Sorry people, this is gonna be a long one, but I'll start with the stuff people care about.
Stats:
MCAT 34
4/28/08 NBME 1: 195
6/13/08 NBME 2: 232
9/08 Medicine Shelf 79
11/15/08 UWorld Assesment 1: 222
11/24/08 NBME 1: 228
11/28/08 NBME 2: 221
11/30/08 NBME 3: 224
12/19/08 UWorld Assesment 2: 244
UWorld Average: 74% low of 56, high of 87. Mode 72.
12/29/08: Step 1: 246
Background:
I'm a US student at an allopathic top 20 school, pass/fail. Probably in the lower 1/2 of my class the first two years. I did not learn the material well during first or second year, partly because of organization/motivation and party because I do not learn well from lectures.
First time:
So school let out in April, and we were given 7 weeks to study. I had listened to some of Goljan's lectures prior to starting studying, and read some chapters in RR path in lieu of studying the class notes.
4/28/08 NBME 1: 195
I tried following the schedule found:
http://rumorsweretrue.wordpress.com/2007/01/09/how-to-prepare-for-the-usmle-setting-a-schedule/
At the time the schedule made sense, and still think its a solid schedule if you have a decent base. I did pretty good sticking to it. Resources I used included: FA, RR Path, RR Micro, BRS Phys, Micro Cards, Pharm Cards, HY Neuro, Gray's Anatomy for Students (Pictures).
I watched some Kaplan lectures for anatomy, focused on doing questions, and tried to go through some of Goljan.
6/13/08 NBME 2: 232
I told myself that I wouldn't take the test if I didn't think I was going to get a 240. So I didn't take it. At the time people questioned my decision, but I am pretty sure I want to do something competitive, and didn't want to close doors. Whats another 6 weeks or even 6 months for a lifetime of happiness?
Interim
So I went ahead and started clinical rotations, knowing I would have to go back and address this monster. I completed medicine, OB/Gyn, and Psych. I would have to say that taking shelf exams, and seeing clinical cases probably helped me answer 2-3 questions every block. After having done psychiatry, behavioral science on the actual step was cake. It also helped with understanding some of the reproductive stuff that I always had trouble with. Drugs were also WAY easier, because I had seen them used clinically.
Second Time
Resources:
In Full:
FA, RR Path,
Levinson's Immuno,
HY Cell/Molec 99
Moderate Use:
BRS Phys, RR Path, Kaplan Biochem
Light Use:
HY Neuro, Robbin's Basic Path, Kaplan Q Book, FA Q Book
Audio: Rapid Recall, Goljan
During my Psych rotation, I read the first two chapters of Robbins BASIC Path (the 700, not 1300 page version), and did the corresponding chapters in Robbin's Review QBook. I also did Levinson's (just the immuno section, ~80 pages, which I printed for free from our school's online access) and did 1/2 of the Immuno questions in UWorld. Towards the end of my psych rotation, I reviewed chapters in BRS Psych that were relevant to both my upcoming shelf, as well as the end chapters on statistics. I then did the 1/2 the behavioral and biostats questions in UWorld. I also did some UWorld step 2 questions, in preparation for my shelf.
The psych rotation ended, and I decided to use UWorld as a shell to direct my studying.
11/15/08 UWorld Assesment 1: 222
I read through Taus' plan, and modified it some to suit my needs. I focused on understanding why, and not so much on memorizing.
1. Organ systems: In UWorld I created tests for each organ system. Specifically, on the subjects/left side I chose Phys, Path, Pathphys, and pharm, and selected the organ system on the right. I made the tests in tutor mode using up 1/2 of the questions available. (I like tutor mode for comprehension as I don't have to re-read the question to remember what it was about, like in timed blocks of 48.) I then read the chapter in BRS phys, did the end of chapter questions, read the corresponding chapters in RR path, read through the drugs in FA, and then did the UWorld questions I had created. I did this for GI, Renal, Cardio, Pulm, Endocrine, and Repro. For Neuro, Heme/Onc, Musc/Skel, and any of the other organ systems in RR that didn't have a corresponding chapter in BRS, I just read the chapters in RR Path, and did UWorld questions.
2. Subjects: I made tests in Tutor mode by subject, using half the questions available. This included, embryo, anatomy(excluding Neuro), Neuroanatomy, Micro, Biochem, and Genetics.
FA for embryo, anatomy (beginning sections of each organ system except neuro), and Micro.
FA Neuro (anatomy section) and select pages from HY Neuro for Neuro anatomy.
Kaplan's Biochem (from overview of metabolism through fat metabolism).
HY Cell/Molec (even though I didn't like it because everything seemed outdated, and they kept talking about what things "probably were" when in fact now we know. (i.e. the mechanism of huntington's disease.)
After reading a subject, I did the questions.
Somewhere during this time I did some NBMEs. The first one was ok, but then I got demoralized after the second one. The whole time I was worried about why my score wasn't going up. I also tried grading them, which took up a decent amount of time. After the 3rd one I figured I clearly didn't know enough, so my nose went to the grindstone. In a way, the anxiety it produced motivated me. not gonna lie though, it was miserable to think my score was going down. If I had to go back, I would have given myself at least 2 weeks in between NBMEs.
11/24/08 NBME 1: 228
11/28/08 NBME 2: 221
11/30/08 NBME 3: 224
3.This left me with 1/2 the question bank to use for timed random. I did 2 blocks a day, and then reviewed them.
I started on Taus' last two week plan, but actually did it over about 3 weeks, knowing I would have to take some days off for a friend visiting. I didn't get through everything as much as I would have wanted, and it was making me miserable.
Ten days before the test I took another assesment.
12/19/08 UWorld Assesment 2: 244
I finished up timed random questions, and started to repeat questions I got wrong.
Tip: UWorld has this weird thing about using the most recent wrong questions to make tests. This is annoying because you remember the answer when you really wanted to try to review the mechanism. If you make the tests as soon as you have 48 wrong questions, the questions you review will be the most distant.
I went to kinkos and made a laminated sheet, and got some dry erase markers. I practiced writing things out from memory, and whenever I didn't know it I would review it. I did this mostly for biochem, but also for drugs, diagrams etc. I'm a visual learner, so this was helpful for me, and I would reccommend it to for the last week or so when your really trying to pack it in the details.
The last 3 days was FA tagged pages, some HY Neuro pics, Goljan's Margin notes,
Goljan questions (the last 100q's in his book, which I thought were
AWESOME with excellent explanations).
Test Day:
I stayed at a hotel across the street from the test center, since it was about an hour away from my house.
I had this weird dream about taking the test in some conference room, and then having a bunch of people kick me out of the room and needing to reschedule the test. Weird.
I woke up at 5AM, and did the rapid review section in FA while having some continental breakfast. I made sure to have some protein for lasting energy, as well as avoid drinking too much. I also had a cup of coffee to give me a little pep. Reviewing the day of is a personal preference, as I like to get my brain warmed up before I start a test.
I memorized a bunch of formulas, wrote them down right when I got in the test, and ended up never using them (hah!). I also brought my FA, RR, HY Neuro, and BRS phys to the test center, also never used. (double hah!)
I did the sections two at a time, taking between 10-15 minutes between, when I ate 1/2 a sandwich, and drank some vitamin water energy. The point of these breaks was to clear my head and make sure I wouldn't be distracted by hunger pains. I knew I couldn't eat too much or I might have a food coma.
Actual Test
After writing my formulas, I paused for a moment, the put in my code. I made sure my headphones were working, then started block one. Questions were of comparable length to UWorld, maybe on average 1-2 sentences longer. Their were 10+ line questions and 2 liners. It was a mix, but most were about 3-4 lines. I was hoping it would be like that, but was prepared for questions like the medicine shelf, which would have been tough.
I read the last line of the question first, and about 1/3 of the time could come up with the answer. Somewhere in block 5 I realized if I read the last two lines of the question, I could come up with the answer 50% of the time. This is def. useful if you are a slow test taker, like I used to be =). I made sure to read the rest of the question to be sure I didn't miss something.
I saw one question verbatim from UWorld, and at least 10 that were essentially the same question with some minor variation. I marked on average 7-8 questions per block, and finished each block with about 10 minutes to spare, during which I would go over my marked questions.
In general UWorld, FA, and RR covered everything.
The one thing that surprised me was that I got a lot of pelvis anatomy. Only 2 brachial plexus questions. One or two brainstem questions. Nothing really came out of left field, but I realized my weakness was the questions that were verbal path descriptions. I got one audio/visual, which was pretty easy.
I definitely felt the UWorld beatdown makes you feel better on test day, despite feeling like crap while studying. I felt like the test was OK, fair, slightly easier than UWorld, not as tricky, etc.
Thoughts:
In class: I would have read Robbin's Basic, instead of reading Big Robbins, and would have done Robbin's QBook with. I read probably 6 or some chapters of big robbins, but am not a fast reader, and did not retain a lot of the information. For those of you who do not like dense textbooks, look into Robbins Basic Path.
First time around: I would not have done so many questions to begin with. I started with random timed, and probably would have been better off by subjects until I had a good grasp of the material.
The last week was really stressful for me. I did UWorld, and would be grateful for a 244, but wasn't sure if it was a fluke. I also didnt want to take another NBME and get knocked down. I kept reminding myself that even the high scorers feel stressed during the last week. I told myself I'd be happy with anything above a 235, and that I needed to focus on memorizing as much as possible in the last week.
Thanks
I want to thank DWade, Taus, and all the previous USMLE Step I experience posters. Reading these boards not only gave me a idea of the process, but also kept me sane by reassuring me everyone experiences the rollercoast of Step I prep.
If I think of more stuff I'll update, and I'll also update with my score. I'd be more than happy to field questions. The sooner the better, as the experience is fresh in the brain.
P.S.
So there was this other student there taking step II, and they were using the New Fredv2 software.
If you look at the USMLE.com step I 2009 orientation materials, the step I tutorial is in Fredv2 Software. There are some weird 2 step questions (i.e answer a question, and then it asks you a second in regard to the first), and more audio/video materials.
So the other girl taking the test had a Windows runtime error, and they had to pause the test. I'm glad I didn't have to use the new software.
Score Update
Score in, 243. Although I was hoping to get >250, I'm happy with my score and in no way does it restrict my opportunities.
