USMLE 1 advice needed

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

 

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.

 

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

 

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

 

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...

 

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.

 

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).]

 

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