The USMLE Step 1 tests you on the basic science subjects namely Anatomy, Physiology, Biochemistry, Pathology, Pharmacology, Microbiology, Bio statistics and Epidemiology and Behavioral sciences. A common question IMGs have is “Which is the best time to take the USMLE Step 1?
The timeline for American Medical Graduates (AMGs) is relatively standard and most AMGs take their Step 1 at the end of their second year in medical school and take Step 2 in their fourth year.
The situation for International Medical Graduates (IMGs) is quite different as the medical school curriculum in your home country may not be geared to taking the USMLE Steps.
This creates a lot of confusion about when to give the exam. Also, your medical school may schedule their own exams throughout the year. Considering all these factors, there is no fixed time when IMGs take the Step 1.
Having completed medical school from India, the tips that I provide in this article are in context to the medical education system in India. I would love to hear your perspectives from different countries in the comments section below. However, these tips can be adjusted to suit the timeline of your home country. Here is what I recommend.
The AMG route – Step 1 at the end of second year of medical school
The first two years of medical school in India cover the basic science subjects mentioned above that are tested on the Step 1. While many IMGs may not even have decided whether they want to pursue their residency in the US, if you have taken your decision early on then this is the best time to take the exam. Here’s why:
You are relatively fresh with the basic science subjects.
Second year of medical school in India is long (1.5 years) and you have plenty of time to study for Step 1 apart from your medical school exams and clinics.
USMLE rules are changing. The board has announced that you will not be able to take the Step 2 CS without first passing Step 1. Note however, that this change will not come into effect before March 1, 2021. Check for announcements on the USMLE website.
You will have a strong foundation in the basic sciences which will be an advantage before you enter the clinical years in medical school.
It is rather frustrating to come back and study the basic sciences from scratch once you have already entered the clinical years in medical school.
Having completed Step 1 early on, you have enough time in the later years of your medical school to engage in research, electives, and other extra curricular activities.
Considering these factors, I think that the best time to take the USMLE Step 1 is at the end of your second year or the beginning of your third year in medical school.
There are two pre requisites to this:
You need to take a call early on and decide that you want to pursue USMLE and a residency in the US.
You need to be able to make a timeline around the requirements of your medical school and find time to study for Step 1.
Update : Starting in January 2022, the board has decided to score the USMLE Step 1 as Pass/ Fail rather than the 3 digit score. Considering this, it will be best to get done with your Step 1 early on as you just need to pass. Note however, the 3 digit scoring is still valid for those taking the exam before USMLE officially declares the date of the change.
Taking a decision early and planning out your USMLE timeline to fit your medical school schedule can go a long way in ensuring that you have enough flexibility to accommodate everything.
If you have any questions, use the comments section below. For personalized consultation and help with your timeline, resources and strategies, fill out the consult request form and I will get back to you.
This article has been written by Dr. Rohit Nathani who is a medical graduate from Seth GS Medical College. Ask your questions in the comments section below.
To submit your USMLE experience, go to the Contribute page. Your experiences can help other IMGs in their journey! You can also email us at theindianmedicalstudent@gmail.com
Studying for the USMLE Step examinations can be a daunting and often tiring task. You can put in hours and hours of study and still not see a visible improvement in your performance on practice tests. Here are a few tips so that you are more productive in the time you spend preparing for these exams.
Spend more time reviewing
The number of questions solved has been associated with the score one gets on the test. However, not spending enough time reviewing the explanation for the questions is something you should avoid.
Make sure you are reviewing not only why the correct answer is the right choice but also why the other options are incorrect.
It ultimately boils down to UWorld being a practice tool and not a testing tool. Make sure you take down notes or save flashcards from the explanation so you can come back and revise what you have learned.
Be selective about Resources!
It can be tempting to jump from one resource to another thinking that the more you do, the better you will score.
The reality however is that, high scorers are often more selective about the resources that they use. Then make sure you master these resources and know them 100%.
Make sure you spend enough time with First Aid and UWorld.
Have a timeline in mind
Have a rough timetable over the long term and short term. You do not need to account for every minute but, having a structure in your head helps you be more organized.
Also, once you have booked your exam date, try not to postpone it unless you have an emergency or you are doing very poorly on practice tests.
Simulate the testing environment
While solving blocks of UWorld or any other Question bank, make sure you approach each block as though it was your final exam.
Have enough practice solving questions in timed mode. Also, make sure that you have good practice in solving tests which involve multiple systems that is random questions.
It is easy to get the answer if you know the block is only about Cardiovascular system. Train your mind to think of each question as it comes.
Study Groups
If you are someone who studies well with other people, form a study group.
Keep in mind however, to find partners whom you are comfortable with. That means, make sure they aren’t too slow or fast and are at the same general knowledge level as you.
If you find that you are not benefiting from these sessions, be quick to understand and act on it.
Rest and Exercise
This is probably the most important but least spoken about productivity hack. The USMLE exam prep can be a stressful period and can lead to burnout if you do not give your body adequate rest.
Make sure you get enough sleep to wake up fresh and study each morning. Also, any form of exercise, even a short 15 minute walk in fresh air will go a long way in improving your productivity.
If you have any questions, use the comments section below. For personalized consultation fill out the consult request form and I will get back to you.
This article has been written by Dr. Rohit Nathani who is a medical graduate from Seth GS Medical College. Ask your questions in the comments section below.
In February of 2020, the USMLE parent organizations (FSMB and NBME) approved the change of USMLE Step 1 scoring outcomes from a 3 digit score to Pass/Fail. This post aims to provide a better perspective on this change and how the USMLE Step 1 Pass Fail will affect IMGs.
Major changes made:
USMLE Step 1 Scoring from 3 digit score to Pass/Fail
You must take Step 1 and Pass prior to taking Step 2 CS
The number of attempts on any USMLE exam is reduced from 6 to 4
As you can see the major change is the shift from a 3 digit score on the USMLE Step 1 to Pass Fail.
The USMLE Step 1 Pass Fail will not be implemented before January 2022
Why the change to a Pass/Fail reporting?
The idea was debated several times before it was passed. The main reasons to change from a 3 digit score on the USMLE Step 1 to Pass Fail were:
The content tested on USMLE step 1 does not correlate well with how good a clinician you will be. Although you need to have a good understanding of the basic sciences to have solid clinical concepts, knowing them does not necessarily mean that you are a good clinician.
Student well being and burnout prevention.
Here are some of the pros and cons of USMLE Step 1 Pass Fail that were discussed and are available on the website.
PROS
CONS
USMLE offers highly reliable, objective assessment of relevant competencies. A national standard.
A passing score on USMLE demonstrates minimum competency. Pass/Fail reporting suffices for this.
Mitigates the reliability challenges of some medical school assessments
Licensure requires only a Pass/Fail outcome
May stimulate student preparation more than a Pass/Fail outcome
Focus on numeric scores negatively impacts student well-being
Incremental numeric USMLE performance correlates with other valued measures e.g., specialty board certification, state board disciplinary actions, improved practice
Standardized test scores best predict other standardized test scores (vs. clinical performance)
Offers a “level playing field” for all examinees, including those from international and new or lesser known schools
Maintaining 3-digit score reporting may limit diversity within various specialty programs
If no USMLE numeric score exists, and the demand for a national assessment remains, what fills the gap?
Maintaining 3-digit score reporting has an opportunity cost due to students’ heavy focus on maximizing USMLE scores (e.g., less time for research, volunteerism)
USMLE Step 1 Pass Fail – Overall Impact
Since its inception, the USMLE Step 1 three digit score was used as one of the main factors in screening residency applicants. With that factor now gone, here are a few things that will become more important.
Step 2 CK score. There has been no change in the 3 digit score reporting for Step 2 CK. Step 2 CK is a much better reflector of a good clinician and residency program directors will place more emphasis on the Step 2 CK score.
Medical School and Letters of Recommendation. Prestigious medical schools and the quality of letters of recommendations from renowned faculty members will become much more important in differentiating applicants.
Research. Although research is currently cited lower on the list of factors that program directors consider while chosing applicants, with the introduction of USMLE Step 1 Pass Fail system, research publications will be considered more strongly.
Basically, you application as a medical student will be looked at in a holistic fashion considering a lot of variables that were originally masked by good Step scores.
How does the USMLE Step 1 Pass Fail affect IMGs?
The short answer is – USMLE Step 1 being Pass/ Fail affects competitive IMGs negatively. (Notice the word competitive.)
If you see the trends of matches in different specialties and compare American Medical Graduates (AMGs) to International Medical Graduates (IMGs) you will notice that for the same spot, an IMG has a higher step 1 score as compared to an AMG.
This Step 1 score was one of the important factors that helped IMGs stand out when it came to competitive residency applications. By removing that factor, the game is now tougher for IMGs.
So what can IMGs do to improve their chances?
Firstly, these changes will come into effect no earlier than January 2022, so if you will be applying prior to 2022, you have no reason to worry.
For the IMGs who will be taking the USMLE Step 1 post 2022, here are some things to keep in mind.
If you are reading this and haven’t yet entered medical school, work hard. Try to get into the best medical school that is recognized widely.
If you are already in medical school, be awesome. Work hard on your grades to get great transcripts and deans letter.
Take Step 1 early. Many IMGs used to take Step 2 CS as their first exam. With the new rules, this will not be possible unless you first finish Step 1. It is best to take your USMLE Step 1 immediately after you have finished you basic science years in medical school. Remember, you only need to pass now, no stress 😛
Focus on your clinical subjects and score really well on USMLE Step 2 CK. Check out my book on How to Crack the USMLE Step 2 CK for guidance on how to study for this beast.
Keep electives in mind and apply early. You can do hands on electives as a final year student. Apply atleast 6-8 months before you plan to do the elective. Read my posts about electives here.
Approach your application holistically. Remember to do research during medical school and publish. Get involved in volunteering and other leadership opportunities.
Try to take USMLE Step 3 before you submit your rank order list. This has 2 advantages. One, you have something that distinguishes you. Two, you qualify for an H1B visa if the program offers it.
Although this may seem like a lot and may seem unfair, remember that IMGs have always been a part of the US healthcare system and if you are good, you will find a residency spot.
If you have any questions, use the comments section below. For personalized consultation fill out the consult request form and I will get back to you.
This article has been written by Dr. Rohit Nathani who is a medical graduate from Seth GS Medical College. Ask your questions in the comments section below.
Pharmacology for the USMLE Step 1 requires you to know just the basics about the commonly used drugs in medicine. Here are a few things that you MUST know about the drug.
Which class does it belong to?
What is the mechanism of action?
What are the uses?
What are the sideeffects?
Apart from this there is very little that can be asked about pharmacology. Be sure to understand the drugs you study in this manner.
Pay special attention to the side effects. The examiners love these questions.
So what resources should you use to study for USMLE Step 1 Pharmacology? Thankfully the list is quite short for this one.
“Must do” Pharmacology USMLE Step 1 Resources
Review videos and notes
Video lectures and notes summarize pretty much all the basics you need to know about pharmacology for the USMLE Step 1.
You can buy these from any of the sources available online (Kaplan, Lecturio, Becker, etc).
If you feel that the videos are very time consuming, you can watch them at a playback speed of 1.5x or more.
If you are someone who prefers to read notes instead of watching videos, stick to that. The notes by Kaplan are concise and easy to understand.
First Aid
This is an absolute essential when it comes to Step 1 prep. There is no bypassing First Aid. This book along with UWorld is your ultimate resource for Step 1.
Be sure to go through Lecturio, Kaplan or any other review material you are using before you start reading First Aid.
The information in First Aid is ONLY the most high yield stuff and it doesn’t really explain concepts. This book is good if you have strong basics and want to have a review of all the subjects from 1 common book.
Every word is super high yield. Pay special emphasis on the mechanism of action and the side effects.
UWorld
Although this goes without saying, the list of resources for pharmacology would be incomplete if we don’t add UWorld. This is an extensive learning tool. Make sure you read the explanations really well.
This is a Question bank with nearly 2500 quality questions. Make sure you solve them and spend enough time reviewing your tests. There is a massive amount of information in each explanation.
This is a good book to read during the initial years of your medical school to build strong concepts in pharmacology.
However, it is neither required nor recommended that you read this book during your dedicated USMLE Step 1 Prep as this book includes a lot of non high yield material as well which can be very time consuming.
You can also consider making flashcards of the most commonly tested drugs and practice them. There are a lot of ways to study, videos, notes, flashcards, pick what works best for you and stick to it.
Have any other resources that you would like to recommend? Mention them in the comments section below or write to us at theindianmedicalstudent@gmail.com.
Choosing high yield USMLE Step 1 Physiology resources will go a long way in building basic concepts that you need to master this subject. But is physiology really even tested on the USMLE Step 1? And what are these high yield resources? Let’s find out.
Why is Physiology even important for the USMLE Step 1?
Unlike the topics like biochemistry and anatomy which involve a lot of memorizing, physiology is conceptual. This means that if you have a mastery over a few concepts, you should be able to tackle these questions on the exam.
Another reason why mastering physiology is so important is that you need to have a good understanding of physiology to really understand pathology for the USMLE Step 1.
How to master USMLE Step 1 Physiology and what Resources should I use?
I am going to give you a comprehensive list of the most high yield resources that are out there as well as when and how to use them.
At the start of medical school
These are the physiology resources that I recommend you use at the start of your medical school. This is when you will be forming your basic concepts. You will also have time on hand so, take this opportunity to really learn physiology.
Guyton and Hall Textbook of Medical Physiology
Although this book may seem like a lot to study, don’t get overwhelmed. When you start reading the book you will realize that everything is explained so simply.
There are diagrams and flowcharts that will simplify what you read. Don’t try to remember every word of the book. Read it like a novel and try to take home the important points only!
Dr. Najeeb’s Video Lectures
If you are an audiovisual learner, this is the best resource for you to build a foundation in Physiology. Dr. Najeeb explains concepts at the most basic level.
His diagrams and his teaching style will make sure you understand every concept.
Here are a few pro tips to keep in mind while watching these videos
Make notes during the lectures. It will not be possible for you to watch the entire video again as it is very time consuming.
If you find that the lectures are a little slow for you, increase the playback speed to 1.5x or 2x. But make sure you have enough time to think about what he is saying.
Do NOT try doing these videos if you have a deadline. They will take up too much time and you will end up doing too little.
During your dedicated USMLE Step 1 Physiology prep
Kaplan Physiology
If you want to do a quick review of physiology, the video lectures and notes from Kaplan should be your “go to” resource. The high yield points are covered very well.
I recommend that you buy the entire series of notes from Kaplan as you will be needing it for the other subjects as well.
However, if you feel that the amount of information is not enough and you have time on hand, you can use BRS physiology.
BRS Physiology
If you do not have solid concept in physiology from you medical school years and you think the the amount of information in Kaplan is insufficient for you, BRS physiology is what you are looking for.
However, keep in mind that you need not do both Kaplan and BRS Physiology. One will be sufficient.
First Aid
As with all subjects in USMLE Step 1, you will ultimately be studying from First Aid. Since this book is a compilation of all the subjects in one book, it is difficult to explain each concept in detail.
Make sure you are familiar with the basics from the resources mentioned above before you start using First Aid or else you will not be able to do justice to the information in this book.
Although there are a lot more resources out there for you to choose from, limiting your resources to a select 2-3 will help you master what you study.
Want to learn how to master the resources mentioned here as well as a lot of useful tips and strategies on how to ace the USMLE Step 1? Check out our eBook The ULTIMATE USMLE Step 1 Study Guide for IMGs
Do let us know if you come across a resource that you would like to recommend to others in the comments section below. You can also reach out to us at theindianmedicalstudent@gmail.com
Starting September 2018, ECFMG has now made it compulsory for international medical graduates to fill out an ECFMG Form 186. This process is required in order to proceed further with your USMLE applications. Without filling Form 186, you cannot get access to the link to apply for USMLE.
Here is a complete guide about how you should go about filling ECFMG Form 186.
Step 1: Download ECFMG Form 186
When you log in to your ECFMG applicant portal, you will see a link that opens up your form 18 in a PDF format. The first page of the PDF looks like this:
The second page will have your personal details pre filled. It will look something like this:
The blocked areas will have your personal information
Read through the information carefully.
Step 2: Upload your documents on the NotaryCam Website
This is a website that provides online notary services. Go to the ECFMG portal of NotaryCam.The page will look like this
On the next screen, you will be asked to fill your personal details as well as upload the Form 186 that you downloaded from the ECFMG website.
Click Submit.
Step 3: Book an interview appointment
Once you submit the form, you will receive an email from NotaryCam saying that they will verify your document.
This is a relatively quick process and you will receive another email (typically within 15-20 minutes) saying that your document is verified and you can proceed for your session with an online notary.
You have one of two options here
Proceed with the online session immediately
Book a date for your online session
Step 4 : The Online Session
Before you start your session make sure you have 2 important things
You are dressed appropriately
Your passport should be handy
You will be taken to an online chatroom with your document already uploaded. Once the notary official is ready for the session, you will see a blinking message that allows you to turn on your computer’s webcam.
The people on the other end are really nice, they will ask you for a few things:
To confirm your personal details
To show your passport on the laptop screen for verification
To place a digital signature on the already uploaded form 186
Once this is done, they will tell you that everything is OK and that they will forward the document to ECFMG. You can exit the chat screen now.
Step 5 : Waiting for ECFMG Verification
This can take a few days. The ECFMG will notify you once your Form 186 is accepted!
Congratulations! You have just completed your Form 186. You can now log into your ECFMG account and find a link to the Form 183. The steps for the rest of the application are the same as mentioned in my article on The [6 Step] USMLE Application guide.
This article has been written by Dr. Rohit Nathani who is an intern at Seth GS Medical College, Mumbai, India. To ask questions, use the comments section below.
So, you are finally done with your USMLE Step 1 exam. Now its time to wait for your USMLE Step 1 scores. This will feel like forever but, be patient. Here are things you need to know about USMLE Step 1 results.
Knowing what to expect before hand will reduce some of the anxiety you have regarding the USMLE Step 1 results and score reporting. Here’s what you should know.
1. When will my USMLE Step 1 Results arrive?
While this is not a rule, most USMLE Step 1 scores are released on the 3rd or 4th Wednesday after your exam date.
The results are generally released at around 18.00 IST which is around 08.30 EST.
2. How will I know when my USMLE Step 1 scores have been released?
You will usually get an email from ECFMG once your scores are available. The email subject line reads,
Your Score Report is Available
Yes! you may get a mini heart attack when you see this.
3. How do I check my USMLE Step 1 score report?
The email will have this link –https://oasis2.ecfmg.org/to the OASIS (Online Applicant Status and Information System) website.
Once you log in using your ECFMG id and Password, you will have access to a link that opens your score report.
4. What will my USMLE Score report have?
The USMLE score report will open up as a PDF. This report will have a comprehensive evaluation of your exam performance as well as your 3 digit Step 1 score!
There are graphs which show your performance in each topic relative to the average.
Note: Don’t forget to save this USMLE Step 1 Score Report PDF. It will not be accessible after a few weeks.
Note: Do not share your score report on social media. This score report has your ECFMG identification number and other personal information that can be misused. Blur the personal information if you really want to share!
5. What do I do if my USMLE Step 1 results do not arrive in 3-4 weeks?
While most results are released withing this time frame, there could be Step 1 reporting delays. You can find out about these delays on the USMLE Score reporting archives.
If there are no delays mentioned for the time period in which you are expecting your results, it is best to wait for another 1-2 weeks before you shoot an email to ECFMG.
6. My results are withheld by ECFMG pending further verification. What should I do?
This is a problem faced by some international medical graduates (IMGs). The ECFMG may require additional verification before it releases your USMLE Step 1 results.
Note: This is not in any way dependent on your scores. It is just an additional check point used by ECFMG sometimes.
This additional verification form is shipped to your medical school by ECFMG and may take a few days to arrive. Once your medical school verifies you, then you need to send the forms back to ECFMG. Make sure you send these forms by a courier service like FedEx or DHL to ensure faster delivery.
Note: Once the verification form is received by ECFMG, a request to release your USMLE result will be made by them. You will then receive your USMLE Step 1 scores. This does not have to be a Wednesday. The scores will be released once all the requirements are fulfilled.
7. I want to get my USMLE Step 1 Scores rechecked
If you feel that your exam was way better than the scores you received, you can challenge the score and ask for a recheck. More information on how to request a USMLE Step 1 score recheck can be found here.
Remember that these requests need to be sent within 90 days of receiving your score and require you to pay a fee of $80.
Hope these tips were helpful. If you have any questions, you can post them in the comments section below.
You can check out other USMLE related articles here.
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.
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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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.
Dr. Priyanka Lakshmanan shares with us how she scored 267 on the USMLE Step 1 Exam. Her in depth USMLE Step 1 experience will answer your questions of how to score 265 + on the USMLE Step 1.
I am an IMG from Mumbai and took my Step 1 currently in my 3rd year of med school (2015).
So I went over to a counselling center and enrolled myself for the Kaplan courses (center prep) in the year 2013. I started the lecture series in the year 2014 as I had to wrap up some stuff prior to that.
By Aug 2014 I was pretty sure of wanting to give off the exam in the year 2015. I visited the center almost 2-3 times a week. I would sit for 3-4 hours at a stretch and do the lectures.
By the end of 2014 I was done with most lectures except Behavioral sciences and parts of biochemistry, pathology, physiology.
What I covered from Kaplan courses
1) Behavioral sciences: The whole thing. Found it extremely useful. Dr Daugherty is an amazing professor and clarifies stuff amazingly. Did the lectures for chap 1 and 2 twice.
2) Biochemistry: All chaps once.
3) Pathology: Covered the whole of systemic. Did only neoplasia from the general path section.
4) Pharmacology: Again all lectures. Did the lectures for the volatile stuff like ANS and anti-arrhythmics twice.
5) Microbiology: All lectures once.
6) Physiology: Just CVS, Renal a bit of respiratory physiology, the whole of chap 1 (fluid distribution), nerve and muscle physiology.
7) Anatomy: The whole of anatomy except neuro anatomy. Histology lectures were a waste of time. Did anatomy as my last subject because it is extremely volatile.
Materials other than Kaplan that I used
1) FIRST AID FOR THE USMLE (LATEST EDITION) – Practically the bible for step 1.
2)BRS for physiology : Very concise. Would recommend only if your basics are strong.
3)High yield neuroanatomy: Again extremely concise and volatile. Good for the neuroanatomy stuff tested on step 1. But again your basics have to be strong else you find yourself reading your base book every now and then (happened to me).
4) Dr Najeeb’s lectures: OK! SO this one is MASSIVE!!!! Concepts cleared BEAUTIFULLY!!! The lectures are amazing. Unfortunately, I found out about these extremely late during the course of my preparation. So did a select few chapters of physiology (renal and respiratory), neuroanatomy (a few lectures), ECG.
5) Goljan for pathology: The whole thing once. (every single page) Revise chapters like skin, musculoskeletal. (These are tested very frequently on the exam).
NBME FORM 15, 16, 17. (Have heard that form 13 is a good predictor of your final score. But an average of all your u world and NBMEs is a better estimate rather than one single test).
Study Period
7 months intensive preparation
PHASE 1
I had started doing the Kaplan lectures and taking down notes into the Kaplan books since May 2014. Since I had to manage other academic and extra-academic stuff with it, it went a little slow.
Nevertheless, I managed to complete most of the important subjects (except physiology) by the end of Jan’15 (the year of my step exam).
Annotate as much as you can from the lectures. It is better to be thorough in the beginning rather than incomplete later on. It takes some time but it is worth it in the end. Serves as a good reference book once you start solving the tests and you need to get a few concepts clear.
PHASE 2: January ‘15 – June’15 (First week)
This was a very important period for me as I had to finish up all the Kaplan notes, BRS for physiology, High yield neuroanatomy, Goljan for pathology along with videos of Dr. Najeeb.
I had also started reading first aid some time around the early part of May.
Dr Najeeb’s videos were extremely useful for some chapters of physiology like Respiratory (highly recommend), Renal, Cardiovascular (ECG) and any other system which you are particularly weak at. Again, this is very time consuming because you need to take down notes for the same, BUT they are totally worth it.
Lectures for reproductive and endocrine physiology and GI physiology are a waste of time and I do NOT recommend doing them. You can refer to the Kaplan videos for the high yield systems for physiology if time permits.
With reference to Dr Najeeb’s videos, neuroanatomy requires a special mention. His lectures on intracranial hemorrhages, spinal cord lesions, meninges and the vestibular system are the only ones I could do due to a time constraint.
But his neurology lectures are pretty elaborate and I would recommend doing most of them only if you have started your preparations in advance and can spare time for these. Now you can do away with these lectures as the neuroanatomy questions that show up on the main exam are relatively simple. But that is my perspective and opinions may vary.
This was also the time when I finished reading Goljan for pathology. Again, a time consuming process but a one-time thorough reading is definitely recommended.
The Kaplan Q bank was particularly useful during this period as it helped me apply what I was reading and also helped me with time management. I never faced a time crunch for any test- Neither U world nor NBMEs and Neither on the main exam.
PHASE 3
I started solving my U world Q bank (3 month subscription) in mid-June.
Now this is a MUST-DO for the exam. There is no escaping this and each and every question needs to be solved and reviewed at least once.
I solved the tests on the Timed mode. Initially, I would combine 2 systems together and solve tests till I had about 80-100 questions pending per system. Now this number is variable as some systems have a lot of questions but others have very few.
So be judicious and careful. The last 30 tests or so that I solved were mixed, like they show up on Step1.
Reviewing the tests is a task and it took me practically 4.5-5.5 hours to review each test. I would practically write down every little detail form u world into my FA. I had to attach at least 5-6 extra sheets per chapter to fit in the notes after there was no more space left on the FA pages.
But doing this helped me a lot as my first time doing U World was very thorough and I could read up my notes every time I revised first aid.
FA is the only book recommended while you’re in the whole U World phase because you need to get thorough with FA and you practically do NOT have the time to read anything else, especially if you’re still a student. You cannot compromise your academics at any cost because they matter equally.
PHASE 4
26th July onwards till the date of my main step (1st September).
This is the time to solve NBMEs, Kaplan simulated exams, Uworld self-assessments and also continue revising FA.
I did the whole of FA thrice. A minimum of 2 readings is essential. You can revise the U world tests if you want to during the last 1.5 months.
This is a timeline of my tests and the scores on each (All taken in the year 2015)
Kaplan simulated taken on 26-7-15 score 81%
NBME 15- (2nd August) 251
NBME 16- (15th August) 260
NBME 17 – (25th August) 254
UWSA 1 – (8th August) 263
UWSA 2 – (23rd August) 262
UWorld Total – 77%
UW LAST 30 TESTS – 82%
Kaplan Q Bank Solved 54%. SCORE 72%
Now a lot of people wonder what a good score is and many a times get de-motivated with their NBME or UWSA scores.
The deal here is NOT the individual scores but your progress and consistency.
If you are scoring in the lower range (220-230) in your first NBME, your scores are bound to increase in the subsequent ones. So try and maintain a graph that is positive and if you have reached a point of saturation (250+) try and maintain that.
The length of the questions on the main step corresponds to the length of the UWSA questions, but the difficulty is more along the lines of the NBMEs.
The key here is to NOT get bothered, even if your scores are below your expectations. You have to work hard, keep going and give it your best shot on the main exam.
Go through the heart sounds over and over again and also the CTs, MRIs and other images.
There is a discrepancy between my test scores and my actual score. This is because, while doing these practice tests, I realized that I had a crazy tendency to over analyze the questions and keep changing my answers and that actually got me a lot of incorrect questions.
So I restrained myself from last minute changes and went with my gut feeling. It was a risky move but it paid off for me. So try and analyze why you are going wrong and work towards correcting them your way.
Ohkay! Now I could fill up an entire page again on my experience on the day of the exam. But I’m going to keep this very concise and give you bullet points of the DO’s and DON’T’S
DOs
1) Get a good night’s sleep one day prior. Have a well-adjusted circadian rhythm. A sleepless night and anxiety won’t get you anything.
2) Wind up all your last minute revisions by the evening of the previous day. You have to resist the urge to keep going through FA. It messes with your mind and confuses you even more.
3) Comfortable clothing is the way to go. Preferably no pockets.
4) FOOOOD! Please carry good food and enough drinks to keep you hydrated. Anything that makes you feel good. Chocolates, cookies.. Whatever. It makes a difference.
5) Plan your breaks appropriately. Take a break after every block if you need it. I did the same.
6) Don’t panic staring at the questions. Try and guess an answer even if you’re not sure. Try NOT to skip and leave too many questions unanswered till the end because that can stress you out.
7) Pee when needed.
8) Never re-enter the exam room from a break just for the heck of getting done with the test. Re-enter only when you feel fresh enough for another block.
9) ENJOY after the exam regardless of how it went. You deserve it.
10) No USMLE predictor (online) can predict your actual score.
DON’Ts
PANIC, PANIC, PANIC!!!!
Have some faith in all the efforts you have put in for this one day. It will pay off in the end. Don’t let your worry get the better of you.
(And then finally wait for 3-4 painful weeks for the results to arrive)
THE REAL DEAL: 267. (23rd September’15)
It’s a long journey and it tries your patience at practically every other level. From an ECFMG certification to the application and what not.
But that’s what you have friends for. Having a study partner helps you get through this exhausting process alive and breathing.
It’s tougher when you’re all by yourself with no one to handle those frequent panic attacks and nightmares. Yes we all go through them and it can mess with you.
And the only silver lining at that time is the support of your family and friends who believe in you more than you believe in yourself.
So don’t lose hope! And HAPPY STEP 1 DIARIES to all!!
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