USMLE step 1 experience

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Blue One

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Hello.

After about a year of using SDN as a resource of knowledge I thought, that maybe it is my turn to give something.
I am studying in Europe and about 2 years ago I decided wth my girlfriend, that we will try to take USMLE.
Lots of doubt along the way, no one knew how, no one had gone this way before. I had to explain everything, and lead my Deans Office step by step in what should they do. I have been 2nd student to ever take USMLE in my uni.


So here is what I have done:

1. About a year of reading all the Kaplans in 3-4 week periods dedicated to given subject. Not that much, maybe 4-5h each week. Started with less-clinical ones (anatomy, biochemistry), and ended with pharm and path. I have been doing 1-2 tests (Robbins, BRS) weekly.

2. 2 months before my mandatory (required by uni) NMBE test I have started to focus more on First Aid. Last month was time of dedicated study - 8am to 17pm with FA and UWorld. I have been doing about 2 45 question tests daily, reading explanations of hard questions. I know that people recommend reading it all religiously, but it was not my style, also I have been quite short on time. Resources used - solely FA and UW. First time UWorld mean about 80% (started with 65, in 3 tests went to 70+, ended with 85-90, although there were quite a few drops in my scores).

3. NMBE - I have been shocked. It turned out pretty easy, like 2x easier than UW. I had almost no doubts. I have never done NMBE before (2nd thing people recommend). Score arrived 3 days after - 260, I was all in heaven. Lots of fuss with paperwork, I was lost, Deans Office was lost, but after like 1 week my Certification was sent to ECFMG and I was waiting for all the necessary confirmations to schedule my USMLE.

4. I still had a bit more than 1 month of holidays left and was desperate to take my step before rotations and lectures start. While waiting for ECFMG to process my Certification I was studying once again. This time I have been doing UW from the beginning, it was a lot easier. 4 tests daily, mean for second pass was about 90%. The only other resource was FA, I swear, that by this time I knew every letter of this book. I started having doubts, if FA will be enough. Maybe I should include another book?

5. My application was processed by ECFMG, I still had more than 2 weeks of holidays left. Scheduled an appointment one week before rotations start. I had to take train to another country to take USMLE, there are only a few Prometric Centers in Europe.

6. The big day! I was shocked once again. The questions were a way less specific, blurred, required a way less knowledge and a way more "feeling" than any test I have taken so far. Some topics (exact same background, same answers) reoccurred 2 times. I had maybe 2 direct biochemistry questions. Microbiology only on basic level. I left knowing, that I have done well, but deep down there was dissapointed - I had a feeling, that I had so much more knowledge to present, but there was no opportunity. Questions rarely addressed specific facts, complex relationships that I knew and could rock if an opportunity presented.

7. 3 weeks forward I have been deep into my 6th and final year of med school when the results arrived. 260 once more. Ecstatic feeling. As for an IMG, studying in my native language, 3 years deep into clinics I still managed to rock this basic sciences test. It was my great fear. I have been really good with basic sciences, but I have passed anatomy was 4 years ago, biochemistry 3, how much knowledge could I possibly retain?



Time for conclusion:

1. Study companion - for me support of my girlfriend, feeling that we are going through it together was crucial.
2. First Aid IS enough.
3. Taking 100 NMBE tests before is an option, but you can do it without.
4. UW is a grat resource.
5. Even thou european standards of education focus a way more on clinics, than on basic sciences - it is not a great gap. Clinical knowledge helps a lot.



Time to ditch Krebs cycle and finally focus on clinical subjects.

Hope I have brought some hope into your hearts, fellow IMGs. In case of any questions - feel free to ask.

See you on the wards!

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If I had to do it once more I would never buy anything more. My guess would be that another qbank is an investment of 50h~ that would translate to maybe a few more points.
General conclusion - FA + UW is enough to take you to 260. If you need more - you may need another qbank/books, but if 260 is ok for you I wouldnt bother.
 
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Congrats! How much do you think Kaplan LNs helped you in your preparation? Did you also watch Kaplan videos? Don't you think that when you say FA+UWORLD is enough, it only applies in your case, as you seem to have had very, very strong background and knowledge in basic sciences? as this recommendation would be misleading for others just to do fA and uworld. Thanks.
 
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Kaplan LN were great to warm me up, refresh informations that were burried in my head for the past 3 - 4 years. I haven't used them in my dedicated study time, thery are a way too detailed. It is better to know every word in FA than 70-80% of BRS. I haven't watched any videos and have no idea if they are of any use.
If it comes to strong basic sciences background. I was starting at a lower level than the majority of people taking step 1. All the biochem, micro, behaviorals, it was starting from scratch. So if you are like me - 3 years deep into clinics, it would be nice to start a few months earlier with BRS/Kaplan, but last 4 - 8 weeks should be FA + UW.

Thanks and best wishes.
 
Hello.

6. The big day! I was shocked once again. The questions were a way less specific, blurred, required a way less knowledge and a way more "feeling" than any test I have taken so far. Some topics (exact same background, same answers) reoccurred 2 times. I had maybe 2 direct biochemistry questions. Microbiology only on basic level. I left knowing, that I have done well, but deep down there was dissapointed - I had a feeling, that I had so much more knowledge to present, but there was no opportunity. Questions rarely addressed specific facts, complex relationships that I knew and could rock if an opportunity presented.

See you on the wards!

Thank you very much Blue One for the detailed write up, and congratulations on the stellar score. I was wondering if you could expand upon what you mean by "less specific" "blurred" "way more 'feeling' than any other test". Like can you give a hypothetical example? This is a question I have always had and never was able to find a solid answer for it.
 
Kaplan LN were great to warm me up, refresh informations that were burried in my head for the past 3 - 4 years. I haven't used them in my dedicated study time, thery are a way too detailed. It is better to know every word in FA than 70-80% of BRS. I haven't watched any videos and have no idea if they are of any use.
If it comes to strong basic sciences background. I was starting at a lower level than the majority of people taking step 1. All the biochem, micro, behaviorals, it was starting from scratch. So if you are like me - 3 years deep into clinics, it would be nice to start a few months earlier with BRS/Kaplan, but last 4 - 8 weeks should be FA + UW.

Thanks and best wishes.
Thanks a lot for reply and good luck in your other Steps!
 
ASAP I truly wish I could be more detailed, but I have taken USMLE almost 2 months ago. Even afer leaving Prometric I could barely remember any questions (strong emotions, exhaustion, shreer number of questions, you name it). And you can imagine, that general, nonspecific questions are harder to recall.
What I can tell thou, it that the questions were quite stright forward. In UW it is like 4 questions in one, eg.
1. by side effect you need to guess treatment
2. knowing the treatment you need to guess bacteria species,
3. once you know it you need to recall virulence,
4. knowing the virulence factor you are asked about what other bacteria have similar (just an example)
In my exam there only 5 - 10 questions 3 layers deep.

One very important thing that may be the crucial in understanding what I mean by 'blurred': Answers never pointed one specific condition. When you know diagnosis it is easy to pick the correct answer, but by reading the answers you can't 'think your way back to diagnosis' (probably designed to make it impossible). Answers never hint a thing.

What also startled me were behaviorals/ethics. There are no clean cuts if it comes to what a doctor should do facing addicted, chronically ill patients (or other ethic deliemmas), and the cases were really not black and white.

It may be better if I name some of the (surprising) things that didn't appear. No questions or barely any about: specific biochem pathways, mutations, virulance factors, one cancer histopathology to diagnose (really easy one), no bacteria/fungi to recognise (microscope), only soft balls if it comes to antibiotics.

Thanks and good luck!

@ed: One book I have forgotten to mention - CMMRS. Maybe not the best pick 4 weeks before the exam, but hepled me greatly to build some foundations for more specific microbiology.
 
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Hello, ive recentl taken my step 1 exam on april 6 2017, ive counted 11 mistakes so far, just was curious how many mistakes can someone make to achieve a 260+ goal? thanks
 
Hello, ive recentl taken my step 1 exam on april 6 2017, ive counted 11 mistakes so far, just was curious how many mistakes can someone make to achieve a 260+ goal? thanks

Nobody knows how many you can miss on the real exam for a certain score - and it ranges between exam forms depending on difficulty. So nobody can answer this question for sure. Plus a number of Qs on the real exam are experimental. If your exam felt harder than the NBMEs then prob you can miss more and still get a that score.
 
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