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You know, above 250 it doesn't really matter in terms of residency or whatever. And above 260 it's probably mostly an element of lucky guessing, so I wouldn't put too much weight into the score - above 260 it's essentially all the same. But for those of you who are curious, here are my random "pontifications" on preparing:
...for a description of my exam experience please see this thread:
http://forums.studentdoctor.net/showthread.php?t=291773
1) Use the NBME tests for four purposes:
a) Gauge your performance
b) Learn how they ask questions
c) Learn what level of detail is required
d) Know what concepts they like - then research every question you are unsure of.
2) Goljan is the single best source out there, bar none. His 37 hours of audio and his Rapid Review Pathology book are brilliant. Start early! There are so many nuggets in there that it will take several times through the audio and book to absorb them all. And beyond the USMLE, I noticed that when the surgery residents ask me questions, I have heard many of the answers straight out of Goljan's mouth. He may be schizophrenic or whatever, but he explains things with an incredible clarity.
3) QBank is overpriced, overrated, outdated, and actually counterproductive. About 1/3 of the QBank questions are good. The rest are a complete waste of time, requiring a level of clinicallly-irrelevant minutia that is NOT indicative of the real test.
4) For those of you who have not yet started second year, make your own notes. It's so much easier to breeze through a 20-page summary of each exam instead of trying to make your way through a binder full of powerpoint printouts. No matter what school you go to, your second-year lectures are given by clinicians and pathologists - the same people that make the USMLE questions.
5) I studied one month "pure" (no classes), but I also started studying seriously after spring break 2nd year, so I studied about 3 or 4 months "dirty" (with classes going on).
6) Review when appropriate. The day before you start cardiac pathophysiology second year, spend some time reviewing cardiac physiology from first year. If you do this for every block, you will have reviewed mostly everything except for biochem and anatomy by the time boards rolls around.
7) Have fun! Like I said before, above 250 makes no difference for residency. You should study because it's fun, because you're finally piecing things together and learning things all the way through.
THE SOURCES: (aside from Goljan, who is far above all the others)
- Robbins Review Path Questions. 1200 Outstanding questions. I did all of them except for the "final exam" at the end. I highlighted all the answers that said something important, then reread my highlights after I finished the book. Great explanations, and the questions are pretty difficult.
- First Aid. Not such the bomb that everyone says it is, but a great source nonetheless. The main problem I thought was that it told me stuff that I either knew or couldn't decipher if I didn't. Some sections have too much detail (i.e. leukemias M1 through M7, and embryology of the genital tubercle), and some sections are of course too shallow (path). Generally very good, especially behavioral, pharm, phys (short but has most of the important graphs). I didn't read this seriously until 2 weeks before the test, and in the last day of study read the entire book once over for review.
- All of Dudek's HY books (Histo, CMB, Embryology, Anatomy). Just pick and choose here. There's way more detail than you need in any of these books, but the pictures are nice and they are good to skim as a review. If I had to pick one I'd go with HY histo, which as I've posted before is really a "Sleeper" - there's a lot of juicy stuff hiding behind its unfortunate title. Don't spend more than half a day on anatomy unless you don't know what the brachial plexus is. The embryology book is good for the nice chapters on menstrual cycle, pregnancy, fertilization, and chromosomal splitting (meiosis).
- Katzung pharmacology. THE BIG ONE. No, of course, I didn't read it. But I did spend half a day reading the caption to every illustration - many on the test were very similar.
- MAKE YOUR OWN NOTES. In addition to everything above, I relearned all my own notes (which were my primary sources for Micro, Neuro, and Pharm).
- BSS (Board Simulator Series). I posted on this earlier, do a search. Outdated, so don't take it too seriously, or get offended if you score 60%. The pathophysiology questions with lots of arrows going every which way were extremely helpful.
- Kaplan biochem. This is the one thing I've seen from Kaplan that's really good. I read through all 293 pages about 3 times, but they're so good that you'll enjoy it...
Ok, that's enough for now. I'm doing my surgery rotation now, so it may take me a while to get back to you if you PM so please just post a question here if you're wondering anything or even cared to read this far....
