surgeon1
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This post may be helpful for those IMGs that don't need top USMLE scores, because they have already secured positions in the US - and they just need ECFMG certification.
I am a UK trained surgeon (I qualified in 1997). I am going to do a couple of fellowships in the US, and I simply needed to pass the USMLE. Scores were therefore pretty irrelevant.
I had a really busy time with work and other commitments (writing papers, books, and getting married, and a really imporant UK post-graduate exam). I did not manage to do any USMLE revision until six days before my first exam. I did Step II CK first and Step I three days later.
I chose to do Step IICK first because I hoped it wuld be a bit easier - I spent Friday afternoon, Saturday and Sunday revising for that. I concentrated on the topics I knew next to nothing about - Paediatrics, Obs and Gynae, Psychiatry, Endocrinology and Infectious disease. I used Advanced Life Support for the USMLE - fantastically concise. I bought a whole load of Review bokos from a friend - they were a Complete Waste of Money. I never had time to open them. I used the concise text books I liked when I was an undergraduate - familiarity seemed to help.
I spent the Tuesday, Wednesday and Thursday BEFORE that cramming for the Step I. And, as I'd booked that after the Step IICK, I then spent the three days after the Step IICK going over the stuff I'd done a few days before. I used First Aid for the USMLE, and alll of the At A Glance series, concentrating on the topics I didn't know well (endocrinology, genetics, biochemistry, pharmacology). I didn'r revise anatomy, physiology or pathology - if you've passed MRCS (UK surgical postgrad exam) you probably know enough of those to pass USMLE.
I got 42-44/50 on each of the CD's first time round. I didn't have time to do any other mock exams.
I found the real exams hard going (I was ill at the time because I was taking HIV PEP after a scalpel injury at work). The questions are a LOT longer than the ones on the CD. Everything has already been said well in these fora, but the one thing I would emphasise is use your common sense. I felt I could almost always narrow the choice down to 2 answers that were obvisuly the best, and although it often felt as though I was guessing between the two, usually there would be a hint in the question to point the right way (and yes. For those of you that revised PROPERLY I'm sure this wouldn't be a "hint" but a completely BARN-DOOR CAST IRON BANNER SCREAMING CHOOSE ME! But you guys can go and play on a 99 score thread.  )
Anyway. Exams on 19th and 22nd December, reported on 18th and 19th January (in reverse order bizarrely) and the OASIS trick today and this time last week says I passed. I am sure my scores will be borderline and I'll post them as soon as I get them.
Main points:
1) I got plenty of sleep - I'm too old to revise through the night
2) USMLE First AId and Advanced Life Support - excellent
3) Don't buy big single topic review books - stick to your old undergraduate favourites which worked for you then OR I'd suggest the At A Glance series.
4) Use the USMLE practice CDs to work out if your first guess is usually right - once I realised that when i went back and changed answers I was more often wrong than right I stpoped bothering to check through my answers. Saved a lot of time and a few points.
Really hope this hlpes (and doesn't sound too arrogant). It was just a desperate srtategy for a desperate situation. I'm not particularly bright so if I could manage it, anyone can.
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| cyra
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Congratulations and wow!!
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| surgeon1
Forum Newbie
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Thanks! I'm incredibly relieved - I was psyching myself up for the retake, but to be honest I don't know if I could have faced Step I again. The main disadvantage with cramming like this for an exam (apart from the obvious one that you're much more likely to fail) is that a week later, you can't remember a single thing you memorised. Effectively if you have to retake - you're going from scratch.
Also those exams will forever be linked in my memory with trying to swallow 10 massive blue tablets and five little white ones daily, waves of nausea, stomach cramps, trying to hold out until the breaks, and not being able to eat anything more substantial than bananas. But that's a whole other story.
(Where's a vomitting smiley when you need one?)
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| busy_mom
Forum Senior
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Hey Surgeon,
Wow, wow, wow ! (Where´s that envious smiley when you need one ?!) Hats off to you - wish I had the brains (or to put it in your words: "common sense") to do that !!!
Well congratulations on your incredible acomplishment - if you do something similar for Step2CS, please let us know. (Although I bet you´re probably not going to study for more than a weekend ?!)
Looking forward to hearing from you...
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| rm
Forum Senior
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4 days and you passed---AMAZING!!! Congratulations!
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| reet
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 MIRACLE.. in 4 days.
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| Achillis
Forum Newbie
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what you said does happen once in 1.000,000,000,000,000....
I'm sure most of the people who read your post were admitted to ER with shock and abrupt psychological changes  
it's amazing man .....really it is.
I think to be a surgeon is not enough for you.you should practise many specialities at the same time and you will be successful in all of them. 
wish you all the best.
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| surgeon1
Forum Newbie
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I honestly don't think this was due to brain power.
If you have been practising in a speciality that has a broad knowlege base (A&E, ITU, general medicine, surgery) for a few years, and have revised hard for your own speciality exams - you probably know a surprising amount of the USMLE syllaus already - and it's just a question of focussing on the areas tht are way outside your recent experience, and even more specifically knowing the "high yield" areas.
I'm not proud of doing it this way - it was just a desperate situation arising because I was about to run out of time in my remaining eligibility period. And I'd be worried if I was a medical student because the knowlege doesn't stick if you do this. I know enough for my speciality practice - but if I was an intern - I wouldn't want to be treated by me!
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| premonition
Forum Elite
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4 days!!!!!!!
Incredible! Awesome!!!
This is where my vocabulary deserts me.
Guess my idea of going for the thingus (a neologism I coined for the Step 1) in 4 months is not bad. The numerical is the same I guess  4!!!
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| motivated2
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beat me up!! i feel soo dumb but hey Congrats!! i envy you in a good not harmful way!
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| Doc2378
Forum Guru
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 ...hey surgeon....are you human like us or pretending to be one!!!
Ha!ha!...awesome work there...hats off n' congratulations...enjoy your fellowship!
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Courage does not always ROAR. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow" - Mary Anne Radmacher
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| robin082006
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you're really a genius
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The Key to Succeed is Patience.
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