Worried as first year comes to a close

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dcnetsfan77

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Hey all,

I am finishing up my last block as a first year at a NJ medical school and had some time to reflect on my performance. As someone trying to go for a surgical sub specialty (like ortho) I am pretty worried. My grades have been high and low but overall they have hovered around the class average and I am getting really worried that this is a reflection of how Step 1 is going to go.

How indicative are medical school test grades on Step 1 performance? Can I get over this "average" feeling and crush it with crazy hard work? Any advice for this summer (to study, or not to study or how to study?!)

(just as a side note I am someone who spends a lot of time studying and often have to go through many repetitions of my notes as I can't absorb information as well as a lot of my classmates so I make up for it by putting in more hours)

Thanks!

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They are heavily correlated to your Step 1 performance. However, this is also dependent on how well your school teaches toward the boards. My school was not very good at it, so people that did just the minimum but hyperfocused on boards did a lot better than those that only sticked to the curriculum.
 
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They are heavily correlated to your Step 1 performance. However, this is also dependent on how well your school teaches toward the boards. My school was not very good at it, so people that did just the minimum but hyperfocused on boards did a lot better than those that only sticked to the curriculum.

This.

My school's curriculum kinda sucks at teaching to the boards, so I switched from studying 100% lecture material to studying 10% lecture material and 90% boards. My grades have fallen from A's to B's, but I feel like I'm going to be way better prepared for Step 1. The caveat is that I go to a true P/F school, so I can afford to ignore classes.
 
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Hey all,

I am finishing up my last block as a first year at a NJ medical school and had some time to reflect on my performance. As someone trying to go for a surgical sub specialty (like ortho) I am pretty worried. My grades have been high and low but overall they have hovered around the class average and I am getting really worried that this is a reflection of how Step 1 is going to go.

How indicative are medical school test grades on Step 1 performance? Can I get over this "average" feeling and crush it with crazy hard work? Any advice for this summer (to study, or not to study or how to study?!)

(just as a side note I am someone who spends a lot of time studying and often have to go through many repetitions of my notes as I can't absorb information as well as a lot of my classmates so I make up for it by putting in more hours)

Thanks!
How are you doing on shelf exams? Not all med schools teach board-relevant material or have exams that are similar to NBME-type questions, but shelf exams supposedly correlate better with Step 1 scores. From my understanding (though not personal experience yet), average med students can excel on Step 1 by doing tons of questions and essentially memorizing First Aid and Pathoma. I personally plan to review everything from M1 this summer and start using Qbanks (USMLE Rx and Kaplan) as I start M2.
 
Yes you can make up for it. Especially because its not like you are below average struggling to get by. Step 1 is very M2 heavy regardless. School grades usually are indicative as a general trend but you are not a statistic.

My tip would be to learn to study more efficiently. M2 is more time intensive so in order to improve your performance I think you need to figure out ways to study better (not simply more).

For me this was primarily Anki (especially if you need repetition), taking notes on PPTs on a computer software (onenote), and then handwriting little study guides, combined with practice questions throughout the year along with your courses (I used Kaplan).

I used Anki over the M1/M2 summer but to be honest I didn't find I got that much from it. The M1 topics you forget will come back up during dedicated/practice Qs so I would just worry about it then. Maybe you can find some better way but in general I wouldn't stress too much about studying over the summer.
 
Your performance on Step 1 is 100% dependent on the work you put into it.

At my school the only factor positively correlated with a higher Step 1 score was the number of total Qbank questions completed and reviewed, not preclinical grades, and not class rank.

Use this time to research the study method that could work best for you and start when you feel you're ready. Set a goal score for yourself and reach it. Best of luck!
 
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Yes you can make up for it. Especially because its not like you are below average struggling to get by. Step 1 is very M2 heavy regardless. School grades usually are indicative as a general trend but you are not a statistic.

My tip would be to learn to study more efficiently. M2 is more time intensive so in order to improve your performance I think you need to figure out ways to study better (not simply more).

For me this was primarily Anki (especially if you need repetition), taking notes on PPTs on a computer software (onenote), and then handwriting little study guides, combined with practice questions throughout the year along with your courses (I used Kaplan).

I used Anki over the M1/M2 summer but to be honest I didn't find I got that much from it. The M1 topics you forget will come back up during dedicated/practice Qs so I would just worry about it then. Maybe you can find some better way but in general I wouldn't stress too much about studying over the summer.
Out of curiosity, what do you mean when you say Step 1 is M2 heavy? Is that based on a certain curriculum?
 
Out of curiosity, what do you mean when you say Step 1 is M2 heavy? Is that based on a certain curriculum?

He means courses like pathology, pathophysiology, pharmacology, and microbiology are emphasized over biochem and anatomy.

First year courses do and will come up, but more often than not in the form of some pathology.
 
He means courses like pathology, pathophysiology, pharmacology, and microbiology are emphasized over biochem and anatomy.

First year courses do and will come up, but more often than not in the form of some pathology.
He means courses like pathology, pathophysiology, pharmacology, and microbiology are emphasized over biochem and anatomy.

First year courses do and will come up, but more often than not in the form of some pathology.
Gotcha. I figured that was probably the case, but my school changed to a systems-based curriculum, and I was told we were late to the game and that most schools are systems-based now.
 
How are you doing on shelf exams? Not all med schools teach board-relevant material or have exams that are similar to NBME-type questions, but shelf exams supposedly correlate better with Step 1 scores. From my understanding (though not personal experience yet), average med students can excel on Step 1 by doing tons of questions and essentially memorizing First Aid and Pathoma. I personally plan to review everything from M1 this summer and start using Qbanks (USMLE Rx and Kaplan) as I start M2.


You don't take shelf exams until clerkship years, which is after you take Step 1.

You are correct though, the questions are very similiar
 
You don't take shelf exams until clerkship years, which is after you take Step 1.

You are correct though, the questions are very similiar
Interesting- our school takes NBME shelf exams after each block. I didn't know that wasn't done everywhere.
 
Hey all,

I am finishing up my last block as a first year at a NJ medical school and had some time to reflect on my performance. As someone trying to go for a surgical sub specialty (like ortho) I am pretty worried. My grades have been high and low but overall they have hovered around the class average and I am getting really worried that this is a reflection of how Step 1 is going to go.

How indicative are medical school test grades on Step 1 performance? Can I get over this "average" feeling and crush it with crazy hard work? Any advice for this summer (to study, or not to study or how to study?!)

(just as a side note I am someone who spends a lot of time studying and often have to go through many repetitions of my notes as I can't absorb information as well as a lot of my classmates so I make up for it by putting in more hours)

Thanks!


You just need to pass your pre-clinical classes.

The grades you get there is not necessary indicative of how you will do on the test. You are right in your time of training where every student will start showing up with a First Aid book. At least in my school, many students started slipping in their class grades because they needed to focus on the Step. It shouldn't be that way, but the Step 1 is just so damn important.

Realize that licensing exams are not about actually knowing medicine, they are about answering test questions correctly. This becomes readily apparent the further in your training you get, as you will meet many excellent physicians when you are a resident who do poorly on these exams. Good at medicine, bad at answering test questions.

The key is to practice answering test questions. Do the question banks. Do them in real time. Go over why every answer was right or wrong. The question stems are all about pattern recognition. Learning that when certain things are in a test question they are pushing you toward a certain answer. The Q-banks that have explanations will teach you the subtle difference between two similar disease processes.

I did (and continue to do) very well on all of my standardized exams, and I almost never looked at a review book (get First Aid, it really is a good primer). I didn't do Goljan, and definitely not Pathoma. I just did a TON of practice questions, and you should to.
 
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Interesting- our school takes NBME shelf exams after each block. I didn't know that wasn't done everywhere.


Interesting....very expensive for the school (although you are paying tuition for something). They would be excellent preps for the Step exams, as discussed above, but they tend to be more advanced in material, and are closer to the test questions you will see on Step 2. They focus a little more on treatment and management.

We took them after each major clerkship (IM, FM, Psych (hardest one by far), OB/gyn, etc....)

I wonder how you would take an IM shelf exam without having finished year 2 and gotten into some clinical medicine? Seems like a recipe for some very frustrated medical students.
 
Your story sounds similar to mine (I'm now a MS3 pursuing ortho). However, being insightful is a plus and I think you'll be able to keep improving. Over the summer, you can brush up on what you've learned in MS1, and fill in any blanks in your First Aid blocks. Do it very lightly, as I don't think devoting too much time in the summer will help. It's much more importantly to enjoy your vacation :)
 
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I wonder how you would take an IM shelf exam without having finished year 2 and gotten into some clinical medicine? Seems like a recipe for some very frustrated medical students.

I think they're referring to the pre-clinical shelves-- NBME offers shelf exams in physiology, pathology, microbiology, etc. Not all schools offer them, and the way they're utilized varies (course final vs boards review) so they're useful but not as relevant to Step 1 as the clinical shelves are to Step 2.
 
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He means courses like pathology, pathophysiology, pharmacology, and microbiology are emphasized over biochem and anatomy.

First year courses do and will come up, but more often than not in the form of some pathology.

Yes exactly. I actually felt like I learned some M1 topics much better in M2 because then they were presented in a more clinical way.

Also just a side note because a couple people mentioned moving away from Pathoma, I would recommend doing the videos for sure. I never used the book. The videos definitely help connect the dots though. I would watch the relevant chapters during test blocks and then I went back and rewatched them all during dedicated (Usually like one chapter every day or so). I know some people watch them as an introduction to a topic but I would actually usually do them more towards the end once I had gotten alot of the key facts down but maybe didn't have the best understanding of the whole picture.
 
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