bluedusk
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Well, guys, it's over. Since who knows if I'll still be on this board by the time I get my score, here are my thoughts for you all....
BM wrote a week ago here that she would have studied a lot less. I probably agree with her by now. I used FA 2004, Goljan notes (audio, 44 pages, 100 pages, and lecture notes). I did all of Q-Bank probably about 1.8 times through. I also read (but feel I didn't absorb every last detail of ) Jawetz, BRS Path and Pharm, Lippincott Pharm, and the HY for Biostat, Biochem, Neuro, Anat, & about the 1st half of HY Embryo and Histo.
Oh, and it's been ten years since I took time off after the 1st 2 years at a US med school, and I was mostly doing lab stuff then, so I starting off knowing NOTHING.
I got 680 on the NBME part I about four weeks ago, but felt I still didn't know squat. I scored 43, 44, and 47 on the NBME CD. I was at around 75% on the Kaplan simulated exam, probably at about 80% when I did it a few days before the exam, after adjusting for questions that I remembered the answers to.
IF I HAD TO DO IT OVER AGAIN...well, I had to do as well as I could, both because of my personality and what I want to do, so maybe I wouldn't have changed anything. But I still could have studied a lot less. Here is what I would do if I weren't so OCD but still wanted to do very well....
1. Give yourself plenty of time. If you need to do well on this exam, start off with a year runway and cut it down as you need to. If you don't feel good about it, put it off. There is absolutely no reason to go through this misery halfway. None.
2. Memorize FA 2004. If you have a year, you can do this at a somewhat leisurely pace. If you don't have anyone to study with (like I didn't), then just write a question to yourself in the margins anytime you hit a detail you don't know. If you keep doing this, you will soon memorize the whole thing. Use mnemonics and go over them.
Draw the figures! You should be able to draw the cavernous sinus or the brainstem with the circle of Willis. Heck, I'm a D- artist, but I could draw all the neuro stuff from FA from one night of studying, and I just practiced 1-2 times a week coming up to the exam.
People are right, the details in this book are key. I didn't get every detail of them in the exam, but the details I needed to know were in there or Goljan. Little picky things like the fact that Paclitaxel STABILIZES polymerization but Vincristine DISRUPTS polymerization. Things at that detail. I didn't get those on my exam, but it's that kind of stuff. It's there in FA, but you almost don't see it until the 99th time you read it. All the drug side effects. I probably used a FA factoid every 3-4 questions.
2. Goljan rocks. I probably got as much on my exam from him, if not more, than from FA. I mean, and it's more readable and shorter. Listen to his audio twice and read the notes in between. It's totally doable. There's nothing to compare to him. He gets FA-missed points in spades.
3. Get the Pretest books (clinical series with lots of Q's) for Medicine and Surgery. I did one year of clinics before taking this exam, but I can't imagine - it would have been 100x harder if I hadn't. If you're a 2nd year medical student or have been off the medicine rounds for a long time, just get these books. They're super easy to assimilate (just questions!) and super HY.
4. I have a Ph.D. in genetics, but if you don't go get the HY for molecular bio and know it cold. There is a ton of experimental stuff, and if you know how people do experiments, it helps 100x.
That's it. OK, now a few notes from the exam. Lord knows how I did, but I found it almost identical to the NBME practice in difficulty - if anything, almost a bit easier. I did QBank so long ago I can't compare, but QBank is all facts and buzzwords. This exam requires you to think (exactly 1.8 steps per question).
1. ALL THE PEOPLE WRITING THAT YOU NEED TO KNOW DETAILS LIKE CLOSTRIDIUM DIFFICILE INHIBITS RHO PROTEIN OR THAT TAP PROTEINS WORK WITH MHCI. No. No, no, no, no, no. Take all the time I wasted learning this crap and memorize another FA fact. If you know FA cold, don't stress. You'll be OK. Okay, maybe I got an easier exam. But what I saw was that there were plenty of details I'd never heard of, but the point of the question was almost NEVER the detail. They were using it to ask a question about your understanding.
I'll use one example from the NBME practice exam I remember - about drug resistances in cancer? It seemed like a really difficult question, because how are you supposed to know how every tumor develops resistance to these drugs! Impossible! But if you look at the answers, there was one drug for which each of the resistance mechanisms was flat-out impossible. So the only one left was a protein that transported the drugs out of the cell, which turned out to be the right answer.
I thought the entire USMLE Step I, in terms of details, was EXACTLY like this. If you just relax and think about it logically, it's not crazy. They don't want you to know crazy stuff. It's actually kind of cool. I'm surprised they made such a perceptive exam.
2. THIS IS A PRECLINICAL EXAM. Um, not really. They just don't remember what it's like to be a preclinical student. All I know is, if I hadn't done clinical work, the clinical fluency of this exam would have been daunting. Go do those two Pretest books I mentioned up there and know them cold. I had to do them on my wards, and I have to say that knowledge alone relaxed me completely with the clinical scenarios.
3. ON THE EXAM ITSELF - I thought it was fair. Almost everything was in there - a little embryo, a little anat, plenty of path, pharm, micro, phys. Well-balanced. No crazy details. Most sections I had done in 30-35 minutes and found probably ~2 mistakes per section when I reviewed them. That plus the handful I was clearly making a wild-ass guess on.
I kept waiting to have to pull out my knowledge that CCK and secretin are Q receptors or that Salmonella causes bradycardia or that benzo's decrease Stage 4 sleep, blah, blah, blah. NOTHING! Ditto for my hard-won ability to churn back every FEP, steroid pathway, and TBG level on Goljan's notes! Like I said, if you memorize FA and Goljan, start to finish, you're better than done on the details. Seriously. You won't even see 75% of that stuff.
Um, that's it, I think. Some of you were really cool to bounce questions with. Glad this site is around. To all of you out there, best luck on reaching your dreams. I'll have a good thought for you.
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| bluedusk
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Oh, and by the way, to CL whose post about rereading HIV I read at like 9pm last nite and almost threw up with exhaustion bringing myself to read...thank you. Very much.
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| bluedusk
Forum Elite
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Oh, just in case I mess someone up, secretin is a cAMP receptor. See? I'm starting to forget already. Thank god.
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| rubensssss
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Congatlation, for taking your test, wish the best, hope you do fine.
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Ruben sssss
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| Alina T
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hey bluedusk! Thanks for the post, u made it pretty clear and concise. gave me confidence and strength to go further.
i'm sure u'll get a good score!  now just relax and get your forces together for the next one.
how long did u study for this test? u said u shoud have studied less.....how long is that?
thanx
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There are 3 types of people: those who make things happen, those who watch things happen, and those who wonder what happened.
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| dxtxpx
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well u r done for now so i am sure u r relaxing i really like your post in sense that it really potray your experience. thank you for writing bout FA and goljan cuz i am reviewing FA this week for god knows how many times and thinking that maybe i should read some more details from some real books but dont feel upto absorbing such details at this time when i wanna take the exam in less than a month. so your post really encouraged me, i felt like i am on the right track. thing u said bout clinicals: i have passed step 2 earlier and love clinical scenarios so hopefully i will be ok with that and i have done those pretest books earlier for step2.
thankyou again for such an encouraging and positive post. Wish u the best of luck on your scores and for future
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| bluedusk
Forum Elite
Topics: 35
Posts: 217
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you guys will rock! sadly i had to start my subI today, so it's back to the grind, but ah well. i've stocked my fridge with beer to keep me company when i get home at nite.
sarangi asked me a good question about images - to be honest, i went and looked up all these images (btw, screw an atlas or some paid site - google images search function is incredible and will find anything you need) but it doesn't help all that much. i mean if you know staph are in clusters and strep in chains, i don't think it's worth the time to GO LOOK at bacteria in clusters unless you are really bored and have nothing else to do.
i think i got one question right for looking at like 100 pictures. my ct's were kind of obscure - if you do them at all, just make sure you'll recognize hy stuff like where the hepatic vein hits the ivc, etc.
i became a little too fixated with the details at the end. i knew the mirtazapine receptors, but forgot that metformin was classified as a biguanide : ) guess which one i got on my exam. hit the big stuff first : )
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| bluedusk
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Topics: 35
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oh, for alina, i'd say i was trying to read brs and jawetz on call nights for 1.5 years, but mostly succeeding in falling asleep. and making my residents wonder "why the heck is he studying for step 1 on the wards"?"
3 months of intensive studying, though honestly i couldn't get myself to haul butt til the last 2 months. i was just so overwhelmed, which was, in retrospect dumb.
i wish someone had told me, start off by memorizing fa and goljan (i lost track of the 100 p hy goljan til the last week, if that tells you how inefficient i was). then add hy anat/neuro. then if you have time and are off your zyprexa, go for some medicine pretest.
oh, and man, i know people say this, but find a way to sleep the night before. i mean, it's such a "thinking" test, that you just can't do it on adrenaline. i couldn't sleep at midnight, so i scarfed a huge meal just to tamp it down.
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| nsh_00
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Hey Bluedusk remember me from the behavioral forum. Glad to see you're done now. By your description, I'll put my money on you getting at least a 250. With nothing else said, just finishing those blocks in 30-35 min is beyond amazing. And those nbme scores, another WOW.
I'm expecting my result this week, I agree with all you have to say of the exam ESP. the fact that those seemingly far-fetched questions are all based on Simple Principles.
The only difference is that my test was WAY more difficult, longer, and detailed than NBME. I guess everybody has a different test. Do keep in touch on the board and at least post your score. Best of Luck TO YOU.
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| bluedusk
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hey nsh. it's funny, i think today is the first time i actually started to feel like i'm done. i'm so conditioned to study that i keep wanting to read some fact or check this website. must....stop....
maybe nbme was easier. i just remember on both thinking, around 10 out of 50 i knew i was taking a crapshoot on between 2 choices and being okay with that. i thought the big difference from the kaplan tests, including simulated, is that at least on the nbme and actual usmle, there were at leaset some i was SURE of.
hope you get a great score and best of luck in the future! probably i'll pop up on the step II.
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| JCM
Forum Newbie
Topics: 1
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Congratulations, I am sure you did great!
Question: you recommend memorizing goljan, I only have time for reading one of the goljan notes (maybe not the lecture notes).. which one is a must 36p, 44p, 100p or audio?.. Thanks
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| bluedusk
Forum Elite
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i'd go with the 100. easier to reference bc it is well organized.
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| Malu
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thanks so much for such a detailed report...could you tell me how i could get the goljan 100 pages? ive tried everwhere and it seems near impossible to get a hold of these mysteriouse notes...please <:help:>
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| shb
Forum Newbie
Topics: 0
Posts: 2
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Hi,
I don’t feel myself well. I’m graduate from outside of America and I did take step 1 in the end of August. Today I get my score it is 64, I faild. I read you massage. Would you please give me some information about how can i try one more time and pass the exam?
I read High Yield series (pharmacology, biochemistry, Behavioral science), Clinical microbiology made ridiculously simple (medmaster), Clinical anatomy made ridiculously simple (medmaster), Step 1 first Aid, Kaplan Q book, USMLE simulated CD, and Kaplan webprep CD.
I really need your help. I’ll be appreciating if you give me more tricks or information for passing the exam. :shock:
Thank you
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| bluedusk
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Hey guys. Shb, my guess is that you have the materials you need. I mean, who knows, maybe I didn't even pass, but I can tell you that more materials wouldn't have helped me too much. What I would do is MEMORIZE FA. Like, do you remember the antibody class responsible for IgE expression, or for eosinophil attraction in FA? Do you remember which immunosuppressive is a derivative of an anticancer drug? Can you draw the entire cardiac cycle and tell yourself where all the heart sounds are and juxtapose on top all the jugular venous waves and EKG spikes?
If you do that, you should be fine. I'd also get the Goljan tapes and maybe Medicine Pretest and know those two cold too. Oh, and also the Goljan 100 pages notes - memorize those. FA, Goljan audio/100pages, HY anatomy, HY neuro, and Medicine Pretest. That is my prescription. Good luck!
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