Dismiss Notice
SDN members see fewer ads and full resolution images. Join our non-profit community!

USMLE 1 advice needed

Discussion in 'Medical Students - MD' started by jeremiah, Mar 5, 2001.

  1. jeremiah

    jeremiah Junior Member

    Joined:
    Mar 4, 2001
    Messages:
    6
    Likes Received:
    0

    Ok, I?m just beginning my step 1 review and could use some advice. I asked some fourth years at my school just recently and they said, ?yeah, use first aid, its got everything you need to know,? and I was focused towards this and one or two other review books by basically everyone. So I picked up a copy of First Aid and thought, is this it? Because in all honesty the amount of material there is something I can knock down in 4 or 5 days, or a week max.
    So I checked out the USMLE practice questions on the CD ROM they give you, and thought, how does anyone even PASS this exam with just First Aid? To me the questions were as detail oriented as the usual med school exams, and required as much knowledge. As I made some very good summary notes during my regular coursework I?m thinking of using these as my base instead, with a little pruning and other supplementation here and there, and in no way depending on First Aid and the like. So I?m wondering, has anyone else done it like this? Since it seems that EVERYONE is so big on the review books I?d like to know why, as to me it seems like way too little! Are the CD ROM practice questions just much harder than the real thing? Thanks for the help..
     
  2. Thread continues after this sponsor message. SDN Members do not see this ad.

  3. jawurheemd

    jawurheemd xx ToXiC xx

    Joined:
    Aug 8, 1999
    Messages:
    160
    Likes Received:
    1
    First Aid is good, but it doesn't have everything in it -- definitely know everything in First Aid to do well -- the reason it's so good is because it covers most of the topics that repeatedly appear on Step I. I wouldn't use it as your only resource however. I feel that the best way to prepare is to actually do the questions -- the NMS book was pretty good as well as the Board Simulator Series -- when you do these questions, don't get too discouraged -- the questions are really hard! Also do the sample questions that came with the USMLE application -- I actually got some of the same exact questions on my Step I! Doing the questions and understanding the answers is the best way to get ready for the real thing. Of course, review all the material at some point, but don't get too bogged down -- if your class notes are what work for you -- great -- but you don't get caught up in the nitty-gritty. If you spend half a day memorizing the structure of all the amino acids, essential fatty acids, and vitamins -- you won't be studying effectively. Part of the reason that I didn't use my class notes for studying for the boards was for this very reason -- it was full of details that were low-yield for the USMLE Step I. What First Aid does is it picks out information and facts that have been tested repeatedly in previous board examinations -- that's why it's such a valuable resource. But, again, it's not the end-all be-all. Definitely use it as a supplement for your studies, and don't give up on your notes. Most importantly, make sure you leave enough time to do those questions. Hope this helps.

    -James
     
  4. jeremiah

    jeremiah Junior Member

    Joined:
    Mar 4, 2001
    Messages:
    6
    Likes Received:
    0
    Ok I hear you but if first aid can be considered to have the 500 most essential facts with the highest likelihood of showing up, you still have to consider what percentage of questions one can predict to be able to answer with those. From my brief experience with the USMLE CD I'd place the percentage of questions readily answerable with First Aid at well under 10%. To me that's pretty low yield!! From what I've learned over the past two years I'd estimate that I could answer closer to 50% of the questions. Much better! but its true that resurrecting all that is a bit of work. What I really think someone should come up with is a comprehensive review book. Something that gives ALOT of material, close to almost everything you could possible get on the USMLE, but with a very highly specific USMLE focus. Its unfortunate that the only options now are the ultrasimple review books and way too complex regular texts.

    Your post also brought up another question of mine though. I know we should be doing practice questions as a major part of reviewing but I noticed in flipping through the review books that none of them, including the NMS one, gave questions similar to the ones on the USMLE CD ROM. They were definitely different. That makes me a little hesitant to trust the review book questions as being "what I need to know" if they can't even mimic the general format! I suppose I don't have much choice though if thats all thats out there! but it would really be nice if there were more USMLE-type questions around. Maybe its just that the computer based and vignette format are still pretty new.

    Thanks really for the reply!

    [This message has been edited by jeremiah (edited 03-06-2001).]
     
  5. Djanaba

    Djanaba Senior Member

    Joined:
    May 4, 2000
    Messages:
    676
    Likes Received:
    2
    I think you may benefit from reading the intro in First Aid. It's the outline for your knowledge -- if you can explain underlying mechanisms and round out the info that's presented, you're all good. It is the backbone on top of which you add details. If you know the book, you've got half the battle, but you need to do more than that (especially if you did average or below in med school and want to do more than just pass the exam).

    As for question format, it's nice to be comfy with how questions are worded, but don't get your underwear in a bundle. If you know the info cold, it shouldn't matter how they ask the info.
     
  6. jawurheemd

    jawurheemd xx ToXiC xx

    Joined:
    Aug 8, 1999
    Messages:
    160
    Likes Received:
    1
    Jeremiah,

    I understand your concern - from my experience though, most of what I was tested on was somehow addressed in First Aid - things may have changed - I took the exam two years ago. The problem with First Aid is that it provides a framework that people will benefit from only if they understand the information that is being presented in the book and applying that information to the test itself instead of just memorizing the words. Hence the need to do practice questions resembling those that appear on the actual exam -- unfortunately, no book can mimic the exam exactly, but I felt that the Board Simulator Series did a pretty good job -- NMS not as good, but still similar -- Appleton and Lange not at all.

    I'm taking a look at the sample items right now -- true, not all the questions can be answered with knowledge from just first aid, but many can.

    Question#1 - the question basically asks for the mechanism of finasteride -- this can be found in the pharmacology section of first aid

    Question #2 - this question is basically addressing developmental milestones -- in a 10-month-old kid, stranger anxiety is the most likely answer - in the behavioral science section of first aid, it shows that stranger anxiety is develops around 7-9 months

    Question #3 - this is basically asking what drugs cause a lupus-like reaction - first you need to recognize that this person has a lupus-like reaction based on the clinical findings - this is addressed in the pathology section under systemic lupus erythematous - in fact, it even tells you here that "Drugs (procainamide, INH, hydralazine) can produce an SLE-like syndrome that is commonly reversible." If you look under hydralazine in the pharm section, it will tell you that it can cause a lupus-like reaction.

    Question #4 - First Aid can't help you here, but I was still able to get the answer right even though I haven't taken anatomy in three years.

    Question #5 - First Aid can't help you here either - it requires that you remember a little histology - I still got the answer right (I may be remember these answers from before).

    Question #6 - basically asking you what the difference between gram neg and gram pos bacteria - First Aid does a nice job at addressing this - you just need to make the intuitive assmumption that the outer membrane is what in fact confers the resistance gram neg bacteria possess against penicillin

    Question #7 - simple epidemiology question that doesn't require any real knowledge - you just need to be able to interpret the figure and realize that you want to catch all incidents of this particular disease, and to pick the point at which this will happen while giving you the lowest number of false positives.

    Question #8 - the menstrual cycle is nicely illustrated in first aid - you will realize from this diagram that ovulation occurs shortly after the LH and estradiol peaks.


    I could go on, but I think my point is made - a lot, but not all of the information that the USMLE tests on is addressed in First Aid. If you know all of the content of First Aid and then are able to apply that information to these questions, then you'll be on the right track. The trick is to practice applying this information - that's where the practice questions come in.

    I know that you're looking for an all-encompassing review book. They are out there. If this is what you are looking for, I know that Kaplan has a set of books that will accomplish this. I got a set of these books as a perk for teaching Kaplan MCATs. They were very comprehensive and written pretty well - I just didn't have the time to read through all of the books. In the end, I don't know how much more I would have benefitted had I gone through those books. If you have about 6 months to study intensely, perhaps these books would be good. Be sure to leave at least 1 month for doing practice questions though - it takes a long time to go through all the questions (Board Simulator Series and NMS) and understand all of the answers.

    I hope this helps. It seems like a long time since I took this test, but I remember it was a pretty stressful event. Just think, I was also in the middle of planning for my wedding which took place 11 days after I took Step 1. The test didn't really live up to all the hype, but it is kind of nice when you take away a good score.

    Good luck with your studies.

    -James
     
  7. jeremiah

    jeremiah Junior Member

    Joined:
    Mar 4, 2001
    Messages:
    6
    Likes Received:
    0

    Thanks for the input and I think we?re on close to same the page now. I still think from my experience with the CD though that I?m missing questions for no other reason than that I?ve simply never seen the material before. I have no magic powers, no clairvoyance-- unfortunately! So I?ll use the review books but also try to expand my knowledge base.

    A final question if you have the time.. how accurately would you say the practice test mimiced the real thing? From my experience with the CD I?m considering tossing my biochem and embryology notes down a deep well. They were non-represented except where directly clinically relevant. Biostats and psych? Give me a break! I think reviewing any of that would be simply counter productive. Did the real thing represent these to any greater degree? It seemed cell biology and non-clinical micro were pretty well represented though.
    Much thanks!
     
  8. jawurheemd

    jawurheemd xx ToXiC xx

    Joined:
    Aug 8, 1999
    Messages:
    160
    Likes Received:
    1
    Oh geez -- it's been a while since my exam -- a review of everything is important -- I felt that the sample items were the most representative of the actual exam. I think the most tested topics on the exam seemed to be pathology, pharmacology, micro, and physiology. Anatomy (especially neuro) made up a moderate amount of the exam as well. Biochem, histo, epi, stats, and embryo, weren't tested as much, but they were all covered on my exam -- so I wouldn't ditch those topics completely. I know this is a bit general, but my memory fails me on the specifics of my Step 1 -- sorry. I hope this helps somewhat.

    -James
     
  9. I'm on the same page with Jeremiah - been awhile since the exam but in my version I was presented mostly with Path, Pharm and Micro. Very little Anatomy, histo/embryo; couple of Biostats questions and Behavioral Sciences. See my description on Medschool.com forums for more detail as its fading from memory.

    What stands out most is that the vignettes were highly clinical (I got NO Biochem questions which weren't clinically oriented) and longer than that on the CD or any of the practice tests (USMLE or NMS, Appleton). I got tired of reading them and much of the info was "filler" - take my advice and read the question first before tackling long passages full of interesting, but not particularly useful stuff (ie, I could answer some questions, especially those with graphics without reading the passage).

    Remember you are NOT expected to know all of the answers. If you were, passing would be greater than 55-65%. Don't freak or beat yourself up if you come across some you don't recognise. Some questions are testers for future trials, some are poorly written and some are really hard and help the testers differentiate between those with a 215 (average) from those with a 230.

    Best of luck...
     
  10. jeremiah

    jeremiah Junior Member

    Joined:
    Mar 4, 2001
    Messages:
    6
    Likes Received:
    0

    Thanks James and other senior members!!
    I think I'm on track
     
  11. dcdo

    dcdo Senior Member

    Joined:
    Jan 26, 1999
    Messages:
    172
    Likes Received:
    0
    Personally, I thought the Board Simulator Series was hands-down the best. Their questions were by far the most difficult, in fact harder than the actual USMLE. But you also learn topics in great detail. If you can consistently score over 60% on these exams you will kick butt on the USMLE. Give yourself at least a month to get ready though because these books take a long time, especially if you get all 5.

    Good luck.
     
  12. Future Surgeon

    Joined:
    Aug 18, 2000
    Messages:
    38
    Likes Received:
    0
    Hey -

    For when you get sick of going through First Aid for the 1,000th time, check out that Path site I posted on this page.

    For my 2cents on studying for part I -- I used First Aid but for each section I also read a short textbook,the "high yield" book for that topic, and the underground vignette book for that topic.

    As far as textbooks, for pharm I used Pharm by Katzung (Appleton and Lang), biochem I used lippincott's review, ID I used micro made ridiculously simple (awesome book), Path I used BRS (another outstanding book), Behav Sci I also used BRS and Physiology I went through as much Ganong (Appleton and Lang) as I could stomach, and I read the blue boxes in baby Moore for Anatomy.

    It was a GAUNTLET to read all of that stuff and it took me 6 weeks FULL TIME, but I scored a 252 and that totally helped in my residency applications process.

    First Aid is super key though -- you must know those facts (especially the bolded ones). The above books help to round it out and help it stick better. Especially when you start noticing the same points over and over in different books .... repetition always helps.

    Good luck studying and check out that site -- it will also help you.

    -FS

    [This message has been edited by Future Surgeon (edited 03-14-2001).]
     
  13. jeremiah

    jeremiah Junior Member

    Joined:
    Mar 4, 2001
    Messages:
    6
    Likes Received:
    0
    Dear FS

    Your post may have answered one of my original questions.. are you saying that your primary studying was with books and not practice questions? I'll definitely get to the questions also but think at this point that a properly focused (<- key point!) attack on the facts is a key starting point. I'd like to approach the questions already being able to answer most of them rather than use the questions as my primary learning source. So I've been doing my studying somewhat like it sounds like you did, with hitting board review books, notes, etc, and sifting out and storing away the usmle-type material. Was this how you did it?

    signed,
    another future surgeon
     
  14. Future Surgeon

    Joined:
    Aug 18, 2000
    Messages:
    38
    Likes Received:
    0

    Yeah -- I primarily studied books. Later on in my studying, I did do questions (I used the retired boards questions -- they were on file at my school's medical library), but I found it most helpful to do the questions after my fund of knowledge had been buffed (like it sounds you're planning to do).

    You've definitely got the right idea about using a lot of sources, then sifting out and storing away the high yield boards facts. That's what First Aid has done for the most part ... but precisely because it is SO condensed, it makes it easy to gloss over stuff. When you read a textbook or a lecture and see a whole paragraph devoted to a point, then notice it again in First Aid, it TOTALLY sticks better.

    As far as other things to help in your sifting and sorting mission ... pay attention to BOLDED points or terms in review books. I know this sounds obvious, but I specifically looked out for this. I'd see a point that was bolded and think, "now why do these authors think THAT is an important point? Why did they pick that fact out of all of the other possible facts related to this topic?" Then I'd start noticing it over and over again ... then it would stick. Keep an eye out for things like that -- things that show up again and again in different sources.

    Good luck -- feel free to write again if you have any more questions...

    -FS
     

Share This Page