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So I just finished the exam earlier today and thought I'd share some thoughts while things are still fresh.
If you aren't taking a practice exam at your centre then this first bit will be helpful to you:
When you arrive, you need your scheduling permit and a piece of photo ID with a signature. I brought two just in case but didn't need it.
You are then handed a sheet of paper with a list of rules, etc. It's just a formality. You get a small locker and can store all of your stuff in the locker. The only items you can bring into the exam room are your ID and your locker key.
You then register and they may or may not take your fingerprint (didn't take mine). They will take a photo ID of you. They will give you a markerboard, or markerboard-type paper, as well as a couple of dry erase markers. You need to put your name and CIN number on one of the markerboards - the CIN is on your scheduling permit, but they'll remind you of that when you are there.
You then sign into a log book and proceed to the exam room. *Every time you leave the exam room (breaks after blocks) you sign out, in the log book. When coming back from break, you sign in, in the log book.
So you are assigned a seat, and you can change it if you don't like where they put you. Once you are sat down at the computer, the proctor will make sure you have everything you need - headphones for the audio and headphone-earplugs.
You then click on the computer screen and it will prompt you to enter your CIN.
Once you do this, the clock begins ticking...
So this is the time breakdown.
7 blocks of 48 questions, and 1 hour to complete each block.
45 minutes break time.
15 minutes tutorial.
So that means, if you were to finish every block at the last second, you would have a total of 45 minutes break time throughout the exam. This INCLUDES any time you may want to eat lunch. So you basically have short breaks throughout the day.
Now, if you basically skip the entire tutorial, you can add that tutorial time to your total break time = 60 minutes of break time (45 minutes scheduled + 15 minutes added from skipping the tutorial).
**However, I would not just skip right through the tutorial. Make sure your headphones are working properly when the headphone tutorial page comes up. Mine weren't working, and the proctor had to run over and find some that worked... and the whole time the clock was ticking. So that was annoying but at least it didn't disrupt an actual question block.
After the tutorial, there is a screen with 2 boxes that read:
Proceed to the next block of questions?
and
Take a scheduled break?
Obviously you aren't going to take a break here so you click on the box that takes you into the actual exam. You now have 60 minutes to complete the first block of 48 questions. At 5 minutes, a warning message will come up on the screen saying you have 5 minutes left in the block.
The format of the exam is basically EXACTLY the same as USMLE world. So definitely familiarize yourself with the lab values tab, etc. I used it a lot more in the actual exam than I did when doing UWorld. Not for every single question or anything, but more often than UWorld. So make sure you know where things are on that tab - i.e. TSH values, WBC differentials, Urine creatinine, etc. etc.
*What is unique to this exam:
1) for the audio questions, you are able to actually move a stethoscope over a picture of a patient's chest. There are 3-5 areas of the chest with yellow circles that you can move the stethoscope to and you will hear different sounds based on the location you put it. Was cool, but it obviously made the question take longer.
2) there are video questions! I didn't have any, thank God, but there definitely are potentially video questions. In the tutorial, there was an example of a patient with Parkinson's displaying Parkinson's symptoms. So just don't be caught off guard if you get a video question.
--> so for either of these types of questions, you will a prompt at the beginning of the question saying "this has accompanying audio, etc" then have the regular question stem, then the answer choices below the question stem, then in the bottom right corner of the screen there will be a box that says "audio" or "video" or whatever. You can't miss it.
Ok, so now you've finished your first 48 questions. Yay that wasn't too horrible, and if it was, who cares, those are just the questions that don't count towards your actual score.
Now, you will select "End block" at the bottom of the screen. The computer will prompt you "are you sure" and you click "yes" to proceed or "return to question block" if you clicked that by accident. If you click "yes" you will again be taken to the screen that says:
Proceed to the next block of questions?
and
Take a scheduled break?
At this point you may take a scheduled break.
If you click "Take a scheduled break?" you will be taken to a screen that reads:
Total break time remaining: xxx
Total exam time remaining: xxx
You may now get up, and leave the exam room and sign out with the proctors to get some food, a drink, walk outside... whatever.
You can take as long or as short of a break as you want, but obviously don't take a 20 minute break since you may not leave yourself with anything later in the exam.
As an aside: When doing UWorld questions, I always had at least 10 minutes to spare after each block of 48. The most I ever had for the real USMLE Step I was 4 minutes. Four of the blocks I finished with like 30 seconds left. So don't assume you're going to be able to bank a ton of time cause when the real exam is on, you double, triple, and quadruple check your answers (or at least I do because I have OCD... or OCPD... or.... who the hell cares, I'm done )
Once you are done with your break, you sign back in again in the log book, and go back to your computer. You are then prompted to put in your CIN again, and once you have done that, you are taken to the next block of 48 questions.
Rinse and repeat until you are done all 7 blocks. And that's it!
Oh, then at the end there is some survey you can fill out that takes 5 minutes.
OK so now the stuff you guys want to hear: what was on the exam?
Quite honestly, it was DEFINITELY easier than UWorld. Like night and day. I'd say it was tougher than the Free 150 questions that you can do if you do a practice exam at your centre.. and probably about the same difficulty as the practice NBMEs.
I was considering pushing my exam date back 2 weeks but I'm glad I didn't. Using the resources I did (FA, UWorld, and Goljan) I wouldn't have done any better going over all of that again.
So what I 100000000% recommend, is in your last 10 days of studying, MAKE SURE you go over FA in its entirety. Like, know FA cold. Just like everyone says. I heard from upper termers to do this, and I did. And I'm VERY glad I did. So many questions I just flipped through FA in my mind and basically grabbed the answer right out of it. Like I can't emphasize enough: GO THROUGH IT.
One thing about this exam that I really liked was that it was, without question, the most fair and best written exam I have ever taken. Out of the 336 questions, there was only 1 I was slightly confused about. All of them were worded well otherwise.
OK breakdown:
**: know that chapter well, nothing crazy, but do know the stats questions. cause having to figure out the math through reason takes up too much time. so make sure you know PPV, 1-B, etc. just so you don't have to think about it if you get a question.
Embryo: FA is more than enough
Micro: FA is more than enough
Immuno: FA is more than enough
Pathology: FA and UWorld are essential
Pharm: FA is more than enough, and definitely focus on mechanism, side effects, drug interactions. Uses were less yield, but still important. i.e. I had a question on malignant HTN and it asked which drug to use. I had a question with a pt who had an anthrax infection and it asked which antimicrobial to use.
Anatomy: make sure you know the nerve distributions in the shoulder/arm/hand. Dermatomes are important too. I had some randoms involving the leg and origin/insertion questions. meh, close eyes and guess.. haha
hmm what other subjects are there?
Psychiatry: FA is more than enough
Neuro: look through a neuro atlast for brainstem, medulla, midbrain slices and look at where the tracts are that go through each area. FA covered the spinal cord well.
And I think that's it? Oh physio: FA is prob all you need.
So ya, look at all of that. FA is definitely $ in the bank. The questions I didn't know were questions I wasn't going to get no matter what I studied, unless I used my old class notes, so I wasn't too worried about those since I don't think most ppl would have studied that stuff
i.e. what are the layers that cover the ureter and bladder and something about putting a needle through it and which structures would you hit/ they were all random things, i dont' remember it exactly, but i was like ***??
Um, so ya. I think that's about it.
The key to success here is to maintain mental focus. Constantly remind yourself to keep it together. Remind yourself that you've been studying for 2 years and you aren't going to lose focus now.
The beginning you are nervous, the end you are drained. Be prepared to feel this way so that you can know how to overcome it when it happens.
so ya! good luck to you guys, let me know if you have any specific questions!
Keyser
If you aren't taking a practice exam at your centre then this first bit will be helpful to you:
When you arrive, you need your scheduling permit and a piece of photo ID with a signature. I brought two just in case but didn't need it.
You are then handed a sheet of paper with a list of rules, etc. It's just a formality. You get a small locker and can store all of your stuff in the locker. The only items you can bring into the exam room are your ID and your locker key.
You then register and they may or may not take your fingerprint (didn't take mine). They will take a photo ID of you. They will give you a markerboard, or markerboard-type paper, as well as a couple of dry erase markers. You need to put your name and CIN number on one of the markerboards - the CIN is on your scheduling permit, but they'll remind you of that when you are there.
You then sign into a log book and proceed to the exam room. *Every time you leave the exam room (breaks after blocks) you sign out, in the log book. When coming back from break, you sign in, in the log book.
So you are assigned a seat, and you can change it if you don't like where they put you. Once you are sat down at the computer, the proctor will make sure you have everything you need - headphones for the audio and headphone-earplugs.
You then click on the computer screen and it will prompt you to enter your CIN.
Once you do this, the clock begins ticking...
So this is the time breakdown.
7 blocks of 48 questions, and 1 hour to complete each block.
45 minutes break time.
15 minutes tutorial.
So that means, if you were to finish every block at the last second, you would have a total of 45 minutes break time throughout the exam. This INCLUDES any time you may want to eat lunch. So you basically have short breaks throughout the day.
Now, if you basically skip the entire tutorial, you can add that tutorial time to your total break time = 60 minutes of break time (45 minutes scheduled + 15 minutes added from skipping the tutorial).
**However, I would not just skip right through the tutorial. Make sure your headphones are working properly when the headphone tutorial page comes up. Mine weren't working, and the proctor had to run over and find some that worked... and the whole time the clock was ticking. So that was annoying but at least it didn't disrupt an actual question block.
After the tutorial, there is a screen with 2 boxes that read:
Proceed to the next block of questions?
and
Take a scheduled break?
Obviously you aren't going to take a break here so you click on the box that takes you into the actual exam. You now have 60 minutes to complete the first block of 48 questions. At 5 minutes, a warning message will come up on the screen saying you have 5 minutes left in the block.
The format of the exam is basically EXACTLY the same as USMLE world. So definitely familiarize yourself with the lab values tab, etc. I used it a lot more in the actual exam than I did when doing UWorld. Not for every single question or anything, but more often than UWorld. So make sure you know where things are on that tab - i.e. TSH values, WBC differentials, Urine creatinine, etc. etc.
*What is unique to this exam:
1) for the audio questions, you are able to actually move a stethoscope over a picture of a patient's chest. There are 3-5 areas of the chest with yellow circles that you can move the stethoscope to and you will hear different sounds based on the location you put it. Was cool, but it obviously made the question take longer.
2) there are video questions! I didn't have any, thank God, but there definitely are potentially video questions. In the tutorial, there was an example of a patient with Parkinson's displaying Parkinson's symptoms. So just don't be caught off guard if you get a video question.
--> so for either of these types of questions, you will a prompt at the beginning of the question saying "this has accompanying audio, etc" then have the regular question stem, then the answer choices below the question stem, then in the bottom right corner of the screen there will be a box that says "audio" or "video" or whatever. You can't miss it.
Ok, so now you've finished your first 48 questions. Yay that wasn't too horrible, and if it was, who cares, those are just the questions that don't count towards your actual score.
Now, you will select "End block" at the bottom of the screen. The computer will prompt you "are you sure" and you click "yes" to proceed or "return to question block" if you clicked that by accident. If you click "yes" you will again be taken to the screen that says:
Proceed to the next block of questions?
and
Take a scheduled break?
At this point you may take a scheduled break.
If you click "Take a scheduled break?" you will be taken to a screen that reads:
Total break time remaining: xxx
Total exam time remaining: xxx
You may now get up, and leave the exam room and sign out with the proctors to get some food, a drink, walk outside... whatever.
You can take as long or as short of a break as you want, but obviously don't take a 20 minute break since you may not leave yourself with anything later in the exam.
As an aside: When doing UWorld questions, I always had at least 10 minutes to spare after each block of 48. The most I ever had for the real USMLE Step I was 4 minutes. Four of the blocks I finished with like 30 seconds left. So don't assume you're going to be able to bank a ton of time cause when the real exam is on, you double, triple, and quadruple check your answers (or at least I do because I have OCD... or OCPD... or.... who the hell cares, I'm done )
Once you are done with your break, you sign back in again in the log book, and go back to your computer. You are then prompted to put in your CIN again, and once you have done that, you are taken to the next block of 48 questions.
Rinse and repeat until you are done all 7 blocks. And that's it!
Oh, then at the end there is some survey you can fill out that takes 5 minutes.
OK so now the stuff you guys want to hear: what was on the exam?
Quite honestly, it was DEFINITELY easier than UWorld. Like night and day. I'd say it was tougher than the Free 150 questions that you can do if you do a practice exam at your centre.. and probably about the same difficulty as the practice NBMEs.
I was considering pushing my exam date back 2 weeks but I'm glad I didn't. Using the resources I did (FA, UWorld, and Goljan) I wouldn't have done any better going over all of that again.
So what I 100000000% recommend, is in your last 10 days of studying, MAKE SURE you go over FA in its entirety. Like, know FA cold. Just like everyone says. I heard from upper termers to do this, and I did. And I'm VERY glad I did. So many questions I just flipped through FA in my mind and basically grabbed the answer right out of it. Like I can't emphasize enough: GO THROUGH IT.
One thing about this exam that I really liked was that it was, without question, the most fair and best written exam I have ever taken. Out of the 336 questions, there was only 1 I was slightly confused about. All of them were worded well otherwise.
OK breakdown:
**: know that chapter well, nothing crazy, but do know the stats questions. cause having to figure out the math through reason takes up too much time. so make sure you know PPV, 1-B, etc. just so you don't have to think about it if you get a question.
Embryo: FA is more than enough
Micro: FA is more than enough
Immuno: FA is more than enough
Pathology: FA and UWorld are essential
Pharm: FA is more than enough, and definitely focus on mechanism, side effects, drug interactions. Uses were less yield, but still important. i.e. I had a question on malignant HTN and it asked which drug to use. I had a question with a pt who had an anthrax infection and it asked which antimicrobial to use.
Anatomy: make sure you know the nerve distributions in the shoulder/arm/hand. Dermatomes are important too. I had some randoms involving the leg and origin/insertion questions. meh, close eyes and guess.. haha
hmm what other subjects are there?
Psychiatry: FA is more than enough
Neuro: look through a neuro atlast for brainstem, medulla, midbrain slices and look at where the tracts are that go through each area. FA covered the spinal cord well.
And I think that's it? Oh physio: FA is prob all you need.
So ya, look at all of that. FA is definitely $ in the bank. The questions I didn't know were questions I wasn't going to get no matter what I studied, unless I used my old class notes, so I wasn't too worried about those since I don't think most ppl would have studied that stuff
i.e. what are the layers that cover the ureter and bladder and something about putting a needle through it and which structures would you hit/ they were all random things, i dont' remember it exactly, but i was like ***??
Um, so ya. I think that's about it.
The key to success here is to maintain mental focus. Constantly remind yourself to keep it together. Remind yourself that you've been studying for 2 years and you aren't going to lose focus now.
The beginning you are nervous, the end you are drained. Be prepared to feel this way so that you can know how to overcome it when it happens.
so ya! good luck to you guys, let me know if you have any specific questions!
Keyser
