asterix
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Dear All,
This forum has been extremely helpful - thought i would do my small bit and contribute my exam experience and preparation.
I was introduced to this forum by xeroorex - my classmate who first used it way back in 2004-2005 and did spectacularly well on the step 1 and 2 - his excellently summarised post is somewhere here ( would strongly encourage a read ! )
About myself : first year resident in singapore,( the tiny island that may not be visible to the human eye on the world map ). Graduated in 2005; hoping to train in pediatrics. Didn't seriously hit the books until June 2006 ( was doing a lighter community pediatrics rotation then ). Took the exam October 30, 2006. Scored arrived ( in a badly sealed evelope ) on December 1st exactly : 249/99
My Preparation - the long and hopefully short of it :
It took me a lot of courage to write to the step 1. Went through a period of depression in the first 2 years of med school with less than desirable grades - so it remains a huge blur in my memory !!! So studying for the step 1 was like reading everything for the very first time ! Just thought I'd say this at the outset - to encourage people who did not do as well in their basic sciences courses in med school. I am one of them and I think God gives us all second chances - and that's encouraging !
My resources : I was really fortunate to have kind friends ( including Xeerorex, aaron leong, mohan and kavitha ) who lent me the books they used in their preparation. These I found very useful :
Main texts :
1. First Aid - Enough said i think about FA. Actually used the 2004 edition cause i had it somewhere in my bookshelf. Annotated it during my prep throughout and used it and Med Essentials solely in the last 2 weeks before the exam
2. Kaplan's Medessentials - Also another book that i just happened to have cause a friend lent me the book. Found the systems based review very comprehensive! Also i was using FA 2004 which does not have a systems based review so this book complemented FA very well !
Subject resources :
1. Anatomy , Embryology, Neuroanatomy.
Neuroanatomy - Used high yield neuroanatomy which was fantastic. I think it is helpful to look at CTs and gross specimens. Would be useful to have an atlas and study neuroanat side by side - having said that i did not really do that and probably paid the price cause my exam had quite a significant proportion of CT brains and gross specimens.
Anatomy - was and still is my worst subject - just used high yoeld anatomy , read through snell ( just the important snippets ) for upper limb and lower limb. Thankfully my exam did not have too much and too detailed anatomy.
Histology - I had high yield histology but i think its too much information - the first few chapters are particularly useful.
Embryology - Used High yield. Some people say there is too much information in it - which i agree : Not all of it is necessary for the exams, first aid should be more than enough. But i was going to start on a neonatology rotation right after my exams, so found the book very enjoyable to read
2. Physiology - Used BRS physio - to clarify concepts. It will be great to do it together with pharm and patho to get an understanding of pathophysiology. The questions on Q bank were also useful in clarifying concepts.
3. Microbiology and Immunology - Used microbiology made ridiculously simple ( I am a huge fan of extremely simple books ) and just read the short section of immunology in BRS Micro and Immuno and Medessentials. My exam was tons of immunology - all in the form of strange experiments. I really found the immunology questions extremely difficult !
4. Biochemistry : Initially used High Yield but i think its only useful if you already have a good background in biochem. Miraculously someone lent me Kaplan's biochemistry which i found extremely useful ! infact I began to enjoy reading biochem finally after 5 years of med school !
6. Pathology : Used BRS pathology alone, went to web path to look at the slides as well as do the questions. I think the one thing that aided me in the path and pharm questions in the exam was clinical experience. Most of the questions were in the form of clinical scenarios ( with many distractors !! ) but somewhere along the line you remember a patient you have seen with a similar condition and its strange the tricks your brain does to retrieve some hidden info somewhere !
7. Behavioural Science - used BRS behavioural Science. I found the behavioural science questions in my exam very strange and tricky - not like the ones i was used to doing. I think this is a subject that is difficult to prepare for, you just have to choose the best answer and hope its right !
8. Pharmacology - till the very end never really found 1 good source. Used both high yield pharm and kaplan's pharmacology. I found Kaplan more useful. Having said that, I think FA's systemic pharmacology is more than enough for the exams.
9. Genetics/ Cell and Molecular Biology: Used kaplan's biochem which has a genetics section and high yied cell and molecular biology. I found the section on cell surface receptors in high yield particularly useful and summarised.
10. Biostatistics - i think just a couple of basic concepts : Sensitivity, Specificity, PPV, NPV, various types of studies should be good enough. i had high yield biostats but again too much info. BRS patho has a section on statistics - so that together with FA should suffice !
I think a few reads of each subject is useful. After the first read i could not remember a thing but it got better and faster with the subsequent reads. In the 4-5 months, read everything about 4-5 times ( roughly a month for each read )
Question resources :
1. Q bank - I used the 3month Q bank cause i used it along side with my revision to fine tune concepts and zero in on areas to focus on.
Cumulative score - 78 %, last 10 blocks : 80 - 90 %
2. Q book - Again lent by another friend, arranged subject wise so i did it after reading each subject.
3. NBME forms. Was not sure initially whether i even wanted to do them but i a glad i did in the end cause while the questions in the real exam are harder, they resemble NBME questions the most.
Started only 1 month before the exam, so did only 3 forms, I would advise doing all 4 forms for practice ( though it is expensive no doubt ! )
NBME Form 1 - 620
NMBE form 2 - 630
NMBE form 3 - 630
4. NMS - Xeerorex lent me the NMS book he used - the questions are tough, so i just did about 10 tests ( was also running out of time ). Overall score - 75 %
5. Also found Tommy K's posts on ValueMD very useful - there are more than 1000 questions there, i think i only read ike a 100. Discovered it too late , about 2 weeks before the exam
6. Also used Goljan 100 page notes - just read it once a couple of days before the exam but the lack of organisation make it difficult to assimilate.
7. And this forum ofcourse ! To see what was commonly tested.
The exam :
Everything that could go wrong did. The biggest lesson i learnt was never to try anything new the night before the exam ! Went for a nice indonesian traditional massage the night before thinking it would help me relax and sleep. It did the opposite !!! I think circulation to my brain was so enhanced after the massage that i was completely refreshed and could not sleep the whole night !!! Woke up slightly later than usual after a whole night of trying to sleep and was caught in a huge Monday morning jam. Arrived at the test center barely 5 minutes before the exam. They nearly did not let me take the exam !
Started the first block in an extremely tense state but it got better after a while. My exam is really a blur too, was in this strange awake yet asleep state. Was feeling tired after the second block and only redbull and more redbull kept me fresh through the exam.
I went in preparing myself for extremely challenging questions. Yes there were challenging questions but many questions i had were simply what i would classify as "wierd", till today i don't know the answers.
Overall i found the exam very difficult, with maybe 2 relatively easier blocks, 2-3 moderately difficult blocks. But generally all subjects are well represented. Some questions are lengthy, while others are short 2-3 liners. I had many questions in the form of experiments , so it took me a while to even figure out what the question was all about. Some blocks i was really rushing for time, but i think it is good advice to not get stuck too long on 1 question. Also I think i changed too many answers which in retrospect was not the cleverest thing to do.
Felt totally drained and sad after the exam. Came home and cried, felt all the effort i had put in was totally wasted but did not really regret the studying cause finally i had a chance to understand the basic sciences more and it would be useful in my clinical practice in the long run !Though i must admit I wished really hard my scores would get lost in the mail and i would never get to open it !
Then i told myself that i would only open it after step 2 in case i did so badly that i would be totally discouraged from even attempting the step 2.
After tons of nightmares and an emotional rollercoaster, the scores came on December 1 - earler than i expected ! The envelope came open so i had no choice to open it. And i still remain speechess. I can only thank God for his infinite grace .
Its been a lengthy post, so thank you for your patience in reading it. Just hope it can encourage anybody out there who may be feeling low during prep / after the exam !
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| elisamik
Forum Senior
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thank you for your post and good luck in step 2!
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| drbcshah
Forum Elite
Topics: 48
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Thank you for a detailed and sincere advice.
I have exams coming up so needed every bit of it.
Wish you all the best for Step 2 CK, CS and 3.
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| My Destiny
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Hi Asterix..thank you for your advice!. I can see that you had a hard experience but with good results.
My experience is similar. One year ago, i took the step 2 first, but i didn't pass. After that i had a long time of depresion. Now i want to start again, but i'm afraid. I would like have encourage like you.
Could you give some advice?. Will be better if i study for step 2 again or for step 1?.
Thank you
My Destiny
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| inkspot
Forum Guru
Topics: 30
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asterix! i am glad you posted your detailed exam prep and expierence.
I am impressed and wish you all the best for step2 and cs!
good luck
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| Seltzer
Forum Newbie
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thanx for sharing this great post
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| asterix
Forum Newbie
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Thank you so much Seltzer, inkspot, drbcshah,my destiny, elisamik for your replies ! All the best in your preparation as well !
My Destiny : Yes it is natural to feel depressed after not making it on the exams but the most important thing is to not give up but to try again. You really come out stronger. Any advice that i can give ? Perhaps try to identify what went wrong the first time? Was it the lack of time to prepare, insufficient material, or studying the wrong material ?, not enough practise? burn out / stress ? There could have been so many factors. if you could identify your weak areas and build on strengthening them while also paying attention to your already strong subjects/ areas that may help ! While starting to prepare again, don't be frustrated if you cannot remember everything at the start or if it a bit too slow at the start - take your time initially to understand the material you are reading and understand concepts. I find that the USMLE is a test of how well you can APPLY knowledge more than how well you can remember which is why many questions are in the form of scenarios, experiments etc. Find out what is your learning style, are you a visual learner ? aural learner and use a technique that works best for you to remember material. identify your blind spots by practising questions, don't stick to just studying.
Whether to write step 1 or step 2 again ? Unfortunately that is a question i cannot answer too well right now, some people suggest that step 1 should be done before step 2 because many of the concepts from step1 are tested again in step 2. I was initially considering doing step 2 first cause i just finished internship so i figured i might be closer to the clinical material. But in the end i did step 1 first because i was doing a community pediatrics rotation which gave me more time to study, and i have read that step 1 requires a longer time to prepare and is typically the harder step for IMGs.
hope i have answered your questions, if you have anymore or any specific queries, will try to answer them !
take care,
asterix
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| klimt
Forum Guru
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congrats asterix! good luck with step2!
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| abdo
Forum Senior
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i want to know how many questons in
the nbme , what is it 's system and did u use usmleworld or kaplan q bank and what do u think regarding them .
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| drbcshah
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Can you pinpoint on most important concepts/ topics you had on exam?
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| asterix
Forum Newbie
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Abdo : the nbme has 4 forms, each form has 200 questions and costs 45 US dollars ( per form ) . There are no answers provided but the format is very similar to the actual USMLEs. the questions are supposed to help you identify the areas you are weak at. At the end of each exam you will get a distribution of your performance just like the USMLE.
you just need to go to www.nbme.org to purchase the forms. I did not know about usmleworld, though i find a lot of people on this forum seem to be using it ! I used kaplan Q bank. I found Q bank good - there are detailed explanations and they also help you revise important concepts and topics. You can also get used to doing questions in front of a computer screen !
drbcshah : From what i remember from my exam , i can write down a few concepts/ topics that were tested, but i think it is really very variable exam to exam
1. Anatomy - Limb anatomy
2. Neuroanatomy - crabial nerves, brain stem, lots of scans and diagrams
3. Physiology - A good spread, endocrine, cardiovascular physiology
4. behavioural Science - doctor patient relationships, confidentiality - but trust me some of the scenarios are so strange that you really cannot prepare for it
5. Microbiology - standard questions on enteric organisms, basic taxonomy of viruses
6. immunology - this one was really tough in my exam - not the standard immunodeficiency diseases - many experiments asking you to identify the underlying problem - eg - MHC II deficiency etc
7. pathology - had a lot of haematology and endocrinology
This is about all i can remember - hope that helps !
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| drbcshah
Forum Elite
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Thank you very much
wish you all the best
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| dr.sunshine0519
Forum Newbie
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Hey asterix... i just have a question, did u use kaplan lecture notes for all the subjects? and how long did it take for your preperation? im planning to take it in june but by the way my studying has been doing i would probably prolong it by a month... your post was relieving to read... good luck on step 2 and eventually 3!
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| drbin
Forum Guru
Topics: 27
Posts: 535
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Hi asterix, which part of singapore r u from? Im staying at East Coast. i also had the same experience as u bs of monday morning huge jam at PIE,reached centre just 5 mts before. The panic is undescribable, but the prometric people r so nice. when r u planning ur step 2? Congrats for ur great success
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