zerocool79
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Topics: 8
Posts: 75
| | 03/01/06 - 12:15 PM
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| #1 |
Greetings!
So i just took step 1 two days ago, and i'll do my best to be thorough about my review of it, and how I prepared and how to reduce anxiety etc. I know i definitely went through the gamut of ups and downs during my pre-test anxiety the few weeks preceding my date.
I'm going to try to be as complete as possible so this might get a little bit lenghty... i'll try not to be too dry and boring in the way that I write. I'll aim to be concise. Just cuz i feel like being a bit anal, i'll put a little table of contents here so you can see what I'll be talking about in my review of my exam/preparation experience.
1. Kaplan Q bank experience/scores
2. Study material/exam commentary for each subject
3. General comments, and other pearls of wisdom that I can pass on.
1.
I crammed Kaplan Q bank in about 2 weeks total...and yeah, it was really exhausting, and i'm not sure i got the best out of it that I could have. When I was 4 weeks away from my exam, i decided to use 2 weeks to get through all 2100 questions, and read ALL the explanations to expose myself to what is high yield and what's important(from Kaplan's perspective). My Q-bank scores aren't exactly the highest.. but then again, i hadn't really begun my "hard-core" reviewing and memorizing yet. Most of the material was familiar to me, but it was far from being solid or fluent in my head,.. i guess you could say it was more or less of a nebulous mess in my head, but for the most part, i had seen all the material once through before I started Q-bank.
In general, I thought Kaplan was really detailed, and a lot of their questions exist only to make a point about a famous one-liner fact. I wouldn't stress-out too much if you don't know all the one-liner points. Just take note of them, but don't let it disturb your confidence. My Step 1, didn't have too many one-liner fact-type of questions. So it's not really worth it to stress yourself out if you don't know all of buzz-word information in the back of First Aid.
I thought that the Kaplan questions were a good way of putting ideas together, but I thought that the questions were actually better written than step 1 itself. I found that the language and writing style of the board questions was not the simplest and direct as it could have been, but then again, I think they intentionally try to be ambiguous sometimes. I found that Kaplan's questions were a lot more articulately written.
So here are my scores for Kaplan, during my 8 hours a day after school of doing 3-4 blocks per night reading all the explanations... and yeah it was super exausting. (i went to bed with a headache each night, but hey, i finished it, and saw everything it had to offer. It was a benefit, hands down)
Completed questions: 98%
Overall % Correct: 63%
Behavioral: 48%
Biochem: 61%
Biostat: 63%
Cell Biology: 49%
Embryology: 58%
Genetics: 68%
Gross Anatomy: 64%
Histology: 54%
Immunology: 66%
Microbio: 67%
Molecular Bio: 39%
Pathology: 67%
Pathophysiology: 70%
Pharm/Theraputics: 62%
Physiology: 68%
And my Organ Systems average score was: 65% correct.
Once I was midway through the Q-bank, I started to look through First Aid very carefully, and found that most of the information there was enough to answer the Q-bank questions with a really high percentage.
On a separate note, I bought First Aid for 2006 about 2 weeks before my exam. So when I was done with Q-bank, I intensively went through the 2006 version of First Aid, which I must say is about 300% better than the 2005 version. It is better organized, and it actually feels like LESS material because of the organization. My friends thought I was crazy for trying to go through the 2006 2 weeks before my exam, but I think the new organ system structure of organization helped me to consolidate the facts in my brain in a really efficient way that is most conducive for quick integrative retrieval.
2.
:::::::::::::::::::::::::::::::::ANATOMY::::::::::::::::::::::::::::::::: ::::::::
I went through the High Yields for both gross Anatomy and Neuroanatomy. I think they are great books, but they are a little over the top as far as details are concerned. True there were some strange one-liner questions on my exam, but i don't even think that memorizing the HY books would have guaranteed that i would answer these questions 100% correctly... so i would recommend just exposing yourself to the material in them, and getting the big picture of each organ system, and then zeroing in on what the high yield topics are. (i.e. portal venous system, median nerve!, obdurator nerve, knee, common peroneal nerve, brachial plexus, celiac plexus, cranial nerves,... stuff like that) I wouldn't try to memorize what is in each region of the mediastinum or all the various lung segments--i think it would be a waste of time to learn all of that stuff if at most, you would only get 1 or 2 questions from that minutia of detail. ... honestly, some questions are worth missing... and to tell you the truth, i thought that anatomy was really straight forward, except for maybe a few questions, which i would probably have missed even if I studied more anatomy and memorized everything--some questions are just meant to be missed like that. ...I must say though, that I did flip through all the "blue sections and green sections" in Moore's anatomy(yes the big book) and i just browsed through that stuff to see what was clinically applicable, because if it's not clinically applicable basically it's not very important. And it's nice to revisit all the CTs and radiographs once you have completed pathology and physiology, and are not a first year student anymore trying to cram anatomy. I thought reviewing the blue sections wasn't too overwhelming, and didn't take more than 2 hours. Overall, i would say that my anatomy on my boards was mainly big picture ideas like carpal tunnel syndrome, trendelenberg gait, knee injuries, recognizing/localizing a gallstone obstruction based on the clinical signs, radial nerve course, ulnar nerve lesions, etc.
:::::::::::::::::::::::::::::::::::::NEUROANATOMY:::::::::::::::::::::::: ::::::
This subject on my exam was a bit crazy I thought. i didn't have much neuro on my first 6 blocks. However my 7th block was almost over the top Neuro. In my preparation, i focused in on neuroanatomy because I knew that it was a subject that my classmates said was really tough on the boards and it is what negatively affected their scores the most. So i used HY neuroanatomy and I went through the Neuro section of the 2005 and 2006 editions of FA (First Aid). I knew that stuff really well, and i felt pretty comfortable with what i had seen in the books. However on my exam, the neuro was completely foreign. I wouldn't have felt differently if it was written in Russian. It was stuff I had never seen before... i.e. have you ever heard of nystagmus caused by someone going down stairs? i haven't, but it was an answer choice that was on one of the neuro questions, and most of the questions were just completely foreign, and i just was resigned to the fact that I was prepared for neuro fairly well, and if I had never seen any of this stuff before because it wasn't in the books, then probably other students might not recognize it either. But yeah, my neuro in my 7th block was totally written in russian or something. :-P I still highly recommend putting in the time for neuro however, even if it feels like a black hole. Definitely learn what FA has to say about it, that way you can rule out some answer choices because you know they are associated with topics that you DO know. (for instance, the MLF lesion causes a unilateral nystagmus when a patient tries to look to one side, and the adducting eye cannot look in the nasal direction—this is pathognomic for MS, and if it's an answer choice, and the case doesn't seem to be MS, then you can rule it out… I thought my neuro studying helped me most by the fact that I could narrow my guesses down to 1 out of 3, rather than not being able to cross out any answer choices… so yeah, I recommend trying to have a good working knowledge of the neuro that is covered in FA at the very least.)
:::::::::::::::::::::::::::::::::::::::PHYSIOLOGY:::::::::::::::::::::::: ::::::::::
I used BRS, only because it got such a high ranking by FA. However, i went through the kaplan lecture notes for that subject also, because i was weak in Physiology. I really liked Kaplan for that subject, but it is a really thick book, and looks overwhelming at first glance, but it's not too bad. I had minimal direct physiology questions. Most of my physiology came in the form of a mechanism used to describe a pathology. I didn't have much on lung, heart or kidney oddly enough. I had maybe one question on a GI hormone straight up, and it was straight forward. There were a few graphs, but nothing completely unexpected. Endocrine of course came up, as it always does but I don't recall that there was anything too tricky about it. I was really lazy and didn't memorize all my formulas for physio, and luckily i was happily surprised that I had maybe one question about a calculation, and it was a really high level question relating a heart defect and some strange shunt, and strange mixing of blood between R-heart and pulmonary vein, and the O2 values were all strange, and they gave all these values and then asked about the blook flow through the lung. I thought it was strange, and i just let that question fall into my "let's just pick B, and save ourself 72 seconds and move on." and whta's 1 blind guess out of 350. Overall, i wasn't surprised by anything weird about the physio, it was fairly straight forward... granted that most of the questions are written in such a way so as not to use buzz words to give away the "punch-line" of each question. They like to beat around the bush in the way that they talk about a concept, but if you are solid on your concepts, you'll be able to recognize what they are talking about when they present you with something in a strange way. And once you recognize what they are getting at, the question becomes pretty straight forward.
::::::::::::::::::::::::::::::::::::::::PATHOLOGY:::::::::::::::::::::::: ::::::::::
So they say this is the "meat and bones" of the boards... which I supose it is. I used Kaplan, and BRS, and listened to the Goljan lectures and that's about it. I liked Goljan's organization and confidence, but I thought that a lot of cases that he talks about were much harder than my board exam, and that my exam didn't really get into the type of depth that Goljan gets into. I think Pathology comes up somehow in most questions in an indirect or direct way. I didn't have many pictures, and all the buzz words didn't really come up. (it made me really gald that I didn't spend too much time memorizing those crazy lists of buzz words in the back of FA.) And as for showing say a "clue cell" for gardenella, instead they like to describe it vaguely... so that way they won't trigger your memory, unless you are already thinking along that train of thought. Overall though, i would say that pathology was fairly straight forward also, if you recognized the concepts that they indirectly talked about. I didn't really have any questions on cushings oddly enough, but I had like 3 ectopic pregnancy questions, and 2 PCOS questions. I think that doing a lot of practice questions, and learning about this "indirect" writing style that step 1 has, is one of the best advantages to have
::::::::::::::::::::::::::::::::::::::Biochemistry:::::::: :::::::::::::::::::::::::::
I used Kaplan and FA for this subject. I didn't get too indepth with all the pathways or cofactors, but I stuck to emphasizing the DNA section, and enzyme information, and went over everything that was clinically applicable. Overall I would say that the biochem section on my exam was fairly low yield. However, anything that relates to another subject is VERY high yield for biochem. For instance, hemoglobin enzyme kinetics and the sigmoid curve tends to come up, relating it to physio and how oxygen dissociation changes, bla bla bla. Another example might be in SCID (severe combined immuno deficiency syndrome) is often caused by an (ADA) Adenosine Deaminase deficiency. Although I may not know what that enzyme does, I knew that it is associated with that immunological disorder, and that fact is pretty high yield. So yeah, I would emphasize the biochem that is related to other subjects definitely!!! That is what seemed to come up!! (tyrosinase deff. for Albinism, vs. tyrosine kinase deff. For X-link-Bruton's agammaglobulinemia, these are easy to confuse so becareful)… another funny thing that happened on my exam is the way that they wrote an enzyme names. They didn't always write the name I was familiar with. For instance, for McArdle's Type IV glycogen storage disease, we all know that it is associated with a muscle problem (M-uscle M-cArdle M-uscle glycogen phosphorylase deficiency). However, the answer choice that they *might* have will be "phosphorylase" only, along with all the other random glycogen related enzymes. So the buzz "M" was missing from that enzyme name. I found that particularly tricky of the exam to present it that way. So yeah, definitely learn what is high yield, and try to be flexible enough so that you will recognize only "phosphorylase" when the enzyme you are looking for is "Muscle glycogen phosphorylase."
::::::::::::::::::::::::::::::::::::::Pharmacology:::::::: ::::::::::::::::::::::
I was really worried about this subject, because up until about a week before I took my exam, I felt like Pharmacology was an endless black hole of details and side-effects and facts that I didn't know…. And antimicrobials was the biggest headache of all of them. I used Kaplan lecture notes, FA(which is almost more than enough), Boards and Wards, and Road Maps. I thought Kaplan was waaaay too much, but it seemed to clarify the concepts the best. Most of my pharmacology was conceptual pharmacology. There was only 1 equation question, and it was so straight forward, nothing to worry about really. There were maybe only a few questions that were straight up what is the drug used to treat something… but most of the drugs or concepts they picked were the "famous" stuff. I didn't have any questions on seizure medications, thank god, so I am really glad I didn't memorize all those strange differential seizure medications(I probably would only expect 1 question would have come from that anyway, and 1 missed question never hurt anyone). I did notice that they used famous classes of drugs, but they picked slightly less popular drugs in the class as their example. An example may be that negative symptoms are presented, so you know to pick an atypical anti-psychotic… however, the 3 main drugs that you know of are not listed as answer choices… only "Quetiapine" is there… so unless you know that that is an atypical, then you'll be lost maybe… But I thought that High Yield was more than enough for the behavioral-related drugs, and Kaplan did a good job of most of the rest. Definitely be familiar with most of FA pharm, but don't beat yourself up in memorizing all the drugs and all their mechanisms. The pharm on my exam was very popular stuff, like Acyclovir and Aminoglycosides, vs. the more obscure stuff like polymyxins. I would definitely focus in on the drugs that have to do with certain biochem related topics… like the protein synthesis stuff of the antimicrobial mechanisms, and some of the activation of viral drugs, and some of the metabolisms of a few of the chemotherapeutics, ie. 5-FU or 6-MP. I found these to be high yield throughout my preparation, and exam. I found that anything that had to do with integrative topics was very high yield… almost 75% of these integrative-type topics came up on my exam actually. Definitely learn those drugs before any other ones that might give you a headache.
:::::::::::::::::::::::::::::::::::::MICROBIOLOGY::::::::: ::::::::::::::::::
I was really afraid of this subject at first, because I was really weak in this area when I started studying. What I found most helpful for me was High Yield (are you starting to see a pattern in what I prefer? I don't like lengthy texts, and I like to learn from more than just tables and or flash cards.) I found that HY explained things in a really concise way, and they had really good organization, and helped me *learn* microbiology in a few days. I thought MRS(made ridiculously simple) was an ok book. It was a bit wordy..(heh heh,, I know I know, look who's talking) and that it was a really thick book, and had almost too much detail. It was overwhelming for my taste. On my exam, I felt that the majority of the micro was really general topics or famous infections. I think FA is almost more than enough if you are looking for the fastest possible review. If you need to LEARN micro in a hurry, like I did, then I recommend HY. It is more than enough. I would definitely focus in on the famous symptoms of the popular bugs. Focus on the mechanisms of the toxins, that always comes up. But as I have been talking about this indirect way that Step 1 is written, I found that they wouldn't necessarily say the bug name all the time, but rather ask you what is the common mode of infection or what is another symptom that you might expect from the causative agent. Basically they are asking you what bug it is, but in the language of what it's famous for. I though there were a lot of CF related bugs on my test. But then again, every test will be different.
::::::::::::::::::::::::::::::Immunology:::::::::::::::::: :::::::::::::::::::::
Yeeeeeeeeow!! This topic is like ALL high yield. I would say to know this topic extremely well. The good news is that FA is enough. Definitely know what cells are present during each part of infection or inflammation or allergy. Pay special attention to the hypersentivity reactions, they were very tricky with these. You may think you know them, but be certain that you don't make the mistake of thinking that RA is type II, otherwise you'll miss a very straight forward question. In my review, I found that questions often like to give you a disease, and then ask you what other disease has a similar mechanism of action(ie. What other disease is the same type of hypersensitivity reaction). So yeah, focus in on these, it sounds simple enough, but I thought the hypersensitivity questions were slightly tricky, so don't be too snappy when you confront them. Definitely also know your immuno lab techniques, because they will often use theses concepts, but not in the standard means that you are familiar with. I found that my exam like to create new experiments with lab mice or what not to make a point, and I didn't recognize the experiment, but I was still able to recognize the concept behind what the experiment was meant to illustrate. So be rather fluent with your lab techniques if you have time to hone in on this topic. It tends to overlap a lot with biochem and genetics I found.
:::::::::::::::::::::::::::::::::::::::::::::Behavioral::: ::::::::::::::::::::::::::::::::::
I used High Yield, which is excellent, it is actually almost too much and too detailed, but it's worth going through just to seal the deal and get most of the behavioral questions. I found that my exam behavioral questions were really straight forward, and the famous stuff. It wasn't too tricky. Biostats was pretty straight forward also. Maybe one trick that they did was ask me to compute the relative risk of something, but they didn't give me a square table of the values. Instead they wrote out the values in sentence format, and in a different order, and it was up to me to arrange the values in the proper square table format on my own. It was a little time consuming, but it was a free question if I knew what to do, which I did, thank god. But yeah, I found behavioral to be straight forward and not too sneaky.
::::::::::::::::::::::::::::::::::::::Miscellaneous topics:::::::::::::::::::::::::::::::
I went through the Molecular bio HY, and I liked it, but it was kinda dense, and was a perfect collection of everything that gave me headache. But with some concentration and some patience, I got the jist of molecular. It was a good book overall, pay special attention to the last chapter, it's really high yield. I thought the histology came up, but always indirectly. They would talk about a common disease, but ask you to pick the organelle that the disease most commonly affects, or where a reaction takes place—ie. Catalase.
3.
So if you have time, I think the two best books that helped me have a conceptual grasp on everything was "USMLE Step 1 Secrets" and "Blueprints Step 1 Q&A." I loved these two books. Definitely try to get through these 2 books at least once. They helped to boost my confidence, and to shed a lot of light on how the exam was going to be like, and what sort of conceptual integrative concepts might arise. If nothing else, these two books gave me a really good sense of what is high yield information, on top of Kaplan and FA of course.
I think learning what is high yield is the true secret to performing well on the exam. Afterall, for every 20 facts that I memorized, if the 21st fact is the question that they ask, and I didn't know it, then memorizing the first 20 facts didn't help me whatsoever is correctly answering that question. So along these lines, don't kill yourself over trying to know every detail… cuz out of the hundreds of details out there, maybe 8% of them will be tested, and more likely than not, you can still miss these questions even if you know a lot of random details. I felt that there weren't many detail specific questions, thank god. Step 1, did a pretty good job about asking integrative questions that drew on more than one subject. Of course they were often indirect in the way they wanted you to answer, or in the way they asked the question. As I mentioned earlier, they like to avoid mentioning the buzz word, but instead describe what a picture looks like, instead of actually giving you a slide of "starry sky" for instance. And then for the answer choices, they like to ask you ABOUT the disease, rather than the disease itself. So it's good to know random details that are focused around really popular topics… for instance I wouldn't necessarily memorize all the translocations or all the side effects of every drug, or know all the diseases associated with each microbe… but I would definitely hone in an know everything there is to know about Pseudomona for instance, because it's a very high yield bug. And although there are so many differential enzymatic characteristics for each bug… the fact that Pseudomona is oxidase positive is important, only because pseudomona itself is important. So try to tailor your detail memorizing to high yield topics. One more comment on this subject is that I didn't really memorize all the lysosomal storage disease or their enzyme defects of the accumulating products… I just said to myself (at most there will be like 3 questions on it, and most likely they are worth guessing, rather than memorizing this entire table)… luckily for me, I knew the main ones, like Tay-Sacks, or the fact that Fabry's is X-linked. I didn't know everything, but I knew a few key high yield facts, … and luckily for me, the 2 lysosomal storage disease questions focused around Tay-Sacks… score!
Now, I have one word of advice that should reeeeeeeeeally help you on your exam…. READ THE QUESTION FIRST!!!!!!!!!!!!!!! If you go right to the bottom of the paragraphs, and read the question first, you can save yourself a lot of anxiety and time. If you know what you are looking for before you read the stem of a question, then you can basically just speed through the stem looking for only key points that will lead you to answer the question. This will reduce a lot of stress and time also because usually the stems like to change the direction of their train of thought, and when you finally get to the question, which is always the last sentence, then if you weren't reading "actively looking for a specific point", then by the time you actually read the question, then you'll probably have to go back and skim the stem of the question again anyway. This wastes a lot of time, and actually stresses you out more if you are a slow reader like me. Also, I noticed a good handful of questions that I could answer by ONLY reading the question, and not the stem… this saved me like 72 seconds a number of times, which REALLY helped me to do well on the other harder questions. For instance, there might be a long stem.. bla bla bla.. and then the last question is "What do type II pneumocytes secrete?" and once you get to that sraight forward question at the end of a long stem, you'll want to shoot yourself for spending so much time and energy and concentration meticulously reading the stem, when you could have answered the question from the question alone(surfactant). So yeah, I am a really slow reader, and I used this technique and I had no time problems whatsoever on the exam. I even had time to go back over my unsure questions, and then still finish a 2-6 minutes early, which is free break time. So I highly recommend reading the questions first, before you go read the stem. It's a MIRACLE technique almost.
Lastly, I just want to comment on what I found helpful for my examination preparation. STRESS MANAGEMENT!!!! When I was about 2 weeks away, I realized I didn't have the whole of embryo memorized, and I didn't have a lot of lame tables memorized, or any equations memorized, and I felt overwhelmed. I had my first partial anxiety attack… and then with some patience, and perseverance, I just made the best use of my time and kept plugging away at my books, knowing that stress is only a waste of time and energy, and a headache—energy that could better be used for learning 1 more concept. So I continued to just do my best about staying calm and relaxed.
By the time one week before my exam rolled around, I had pretty much been through everything, and I knew where my holes were, and I was familiar with just about all of First Aid. I was by no means secure with all of the material though, I had holes everywhere, but I also knew that my holes were in low-yield material, which is somewhat comforting. Basically the week before my exam was less of an academic battle, but more of a personal battle. It's extremely important to keep your head clear, and your stress at a minimum. It doesn't do your studying any good to get insomnia the week before your exam, and then get sick, and be cloudy headed a few days before your exam, that will probably only stress you out more.
In my experience, it was the most difficult to keep myself calm and relaxed. Even though I didn't know everything still, I was able to study still, that wasn't the problem. Studying actually reduced my stress. So I learned that it was more important to concentrate on keeping myself in a healthy state of mind than to bust my butt trying to learn everything in the last few days before my exam.
Overall, I found that my exam was mostly high yield things, and that my holes weren't really discovered by the exam. Like I didn't know much about the leukodystrohpies, and thankfully I didn't have a single question on them. So I am happy with my exam, It wasn't really anything too surprising, and I thought that it went fairly well. I can only hope for the best now.
I'm not sure what is a good raw % to get on the actual exam, but I was trying to keep my number wrong/unsure under 15 per block. So that would put me roughly around an uncurved 245 if all goes as planned. I can only hope for the best at this point. Just to give you an estimate of how I felt during my exam.
Blocks I-VI: I was averageing 8-14 questions wrong/unsure
Block VII: I had about 22 questions wrong/unsure (because of the crazy bombardment of impossible neuro questions, and other random foreign appearing things.)
So yeah, wish me luck, and I'll post my score when I get it in 4-6 weeks.
Ugh, how many people actually read through this whole post to the bottom. I hope I've helped inspire some of you who aren't scoring in the 80-90% on Kaplan or on the USMLE CD. Best of luck to everyone!!
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| Doc2378
Forum Guru
Topics: 46
Posts: 688
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Hey Zerocool...awesome post...thnks for taking the effort and time to write this...am sure will help a lot of test takers!!!
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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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| gogetit
Forum Senior
Topics: 39
Posts: 104
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wow... thats the most detailed exam experience i have ever read... gr8 job!!!!!
thanks a lot for this... goodluck !!!
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| robin082006
Forum Hero
Topics: 471
Posts: 5,125
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Thank you very much for your time to post your experience. It's very helpful.
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The Key to Succeed is Patience.
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| vanshita
Forum Guru
Topics: 25
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good luck for your score
Thank you.
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| malinda
Forum Guru
Topics: 162
Posts: 654
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I am just amazed how you came forward to help so many like me.Your post sure will be a very good guide.Wish you all the best.
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I CAN DO IT.
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| sarika
Forum Guru
Topics: 195
Posts: 1,200
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zero cool i think the two of us got the same exam exactly...my 7th block was full of neuro......
But overall exam was ok.i took mine on 28th...does it happen like two people getting the same exam?
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| ramo7
Forum Senior
Topics: 15
Posts: 126
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wow...that took a chunk of my study time! you should be a jornalist(guess no point now you have taken the exam:nod ...but great advise..thanks a mil!
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| Merie
Forum Senior
Topics: 2
Posts: 12
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It is really inspiring to see such a detailed exam experience. It is nice to know only the high yield and let the few holes be gone nice advice and comment.
Good luck, you will ace the exam.
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| ing
Forum Guru
Topics: 45
Posts: 435
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Thanks for sharing your experence. It's very helpful. Wish you the best.
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Never give up!!
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| SalmanKhan
Forum Newbie
Topics: 0
Posts: 6
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Awesome !!! I am starting my prep from today ..what a great start I am having...
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| star1
Forum Guru
Topics: 93
Posts: 827
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Thanks you very much for writingg such a good post . It will surely help us . Best of Luck for your step 2
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| zerocool79
Forum Junior
Topics: 8
Posts: 75
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thanks a lot everyone. it's nice to know that my post is appreciated. I just know that when I was nervous before my exam, it was really reassuring to read about people who wern't scoring 90% on Kaplan, but were still able to get above 95th percentile.
So i just thought I'd try to reduce your stress and anxiety a little, because that's what it's all about. Stress management i think is about 40% of your score. If you don't have the cleverness to manage your stress, then you'll probably miss questions that you know, and that just is painful for anyone to deal with huh? "Post-exam remorse" is never fun, so yeah, just keep cool, and don't worry about random details too much, you win some, you lose some, but overall i'd say that there were only like maybe 12 straight up spot detail questions, and in the big picture, you'll probably guess 4 of them correctly if you blatantly guess on all of them, and from what it seems, you can walk out feeling like you got maybe a raw 60% of the exam right, and still get above the 95th percentile(going by the advice of my colleagues). So yeah, Try to keep a clear head about it all, and don't forget to enjoy the preparation time, it's a chunk of our life afterall, and it's suppose to be fun. :-P, heh heh
Sarika: i think it's very possible that we had the same exam. That's really cool, best of luck to you!! I hope we both get 99s :-P, that's be a dream, wow!!
Good luck everyone else who is starting to prepare, I think it's not as daunting as one might think.
I felt that the longer I studied, and the more I knew, the more connections seemed to precipitate out of my brain, and everything started to come together really nicely toward the end. But in all honesty, when i was 2 weeks away from my exam, i felt completely insecure with what i knew, and i had major holes in my subjects... but with some patience and diligence, i just kept reviewing my weaknesses, and strengths too (it's easy to take for granted what we THINK we know), and when I was in the exam, i felt like i could just look at the answer choices, and already know what's high yield, and what the answer probably was, and then just speed through the stem, trying to see if there was anything that supported my initial hypothesis that it's probably "Strep. Pyogenes" or something really high yield like that. As you are further in your studying, and do a lot of questions, you'll start to notice what questions really appear a lot, and in the contexts that they appear. And you almost can predict what types of tricks will be used to try to "hide" the concept or the answer from you. It's completely do-able you guys. Trust me. Just keep on chuggin', and try to read something right before you go to bed each night... sleeping is the best time for encoding newly learned things, and it'll stick better in your mind if you see it right before you jump into your sleep spindles and k-complexes. :-P
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| p53
Forum Guru
Topics: 51
Posts: 804
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I think your detailed post will be very helpful for other human beings preparing for step 1.
one correction only, if you don't mind:
2 digit number which you will receive as assessment of your proficiency on step 1 isn't percentile (and isn't percent either), it's just 2 digit score (I wish you 99 - it's maximal 2-digit score, because 99 is maximal 2 digit number).
you will also receive 3 digit score. they will also give you mean & standard deviation for 3 digit score (not for 2 digit score!) for first-time examinees from US and Canadian medical schools (not for IMGs!). In my step 1 score report it's 216 & 24, respectively. using these numbers i.e. your 3 digit score, mean & SD and statistical table you can calculate approximate percentile i.e. percent of US & Canadian examinees who received scores below than yours.
I also have sent you PM, please check your inbox.
GL
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| mitty
Forum Guru
Topics: 52
Posts: 376
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Thank you very much for sharing your experience.Have you read the 2005 editoin of FA?Is there any new thing in the 2006 version or is it simply change of presentation?
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| general malaise
Forum Guru
Topics: 14
Posts: 433
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thank u for the detailed experience....its not many people who take the time and effort to completely map out their experiences in such detail which is VERY helpful for those of us preparing to take it. u deserve a 99
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| mjl1717
Forum Hero
Topics: 956
Posts: 5,452
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Thank you-you're a good writer. {you could probably publish}
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Smell the coffee! "Is That an Osler move??"
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| mu
Forum Senior
Topics: 21
Posts: 85
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Thanks a lot for the post. It's going to help me a lot in my studying. I would like to know how FA relates to the exam. is it really true that every question in the exam has it's answer somewhere in First Aid? Lots of people say that.
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| zerocool79
Forum Junior
Topics: 8
Posts: 75
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I sort of went through my books half-ass for a few months, and kept putting of taking the boards until it "felt right." And then i'd say that the 2 months before i took the test, i really turned it on and accelerated my efforts. I think this sort of concentration really helps because you get to see everything in a short amount of time, and the connections are more likely to precipitate out in your mind, rather than if you just learned everything over a long period of time, and forget the earlier stuff (recency effect).
I wouldn't say that FA is really enough for EVERYTHING. I think that FA focuses a lot on details, but it doesn't really teach concepts. It's important to check out other books, (High Yield) to clarify concepts, and i liked USMLE Step 1 Secrets for conceptual learning. FA has a lot of good high yield points however.
I thought that a lot of questions asked for things that weren't exactly in FA. For instance FA says that the influenza virus predisposes to super infections, and that's all that is mentioned in FA. On my exam, i was asked WHY or what is the mechanism that predisposes a patient for super infections when they have an influenze virus infection... So it made me think, and the answer wasn't really in FA.In my opinion, a simplified version of what the question was asking, or a "translation of the question" would be: "What makes someone susceptible to lung infections?" And if you consider that question alone, and disregard all that mumble about influenza virus and mechanism and bla bla, then the question becomes very simple. The answer I went with, even though i'm not certain by any means, is that it disrupts the mucociliary elevator. That would predispose anyone to pulmonary infections.
But yeah, overall, i don't think FA had EVERY fact that i was tested on. It had most of the main ideas, but my exam did a good job about asking the point that wasn't in FA. It's like THEY KNEW!!!! h ahaha
As a rule of thumb, they will give you usually a few parts of the puzzle that will sound familiar, and then the thrid piece will be completely off the wall. So my advice is to go with best 2 out of 3 parts of the puzzle, and just assume it's what you think it is, even if you've never heard of the 3rd piece of information. They like to try to fake you out, and make second guess yourself that way. But in all honesty, it's not SOOO tricky, only maybe 30% of the questions are sly like that--a good 45% of the questions are ridiculously straight forward--but answering these questions correctly won't distinguish you from the pack.
I thought of some things that helped me to prevent insomnia, or anxiety flare ups...
use your physiology knowledge!! there are 3 known reflexes to slow your heart rate down and supress your Sympathetic Nervous System.
1. Corneal-heart reflex: pressing on your eyes slows your heart rate down (CN V1-aff. limb, CN X-eff. limb)
2. Carotid Massage: putting pressure on your carotid sinus to depress heart rate (CN IX-aff. limb, CN X-eff. limb)
3. RSA (Respiratory Sinus Arrhythmia): when you inhale it raises your pulse, and when you exhale it depresses your pulse rate: (CN IX-aff. limb via carotid sinus, CN X-eff. limb)
So yeah, use these physiology techniques to keep your heart rate down, and stay relaxed and to suppress your SNS when you have an anxiety flare-up. I preferred to press on my corneas when I was in bed, and having insomnia, since my eyes were closed already anyway, and i could feel myself having hard-core bradycardia, and that really helped to put me to sleep when i was tossing and turning.
As for when you are studying, or during your exam even it's VERY important to BREATHE!!! But not just normal breathing, take advantage of the fact that when you exhale, it raises the intrathoracic pressure and forces more blood out of the heart and puts more pressure on your carotid sinus, thus causing a reflex bradycardia. So yeah... inhale deeply, and concentrate on a slow exhale, so as to prolong the effects of the expiratory reflex bradycardia... and by no means hold your breath!!!! that will only increase your sympathetic system and give you more anxiety. So when you catch yourself feeling stressed, remember to breath!!! And when you find a question you don't know on your exam, catch yourself, and don't let yourself hold your breath(cuz that's my first automatic response is to hold my breath when i get nervous). Holding your breath is just about suicide if you are already in a stressful situation. Work on controlling your Sympathetic nervous system, it's completely in your control, just use physiology!!! :-P that's what it's for. hee hee
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| mu
Forum Senior
Topics: 21
Posts: 85
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Thakns a lot. I have yet another question. What books would you recommedn for s.o. who has just 2 more months to study for the exam. The Kaplan books r too big and I'm having a problem with them. You mentioned High Yield and I checked that out and found out that they have 1 for every subject!!! I was hoping it was just one book for all subjects. Definitely I cannot afford that. Which High Yield books do you think are the most importnatn? I'm sorry for this sudden barrage of questions but I need a formula to enable me get a high score in the little time that I have. I am scoring badly in Kaplan Q bank, barely getting 55%, sometimes even 50% or less. So now you know how desperate I am. Lots of books around, I need to know the ones to use for quick review.I eagerly await your reply. Thank you. Also check ur PM
Edited by mu on 03/02/06 - 09:36 AM
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| spring06
Forum Newbie
Topics: 1
Posts: 16
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hi zero cool, thank u for the detailed explanation. wish u all the best
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| zerocool79
Forum Junior
Topics: 8
Posts: 75
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mu you are 2 months away? that is a lot of time believe it or not. I would start with FA, and keep at it until you are very familiar with most of it, that should take you about a week if you are super diligent. Once you are familiar with it, then maybe try to start memorizing a little bit at a time, don't freak out, take baby steps, you'll get through it. FA is a very good book, and i know a lot of people who use it as a primary source, and do well on the exam. If you have time for other books, then maybe just check a few concepts here and there when you feel the need, but only if FA makes you curious to understand a concept more clearly.
Just take it slowly, and try to learn from Qbank, don't be discouraged by it. I didn't score well from it, and i was 2 weeks away from my date when i was doing Qbank. Just use it more as an indicator of what points are high yield, and what topics seem to come up the most---ie. don't go and memorize ALL your attachments if you are worried about anatomy, that'd be a total waste of time. Just stick to the things covered in FA first and foremost, after that THEN you can star to fill in the other details that you have time for.
I have a nice analogy for you to think about in your preparation.
Imagine that You have a bucket and some big rocks and some sand. Someone asks you to put all of it into the bucket. Everyone knows that if you put the sand in first, then your big rocks won't fit into the bucket afterwards. However, if you put the big rocks in first, and then dump the sand in after, then everything will fit fine.
So in preparing for your test, think of the main high yield facts as the big rocks, learn them first, they are most important. Once you have those in place securely, then you can worry about filling in the gaps with as many one-liner facts as you can get your hands on in the 2 weeks before your exam. But really, don't stress over one-liners, they are only icing on your cake, and probably only maybe 8% of the one-liners that you study will actually come up. So really, don't stress if you don't know everything... but definitely try to know ALL of the major concepts and buzz topics.
Best of luck, i think 2 months is a long time to prepare, believe it or not... i mean granted you were at least semi-conscious during your first 2 years of medschool, like i was.
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| mu
Forum Senior
Topics: 21
Posts: 85
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Thanks a lot for the advice. Trust me, your reward will be great!! I'm really encouraged, cos at a time I was wondering whether this was going to work or not. I mean the whole USMLE thing. So much pressure, and everyone tells you that if you score low, then it's better that u failed cos with a low score, u're DOOMED forever. It's scary man! As u said, I'll work on my FA. Memorizing has never been my thing. I'm better at explaining than at picking out detail, but I'll see what I can do. At least I'm begining to think that maybe I can do this after all. When I see the posts about pple that read their material 3 times over e.t.c.............. I get goose pimples!! I'm like "Are these guys human, or are they from another planet" Thank you once again. I'm sure u'll score in the high 90s. I've been observing the trend here on this forum and I've noticed that the way one describes an exam after taking it reflects on the result one is going to get. Obviously you were not too rattled by the exam. Good news then.
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| penshoppe
Forum Junior
Topics: 5
Posts: 33
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zerocool, thanks so much for this post. This will surely help all of us who are still preparing for step 1. God bless.
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| cliffh
Topics: 5
Posts: 24
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Congratulations! You are so well done. Thanks for sharing your experience!
When you took the test, did you skip the tutorial part? If so, you got total one hour break time or 1hour15minutes? Did you go directly to the 1st block without even look at the tutorial section?
When you had the test, how about the test center condition? People bother you a lot by typing?
GL
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