dinosaur
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I am devastated. I took the Step 1 during the summer and scored 160. So I studied again for 3 months, averaged 7-9 hours a day, took 2 NBME tests and everything. My first NBME I took 2 weeks before the test and got 175, the next week I got 192. I was averaging 60-70% on the Usmlerx question bank.
I was aiming for a 210, so 192, while low, was certainly OK given that 182 is needed to pass. The 2nd NBME was on a Saturday, and the real test was the next Wednesday (early November). I re-read the FA and overall felt confident during the test. I thought that I could get 200, short of my goal, but doable given that I read the FA again before the test. The first 2 blocks felt hard, the 3rd one super easy, the 4th-6th challenging, and the last one was difficult. I had plenty of time in all of the blocks except in the first two.
So imagine my surprise, the school received the results early (which is a miracle in itself) and I got a 173!! I thought the NBME diagnostic test was supposed to be indicative of the real thing! I mean, yeah I did improve, but a 173 feels like a slap on the face.
So what to do? What should be my game plan studying-wise? I'm planning on using the same sources - FA, Webpath, BRS physio/path, Goljan, some HY - but reading them 3-4 times, instead of 1-2 times... but I don't know how long to study for it, or even the order of the subjects, for this 3rd attempt. Should I study Pathology first, like I did this time, or last? Or at the beginning and the end as well? And for how long?
Just thinking that I have to sit for 8-10 hours a day for 3 months makes me sick, because I know myself well enough to know that I'm not that kind of guy.
All I know is I feel like crap and have a cluster headache that hasn't gone away in 2 weeks (started becoming stressed out 1 week before receiving the score because of anxiety - might have to go to a counselor), a mother that thinks the Step 1 is just like any other college test, and a wife that is trying to cheer me up to no avail.
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| dinosaur
Forum Newbie
Topics: 6
Posts: 25
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Any suggestions from the more experienced forum members are greatly appreciated.
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| dinosaur
Forum Newbie
Topics: 6
Posts: 25
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A colleague of mine also failed the Step and we'll study together... that's the good news. The bad news is we need a plan! Any help from those that have gone thorough the experience will be greatly appreciated.
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| girl^interrupted
Forum Elite
Topics: 68
Posts: 264
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Hmmm....
The fact that you had too much time left on each block might mean you hurried through and over looked a bit of important info in the question stems . Whatever the reason , you need to identify your weak areas. By that I mean, REALLY know why you failed the exam. It must be there on your score report , all the systems or subjects in which you didn't perform well. You have to resolve this issue before starting studying again, otherwise it'll be like aiming in the dark. REally sit back and think what went wrong. You'll know in a few minutes where you lagged. Nobody can tell u what to do but yourself.
You have already taken the nbme and might know very well what your weak subjects are.
Start with your weakest subject. Otherwise, if you dont want to and want to start all over again open up Physiology. If you have read BRS , then don't change the book this time, its a pretty strong book. Do questions once you're done with that subject (After understanding, plz memorise concepts) When you do questions, you'll know what you over looked during your study.Physiology, Biochem and anatomy (the basics covered first) Then go to pharma, behavioral, micro and then patho. Depends on what works for you. Dont try to rush things, take everything in slowly until you understand the concept really well.
And please, aim high. If you're happy at getting about 60% on the practice exams, it won't do u any good. Exam nowadays is harder. Needs more serious thought. Think about getting above 90ies. Aim high. Aim high. Aim high. But do not set a target that exceeds your abilities as it'll produce frustration in the end when the target isn't met.
And remember:
" Most success springs from an obstacle or failure "
" Discouragement and failure are two of the surest stepping stones to success" (Dale Carneige)
Please do not get disheartened, you will get a great score this time.
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If you plan too much ahead of time, You lose your focus.
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| dinosaur
Forum Newbie
Topics: 6
Posts: 25
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Thanks for the response. I didn't finish each block with plenty of time, but with 5-10 minutes left. The first 2 blocks I finished with 2-3 minutes left, and the others with 5-8 minutes. However, the 3rd block I did finish with 15 minutes to spare - it just felt easy, but maybe I did overlook some stuff.
I don't have the report yet, but my guess is genetics is going to be low, so maybe I will start with genetics and biochemistry. Also, I studied for pathology in the beginning, because I felt that was my weakest area the first time I took it. The NBME diagnostic showed I improved substantially in pathology, pharm & physio, but when I have the real thing I can evaluate it better.
I will not study during the Christmas break - instead I'll just work on a schedule, but I don't know the official dates my school requires, so I can only work on an estimate. But I know that I need to take the test sometime in May 2007, so I have close to 4 months to study.
Any other suggestions are greatly appreciated.
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| oldkidontheblock
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MY SIGNATURE SAYS IT ALL!!!!!!
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Malcolm Forbes: Victory is sweetest when you've known defeat
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| dinosaur
Forum Newbie
Topics: 6
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Any other ideas/suggestions are greatly appreciated.
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| ManuNastai
Transilvanian..
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I don't know you, so the things i say may be wrong.
At first I wanted to say to memorize FA, but I changed my mind. You've done FA and other books and with no success. From my exam experience I'd say that knowing and UNDERSTANDING what's in there answers about 70% of the exam. Everything is in there. Now, the reason why it didn't work for you is because (probably) you don't have clear concepts, maybe you don't understand different things very well and because you memorized all your books. Is the only explination I find. Understanding all those stuff makes you respond in a correct way Qs that you encounter for the first time, not answer from memory if you encountered the same concept before, in your prep.
FA is not good for understanding logically stuff. It is for review after you know it all very well. I think the best aproach is to do Goljan (the scanned 2 books with spiral that is everywhere on the net) because it's integrative, it contains not only path, but biochemistry, microbiology, physiology and immunology concepts, all mixed together and related.
Another great book is Robbins' Review of Path (by Klatt and Kumar) - click here
The schedule should be done according to your weak and strong areas. Also, read the Qs and answers posted here, especially the NBME discussions.
Good luck!!
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"Love is the only inflamation of the heart that drains in the vagina" (translation after Dr Petre Florescu, Professor of Pathology, UMF "Iuliu Hatieganu", Cluj Napoca
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| dinosaur
Forum Newbie
Topics: 6
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ManuNastai,
Thanks for your comments. Everyone says, memorize the FA, so I did. It doesn't mean that I don't understand all the concepts well, but certainly there is plenty to improve upon.
I will read from a select variety of sources, then focus on the FA at the end. Regarding the FA, I don't know if I should buy a new one, so I am forced to write new comments on them. Most of the comments on my FA, believe it or not, are from Goljan, because I studied from it as well. But one thing I can definitely change is that I studied pathology in the beginning, not near the end. For example, for pathology, I did the BRS and Goljan, and did questions from the Robbins book. I spent 30-40 days on that and then moved on. But my total prep time was 3 months, so I think again I definitely forgot what I studied. By the time I was finished, I just reviewed the pathology part from the FA. This approach, I believe now, is not the best one because I think I definitely forgot what I studied. That's one of the reasons I'm so upset, because I did the Robbins path questions and if I got less than 70%, I read the material again.
I definitely will change the order of subjects so the basics - anatomy, physio, biochem - are covered first and pathology is last.
I do have the Goljan scanned books, plus his Pathology Review. I stopped doing BRS because I just got tired of it. In January I will receive the 2nd version of Goljan's Rapid Review Series, and since I like his integrative style and believe his approach works for me, will give this book a try.
Regarding schedules: what I think is that I should read the material throughly 2-3 times. I will study for 2 months, then take a diagnostic, just like if it were the real thing, then take a mini-vacation (3-5 days). Then study again everything for another month and take another diagnostic.
After that I should evaluate if I feel ready or if I need a couple more weeks.
What does everyone think?
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| wizard
Forum Junior
Topics: 2
Posts: 14
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kap med essentials is also supposed to be a good review (kind of in the same format as the First Adi), if you do get time. I haven't gone thorugh it completely yet, but it's supposed to have helped many..
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| dinosaur
Forum Newbie
Topics: 6
Posts: 25
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Well I already have FA and Step Up, so Med Essentials might be overboard.
By the way, I just found out I have until July 1st to take the test, so that's 6 months worth of prep. I'm still in school (U.S. med school, not IMG) so I don't know if 6 months is too much. And I don't know if I can even keep it up for 6 months! 
So what kind of schedule can someone suggest? I'm planning on studying everything in 2 months, maybe 2 months and 2 weeks, then taking a diagnostic to see where I stand. Then I read everything again (or twice, if I can) for a month or so and then another diagnostic. After 3 months, and with the results of a diagnostic test, I can define in a realistic manner if I should study for 1-2 more months or if I should take it in the following weeks.
Also, here is a list of the books I will use. I kind of get frustrated when I use a lot of books, so that is why I mostly stuck with the FA. But since memorizing the FA is not giving me results  , I will use the following:
Anatomy/Embryology - High Yields
Biochemistry - Rapid Review Biochemistry (Goljan is co-author of the book)
Behavioral - Kaplan Behavioral book/videos (maybe High-Yield later on)
Genetics - Kaplan Genetics book/videos, HY Cell & Molecular Biology (in both tests I got far too many impossible genetics questions)
Histology - don't know yet, HY histo or Kaplan Histology/vids? (should I even bother that much?)
Micro/Immuno - FA, Kaplan Micro/Immuno book/videos (both videos are boring though)
Neuro - HY Neuro
Pathology - Pathology Rapid Review (Goljan), Goljan audio, Robbins Review of Pathology, Webpath.
Pharmacology - FA is enough. I improved a lot on pharm just with FA and tons of questions.
Physiology - BRS Physio.
Questions - Kaplan Qbank. I also tried USMLERx and really liked it, because the answers are linked to the FA. The pharmacology questions were stellar. But maybe I can finish the Qbank first and then try USMLERx again.
General review - FA, Step Up.
When I finish with my first "cycle" of studying, I'll simply read everything again. It should go by faster on the second read, right?
By the way, I love Webpath. I did it for my pathology & pathophysiology courses and did very well on the examinations when I used it. My question is, how to integrate the Robbins Path Qbook with Webpath? Maybe do Webpath first and then Robbins? Or should I leave Webpath for later?
Any other suggestions are greatly appreciated.
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| ltlt2006
Forum Newbie
Topics: 0
Posts: 2
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About preparing for step 1, does anyone know if kaplan webprep is sufficient
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| ing
Forum Guru
Topics: 45
Posts: 435
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I feel just by reading books over and over is not very efficient. What I did is subscribe a question bank (i.e. usmleworld, kaplan, or qmax) that I never used before, do 50 questions, random, timed. After the test, review these questions, take notes, list 2 or 3 the weakest areas from the result, study these weak subjects, repeat this process. It worked for me very well. At least my nbme score increased from 350(form 1) to 500 (form 2). But I haven't received my step 1 score yet. Hope I did well. So you may want to try this.
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Never give up!!
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| dinosaur
Forum Newbie
Topics: 6
Posts: 25
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Ing,
Your advice is not bad, but in my case I need to study everything well before I start dwelling on my weaknesses. I'll try your suggestion in the last month before the test.
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| md1844
Forum Newbie
Topics: 0
Posts: 1
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I got a score of 144 after 10 months of prep this is my third attempt after 3 years. Advice???
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| askdoc
Forum Junior
Topics: 2
Posts: 89
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Actually, I've answered a similar post a few months back. The guy/gal also failed Step 1. My answer was really long, so cannot repost it here. If you are interested click on my ID, look up my post under "What to do?".
I did my Step 1 last April 2006 and my score was 99/256. Take whatever you find useful and adopt to your plan of studies. Good Luck.
People can't seem to find the post so I am adding it here.
http://www.prep4usmle.com/forum/thread/34492
Edited by askdoc on 12/18/06 - 10:29 AM
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Step1 99/256, Step 2 99/258, Old IMG, 1989 grad. A man's reach should exceed his grasp, or what's heaven for. http://blogs.askdoc-usmle.com
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