Step 1: Heme-onc, anatomy, + embryo

[H Y F R]

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Hey gang,

Almost done with MS2 and I've been working in board review this whole year. I generally feel like I can crush step 1, but I have a couple of really really really weak areas: heme-onc (learned nothing in that class), anatomy (if I could take all of anatomy over again now I would kill it), and embryo (really, who likes embryo??)... I'm wondering how high-yield these subjects are, and which resources I should stick to in order to get high-yield info, while not getting too heavy, as I don't expect my points to be coming from these subjects anyways... Anyone who can share some views would be very much appreciated!

 

[DermViser]

Hey gang,

Almost done with MS2 and I've been working in board review this whole year. I generally feel like I can crush step 1, but I have a couple of really really really weak areas: heme-onc (learned nothing in that class), anatomy (if I could take all of anatomy over again now I would kill it), and embryo (really, who likes embryo??)... I'm wondering how high-yield these subjects are, and which resources I should stick to in order to get high-yield info, while not getting too heavy, as I don't expect my points to be coming from these subjects anyways... Anyone who can share some views would be very much appreciated!

Depends, what is your score goal?

 

[H Y F R]

Depends, what is your score goal?

Our dean projects me at 240-250

 

[username456789]

Our dean projects me at 240-250

But is that your goal?

Heme/onc can be rather high yield. Expect plenty of photos of peripheral smears, as well.

Anatomy was surprisingly over-represented the year I took Step I, and much of SDN was in an uproar about that.

 

[H Y F R]

But is that your goal?

Heme/onc can be rather high yield. Expect plenty of photos of peripheral smears, as well.

Anatomy was surprisingly over-represented the year I took Step I, and much of SDN was in an uproar about that.

Well, I'd like to reach that score range. If Linda Costanzo (yes, that Linda Costanzo) is using my performance to project that score, then I hope to meet that challenge. I think it's completely doable, with the obvious concern for these areas I have listed.

 

[username456789]

Well, I'd like to reach that score range. If Linda Costanzo (yes, that Linda Costanzo) is using my performance to project that score, then I hope to meet that challenge. I think it's completely doable, with the obvious concern for these areas I have listed.

I have no idea how well she has done in the past predicting VCU students' board scores.

I'm asking, because in aiming for around/just under 240 the approach will likely differ from someone aiming for a 250+.

 

[H Y F R]

I have no idea how well she has done in the past predicting VCU students' board scores.

I'm asking, because in aiming for around/just under 240 the approach will likely differ from someone aiming for a 250+.

Understandable- she has an excellent track record here. So for the purposes of this discussion, let's assume she is mostly correct...

How do you think the approach may differ from a 240+ to a 250+? Can I hit the 240+ with these weaknesses, given your experience?

 

[DermViser]

Well, I'd like to reach that score range. If Linda Costanzo (yes, that Linda Costanzo) is using my performance to project that score, then I hope to meet that challenge. I think it's completely doable, with the obvious concern for these areas I have listed.

Well if your goal is to hit the 240-250 range, then yes, you will need to know Gross anatomy/Embryo and Heme-Onc. Heme-Onc is definitely a highly yield organ system on the boards. Have you taken an NBME self-assessment?

 

[H Y F R]

Well if your goal is to hit the 240-250 range, then yes, you will need to know Gross anatomy/Embryo and Heme-Onc. Heme-Onc is definitely a highly yield organ system on the boards. Have you taken an NBME self-assessment?

Cheers- I guessed of the 3 that heme-onc will require some extra time.. No NBME yet, but I'm scheduled to take my 1st in about 10 days.

 

[DermViser]

But is that your goal?

Heme/onc can be rather high yield. Expect plenty of photos of peripheral smears, as well.

Anatomy was surprisingly over-represented the year I took Step I, and much of SDN was in an uproar about that.

Seems like overall it's getting harder and harder
--more testing of anatomy
--addition of cardiac heart sound of murmurs
--conversion of more and more non-clinical vignette questions which were gimmes to clinical vignettes

 

[H Y F R]

Given this, which resource is the best for anatomy? I have high yield anatomy, and although it's more straight forward than the cr*p thrown at us during anatomy, it's still really heavy. Should this resource be #1, or is FA money?

 

[Flamen04]

FA definitely does not cover all the anatomy tested lol.. only the highest yield points

 

[DermViser]

Given this, which resource is the best for anatomy? I have high yield anatomy, and although it's more straight forward than the cr*p thrown at us during anatomy, it's still really heavy. Should this resource be #1, or is FA money?

First Aid is a good brain recall tool. It's not a good way to learn information, esp. if you're weak in a subject. Hence why it's supposed to be used along with your coursework. High Yield Gross is probably your best option. Some people thought Rapid Review Gross Anatomy, instead was good. Flip thru both and see which one you can easily read.

I also got this from the library as a good way to test myself, as Anatomy was my weakest subject (due to having to know 6 other subjects) :
http://www.amazon.com/Anatomy-Review-USMLE-Third-Edition/dp/1888308176/ref=sr_1_fkmr1_1?ie=UTF8&qid=1397397492&sr=8-1-fkmr1&keywords=Gross ANatomy USMLE Step 1 kurt johnson

 

[H Y F R]

You guys are awesome!!!

I really appreciate all the insight and advice. It's a daunting exam, but like everything else in medschool, if you approach it the right way one will be just fine. I wish you all much success in your future endeavors!

 

[username456789]

I'm honestly not sure what resource would be idea for Step I anatomy. Anatomy was probably my strongest subject of medical school and I didn't do much beyond First Aid review for it.

For Heme/Onc, I had mostly used Goljan's RR Path for much of 2nd year, and found that to be a very helpful resource in combination with the Goljan audio. Specifically, leukemias/lymphomas were poorly taught in my medical school. Anemia and such was done well, but Goljan makes even that 10 times more understandable.

 

[Smokemont]

Pathoma is awesome for heme. He does RBC and WBC in separate sections and his organization is great.

 

[H Y F R]

I'm honestly not sure what resource would be idea for Step I anatomy. Anatomy was probably my strongest subject of medical school and I didn't do much beyond First Aid review for it.

For Heme/Onc, I had mostly used Goljan's RR Path for much of 2nd year, and found that to be a very helpful resource in combination with the Goljan audio. Specifically, leukemias/lymphomas were poorly taught in my medical school. Anemia and such was done well, but Goljan makes even that 10 times more understandable.

No surprise here- leukemia and lymphoma was garbage at our school too. You'd think medschools would take the time to teach such a critical topic much better. I love Goljan- he's been my syllabus all year, with pathoma being my quick review guide. I honestly feel all schools should dump syllabi and instead use Goljan.

 

[DermViser]

No surprise here- leukemia and lymphoma was garbage at our school too. You'd think medschools would take the time to teach such a critical topic much better. I love Goljan- he's been my syllabus all year, with pathoma being my quick review guide. I honestly feel all schools should dump syllabi and instead use Goljan.

Yes, the lymphomas and leukemias can get pretty crazy. I used Goljan as well along with his audio. The man is brilliant. The guy is a master at thinking the way the NBME writes USMLE Step 1 questions:
.

 

[Cytarabine]

Heme is one of pathomas strongest sections imo (and i think highly of every section in it). Anatomy is such a broad topic, I'd focus on mastering the high yield aid and let them take the points on the random anatomy. Can certainly score in your target range doing so

 

[Psai]

I agree with everyone here saying that goljan and pathoma did a great job with heme. I don't get how medical school professors can make the topic so complex and difficult to understand. It feels like they are throwing a ton of information at us without any organization or method of thinking about these diseases.

 

[H Y F R]

Heme is one of pathomas strongest sections imo (and i think highly of every section in it). Anatomy is such a broad topic, I'd focus on mastering the high yield aid and let them take the points on the random anatomy. Can certainly score in your target range doing so

Cheers! I thought Pathoma was solid for heme-onc too, and I'll use it as my go-to-guide for that subject. I'm totally good with spotting them the point in anatomy. And I appreciate your input!

 

[H Y F R]

I agree with everyone here saying that goljan and pathoma did a great job with heme. I don't get how medical school professors can make the topic so complex and difficult to understand. It feels like they are throwing a ton of information at us without any organization or method of thinking about these diseases.

Some professors have a remarkable ability to take what should be a fantastic subject and instead turning it into one of the worst educational experiences ever. Sad, but true.

 

[Flamen04]

Guess I should give my school more credit then... Our heme block was so good I've barely had to study heme when doing questions lol

 

[GangaMaster]

Jesus Dr. Costanzo is at your school? Your physiology class must be one of the best ever.

 

[DermViser]

Well, I'd like to reach that score range. If Linda Costanzo (yes, that Linda Costanzo) is using my performance to project that score, then I hope to meet that challenge. I think it's completely doable, with the obvious concern for these areas I have listed.

You lucky son-of-a-gun, having the esteemed Linda Costanzo to advise you! She's probably a better resource for Step 1 than all of us combined, considering no other Physiology review book for Step 1 on the market can compete against hers.

 

[Anastomoses]

You lucky son-of-a-gun, having the esteemed Linda Costanzo to advise you! She's probably a better resource for Step 1 than all of us combined, considering no other Physiology review book for Step 1 on the market can compete against hers.

What bout those with Dr. Sattar?

 

[DermViser]

What bout those with Dr. Sattar?

Them too. It's just that Linda Costanzo has been doing USMLE Step 1 prep for decades. Pathoma is quite a recent development in board prep (before it was Goljan).

 

[DermViser]

No surprise here- leukemia and lymphoma was garbage at our school too. You'd think medschools would take the time to teach such a critical topic much better. I love Goljan- he's been my syllabus all year, with pathoma being my quick review guide. I honestly feel all schools should dump syllabi and instead use Goljan.

And now you know why most top tier med schools have changed to P/F grading in the first 2 years.

 

[H Y F R]

You lucky son-of-a-gun, having the esteemed Linda Costanzo to advise you! She's probably a better resource for Step 1 than all of us combined, considering no other Physiology review book for Step 1 on the market can compete against hers.

Cheers! Unfortunately she doesn't teach all of the physiology anymore, but we get her for a considerable amount in M1/M2 renal, pulmonary, and diuretics. Honestly, that woman is amazing at teaching, but also predicting and stratifying student performances on step 1. I had my board prep meeting with her, and she outright tells me not to spend more than 1 day for all of anatomy and embryo, telling me I will more than make up for those subjects by killing the rest of it. She also predicted my NBME #12 score before I took it a few days ago, and she was dead-on --> passed with a 209 converted score. I'm taking her plan for me and I'll follow it to a T.
Sattar is a certifiable G as well, and I love his chalktalk.

 

[operaman]

Agree with above about pathoma and goljan -- both fantastic and should have you set to crush the heme/onc stuff. Listen/watch as many times as it takes and you'll eventually start to get the hang of it. Through it all, try to make sure you understand the underlying mechanisms behind things. Heme/onc is a great place for them to integrate cell/molecular bio, pharm(chemo), path(smears), etc. Don't just memorize things like tumor markers, understand WHY they are elevated and why they are/are not elevated in other conditions.

Anatomy is a hard thing to review because it covers such a vast area compared to the number of questions that directly test it. If I were you, I would probably use something like BRS Anatomy and take all the practice questions at the end of each chapter BEFORE reviewing. Use that to see where your weaknesses are and then review those. Chances are you'll remember more than you think. I had some anatomy on mine but I don't remember them being all that bad; probably only missed 1 or 2 based on my score report. Here too, look for ways to integrate various subject areas in a clinically relevant way because that's what they're doing most of the time. It's easy to imagine how a neuro question can ask you to pick the correct nerve/pathway/etc based on symptoms. Injury questions are classic for a reason. Easy to test cardiac anatomy with MI questions, can incorporate an EKG, etc. It would be totally fair game to show you an abnormal EKG and tell me which vessel is most likely occluded. They always love fetal circulation (now we're bringing in embryo). The point is that there are lots of opportunities to review anatomy as you review other material if you're attuned to the different ways a question can be asked.

Embryo was pretty low yield for mine. Know the big stuff and you'll be fine. Primitive heart, derivatives of all structures, pharyngeal arches/clefts/pouches, etc. Again all that stuff can easily tie in with clinical findings.

 

[JoshSt]

OP:

Heme/Onc -- FA
Embryo -- nothing/FA
Anatomy -- Moore's blue boxes and/or BRS blue boxes; review some neuroanatomy however you were taught it (focus the most on neuro anatomy); the NBME practice tests were the highest yield for anatomy on my test, prob got me 5 to 6 Q's right of my ~20 anatomy questions

Everyone's test is different, I was mega-freaking out about heme/onc and didn't have 1 pure leukemia/lymphoma/anemia question on my test. Whatever I had in heme/onc was really easy

 

[synecdoche]

Anatomy -- Moore's blue boxes

that's great to hear, my anatomy prof loves to test those things. anatomy is still relatively low yield for boards though, right? just getting slightly less low yield?

 

[Cytarabine]

Agree with above about pathoma and goljan -- both fantastic and should have you set to crush the heme/onc stuff. Listen/watch as many times as it takes and you'll eventually start to get the hang of it. Through it all, try to make sure you understand the underlying mechanisms behind things. Heme/onc is a great place for them to integrate cell/molecular bio, pharm(chemo), path(smears), etc. Don't just memorize things like tumor markers, understand WHY they are elevated and why they are/are not elevated in other conditions.

Anatomy is a hard thing to review because it covers such a vast area compared to the number of questions that directly test it. If I were you, I would probably use something like BRS Anatomy and take all the practice questions at the end of each chapter BEFORE reviewing. Use that to see where your weaknesses are and then review those. Chances are you'll remember more than you think. I had some anatomy on mine but I don't remember them being all that bad; probably only missed 1 or 2 based on my score report. Here too, look for ways to integrate various subject areas in a clinically relevant way because that's what they're doing most of the time. It's easy to imagine how a neuro question can ask you to pick the correct nerve/pathway/etc based on symptoms. Injury questions are classic for a reason. Easy to test cardiac anatomy with MI questions, can incorporate an EKG, etc. It would be totally fair game to show you an abnormal EKG and tell me which vessel is most likely occluded. They always love fetal circulation (now we're bringing in embryo). The point is that there are lots of opportunities to review anatomy as you review other material if you're attuned to the different ways a question can be asked.

Embryo was pretty low yield for mine. Know the big stuff and you'll be fine. Primitive heart, derivatives of all structures, pharyngeal arches/clefts/pouches, etc. Again all that stuff can easily tie in with clinical findings.

How did you end up doing on step out of curiosity, if you don't mind my asking? I remember reading your posts when you were studying - always thoughtful and great insight into test taking strategy

 

[AnonymousD.O.]

Have a question here and I think someone on here can answer it. I am a first year student and I have spent about an hour or so trying to figure out what the NBME tests are. My school has said NOTHING about them? Is this something that you just go on their website and pay for. They are organ system based questions right? can somebody please give me a quick explanation. Yes I know there are other threads, they are convoluted with other things

HFYR if you are that aware of your goals and weaknesses, I bet you do excellent, that is half the battle I think for any test

 

[DermViser]

Have a question here and I think someone on here can answer it. I am a first year student and I have spent about an hour or so trying to figure out what the NBME tests are. My school has said NOTHING about them? Is this something that you just go on their website and pay for. They are organ system based questions right? can somebody please give me a quick explanation. Yes I know there are other threads, they are convoluted with other things

HFYR if you are that aware of your goals and weaknesses, I bet you do excellent, that is half the battle I think for any test

https://nsas.nbme.org/home

 

[notbobtrustme]

Them too. It's just that Linda Costanzo has been doing USMLE Step 1 prep for decades. Pathoma is quite a recent development in board prep (before it was Goljan).

just took the pathology shelf today. >70% of the questions were answered directly in his lectures and the remaining 30% could be gotten based on the concepts he provided.

 

[DermViser]

just took the pathology shelf today. >70% of the questions were answered directly in his lectures and the remaining 30% could be gotten based on the concepts he provided.

Nice! The shelf in Path can be quite hard.