bm
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Topics: 37
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:icon_bounce: yey you're done! i followed your lead  doing the diary now, so you can give me a good spanking when i don't do my job have a great day!
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| Ahdy2000
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done! Wow, Namf. I almost can't believe it....that you're done!! COngratulations man!! Keep your eyes looking forward and upward. Many many congrats, and good luck with that surgery. I think you'll find all that board studying will come in handy. stay in touch
a2
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| Ahdy2000
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just curious to know if you had tons of physio endocrine receptor Qs...
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| nuprin
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congrats, namf! now you're done with that pesky exam (absolutely NO doubt about it)! best of luck in surgery.
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| Binz
Forum Senior
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hey namf! you're done!!!!! congrats dude and enjoy the much deserved break. with ur hard work and all the prayers i'm sure u rocked the exam. hey, now that it's over....don't forget about us people who still have to take it.  keep us posted.
binnie
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| namf
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Thanks everyone so much for your warmth--always there, always wonderful...I just wanted to say, I never have forgotten anyone or anything I said--I will give you the inside scoop on the exam in the detail you deserve at the right moment. It's just that right now I'm in an impossible situation. Please try to understand: I am in a place where the rule is eat when you can, sleep when you can...I am not sleeping over 4 hours (seriously) per night, and my whole day goes by in a super-fast forward blur of standing on my feet looking deep into someone's guts. (My earnings from all this studying). Still, I am exhausted, and my note will be lousy. Just please give me until the weekend.
I know this sucks. I am really sorry, I just wouldn't be able to understand why if I had not taken a surgery rotation either. More very soon--I promise, and I'm sorry.
Namf
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| Jsmart
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Namf don't you worry about posting, you will do whenever you have time we all know how busy surgery is!
Congratulations for finishing it! I am proud of you .I know everything went OK.
Enjoy the "cutting" :wink:
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| Ahdy2000
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i thought the rule was eat when you can, sleep when you can, and don't mess with the pancreas. 
Don't worry about the posting. Just take care of yourself and try to stay healthy.
a
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| kalsam
Forum Elite
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Ooh... :icon_bounce: :icon_bounce: :icon_bounce: <:flag:>
I am 100% sure YOU WILL PASS THIS TIME... [-o<
___________________
"Read Repeat Recall Remember Recognise & Reproduce"
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| namf
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Finally--a free moment on a Sunday night before the maddness of surgery rotation resumes tomorrow at 4:30am with the alarm...
Well, I don't know what to make of my USMLE performance, but I will try to give you the hindsight experience that I wish I had when I was preparing (of course, hindsight is always 20/20). If you are slower moving--because you're always trying to read up on the background you feel you don't know on each question--making every question as long as a 1 hour affair, your learning style may have similarities to mine...I think you'll be able to gauge a lot about me by scanning through this diary, but in sum:
I failed the first try 4 months ago 169, prepared again for this 2nd try 2 months. The first time, I didn't use Qbank or NBME assessment $45 tests, the 2nd time I did. My scores on the two NBMEs came 1 month before this my 2nd USMLE at 370, and then within days of the exam on the 2nd I got 460. My Qbank average with about 70% done, mostly random 50s, was about 54%. I also listened to Goljan and tried to follow his notes through, but I didn't have that much time/I was too slow to get through all of his stuff. I flipped through HI-yield neuroanat, anat, cell & molec biology, and immunology. Also MMRS & Lippincott's Pharm, Step Up, and the Micro and Pharm Cards, and Pathophysiology for boards/wards. So many resources!
Before I give my "in-hindsight, this is how I would have studied" tips, here is what I remember of the exam...So the exam was nothing like I expected, as usually would be the case. I did better on some blocks then others, I think, and in my typical slowly pondering way, I would watch the clock as I fell behind on the first half hour with questions, only to race to finish at the end--I don't think that was harmful in particular, because I didn't let myself fall to much less than 1 minute per question remaining time.
There was a random assortment of "what would you say" questions that were really interesting--here's why: instead of just judging what the best thing to say to the person was as with Qbank,the new twist here was that you had to consider the medical aspects involved in your advice! For example, if you had someone who was eating poorly, smoking, not exercising, drinking caffeine and something else, would you tell them that for their current lung problem, the most important thing is to A)stop eating badly B)stop smoking , etc. In other words, you had to know what was the medically best advice to give besides saying it in a way that would not hurt feelings, be ethical, etc!
The other thing was that I got slaughtered with bug-drugs--I hadn't been as prepared for that as I would have liked. But of course, it's random. You never know what your test will focus on. For example, I had no embryology this time (or maybe 1?), but I had a bunch of anatomy--1 or 2 questions every block. Yet I had virtually no neuroanatomy--maybe something with the tonsilar herniation (which Syndrome was that again?!).
I don't really remember a single bug question, though!! Isn't that amazing!? I mean, maybe there was 1 or 2 at most that I have completely forgotten by now...But again, you never know. I did have
some cell/genetics, but it wasn't overly much. I had some pesky kidney phsyiology that made me wish I had studied the GFR, FF, and such formulas more carefully. The killer was the 1/v type graphs for pharmacology that I had looked for info on prep4usmle but no one was able to really help me with. It was there in First Aid actually, on some darn page that I had forgotten to read...Most of the test was definitely pathophysiology, drawing on random topics, from hemathology, to cancer, to female menstrual issues, and so on....
I don't know if there's any higher-yield overlap pattern that I can point out in particular between my 2 experiences with the USMLE now. If there was anything, I think it's that the kidney is bound to show up in one way or another because there is just so much going on there--from pathophysiology of filtration, to calcium metabolism, to pharmaceuticals and what mechanisms they use, to bugs and what they do to the kidney, to straight pathology--the kidney is a lot. Same can definitely be said of the heart and lungs. I guess those are probably your big 3 organ systems you should know: heart, kidney, lungs. It's key to know the physiology of the interactions that take place at all these levels. Know pathophysiology well, and then everything else is 2ndry.
So what I would have done differently..I definitely feel Qbank helped. First, by getting timing down--I would be sure to remember this so you never lose your pace: 6 mins/5 qs, 12 min/10qs, 18min/15qs, 24 min/20qs, 30min/25qs, etc, is what you're shooting for (i.e., 60min/50qs ultimately). Also, the wrong answer explanations can be helpful to solidify information, because a lot of Qbank begins to repeat. So this is good for those who go faster--if they miss something once, it crops up again a little later..Also, gauging about where you stand in USMLE through Qbank is not as accurate as through the NBME exams, but it's also good. If you know you are below 50%, then you may reconsider taking the USMLE yet. On the other hand, 60%+ on random 50s is almost surely a USMLE pass.
Then the 2x$45 NBMEs come in, as well as the free released questions from them. These are the gold-standard for what your grade will probably be. I would suggest taking the free one first and checking your answers to all of them (because it is common for questions to repeat, and most folks get 2-3 questions from each of the 3 sources at least. Next take the NBME first assessment after about half of your studying. You will see about how far it is to your goal with the remaining time, and then be able to know exactly where you stand. Take the test in tutuorial mode, and use a browser like firefox or opera (get them at cnet.com, from the downloads section, free). That way, you can clip and paste the tests into word, and have time to look for the correct answers later. In tutorial mode, you get 4 hours. Take the test in the 1st hour under test conditions, but spend the next 3 hours searching for the correct answers. Take the final NBME about 1 week before the exam. I took mine later because I was scared. Scared that if I saw another 350-400 score, I would be hurt in my confidence during the last week. So I tried to learn as much as I could first, and take the test as late as possible. However, I think it is better to get hurt--meaning get scared--in the last week if your score is borderline. Then you will be forced to study very hard in the final days before the test, and can possibly be able to acquire the information you need in a more effective manner so you can pass.
Finally, I have saved the best and most important for last. I think the Gold Standard for the USMLE--for myself, a traditionally visual learner--is to comb through Goljan's lectures in print while listening to them on audio. Working through his notes and audio lectures is DEFINITELY, BY FAR the best thing you can do to prepare. His system is amazing. Far more than Qbank and FA, there were so many times that I could think back to questions I had while listening to him or working through his notes that I wished I had completed but had not..It's like seeing everything that can be on most of the USMLE beforehand. Goljan is the man, and he takes you through all the main pathophysiology points and how they can be presented in their variations. I really feel he does this masterfully. Especially if you give your time to doing Qbank with FA to get the basics down, Goljan will then be there for you now that you have the basic "notes" and he helps you play the "symphony" with these notes that the USMLE expects you to play. Honestly, I feel that if I had done Goljan with the thoroughness I would have if I knew he should be the centerpiece of my program, I think it would have been possible for me to score in the mid 250s. As it is, I have already gained about 90 bid points on the NBME just from mixing in Goljan, Qbank, and FA/Step Up.
Doing those 3, you could probably get in the 250+ range, even as a mediocre student, if you gave it about 2-3 months. The way I would do it is: following unfamiliar topics along in either Step-Up or FA while doing Qbank (and reading up in other source books when necessary). Then going to Goljan and following his notes/audios as the heart of my studying, and then shuffling back to Qbank/FA/Step Up. With about 2-3 passes through all Goljan, Qbank, and StepUp/FA, I think you can get 250+.. Although I would go through FA and Step Up at least 2 times each optimally (go fast....!!!), I would be doing this more with the Qbank than with Goljan. Goljan's notes are virtually comprehensive for the topics he speaks on. The stuff I would stop to look up while doing Qbank should be select material, though, that you have grown fairly curious about and feel "on the verge of learning" because you have seen it so many times or been thinking about it so much...Don't just look up everything you don't know in anxiety like I would do..just let some of it go with faith that if it was truly important, it would have beenl either familiar to you from before, or you'll see it again.
Very important in all of this is your mood and your mental happiness with your life being spent doing this..don't become discouraged that you're not learning fast enough like I was. Just make sure you keep pushing and learning regularly. Steay 6 hour days are better than one crazed 12 hour day, followed by an unproductive day-after..
Basically, I would try to study everyday, all day, only taking breaks for tv, friends, maybe 1-2 half days a week , and some time during the day too. when you know your productivity is fading for friends and fun. Being hardcore about it will leave you with no regrets later. As I said, I got discouraged a lot when I fell into this pattern: 9 hour, good study day, followed by a fuzzy-brained, exhausting, sick-of-it-all day the next. I would over-do it, and feel discouraged that it didn't seem like enough. I did that pattern for a while: day ON, then day kind of dragging ass, then day dragging ass and feeling guilty, then day ON again...It would have been better to just do 8 hours or 6 hours daily where I was moving with decent speed (my problem is speed--I can easily spend a whole day reading up on and making notes on 50Qbank questions--that is why I only finished 70% of the questions!!).
Finally, a big question for me was the Qbank vs. FA vs. Goljan thing--which is best? I would say they all have strengths and weaknesses, but that Goljan is the single best if you only do one. Ideally, though, I would do all 3 as I described: Qbank supplemented by FA, and then Goljan bringing everything together...As for FA vs. Goljan, I would say Goljan is better for a weak student like me. That's because FA is just some words and graphs to trigger things. IF those things aren't there or have become misty, there'll be nothing to trigger! Goljan gives you the background and the reasons why, not just the basic "what" of information.
Best of all is the integration of the memory element (FA mostly and Goljan definitely does this too as it's inevitable in science/medicine), with the integrative undedrstanding that is able to manipulate the known facts to answer any number of questions--which is what Goljan prepares you for...
That's why 3 passes through both would be ideal. Finally, as for the Step-Up vs. FA question, I could tell you I LOVED Step-UP, but there are things that it covers that FA misses, and vice versa. That is why I would also go with 3 passes through that too. Although I love Step UP, I would still focuse on FA first just because of its track-record. But defijnitely use Step Up as your primary resource alongside Qbank if you enjoy it that much, and then do your FA as a secondary source you give 2-3 passes to nonetheless, especially for peripheral subjects not covered as thoroughly in Goljan: embryo, biochem, neuroanatomy, beh sci, etc. Only focus on non-pathophysiology 2ndrily to the heart of the test: pathophys.
The most important thing: keep going forward every day. No regrets. The little drops of water in the bucket will add up...I promise!
Well, sorry for the LONG letter--I just feel a lot for you all as I was in just the same position only a few days ago. It is really agonizing. And I so much want to see us succeed. This is really an incredibly difficult experience (at least it was for me). I hope you can push on ahead and manage well. Please write me if any of this was unclear or you have any other questions.
Love to all my angels who have helped me get this far,
Namf
P.S. Of course I will let you know my score, pass, sail, or fail.
P.P.S. Be very careful with managing your break time. B/c the clock only shows you the 1 hour you have for the current block,not the overall test time (how stupid!). So if you count the 15 min. for tutorial in the beginning, and the 45 min of break you can have anytime, you also have to factor in 7 hours of testing time for a total of 8 hours to finish all. But when you get to your final block, if for example you started the test at 9am, and it is 4:15 by the time you get to it, you will see the same message I saw: "YOU HAVE GONE OVER YOUR ALLOTTED BREAK TIME! YOU ARE STARTING THIS BLOCK LATE, AND THE APPROPRIATE AMOUNT OF TIME HAS BEEN DEDUCTED!" In my case, I had miscalculated by only 30seconds, thank goodness! But if you only have 40, 30, or 15 minutes left for your last block due to some major miscalculation, this will be terrible. So note when you start, and count your break times+ tutorial time--they should not be more than 1 hour, and you must be done with the entire test 8 hours from the moment you started. GOOD LUCK EVERYONE!!!!! KEEP PUSHING!!!!!
P.P.S. Unbelievably, my Qbank is still available! The 3 people who wanted to buy it have decided otherwise, it seems..If interested, I will throw in Webprep as well and Goljan (at huge savings)! My Qbank is 70% done and good to September 9th--don't miss this great opportunity!Thank you~
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| PsychDr2B
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Topics: 35
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NAMF My friend, THANK YOU THANK YOU THANK YOU! This was great feedback. My test is coming up too quickly, so I will definitely buckle down on Goljan notes. I was curious about genetics and biochemistry in general. There seems to be inconsistancies among people giving feedback on those topics after their exams. How was your expereince(s) in these topics? My fingers crossed awaiting your results! Go Namf Go Namf!
Continued best of luck with your Surgery rotation.
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| Ahdy2000
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Namf,
I wish and hope the best for you...and that is a spectacular score on this test. Thanks for your description.
a
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| namf
Forum Elite
Topics: 80
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Ahdy2000--You are the last person who'll ever need my description! :lol: :lol: :lol:
But I appreciate your words. I hope you are patient with me, general. This foot soldier is seeing some rough terrain right now, and I haven't been visiting prep4usmle much at all...
It's strange to have my hands off of everyone's pulse here...I guess I am putting my hands on the pulse of others, then...
I am sure you are doing great on the wards. You were right too--all this stuff comes in handy all the time with the pimping, etc.
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| Jsmart
Forum Elite
Topics: 16
Posts: 230
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For nice description .
Praying for you... [-o< [-o< [-o<
No question this time you will pass .
Good luck in your result and in butchering :wink:
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| namf
Forum Elite
Topics: 80
Posts: 312
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Thank you so much, lovely Jsmart! I pray for the best for both of us, and all the others here who have hopes for good results--G-d help us!
I pray for you too--and thanks for all your support throughout this difficult time
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| namf
Forum Elite
Topics: 80
Posts: 312
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I have this scared feeling that I'm going to be getting my test scores back today....I'll let you know if it happens.
PRAYING for PsychDr2B's success, and celebrating JSMART'S AWESOME SCORES,
Namf
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| ELM
Forum Guru
Topics: 28
Posts: 936
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Hey Namf....... stop being a scared little boy now........ BE BRAVE AND HAPPY TO RECIEVE YOUR VICTORY!
We have no doubt that you did well on this time....... so HAED IS UP NOW! :P :P :P
Be ready for the big news and make plans to celebrate!!!!!!! I know you did well!!!!!!!!!! :wink: :wink: :wink: in few hours you will find out!
___________________
ELM
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| Jsmart
Forum Elite
Topics: 16
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hello surgeon namf :wink: , do not worry much as I am sure the scores will be great and looking forward to celebrating soon... :P :P :P
I am so happy now :lol: :lol: :lol: waiting for your scores guys!
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| namf
Forum Elite
Topics: 80
Posts: 312
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"PASS"
That's what my eyes lit on first after ungluing & unfolding the surprise that sat in my mailbox just 3 1/2 weeks after my USMLE 2nd attempt...It was the same letter that I had seen come once before in May...My heart gave a stab and a very living jump when I recognized it, unexpected, there. The cheap, perforated edges and glue-drop sealed envelope that I was standing in front of, by myself, in that hot room in which I had sat studying by myself so many days and dreaming of this moment--FEARING my life being thrown back into the abyss of months more preparation... and wondering if I would ever go on with this life as a doctor if I failed this 2nd time. I was standing in front of a cross-roads in my life on that stupid little piece of paper--pass or fail--a verdict before which I would go on or be stopped in my tracks on this long journey to nowhere, so far.
I looked for the score. 195/80. I did it. 13 points above failing, leveling my 13 points below last time. I got my green light and felt a very gentle, distant backdrop of happiness on which I floated for most of the day. It was only the fact that I am already in the midst of another brewing storm that I could not have my erruption of giddy release like the Olympians who snatch gold from against all comers and darker faiths..Perhaps that day will come when I pass through the 4th year and get my MD after all this???
Certainly, I had missed the boat by a good distance. Thankfully, I can still see the ship on the horizon, and I am making mad time in my own tiny vessel--closing fast, I hope. Though I would have to put in yet many more nights of solitary travel to catch them again, I new I was back in the hunt for real. I spent the rest of the weekend studying, pushing on...There really is no time to lay back and rest upon this victory. It is in some sense just a draw--the test could not break me entirely, but I too did not steam-roll over it. Now I need to make my way across the next challenge. This process is discouraging sometimes..I am encouraged by passing, of course...But the prospect of forever being a struggler in the company of my medical colleagues..? I mean, how many years of slavish study do I need to put in to be on a par with them--if ever!!?? That is the very thought that disheartens me and bothers me ceaselessly now, robbing me of my former impetus to study, foiling any momentum before it begins into that blackhole of doubt. I thought most of the deep struggling and suffering would be over by now.Yet, it seems that still after all this nothing is at all assured. I have to work for every inch I gain in this ceaseless race, on and on....
From here I would just like to avoid this kind of fiasco and mess again. In the clerkships I go through--6 hard tests, 6 hard chances to fail...or pass. I hope to do the latter--on the 1st attempt. I am giving the books what I've got to give. I feel new, green, and not at all entirely sure of how to be and what to do to get through the "Wards" training phase of my education that I have now by all claims fully earned.
It is good to know that I am truly in the 3d year now, 3 months after it has begun. It is good to know, very good to know..Now I have to complete the race and show myself equal to the task of taking this crud called the Surgery shelf, then the other shelves as well: peds, family, ob-gyn, psych, medicine....So far, I have been awed by the abilities of the surgeons, and other doctors. I keep having this thought that I was just not suited for this work. That I am only here through sheer willfullness. And then there is a time to realize that you are not meant for something and move on?? I feel like I am at a nadir even amidst my celebration. I am sorry it is not more blissfull...Yes, I am thankful. Thankful to all of you for your support, and thankful to have the choice to go on. I have felt the full misery of what it would mean to not make it.
But as the truth of the struggle inside me continues, the demons within I wrestle now are the ones that ask if this is truly what I was meant to do. If it is, then why do I dislike this work so much/find so little success at it compared to my classmates???
My search continues. I will likely do a similar log for my Step 2 quest. But first, there is much to survive in this, the 3d year of the medical school MOUNTAIN.
THANK YOU ALL SO MUCH FOR YOUR SUPPORT!!! ONLY THROUGH YOUR PRAYERS DO I CONTINUE IN THIS RACE ANYHOW...BLESS YOU ALL FOR YOUR GREAT LOVE!!!
P.S.
PsychDr2B: you have a great heart and no doubt, as Martin Luther King says, "The arc of the moral universe is long, but it bends toward justice". And as far as I know you, that justice could only mean one thing: someone as good-hearted as you will reach your goal and I only await the joy of celebrating your passing score together. G-d bless you my friend!
Jsmart, thanks as ever for your kind words--you've always been a blessing!
Ahdy2000, my brother-in-arms el Generalisimo, and the original diary master: I will be joining you on the USMLE Step 2 battlefront just as soon as I can rally the troops past these clerkships.
Nuprin, babe, wherever you are, I miss you and hope you're kicking buns.
This forum is hardly the bright-lit place it always was when your pretty little face was popping up on every 2nd message, giving somebody else who was struggling a hand...what a winner you are.
And everyone else I'm neglecting--you made this trip a good one for me through a dark land...Though I walked through the valley of death, I feared not because I was not alone. And all the more so because I knew that I walked with you, too. Thank you so much, this place has meant so much to me.
So ELM, I guess I can "stop being a scared little boy" now--and begin in earnest on being a terrified big man!!! :P
Yeah, Surgery is the sssstuff...HOLY COW IT'S SCARY!! I'm frightened out of my gourd!! I mean, the bottom line is I know my weaknesses and strengths. And the fact of the matter is I have always struggled with these tests; I am also not saying that it's not possible that I can break through this time. In fact, if there ever was a rotation on which I could break through--this might be it--I love anatomy (a deep, dark secret..)!! Yes, when I take my Surgery shelf at the end of September, you better believe I'll be praying HARD!!! In the spirit of the mighty OLYMPICS, then:
Citius, Altius Fortius my good friends! Citius, Altius Fortius in your truly Olympian quest for the USMLE gold!!! I could not be in more earnest.
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| dxtxpx
Forum Guru
Topics: 259
Posts: 1,233
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CONGRATS u made it. i enjoyed your narration of the letter opening experience, it was so true. anyways good luck in future. u r definetely gonna make it. this path is full of struggles but we chose it ourselves and we will be successful
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| ELM
Forum Guru
Topics: 28
Posts: 936
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Aaaaaauch!!!!!!!!!!!!!!! 195/80!!!!!!!!!!!
YOU MADE IT MAN!!!!!! What can i say??????????
CONGRATULATIONS!!!!!!! After every bloody battle there is allways VICTORY SOMEWHERE and SOMETIME and for SOMEONE!!!!!!!........ that's how you did it!!!!! I am so happy for you man!!!!!
NOW YOU ARE READY TO BOLT WHATEVER YOU AIMED FOR!!!!!!!!!
You know what......... we all did this damn thing....... WE ARE...... THE people in our step 1 team!!!!! You were the last person i was waiting for the SCREAM!
So happy for you.......... hope you would join with us to Step 2...... becuase...... we enjoy..... personally i enjoy so much of your little recreational editorials!!!!!! :wink:
___________________
ELM
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| friscan2b
Forum Guru
Topics: 86
Posts: 447
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:icon_bounce: :icon_bounce: :icon_bounce: :icon_bounce: =D> =D> /
Hip, hip, hurrah! You made it! Congratulations!
Good luck with the rest!
A.
:wink:
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| docarjun
Forum Elite
Topics: 11
Posts: 334
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/ / / / / / / /
you did it,man!
i always felt that you will surely make it,and yes...now you made it!!!!!
congratulations!!
and good luck for the surgery postings!
hope you will join the step 2 team soon.
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| Jsmart
Forum Elite
Topics: 16
Posts: 230
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:lol: :lol: :lol: :lol: :lol: YOU HAVE MADE MY DAY WITH THIS GOOD BREAKING NEWS :P
I am so happy for you / / <:can_u_hear_me_now:> <:flag:> :icon_heh: You have killed the monster,climbed the Mt Everest and you are on top of it now! CONGRATULATIONS!!I hate this test :evil: and no more step 1 now...
heheee Please do not quit medicine it's lovely only that the nbme people make it complicated...
Congratulations for a GREAT score namf
Now no time for complaints just CELEBRATE AND JUMP :icon_bounce: :icon_bounce: :icon_bounce:
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| namf
Forum Elite
Topics: 80
Posts: 312
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Docarjun, you've been a steady and good friend throughout my studies and made this road easier for me to bear. I'm sorry that I did not mention you in my earlier letter--there really is no excuse after all you have done with your wonderful support for me. I just want you to know that I remember you, of course, and I read a little bit of your current struggles. I pray for you, my friend--surely, you too will take your place in the sun-shine of the USMLE success stories here on student-doctor--a place of friendship and warmth for all doctors from all walks of life and the world. A beautiful community precisely because of members like you. THANK YOU!
And friscan2b, I never forgot your earlier brief message in support and solidarity. Myself often someone who has read boards avidly without writing much (until now, of course), your enduring support and the fact that you would surface to send your wishes of success and congratulations means more to me than you may know. Thank you so much for resurfacing now for me--your words mean much to me. Thank you.
Please forgive me if I forget to mention all the beautiful faces...HIWA! You come to mind!! And there are so many others..Bless you and thanks. We will go to battle again shortly...Josh2004~! bm!! Binz!! LaMaDa!!! Everyone--too many blessings to count!
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