Acute pancreatitis is a common cause of acute abdominal pain. It generally presents with epigastric pain radiating to the back. Management is conservative initially unless complications develop. Here is a catchy Mnemonic to help you remember the causes of Acute Pancratitis:
Mnemonic for Causes of Acute Pancreatitis
I: Idiopathic
G: Gallstones
E: Ethanol (alcohol)
T: Trauma
S: Steroids
M: Mumps (and other infections) / malignancy
A: Autoimmune
S: Scorpion stings/Spider bites
H: Hyperlipidemia/Hypercalcaemia
E: ERCP
D: Drugs
Mnemonic for Causes of Acute Pancreatitis. Right Click and Save to Download
Well, monotonous morning, mundane work, I need more sleep!
As I woke up, these were my lazy thoughts. But , I saw the time and I was already late, so I hurried, rushed to the washroom and somehow managed to reach the ward.
With the morning thoughts still in my head as I rushed to get on time, I was struck again by the dreaded (blood collection) “list”
The same patients again!? I was like WHY, god why?
But, as I enter the world of patients, I always forget myself, my worries and my thoughts. I am just a “blood sucker” in their lives, I thought to myself.
Haha, so like a monster with my weapons of mass destruction (the syringe and needle) , I reached to the 3rd patient on my list.
She was already dreading me as I collected samples from patients before her.
As I reached her, she said in a grumpy and angry voice, “You again? Why? How many times are you going to collect my blood? Is this the only thing you do? Will I need to take all the samples to the lab myself? When am I going to get a discharge?”
All questions were like a bullets from machine gun fired at me.
So as usual, I went into “Neo mode” from The Matrix movie and I dodged all her questions… Haha just kidding.
I smiled back and said, “Auntyji, I am sorry” and told her that this will be the last time, after this I won’t do it again.
Again, I smiled back, and I don’t know what came into my mind but I just said, “Happy birthday!”
I know I always try to cheer people around me and this was my spontaneous response to her agony. Suddenly, something happened which I never anticipated.It WAS her birthday!
Are you serious!? Just to confirm I checked her admission file. Hola! It was her birthday!
So I told her, “Auntyji, Aaj kuch ho na ho par aap ka b’day jaroor manaunga! ( I will celebrate your birthday today!)
Ater my finishing my OPD and other work,me and my co-intern called for a cake. By the time we actually reached the ward after finishing all our remaining work, the cake was already there. My housemen and 3rd year resident had already paid for it .
We asked everyone from my unit to gather for the cake cutting. Her family also brought a cake as well!
Everyone, every patient and every doctor , sister, mama ,maushi, everyone was there to celebrate her birthday.
I could see her face full of happiness and joy. A big smile, which i can’t forget. I could see every patient smiling even as they were tensed about their surgeries. For those 15-20 minutes they forgot everything.
I was happy, (and I did not know that I was crying too)
Someone asked me, “She is always grumpy, shouting and angry ! Why did u celebrate her birthday?”
Well, I could not answer because what i felt couldn’t be explained or expressed.
I felt immense joy.
That day, she was so happy.
As soon everything was over, the whole ward was like a pin drop silence zone again but inside me, her smile and joy on her face was dancing and singing.
Next day, I met her again, but this time she looked at me with a smile. I think this was the answer why I celebrated her birthday. To see that smile.
I will remember her and I hope she will too. Remember a bond between a doctor and patient. Between two humans.
This article has been written by Dr. Ashutosh Sharma a.k.a Dr. Smile spreader. He is currently bringing smiles to people’s lives working as an intern at Seth GS Medical College.
We have with us Dr. Arjun Chatterjee sharing with us the most detailed USMLE Step 1 experience for IMGs. He gave Step 1 in his 3rd year of medical school. Here is his complete USMLE Step 1 experience.
I dedicate this post to my family, my teachers(from both my school and college), Dr. Srinivasan. Without the support of my mother and the rest of my family, this wouldn’t have been possible.
Disclaimer:
In this post I will write my story, how a guy without any doctor among his extended family, no one to guide him, just by sheer determination, hard work, and browsing the Internet cleared the Step 1.
This thread is all about my opinion, during/after reading this you may think I am arrogant, you may find it unnecessarily detailed, but I DON’T CARE.
If I had sent myself this email three years ago, it would have saved me a lot of time. This is going to be a long post, three years of my life sandwiched into this thread, so take your time, but I can promise you that you won’t regret it!
So like anyone else’s opinion I would suggest you take it with a grain of salt, modify it and use this in your way or ignore it altogether, we all are unique so find whats best for you! So this is my humble story.
Introduction
I am a 3rd-year Medical Student from Kolkata, India. During my first year I came to know about this exam called USMLE, and after that, I tried googling what it is all about.
After a few days of skimming through useless search results and forums, I came across USMLE-FORUMS and started reading the Recommended Step 1 Threads.
During my first year due to lack of guidance, I could not implement the USMLE materials in my study schedule, but I made it a point to include all of them in my 2nd Year.
The 2nd Year in Indian MBBS curriculum consists of one and a half years, i.e., 3 semesters and it was ample time to revise all of my first year subjects as well as do my second year subjects, but this time instead of doing all this from Indian authors(which my peers prefer) and “the big foreign books”, I started using USMLE prep materials and solely relied upon them to help me through my 2nd year (List will be provided below).
Apparently, before my college exams, I used to consult the Indian authors and prepare the essential questions that may come in that exam, but I never let college exams become my primary focus instead I studied from Kaplan and Pathoma and supplemented from Shanbhag(Indian author) and Robbins(Basic) when necessary.
During my 2nd year, I had almost covered every subject, i.e., revised Anatomy, Biochemistry and Physiology and also did Pharmacology, Pathology, and Microbiology.
It was tough but manageable if one is willing to put in the effort and sacrifice. So at the beginning of this year I only had Behavioral Science and Biostats left, which I finished in two weeks and then I planned to take my exam during the period July-September, July is my target, but I ended up taking it on Sept 7th, 2016! Below I will go into details about what I did during these three years.
So without beating around the bush lets get started,
The Materials I Used during the first two years (I will describe all these later in my post)
1. Anatomy: Kaplan Anatomy Video Lectures and book, High Yield Anatomy [Note: Neuroanatomy from Kaplan also, I did not find High Yield Neuroanatomy to be High Yield]
2. Physiology: Kaplan Physiology Video Lectures and book and BRS Physiology book
3. Biochemistry: Kaplan Biochemistry Video Lectures and book
4. Pharmacology: Kaplan Pharmacology Video Lectures and book
5. Pathology: Pathoma and Goljan Audio Lectures and book(Rapid Review Pathology – selected topics only)
6. Behavioral Science: Kaplan Video Lectures and book
7. Biostats: Kaplan video Lectures and book and UWORLD Biostats review
8. Microbiology: Clinical Microbiology made ridiculously simple and Kaplan Video Lectures and book
9. Immunology: Levinson(only did the immunology part) and Kaplan Video Lectures and book
With that out of the way, I will describe in detail what I did during these three years, so if you thought the intro was extended, by the time you would finish this post your hippocampus might herniate due to the immense detailing of this post 😛
The Journey – Proper
1st Year
As I said before I didn’t know about all this during the first six months of my first year otherwise I would have done things differently.
In India we focus on minute details and often miss the bigger picture i.e. someone may remember the course of the vertebral artery through the transverse foramina present on the side of the cervical vertebrates but forget the branches of the arch of aorta or the clinical features found in the lesions of brachial plexus, at least that was my case, due to the unnecessary detailing I lost the bigger picture, and this was the case in all three subjects – anatomy, physiology, and biochemistry.
During my second semester, I was lucky enough to come across the Kaplan Video Lectures and started doing the physiology and biochemistry lectures.
I would like to mention that I was not sure about giving USMLE that time, so I only skimmed through them and was surprised with the logic and scientific reasoning provided in these lectures, while in my college the teachers(most of them with few exceptions) just read out facts without any reasoning at all.
During this semester I was able to view all of the three subjects once and take notes as I did not buy the books but my approach was not aggressive enough, and I only tried to do the topics tested in college from these lectures.
I gave full attention to my college exams and not to USMLE, and that was not the right approach, which I rectified in the second year. I passed with honors in physiology and biochemistry and near honors in anatomy(I don’t regret not getting honors in anatomy as I didn’t focus on the bigger picture but instead tried to impress my teachers and peers by the minute details which I would forget anyway two weeks after the exam).
I would like to thank Conrad Fischer, Robert Dunn and Wazir Kudrath for helping me grasp some crucial concepts in physiology, also thanks to Lionel Raymon, David Seastone and Sam Turco for making me strong in biochemistry as I ended up getting highest marks in college.
2nd Year:
Although in the first year I got good marks in college, I was not happy with my knowledge base and didn’t want to repeat my mistakes like “not getting the bigger picture and getting bogged down with minute details.” So to avoid this, I did two things –
1a. Didn’t buy most of the local Indian authors my peers purchased (most of the books are poorly written and copied from different foreign authors) – later bought only a few and that too for supplementary use
1b. I bought the big names like Katzung and Robbins (but only used them sparsely)
2. Made my USMLE prep materials my primary resource which I was going to use in the next three semesters. That was a bold move for me, as while my peers were relying on private tuitions while I was studying on my own for “the” test people take after passing MBBS after all the clinical subjects, and no one was there to guide me about this, but I found the method by which the lectures taught you somewhat appealing and went on with it, this later proved to be a right decision.
The second year was filled with ups and downs as I was slowly making my mind to pursue USMLE, but there was a big hurdle in front of me.
In India, if you try to do anything different people will criticise you and give you examples of people who have failed before you, knowing this general trend I kept my thoughts to myself and didn’t share anything about all this with anyone, which later proved to be a right decision.
There was tension in the family when I told them about this test, the next year two seniors specifically warned me about getting low marks in Step 1, lost many friends to this cause, had to let close friends go who didn’t share the same dream.
Gave up most of the social interactions, attending parties, hanging out, deleted social media accounts. Although people might argue that I should have taken a different approach, I felt it was necessary to back then and I did it. Still today it bugs me, but it is how it is I guess!
“You can’t always get what you want, but if you sometimes try well you might find, you get what you need – Rolling Stones(Rock Band) – House MD.”
Pathology
This is the basis of everything, don’t get me wrong, you won’t get 90% of the questions from pathology but 90% of the items will need you to understand the pathology mentioned in that question, and then they may ask the related microbiology.
For pathology, you need to do only one thing, and that is PATHOMA! Yes, Husain Sattar is the King of Pathology, the videos are fantastic, and the book is the “Bible of Pathology.” Every word of that book needs to be understood and memorized.
I am going to repeat this, “Every word of that book needs to be understood and memorized” and also take adequate notes from his videos in the book! I did pathoma two or three times during my second year, and this was my main pathology resource.
The most important thing for USMLE is to connect Physiology with Pathology so before starting a chapter of systemic pathology from Pathoma always revise the associated system from BRS Physiology and you will do good.
Now coming to Goljan, SIR EDWARD GOLJAN is “GOD”, his book Rapid Review Pathology is “The Book” but sadly its not for 2nd year students, it is medicine and not pathology, it has everything from biochemistry to biostats in that book, so if you want to get lost in an island with only one book, don’t choose Dorland’s Medical Dictionary, choose this, and by the time you will be rescued, you will turn into an expert clinician, I guess.
However, I found it too detailed and since it is not provided with any video lectures, doing the whole of Goljan was too difficult for me.
Don’t get me wrong, you use Pathoma, and you score above 240 but you treasure Rapid Review Pathology for Life, I will use it with my internal medicine and STEP 2 CK. Don’t use the whole of Goljan for Pathology but some topics are important which is not covered in pathoma/needs supplementation – they are Types of Shock, Dermatology and Nephritic Syndrome.
Only after completing everything(by this I mean – anatomy, physiology, biochemistry, pharmacology,patho ma, and microbiology) I started with Goljan Audio Lectures which are still available on the net.
I did this to integrate my knowledge, he does an amazing job of integrating subjects and making you think exactly as you should in a UMSLE exam, but don’t think it will cover pathology fully, so do Pathoma, and after finishing all the subjects, you may use this as a supplement.
For college exams and viva, I relied heavily on Pathoma and only consulted Basic Robbins when I saw a 12marks useless question on the “Types of Cirrhosis”(hope you get the sarcasm). I ended up getting honors in college as well as became the senior class assistant pathology.
Pharmacology
I have only one thing to say, “Dr. Lionel Raymon”, his way of teaching, his sarcasm, his funny comments, his golden hair, his French accent, everything, this guy is the “Pharma King”, he was with Kaplan during 2010 classroom lectures but sadly now has joined Becker, so you have no choice but to rely on the old video to get him.
The Kaplan book is all you need to do well in any pharma exam anywhere in the world. No need to study or consult Katzung or Tripathi(Indian author) or anything.
Before my college exams for the completion sake, I also did a prep manual, Shanbhag(Indian book), which was concise but then again written in a non-scientific manner, just a stack of facts.
This review will be incomplete without mentioning the name of Dr. Steven Harris who also did an excellent job with general pharmacology and toxicology. In short, Kaplan is enough for any pharm exam anywhere in the world and this helped me to secure the highest marks with honors in pharma in the final review of my college, and I also was selected as the junior class assistant.
Microbiology –
Well, this is one of the most hated subjects among the medical students and believe me I am no fan of microbiology. I did microbiology from CMMRS written by Mark Gladwin, and this book is one of the most well-written books according to me!
Every author should ditch the plain facts providing method and start writing novels in more of a storytelling method. This book is just excellent, the pictures, the charts, the mnemonics, one will never forget the nasty buggers they learn from this book.
Doing micro for college was tricky because in India, teachers like to know useless facts like which bugs give positive result to Methyl Red Test and another principle behind such tests which the clinician doesn’t need to know, so for learning all this crap I used Nagoba(Indian book), a prep manual, which took care of those shitty pieces of information.
I did not know about Sketchy then so I couldn’t try it, and I did not use Levinson for microbiology. I supplemented CMMRS with Kaplan video lectures and book when necessary, especially DO VIRUS, PARASITES, and FUNGI from the Kaplan video lectures for microbiology as it is relatively weak in CMMRS. In microbiology, I also ended up getting honors and was selected as the junior class assistant.
Immunology –
I am making this a separate section because it deserves to be independent and the Indian microbiology authors should read foreign authors before writing their books because what they write is absolute bullcrap in the name of Immunology, which makes no sense at all and forces the student to mug up facts.
If you think you can mug up immunology or anything for the USMLE, “you will fail!”, “Understanding is the key,” with all that frustration out of the way now let’s talk about what I did.
I used Kaplan video lectures for immunology where Kim Moscatello tried to make immunology easy through her animations but sadly that did not prove to be enough for me as a beginner, so I supplemented it with the best Immunology book till date, Levinson! If you use Levinson and Kaplan Immunology Lectures together then you will be untouchable, you will finally understand what interleukins are released when and what are the after effects, also in the second chapter of pathoma Sattar provides a concise review of what you need to know. Combine all three, and you know everything there is to know about immunology!
Now let’s come to the most crucial part of 2nd year i.e.
REVISION of first-year topics –
I didn’t pay much attention to Kaplan during my first year, at least I didn’t give my 100% and so I needed to revise the three giants, anatomy, physiology and biochemistry! Without a “strong,””logical” and “scientific” foundation in these three subjects you can never practice evidence-based medicine.
Anatomy –
For this, I later realized that High Yield Anatomy (Ronald Dudek) does an excellent job of providing the bigger picture, but I also did Kaplan anatomy because of the radiological images and the high yield points they mention in their videos.
The way they teach is more clinically oriented and doesn’t require you just to mug up the facts. If you are to choose between these two, go for Kaplan. I used High yield later, only during the third year when I didn’t have enough time to revise the whole of Kaplan, and I wanted a concise book, it gave me all that.
Now from going through this forum I learned that High Yield Neuroanatomy is a favorite among the Step takers, but I didn’t find it high yield at all, instead Dr. James White in the Kaplan neuroanatomy section provides a very concise and top yield review with his weird emotionless style of speech, bare with him and take notes, it will help later.
For me, Kaplan was enough for neuroscience, i.e., neuroanatomy and neurophysiology which are taught separately in Indian colleges and usually both the departments fail to interpret and integrate the two properly!
I want to add one thing on this topic that it might be hard for you to understand the pathology part of neuroscience so do Pathoma Neuro section first and then start the neuroanatomy or do neuroanatomy twice like me, before and after Pathoma because its highly volatile, very high yield and tested very often.
Physiology –
Having studied from Kaplan physio during the first year, I didn’t use its lectures for revision but instead used BRS Physiology.
This book is a beast and if you have to choose between Kaplan and BRS go for BRS, its perfect and the writing is scientific unlike Indian authors or even some prominent authors like Ganong(who purposefully write their book in such a manner, so that, it would be difficult for a “novice” student to grasp concepts, clarification: Ganong is a good book but not for beginner students), ideally do BRS Physiology(Linda Costanzo) and the parts you don’t understand use Kaplan videos for them and maybe once in a while use Ganong to look up important facts!
I am repeating this once again from the pathology section of this thread,
“The most important thing for USMLE is to connect Physiology with Pathology so before starting a chapter of systemic pathology from Pathoma always revise the associated system from BRS and you will do good.”
Biochemistry –
Revised all the video lectures once again.
Now with the second year behind me, five honors, 4 class assistantships, two subject highest, I was still unsure whether to move ahead or not.
People refer to the third year as the most relaxed year ever in the MBBS curriculum with EYE, ENT and Community Medicine(Preventive and Social Medicine). So this was my chance to give STEP 1, and I had to take it by hook or by crook!
3rd Year
The second Year was long and rough, I did my part correctly, and unlike first year I was happy with the knowledge I possessed. Anyone and everyone are almost given honors nowadays, so it doesn’t matter, what matters is your knowledge base, on which you are going to practice medicine for the rest of your life.
This time I had nailed it but was not accustomed to FIRST AID or UWORLD and now was my time to do this. 3rd Year is going to be most detailed because it’s these six months that puts the icing on the cake, and believe me, the difference between 220 and 240 is much less than 240 and 260, so I needed to up my game and here is what I did –
Behavioral Science(Psychiatry) and Biostats –
These subjects are not included in the normal MBBS curriculum so I needed to start from scratch, having no idea how to differentiate schizoid, schizotypal and schizophrenia I started with the Kaplan Behavioral Science videos.
Sir Steven Daugherty is a genius; he makes this tough subject so easy! Browsed the videos and read the books a couple of times and I was done, at least for now. Later this year I would use Uworld Biostats review and Conrad Fischer’s book “100 cases” to solidify my base of Biostats and Ethics respectively.
UWORLD –
I completed UWORLD only once with a 76% average in tutor mode and took “heavy” notes, two fat notebooks – 800 pages total – (which I might share soon), many people say do UWORLD twice or thrice maybe, but I did it once, took a six months subscription but only used it for two months, actually 50 days was enough, two or three blocks each day, read the explanations, everything that is written in the comments can be tested on.
Even read the explanations of the ones you got right, we sometimes get questions right for the wrong reasons. Read why the wrong choices are indeed wrong and when will they be considered correct, by this way every question has about 5/6 options, and you are doing 2400 questions, by reading the explanation of every choice you are doing roughly 12000/15000 questions in reality. Take notes, proper notes, write the question and answer in short like.
# Newborn is found to have a cervical rib. Transformation of the seventh cervical segment to thoracic identity. Which is true of HOX gene alteration?
– Expression of a HOX gene normally expressed only caudal to C7
Now if you don’t know about HOX(Homeobox genes) search google, but search like this “HOX usmle,” adding Usmle behind the topic you want to eliminates all the useless results and Google provides you the relevant ones only.
I would revise my two notebooks, 2400 questions every now and then, and it took only two days to review them, so now you decide , should you do UWORLD twice or take the required notes at the first go and later revise the entire UWORLD in just two days(two fat notebooks – 800 pages) .
This technique helped me to study the pattern of questions just before the exam, and I revised my journals ( 800 pages total ) 3-4 times, so in other words, I did Uworld 3-4 times, each time within two days.
Hope you get what I mean. Some people add UWORLD notes to first aid but I didn’t do it, and I am glad because by taking proper notes I saved a lot of time later and the questions and all the answers could be more subsequently revised quickly.
FIRST AID –
At first, reading First AID, a mere collection of facts, was boring as hell, so I skimmed through the book, did what I thought was essential and moved on to give NBME 12 and 15, but this later proved to be a mistake, every word of FIRST AID can be tested, when I say “every word” I literally mean “EVERY WORD”, you will be amazed by the detailing of this book.
I did two through passes, first pass – 60 pages each day, took me 10days, I searched the net for facts I didno’t understand, again using the same technique, “Sturge Weber Syndrome usmle” in google and read the first few results and this forum and other related forums helped me to understand the disease, knowing the facts in first aid doesnt help, those facts are written there to remind you of the story about the particular disease that you learned in class, but if you havent heard of “Oncocytoma or Peyronie’s disease”, be active and search google “Peyronie’s disease usmle” and go through the top 5/6 results and form a story in your head about the clinical presentation and dont try to memorise the facts instead because you will forget them eventually.
NBMEs –
Took 4 of them online and did the rest offline, NBME 11 to 18 did it all, so that also counts towards the number of questions you do, 200 questions each, I even re-did the online ones offline to check whether I got the questions right by fluke and to revise them and also took notes this time.
The NBME does not provide the answers so, I had to search google for it, but a simple trick like “NBME 18 answers and explanations” will do or explore the specific questions. I will provide my marks in the NBME later.
UWSAs –
UWORLD Self Assessment tests are cheap but usually over-predict the score, and it did for me as well, but worth doing as the question in USMLE is difficult like NBMEs, but the length of the questions matches that of the UWORLD.
I peculiarly used them, I bought both USWA 1 and 2 and took them one after the other on the same day. Exactly one week before the exam I wanted to stimulate my “Autonomic Nervous System” with a test like experience, so sat at 8 am and did eight blocks till about 5 pm (real exam is seven blocks, yes one more just in case to test my stamina) continuously one after the other.
Took breaks in between and the experience was good because you get an idea when should you have your caffeine, after two block or three blocks and what is the frequency of you wanting to pee in such a condition :P, Jokes apart the experience was fulfilling and gave me a lot of confidence as well.
X-Factors – (things that help you score above 240)
The X-factors are the things which I did extra, and it provided me with complete knowledge of the disease and extra confidence regarding some topics, (these are often not mentioned in the other USMLE experiences you are going to read in this or some other forum, but I found them useful)
– First Aid Q/A for USMLE Step 1: Highly under-rated, an excellent resource which everyone should use, has 363 cases, you can do a fixed number of cases per day and the facts co-relate with that provided in the First Aid book
– USMLE-Rx : After giving NBME 15(245) I realised that even though I have done UWorld once I didn’t yet master how to answer every question as I did UWORLD in tutor mode, so I had to choose between USMLE Rx and Kaplan Qbank, Rx is better in the sense that it shows the first aid page along with explanation, did 50% of this Qbank, only hard and medium questions, avoided the easy ones, got 82% and it predicted a score of 262, took notes but this time did it in Random mode like the real examination which helped me a lot.
– First Aid for USMLE Step 1: Yes I include this once again on this list because one might get bored of studying first aid at least starting to read from the beginning of the book with biochemistry and biostats, YUCK!!! I did something different, I started from last topic, Respiratory system and moved towards the first page, the book is 600 pages effectively, and I covered it cover to cover twice, skimming it before UWORLD was a mistake, one should remember every page of this book, try to create a photographic memory of every page of this book. If one works hard enough, he/she can finish first aid in 5 days, 120 pages each day, I did this during my second pass.
– 100 cases by Conrad Fischer : “Ethics” is not my cup of tea, but I guess you understand that by reading my way of writing :P, anyway I did this book once, its okay, I didn’t get a star in ethics in the real exam, but I did alright. According to me, Kaplan video lectures along with this book is more than enough.
– Revised Full Pathoma video lectures in two days before the exam, the videos can be watched at 1.7x speed and will take around (20 hours, will post detailed hour scale of each topic below). You don’t want to mix types of necrosis the week before so do this!
– Med bullets: google it, great site, under-rated review material, free of cost, even provides with some UWORLD like questions in the free account, I gave many disciplines a reading like GI, Resp, and Dermatology, no need to buy the premium account! You can use this website to read on facts you don’t understand in First Aid.
– Search Youtube Videos: “Tuberous Sclerosis Usmle” and watch the videos
– Kaplan QBook: I did Biochemistry and Psychiatry form this, doing these topics helps you to build a strong foundation
Resources that I didn’t use –
Here I am going to mention the resources which I know(and most people use it), but I didn’t use them –
1. Rapid Review Pathology – Do Selected topics, for rest rely on pathoma
2. Najeeb Lectures – Simply too detailed, I didn’t have the time, if you are in the first year go ahead and try them, else don’t waste time
3. Kaplan Qbank – didn’t use it because I already did Uworld and wanted to revise First aid along with USMLE Rx
4. Kaplan Pathology Book – just don’t!
5. Kaplan High Yield Course – it’s not for international students, it is far less detailed and was not for a newbie like me 😛
6. Sketchy Pharm and Micro – didn’t know about this, so can’t judge, what I did worked, maybe this will work for you
7. Becker Course and Qbank – I only trust the trailer and tested, sadly they now have Robert Dunn, Steven Daugherty, and Lionel Raymon.
8. High Yield Neuro/embryology and biostats – too detailed, waste of money, maybe you can look at the CT scans of HY neuro but again for that Kaplan and UWorld should do!
9. DIT – didn’t use it, instead used Kaplan, it’s all right, you can go for it
This is my opinion if you like a particular resource stick to it!
Let’s talk about the day and the week before STEP 1 :
The week before, I revised pathoma in two days and Full Uworld notes in the next two days and gave some topics of first aid a brief look, I prepared this list during my second reading of first aid, the things which I usually forget (there is a list by ex-moderator of this forum Rasheed, but I am unique and so are you so make your own!), studied the topics in the list and during the last 2/3 months I started exercising, mainly playing football alone while listening to songs for half an hour each, you need some exercise, one just cannot just sit and study for 10-12 hours a day without any other physical activity.
Also watched many TV shows like House MD(this always gives me hope, maybe there is some science left in medicine, and perhaps we can cure disease by the correct diagnosis rather than just trying to manage the symptoms superficially), played FIFA 16 and GTA 4 and 5, watched some new films but kept away from every distraction possible and kept me almost isolated during the final 6 months, no hanging out, no parties, no 21st century socializing.
Anyway, the day before the exam didn’t go as planned, I thought I would sleep for about 8hours or so and go for the examination next day, but that night I stayed awake all night. It was awful, the next day I guess the ANS reserve kicked in, and I did just fine. Little advice on test day, take enough food and drinks with you, eat your breakfast, I made some tea, and few bars of Snickers(chocolate) with me to keep my blood sugar high and took a lot of breaks (for about 2/3 mins almost after every block.
First, 10/15 questions were practically undoable due to anxiety, but due to the reduction in the number of items (now 40 per block) I had 10/12mins left after each block in which I revised the marked questions from that block. I made five foolish mistakes, straightforward questions, second guessed myself, I will regret this for a few more years. Got about 1-2 WTF questions but they seemed experimental really because no logic seem to apply on them and the last block was of 28 items, all in all, the day went well for someone who didn’t sleep the night before. DONT STUDY THE DAY BEFORE, it messes up your brain! I studied in the morning and evening, and you know the rest!
SCORES:
Uworld – 76% – finished 4months before STEP 1
UsmleRx – 82% (did only medium and hard)
Free sample questions – 94%
NBME 12 – May 02 – 256
NBME 15 – May 27 – 245
NBME 17 – Jun 11 – 262
NBME 18 – Aug 20 – 262
USWA 1 – Aug 31 – 269
USWA 2 – Aug 31 – 264
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Find out how I scored 266 on USMLE Step 2 CK – Click Here
Dr Arjun Chatterjee is an intern at Calcutta National Medical College, Kolkata, India. To ask questions and interact with the author, us the comments section below. For more USMLE articlesclick here.
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Von Hippel Lindau is a rare syndrome. However, this is a frequently tested topic on NEET , USMLE and other entrance tests. Here is an easy to remember Mnemonic for Von Hippel Lindau Syndrome:
C – Cerebellar Hemangioma
A – Retinal Angioblastoma
R – Renal Cell Carcinoma
P– Pheochromocytoma
E – Epidydymal nodule and tumor
E – Endolymphatic sac tumor
P – Pancreatic endocrine tumor and cyst
Mnemonic for Von Hippel Lindau (VHL) Syndrome. Right Click and Save to Download
Drugs causing CYP 450 inhibition are important in pharmacology because of their drug interactions. A particularly important and frequently tested interaction is with Warfarin. These drugs inhibit the metabolism of warfarin and can lead to toxicity such as bleeding. Here is a Mnemonic for CYP 450 inhibitors.
Mnemonic for CYP 450 Inhibitors – CCOAAATS
C – Cimetidine
C – Cranberry Juice
O – Omeprazole
A – Antibiotics / Antifungals
A – Amiodarone
A – Acetaminophen
T – Thyroid Hormone
S – SSRIs
Mnemonic for CYP 450 inhibitors. Right Click and Save to download image
We have with us today Akarsh Agrawal sharing with us some of the things he learned after joining Medical School in India. These are first had life experiences and problems every medical student in India faces.
1. Choosing the right medical college
After my NEET-UG result, I did an extensive research before selecting the right college for me, by consulting seniors and visiting the shortlisted colleges with my dad.
Based on my experience, if you have are confused in selecting a college then following points must be kept in mind while choosing one:
Reputation
Don’t go for the rankings published online, they are highly misleading, rather seek for personal recommendations from students and teachers. Analysis of previous year trends gives good insights.
Academics and extra co-corriculars
Ask the students of that college to know more about the same. Do try visiting the colleges before you select one.
MONEY
Yes you read it right money! It is infact one of the prime factors to keep in mind. Look out for college fees and don’t forget to compare the rural service bond.
Distance from home and location
Choose a place close to home. You’ll soon realize what it feels like to go home after the “MBBS Hostel Life”
Advantages in Post Graduation
Yes that sounds a little too far, but it’s the post graduation that matters the most. Know about stuff like the domicile and availability of a pg coaching etc.
2. You don’t have to be perfect in Medical School!
I have realized that the biggest myth about getting into a medical college is the idea that you have to be perfect.
You need to do well but you don’t have to be the best. Don’t be intimidated being surrounded by a lot of smart people. Don’t compare yourself with others.
Remember that your only competition is with your own self.
Be persistent in your studies, but it is okay sometimes to miss your studying hours and enjoy a movie or hang out with your friends. ” Don’t just sacrifice anything because you don’t have time for it”
3. Pursuing hobbies
I think it’s necessary to look forward pursuing your hobbies, be it playing a sport, an instrument or photography and painting etc.
My recreation has been playing badminton and outings with friends. Medical college is a lot more than simply studying and gaining a degree, so I try to learn about myself and other people and hopefully build myself into someone who is capable of being a good doctor.
4. Trying Different Study Methods
My old studying methods seemed no longer serving me in med school. So I tried different study habits and asked around to see what other people are doing.
Know yourself and how you study the best. Be willing to adjust as necessary. Find a study buddy or a study group to keep yourself going.
5. How to Stay Motivated
With long college hours, specially in the first year, frequent and arduous exams and of course competition, such is the life of an MBBS student that it does brings you down to knees.
At such times I find it fine to take a break and put your mind off to doing something else. I also remind myself how and why did I begin.
I think it in this way that there are still lakhs of students competing to be where we are today. At the end, a quote which I read about medical profession which I find to be very true.
“Yes it’s tough, it’s meant to be tough, if it wasn’t so then everybody could be able to do it, tough is what it makes it great”
Akarsh Agrawal is a second year medical student at BJ Medical College, Ahmedabad. Apart from being great at studies, he can be seeing playing badminton on college campus. He also enjoys reading and writing. To interact with the author, use the comments section below!
Share your experience!
We would love to hear your story and tell it to medical students all over the country! Head to our Contribute page to know more!
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Lichen planus is an autoimmune dermatological condition characterized by multiple itchy red lesions most commonly on the lower back, wrists and ankles. It can also present with white lines on the mucosa of the oral cavity – Wickham Striae. It is associated with hepatitis C infection. Here is a mnemonic to help you remember the clinical features of the lesions in Lichen Planus.
Mnemonic for Lichen Planus – The 6 Ps’
P – Pruritic
P – Planar
P – Polygonal
P–Purple
P – Plaques
P – Papules
Mnemonic for Lichen Planus – The 6 Ps’. Right Click and Save to download image.
A lot of international medical students are confused about the USMLE Step 1 application process. The following is a complete 6 step guide on how to apply for the USMLE Step 1 examination.
The steps must be followed in this order only. Each of these steps is super important and cannot be skipped.
You will need to request a USMLE/ ECFMG identification number.
Once this is done, you will be taken to another window where you will have to fill in your details in a form.
Fill in the details and submit form.
Wait for a couple of weeks. ECFMG will send an email with your USMLE/ECFMG id and Password (which you can change)
Step 2: Head to ECFMG website and fill the USMLE Step 1 application form
Once you get an email from ECFMG, sign in with your user id and password from the same screen as before.
You will be taken to another window.
Click on begin new application.
There is an elaborate form that you have to fill out. Make sure you enter all the details correctly.
Note: You will be asked to select an eligibility period. This is a three month period in which you can choose to schedule your test. Select an eligibility period wisely.
At the end of the form you will be asked to make the payment for the examination.
Step 3 Form 183
Once you have made the payment, you will find a link in the same window, this is for the form 183.
This is what Form 183 looks like. Check your details and re check them. The boxes will have your details.
Fill in the required details.
The form also requires to be signed and stamped by the Dean of your medical school.
Note Very Important : Make sure the dean’s sign is the same as the on on the ECFMG records. Emphasize this to your office staff so that no mistake is made. If the signature does not match your form will not be accepted!
Step 4 Send Form 183 to Philly
Once you fill the form you have to send it to the address mentioned on Form 183. That is
IWA ECFMG 3624 Market Street Philadelphia, PA 19104-2685 USA
The envelope must be forwarded from your Dean’s office and should bear the Dean’s stamp. Your college office will generally be familiar with this process.
Step 5: Wait for your Scheduling Permit
2 to 3 weeks after sending form 183, you will receive an email from ECFMG. This email will contain a scheduling permit.
This is a very important document. Something that you will have to carry with you on Exam Day.
Ensure all your details are correct.
Step 6: Book a date at Prometric
This is the final step in your USMLE Step 1 application.
Prometric is the testing service that conducts all USMLE exams. Go to the Prometric Website.
Select USMLE. Select your testing location and preferred date of exam within your eligibility period.
You will have to enter details from the scheduling permit in order to complete the booking process.
Aaaand that’s a wrap! It is a long process and do be sure you do it correctly. Keep at least a month or two for application so that you don’t have make last minute mistakes.
Hope this 6 step guide on How to apply for USMLE Step 1 helps you with your USMLE Step 1 application process.
You can check out other USMLE related articles here.
If you would like to contribute your USMLE Step 1 experiences, head to our contribute page.
This article was written by Dr. Rohit Nathani, intern at Seth GS Medical College, Mumbai. USMLE Step 1 score 255. You can ask your questions in the comments section below.
Sturge Weber syndrome is a sporadic disorder caused by activatingmutations mutations in the GNAQ gene. Here is an easy to remember mnemonic for the clinical features of Sturge Weber Syndrome.
Mnemonic for the Clinical Features of Sturge Weber Syndrome – STURGE
S – Seizures
T – Tram track calcifications
U – U/L port wine stain and weakness (usually opposite side)
R – Retardation
G – Glaucoma
E – Epilepsy
Mnemonic for the clinical features of Sturge Weber Syndrome. Right Click and Save image to download.
Drugs causing disufiram like reaction are fairly commonly tested on most medical entrance tests including NEET, USMLE, etc. Here is a fun mnemonic for drugs causing disulfiram like reaction.
The importance of knowing drugs causing disulfiram like reaction is that, patients should be advised to abstain from alcohol while on there drugs.
If alcohol is consumed with these drugs, the patient will suffer from symptoms we typically refer to as the “hangover”. These include headache, nausea, vomiting, flushing and abdominal discomfort.
Out of the many mnemonics for drugs causing disulfiram like reaction, we found this the best!
Mnemonic for drugs causing disulfiram like reaction
Sorry – Sulfonylureas (1st generation – like chlorpropamide)
Pluto– Procarbazine (Anticancer drugs)
Can’t – Cephalosporins (Cefotetan, Cefoperazone)
Go – Griseofulvin
to
Mars – Metronidazole
Mnemonic for drugs causing disulfiram like reaction. Right click to save image.
