Why is Step 1 so important?

Burrell College of Osteopathic Medicine
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Members don't see this ad.
Anicetus said:
This is so common where someone with a 255+ walks on into the convo stating they think they are middle of the pack intelligence. It's like if a Bill Gates gave a motivational talk spewing crap like "I'm not special guys! I'm just your ordinary guy!" as if someone could then walk out realizing they can do it too.

Well guess what, I consider myself very middle of the pack at my MD school and I worked my *** off for 7 weeks of dedicated studying, worked with learning specialists throughout my MS1-2 as well to develop the most efficient study strategies for myself and I never once broke 240 on a practice test and certainly didn't for my actual step 1. Not to mention I also study more than most of my classmates (10 hours a day on average) during the year for MS1-2). Talking as if a 250 (80-85percentile) is attainable for almost everyone if they "try hard enough" is BS and only stated if someone got a 250+ themselves or they slacked off and got just under it and now realize they could've attained the 250 HAD they tried.

For some reason people downplay overall intelligence and memory capabilities on this forum and most of the smartest folks don't ever admit that they are actually more intelligent than most of their med school peers. Maybe they don't even know it, but it's quite fascinating if you ask me.
Click to expand...

kendrick told everyone to be humble
 
Azete said:
Nothing special. Started a FA Anki deck (similar to Bros) after M1, did a full pass of UWorld before dedicated, and drilled Micro/Pharm very early and reviewed it every single weekend. During dedicated I did another pass of UWorld, focused heavily on physio concepts (watched a lot of Najeeb), did Pathoma twice, and reviewed all the bugs & drugs every night for 2 hours. Outside of my Anki deck, I never really opened FA and definitely never annotated it.

I also made a 10 page review sheet of all the "**** I always forget" -- which ended up being my savior because it I basically memorized it the last few days before my test and it scored me at least 20 questions I otherwise may have missed.
Click to expand...
i need to start doing that. whenever i come across something like that, i just think to myself "nah it's cool. i can remember it."

spoiler alert: i can't
 
I see this "intelligence and Step 1" discussion ad nauseum on these forums, and thought I would finally throw in my view on it since I feel I may have a slightly unique perspective. For reference, I am a US MD student who was for the most part slightly below average during my preclinical years for a number of reasons (suboptimal effort, poor organizational and study skills, etc). Still, I ended up scoring ~270 on Step 1 largely due to the factors listed below, in order of importance to Step 1 score.

1. Content memorization and mastery: I was certainly nowhere near the knowledge baseline of many of my peers nearing the end of second year classes. Knowing this, I had planned in advance to finish >10,000 unique practice questions prior to taking Step 1, with probably half of these completed before my dedicated period even started. A good underlying mastery of the content, in my opinion, is the single most important determinant of your Step 1 score (by far), however you go about accomplishing this (doing consistently well preclinically in a curriculum geared towards Step 1, completing tons and tons of questions, etc).

2. Pattern recognition and critical thinking/extrapolation ability: You could interpret this as being related to intelligence, but I firmly believe this is largely learnable. When you complete >10,000 practice questions and see a certain concept tested in 5-10 different ways, you are not going to miss that question on the real deal, almost regardless of what your IQ is. Moreover, reading explanations thoroughly in an efficient manner will definitely improve your critical thinking/extrapolation ability, beyond whatever baseline your intelligence grants you in this area.

3. Standardized test-taking ability/strategy: I think a lot of people on these forums underestimate the importance of test-taking ability/strategy to Step 1, and even often end up confusing this with intelligence. Let me be clear when I emphasize that I believe this to be largely under your control, unlike your raw innate intelligence. I don't intend to be mean-spirited when I say this, but I see a lot of post-Step 1 experiences on this site with some variation of "I ran out of time on almost every block and had to leave x questions blank", and I cringe every time I read this. Having your timing and question-approaching strategy down solid prior to taking Step 1 is absolutely essential to a great score. For example, the strategy I personally chose allowed me to go through every question at least 2 and often 3 times. As a result, I don't think I made a single "stupid" mistake on my Step 1. Every question I missed was due to not knowing a certain concept well enough. Other things that fall in this category include knowing the NPV of your unmarked questions (probability that your unmarked questions are answered correctly), knowing how often your changed answers are correct vs your original answer, etc. All of these components to test-taking strategy can be learned and mastered through a large number of practice questions.

4. Test day factors like the specific form of the exam you receive, mindset/confidence the day of the exam, and sleep the night before the exam: These are self explanatory, and more important than you might think.

5. Raw innate intelligence: Finally, we reach raw intelligence. I am not going to deny that medical students with higher IQs will do better on Step 1 on average than medical students with (relatively) lower IQs, but I believe many people on this site either greatly overestimate the contribution that intelligence plays in regards to a content mastery exam like Step 1 or often don't realize that a good amount of what they consider to be "intelligence" is actually fully learnable (as above). Many of my classmates are much better than me at memorization - as evidenced by their stellar preclinical grades - but I outscored them largely through my personal approach to the exam.

To summarize this already long post, intelligence does of course play a role in your Step 1 score, but not nearly as large as many people think. In no way do I mean to downplay the efforts of the many students who gave it their absolute all during their dedicated period and did not score a 250, but it is crucial to realize that just as important as how much you study is how well you study. It is also important to realize that many high scorers will either have started preparing for Step 1 well before their dedicated period starts (whether this is doing tons of questions or perfecting approach/strategy). There is only so much you can accomplish in 6 to 10 weeks after all, regardless of your level of effort doing this period.
 
Nucleus Accumbens said:
Well how can we explain the FMG students who study for 2 years and get 260s like it's nothin'!? I'm assuming the "effort" component of that equation may overshadow the other two over time.


Sent from my iPhone using SDN mobile
Click to expand...

I think it's a balance between hard work, intelligence and test taking skills. 2 years of constant studying would obviously help you score better, but even with that plenty of people still can't do well.
 
Nyctalopia said:
I see this "intelligence and Step 1" discussion ad nauseum on these forums, and thought I would finally throw in my view on it since I feel I may have a slightly unique perspective. For reference, I am a US MD student who was for the most part slightly below average during my preclinical years for a number of reasons (suboptimal effort, poor organizational and study skills, etc). Still, I ended up scoring ~270 on Step 1 largely due to the factors listed below, in order of importance to Step 1 score.

1. Content memorization and mastery: I was certainly nowhere near the knowledge baseline of many of my peers nearing the end of second year classes. Knowing this, I had planned in advance to finish >10,000 unique practice questions prior to taking Step 1, with probably half of these completed before my dedicated period even started. A good underlying mastery of the content, in my opinion, is the single most important determinant of your Step 1 score (by far), however you go about accomplishing this (doing consistently well preclinically in a curriculum geared towards Step 1, completing tons and tons of questions, etc).

2. Pattern recognition and critical thinking/extrapolation ability: You could interpret this as being related to intelligence, but I firmly believe this is largely learnable. When you complete >10,000 practice questions and see a certain concept tested in 5-10 different ways, you are not going to miss that question on the real deal, almost regardless of what your IQ is. Moreover, reading explanations thoroughly in an efficient manner will definitely improve your critical thinking/extrapolation ability, beyond whatever baseline your intelligence grants you in this area.

3. Standardized test-taking ability/strategy: I think a lot of people on these forums underestimate the importance of test-taking ability/strategy to Step 1, and even often end up confusing this with intelligence. Let me be clear when I emphasize that I believe this to be largely under your control, unlike your raw innate intelligence. I don't intend to be mean-spirited when I say this, but I see a lot of post-Step 1 experiences on this site with some variation of "I ran out of time on almost every block and had to leave x questions blank", and I cringe every time I read this. Having your timing and question-approaching strategy down solid prior to taking Step 1 is absolutely essential to a great score. For example, the strategy I personally chose allowed me to go through every question at least 2 and often 3 times. As a result, I don't think I made a single "stupid" mistake on my Step 1. Every question I missed was due to not knowing a certain concept well enough. Other things that fall in this category include knowing the NPV of your unmarked questions (probability that your unmarked questions are answered correctly), knowing how often your changed answers are correct vs your original answer, etc. All of these components to test-taking strategy can be learned and mastered through a large number of practice questions.

4. Test day factors like the specific form of the exam you receive, mindset/confidence the day of the exam, and sleep the night before the exam: These are self explanatory, and more important than you might think.

5. Raw innate intelligence: Finally, we reach raw intelligence. I am not going to deny that medical students with higher IQs will do better on Step 1 on average than medical students with (relatively) lower IQs, but I believe many people on this site either greatly overestimate the contribution that intelligence plays in regards to a content mastery exam like Step 1 or often don't realize that a good amount of what they consider to be "intelligence" is actually fully learnable (as above). Many of my classmates are much better than me at memorization - as evidenced by their stellar preclinical grades - but I outscored them largely through my personal approach to the exam.

To summarize this already long post, intelligence does of course play a role in your Step 1 score, but not nearly as large as many people think. In no way do I mean to downplay the efforts of the many students who gave it their absolute all during their dedicated period and did not score a 250, but it is crucial to realize that just as important as how much you study is how well you study. It is also important to realize that many high scorers will either have started preparing for Step 1 well before their dedicated period starts (whether this is doing tons of questions or perfecting approach/strategy). There is only so much you can accomplish in 6 to 10 weeks after all, regardless of your level of effort doing this period.
Click to expand...

I think many people are lumping in intelligence, critical thinking and test taking skills all together when they just say intelligence. Many are just naturally better at these things with others. I also think some people simply have a talent for memorizing content, which is a large part of why some people do really well on the mcat but not well on step 1.

I agree on studying methods as well. Knowing how to learn is an important skill
 
sliceofbread136 said:
I think many people are lumping in intelligence, critical thinking and test taking skills all together when they just say intelligence. Many are just naturally better at these things with others. I also think some people simply have a talent for memorizing content, which is a large part of why some people do really well on the mcat but not well on step 1.

I agree on studying methods as well. Knowing how to learn is an important skill
Click to expand...

I think I memorized a lot less for the MCAT than for step 1. But the corollary between the two exams is fairly difficult to draw. I won't say that a high MCAT can lead to a high step 1 bc it's too variable.


Sent from my iPhone using SDN mobile
 
Womb Raider said:
Jesus - how did you find 10k unique questions?
Click to expand...
UWorld (+ incorrects), UWSA 1 and 2, USMLERx, Kaplan, Kaplan full-length simulated exams, CBSE, and all the NBMEs (including all the old offline ones). I even experimented with Becker a little bit, but those just weren't for me. Once you reach a certain point, you have to accept that you will not be seeing questions and explanations at the quality level of UWorld and just roll with it to a) see unique questions, b) perfect test-taking strategy, and c) follow your personal studying approach (as was the case for me, obviously). The benefit you receive after say the 7,000 question mark is another discussion entirely.
 
Last edited:
Womb Raider said:
Yeah the 2x uworld is a problem if we're trying to find unique questions. I'm just wondering what lesser known questions he used.
Click to expand...

Reasoning is UW is supposed to be the highest of yield with good testable info! So doing it twice is in fact worth it to memorize the patterns


Sent from my iPhone using SDN mobile
 
Nyctalopia said:
UWorld (+ incorrects), UWSA 1 and 2, USMLERx, Kaplan, Kaplan full-length simulated exams, CBSE, and all the NBMEs (including all the old offline ones). I even experimented with Becker a little bit, but those just weren't for me. Once you reach a certain point, you have to accept that you will not be seeing questions and explanations at the quality level of UWorld and just roll with it to a) see unique questions, b) perfect test-taking strategy, and c) follow your personal studying approach (as was the case for me, obviously). The benefit you receive after say the 7,000 question mark is another discussion entirely.
Click to expand...

Dude that's crazy. Props, I had trouble just finishing uworld
 
sliceofbread136 said:
Dude that's crazy. Props, I had trouble just finishing uworld
Click to expand...
Thanks. I don't think it's a whole lot different than the students doing Firecracker or Bros' Anki everyday on top of M2 class material, but I personally was much more motivated to use that time for questions.
 
sliceofbread136 said:
This, tired of seeing that crap. I think it's also due to our demographic being mostly limited to the highly educated. Go talk to a morbidly obese blue collar red neck and tell me that guy could do well on step 1 just by working hard
Click to expand...
Inb4 someone says rich people can also be fat 😉
 
51EA9B9D-AE62-4BC3-A14C-1BC7A3838F46-10459-000009F562353C44.png
 
Nyctalopia said:
I see this "intelligence and Step 1" discussion ad nauseum on these forums, and thought I would finally throw in my view on it since I feel I may have a slightly unique perspective. For reference, I am a US MD student who was for the most part slightly below average during my preclinical years for a number of reasons (suboptimal effort, poor organizational and study skills, etc). Still, I ended up scoring ~270 on Step 1 largely due to the factors listed below, in order of importance to Step 1 score.

1. Content memorization and mastery: I was certainly nowhere near the knowledge baseline of many of my peers nearing the end of second year classes. Knowing this, I had planned in advance to finish >10,000 unique practice questions prior to taking Step 1, with probably half of these completed before my dedicated period even started. A good underlying mastery of the content, in my opinion, is the single most important determinant of your Step 1 score (by far), however you go about accomplishing this (doing consistently well preclinically in a curriculum geared towards Step 1, completing tons and tons of questions, etc).

2. Pattern recognition and critical thinking/extrapolation ability: You could interpret this as being related to intelligence, but I firmly believe this is largely learnable. When you complete >10,000 practice questions and see a certain concept tested in 5-10 different ways, you are not going to miss that question on the real deal, almost regardless of what your IQ is. Moreover, reading explanations thoroughly in an efficient manner will definitely improve your critical thinking/extrapolation ability, beyond whatever baseline your intelligence grants you in this area.

3. Standardized test-taking ability/strategy: I think a lot of people on these forums underestimate the importance of test-taking ability/strategy to Step 1, and even often end up confusing this with intelligence. Let me be clear when I emphasize that I believe this to be largely under your control, unlike your raw innate intelligence. I don't intend to be mean-spirited when I say this, but I see a lot of post-Step 1 experiences on this site with some variation of "I ran out of time on almost every block and had to leave x questions blank", and I cringe every time I read this. Having your timing and question-approaching strategy down solid prior to taking Step 1 is absolutely essential to a great score. For example, the strategy I personally chose allowed me to go through every question at least 2 and often 3 times. As a result, I don't think I made a single "stupid" mistake on my Step 1. Every question I missed was due to not knowing a certain concept well enough. Other things that fall in this category include knowing the NPV of your unmarked questions (probability that your unmarked questions are answered correctly), knowing how often your changed answers are correct vs your original answer, etc. All of these components to test-taking strategy can be learned and mastered through a large number of practice questions.

4. Test day factors like the specific form of the exam you receive, mindset/confidence the day of the exam, and sleep the night before the exam: These are self explanatory, and more important than you might think.

5. Raw innate intelligence: Finally, we reach raw intelligence. I am not going to deny that medical students with higher IQs will do better on Step 1 on average than medical students with (relatively) lower IQs, but I believe many people on this site either greatly overestimate the contribution that intelligence plays in regards to a content mastery exam like Step 1 or often don't realize that a good amount of what they consider to be "intelligence" is actually fully learnable (as above). Many of my classmates are much better than me at memorization - as evidenced by their stellar preclinical grades - but I outscored them largely through my personal approach to the exam.

To summarize this already long post, intelligence does of course play a role in your Step 1 score, but not nearly as large as many people think. In no way do I mean to downplay the efforts of the many students who gave it their absolute all during their dedicated period and did not score a 250, but it is crucial to realize that just as important as how much you study is how well you study. It is also important to realize that many high scorers will either have started preparing for Step 1 well before their dedicated period starts (whether this is doing tons of questions or perfecting approach/strategy). There is only so much you can accomplish in 6 to 10 weeks after all, regardless of your level of effort doing this period.
Click to expand...
Could you please provide the sources for the 10k+ questions. This strategy served me well in the MCAT and I plan on using it for step .

Never mind didn't read down far enough.


Could you share when you started doing questions ? How you ended up doing on the test and any other suggestions for tackling this from day one. Thanks !
 
Last edited:
libertyyne said:
Could you please provide the sources for the 10k+ questions. This strategy served me well in the MCAT and I plan on using it for step .

Never mind didn't read down far enough.


Could you share when you started doing questions ? How you ended up doing on the test and any other suggestions for tackling this from day one. Thanks !
Click to expand...

+1

he/she said they scored around 270, and had completed about 5k Q's before dedicated, so over the course of M1 and M2 presumably, but I would love to hear more as well because I have done really well on exams using this strategy but didn't know how feasible this would be for step 1
 
Nyctalopia said:
UWorld (+ incorrects), UWSA 1 and 2, USMLERx, Kaplan, Kaplan full-length simulated exams, CBSE, and all the NBMEs (including all the old offline ones). I even experimented with Becker a little bit, but those just weren't for me. Once you reach a certain point, you have to accept that you will not be seeing questions and explanations at the quality level of UWorld and just roll with it to a) see unique questions, b) perfect test-taking strategy, and c) follow your personal studying approach (as was the case for me, obviously). The benefit you receive after say the 7,000 question mark is another discussion entirely.
Click to expand...
Anki?
 
SouthernSurgeon said:
IMHO a big part of it is not just that the test is standardized, but that the effort is standardized.

What I mean by that is - everyone puts their nose to the grindstone and busts their a** studying for step 1.

Step 2 has far more variable levels of preparation. As noted above a number of people don't even take it before they apply for residency (I didn't). The old joke of 2 months, 2 weeks, #2 pencil (the relative amounts of preparation for Steps 1, 2, and 3 respectively) still somewhat holds true.

So as a PD you use Step 1 since you know that's the test that best demonstrates maximum performance.
Click to expand...
I think you have the direction of causality backwards. Step 2 gets less effort/more variability because it is less important, and it's less important because step 1 is so important. Get rid of step 1 and I bet you'd see major shifts in the amount of studying and the timing for step 2.
 
libertyyne said:
If it is just a memorization test, I am screwed, I should probably just withdraw right now.
Click to expand...

This worries me too. I did much better on the new MCAT precisely because the slant moved from random facts to pattern recognition, critical thinking, and data-driven inference (still built on a basic framework of coherent understanding our unified theories of physics, chemistry, and biology).
 
Last edited:
libertyyne said:
If it is just a memorization test, I am screwed, I should probably just withdraw right now.
Click to expand...
it's not a memorization test.

Memorization of associations helps, but there is a ceiling of how far "pure memorization" will get you

The real key is conceptual knowledge. Understand how things work. This makes "memorization" intuitive and allows you to answer questions that present concepts in ways you haven't seen before. It allows you to interconnect concepts, and take it even one step further and extrapolate to situations you haven't seen before. Step 1 tests you on concepts by convuluting the stems and answer choices with obtuse wording, using pathologic descriptors rather than buzzwords, asking you to integrate two concepts that would seemingly be unrelated, or even give you a totally MADE UP physiologic/pathophysiologic process, and expecting you to answer the question using conceptual knowledge. These ruses they dress up the questions with make the exam seem very hard. But if you really understand big picture stuff, it can be made easier. it is hard to get this level of understanding though, let's be real. It takes work, but it means more time spent thinking about big picture and less time spent memorizing first aid or burning through 1-liner anki cards.

Obviously there is an element of memorization that is helpful. You need to fill in the gaps. There will be many questions that are nothing more than memorization and thus you need these discrete facts. But these are not the bulk of the test.

Don't worry. just try to learn as much as you can throughout first and second year. The more you learn now, the more will stick later. When you get to your dedicated, you want to be reviewing things, not learning them for the first time.

If anybody disagrees, feel free to discuss but I probably won't reply for awhile, being a brand new MS3 on IM is time consuming
 
libertyyne said:
If it is just a memorization test, I am screwed, I should probably just withdraw right now.
Click to expand...

There is some critical thinking, but imo the largest component being tested was "do you have X factoid memorized that you need to know to differentiate correct answer A from not-quite-correct answer B". It is largely memorization, but I think there are ways to simplify or minimize the memorization to make it easier on yourself (ie. these 2 disease have basically the same presentation, but this one has x present while the other does not) instead of trying to memorize everything with brute force.

Edit: FindMe responded right before me, so in response to that: it's not memorization in the sense of "here's a random list of numbers, remember as many as you can in that order", but even with the concepts there is still a significant amount of memorization that's needed. I do think that understanding the concepts is something necessary to do well on boards, but it will only get you so far and is far from enough to hit those upper level scores. I say so because learning concepts is something that I find to be incredibly easy and did very well with, but did not do all that great on boards. I'm pretty sure it was due to the fact that a lot of questions come down to remembering a specific detail which you need to have memorized to get correct.
 
Last edited:
FindMeOnTheLinks said:
it's not a memorization test.

Memorization of associations helps, but there is a ceiling of how far "pure memorization" will get you

The real key is conceptual knowledge. Understand how things work. This makes "memorization" intuitive and allows you to answer questions that present concepts in ways you haven't seen before. It allows you to interconnect concepts, and take it even one step further and extrapolate to situations you haven't seen before. Step 1 tests you on concepts by convuluting the stems and answer choices with obtuse wording, using pathologic descriptors rather than buzzwords, asking you to integrate two concepts that would seemingly be unrelated, or even give you a totally MADE UP physiologic/pathophysiologic process, and expecting you to answer the question using conceptual knowledge. These ruses they dress up the questions with make the exam seem very hard. But if you really understand big picture stuff, it can be made easier. it is hard to get this level of understanding though, let's be real. It takes work, but it means more time spent thinking about big picture and less time spent memorizing first aid or burning through 1-liner anki cards.

Obviously there is an element of memorization that is helpful. You need to fill in the gaps. There will be many questions that are nothing more than memorization and thus you need these discrete facts. But these are not the bulk of the test.

Don't worry. just try to learn as much as you can throughout first and second year. The more you learn now, the more will stick later. When you get to your dedicated, you want to be reviewing things, not learning them for the first time.

If anybody disagrees, feel free to discuss but I probably won't reply for awhile, being a brand new MS3 on IM is time consuming
Click to expand...

This is extremely comforting to me; after all, to have the big picture coherently set in your head requires a critical mass of discrete facts anyways. I suppose the more complex the picture, the more facts are required to reach that critical mass for an epiphany.

EDIT: I should say that, for me, this is particularly good to hear, because memorizing facts with the aim of some coherent mastery is extremely entertaining. Memorizing facts in order to memorize facts is a lot of work for me; I don't do so well with it.
 
Last edited:
FindMeOnTheLinks said:
it's not a memorization test.

Memorization of associations helps, but there is a ceiling of how far "pure memorization" will get you

The real key is conceptual knowledge. Understand how things work. This makes "memorization" intuitive and allows you to answer questions that present concepts in ways you haven't seen before. It allows you to interconnect concepts, and take it even one step further and extrapolate to situations you haven't seen before. Step 1 tests you on concepts by convuluting the stems and answer choices with obtuse wording, using pathologic descriptors rather than buzzwords, asking you to integrate two concepts that would seemingly be unrelated, or even give you a totally MADE UP physiologic/pathophysiologic process, and expecting you to answer the question using conceptual knowledge. These ruses they dress up the questions with make the exam seem very hard. But if you really understand big picture stuff, it can be made easier. it is hard to get this level of understanding though, let's be real. It takes work, but it means more time spent thinking about big picture and less time spent memorizing first aid or burning through 1-liner anki cards.

Obviously there is an element of memorization that is helpful. You need to fill in the gaps. There will be many questions that are nothing more than memorization and thus you need these discrete facts. But these are not the bulk of the test.

Don't worry. just try to learn as much as you can throughout first and second year. The more you learn now, the more will stick later. When you get to your dedicated, you want to be reviewing things, not learning them for the first time.

If anybody disagrees, feel free to discuss but I probably won't reply for awhile, being a brand new MS3 on IM is time consuming
Click to expand...
This is very reassuring. for me personally this has always been my mode of memorization. memorization without understanding just never sticks for me . Going through practice questions to drive a concept home and solidifying understanding has been the key for success for me. Furthermore, what enjoyment is there of the material if you dont have conceptual understanding.


JJRousseau said:
This is extremely comforting to me; after all, to have the big picture coherently set in your head requires a critical mass of discrete facts anyways. I suppose the more complex the picture, the more facts are required to reach that critical mass for an epiphany.
Click to expand...
1+
 
You took time off to study for Step 1.

Now is the time to bust your ass, not to question the merits of the exam.

Also, it's a memorization exam only if you don't know things. You can't apply what you don't know... (and trust me when I say that I understand this)
 
Since when are 'memorization ability' and intelligence mutually exclusive? To me, the ability to retain information quickly and easily is a significant aspect of intelligence. But overall, @FindMeOnTheLinks last post was spot-on.
 
ridethecliche said:
You took time off to study for Step 1.

Now is the time to bust your ass, not to question the merits of the exam.

Also, it's a memorization exam only if you don't know things. You can't apply what you don't know... (and trust me when I say that I understand this)
Click to expand...

Ya, well a bit extra time makes you question step 1 as well as life lmao. Latent side effect of losing your mind.


Sent from my iPhone using SDN mobile
 
Then you should:

1) Study your ass off
2) Take it as early as you possibly can without shooting yourself in the foot.
3) Go on vacation for a couple of weeks before you start third year.

You can only study at that pace for so long before you start to resent it and your diminishing marginal returns run into the negatives.

I started my surgery rotation right after my exam... I legit got one day 'off' which I spent getting groceries and getting my life together. I'm really happy to have started rotations, but I'm exhausted and find it really hard to dig down and study right now.

You don't want to end up in this position.
 
Shams al Deen said:
Since when are 'memorization ability' and intelligence mutually exclusive? To me, the ability to retain information quickly and easily is a significant aspect of intelligence. But overall, @FindMeOnTheLinks last post was spot-on.
Click to expand...

They aren't mutually exclusive, but I do think there's a difference in the cognitive ability and skills required between rote memorization of factoids and integrating information in a rational way that allows for a slightly more intuitive understanding of whatever material is being tested.

Of course, step 1 does require a lot of memorization, but actual clinical skills - you know, the things that actually matter - require less factoid memorization and more synthesis and "higher level" cognitive function. There is a difference, though, as you say, they aren't necessarily exclusive.
 
to score well you need:

MCAT: 4/10 memory, 8/10 critical thinking, 6/10 dedication and work ethic
Step 1: 9/10 memory, 9/10 critical thinking, 9/10 dedication and work ethic

These scales are obviously arbitrary, but it gets the point across. Step 1 measures everything and if you're deficient in any, your score will suffer. Every person who's scored 250+ has all three.
 
I think that with the MCAT it was far easier to narrow down an answer if you had some basic understanding of the topic. On step, the answers often have differences that you'd only know if you had a solid understanding of the topic. Otherwise, you can narrow down to two answer choices and hope you guessed right.
 
ridethecliche said:
I think that with the MCAT it was far easier to narrow down an answer if you had some basic understanding of the topic. On step, the answers often have differences that you'd only know if you had a solid understanding of the topic. Otherwise, you can narrow down to two answer choices and hope you guessed right.
Click to expand...

I think this is a much more concise way of putting what I was trying to say. The whole test isn't memorization, but to get past that final 50/50 choice you often had to remember a specific detail. That's also why I said it's not necessary to brute memorize. If you can get the concept, you just have to know how to differentiate between the last 2 options. I'd guess that of all the questions I missed, around 80% were questions where I got it down to a 50/50 and just didn't know that last differentiating point (which was typically something you had to memorize, imo).
 
Stagg737 said:
I think this is a much more concise way of putting what I was trying to say. The whole test isn't memorization, but to get past that final 50/50 choice you often had to remember a specific detail. That's also why I said it's not necessary to brute memorize. If you can get the concept, you just have to know how to differentiate between the last 2 options. I'd guess that of all the questions I missed, around 80% were questions where I got it down to a 50/50 and just didn't know that last differentiating point (which was typically something you had to memorize, imo).
Click to expand...

A few of the really good students/test takers I know usually end up thinking about things in A/B pairs.

Let's take Crohns and UC as examples. They'll learn the things common to both of those, then learn the differences for one. So let's say they learned the details for Crohn's, but now they have something that looks like it in the exam, but starts in the rectum and doesn't really have any indications of granulomas, well then it's probably UC. Stuff like that can decrease the memorization.

It may make some questions more challenging if you have to work through everything and narrow it down to one because you don't know the details off the top of your head.
 
FindMeOnTheLinks said:
it's not a memorization test.

Memorization of associations helps, but there is a ceiling of how far "pure memorization" will get you

The real key is conceptual knowledge. Understand how things work. This makes "memorization" intuitive and allows you to answer questions that present concepts in ways you haven't seen before. It allows you to interconnect concepts, and take it even one step further and extrapolate to situations you haven't seen before. Step 1 tests you on concepts by convuluting the stems and answer choices with obtuse wording, using pathologic descriptors rather than buzzwords, asking you to integrate two concepts that would seemingly be unrelated, or even give you a totally MADE UP physiologic/pathophysiologic process, and expecting you to answer the question using conceptual knowledge. These ruses they dress up the questions with make the exam seem very hard. But if you really understand big picture stuff, it can be made easier. it is hard to get this level of understanding though, let's be real. It takes work, but it means more time spent thinking about big picture and less time spent memorizing first aid or burning through 1-liner anki cards.

Obviously there is an element of memorization that is helpful. You need to fill in the gaps. There will be many questions that are nothing more than memorization and thus you need these discrete facts. But these are not the bulk of the test.

Don't worry. just try to learn as much as you can throughout first and second year. The more you learn now, the more will stick later. When you get to your dedicated, you want to be reviewing things, not learning them for the first time.

If anybody disagrees, feel free to discuss but I probably won't reply for awhile, being a brand new MS3 on IM is time consuming
Click to expand...

Right. So if I can understand which hemophilias are X-linked and which aren't then it's not memorization?

If I can understand which RTA 1/2/4 corresponds with what defect?

Don't even get me started on genes... Or trying to understand why Felty syndrome is called felty syndrome, what do you read their biography to understand why he named that particular association?? Or the glomerular disease associations, or like you said any disease associations.

I agree that it's understanding and some things can be helped remembered via understanding, but if you try to understand absolutely everything, 30% of the facts that are straight up memorization will send someone on a wild goose chase through Pubmed and wikipedia only to find that we don't know why something is associated with it, it just is.

The way I see it is it takes memorization first for 90% of it and the next step is applying it. You can't apply what you can't remember. You also can't pick a disease out of a vignette if you can't remember the features of a disease, which sometimes just have presentations you can't reason out unless you read into a molecular reason as to why it presents as it does.

It's funny how people with the best memories advocate that step 1 is more understanding than it is memorization. It's as much understanding as it is memorizing different shopping shopping lists and then making inferences on who is a vegetarian and who is a vegan. Beyond that, the amount of "thinking" isn't that complicated.
 
ridethecliche said:
A few of the really good students/test takers I know usually end up thinking about things in A/B pairs.

Let's take Crohns and UC as examples. They'll learn the things common to both of those, then learn the differences for one. So let's say they learned the details for Crohn's, but now they have something that looks like it in the exam, but starts in the rectum and doesn't really have any indications of granulomas, well then it's probably UC. Stuff like that can decrease the memorization.

It may make some questions more challenging if you have to work through everything and narrow it down to one because you don't know the details off the top of your head.
Click to expand...

I agree, as I did the same thing with a lot of conditions (your example being one of them), but there's still a fair amount of memorization in that technique that understanding concepts doesn't help. For example, it's counterintuitive to me that anal fissures would be related to Crohn's and not UC when UC is the condition that always starts distally at the rectum while Crohn's can occur anywhere in the digestive tract.

So while there are tricks to cut down on the memorization so you don't have to brute memorize everything. Sure, understanding the concepts can help you work through some things in which straight memorization would be difficult (imo you can do this with most heart murmurs). However, you still have to memorize a significant amount of information in which just understanding the overarching concept is inadequate to arriving at the correct answer. That's what I was saying.
 
Brorthopedic said:
to score well you need:

MCAT: 4/10 memory, 8/10 critical thinking, 6/10 dedication and work ethic
Step 1: 9/10 memory, 9/10 critical thinking, 9/10 dedication and work ethic

These scales are obviously arbitrary, but it gets the point across. Step 1 measures everything and if you're deficient in any, your score will suffer. Every person who's scored 250+ has all three.
Click to expand...
Me likey.
 
ridethecliche said:
A few of the really good students/test takers I know usually end up thinking about things in A/B pairs.

Let's take Crohns and UC as examples. They'll learn the things common to both of those, then learn the differences for one. So let's say they learned the details for Crohn's, but now they have something that looks like it in the exam, but starts in the rectum and doesn't really have any indications of granulomas, well then it's probably UC. Stuff like that can decrease the memorization.

It may make some questions more challenging if you have to work through everything and narrow it down to one because you don't know the details off the top of your head.
Click to expand...

A lot of this comes from doing loads of questions and understanding pattern recognition!


Sent from my iPhone using SDN mobile
 
Stagg737 said:
I agree, as I did the same thing with a lot of conditions (your example being one of them), but there's still a fair amount of memorization in that technique that understanding concepts doesn't help. For example, it's counterintuitive to me that anal fissures would be related to Crohn's and not UC when UC is the condition that always starts distally at the rectum while Crohn's can occur anywhere in the digestive tract.

So while there are tricks to cut down on the memorization so you don't have to brute memorize everything. Sure, understanding the concepts can help you work through some things in which straight memorization would be difficult (imo you can do this with most heart murmurs). However, you still have to memorize a significant amount of information in which just understanding the overarching concept is inadequate to arriving at the correct answer. That's what I was saying.
Click to expand...

The rectum and anus aren't the same thing though. UC goes up from the rectum, not the anus. In terms of GI ish, an anal fistula would have Crohn's pretty high up on the differential, depending on patient history obviously.
 
ridethecliche said:
The rectum and anus aren't the same thing though. UC goes up from the rectum, not the anus. In terms of GI ish, an anal fistula would have Crohn's pretty high up on the differential, depending on patient history obviously.
Click to expand...

I understand that, but to me it makes more logical sense that the condition that always starts out with the pathology in the distal location adjacent to the anal fissures would have an association with them instead of the condition which is more likely to start in small bowel or cecum. So you're just supporting my point that even with conceptual understandings, you still have to memorize details to differentiate the two diseases and answer a 50/50 correctly.

Edit: To clarify, I'm not saying anal fissures should be associated with UC. It's very clear they have a far higher association with Crohn's. I'm saying that it's a fact you have to memorize, not something you'd be able to conceptually reason through on a test.
 
You must log in or register to reply here.

Similar threads

cerebellar
Step 1 advice!
Replies
0
Views
437
cerebellar
cerebellar
S
M1 Step 1 Advice
Replies
4
Views
421
Goro
Goro
C
the state of step 1
2
Replies
84
Views
7K
Reanox24
Reanox24
C
Why is the NBME test taking software so ****ty?
Replies
2
Views
578
voxveritatisetlucis
V
B
Step 1 Advice Needed
Replies
7
Views
2K
BeeBoo420
B
Top