mosfet
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HA....finally done with the exam today. Never thought this day would come. I have been what you might call "a silent reader" on this forum. Your exam experiences have been really helpful and I wanna thank everyone that contributed their share to help others. So I figured I would return the favor back to you guys. I actually wanted to post my experience after I got my score but I realized I will probably forget how I felt about the exam by then. So I will just go ahead and do it now. This post might be verbose, so read at your own risk.
Interestingly, my exam experience was very similar to sarika's post on her exam experience. It is a very doable exam.....they did not ask any out of whack questions or rare syndromes. I can say for sure that kaplan is good enough for most if not all subjects. If you MEMORIZE kaplan cold, there will be very very very few questions that you will have a hard time with. But one thing I realized after the exam today is, no matter what book you pick to read, make sure you know it absolutely cold. Don't just read for the sake of reading it. The more stuff you memorize from that book, the more familiar you will be with the concept they are asking. I say this because pretty much 75-80% of the questions that step 1 asks you are very basic concepts. However they seem to do a good job in blending in that basic concept into a seemigly complicated question. So if you memorize, and yes, the key word is memorize, not just understand, then you will see right through the complexity of the question. It's as simple as that. There were so many instances, especially with those lame experimental and graph type questions where I didn't understand what the f**k they were talking about, but I got the gist of the question and was able to answer it just because I remembered reading that related concept in kaplan or whatever book I read. So the key again is MEMORIZING. I know some people will disagree with me on this and say you have to "understand the concepts" and all that crap. I am not saying understanding is not important but memorizing is way more important than that. After all, we are not doing engineering or mathematics here. This is medicine people.
As for the exam, it was well distributed with path and pathophysio being most representative. After that, I had quite a bit of Neuroanatomy and Pharm. Then came Micro/Anatomy/biochem/behavioral. I was glad that I didn't get a lot of behavioral....it's my weaker subject. There were some long questions(5-6 lines) and also one-liners. Some path questions were even longer 'cause they had all soughts of garbage lab values that you didn't even need sometimes. I had about 10 path questions with slides and pics. 5 to 8 anatomy and neuro questions with radiographs and pics. There were about 5 pharm questions with graphs and the questions basically asking what drug is injected to cause this change in the graph and stuff like that. But most of the pharm focused on MOA of popular AND obscure drugs. The MOA for the obscure drugs is pretty straightforward if you memorized it. But the tricky part was the popular ones like the MOA of Anti-HIV drugs, where they actually gave five molecular structures of DNA with bases and phosphates and asked which of the molecules will inhibit reverse transcriptase. Basically, you should look for the DNA molecule that has a different 3' end than normal DNA, that way reverse transcriptase will not be able to do its job. So basically, that was a question on the MOA of Zidovudine without even mentioning that word in the question. And that's what I mean when I say that they hide relatively simple concepts in complex questions. Now....there are nothing to understand in that question.....if you had memorized that Zidovudine works by terminating DNA at the 3' end thereby inhibiting reverse transcriptase, then the answer will automatically pop out of the choices. But not to worry, there are a lot of questions that were straightforward, especially in anatomy and neuro. I went in not knowing absolutely anything in anatomy and neuroanatomy but luckily I got a lot of basic questions.
I really don't know what to say anymore. As far as books that I read:
Anatomy/Neuroanatomy - kaplan is enough for anatomy and definitely more than enough for neuro. Infact, kaplan neuro is way better than HY neuro. First Aid is really good for anatomy and neuro but defnitely isn't enough. In anatomy, the emphasis was mostly on upper limbs and lower limbs, so at least do those. In neuro, know the spinal cord, brain stem, optic tract pathways, and cerebral cortex lesions and you will be able to answer most questions.
Histology - HY Histo. Make sure you read the first 3 chapters which are very high yield. Also, do the respiratory and renal histology. In chapter 1 of HY Histo, know your Cell biology really well such as where are long chain fatty acids metabolized and so on (in the peroxisome). Know the functions of all the organelles in the cell. In chapter 2 of HY Histo, make sure you do all the desmosomes and gap junction stuff. They love those things and those questions are easy to get right once you read that three page chapter. In respiratory, know about the functions of different cells like clara cells, type I and II pneumocytes etc...
Also look at the electron micrographs if you have time, but my test did not even have 1 elec. micrograph.
Biochemistry/Genetics - I read kaplan for this and it is probably the best in the kaplan series. Memorize it cold and you will get every question right. The biochem questions, I noticed, were mostly big picture questions in both the real exam and in the nbme tests. So don't go too much into detail and try the understand the big picture like what insulin and glucagon do in general. I also read part of HY Molecular biology but I don't think it is necessary. Kaplan genetics should suffice.
Physiology - Kaplan again. Did not do BRS. Again, know kaplan well, especially Endocrine, heart, renal, respiratory in that order. These questions were mostly asked with path combined. Know PTH-VitD-Ca system and Renin-Angiotensin-Aldosterone system well. You WILL get a bunch of quesstions right if you master just these. They are actually pretty easy and straightforward questions too.
Micro/Immuno - RapidReview/Lange for Micro and Lange for Immuno. The Lange for Immuno is probably one of the best medical books I ever read. I was really weak at immuno until I read those last 80 pages in the book which are absolutely excellent. It looks long and boring at first sight but once you get into it, it gets interesting. Focus on the chapters on hypersensitivity, autoimmune diseases, and the first couple of chapters on B cells and T cells. For micro, pretty much any book you pick should suffice as long as you know it well. I really don't know how good kaplan is for micro/immuno because I didn't do kaplan for this.
Behavioral - Again, for Behavioral, any book you pick will be good enough. But for epidemiology for stats, do the first 2 chapters in kaplan. But for the rest, do kaplan, BRS, HY....doesn't really matter. 90% of my behavioral on the exam had epi, stats, ethics and that's it. I really can't remember any other questions. Doing a lot of practice questions from BRS and Qbank will help.
Pharm - How you do on pharm depends on how good your memory is and many times you read a pharm book. The more times you read, the faster it will trigger your memory during the exam. So try to memorize all the MOAs of all the drugs and at least major side effects. Even the pharm questions with pictures and graphs are very answerable if you remember your stuff. Otherwise, you will be lost. So I think studying pharm is very straightforward. Pharm on my exam, was well distributed among all topics with a little bit more stress on antimicrobials, antineoplastics, and CNS drugs. Some of these questions were incorporated into pharmodynamics comparing potencies and blood/gas coefficients of anesthetics etc.. Step 1 has some really unique ways of asking questions. But don't worry, if you know your stuff, they shouldn't bother you that much, but they are time consuming to figure out during the exam.
Path - I read Goljan Rapid Review for path and that's it. I didn't do any practice questions or anything. It will give you more confidence if you do the Robbins Question book but it is not really necessary. Path was very straightforward on the exam except for a few questions with pictures and slides which can be a little confusing. I can't emphasize how important it is to memorize Goljan cold. Pretty much all the answers in Path are in that book. I actually started out reading the Goljan 500 page notes that I really think its way too much and it is not good for memorizing. So I bought the rapid review which was only 350 pages AND had everything I needed. So I recommend Rapid Review. I listened to some of his audio but I didn't finish it. But that's okay....everything he says in the audio is already written in the book.
I studied for 3 months. I bought first aid 2005 but I did not end up reading it. The only thing I used first aid for was for anatomy. Until the last day, I just stuck to reading the books that I have already been reading. So I can't really say if first aid helps or not. But I repeat myself by saying that whatever book you pick, know it inside and out. After the exam, I realized that most review books go over pretty much the same important information...so it's just up to you to sit and read it and know it. There is no point in wasting time trying to find that perfect book 'cause it won't matter. I am saying this because when I first started my review 3 months ago, I was so concerned about what book to read rather than just sitting down and reading. I guess it was just my excuse to not wanting to start studying.  I bought Qbank but finished only 10% of it. I basically did questions for behavioral, biostats, and molecular biology and that's it. I didn't feel like wasting my time on doing questions that didn't really represent the exam. But they are good for learning when you get sick of reading the books. I am not very big on doing questions, so it is just a personal choice as to whether or not to buy Qbank. For all the people that say you HAVE to do questions to fare well on the exam, that is total bullshit. If you know your stuff really really well, that's just as good as doing 5000 questions. 
As for the questions on the exam, they were very similar in length to Nbme 3 and 4 and the USMLE CD......however, the questions were slightly easier than 3 and 4. They were harder and differently asked than Nbme 1 and 2. Nbme 1 and 2 had more direct questions which is not the way to real exam is. But again, that doesn't really matter, because the concepts they ask are still the same difficulty, just wordy in a harder way. The behavioral questions were similar to the behavioral/biostats questions on Qbank. So I thought Qbank was only good for behavioral. I had about 5-6 questions on the exam repeated exactly from nbme and usmle cd. My scores on the nbme and usmle cd are:
USMLE CD 39/45/40 Spread over my 3 months of review
Nbme 1: 540 (228) 6 weeks before the exam
Nbme 2: 630 (245) 2 weeks before
Nbme 3: 590 (236) 1 week before
Nbme 4: 580 (234) 1 week before
Qbank: Didn't do it
When I get my score I will let you know how well it correlated with the nbme. Guys....stay positive and you guys will definitely do well. It was really hard for me to study the last 2 weeks before the exam. I couldn't focus and I just wanted to get it over with. If you feel like that I guess it's normal for everyone. You just have to somehow fight it and make it through. I will be happy to answer any questions.
Edited by mosfet on 03/28/06 - 08:07 AM. Reason: put in extra info
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| general malaise
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thanks for the post, mosfet. i'm sure you'll do great!!
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"El respeto al derecho ajeno es la paz" Benito Juarez
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| Lups
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Thank you, thank you, thank you....
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| thegodsmustbecrazy
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thanks mofset
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| robin082006
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thanks for sharing.
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The Key to Succeed is Patience.
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| ing
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It's very helpful. Thanks for sharing. Wish you the best!
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Never give up!!
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| dipti
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thanks mosfet.wish you a good score!
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| chlorpromazine
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Thanks for a great post. I am just curious how many times did u manage to go through the books. i am on my second read and i feel i dont remember anything. the only consolation i have is that the books look familiar. any suggestions? i know u will be posting soon with a 99. all the best on step 2.
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| tolito
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thanks mosfet. GL
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It has been a looooong hard journey but I am inches away from my destination...
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| mosfet
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Chlorpromazine, I read most books 3 times except kaplan anatomy which I couldn't even finish reading twice(I just didn't feel like reading it). But don't worry....you are on the right track. Familiarizing yourself with your books is the first step to memorizing. Also during every reading, try not to read passively. The way I did to memorize is to ask myself everytime how they would ask a question on that topic that you are reading. For example, when you are trying to memorize Adult Polycystic Kidney disease from Rapid Review, just ask yourself what important questions the boards can ask about that disease and that includes small details.....and picture that question appearing in front of you during the boards and the answer in the multiple choice. I know it all sounds weird but whatever it takes to memorize, you gotta do it. That's another reason why I was hesitant to do questions....it takes too much out of your memorizing time. And if you don't master the book that you are reading, you are sure to miss questions on the exam. So unless you have infinite amount of time to do questions, try first to focus on reading. Also, as you keep reading, it gets faster and faster...the important thing is to not get frustrated that you are not remembering. Trust me, everyone will feel that way but when you see the questions during the exam it will all come back. And let me tell you, the last week is really crucial. Make sure you quickly flip through all the books that you familiarized yourself with (do not read any new books) and you will be surprised how much you can cram and how glad you will be during the exam that you crammed. So THIS is the trick to memorizing. The reason why you start reviewing 3-4 months before the exam is not because you are expecting to remember everything that you read till the exam date. That's just impossible. The reason is that the more times you read it earlier the faster you can cram more subjects into your short term memory during the last week.....and it's mostly that short term memory that will serve you well on the exam. For instance, if you are reading goljan for the first or second time it will take you 1week to memorize everything. But if you are reading everything for the third or fourth time, then you can cover all the books during the last week or week and half and you will remember everything for the exam by putting it in your short term memory.
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| hihopes
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Thanks for your post mosfet. Good luck!!
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| suma
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tanx mosfet,ur post is really helpful
how many months did u prepare for the exam?
ALL THE BEST for ur score
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| xwxf
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Thanks alot for the detailed summary. It's really helpful for me.
Here,I have a question about a minor thing. Have you skipped some part of knowledge in your study? I am bored with those crazy names of the parasites and thinking of skipping this section. Could you recall how many questions you encountered for parasite in the exam?
Thanks again.
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| xwxf
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could you tell me what book you used for embryology?
thx
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| mosfet
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Taking out all the breaks I took, I studied for 3 months. As for embryology, I skimmed thru first aid and kaplan. This combo is probably more than enough. I didn't have even one question on embryo in my exam.....so it's not a very high yield topic. For protozoa and helminths, I just read the 2 pages from first aid with a table for each of those. Again, that is probably enough. Concentrate more on the drugs for protozoa and helminths that are listed in that same table like mebendazole and metronidazole and stuff like that. I had a couple of questions on these but not too many.
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| zzzz
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thank you so much i know you will get a very good score.
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| chlorpromazine
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thanks for the reply mosfet. do u think if i am running short on time, i can do biostats & micro just from first aid?
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| lavendersblue
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hi!
thanks for the experience!
did you find that the exam was the same difficulty level and style of questions as the USMLE cd? or was it harder?
thanks!
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| jaal
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Hey there.....thanks for the great post!
I have a question.....The Lange for Immuno that you are talking about.....thats the Medical Micro and Immunology be Warren Levinson?
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| xwxf
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One more question related to lavendersblue's question above. Could you tell us which simulation test is the closest to the true one in terms of the level of difficulty?
THANKS
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| lecheah
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 mosfet,
thank u so much...
i am sure u will get a great score
good luck
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| mosfet
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Sorry about the delay....I was starting my rotations and got kind of busy. The style of exam questions was exactly the same as the questions from the USMLE CD. However, the difficulty of the exam was a bit harder overall than the USMLE CD. But when I say 'hard', not all the questions are harder than the USMLE CD. Then everyone will fail the exam. About 30 questions in each block are very easy to answer if you had thoroughly read the material. About 10 questions, you kind of have to think about it and answer because they will be asked in an indirect manner with graphs and pics and stuff like that. The remaining 10 questions can be very chalenging and not only do you have to know your stuff but you need to be able to integrate the material and come up with the answer. As for simulation tests, any one of the NBME tests will do but 2,3,4 would be my preference.
And yes, Lange Micro/Immuno is the same as Medical Micro/Immuno by Levinson.
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