Hi guys,
I have spent a lot of time going through the USMLE step scores and experiences to identify the best revision method suitable for me.
Unfortunately most of the experiences come from US graduates, which are useful, but truthfully IMGs have different challenges.
That is why I thought it would be really useful to start this thread.
Details that would be useful are:
1) Country of origin
2) Step 1 or 2 scores
3) Timeline
4) Revision material
5) Any further tips/challenges etc
I hope we get lots of responses. Your help can truly make the difference for all of us!
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I recently presented my USMLE step 1 exam; graduated 3 years ago from med school, and have been working in research in the US since then. Suggested by my lovely fiancé and due to a lot of budget fluctuations in research jobs I decided to pursue getting board certified while working.
What to use:
FA, UW(or Rx), sketchy mycro and google spread sheet. Optional: Create your own pict nemonics.
How to start studying and when?
Having a full time job is a pain when you are studying for the boards. My strategy was waking up at 4 AM during weekdays, and study till 8:30AM or so. It requires a lot of commitment to do this. In the first weeks you still need to adjust your circadian cycle, but at the end I really worth it. I work in NYC so definitely early morning is the best time to study due to the endless noise in the streets. During the weekends I woke up when felling rested and studied for 6 hours or 8 sometimes.
Note: remember to go to bed early, around 9:30PM start to get ready to go to bed so you can be in bed at around 10 PM, this secures you 6 hours. Believe me, after waking up at 4 AM all you want is go to bed by 10 PM.
Study Plan - Timeline
KEEP IN MIND: You are an IMG so try to do your best, score above average that means above
227, every point counts.
At the beginning (early 2013) I watch Kaplan videos + read Kaplan notebooks for about 6 months which was a waste of time. I ended up not remembering much (May 2013).
Then I started reading FA 2013 with UW (10 questions blocks-random) at the same time, at that moment I get the feeling that I was actually remembering something for the exam.
I suggest keeping the questions random at the beginning; this gives you a sense that you can get a biochem question and then an ethics one. The exam is like that, changes from topics easily.
In the following months I progressively increased the number of questions (till 46), till doing at least a block a day. My UW block score % was around 55 or 50 and then decided to do my first NBME in October. The score was 410, this was honestly disappointing, knowing all that I have studied for about 10 months!… I decided to continue doing UW questions complementary with FA reading.
In summary, I Finished UW (January) with the following percentages in random blocks: 70 61 72 78 57 54 70 61 70 65 67 51. The last percentage on UW was surprising, 51!!! Damn that’s bad! , and my NBME score continue in around the same way, 440 NBME 12 - December, 460 NBME 7 – January.
By then I decided to postpone my exam for March 2014 and to work on my memory and reading skills (bellow) while doing a new question bank, USMLE rx + FA.
IMPROVING 200 – 210 NBME SCORES to 230!
Question reading mistakes: English is naturally not my first language, but I was rapidly reading questions without taking special notice of what they really asked me. My lovely fiancé helped me in this part and she noticed this that I was rushing through questions, without selecting the appropriate answer (when I actually know the answer). I got this when doing expanded feedback NMBE’s, Pay the extra so you get a sense if you mark the right thing in concepts that you supposed to master.
Increasing memory techniques:
- Excel Spread sheet: I started using this since January, putting here key concepts(per day), and tips to remember mnemonics in a quick way. Divide it per day and work on review session on the weekend. This works wonderful for me with the pict mnemonics I created.
- Picture mnemonics: works fantastic for me, but an excel is sufficient for other people, I recommend you to try different techniques and stay with the ones that help you to evoke more easily. This exam is about evoking and associating in the appropriate time.
- Sketchy mycro: fantastic tool, once I saw one video I bought them all.
After doing this for about 2 months + USMLE rx (scoring about 60 - 65) I noticed that I was evoking more easily through questions, with at least 5 -10 minutes to review the block. At the mid of Rx I did another NBME, 510 NBME 15, finally I decent score!!
Now I decided to focus on resistance for the test. Practicing entire 8 blocks sessions, this help you to get a real felling of the exam, another wonderful suggestion by my lovely fiancé. The results were about the same on NBME 510 and 530, UW assessments over predicted a bit 620 and 680. My late USMLE rx percentages were around 70 – 80.
With good NBME scores, I decided to work on the picture mnemonics I created to really memorize them, also watched Sketchy mycro again, revise my huge spread sheets and review past NBME’s.
EXAM DAY
Do it on Monday, so you can mentally rest the other days at work.
Did the following: 2 blocks, 5 min brake, 2 blocks, lunch 20 min, 2 blocks, 15-20 min and 1 block.
During breaks I drink a juice (naked ones are just perfect) with cookies and snacks. Always went to the restroom, and had a candy before entering again, candy’s is the best way to keep me awake. For lunch a sandwich(subway type) is fine.
Other people suggest 1 block and then rest, this is a waste of time knowing that they will check pockets and you have to go over the registration process.
On the exam I ended up marking (flagging) about 8-10 questions per block (Which meant that I was not totally sure). There was one block that I did not ended up flagging nothing. This means there are easy blocks and hard ones. In proportion I can say is like half and half, so no worries.
Scores - timeline:
Exam date – mid March 2014 -
238 yayy!! 
it WORKS!!
7 days before exam 530 NBME 13 – same day with NBME 11
7 days before exam 510 NBME 16
15 days exam UW test 1: 620 – same day with UW test 2
15 days before exam UW test 2: 680
21 month before exam 510 NBME 15 – Half USMLE rx
2 months before exam 460 NBME 7 – January – Done with UW
3.5 months before exam 440 NBME 12 - December
5 months before exam 410 NBME 6 (it was available then) – October – Half UW
Study strategies:
Google docs excel spread sheet:
Write here things that you have to remember, or that are taking you longer than expected. Also in your free time check it at work!! Seems like you are working when having an excel file open!! LOL
Picture mnemonics:
As mentioned in the study timeline, what really change my memory skills was s
ketchy mycro***, after watching their videos I started to do this with everything that requires a lot of details and high yield topics, Eg. Glomerulonephritis, vasculitis, CP450…. This was Fantastic!! Although I ended up creating my own picture nemonimcs I found it really useful
Try to enjoy your studying!! Having fun with your significant other or enjoying breaks with music you like is important to stay constant on your goals!
***Note:
sketchy mycro help me a ton for the subject that I have the most (obviously after biochem) mycro!!. Check some of their videos on you tube, all are great and help you remember all about microbes absolutely easy!!! I thank them a lot I think I got like 5 -10 questions with their videos help.
Check this one for example:
Also for study strategies watch this one:
Do and Do Not -Quick Suggestions for someone starting or lost in the road
Do:
1. Read and memorize FA before questions. One or two times are enough.
2. Start with UW after reading FA.
3. By mid UW start with NBME (old ones first)
a. If you have a good NBME (score around 225) stay with your technique till the end of UW
b. If not a good score, try take more time reviewing FA and focus in your memorization tools. Maybe pay sketchy mycro?
c. Try to get at least 60-65% in UW or 65-70% in Rx, for the last 10 blocks.
4. If this does not get you a good NBME till the end of UW, pay another Q bank, Rx is great but not as UW.
5. Present the exam when having at least 2 -3 NBMEs with a good grade, I mean above average (227). You are an IMG so try to do your best scoring above average.
6. Best predicting tool = an NBME, not the q-banks percentages.
7. Try reviewing the NBME’s, FA, mnemonics and formulas at least once before the exam.
8. Try to find the memorization tool that works best for you (mnemonics, numbers, and pictures).
Do NOT:
1. Kaplan videos and books.
2. Start Q banks without reading first the FA.
3. Q banks subject wise, the exam is not like that.
4. Work is work, not the study area. Be aware of your responsibilities, but when having a free time study a bit.
5. Present the exam with a bad NBME (bellow 210).
