Dr. Arjun Chatterjee is back with his USMLE Step 2 CK Experience where he tells us how he scored 266 on the USMLE Step 2 CK in 2020!
Background
Some of you might know me from my USMLE Step 1 guide, and for those who took the time to read the full article, you know that I am all about minute details.
So sit back and relax because I am going to take you through my Step 2 CK journey. Don’t worry, this won’t be as long as that Step 1 post, but hopefully detailed enough to answer most of your questions.
I took my Step 1 in 2016 (3rd year Part I MBBS a.k.a. Final Year Part -1), then before starting my internship, I went for my electives in 2018, gave Step 2 CS after my electives, and after completing my internship, I took my Step 2 CK in February 2020.
Perspective
Let’s talk about mine. So before beginning any journey, be it a visit to the Eden Gardens to watch a KKR vs. RCB T-20 cricket match or preparing for Step 2 CK, I like to plan. The best way I found is to ask others who have done it before.
Finding parking and transportation can be tricky at 11 pm coming back from Eden Gardens, but if you know which road to park your car in, then you’ll have no problems, while others will wait till 1 am to find some sort of transport. Planning and apprehension are critical! The same goes for Step 2 CK.
If you know what resources to use, and when to use, you’ll save a lot of time and hassle. I have been un-officially preparing for Step 2 CK since I took my Step 1 in 2016. I have read a countless number of posts asking to take the Steps back-to-back else we will run of the risk of doing poorly. At the same time, others will ask to take it slow. I believe that one should take it when they are prepared.
So the obvious question is why such a massive delay between Step 1 (2016) and Step2 CK (2020)?
Skip to the next section if you’re only here to know my resources! Follow the headings you’ll find what you’re looking.
As I said, I took my Step 1 in 2016 so that I could apply for my electives with the score and go before my internship starts. After my electives, I took my Step 2 CS, that too before CK and I passed.
Then after coming back from the US after doing my electives, I started my internship. Calcutta National Medical College (CNMC) has one of the cruelest internships in India.
Although we interns in West Bengal are paid highly compared to the rest of India (23k INR). We are expected to do the work of 5/6 nurses, one ward boy, and one doctor.
I had a reverse mini-culture shock after returning from the US, seeing the way work was done in our hospital. I had got used to EMRs and looking at X-Rays on computer screens. Now for a year, I was being asked to draw blood, fetch reports, take the patient for USG, X-Ray, etc. Go to the blood bank. You name it, I have done it.
And after that if time permits go for the rounds. I used to come back to my house only to sleep. I had lost count of days, weeks and months too I guess.
Did I enjoy it? YES I DID!
Would I trade it for anything else, like applying this year for Match 2020 -NO! I wouldn’t.
The experience which I gained from doing so many varieties of work, and getting to do so much made me humble. I started witnessing the miracle, which goes on in the hospital. From ward boys to security guards, nurses, PGY-1s – I could see a small ecosystem functioning on its own.
And no, I thought of doing an externship with less workload, but the way CNMC has tested me (insults from seniors, doing work which we’re not supposed to do, Work-Sleep-Repeat for months), I am feeling confident for my residency. That’s if I match amidst this Corona scene.
So, in short, I didn’t have time to breathe; forget studying. I still somehow managed to finish UWORLD for Step 2 CK once during my internship. I did it in a system-wise tutor mode, taking fundamental notes.
Once my internship got over, I started my primary prep; details follow.
What did I do?
In this section, I will try to point out the ideal way of doing things. I wish someone would have told me this while I was in my final year. It would have saved me a lot of time and money, which I spent scouting for ideal resources.
If you read the step 1 article, you know that I don’t believe in using 15 different resources when the same can be achieved using one or two.
So instead of mentioning what I did, I am going to tell you what you should.
Basic Read – To get your feet wet (to get an overall idea of the CK syllabus)
FACT CHECK – You should pick and choose what to do based on your situation. You might have three months to prepare for CK, or you might just be starting.
You’re in bad luck! Unlike Step 1, there isn’t a single sized shoe which fits everyone. There is no First Aid to save your ass this time. I have nothing against MTB or First Aid, but I don’t think they are high-yield enough or detailed enough to help you gather basic info.
OnlineMedED – This is what you should use for your final year prep. Dr. Dustyn Williams has spent countless hours recording these free high-quality, high yield videos. This is the best resource to get your feet wet, to know what you’re up against.
The main advantage of using this is you get an excellent but yet detailed overview of the syllabus. The back draw being it’s time-consuming. Someone planning to prepare for CK in only three months shouldn’t use this. Did I mention that the videos are FREE? Also, if you install an ad-block to your browser, the annoying ads stop playing. Do consider supporting his work. I bought a mug from his website; you should too!
First AID for Step 2 CK – As I said before, I don’t rate this book highly. Although I owned it, I never bothered using it. This cannot be compared with FA for Step 1.
Master the Boards (MTB) 2,3 – I bought these after my Step 1, as there is thus big rumor going around. “Study IM from MTB 2 and Paeds, ObGyn, Surgery from MTB3. In my humble opinion, these books are shit.
Dr. Conrad Fischer is one of my human idols. But somehow, I didn’t like the way the book is organized and was trying to feed me information. You should try this before taking my word for it. Maybe you might find it useful, who knows?
Step Up to Medicine – This book is a good book to follow if you’re one of those Goljan guys. I always preferred Pathoma over Goljan as it was concise and to the point. A lot less information to remember. I prefer to make my notes from Onlinemeded and study them instead of going through a 600-page book, and eventually forgetting what I read the week before. This can be a useful resource if used during the final year, but not for Step 2 prep.
Paul Bolin Videos – Like I said, I spend a lot of time researching resources. Dr. Bolin’s Youtube channel has one of the best video collections when it comes to preparation. BUT AT WHAT COST? TIME! If you’re in your final year, you should consider using this. Else SKIP. Not enough High Yield for CK. I remember doing his Ob-Gyn videos during my final year.
Pestana Surgery Audio Lectures and Book – This is a must for most people. Do this, it won’t take you much time! Indians teach surgical methods in college instead of why an invasive procedure is being done. Even if you have a gold medal or honors in surgery, it won’t matter, as you won’t be asked the steps of excision of a sebaceous cyst, rather when should you intubate. The why is always more important than how. Once you know the why, the how is a piece of cake. Sadly “how” is what is taught, and not the why!
In summary, if you’re having time crunch, use Onlinemeded. Do it wisely. See where you stand. Are you an IMG practicing pathology for 15 years in Delhi, and now want to apply for residency in the US? You might need to watch the OB-Gyn, and Surgery videos! Play these at 1.5 speed and make your notes.
You might want to try MTB/FA for CK and see if you like it.
Advance Read – To nail the coffin (to prepare for CK)
UWOLRD – If you want to prepare for CK, you should do only one thing, and i.e., UWORLD. Like every other test taker, I am vouching for UWORLD being the highest yield resource. I did it twice. Once during my hectic internship days, and the second time during my dedicated prep.
A lot of people will tell you to do UWOLRD, but seldom people guide you on how you should use it. I found that doing Tutor-mode System wise 1st time is the highest yield.
Take your time to solve questions, read explanations immediately, and hammer them in your head. Make small notes of why you got the question wrong, instead of copying the whole screen.
2nd time do it in Timed-Random mode. Read the answers after you’re done with a block. Two things which I found extremely useful while solving UWorld is reading the last line of the question first to create an idea of what the problem is about, and the 2nd being reading the Educational objective at the end. Knowing the answer to the question is important, more important is to understand why the question is being asked in the 1st place.
If you’re one of those HOT-SHOTS, Know it all kind of chilled dude who will score 260+ with three months prep. Do Uworld twice; I am not that SMART, I guess!
UpToDate – This is the go-to resource. Long gone are the days when we used to quote “Harrisons 17th ed page 308 para three, 2nd line, 4th word”. Uptodate is the new Harrisons/Davidsons/anysons. It is one of the best resources out there. All the latest medical research is regularly incorporated into it. You’ll be surprised to see the similarity between Uworld and UpToDate.
Whenever you have a doubt, goto Uptodate, look up the topic. Now let me tell you how I used UpToDate. Read the summary section first. Then CNTL+F “Find function” your exact doubt. That way you’ll spend less time reading about stuff which you don’t need. Remember to use your time wisely. Read what you need, ignore the rest.
There are several ways of using UpToDate. Buy it, use a VPN to connect from Norway (Norway people have free UpToDate), apply for a free UpToDate account at better evidence, ask your friend who went for their elective in the US to set you up with a three-month free account.
AMBOSS Library – Amboss has both an online library and a qbank. Let’s talk about the library first. The main advantage AMBOSS has over UpToDate is that it’s exam-focused. It’s quite detailed but free. I used to search google “topicname_space_amboss” for e.g. “sunscreen spf amboss”. Use a pop-up blocker to get rid of that annoying overlay.
AMBOSS QBank – Having used UWolrd twice, and being well-versed with my own notes, I wanted to try something new. AMBOSS QBank is a lot more complicated than UWorld. It hammers in points and tests the depth of your knowledge. Do only if you have time. If you’re confused between the 2nd time of Uwolrd and Amboss qbank. Do UWORLD twice until you know it by heart.
CMS Forms – These are probably rejected/old USMLE questions, which didn’t make it into the real exam, so that have rebranded these as CMS Forms. I did Medicine, Surgery, Paeds, Neuro, Ob-Gyn, Psych forms, and made my notes for the questions that I got wrong (1200+ questions).
The questions which you’ll get wrong are the ones you have zero clues about. But these are very few. It’s not high yield, but for the perfectionists. I will repeat myself once again, to make it very clear.
Do only if you have time. If you’re confused between the 2nd time of Uwolrd and Amboss qbank. Do UWORLD twice until you know it by heart. If you’re unsure on which forms to do, see your weak areas and do those. My surgery was relatively weak.
NBME Forms – I did NBME form 7. NBME 7 – 264. I recommend taking an NBME before your real exam.
UWSA 1,2 – This is gold when it comes to predicting your score in the real deal. I don’t know what witchcraft they’re practicing in UWOLRD HQ, but UWSA 2 is the best predictor for CK out there. I got UWSA 1 – 271, UWSA 2 – 266. I took both of them on the same day, one week before my exam, to fire up my brain. The UWSAs are difficult and vague. Don’t worry if you get questions wrong. Most of us will. Save UWSA for the last few weeks!
Step 1 material – you should revise your Biostats from Step1 and if you have the time to do the UWorld Biostats review. I am quite well versed with my step 1 knowledge even after so many years, so I didn’t feel the necessity to revise from First Aid for Step 1. If you’re feeling a little low on the pharma and micro goodness, give it a quick read.
How much time will you need?
It depends on you, your goals, you timeline. Some will do everything within three months and be happy with a high 240s low 250s. Then there is the opposite end of the spectrum where I belong. So it’s totally up to you. NBMEs and UWSAs will tell you if you’re ready or not. Not me!
How should I prepare for this exam? Give me a summary, dude!
If you’ve around three months – Do Uworld twice. Properly! Consult AMBOSS library, UpToDate, as you prepare. Give an NBME, take UWSAs. You should be good.
If you have around 4-6 months – Do OnlineMedEd videos, take notes; UWorld Solve Tutor mode-Systematic 1st pass; UWolrd Solve Timed mode-Random 2nd Pass. Take relatively detailed notes during pass 1, and exactly why you got the questions wrong during 2nd pass. Consult AMBOSS library, UpToDate, as you prepare. Do CMS forms (areas where you’re weak). Give an NBME, take UWSAs. You should be good.
If you’ve >6months – Get a life. There is more to life than USMLE! Just kidding. Refer above, follow what I did!
With that, I come to the end of this thread. I would like to thank all the kind souls who stood out from the rest and helped me in my prep. I hope that beneath my arrogance and warped sense of sarcasm, you’ll find this post helpful, and share your knowledge with someone else.
I know what it feels like to be helpless; that’s why I put so much time and effort into writing these posts. Every week I have someone contact me on Facebook and ask me about USMLE. Not bragging, but just pointing that apart from the selected few institutes in India, Pakistan, Egypt, Lebanon, Jordan, Chile where giving USMLE is shared by batches over the years. Where seniors share their materials with juniors, there are many out there, ordinary students, just like me, who are hungry for some sense of direction. This post is dedicated to them!
About the author – Dr. Arjun Chatterjee
“I completed my MBBS and internship from Calcutta National Medical College. Having taken all steps and done my clinical electives, I plan to apply for residency in the United States of America (Match 2021). Right now, I am working as a Research Trainee in the Dept of GI at Mayo Clinic, my research interest being pancreatic cancer.”
Ask the author your questions using the comments section below.
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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
Share this post, thank you for reading and Good luck people!
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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Dr. Janhavi Shah is a Second Year Family Medicine Resident at Jan Swasthya Sahyog (JSS), Ganiyari. In this article, she shares with us why she decided to pursue family medicine that too at an unusual hospital in Chhattisgarh. She talks about family medicine in India, the pros, and cons as well as the scope of family medicine in India.
“Chhattisgarh? Dude, Naxalites live there!!”
“Family Medicine! But you’re so smart! You should do ObGyn!”
“But ghar se itna door why you want to go? Opt for a hospital in Mumbai only na.”
“Repeat na. Agle saal kuch better mil jayega”
2 years ago whilst in my internship, I decided to do Family Medicine. A year ago I decided I wanted to do Family Medicine at JSS. I looked up Chhattisgarh on the map, Aaaah-ed at the location staring at me, and told everyone back home what I wanted to do. Half of my family was thrilled and the other half wasn’t.
Family Medicine isn’t a glamorous urban branch! So I get it when people are apprehensive or have concerns.My father is a general practitioner and without realizing it, I fell in love with general practice before I fell in love with Medicine.
I stumbled upon the existence of JSS whilst skimming through an online blog. Then I stalked the website and then the founders. All these years of stalking crushes and their ex-girlfriends and their bua ke dost ka beta with Avanti and Jo (my friends from undergrad at BJ Medical College, Pune) finally paid off!
The hospital seemed like a happy place for the sick, the founders couldn’t have better credentials. Best of all, the administration was super supportive and non-toxic and all departments helped each other with a common aim of healing the sick.
I’ve been here for over a year now and the consultants, senior residents, and even my co-residents are the nicest people ever. I haven’t come across a more skilled set of nurses. The locals here are simple grounded people.
It feels like a eutopic hospital in a dystopic world.
Family Medicine is a combination of all clinical branches and aims at addressing the most common health care needs of the community.
The doctor ideally knows about the entire family’s health status and refers them to another specialist as and when required. This requirement predominantly (and inversely) depends on the expertise of the physician.
For example, Dr. X has insufficient experience dealing with a migraine and would refer to a neurologist for the same; alternatively, Dr. Y is confident and competent to manage the patient at the primary level.
The advantage is the patient convenience, a reduced burden on the specialists and health care costs (especially in public health systems).
From the rural perspective, where the doctor-patient ratios are abysmal, FamMed is the Batman that Gotham needed. In cities, where specialists are easily available, FamMeds may have to make their space.
The upper hand here is that you are the entire Family’s doctor and you don’t burn a hole in anyone’s pockets.
Given the diversity and vastness of the field, it is extremely important that one chooses a good programme for residency.
Choose a hospital which gives enough exposure in all clinical fields. Avoid hospitals where you’d be fillers used for doing most of the paperwork or as floor RMOs in 7-star hospitals. Not the best place to learn!
3 years of residency is the base for the rest of your life; keep it strong. Small locational sacrifices may go a long way in the future.
Currently, there are no super specialty courses designed for FamMed (a generalist super specializing doesn’t make much sense to me!) There are many fellowships one can pursue as per individual interests.
Lastly, about the scope of family medicine.
It can be as vast or as narrow, as high or as low and as gratifying or as bitter as you want it to be.
One may choose it because they like all clinical subjects and don’t want to commit to only one (which a lot of young doctors feel but they eventually settle for a pure specialty) or, one may choose it because they wanted Internal Med and this seems to be the closest 2nd option.
If it’s the former, yay! I hope it brings you immense joy and gratification too. If it’s the latter, I hope you fall in love with the branch eventually (most people I know, did!)
If you would like to interact with the author, you can do so in the comments section below.
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