can ask maybe a lot or a little. Stupid Micro!
Organ system questions are my test were divided into either really really straight forward if you know your stuff from First Aid to somewhat difficult that would expand on a topic in First Aid but not found in First Aid (Get my drift).
Endocrine
I know of at least 6 other people that got an EM picture of the adrenal and they just flat out asked what is made here or consequences of destroying this area or what could you give to increase production in this area. Regulation pathways are very important they always ask this, had at least 7 questions!! For example a person with pseudohypoparathyroidism would have which of the following values for PTH, Ca, P, etc
and they would give you a bunch of up and down arrows. This could be done with lots of diseases so know it! The pathology wasnt bad, most giving you a characteristic and you pick out the disease or what drug to give. Know how to distinguish central DI from nephrogenic DI.
GI
Almost all Pathology for me. Relatively simple if you know BRS Path and First Aid. Had the most pictures in this organ system. Know risk factors for getting certain diseases (i.e. pickled foods in East Asia can predispose you to stomach cancer). Qbank does a good job with gallstones. Again mostly path and not that bad if you know your stuff
Heme/Onc
Stupid Heme/Onc. Didnt have that many questions on this subject, which was good for me b/c it was my weakest. Anyway, I had 1 peripheral smear question and you had to identify the disease (mine was hereditary spherocytosis). Know the description of an apoptotic cell. The diseases associated with neoplasms came up a few times (pg 294). I had like 3 tuberous scelerosis questions. Know your oncogenes and tumor suppressor genes and what disease they cause or are associated with. Paraneoplastic effects was straight forward. Everything else was straight forward ( anemias, thalassemia, bleeding disorders). No questions on hodkins or non-hodkins for me. Goljan was right about the leukemias you can practically get the answer by age. Again the drugs were mostly side effects of caner drugs and immunosuppressives for me.
Dont remember much about Musculoskeletal
Neuro/Psychiatry
Know your pics for this subject. They will give you a description of a disease which is really obvious but they will ask you to point out which structure on the brain is screwed up. I went through the Neuroanatomy review in Webpath like a few days before my exam, it payed off!! The rest of my neuro was a crap shoot; tested a bunch of randomw stuff found in First Aid or HY NeuroAnatomy. Know the anesthetic stuff had a few questions.
Renal
For me it was heavy mostly in physiology and drugs and a little on path. Most of the physiology I know was covered 2nd year but wasnt covered well in the review books. Drugs were MOA and Side effects
Reproductive
Mostly path for me and first aid was good for this in my opinion. Didnt have much on breast diseases, which I was thankful for.
Things to take home with you.
Every test is different so just b/c I said it was on there doesnt mean you should go out and study it nine times before your test. My best advice for studying (like everyone else has said in the past) is to do well your first two years in med school. I cant emphasize that enough!! I would be taking the test and there were questions that were not covered in any review book but the only reason I knew the answer is b/c it was emphasized in class. I used First Aid during class for Cardio/Resp, GI, and Renal. I got lazy and didnt do it for the rest but I recommend that you do.
So at the start of my 2nd semester of 2nd year I read through First Aid once for the entire month of January. In February I went through the micro charts in Ridiculously simple ( I recommend going through the pharm in first aid too b/c I had lots of free time, wish I had done it). Starting doing 50 random qbank timed questions in the middle of March. Before that I would do about 20 random just to get a feel for it and worked my way up. Once March started I pretty much read through BRS phys, then BRS Path, and then First Aid. Before my test in June I went through the BRS series twice and First Aid 3 times. I went through Goljan audio one time and I liked it! Other books I used for reference but didnt read all the way through were HY Neuroanatomy, HY Beh Science, HY Anatomy ( does a great job of integrating path and really good for arm and leg stuff), HY cell/molecular biology (1st seven chapters, but should have read all of it). I took NBME forms 1 and 2 and at my school we had 2 other tests (CBSE) made from the same guys that we took at end of March and April.
It was a tough experience and I recommend studying with people so you can keep your sanity. I just studied with people in the room who wouldnt distract me or talk to much but at the same time were there to ask me ? and for me to ask them ?. It helps keep the material fresh. I knew I needed a lot of time to study because im not very good at standardized tests and I really wanted to do well on Step one. Tommorrow is my first day of psychiatry so im still chillin. Hope this helps and isnt too *$&#^@! Long. If you have any more questions just PM me. Gluck! Ill keep you posted with all those numbers from my practice tests and the real thing.
