USMLE and poor grades as MS-I

[THE instiGATOR]

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I didn't do very well my first year. I have been doing well my second year, after some major adjustments to the way I study. Basically, I feel as if I have a very limited knowledge base established from the first year.

My question is directed at those who have taken step one of the boards already. We are only given one month to study, and it seems that trying to cram in an entire year to compensate for my deficit will chew into the time required to brush up on path, pharm, micro, and other second year classes (I think they are more heavily weighted on the boards). Do you believe that it is possible to cram it all in during a month period? I am actually looking to apply to somewhat competitive specialty programs, so I think I will need to do pretty well on the upcoming exam. I've been told that I shouldn't worry too much about gross, and that I should study phys and biochem if I am going to focus in on any of the first year classes.

Any helpful advice/opinions will be appreciated.

 

[Blade28]

Originally posted by THE instiGATOR
Do you believe that it is possible to cram it all in during a month period? I am actually looking to apply to somewhat competitive specialty programs, so I think I will need to do pretty well on the upcoming exam. I've been told that I shouldn't worry too much about gross, and that I should study phys and biochem if I am going to focus in on any of the first year classes.

Any helpful advice/opinions will be appreciated.

Do you have time to start basic review BEFORE the month-long break? If so, it's definitely possible.

 

[scrupulous79]

I started off first year almost failing anatomy, biochem and doing pretty bad in physio, but I picked up the pace second year (lots of honors second year) and I managed to nail the boards (98)....just start reviewing a early (get First Aid and BRS path and start looking at them)....I started reviewing a little bit at a time around this time--February/March--when I was a second year and it paid off....the way I did it was to pick like two or three subjects to go thru once or twice before May rolls around (i picked pharm and path, because they both require some time commitment) so that studying for everything else would be less daunting in the few weeks before the boards....

there's plenty of time at this point, so you could use the time you have now to go over stuff that you didn't learn too well the first time....

 

[12R34Y]

98 on the boards doesn't say much..........what did you get? three-digit score. 98 does NOt equal 98%.

just curious.

later

 

[Kalel]

Second year grades correlate much better with USMLE scores then first year grades. Even so, some people may be given the option (or encouraged) to take additional time to study for the USMLE by pushing one of their third year rotations back. If you are doing well during second year though, and studying from board review books while studying for your tests, I think that you should be fine. Most of what you need to know from first year is in First Aid (which you should have bought by now), and if you flip through it, you will see that it's not all that much. What is in there is mainly route memorization too (which almost everyone has to re-memorize from scratch), there aren't any of the challenging concepts you may have encountered during some of your basic science courses.

Also, a 98 on step I is a very high score, it probably correlates with 240+.

 

[pikachu]

gross is definitely not that important to boards (or to the actual practice of medicine at all if you ask me. Maybe if they had actually taught us to read films instead of pick out shredded cadaver parts for weeks on end, my opinion would be different. But I digress.) If you managed to pass gross, you probably know enough anatomy for boards. Look at High-Yield Gross Anatomy and High-Yield Neuroanatomy for review -- they like to ask about nerve distributions. Step 1 is much more focused on pathology/pathophysiology, and to a lesser extent pharmacology and physiology. Biochem -- focused on inborn errors of metabolism, some molecular bio techniques. LWW review is excellent for biochem. Physio is very conceptual -- BRS should cover you. The main thing for boards is to do a TON of practice questions. I worked through all the qbank questions, read the big review books and managed to do pretty well above the mean even though I was a B and C student throughout 1st and 2nd year.

If your school is like mine they will try to intimidate you and build up their own egos by saying your performance on THEIR curriculum is correlated well to step 1 performance, but this will be completely untrue. Study using the board prep material, don't blow off 2nd year, and you will be fine I think.

 

[Stinger86]

I feel you, brother -- I skipped my entire first year classes and hardly studied (just the evening before each exam). My grades weren't so hot, and I didn't really care. And like you, I'm taking my second year (the more important of the two) more seriously.

You probably don't want to hear this but... you should have started preparing for the USMLE at the beginning of second year. I'm not talking about hardcore rambo studying, but just using the BRS, FA, and other review books along with your courses is really beneficial and helps to consolidate the information better. This way, you'll remember more of it come the summer.

But it's still early. Whenever you have a free day or weekend, go over all the units in BRS Pathology that you've covered in your course, and start reviewing old classes. I read my HY Neuroscience book about once a month and I read my biochemistry review text about twice a month (just to keep it fresh).

I guess my point is: whatever you do, do NOT wait until your classes end to begin reviewing two years worth of information (unless of course you're going to push back your 3rd year rotations). Keep all this stuff fresh in your mind.

 

[THE instiGATOR]

Thanks for the advice, all.

Stinger,

I do use First Aid and other board review texts as a part of my current study strategy (in addition to transcripts and handouts). That's one of the things I changed during my transition from first to second year (dropping large texts and replacing them with lots of small review books). It doesn't leave me time to fully master the material on the transcripts and earn a 95%+ on the exams, but it is good enough to pull low As and mid to high Bs on most tests (except for the few exams that are really poorly put together ... the ones that everybody bombs). I also do intend to begin officially studying for the boards next month (sometime in the middle). I can't possibly begin before then.

 

[choker]

i think studying is really school-specific, based on how long they give you guys off to study. at pitt, they give us a friggin 14 weeks total off from the end of 2nd year class-beginning of 3rd year. 95% of the class takes it after 8-11 weeks of studying. here, all upperclassmen and administrators pound it into our heads not to even think about studying till classes are over.

i dont think reading BRS in addition to your standard curricular syllabi would do much_ i've found BRS to be much less detailed and comprehensive than what we are responsible for school tests. if you get a lot of time off, i am thinking the best strategy would be to just study hard for your 2nd year courses, because that IS studying for your BOARDS.

btw- how long do you guys get to study for this damn test? i know we're at the upper end in terms of time off, but im just curious what time-line you guys are looking at.

choker
ms2

 

[Stinger86]

Originally posted by THE instiGATOR
I do use First Aid and other board review texts as a part of my current study strategy (in addition to transcripts and handouts). That's one of the things I changed during my transition from first to second year (dropping large texts and replacing them with lots of small review books). It doesn't leave me time to fully master the material on the transcripts and earn a 95%+ on the exams, but it is good enough to pull low As and mid to high Bs on most tests (except for the few exams that are really poorly put together ... the ones that everybody bombs). I also do intend to begin officially studying for the boards next month (sometime in the middle). I can't possibly begin before then.

I know exactly what you're talking about. Whenever we begin a new unit in any course, I take a few hours out and read through the assigned (or unassigned yet relevant!) chapters of the text. That's usually the first and only time I read the book (i guess just to kinda get a broad overview of what I'm about to study; plus, for the pictures). I then spend the rest of my unit study time using review books and ppt slides. I know how frustrating it is to study the high yield info in all the review books, and then still have to memorize all this classroom minutia in order to make a great grade on some PhD's exam.

But hey, even if you make B's along with A's (which is NOT bad, by any means), you can still beat the crap out of Step 1 by keeping up with your review books and never letting all that mess slip out of thought. That's what I'm trying to do. Best of luck, I'll be there in May too. 😎

 

[THE instiGATOR]

I agree about BRS books, choker. The only useful parts of them are the quizzes they put at the ends of the chapters. I like to run over those questions a day before the exam to see if I have any gaps that need to be filled in.

As I've said, we only have a little over one month. If we want more time, we pretty much have to begin studying while our classes are still being conducted.

 

[Stinger86]

Originally posted by choker
btw- how long do you guys get to study for this damn test? i know we're at the upper end in terms of time off, but im just curious what time-line you guys are looking at.

I think my school requires us to take the Step 1 for the first time by the end of July. We don't have to pass it then; we just have to take it. Everyone gets three tries to pass before they're dismissed from the school.

I'm scheduled to take it at the beginning of the third week of May.... which should give me two full uninterrupted weeks of study time.

 

[Stinger86]

Originally posted by THE instiGATOR
I agree about BRS books, choker. The only useful parts of them are the quizzes they put at the ends of the chapters. I like to run over those questions a day before the exam to see if I have any gaps that need to be filled in.

Man, I'm just a postin' machine on this thread tonight...

Yeah, the BRS quizzes are decent, but you should really consider buying Robbin's Review of Pathology if you haven't already. You get like 1100+ excellent quality questions organized into unit chapter. Of course, it only covers Path, but hey Path's important and is incorporated into all of medicine.

 

[THE instiGATOR]

Originally posted by Stinger86
Man, I'm just a postin' machine on this thread tonight...

Yeah, the BRS quizzes are decent, but you should really consider buying Robbin's Review of Pathology if you haven't already. You get like 1100+ excellent quality questions organized into unit chapter. Of course, it only covers Path, but hey Path's important and is incorporated into all of medicine.

I have it. I didn't get it until right before my fourth path test, but it has been very helpful since and will be helpful when I am preparing for the boards. Q bank is also good to use when preparing for course exams, I think. I purchased the extended version, and have been using it for exams ever since I was allowed to sign on.

 

[jaeida8]

Yeah Robbins Review of Path is great. Too bad that I can answer those questions, yet I usually can't do as well on the school's exams.

 

[Stinger86]

Originally posted by jaeida8
Yeah Robbins Review of Path is great. Too bad that I can answer those questions, yet I usually can't do as well on the school's exams.

Same here. But I figure that between the school and myself, I'll be the one laughing come late May.

 

[Blade28]

Originally posted by 12R34Y
98 on the boards doesn't say much..........what did you get? three-digit score.

No? This past year, I believe 98 corresponded to at least 242 (a score of 241 was 97).

 

[Jalby]

At my school we finish classes with new materials in 3 weeks (March 12th or so) then we have 8 weeks of 12 hours a week of review cases that are supposed to integrate what we have learned, one week for a year end test, and then 6 weeks until we have to start school again. Wow. I never realized how long that is. So 7 weeks without classes at all and 8 weeks with half classes, but all review.


And as to using BRS during class, I absolutely love it because I almost have BRS path memorized now because I used it extensively. But I'm at a P/F school, so I didn't have to memorize everything.

 

[Asher]

One approach would be to study by systems -- i.e., when you are studying cardiac pathology review the associated physiology.

Every one's experience on the step one varies but I found physiology to be the only first year subject that was heavily emphasized on my exam. Plus, the aspects of gross anatomy that you are likely to be tested on will be larger concepts rather than nit-picky details. Reviewing with high yield or first aid would probably be the most beneficial -- studying anything more in depth will likely get you a low return in terms of actual questions on the exam.

Personally I think the best thing you can do for step one is do lots and lots of practice questions.