Step 1 in September - what should I do?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

neveryoumindthere

New Member
7+ Year Member
Joined
Aug 4, 2014
Messages
8
Reaction score
1
I'm a long time reader of SDN and have been reading the Step 1 threads and the varied experiences so I have a good general idea of things. But almost two months into my dedicated I'm struggling and I need some advice.

I started dedicated study in mid June with no prior prep other than a bit of Pathoma and Firecracker, which I found too much to keep up with through the year. By late July I did two passes of FA and Pathoma - reading a chapter of FA first and then doing the corresponding Pathoma videos after, annotating into FA as I needed. I followed with a block or two of USMLERx questions on the same organ system in tutor mode, reviewing what I got wrong and then rereading that in FA and Pathoma if I needed more understanding. I also did flashcards for some of pharma to help me there but admitedly don't go over them like a should so that is a weakness.

I was averaging about 40-50% in USMLERx. Not great but thought I could pull it up over time. I took NBME7 in late July and failed it. That freaked me out a bit so I tried to regroup and start another pass but then realized I'd only finished half of Rx and hadn't started UWorld. So I decided to pause on Rx and started UWorld last week. But I'm finding myself scoring a 38% average. 🙁 With just under 5 weeks until my test I'm not sure what to do. I set my goal score of 240 and was so confident at the beginning of my dedicated that I could work hard and make that happen but now I am seriously worried. When I look at the questions I get wrong I often kick myself because most of the time I knew the answer. If I had just thought more carefully or critically I would have gotten it. I have found that is one of my biggest issues. I also seem to work through questions too quickly so I recognize that I often jump to an answer without reading the question really well and considering all the options. But then again there are a good number of questions that I really just don't know the answer.

I'm wondering if I should do UWorld in tutor mode and just look things up as I do the questions, using UWorld as a study tool rather than a knowledge check measure. But I worry that would not be the best use of UWorld.

With just a month left is there any hope I can turn things around? I could delay my test but it will be hard to do clinical rotations and have dedicated study time for this. Any advice for me?
 
I'm wondering if I should do UWorld in tutor mode and just look things up as I do the questions, using UWorld as a study tool rather than a knowledge check measure. But I worry that would not be the best use of UWorld.

You should ONLY use Uworld as a study/learning tool. Reading, Annotating things into FA and looking things up that you don't understand/got wrong in uworld will take you a loooong way. You will see a huge rise in your scores and you will most likely pass your next NBME. FA can be daunting to just read verbatim. Unless you were a rockstar in the first 2 yrs and have a pretty good grasp on everything, then it could come a lil more natural, but even then there are still so many random tid/bits in that book that need clarifying and you can only find that in uworld explanations and wikipedia.

What helped me was i used DIT to go through FA for my first pass. Someone first told me about this and i was like yeah right some guy reading me FA forget it! but i was wrong. It's more than that. I think if you have trouble grasping FA (which it seems like you do) then DIT is the best way to get you through FA and give you a basic feel for the subject matter.

I would start subject wise doing DIT with first aid, after you finish the corresponding subject lets say cardio, i'd watch all the cardio videos for pathoma, then i would do all the uworld questions in cardio. Make sure you do q's in untimed tutor mode by subject, reading all the explanations and really understanding why you got a question wrong or right for that matter. There are a lot of explanations in Uworld that really bring the random **** in FA alive. Honestly, that was the game changer for me, and i saw a huge peak in my NBME scores after i followed this method.

side note: not sure if you are the annotating type, but, I would recommend annotating whatever you see in uworld that is not in fa into your FA. Yes, its painstaking, but it will really help you. I would also do this for pathoma, because there are alot of things Dr.satter says that will help.

I'd do this until your done going through all of uworld, FA, and pathoma. Then take an NBME and see where your at. The only thing is, this is going to take some time. I'd say a good 1.5 to 2 months if you go at it 8-10 hours a day. If you are determined you can find a way to do it and finish it all in 1.5 mos. If you want a chance at a good score (240) then i would give yourself some time and really try to learn those 3 resources in and out.

Some people are against it, but i'd also recommend doing uworld a 2nd time if you have time or maybe just doing your marked and wrong questions in timed random mode. Again, by reading the explanations and taking notes on stuff you missed on the first pass. If you still have time after this i would venture into usmlerx and kaplan. The More questions the better.

Hang in there man. I was in your place a while ago it's been a journey and i take my exam in a couple weeks and i'm finally starting to feel confident. you'll get there keep working hard!
 
The most efficient way to study for USMLE is to do Questions and then read/watch videos about the topics you don't fully understand.

http://usmlethought.com/Question_answering_steps.html

http://usmlethought.com/Newest_Article.html

Great articles. I definitely need to be more careful in my approach to answering questions. Thanks!

EazyE1907, thanks for sharing your experience and suggestions. I'm an average student so yeah, I probably need to get more comfortable with FA. I haven't had a lot of trouble with things as I read AF and listen to Sattar. It all clicks in my mind. It's just putting the pieces together as a whole, I guess. I forget details that help distinguish one condition from another, or the characteristics of organisms, or the fine details of immuno, or which gene is responsible for which cancer or genetic conditon. Plus, biochem pathways make me dizzy. That's the sort of stuff that gets me in questions.

Did you do an NBME before and after adding DIT and find a big jump in your score? $825 is a lot to spend. 😵 I wish they offered shorter term access for a lower price.

Anyone else think DIT is what I need? Would love to hear some more yeas or nays before I spend that kinda cash.
 
I think my problem is a mix of integration and forgetting things or mixing them up.

You make a really good point here:

This is exactly the mistake many people make i.e. they think that they need to to prepare well before start doing QBanks. The psychological basis behind this reasoning is that they don't want to come out of their "Comfort zone". They are comfortable reading books (inefficient/passive learning) and afraid of doing QBanks (efficient/active learning) for the fear of getting questions wrong.
I also had the same approach initially but realized that sooner or later I have to face the beast and the fear of getting questions wrong on QBank is not going to help me on the real deal. I'll rather get the questions wrong on a QBank and do something about it then get them wrong on the real test where nothing can be done.
Once I got a question wrong, I used every available resource (FA, Kaplan lecture notes/Videos, Medscape, Wikipedia, Review books, Textbooks, Articles) to understand the concept even if it took me an entire day.
As Chessmaster3000 said getting questions wrong is part of the learning process.

Bottomline: You can either get questions wrong on the QBank or on the real test. Which one do you prefer!

So, if I approach it this way and work on UWorld as you suggest, I can get a good idea of how well this is helping me by the end of August. And with that I can decide on proceeding with my test in September or rescheduling. Does that seem reasonable?
 
Seems like a good plan.
When you are doing questions, look at all the answer choices and think how are they different from the right answer IOW what makes them the wrong answer. Also, look at the key point in the question stem for the given answer and try changing it for all the other choices to make them the right answer. This will reinforce your concepts on all those five topics.

Remember, we have all been there. It's all part of the process. If I could do it you will too.
Good luck.
 
Last edited:
Top