chileno
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This journal section should serve to chronicle my progression through the demanding pathway that will lead to my taking the USMLE Step 1 around mid March of 2008. Hopefully, I can maintain the course, giving some insight as to my study efforts and gaining some support from my fellow forum members as well as being able to look back on my progress.
I am an IMG (graduated 2007 in Latin America) and hope to apply for the 2009 Match in the United States. I have a wife and two young children and will attempt to reinforce my own motivation regarding this exam as I detail the work that I put into preparing for this endeavor.
Since I have limited myself to 2 months of preparation due to time constraints in other areas (family, finishing MPH degree, etc) I hope to spend most of my time in the trenches and not so much time detailing in the forum.
So here goes...wish me luck as I take on the Big Bad Wolf of medical exams.
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| chileno
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I am going through the various threads that other test takers have submitted to see how to best prepare and attack this exam. There are a number of approaches (KLN, FA, Kaplan DVDs, multiple HYs or BRSs) but I hope to have a working plan compiled by the end of tomorrow, Friday.
I assume that I will need to use KLN + FA + 1 or 2 Question banks and maybe flashcards in order to really pound the material into the brain so that it can be retrieved quickly during the exam.
Hopefully I can narrow the sources down to the most essential material in order to make the best use of my next 2 months. And while my cousins and family in Chile plan out their vacations during the next 2 months, I have to accept the fact that I will be under the fluorescent lights, trying to keep my sanity with the chance of a short escape after the exam has been taken, before taking up the finishing touches on my MPH degree.
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| drsaima
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Good luck!
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| Novak75
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Hi chileno!
Welcome to the forum!!
I think two months is very little time but I have seen others in this forum, like motorola, do it and ace the test so best of luck to you.
I am also an IMG from latin america, but I am planning to take step 1 in april or May, but I wish I could do it sooner but because of jobs, etc, I won't be able to take it sooner.
Good luck!
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| chileno
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Thanks to the members who have voiced their encouragement, I expect that the 2 months will be a concentrated effort with every effort focused on mastery of material and attention to question format.
The last couple of days and nights have been hectic while trying to put together a "plan" for the exam while helping some relatives replace some lighting in their home, as well as worrying about my 3 year old daughter having a persistent cough (lungs were clear, no fever, no change in energy) that would only kick in at night. Went off to purchase a humidifier around 2:30 AM with some camphor additive so that the air in her room wouldn't be so dry and get the cough reflex going.
Thankfully the next two nights were much better for her, but it all serves to remind one of the juggling that will take place between being husband, father, and Step 1 "preparer".
I decided to begin with the big 4 (Path, Physio, Pathophysio, and Pharm) and tonight listened to the first 4 lectures by Goljan. Went to the gym and did an hour's worth of cardio and free weights to keep the body in shape and give the mind a break.
Goljan was good stuff and I will follow up tomorrow with more lectures, then reinforcing with his notes in Rapid Review and doing questions in Qbank in order to use a multi-pronged attack.
I also expect to get to bed earlier and get up earlier in order to have the mind thinking on questions early--in order to begin simulating exam setting.
First serious study day is tomorrow...hope to give a progress report afterwards.
--chileno 
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| chileno
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Finished the first 10 lectures by Goljan and read the corresponding chapters in Rapid Review afterwards. Hope to cover the same topics, including neoplasias, in the BRS Pathology Book and start questions from RR on Sunday. I want to finish as many questions from other sources during the "1st read through" and then begin with Qbank questions.
After my "2nd read through" of the material, I plan on doing UW questions to really solidify all of the cumulative information.
Non-medical: Tonight I took a break to go listen to a group playing gypsy music from India, Pakistan, and Spain. Phenomenal!!! Nice to see what the rest of the world is doing while we surround ourselves with medical books and shut out the other things in our lives. As a former musician, I can appreciate the joy that playing music can bring and the pleasure of playing with fellow musicians. I bumped into a friend who is now a professor at a music school who offered to help me to start learning the guitar once I finish taking the exam. Another nice carrot to dangle in front of me to keep studying and put every effort into getting a great score.
Tomorrow is family day and then Sunday will be back to pathology, pathology, and pathology.
--chileno
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| chileno
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Well...time flies when you are only studying!! I have been covering and recovering the material from Goljan using Rapid Review, Goljan lectures, and flashcards with important details that need to be repeated. Hematology is discussed very well in his lectures and provides a very logical approach to heme questions and diseases. As he mentions, the classification for hematological disorders that he has developed has served him well for the last 25 years.
What I have to keep in mind is that this exam is written for 2nd year U.S. medical students who have not yet started their clinical rotations. So, as a result, I must remind myself that I have to concentrate on the basics and not switch to my own clinical experiences as my base of information in answering questions. The Qbank questions conceal these basic science concepts and I cannot cloud my perspective by reading into the questions, or thinking about connections that are not "most likely".
Tomorrow I will be reviewing again the first half of Rapid Review PATHOLOGY, reinforcing with flashcards, and doing questions so that I begin to know these topics cold, cold, cold!!
February 4th is tomorrow and I still expect to take the exam within the next 2 months. Hope to make much more progress during this week.
--chileno 
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| chileno
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--Finished listening to all of the Goljan audio lectures through hematology (1-18).
--Went through about 100 slides from Webpath that corresponded to the Goljan audio sections.
--After dinner: Expect to get through 3 chapters in Robbins Review of Pathology by tonight and go through 100 Goljan "homemade" flashcards from his lectures by tonight.
--I am by nature a night owl, but I need to really get in the habit of shutting down by 11:30 and then getting up by 7:00am. I cannot get back to the library after bathtime and story time with the kids, so sometimes I get carried away with the quiet studying until after 1:00am.
Overall, things are clicking and it definitely helps to rotate the pathology sources in order to reinforce and to keep from getting bored with a book/website's layout.
--chileno
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| chileno
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Still working through PATHOLOGY..this is definitely the foundation of medicine and even the general pathology is absolutely key to understanding and mastering the systemic pathology. The recognition of pathology (for Step 1 exam at least) must be achieved through repetition, repetition, repetition. The real world requires a much more sophisticated integration, so once again I must stick to what is covered in the review books and not stray too much towards the clinical side of my own experiences. I have read too many experiences where life long pathologists begin by saying, "In my 20+ years of practice I have NEVER seen this disease (X), but on the boards, it is very common". Anyways...
My progress in the last few days--
FINISHED
1. Goljan Rapid Review Pathology (GRRP) Chapters 7,8,9
2. Robbins Review of Pathology question book (ROBBINS) Chapters 1,2,3,4,9
3. Webpath images from "Cell Injury" and "Inflammation" sections
TOMORROW NEED TO COMPLETE:
1. First Aid 2007--Pathology Principles
2. Goljan Rapid Review Pathology (GRRP) Chapters 1,2,3,4,5
3. Robbins Review of Pathology question book (ROBBINS) Chapters 5,6,7,8,10
4. Webpath images from "Immunopathology" and "Neoplasia"
Hope to get through all my initial pathology readings by Sunday February 17. I should start physiology by Monday February 18.
Although it was a very difficult decision, I have decided to rent a studio/motel for the last 30 days of my preparation before the exam so that I can literally eat,drink,sleep USMLE and not have the distraction of my wife and children. I expect that it will be awkward to explain to my older child why Papi will be sleeping in a motel, away from Mami and away from them, but I must do what I have to do in order to focus on this exam and get a HIGH SCORE...chileno needs it and wants it!!
--chileno
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| Kalyann
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You can get anything in life if u sacrifice evrything else for it.
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| chileno
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Kalyann: Thanks for the positive message!
Soon I will be checking into a extended-stay motel and will be updating my progress on a daily basis on this journal since I will be not be interacting with my wife and children except on a once a week basis. (I'll need to save my sanity by communicating somewhere... )
So far though, I continue to emphasize PATHOLOGY, making sure that I am not deficient in this subject in any way...
COMPLETED:
1. Goljan's Rapid Review of Pathology (GRRP)
--Chapter 1: Cell Injury
--Chapter 2: Inflammation and Repair
--Chapter 3: Immunopathology
--Chapter 4: Fluid and Hemodynamic Disorders
--Chapter 6: Environmental Pathology
--Chapter 7: Nutritional Disorders
--Chapter 8: Neoplasia
2. Robbins Review of Pathology Question Book
--Chapter 1: Cellular Pathology
--Chapter 2: Acute and Chronic Inflammation
--Chapter 3: Tissue Repair
--Chapter 4: Hemodynamic Disorders
--Chapter 7: Neoplasia
--Chapter 9: Environmental and Nutritional Pathology
--Chapter 10: Diseases of Infancy and Childhood
3. Kaplan QBOOK
--Read the first 40 pages that deal with test-taking strategies. I will begin the 5 pathology exams after I have finished reading GRRP.
NEED TO DO:
1. Goljan's Rapid Review of Pathology
--Chapter 5: Genetic and Development Disorders
--Chapter 9: Vascular Disorders
--Chapter 11: Red Blood Cell Disorders
The pace has been somewhat slow (only about 6 hours a day), but I expect to start with about 12 to 14 hours a day starting February 18th until the end of March when I expect to be ready to take the exam.
Wish me good thoughts!
--chileno
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| Jlcalisto
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2 monthse exam seem kinda short, anyway everithing is possible, the best advice I can give you is to take NBME form online 1 week before the exam and see your prognostic score. Obviously if you score the way you wuld want to.... reschedule the test.
Good Luck!!
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JL
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| Jlcalisto
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2 months-prep seems kinda short, anyway everything is possible, the best advice I can give you is to take NBME form online 1 week before the exam and see your prognostic score. Obviously if you score the way you wuld want to.... reschedule the test.
Good Luck!!
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JL
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| chileno
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I had to disappear for a while as I needed to meet with my MPH committee and put together some chapters on my MPH thesis. It took me two weeks away from Step 1 prep, but have alerted my committee members to the fact that I will be now be out of touch while preparing exclusively for Step 1.
Changing hats...back to studying for Step 1.
Today is Friday and I expect to be completely finished by the end of Sunday with:
--Goljan's Audio Lectures (1-37)
--Goljan's Rapid Review of Pathology Book
--Robbins' Review of Pathology Question Book
--All the main sections from Webpath
All of the pathology books jumped off the shelf and welcomed me back to the intense period of review!!!
--chileno
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| chileno
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I have also rented an extended stay motel room and have just moved my stuff for the long haul. I will definitely miss my family, but I have to focus on the task at hand and take this drastic action.
chileno is in lockdown mode...
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| step99
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Thats very good chileno, im doing the same thing, for the past two months away from my family
you are using good sources for your prep..keep going
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| chileno
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WOW!! It has been a coupld of weeks since I checked into the journal. I have been holed up in a motel room studying instensely for Step 1. It is surprising to see how the focus on the exam squeezes out all the other "details" in life.
--Studying for the exam has become stress-reducing.
--I find myself cutting phone conversations off early so that I can get back to studying.
--I am eager to get back to Qbank to do more questions.
--I even bypassed making entries into the journal since it would take time away from the studying.
Thank goodness this is only a temporary state...I would hate to always be this way and avoid life in general with such a focused behavior.
I have finished the following:
1. First read through of FIRST AID 2007
2. Goljan's Rapid Review of Pathology (GRRP)
3. Flashcards for key points in GRRP
4. Robbins Review of Pathology 800/1100 questions
**THANKS TO "STEP99" for your encouragement!!
I bought Kaplan Qbank and have started doing 100 questions in the evening. I hope to start 150 questions a day in a couple of days and finish it in a couple of weeks.
Still here...still looking for a HIGH PASSING SCORE.
Chao,
--chileno
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| 5fluorouracil
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whoah!!! you are very motivated, we should all be that dedicated..... one of my biggest problems is family distractions, sounds like a good idea to get away for a while, the time away from family may seem hard now, but it will be worth it in the end..... you're doing great, keep it up!!!
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| chileno
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5fluorouracil: thanks for the encouragement. I made the decision to commit to studying away from family and I can honestly say that for me it was the best decision. I struggled with how the isolation would make me feel as far as not being an adequate husband, adequate father, or family member during this time, but I expect that my family will "get over it" and the sacrifice on everyone's part should pay off with a nice big score on the Step 1. I told my older girl (4 years old) that Papi is staying at a motel to be close to working at the hospital, although I am not doing rotations or anything. I don't want her to have a negative association with "studying" and her father's absence, so she thinks that I am staying here in order to be close to working a a hospital and that the job will be over soon.
As far as the exam preparation...
Today things are really clicking and coming together. Questions are still tricky, but the information is starting to integrate in my mind and I am starting to anticipate the tricky approaches.
I had to extend the motel stay by 3 weeks today.  Don't like spending the money, but it had to be done and I am making some measureable gains. I expect to finish 1000 Qs in Kaplan Qbank in the next week and take an NBME by April 3rd to give me an idea of where I stand.
The feeling of doing well with questions in Robbins Rapid Review and Qbank is getting to be addictive. I am getting excited getting up in the morning and starting on flashcards and more questions.
Back to the books!!
--chileno
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| chileno
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Today was a very productive day, in spite of it being beautiful outside...
--Finished 150 questions from Qbank and Robbins Review of Pathology with good results.
--Went over flashcards for CNS, Musculoskeletal, Endocrine, and Microbiology.
--Reviewed ophthalmology basics.
---------------
Tomorrow I hope to continue the momentum and do the following:
--150 Qs from Qbank
--Micro flashcards / Microbiology from First Aid
--Immunology flashcards/Immuno from First Aid
The idea is to focus to the point where all the information is flowing in a flexible manner and I recognize key points like a well developed reflex.
End of another good day--
--chileno
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| chileno
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Making good progress...
--Completed all questions in Robbins Review of Pathology Question Book (really seeing the various connections that are made and can be made between the disciplines)
--Went over more flashcards in Micro and Pathology
Wasn't able to get cover anything in First Aid today, hope to do better tomorrow. (I have already covered every page in detail in FA 2007 about 3 months ago, but am now going though again closer to the exam)
Have put together CHILENO'S 3 NEW CARDINAL RULES for success on the USMLE:
1) I must dominate and master the material.
2) I must be flexible with the material to recognize it in its many versions.
3) I must be confident in myself as a doctor and confident that my dedication to study and mastery of material will provide me with the mental clarity on the exam.
Building confidence and making sure that it does not waver has to be one of the most important conditions leading up to the exam and during the exam. Plenty of journals have mentioned this pitfall...study like crazy, then do poorly on Qbank or not so great on NBME and then the confidence begins eroding.
I hope to proove to myself and my family that this hard work will pay off and the sacrifice for my wife and kids will not have been in vain.
Positivity breeds power...both mentally and emotionally.
Hasta mañana--
chileno
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| chileno
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Wrapped up several topics including:
--Flashcards in CNS
--Flashcards in Immuno
--Flaschards in Endocrine
Did another 100 Qs in Qbank and getting about 60%...
So, to get an idea of where I am so far, I took Form 2 NBME. The result was not as high as I expected (350--equivalent to 178) but I haven't covered pharmacology nor biochemistry and am still missing completing microbiology. So, as expected, those three subjects were quite low on the performance chart.
Everything else was at least at the borderline to high area which shows consistency. I hope to work on pharmacology, biochemistry and microbiology in the next three days and then retake an NBME to gauge any improvement.
Moving on with the plan...
--chileno
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| chileno
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After discussing the exam and my plan for preparation with my wife, I decided that I have to choose a date and really make a push for it.
HERE IS THE DATE: APRIL 22ND at 8:00am
Unfortunately, I am in a unique position due to having a family and having to continue to pay for a motel room for these weeks. I don't have unlimited study time. So, due to these limitations, I cannot extend my studying by a month or several months. My wife would burn herself out having to be with the kids 24/7 for another 4 to 6 weeks. I will have to compress the studying into the next 2.5 weeks and really concentrate on tightening all of the information. I may not be able to fight for a top score, but I will fight for a HIGH PASS SCORE.
-------------------------------------------------
Today I plan on:
1. Reviewing Pharmacology from FA 2007 and flashcards
2. Reviewing Biochemistry from FA 2007 and flashcards
3. Corresponding questions from QBOOK
4. 100 Qs from Qbank
No days off. No evenings off. No mornings off. The exam is coming and I will be ready!!
--chileno
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| motorola
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i see a high 99er here good luck
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| chileno
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Yes, the exam is in 12 days...
Need to adjust my sleep pattern to be ready for the exam limitations. Currently go to sleep at 1:00 to 1:30am (natural night owl) and get my 7 hours of sleep for an 8:00 to 8:30 wake up time. I will start going to sleep by 11:30 in the next few days and then eventually going to sleep at 10:30pm so that I can wake around 5:30 am on the 21st and 22nd so that all synapses are humming by 8:00am start time.
It should be said that for someone who usually loves to stay up until the late hours studying, the key to changing the wake up time to such a drastic level is being naturally tired by 10:30. I don't remember going to sleep at this time since I was 10 years old. Even in high school I would stay up late studying, after sports, and after practicing music. The other key, being in my small motel room, is to start turning off lights 15-20 minutes before shutting down AND...here is the clincher...no television at all after watching it during dinner. A friend of mine calls television the "Time Robbber" and the same can be said of the computer in this age.
So, study hard then begin to shut off the 4 lights that I have on for wakefulness and then don't even think of getting online or checking the "Time Robber".
The tiredness in my case will come from mountain biking for a solid 60-75 minutes. We, as physicians, are taught to emphasize exercise to our patients, but it is easy to feel guilty about taking time away from studies to exercise. I won't dwell on the obvious benefits of daily exercise, but I will say that I have noticed that studying for the USMLE can easily push everything else of pleasure out of the way. So...I expect to get to bed by 11:30 tonight and up again (surrounded by stacks of flashcards on an ironing board and coffee table, my Netter's Atlas of Anatomy, and First Aid 2007 ready for my attention) by 6:30-6:45.
Right now I am going to quickly hit Biochemistry, Genetics and the three Ps and knock out 100 Qbank questions by lunch time.
motorola: thanks for the encouragement, it all helps to know that there is a world beyond this motel room.
I am in machine mode...machine mode...machine mode...machine mode...
--chileno
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