Step 1 unprepared

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Story time. I have step 1 scheduled in a month, and I feel very unprepared. I was a fairly sub-par student in the first two years of medical school. I passed everything but floated on by. (School was pass/fail). As a chronic procrastinator with then undiagnosed anxiety issues, first and second year were pretty bad. The week before each exam would turn into hyper cram mode where I'd be stress-vomitting and feeling awful. I'd know enough to pass the tests, but everything was crammed in short term memory. I feel like a complete idiot for my lack of foresight about studying for the short-term.

After reading this, I was going to suggest that you take a year off to get your issues under control and prepare for step 1, but....

After second year ended and we started studying for step 1 I finally sought help and started meds. I decided to take medical leave between second and third year, and have been studying on-and-off for step 1 since. It's been a couple months of undisciplined studying. I now realize I don't remember anything from when I started studying since it was way back in April. I have a research opportunity set up for October through April/ May. Step 1 is scheduled for the end of September. I got Kaplan videos, which is amazing for people with awful backgrounds (like me), but it takes forever to go through.

My relationship with my girlfriend has suffered because of the studying/ not paying her enough attention/ freaking out about step 1. My parents, who are helping pay for med school, can't believe I needed the extra time/ am having such difficulties since I did really well at a top notch college. I failed the last NMBE I took by 2 points, and am wondering what to do. The current thought is to do tons of Kaplan Qbank questions (making sure I understand the answers), which I had been neglecting since they're so depressing. I'll take an NBME the week before, then see what's up. Any advice? My goal at this point is 225. It was 245 before I realized my horrible study mistakes.

Strengths: Cardio, GI, Resp, Immuno, renal
Weakness: Neuro, psych, repro, endocrine
Just awful: Biochem, pharm, micro

Edit: The latest possible time to do step 1 wold be the beginning of March. But- I'd have to redo all the forms with my school, talk to my parents about how I couldn't do it despite months of studying, and make things worse with my girlfriend (knowing I'll be done in Sept keeps her sane).

I'm going to be honest with you. You are at very high risk of failing step 1, by a lot. 225 is not a realistic score for what you have described. I scored less than that with 6 solid weeks of prep coming right off of classes. I thought I would fall right in my school's average score of 235 or so. The truth is, that is a very hard score to get, and the only way you can get it is with an insane amount of prep. Then why does everyone get that score? Because everyone actually does study 12 hours a day for 8 weeks solid. With 4 weeks of 12 hour days (which doesn't sound like you will be able to do), you could pass this exam by going through first aid 3 times and doing half of Uworld. But it would just be a passing score. This is an incredibly important exam. Trust me you don't want to be in my shoes trying to get into competitive residences with a middle of the road step 1 score.

Your study plan also is not good. Kaplan videos are for people who have many months to study (namely, IMGs who are already doctors in other countries and are trying to come here) and need to learn the basics. It's passive learning and you don't have time for that. Forget DIT, forget kaplan videos. You need to hit first aid and Uworld. And spend as much time focused as you can. If you need to get a prescription for ritalin to be able to sit still and focus for 10-12 hours a day, then do it. Your thought process still sounds kind of screwed up. You can't take an NBME a week before the exam to see "what's up." This reflects very poor planning.

If I were you, I would bag the research opportunity, and spend a solid 3 months studying for this exam. Not on and off studying, but 200 questions a day and a couple chapters in first aid = 10 hours. Take the exam in November/December. Forget about your parents and your girlfriend. I had a girlfriend in med school during my step 1 study prep who dragged me down and kept me from studying as much as I could have. Guess what, I didn't end up marrying her and we broke up anyway. I'd rather have a better step 1 score.
You've got a whole year off. It is insane to try and push the most important exam of your career up as far as possible. Just don't fall into the trap of pushing it back and thinking, "oh I can just study an hour today and then go to the beach with my gf, I can make it up later"
 
You can't really prepare for the exam part time. It's too much information. It starts to leak out. You need to do it full-time. Doing well on this exam is infinitely more important than your research project. Stick with UWorld as your primary study source. When you review the questions, open up the relevant section in first aid and make some notes. When you hit another question you missed on the same topic, you'll open up first aid and see your old notes and it will stick in your head when you are constantly opening to the same section. Repetition, repetition, repetition. If it doesn't hurt, you're not doing it right. A friend of mine studied for this exam by going for walks and listening to kaplan or DIT audio lectures on the iPod. I was kind of annoyed that it was so easy and enjoyable for her while the rest of us were miserably locking ourselves in our rooms doing mental bench presses trying not to rip our eyes out. Her result = failed step 1.
 
Has anyone had successful experience studying while doing research, taking a month off, then taking the exam?

I am sure someone has, but you seem to be looking for a way to halfass this exam and still do well. I'm sorry, but it's not going to happen. I was in a similar boat and had a girlfriend and other responsibilities and the only reason I didn't fail it is because I literally left town for the last two weeks after half-assing the first 6 and locked myself in a room.

Forget the research
Forget your family
Forget your girlfriend

The only way you will do well on this exam is if you give it 100% of your attention. If your goal is to simply pass and you are content with a 195, then you may be able to get away with less. But you need to have realistic expectations. I have gone through similar stuff like you and I am trying to warn you. Stop trying to find people to tell you what you want to hear and instead start studying as hard as you possibly can and put everything else in your life on the back burner until it's done. If you screw up your research opportunity, your relationship, whatever, deal with the aftermath and put the pieces back together when this test is behind you.
 
I am sure someone has, but you seem to be looking for a way to halfass this exam and still do well. I'm sorry, but it's not going to happen. I was in a similar boat and had a girlfriend and other responsibilities and the only reason I didn't fail it is because I literally left town for the last two weeks after half-assing the first 6 and locked myself in a room.

Forget the research
Forget your family
Forget your girlfriend

The only way you will do well on this exam is if you give it 100% of your attention. If your goal is to simply pass and you are content with a 195, then you may be able to get away with less. But you need to have realistic expectations. I have gone through similar stuff like you and I am trying to warn you. Stop trying to find people to tell you what you want to hear and instead start studying as hard as you possibly can and put everything else in your life on the back burner until it's done. If you screw up your research opportunity, your relationship, whatever, deal with the aftermath and put the pieces back together when this test is behind you.

👍 great advice to the OP..... listen to tha man! he speaks sense.
 
I'm glad you have a positive attitude about this. My opinion is study intensely and then when the test is over you definitely need to address your anxiety issues.
I was in a very similar situation. Every day I elected to spend all of my time studying and had to neglect my relationship. I felt horrible but sometimes you just need to prioritize. If the relationship is toxic, it may be time to get out or at least take a break anyway.
Family was definitely important for me. Lol oh my god, for some reason I remember having panic attacks every Friday night and mumbling nonsense between my tears. Mom always made me tea and calmed me down. No one knows this because I always act like an annoying, tough, hardened b though.
The point of all of this is 1. It's possible to get a good score but you have to sacrifice, 2. stay calm, and 3. it gets better.

Dr.Phil out!
 
First of all, on positive side you are insightful and honest which puts you miles ahead of the ones who lack these.
I agree with most of the advice you have been given sofar

what I can add in a telegraphic manner is:

1) Completely cut off with the gf, she will screw your mind and life.

2)Do at least 5 minutes a day of meditation and mindfullness practice

3)Dont smoke , stop drinking too much coffee, no red bull, make sure you get enough sleep

4)If you are not in mood to absorb first aid, use kaplan high yield series, basically it reads first aid to you
but make sure you use it actively while your first aid is open in front of you.

Good luck
 
In case anyone is wondering, I got my act together and scored in the 230's on the reaholy l thing. Breaking up with that gf was one of the best decisions of my life. I went through Kaplan QBank and UWorld on random/ tutor mode/ untimed. I read every explanation and wrote down QBank info into first AID. Every single time I had a pharm question I reviewed the entire class of drugs, including mechanism of action/ side effects/ how each drug in the class differs. I made sure to fully understand each question before moving on to the next, including questions answered correctly. This process took 12 hours a day for months, was incredibly demoralizing for a while, but I forced myself to just do it.

I had a 162 on my first NBME at the end of second year, so the 230 range was a dream come true.

My anxiety has gotten under control to where I felt fine the entire week before step 1, and I slept well the night before. Therapy was so helpful.

I ended up doing Kaplan videos for biochem and pharm. Those (plus heme/onc) ended up being the categories off the chart on the happy end of my score report.

The current plan is to do third year with study guns blazing.


Holy crap, that's fantastic! I'm in a similar situation figuring out what to do and I'm really glad to see your honestly inspirational success story. Great Job, and go kick the living crap out of 3rd year! BTW, perhaps take a look at firecracker, you can get 1 month for free. It's something i wholeheartedly wish I had done during the first 2 years, and it looks like it may be good for 3rd year and your new crazy successful style of active learning. Perhaps browse it.

Either way congrats again! 🙂
 
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