Goljin it! I can't speak for the audio since I never got past the 3rd lecture....

but the book is worth its weight in gold. If you can only read one book: First Aid. If you have time for 2: FA + RRPath. ? Unless you don't count doing better on the exam as well... Definitely had a number of questions straight outta UW on my Step 1 (Step 1 250+ with a 4.0 GPA)

1.) Do well in your basic sciences, I can't stress this enough. Studying for Step 1 should be mostly to hammer down stuff you already know and remember details that are important. It's a review... not a relearning or hell... just a learning of the material for the first time. 2.) Use First Aid for Step 1 throughout your courses. 3.) Doctors in Training is what I used for review... it's boring, drab and torturous... but it WORKS. You're forced to go through FA and it hammers home the big points. 4.) UWorld. Don't even bother with any other Q-bank. Don't take advice from your friends. UWorld or you're an idiot. 5.) SLEEP. My goodness. I cannot stress enough that 8 hours of sleep is ESSENTIAL. If you're not getting 8 hours, your studying is worthless. Your brain needs time to process all that information and to store it. Read and review your notes before you go to bed, you will remember things much better. There are articles out there that I'm too lazy to go find and post about studying before going to bed. It really works. Check out lifehacker.com As far as kicking ass on rotations... it's all about initiative. Take the initiative to go see a newly admitted patient, go to the ED, take a thorough H&P and get to know your patients. Keep an eye on lab results and micro results and let your attending know when they come back. It's just the small things and attention to detail that your attendings appreciate. If you don't know something, don't make some bullshit up, don't stammer and look stupid, just say, "you know what, I don't know, but I will look it up, read up on it and discuss with you what I find". Have a cool case? Have a routine case? Read up on it no matter what. Nothing is ever "routine" in medicine. UpToDate is literally the greatest clinical source ever created. Use it. It's a great great great reference. Buy a subscription to it if you have to. It's so nice to be able to pull it up on my iPhone and rattle something off really quick. Be inquisitive, ask questions. Don't ask questions that you can look up the answers to, but feel free to get an attending's opinion on something. For example: "I know we normally treat xxxxx with xxxxx, but in this situation, what made you go with xxxxx" Try to get insight about how the clinical mind works, your attendings will appreciate that you're actively trying to learn, that you're interested and paying attention. And attendings always love to talk and share their opinions with someone impressionable. It's like you're the primary care person and they're the specialist, they like that. Be personable, be flexible and be realistic. Don't be a dick. Don't throw nurses, techs, students, anyone under the bus. Be courteous. Thank people, especially nurses for everything and anything. Nurses rank much higher than us in this stage right now. Develop a good rapport with the patients. Spend time with them and listen to their concerns. I can't tell you how many times I've been able to pick up on a key piece of information that had not come out before. These pieces of information have often times

changed the course of our treatment. Don't take the history/physical part lightly. You are an integral cog in this machine and your input IS valued no matter what you may think/be told. Best of luck to you. Study hard. Be humble and above all... Take a moment to think about that and reflect upon just how lucky you are. wow, about ten minutes later got the score, so I guess it can be any time. Does anyone understand the 2 digit score? I got a 266/90, which is weird to me...isn't anything over like a 230 a 99? thanks! my NBME's were usually 247-252, then the one right before the exam was a 261. I only did NBME practices, never a full length. the exam was more clinical than i was expecting (my school does rotations before step 1), so that certainly helped. not nearly as much micro or biochem as i expected based on how much I studied those topics, and not as many "multi-step" questions as kaplan says you will see (there were a lot more 'what is the diagnosis'). but, every test is so different and i wouldn't recommend changing anything because of that. i did a pretty equal mix of reading and practice questions, with a heavy emphasis on practice questions in the last week. test very similar to USMLEworld. good luck! thanks. i did usmleworld, kaplan q bank, and usmle rx. i didn't finish any of the three, but i tried to rotate them so that i could get a good range of question types and difficulty. i found usmle rx much more helpful in the end, as it solidified my knowledge of First Aid. For practice exams, I just used NBME. For books, i liked the following: Lippincott's biochemistry Clinical microbiology made ridiculously simple Costanzo's physiology How the Immune System Works (i forget the author, very short and good background) First Aid as main book High Yield Embryology BRS review series Neuroanatomy I can't remember the rest right now, but those were the main ones. Essentially, I found that having a thorough understanding (i.e. reading the entire lippincott's biochem book) was better for me than using outline-based review books.

USMLE World and First Aid are obviously musts. I think Goljan's Rapid Review Path + audio files probably boosted my score an extra 5 points, maybe more. Very dense, but thorough. I also used BRS Phys for the stuff I was weaker in. I wouldn't recommend an extra source for anatomy, biochem, cell, histo. The stuff that's in First Aid is sufficiently high yield; any random questions you get on those things that aren't in FA you probably wouldn't have been able to retain without sacrificing time spent studying path/phys/pharm.

Besides those, I would also recommend High Yield Behavioral Science. The book is short and you can get through it in a day. The material in it is easy, but so many students struggle with that stuff for whatever reason. Regarding q-banks, obv World is gold standard. I used Kaplan 2 years ago just during my MS2 courses and didn't like the questions at all. It was either very obvious scenarios with multiple buzzwords, or very obscure cell & molecular nonsense that is completely low yield. I've spoken to a number of current MS2's who are using the Doctors in training question bank; no one I know used it two years ago, but maybe it's gotten better/a better reputation since. If you don't have money to throw around, redoing World questions is a great option. There are immense threads on SDN dedicated to the subject, but the above advice is gospel. If you finish UWorld in time, USMLERx is very cheap to buy for a few weeks and is good yield. Additionally, some people have great results from listening to Goljan's recorded lectures (he wrote RRPath)..... since they were surreptitiously recorded, I would never do such a thing. FWIW, I bought Kaplan for I and didn't like it.... I'm using World for II and love it. Only thing I'll add is the stamina and mindset aspects. You should be doing 100+ questions a day, timed, uninterrupted. That way, when you sit for the beast, it will be just like another day. Also, try to work out, don't study the day before, sleep 8 hrs a night, and set your body clock so that you're on in the AM (when the test starts).

First of all...Definitely do all of First Aid and all of Uworld, read every explanation in it's entirety. I posted this exact same thing in a previous thread, but I think it is relevant: I know everyone has their own advice when it comes to usmle step 1 studying, but I thought I'd give mine anyways because I'm fresh off of it. I personally didn't like Goljan. The audio lectures were pretty good, but very slow and more conceptual than high yield in my opinion. I bought his book but it was soooo DENSE and overwhelming it was hard to read. I would HIGHLY recommend this website and the accompanying book [1] http://www.pathoma.com/ The author is a Path professor at my school and he taught us a class specifically directed at step 1 and formed part of the basis for part of his review course. He used to be Falcon's head instructor, now he is Kaplan's head instructor in case your suspicious of his credibility. His book is amazing. Extremely high yield with good pictures, up to date, and not too overwhelming. There's some free stuff on the website too. Whatever you end up using, I'd take a look and see if it fits your studying style. Good luck. http://www.pathoma.com/ 1. A question bank

Theres always the debate about whether Kaplan or USMLE World is the better question bank. I used USMLE World and loved it. The thing that impressed me most about USMLE World was how similar the questions on the QBank were to those on the actual exam. When I came to the test, I felt as though I was just taking another set of questions from USMLE World. Also, the explanations of questions are great. They give detailed explanations of why the right answer is right and why the wrong answers are wrong. I learned five or six important concepts tested on Step 1 from one question and its explanation. This made the QBank a very efficient study tool. I purchased a 6 month subscription to the USMLE World QBank. In retrospect, I would have purchased a shorter subscription. I thought that I would have time to start doing questions before classes ended, but I didnt. So, I would recommend buying the QBank for the amount of time you have committed solely to your USMLE review (probably 2-3 months). I also purchased two practice tests, but only ended up doing one of them. Our school also gave us a practice test. I spent a lot of time answering questions and reviewing them closer to my test, but only got through about half of the QBank. In my opinion, if you really study the answer explanations provided by USMLE world, youll be able to master the concepts covered by the USMLE exam without having to do all of the questions. That was my experience, anyway. Obviously, however, the more you do, the better prepared you will be for the exam. As far as how your QBank score correlates with your final score, UWorld questions tend to be a little harder than the actual test. I was scoring in the high 70s on my question blocks before I went into the test and ended up with at 257. My overall was about 60%, but my percentages were getting much higher on each question block the more questions I did. 2. First Aid for the USMLE Step 1 I dont say this for very many things, but First Aid for the USMLE Step 1 is a must-have. First Aid is essentially a very condensed version of most of the things youll learn in your first and second year of medical school (at least the material that will be covered on the USMLE exam). The more familiar you are with First Aid, the better off you will be when you start using it for your formal USMLE prep. If you use this book during your curriculum, youll be able to have a summary of the things youve learned, as well as seeing what might not have been covered by your school that is covered on Step 1. One tip I have is to not spend a ton of time on the biochemistry section of First Aid. Understand the key steps that have to do with certain diseases (e.g. what does lead poisoning or B12 deficiency affect), but dont try to memorize full pathways that dont have specific clinical relevance. I spent a lot of time on this and saw very few questions on the test. My classmates had the same experience. 3. Rapid Review Pathology by Goljan This book is similar to First Aid in that the material is condensed into bullet points. However, it has more information about the why of diseases than First Aid. It gives great explanations about pathophysiology and this material is stressed heavily on Step 1.

These are the only resources that I used for my Step 1 prep. As you can probably tell, I study more on my own. Also, I learn best from practice questions. If this is not your style, then this strategy is probably not a good fit for you. If you work better in groups, do that. My study strategy and schedule Month 1-2. Monday to Friday I would read a new section in First Aid USMLE and the corresponding section in Goljans book. I would read new material in the morning (around 6-8am), new material in the afternoon (1-3pm) and review the material from the day at night (7-9pm). Those hours might go a little longer on some days. The night review would sometimes include QBank questions on the related topics. On Saturday I would review the things that I had studied in the previous days. This would include questions about the topics. Sunday was a day off! In the middle of this I also took the USMLE World practice test and got a 220. This was encouraging since it was better than before, but lower than my goal of 245. So, I had to keep working. I would also take breaks at times during my studies to go play basketball, run, or watch TV. I study a lot better when I take breaks between. You might be different. My main goal in these months was to finish going through First Aid and Goljan twice by two weeks before my test date. Month 3. This is where I started doing more questions. I had finished most of First Aid and Goljan. Usually I did two sets of questions per day with the same schedule as above. Test day. I scheduled my test day for the middle of June, a couple of weeks before rotations started on July 1st. Looking back I wish I would have done it a week earlier. That last week probably had little effect on my score but took a week away from vacation that I would have loved to have before starting my third year of medical school. So, my advice to you would be to take it at the beginning of June. On test day, make sure you bring snacks and food. Its a very, very long test. I would also recommend taking all of your breaks. I would run around the building, do push-ups or jump up and down to keep my body and mind refreshed. Im sure I looked like an idiot, but it worked for me! So, with all of this, I was able to surpass my target score of 245, with a 257 which made me very happy. Again, this is what worked for me and may not work as well for you. But, USMLE World, First Aid and Goljan Pathology are top notch resources no matter your study preferences. Good luck! HY Topics according to DIT. Numbers before the topic listed are how many questions someone recently had on their actual exam. Personally, I think vitamins are definitely worth knowing. Functions, ODs, and deficiency. 5 star topics 3 Sensitivity/specificity (p. 53) 0 Statistical hypothesis (p. 57-58) 2 Ego defenses (p. 482) (lots) Vitamins (p. 94-99) 1 Capillary fluid exchange (p. 291)

1 Diagnosing disorders of sex hormones (p. 539) 3 Vasculitis (p. 304-305) 1 Weber syndrome and Wallenburg syndrome (DIT neuro p. 20-21) 2 Heart murmurs (p. 285) 1 Adrenal steroid pathway (p. 318) 4-5 star topics 0 Skin cancer (p. 428, 4-5 star) 1 Headaches (p. 467, 4-5 star) 2 Pathologic red cell forms (p. 378-9, maybe 5-star) 1 Brainstem cross-section (4-5 star, DIT neuro p. 16) 1 Nephritic/nephrotic syndromes (p. 516-518) 1 Sex chromosome disorers (p. 539) 1 Developmental milestones (p. 62) 1 G-protein linked 2nd messengers (p 263) 4 star topics 3-4 Drug enzyme kinetics (p 258) 1 Arachidonic acid products (p 429) 3-4 Exotoxins (p. 152-3) 1 Thyroid development (p. 138) 1 Branches of abdominal aorta (p. 339-40) - recognize them on an angiogram 1 Hepatitis serology (p. 191) 1 PKU (p. 112) 1 Warfarin (p. 395) 1 Platelet disorders (p. 387) 0 Physiologic dead space (p. 562) 0 Wegener's (p. 304) 1 Temporal arteritis (p. 304) 1 Cerebral arteries - cortical distribution (p. 442) 0 Label the Circle of Willis (p. 443) 1 Label the brainstem (p. 454-5) 1 Label the brachial plexus (DIT neuro p. 39) 1 Osteoporosis (p. 414) 1 RA; RA vs. OA (p. 418) 1 Gout (p. 419) 0 Genital embryology (p. 141) 0 Sleep stages (p. 64) 1 Tumor markers (p. 254) 0 Celiac sprue (p. 353) 0 Reed-sternberg cells (p. 389) 1 Lab values in bone disorders (p. 415) 0 Lung volumes (p. 561) 1 Abdominal aorta (p. 339) 3-4 star topics 1 Potter's syndrome (p. 140, 3-4 star) 1 Horshoe kidney (p. 140, 3-4 star)

0 Gerstmann syndrome (3-4 star, p. 441) 1 Rotator cuff (p. 405, 3-4 star) 1 Osteoarthritis (p. 417, 3-4 star) 1 Male/female genital homologues (p. 142) 0 Hardy-Weinberg equilibrium (p. 89) 1 Paraneoplastic syndromes (p. 255) 1 Coronary artery anatomy (p. 280) 1 Rotator cuff muscles (p. 405) 1 V/Q mismatch (p. 566) 1-2 Disease conditions a/w neoplasms (p. 252) 0 Lyme disease (p. 165) 0 Mycoplasma pneumoniae (p. 170) 3 star topics 0 Collagen synthesis/structure (p. 83) 0 Heart embryology (p. 130, 2-3 star) 0 Regional specifications of developing brain (p. 133, 2-3 star) 0 Normal flora (p. 195) 1 ECG tracings (p. 289, 2-3 star) 0 Celiac trunk (p. 340, 3 star) 0 Epithelial cell junctions (p. 404) 0 Flumazenil (p. 475) 1 Amino acids (p. 110, 2-3 star) 1 Automonic synaptic cleft pathway (p. 264) 0 Tumor suppressor genes other than p53/Rb (p. 253, 2-3 star) Pathology: Of course the most important topic. I had learned a lot of the stuff 3-4 months ago, therefore it took me quite a while to remember and put the stuff together during the exam. Because of that I got into time trouble, but I looked a few thing up after the exam and they were the very classic presentation (e.g. I had forgotten that you get splenomegaly in ET, but still got it right, yay ). Goljan + FA = 100% of the questions.

1. Once you have gone through the stuff and Uworld, you will see that FA has 90% of the content that's on the exam. If you can "feel" what FA wants to tell you and you can tie in the connections (instead of just studying useless facts), then you're more than ready to go. For the rest use Goljan RR and a few supplements for your weaknesses. 2. I had the Goljan audio, but rarely listened to it. Mainly when I was bored. I listened to 4-5 lectures, but honestly, there were about 5 questions that I remembered straight out of the audio file!! Asked exactly the way he presented it! I would listen to it guys... That stuff isn't outdated. 3. Take a break after each block. Go to the toilet even if you don't have to necessarily. It sucks when it's urgent and you are in the middle of a block. So the message is: FA + UW = 95% of the stuff. I didn't believe it either... but it's very true. I went through UW (100%). End% was 80+. In the last few weeks I was hitting between 85 and 95%. If I didn't have to keep a deadline I would have postponed the exam for 1-2 weeks. DON'T TAKE THE EXAM WHEN

YOU ARE NOT READY. It sucks to realize that you you've learned everything but can't recall it. Take 1 more week and revise if necessary. I hope you guys do well, you can take Step1 only once in your life.... (And btw if this was a question stem in your exam, it would be time to assess whether I'm delusional or suicidal ) Goljan lectures + RR Path), but it'll give you more than FA alone Originally Posted by elektroshok I also took it on friday. There were about 30 anatomy questions, half of which were random and convoluted. I thought most of the stems of all the questions were most similar to world questions, but the answer choices were what made thequestions hard. Also, a ton of molecular and cell bio. prob about 5 per block that were 'wtf' type questions. Was hoping for 240+ but ill be lucky to have pulled 220 I think. I used: World, 86% on random 46s Usmlerx, split by subjects I was studying Fa Brs phys Goljan rr audio and book Hy neuro Got a 223 on the cbse we took at school 6 weeks ago before studying. Nbme 6, 257 Nbme 7, 245 Nbme 12, 257 Should get my scores on the 21St so ill update then. But I def think fa alone wouldn't cut it. not really sure how I would have studied different tho. Lets hope the curve is in my favor! Sent from my AT100 using Tapatalk 257/88 Took it on March 2nd. Pretty happy. So my study plan was basically as follows: I had just shy of six weeks to study and wanted to make two passes. First pass:

Broke up each subject and system as far as I could (i.e. Cardio anatomy, cardio phys, cardio, pharm, etc.). I would study each of those sections individually mostly in first aid and brs text only using outside refs if I needed clarification. I then would take all the questions over that specific section of the system in USMLErx q-bank and review only missed questions or marked questions that I got right. Each afternoon I would review all the path from that system in goljan text. That was basically what I did the first 2.5 weeks to try and re-build my foundation. It was more time intensive than the second half but I got through about 3,000 (the whole USMLErx bank) in that time. Studied a solid 7-8 hours a day with a day off each week at some point. Took NBME 6 at the end of first pass. If applicable, each morning to get started I would take the pharmacy pre-test questions on the drugs from what I studied the prior day. Second pass: My mornings would be either 3 or 4 blocks of random questions on UWorld. I would then review again only the ones I got wrong or marked and happened to get right. If it was a concept I wasn't quite getting I would spend a few more minutes reviewing, but I usually just read the explanation pretty well and moved on. Afternoons were spent reviewing each system/subject again in first aid to make sure I got through it all again as well as listening to all the goljan audio. Took NBME 11 about a week into this and 12 about another week later. Again, a full or half day off each week. General things I felt helped: -Dropped whatever I was doing at 11am each day to workout and eat - super key in keeping me sane I think. -Got rid of call of duty for the time I was studying, since it would have ruined me and taken all of my time -Set an absolute cut off time of like 5/6pm to make dinner (this was more so the first pass, second pass I sometimes decided to review casually after dinner for like an hour) -Used a huge whiteboard to keep a running list of equations and mnemonics that I had a hard time remembering so I could glance at it every day And I for sure think its quality over quantity of time studying. There were only a handful of days I actually studied more than 7 or 8 hours of actual study time. If I was being unproductive towards the end of the day - I called it quits or took a break and watched TV then got back at it. I tried to only be at my desk or with books when I was studying. Don't get intimidated by people who say they are/were studied 10-14 hours a day because no one can get quality time in like that consistently - just make the time you are studying count. I think that is basically it. Let me know if you have more questions. I guess the last thing is I would say not too stress too much too early on about missing practice questions since the utility of the q-banks in my opinion is to learn and get used to taking questions - the NBMEs are for gauging your ability. Cheers UW average: 80ish percent first pass, high 90s second pass. Always did timed random full blocks. Kaplan: No particular pattern to how I did these. I mostly did them on my phone while at the gym or when I had some down-time. UWSA1: 259

NBME11: 262 UWSA2: 264 NBME 12: 263 Real thing: 260 All of my scores are in a tight distribution because I always wait until the end of a study period to start taking full-length practice exams. I basically followed the Taus method and studied for a very long time. I think that my school (UVA) made it very easy to study for classes using board review materials because they didn't test weird minutiae, but rather clinical presentations and broad concepts, so I took advantage of that. I also think that going to a system-based fully integrated school helps with step one because it prepares you to be ready to answer a random mixture of pathogenesis, pharm and management questions once you've localized the organ system. I also had a little bit less than two months of dedicated prep time. There isn't much I can add to the collective wisdom on the board. The test was very similar to what the gold-standard prep material and question banks prepare you for. Exceptions: there were a number of drugs that I had never heard of and some side effects that weren't in first aid, but I just shrugged those off and chose at random. It would have taken way too much time to learn dozens of atypical drugs. On the score distribution sheet I scored very far to the right on pharm, which makes me think that the questions where they point blank ask you the MOA for "drug X" that you've never heard of could just be experimental to see if the schools have started to teach them. There were also many more dentistry questions than I would have expected. I had at least four, and I don't think they were experimental because the questions were well-developed. Otherwise it was a very fair test and it felt like it went by very quickly. Good luck to everyone and thank you to all the students who took the time to type up their impressions and strategies!

real deal: 251/87 uworld: 74% one pass, random CBSSA: 252 NBME7: 233 NBME11: 247 Mainly did Uworld + FA during the last 4 weeks. Overall, I thought the STEP1 was extremely fair, and I thought that it was easier than the NBME's. The answer choices just seemed to be more obvious to me. I guess I just didn't like some of the questions in the NBME's for some reason. The exam hardly required any memorization, the ones that did were MAJOR. The day before the exam, I felt like I didn't know/remember anything... I even wanted to postpone the exam... so don't panic if you have this feeling, trust in your studies

I personally felt that I only had 4-5 anatomy questions, 4-5 direct pharm questions, 4-5 micro questions, (and these were MAJOR topics/drugs~metronidzole/bacteria... don't waste your time on the tiny details/symptoms!!! especially not the last several weeks) and the rest seemed to be well distributed... with probably >90% being from FA + uworld alone. But, I think the key is to do well during your first 2 years. I felt like I would have scored the same, even with only 2-3 weeks dedicated study time, but who knows.

I wish everyone the best of luck! The exam is a lot more basic/simple than most people probably anticipate. CBSE (before studying): 205 NBME 6 (3 weeks out): 221 NBME 11 (2 weeks out):238 UWorld on random: 74% Real thing: 250 First 2.5 weeks went through all of FA and did UsmleRx questions corresponding to each section. Took NMBE 6. Second 2.5 weeks did 3-4 blocks of 46 questions random on UW in the am, went through a section in FA in the afternoon/evening. Listened to Goljan + read RR Pathology once the first pass and again during the second pass. I took the exam 4 weeks ago, still feel adept at commenting on the content. Anatomy: I had a lot of anatomy questions... or anatomy questions I was not prepared for. Probably about 2-3 questions per block, so a total of 15-20. This did not include neuroanatomy, of which I probably had 3 or 4 total questions. Questions like: which muscle do you remove to release brachial plexus compression (ant scalene) or which nerve innervates the lower edge of the lip and would be compromised in a jaw fracture (lingual). Micro: Nothing too out of the box, of the ones I remember, there were like 10 total question of pictures of bugs/skin rashes and you had to ID the bug, so knowing just what they do wasn't sufficient. Heme/Onc: I literally had 15 questions on B12 DEFICIENCY. So, know the difference between B12 and folate deficiency. Other questions were very straightforward; translocations of cancers, lead poisoning, etc. Pharm: was one of my weaker points going into studying, but knowing the basically: 1)MOA 2) what the drug is used for 3) side effects will get you 85% of the questions. I had 3 questions about drugs I hadn't heard of, but by process of elimination I narrowed it down. And 1 or 2 random pharm-kinetics questions which I honestly usually just make an educated guess on anyway.

I've found the Sanjiv Microcards to be phenomenal for learning the algorithms, and of any resource I've used for Step1 so far, they are unequivocally the best study tool I've come across. Memorizing the lists from FA for micro isn't good enough. Get the Sanjiv Microcards and memorize the tree-algorithms. I promise it will make micro your best subject if it isn't already.

I would obviously recommend going through all of the Sanjiv Microcards, but the bare minimum is the algorithm cards; these precede the vignettes. And yes, buy them immediately. Hi everyone, I took the Step 1 in few months back. I have benefited from the info and posts on this forum. It's time for me to give back. Overall Prep time: 5 months ( 3 months dedicated) UWSA#1- 235 NBME 6 ( 6 weeks before test)- 235/560 NBME 11(5 weeks before test)- 257/650 NBME 7 (2 weeks before test)- 245/600 UWSA #2 - 263 UWorld- started low 70's..finished up avg- high 70-low 80s Real Step 1 score- 260/89 I used FA, Kaplan and Pathoma. These were my main sources. I referenced Goljans path book, BRS on occasion. Overall, KEY to doing well was Reviewing as often as possible. UWorld was also very helpful, would highly recommend using this Qbank. Best of luck to you all Originally Posted by rashy Ok guys, thought I would share my experience with you. A few days after my exam and I STILL FEEL LIKE CRAP. Why? Because my exam was so f%"ing easy, probably the easiest exam there can be! But I just couldn't remember everything that I had learned. I knew that I did learn it, I knew which book, which page, but I simply didn't remember. Background: IMG, started to study in october for 2-3months because I had planned to go the US. There were a few difficulties from my school and my trip was cancelled. I wasn't done studying anyway and I needed a good score, so I cancelled my exam. After that, my rotations began and I was really exhausted in the evening, but I kept studying for 1-2h a day. And then BAM, suddenly my school got everything right and I was set to go in 4 weeks!!! Problem: I wasn't even done going through all the stuff ONCE. So I started turbo mode and finished everything with 2 weeks out. Then I started repeating everything. But I couldn't finish... I tried everything, slept for 5h/day, drank every legal stimulant drink there is on the market for nearly 2 weeks, but still.. way to much stuff. I got to finish repeating everything except Biochemistry, Pharm and Pathology. I had a good night sleep before the exam (who wouldn't after 2 weeks of 5h/d), but of course I still felt very tired the next morning.

Exam: Very easy, very straightforward. 80% of the questions were just "what's the diagnosis, what's the mechanism". Rarely you would have to think more than 1 Step. The mix of questions was quite balanced. There was 1 WTF question on my exam and maybe a few that took me long to figure out. Pathology: Of course the most important topic. I had learned a lot of the stuff 3-4 months ago, therefore it took me quite a while to remember and put the stuff together during the exam. Because of that I got into time trouble, but I looked a few thing up after the exam and they were the very classic presentation (e.g. I had forgotten that you get splenomegaly in ET, but still got it right, yay ). Goljan + FA = 100% of the questions. Physiology: Not a lot, in my exam quite underrepresented. BRS will do the thing. Pharm: Straight forward, except for 1 questions where I hadn't heard of the drug that was asked about. Really, FA is the ONLY thing you need for that. Unfortunately I didn't get to repeat everything, so I got only 50% of the questions right. I'm still mad about that. Behav.Science: Very very easy. BRS will do the thing. Biochemistry: A few vitamins here and a few pathways there. There were 2-3 questions about storage diseases, but nothing too fancy. FA is the way to go. Anatomy: Got quite a lot here, good mix of Ana/Neuro/Embryo. But the neuro questions were quite hard. They asked for a specific region that was lettered, but the letters were all next to eachother and I couldn't really remember the pinpoint exact locations of them. FA definitely comes up short here. HY neuro helped a bit, but there were still a few weeeiird questions. Microbiology: Quite a lot there, FA + UW will do the thing. Nothing fancy. In fact, I could swear I had seen a few questions in UW. So all in all, a really fair exam. I swear to God, if I had finished repeating everything I would have gotten a 290 in this exam. No kidding. My original goal was to get 260+ because I wanted to apply for a surgery residency, but now I think I can be happy if I get 230. It's just so depressing... (No offense to you guys, but an IMG needs a higher score) A few hints for you guys: 1. Once you have gone through the stuff and Uworld, you will see that FA has 90% of the content that's on the exam. If you can "feel" what FA wants to tell you and you can tie in the connections (instead of just studying useless facts), then you're more than ready to go. For the rest use Goljan RR and a few supplements for your weaknesses. 2. I had the Goljan audio, but rarely listened to it. Mainly when I was bored. I listened to 4-5 lectures, but honestly, there were about 5 questions that I remembered straight out of the audio file!! Asked exactly the way he presented it! I would listen to it guys... That stuff isn't outdated. 3. Take a break after each block. Go to the toilet even if you don't have to necessarily. It sucks when it's urgent and you are in the middle of a block.

So the message is: FA + UW = 95% of the stuff. I didn't believe it either... but it's very true. I went through UW (100%). End% was 80+. In the last few weeks I was hitting between 85 and 95%. If I didn't have to keep a deadline I would have postponed the exam for 1-2 weeks. DON'T TAKE THE EXAM WHEN YOU ARE NOT READY. It sucks to realize that you you've learned everything but can't recall it. Take 1 more week and revise if necessary. I hope you guys do well, you can take Step1 only once in your life.... (And btw if this was a question stem in your exam, it would be time to assess whether I'm delusional or suicidal )

257/88 Was gunning for 265+, but still good enough to keep me in the game Take a practice test on weekend. Week: Hit the 3 weakest sections. Take a practice test. Week: Hit the 3 weakest sections. Rinse and repeat. You'll quickly know if you are doing effective studying because your weakest sections are likely to stay that way if you aren't doing what you need to during the week.

I scored 250+, and so did most of my friends -- some of them scored high 260's and one of them low 270's. We all pretty much agreed afterwards that FA and UW have all the important stuff. I ONLY used FA, UW, and NBME practice tests, and so did my buddy who got a 269. Think of it like this -- I honestly believe that if I could take step I as an open book test, and get 2 days to do it to account for time needed to look stuff up, I could practically guarantee a 265+. The vast majority (probably 90+%) of the material really IS in FA and UW. Having basic thinking skills is a prerequisite, but anyone who actually finished MS1-2 has the level of skills required to crush this thing under open-book and extended time conditions. Just got my score and am incredibly pumped. 271/91. First off let me throw my (probably biased) 2c into the ring on debate about the value of high scores. There is most definitely diminishing returns to increasing step1 score in that the gap from a 230 to a 250 is much much more important then the gap between 250 and 270. That being said I believe that people who think improving scores beyond the 250ish range doesn't help are probably deluding themselves. It definitely isn't the only part of an application, and a 240 w/ good grades, research, and interviewing skills can certainly be a better applicant then a 270 without any/all of those things. It of course will vary highly between specialties (higher scores probably more important in more competitive specialties) as well as between programs (some value step1 highly, others very little). Thats why I am very skeptical of any anecdotal "well my PD said this . .", and there is undoubtedly a

range between programs. Anyways, enough of that. These threads were very helpful to me in my preparation, so I hope to give back a bit with what I did and what I would/wouldn't change. Study resources: By far the most important was gunner training. I started this winter of first year, and it was absolutely essential for hammering in the facts. Reading first aid for the first time felt like a review, as GT had already hammered in most of the factoids into my brain. It also has lots of things that aren't in first aid, and so is a great supplemental resource. That being said, it is a system that takes A LOT of time to work, so start early and stick with it, or it may not be worth using at all. If only they had it for wards/step 2 . . . I used Kaplan qbank along with 2nd year classes, with a second pass during my study period. Kaplan is a decent Qbank. Generally good questions and explanations, but some overly nitpicky questions. Definitely not as good as Uworld, but I'd rate it as #2 (and newly inexpensive, only $150 w/ AMA discount for many months) I did 2 passes of Goljan audio along w/ 2nd year classes, w/ 2 more during the study period (while at the gym). This is great because he completely emphasizes the HOW and WHY of pathology, which is much more useful then trying to memorize his book, which was garbage IMO (except for the pictures, which I used along w/ the audio). As I explain later, understanding the how and the why is essential, as they love to ask questions about classic diseases but w/ a new twist that makes it very difficult to just memorize the answers. I did a quick pass of first aid along w/ 2nd year classes, then 2 passes during my study period, w/ a last only on pages I'd marked as weak spots. Great review, terrible for trying to learn material. Not much more to say. I did 2 passes of Uworld on untimed tutor mode during my study period. This Qbank is solid gold, with multi-step/conceptual questions and amazing explanations. I highly recommend using tutor mode (or thoroughly going over all answers afterwards, including correct answers). Even if you got the answer right, make sure you got it right for the right reasons by reading the explanations. I also read through BRS physio along w/ classes and once more during my study period. This book is great for understanding of basics of physio, which is essential for reasoning your way through tough questions. Finally, work hard on your classes in the first 2 years. There is no review book/memorization set in the world that can replace a solid foundation in physiology and pathophysiology. About the test itself: First off, I won't talk about areas of focus. I've talked to enough people to know that your distribution of questions is basically random e.g. I had 4 ACE inhibitor questions and not a single lasix or thiazide one. Doesn't mean the latter concepts aren't important, just that it is totally, 100% random what will be emphasized on your test. There are a broad mix of questions. There are many questions that are straight forward and fact based and much easier then uworld questions (assuming you know your facts straight). There are also many questions of Uworld type difficulty, but often testing aspects of a question that you've never seen before. This is a brilliant test in that it asks you questions that force you to make an educated guess based on your understanding of how physiology and path work. Instead of asking you the classic

lab findings of disease X (which you memorized), it can ask you about what you would expect some other random lab finding Y (which you haven't memorized) to be, and you have to figure it out based on the pathophys of that disease. You can memorize yourself to a passing/good score, but not to a great score. I personally felt that there were plenty of questions I wasn't "sure" about, but had made my best guess based on my understanding of how the organ systems work, and I guess I was correct more often then not. That's why there is no replacing a good education in the first 2 years, no matter how many times you read first aid. Likewise, when you take the test, don't feel bad that there are tons of questions you think you know, but aren't 100% on. Thus to all the "are UW + First aid enough" questions, I'd say it depends. Those 2 resources will certainly provide you with enough of the factoids to memorize that you can do very well with just those 2 IF you also have a good understanding of physio and pathophys. If you don't, then use whatever resources you need until you feel you have a good understanding of how the organ systems work and what is happening when things go wrong. Also know that no matter how many resources you use, there WILL be things you haven't seen before, and so your ability to make educated guesses is essential. Numbers: GT = 100% completed, 75% mastery Kaplan Qbank = 84% first pass, 90% 2nd Uworld Qbank = 89% first pass, 96% 2nd (though I remembered many questions) NBME 11 = 255 (5 weeks out, after finishing classes before study period, GT, kaplan 1x, goljan/FA 2x) NBME 12 = 265 (2 weeks out, after first thorough pass of FA in my study period, first Uworld pass, another goljan pass, and some of kaplan) UWSA1 = 265+ (1 week out) NBME13 = 275 (5 days out) UWSA2 = 265+ (3 days out) Actual test = 271/91 Hope this helps. Just activated a new account. SDN has helped me out a lot so I thought I'd contribute. I took step 1 in the first week of april after about 7 weeks of dedicated study time. I used world and annotated in first aid. I finished one pass then did all my missed and marked again. If I found anything confusing I used other books as references, mainly brs physio, pathoma/goljan, and katzung and trevor pharm. uworld, first pass, random timed: 80%, started high 60's finished mid 80's. uwsa 1 (7 weeks out): 256 nbme 11 (6 weeks): 254 uwsa 2 (5 weeks): 265+ School cbse (4 weeks): 98, 265+ nbme 12 (3 weeks): 250 nbme 7 followed by free 150 (2 weeks): 257, 91% nbme 13 (1 week): 264 Step 1: 264/90

Overall, I'd just say have a plan, trust your plan, and try to keep as calm as possible. I think Goljan's HY (like 36 pgs) stole me 10 or so question on really random stuff I didn't know. I thought I was wasting my time the day before the test but it ended up paying off. Just got my scores back this morning from the April 16th test date -- 262/89. I'm very excited. A little bit about my experience -- I did a school-administered CBSSE about 10 weeks prior to Step 1 and got a 210 prior to starting studying, so I definitely came up quite a bit from that. Practice test scores: NBME 12, 5 weeks out -- 228 UWSA 1, 4 weeks out -- 247 NBME 12, 3 weeks out -- 250 (I took the same form again by accident -- but I hadn't done extended feedback the first time so I don't think it dramatically changed my score) NBME 11, 3 weeks out -- 245 NBME 13, 2 weeks out -- 254 NBME 7, 2 weeks out -- 247 UWSA 2, 1 week out -- 262 NBME 3, 6 days prior -- 259 NBME 6, 2 days prior -- 254 I used FA, RR Path, RR Biochem, Microcards, and Pharmcards to study. I really liked the microcards and I think RR biochem was helpful because our school had a pretty weak biochem prep, but I don't think either one was necessary. Pharmcards were a waste of time, IMHO. I went through RR path while listening to the Goljan audio and I feel like that gave me a great baseline (went from 228 to 250 on the same NBME in the two weeks that I worked on Goljan audio / RR path). Once I finished audio / RR, I basically just did lots and lots and lots and lots (>5000 total answered questions) in UWorld and read / annotated FA. I think that once you have the foundation, practice questions and FA are really all you need. Even from the questions I remember struggling with on test day, I'd say 80% of them were in FA in some form or fashion and only 20% were things that I wouldn't have been able to answer even with FA in front of me. Of those 20%, most of them seemed to be pharm -- I got a bunch of out of left field pharm questions on drugs I'd never heard of. Anyway, I'm super stoked about my score -- good luck to everyone taking it and waiting to get their reports back! The waiting period sucks, but it's such an awesome feeling to finally get your scores back and have the whole thing be over. Quick question -- does anyone know what the deal with the two digit scores is? They seem to have changed them this year, so it seems like maybe they're now your percentile? Took the Step yesterday. I also saw a ton of crazy anatomy. Weird. Tore my ACL in the fall. Started studying after reconstruction was done in October, as I literally couldn't do much else. I read the First Aid Organ Systems and Basic Sciences books. Did Organ Systems with our classes (organ curriculum) and used Basic Sciences to review first year material. Also used Kaplan QBank with each block to consolidate before each block's exams.

Supplemental Sources: Pathoma - This man is fantastic Micro Made Ridic Simple Deja Review Pharm MedEssentials for the Behavioral Sciences Questions Kaplan Pharm Cards Vijay's Underground Biochemistry QBanks: Kaplan - Went over it about 2x. World - Finished and then did incorrects USMLERx - Did about 30-40% of it in total. I stopped doing it when they started testing on diseases that literally less than 15 people have ever had in the history of medicine. Practice Tests: Kaplan Diagnostic (After finishing all first time studying) - 79% NBME 11 - 242 NBME 12 - 250 NBME 13 - 264 UW Self Asssessment 1 - 266 Hoping for a score that lines up with what those tests predicted. I'll report back in a month. PM me if you have questions. Coming back to report. I got scores back today: 262/89. Looks like NBME 13 is pretty predictive. Just took my exam yesterday and I want to start off by seeing it was NO WHERE near as bad as SDN made me think it would be. It was easier than any NBME practice test or U world self assessment. That being said, there might be a harsh curve so I not saying I killed it. Just leaving the exam I felt 100% better than i thought I would. Our school have us about 6 weeks to the study for the exam, in which i did UWORLD, RX, and Kaplan. I finished these Q banks in those 6 weeks and also did my incorrect in U world, Micro twice in kaplan, and all biochem again (weakest subject). I split studying up in systems so I would study cardio (for example) 9 am to noon then do questions noon to 10 pm. After that I would do pharm until about midnight with some call of duty interspersed between, of course. I took 4 practice exams and averaged a 260 on them. SO thats how I went about studying. The actual exam: Pretty nerve wrecking taking it but was excited to finally get it over with. My first block was the toughest and the last block was the easiest (random?). I had about 10 questions marked each block but still felt confident about my selections. Whoever said NBME does not use buzz words is sadly mistaken. They were everywhere. 90% of the questions I have seen in before in another form from a QBank. 5% were tricky physio arrows and the other 5% was let me take a random guess and pray. Anatomy: Not much at all. Simple brachial plexus, the classic winged scapula, and not one question on leg or pelvis.

Biochem: This was my biggest surprise. I had literally no questions where i had to recall a whole pathway. It was presentations of diseases that were quite simple. They did have some tricky lab stuff that I could never have studied for, more logic questions. A lot of genetics and inheritance patterns Micro: WOAH MICRO. Talk about low yield ****. I had 8 questions on parasites, worms, treatment of them and what there eggs look like. DO NOT just skip those few pages in first aid. Also look at the egg shapes since first aid does not include them. MMRS covered me pretty well. Immuno: Nothing difficult at all. AT ALL, no crazy CD or cytokines just basic ones we all seen. Heme/Onc: Nothing hard. First aid covered more than enough Behvioral/Biostat: Biggest joke of the test, I wish i spent no time studying. I didn't have to do one math problem with the calculator. Maybe one or two tricky behavioral what to tell the patient next, but can always narrow it 50/50. EMbryo: Some stuff not totally included in first aid but covered during the school year or seen in High yield embryo but only a few questions Pharm: A lot lower yield than i thought. Couple cancer drug questions, one of which i never heard of it but you can narrow it down and take an educated guess. It was basically MOA of the drugs and maybe side effects of a couple like digoxin. No general pharm formulas or anything like that. Cardio: arrows, arrows, arrows and renin pathway is gold Pulm: Smoking, cancer, a couple most common questions Renal: literally nothing except maybe a few simple RTA and RTN questions Endo: just classic diseases with classic presentations and they wanted to know where the tumor was. I think 50% of questions on mine were paraneoplastic syndromes. MSK/derm: not much but a decent amount of term. Maybe like 8 questions on cancer, and what stuff looks like. hyperkaratosis and all that definitions: know them. Neuro: gross specimens with a marker showing a lesion. Pretty tricky but def don't just study this section without looking at MRIs and gross specimen pictures. It was the only way they tested it. Repro: high yield for drugs, and had some breast and ovarian tumors. Memorize those cold Thats all the subjects i can think of on top of my head. Had two audio questions with murmurs and only one question that was grouped with another. And you found out if u get it wrong the second u click next haha. If i were to do it again i would not have studied behavioral or biostat prob at all. I would of done more questions. They were the only thing that prepared me. SO DO AS MANY AS POSSIBLE. I would of also made my test sooner probably. Starting burning out at end.

Hope this helps. Just got my score: 270/91 . This is my first time posting, but I used some of the experiences on this forum to help me prepare so I thought I'd share as well. Plus, I'm really happy that I've done well, and want an outlet to express myself School Prep: I'm in the U.S., so I pretty much just read well-reviewed textbooks while going through my first two years. For most big subjects, I read just one textbook all the way through and reviewed w/ one review book + the relevant section in First Aid before my finals (we had several spread out throughout the first 2 years). Since reading these textbooks was spread over a large period of time, my first two years of med school were actually really pleasant and relaxed. I'd say I studied only about 2-3 hours per day, except before exams when studying would go up exponentially. Here's the general rundown of my sources: Anatomy: Gray's for Students, BRS just for the questions Behavioral Science: BRS Biochemistry: Lippincott's Microbiology/Immunology: Quick skim-read of Clinical Microbiology Made Ridiculously Simple and How the Immune System Works (only took a few days of light reading for both during the summer), followed by Levinson's Microbio/Immuno and Parham's the Immune System during the school year; Microcards sparingly Pathology: ~60% of Medium Robbins and most of Goljan RR Path. Also used USMLEconsult that comes w/ Goljan to review before finals. Did Pathoma during school, right before board study and I thought it was great. I knew I had to review pathology, but there was no way I was going to tackle all of Goljan again. Pharmacology: Most of Katzung and Trevor, a few pharm cards Physiology: Costanzo + BRS for review/questions During Cardio, Pulmonary, Renal, and Gastrointestinal weeks I also read Lilly, Weinberger, Rennke, and LANGE GI, respectively, although for boards those would probably be unnecessary. I also read Blumenfeld for Neurology, which I really enjoyed, and might have even helped for the boards (there was a decent amount of neuro, some of which was quite difficult) I would recommend all of the books I read, although I didn't enjoy Weinberger, Rennke, or Lange GI as much as I enjoyed the others, and again, they were probably not helpful for boards. Surprisingly, although I read an entire textbook dedicated to immunology (Parham), it was still my second lowest scoring section. I did like Parham, but Levinson probably has all that you need for immunology. Usmle Step 1 Prep: I had about 8 weeks of time to prep, during which I did USMLEWorld, Kaplan Qbank (had done a few questions earlier too, before my last finals), Kaplan Lecture Notes (bought off ebay), First Aid, and all the NBME that had extended feedback. Prep was pretty intense b/c I decided to skim-read all the Kaplan Lecture Notes during the 8 weeks, and I hadn't read even a page of it before. I hate re-reading books b/c I get bored out of my mind. In the end, I'm glad I did it since I remembered a few things things on the

exam that I'd learned exclusively from Kaplan. Besides reading Kaplan, I also did exactly two 46-question blocks a day. I might have done 3 once or twice but it was too tiring so I stopped. I did not read Goljan during the board study period, although I'd read maybe 80% of it during classes. Practice Exams: CBSSA in school (around Dec., before doing behavioral science/neuro, both of which i didn't do as well on in this practice): 255 Kaplan QBank: 85% USMLE World: 91% NBME 13 (~6 weeks out): 271 NBME 7 (the next day): 268 NBME 6 (3 weeks out): 268 Prometric (2.5 weeks out): 99% (got one wrong) NBME 11 (2 weeks out): 271 NBME 12 (1 week out): 268 (extended feedback showed me that somehow, I got exactly 6 questions wrong on every single NBME I took) Exam Day: I felt really good through the first 5 blocks, but thought I'd messed up the 6th block before recovering a bit in the 7th. Although I had 20 minutes left over for all my World exams (at least the last 20 or so of them), I never had enough time to check all my answers during the Step, and a few times was unable to check more than 2 or 3 of my marked ones. Like many others have said, during the Step, I wanted to make sure everything I marked was correct, and that takes up a lot of extra time. I also noticed that the test felt harder than the NBMEs. Although the questions are similar, I'm convinced the Step I "hard" questions are more difficult than the hardest questions on the NBME, and so the test most likely has an easier curve. It is very unlikely I got as high a percentage correct on my actual Step as my NBMEs, yet I got the exact same score as predicted. This effect might be more noticeable at higher percentages correct, b/c overall the exam is probably similar difficulty.. it's really hard to tell. Post-Exam: After the exam I felt relieved, but within a few hours I'd remembered a few things I'd messed up on, and for the next week I was feeling pretty bad about the exam. I remembered and looked up ~11 questions that I certainly got wrong on the step, many of which were relatively simple though specific questions about drugs and anatomy. I figured that if the curves were like the NBMEs, there was no way I could reach my practice scores. I thought I might have even done much worse, since I had no memory of that 6th block which I felt I messed up. But as I said earlier, I think the actual Step's curve is less harsh. If you look at the NBME and Step 1 Score reports and compare them side by side, it makes sense that the Step questions would be harder (there is more room to the right of borderline in the step score report... of course this also might just be b/c there are more overall questions). Don't worry too much if you feel bad after the Step. Almost everyone stresses afterwards, and if you don't it just means you have a wonderful and easygoing disposition . The NBME's will probably predict very close to your actual score. Advice/thoughts on if I could do it over:

-If you feel the NBMEs are easy, don't become complacent. There are a few Step questions that require more specific knowledge than the NBMEs test (in my opinion.. who actually knows), so you should still study hard -Cram during the last week. I looked through First Aid during my last 5 days of study, but I pretty much just flipped through it as fast as I could and read bold headings rather than actually reading. If I'd been more careful, there are probably 1-3 more questions I could have answered correctly -Bring food that you really like to eat, and that you can eat quickly -Perhaps look for some anatomy or pharmacology specific practice questions to do (I wish I'd done this) -I regret never reading Goljan's nutrition chapter. It was one of the 5 or 6 chapters I hadn't read in Goljan, and I knew it was one of the items in the step 1 exam content, but in the end I forgot to read it. Reading it might have helped w/ the seemingly nutrition-related questions -Forget about the exam as soon as you finish it. Worrying about it sucks. It might be inevitable if you're the type of person to read a forum like this, but still, it's not helpful. Try. If you have any questions, feel free to ask! Practice scores: NBME 13: 235 NBME 11: 238 NBME 12: 242 Actual score: 248/87

What I did: I read First Aid four times Used BRS physio during the first pass of First Aid BRS behavioral for ethics (everyone should read and do the BRS ethics questions!) Kaplan HY QBank questions: I started them two months before my dedicated step I study time began, and I finished them after I had completed UWorld twice HY Neuroscience: I used this book because the intro enumerates what you need and don't need to know for Step 1. I felt the book was to-the-point, and the CT and gyri images were very high-yielf UWorld: I did the entire bank twice (I think my first pass was in the low 70's, second pass was 95%+). FYI, during the second pass, I was able to do 300-450 questions a day easily Pathoma: I used it during the school year, and re-read it as I did each FA pass. NB: Goljan is unorganized and a waste of time (yes, even the old audio recordings) Did not do DIT because I was told by upperclassmen at my school that as long as you can set your own schedule and follow it, DIT is a waste of money So, what was the key to my success? I believe I did well because I read FA multiple times. If you look at DIT and the Taus method, both stress the importance of reading FA at least three times. My initial pass was two weeks, but in later weeks, I was able to do my FA passes (along with the corresponding Pathoma chapters and 1-2 UWorld blocks) in 9 days; here is my schedule Day 1: Heme/onc

Day 2: Musculoskeletal and derm Day 3: Endo and embryo Day 4: Neuro Day 5: Psych and pulm Day 6: Renal and repro Day 7: GI Day 8: Cardio Day 9: Immuno and biochem I did not dedicate days to pharm and micro; instead, I read a little bit of each chapter everyday Good luck everyone, and I'm happy to answer any questions Skip it. Make sure your book is patched up with the latest errata and stick with it. A fully-annotated, personalized FA is solid gold. US traditional medical student, All qbank scores = random, timed, unused. I am open to questions about any part of it, Kaplan q bank = 68% finished before school ended (march 18) UWorld 77% average Cbsse = 235 8 weeks NBME 13 254 4 weeks Free 150 at site 90% 260 UWSA 1 265 3 weeks NBME 12 254 1 week UWSA 2 259 2 days, Real thing 252 What I did: Started doing some stuff over xmas break. A good time since there you dont have new information coming in at the same time. A good chance to review / solidify what you learned early 2nd year. In January I started the Kaplan q bank doing 1 block a day. School ended march 18 and I started dedicated studying until end of April when I took my test. Resources: Goljian throughout school + lectures at the gym. Read the blue notes in margin in last week. FA- I recommend writing stuff into first aid as much as you can from the q banks / goljian / even some school notes. BRS physio-skim read HY neruo anatomy- look at pictures/ skim. DIT-did in first 2 weeks of dedicated study, I found it helpful to keep me on task and the things he added in were on my test. Tips: 1. Do all you q bank stuff on random. You have to be used to thinking about all systems and integrating information quickly. Doing it system based handicaps you.

2. I highly recommend doing kaplan q bank through before uworld. It is painful and annoying but you get a serious base of information and a good feel for questions even if the answers are crazy. 3. test day- watch out for the time. I finished blocks with 20 min left on u world. I am always someone finished early with tests but I was seriously pressed for time on the first block. You will be over excited / anxious / nervous. What happens is you want to make sure you don't have dumb mistakes and you you spend more time on even the easy questions and don't leave time for the longer experimental types. It can happen to you! Also, don't take too long breaks. Taking breaks longer than 15 min can get you out of focus. got scores back last week. real test: 260+ nbme 6,7,11,12,13 : 260+ didn't use first aid. i think i posted this a little bit earlier, but in a nutshell path: pathoma + Rapid review rest --> kaplan videos didnt really study physio directly qbank: usmleworld

i didnt like first aid too much. i think it sets you up for a 220-230ish score. the other sources above let you dig in deeper. with that said, if you know your stuff, first aid would probably work well I also suggest the Katzung Review book. It's second to none if you want a review of all the main concepts, well-written breakdown of drugs by group, and high-yield review questions - in as few words as possible and packaged into as few pages as possible. As Untraditional said, FA has most of the drugs you need to worry about for the test, however. __________________ Dr. Lionel Raymon in the 2010 Kaplan videos is about as good as it gets. The man is a pharmacology god. On a final note though- I will reiterate that probably the most helpful part of my last week of studying was going through the older NBME exams and looking for recurring concepts they liked to test on. Many of those showed up on my exam. It probably netted me about 20 questions on the exam I might not have remembered. For the actual exam- it's stressful and much more of a time crunch than the practice NBMEs (longer questions, more complicated). I felt like it definitely got to my nerves and I could see myself answering questions wrong during the exam because I wasn't reading things correctly or thinking as calmly as I normally do. For instance, it took my nearly a minute to make the connection that a patient with

diarrhea and pain radiating to the back had a pancreas problem (on practice exams, I'd be in the zone and get this in an instant). My main personal worry is that I missed so many questions on silly mistakes that my board score has very little chance of reaching the levels I was getting on practice tests. Invariably, I expected not to know many of the questions instantly and educated guesses are likely required on a lot of them. This is the same for everyone else taking the exam too. I'm mainly worried because I know I missed easy questions (like really easy questions) for no apparent reason. And enough to add up to it significantly affecting my score (i.e. I could have easily missed 20 easy ones from stress). My personal goal was 80% correct (i.e. 64 or so wrong on the exam)...and I'm pretty confident I came nowhere close to that. I was also marking 15-20 questions/block. And there were probably other ones in there that I wasn't confident about either. Thanks for letting me vent! Not something you wanna talk about with your classmates. if you really wanna be at that level, the word high-yield can't really be in one's vocabulary anymore, that essentially means you nailed all the grab-bag questions that could be derived from anything within a much larger range of material, and you were spot on with the questions that required good reasoning (e.g. good test-taking, spotless understanding of the fundamentals). I'd say to hit that you'd either need to be strong on your class notes along with high yield boards material or extend to resources like goljan rapid review, CMMRS, flip through some pharm flashcards or lippincott's for drugs that aren't in First Aid, etc. Each one of those topics you mentioned is very important to be strong on, and straight phys can only take you so far, since phys questions aren't as likely gonna be the questions that set you apart. That being said, BRS physiology is a must for that level of performance (either knowing physiology at the level of BRS phys from prior experience or having done the book itself). In any case, a 270 is utterly useless and a nutso score haha, and it's likely not attainable from a dedicated boards study period alone and will be much more dependent on prior knowledge from your first two years of med school. Yes this is great. Sattar for the Path. Klatt can supply the Path Images. Goljan for the H-Core Path Review. Raymon could teach Pharm/Biochem. Costanzo/Najeeb for the Phys. Daugherty for the Behav Sci. The rest I could teach myself with review books...except for the gross dissections. Perhaps when we legalize marriage between candy canes and lollipops will this day arise. On a bright note...there was this Dr. Minarcik fellow but he doesn't have A-game. Maybe a A- or B+ game. Subjects: Pathology: A bit trickier than I expected. There werent too many 1st tier give-mes. Almost every question asked a 2nd/3rd tier question about the mechanism, physio, complications/associations. There were more histo pics than I expected. There were a few times where I would assume one diagnosis based on the vignette, but then the histo image showed a completely different kind of organ cancer/damage. I couldnt justify choosing an answer based only on the vignette when the picture obviously shows X. I think they just threw stuff in the vignette to trick you so youd make assumptions without actually looking at the histo. Everything was more or less in FA, but some of the ways they depicted the complication was more conceptual. For example, FA might list X as a complication of this disease, while on Step 1 they show a picture/radiology of that complication instead of flat out saying it in the vignette (I assume so ppl cant rely on trigger words).

Physiology: Definitely glad I did BRS physiology. All the physio questions are increase/decrease (up/down arrows) questions, usually mixed in with some path but occasionally a free standing physio question. BRS physiology really drills how hormone, blood levels change in respect to different things. Having that practice is good here because you can always logically deduce the answer. Even if the vignette has extra garbage to throw you off, it shouldnt bother you if you actually understand the pathways since you find the answer through process of elimination. Pharmacology: Almost all straightforward. I think there were only 2 pharm questions I had no clue on. The other ones I knew without hesitation. Those 2 drugs were super rare and I think were in FA, but they were mentioned more in passing under a path section (not in the more in depth pharm section at the end of chapters). I was generally happy when a pharm question came up because they were somewhat of a break from some of more the conceptually challenging questions that really make you think. Anatomy: Most was in FA. Definitely glad I reviewed neuro/msk anatomy right before the test again. There was one I can remember that was not in FA, but I fortunately randomly knew it from school anatomy. Embryology: This annoyed me bit. Not too much on the test, but the embryology that was there was pretty nitpicky. Again, it was in FA, but there were tiny details youll easily forget. This was one topic I did not review again within the last week of the test. Probably would have saved me 2 questions. Biochem: you either knew it or you didnt. Everythings in FA. If you memorize that section cold, you should get nearly all the biochem. I did review this again the week before and definitely paid off. I was surprised at some of the repeats. Considering how much material they can test you on, it seemed a little ridiculous to me to have 3 questions on the same lysosomal storage disease. Each question was a different concept about the disease, but still, pretty ridiculous they used the same one. Makes more sense to have 3 separate lysosomal storage disease question IMO. Also, they were pretty big on vitamins. One thing I wish I had paid more attention to were vitamin toxicitiesI was good on the deficiencies at least. Also, the night before its good to review which vitamins are used as cofactors in the different pathways. That came up over and overgot most of them but missed at least 1. Wish I had reviewed that the night beforewould have taken a few minutes. Micro: I thought it was all fair. Reviewed all micro the week before. Very glad I did this. Know the main virulence factors and especially lab tests/cultures. Also, the most common microbe causes of diseases based on age group. Those lab charts and age group microbe incidence lists in FA micro section are very very high yield. As everyone has mentioned, know all the fungal, parasites, worms too. A decent amount of histo images associated with the microbes, too. I was usually happy when micro came up since it was stuff you knew right off the bat without hesitation due to the key lab tests. Immuno: Pathoma immune is definitely worth reviewing for this. Hes better at explaining the mechanisms than FA. And when he tells you to memorize certain ILs, chemoattractants, etc, listen to him. There were actually countless questions on these stupid detailsand obviously on these you either know them or you dont. Theres no reasoning through it. Behavioral: pretty straight forward. Everything is definitely in the FA chapter. Easier than the UWorld behavioral questions for sure. Do UWorld questions and youre good. Some of the ethical questions were a bit odd, but I just did what I learned from UW, go with the most open-ended, patient sensitive answer. I think I got these correct for the most part. So, overall, the test is definitely doable. Definitely not harder than UW so if you do those questions youll be well prepared. Read every UW answer explanation. Random things I read on UW helped me get several questions correct. The big difference on the real test was the longer question stems and definitely a bit more conceptual. A few more fake experiments set up, but you still had to use your knowledge to answer them. The answers were not written in the question or anything. As for the impossible questions, I can only recall

maybe 2 questions that were not really doable. They were both very nitpicky cell bio/biochem pathway questions. Definitely not in FA but one of them sounded very familiar from a school lecture at one point. Btw, even tho ppl say the test is more conceptual than expected, the test still tests you on tons of tiny memorization details (biochem, cell bio, vitamins). The test is at least definitely 90+% knowledge-based. They really make sure you understand the concepts of that knowledge, though...i.e. they'll sometimes give you 10 answer choices so you definitely won't be able to guess it. No crazy long graphs or whatever as some ppl claimed. These ppl may have been referring to CO/BP graphs I'm guessing, but these are things you should have seen in your school pharm module anyway. If not, then definitely do BRS physiology. Because it was a bit more conceptual than expected and I was more stressed for time (which generally creates stupid errors), I just hope I broke a 230. A 240 might be possible, but I really have no idea what the real curve is like. If its like the NBME tests (as you in need like a 90% for a 240), then I dont see that happening. If its more like 80-85% for a 240, then maybe. Just glad its over!! 1 week of summer now before 3rd year starts!! jatt12 275 Ok, so let me rewrite my exam experience, that i took on Saturday i wrote my experience yesterday, but that was in midst of hangover lol. Anatomy- Believe it or not i had atleast 3 questions in each block showing brain stem, and other showing s.olivary structure etc, most of them were easy, but had long stem which was kind of pissing me off lol, i had 2 brachial plexus questions, know FA for lower limb nerves, in terms of if you fracture ..... what happens in motor or sensory. I had no female anatomy but one of my friend who was taking exam with me had 1 female pelvic anatomy related question, had 4 CT abdomen basically wanted to know where the particular structure is and identify it, know TIPS and where to create shunt etc. Overall i think anatomy was easy if you know your stuff. Histology: I can't remember but i guess know gap junction, tight junction etc. Embryology: FA is enough, i can't believe i wasted time on school notes. Biochemistry/Genetics: It was straight forward know all the diseases in FA, inside out, sideways or whatever way they all were on exam, easier then uworld. I think i had one or two question from nbme's i can't remember which one though, i had no rate limiting enzyme. Had 2 pedigree in genetics which again was easy to recognize, didn't had to read all the question stem. Microbiology/Immunology: Studied mostly my school notes, which was more then enough. Bacteriology and virology was heavy on mine, but my friend had 5-8 questions in their exam. U world did awesome job in micro and immuno. Know all the receptors like what receptor on T cell know FA cold HINT!!!. Pathology/Pathophysio: I think this was heavy on my exam, board people covered every single organ in my exam. Some were easy, and some questions were like what the hell they asking, it was frustrating because i knew what they were asking and then when i was looking at the options, i would be like could it be B, OR C. Pharmacology: Straight forward, know SE, MoA and drug to drug interaction, some graphs.

Physiology: Endocrinology was heavy plus female reproductive. Behavioral Science/Biostatistic: Ethical questions were nerve wrecking, bio statistic was easier then uworld lol. Know all the definitions etc. Overall i was happy coming out from exam, i had 5 weeks to study and missed all the good weather, but at the end i am glad its over and done with. I would recommend doing more questions in last couple of days, instead of doing FA over and over but again that is my opinion everyone is different, and answer choices were easy, not like uworld where you have to think twice. Hope this help and good luck Also, a lot of people recommend completely relaxing the day before. I'd recommend looking over some stuff though (as long as you're not totally burned out)- I skimmed through some of First Aid, looked over equations, reviewed statistics, and read through some of Goljan's High Yield notes. Goljan's High Yield notes were EXCELLENT and I got a couple questions right simply from reading through that the day before. I'd also recommend knowing statistics stuff well, the questions are straightforward and can be an easy way to gain points. Obviously don't stay up late studying. I took the evening to relax and went to bed early. The bold is actually very good advice. Based on various posters' thoughts over quite a bit of time now, I've come to think that the last day should be used for the Goljan 36-page HY-pdf (there are also 120and 125-page ones), last-minute review of equations/charts in FA, and for USMLE CD (free-150). A few people have suggested the former two for the last day (you being one of them); Pollux (who got his 276) did USMLE CD one-day-out. Hi guys, I felt an urge to post on SDN because I have visited the forums on and off for the last year or so for some extra tips. Just took the test recently and got my score...and I just wanted to share my feelings about it with ya'll My school gave us six weeks to study..the last week was a waste because I was too burnt out. These are my practice scores: Resources: FA 2012, Pathoma, UWorld, Goljan lectures Practice exam scores: NBME 6 : 221 (6 weeks out) NBME 11 : 240 (4 weeks out) UWSA 1 : 253 (3 weeks out) NBME 13 : 235 (2 weeks out) NBME 7 : 254 (2 weeks out) UWSA 2 : 253 (1 week out) NBME 12 : 254 (3 days before) Real score : 256 I took a lot of practice exams..probably because I didn't like studying first aid..lol. Ideas about preparing for the exam not in any particular order : 1. Class ranking is really not as relevant as you'd think for this exam. I guess the strongest correlation between class ranking and board score is that the higher the class rank, the higher the work ethic, etc.

Overall though, the actual board exam is SO much more basic than what is taught in class. The goal of class is to prepare you to become a good doctor, not a good step 1 taker. I know so many top ranked students in my class that did much worse than average students in our class. The amount of preparation going into the boards is the strongest indicator of score, not how well you did in your classes. 2. Resources are not all that important.. Okay, I admit I never hit the 260 range so if you are aiming high for 260s, then skip this post. However, for most non-genious-sdn posters, a score in the 250s is pretty satisfying. I was ecstatic about my grade. 3. The only resource that you should focus on are UW and FA. And between these substances, FA is 100000x more important. UW has a lot of helpful tricks, don't get me wrong, but it also has a lot of detail that is not in FA. If it is not in FA, consider the material low yield. I cannot overemphasize how important it is to pound in FA, rather than try to pound in multiple sources. FA is so dense in and of itself - I don't know if most people can memorize it in its completeness. Expect many "one liners" from FA to appear on your exam. 4. The actual test is more like the NBMEs. If you have been familiarizing yourself with the UWorld style of examining, then I recommend taking at least one nbme(probably 11 or 12) .to familiarize yourself with the way they ask questions. REVIEW THE ONES YOU GOT WRONG, because it allows you to realize the types of mistakes you made. It also enhances your TEST taking ability. Lots of treatment questions on the NBMEs are actually PRACTICAL and basic (i.e. choose the one that costs the last amount of money) Check the SDN forums for the answers to one's you got wrong... Again, the NBME questions have a lot of "hard" questions but the answer choices are so distinct that you usually end up getting a much higher percentage right than what you'd "expect" after taking one. 5. Pathoma is good...,,,.for concepts. I know people love Pathoma, and trust me I do, but even this resource is too detailed for step 1. I reviewed Pathoma 2 days before my exam (one day cram review) and I felt like I knew it cold. I'm pretty sure this may have gotten me one or two extra questions right at most. For the amount of time I spent trying to memorize it though, it definetly was not high yield. Pathoma is a HARD book to memorize cold - it is deceptively dense. I could've spent more time on FA and UWorld which probably would've got me more questions right but overall I can't say too many negative things about Pathoma because the first half of the book especially is incredibly helpful for understanding pathology. 6. Goljan is still the king. His lectures are definetly not outdated and honestly, it takes at least one or two passes through FA before you realize just how powerful Goljan lectures are. He brings together so many different concepts...and you can listen to him while you're exercising, etc 7. The most important thing you can do apart from FA and UWorld is to improve your test taking skills. How can you do this? Make a separate sheet of paper that talks about "mistakes" you made based on tricks. By the end of my studying period, I had accumulated more than 10 pages of common "tricks" that appeared on NBME exams and UWorld. Read the question and study why you made a dumb mistake and what the test makers were getting at. I cannot emphasize how important this is. JUST like what everyone else is saying, the actual test is about : 1. Minimizing dumb mistakes. 2. Recognizing what the question is asking you. You can improve both of these by doing practice questions. But when you do practice questions, think critically and ask yourself "why did I get this wrong" or "what's the trick here" rather than just looking at the answer. These are simple ways but extremely worthwhile ways to improve your NBME practice exam scores. 8, FA and UWorld has all the info you need. Understanding all this info though, can be difficult and that's what you should use other resources for. If you are weak in other areas, then read through a review book and annotate the info into FA. EVERYTHING is pretty much a supplement to FA 9. People that thought the actual test was way harder than UW or the NBME's probably didn't do enough practice questions. Okay I apologize in advance if that may offend some people, but in all

honesty after doing 1000 NBME question and 2500 UW questions I am extremely confident that about 80% of the test was like the nbme and 20% was like UW in terms of difficulty. 10. The actual test is around 10-20% experimental. This is from the intro in FA and anecdotal evidence. Honestly, I feel that this is one of the most underrated topics. Who cares if someone got a crazy question on a new gene? Crazy questions are probably more likely to be experimental than not. My point is, don't worry about learning about some redundant minutia. Reinforce and know the high yield COLD. If it does appear on your exam, the other answer choices are distinct enough for you to make a good guess on the answer. If anyone wants extra help, just message me. Good luck everyone. 11. In summary, FA+UWorld+NBME's are what I would reccomend to everyone. Get Road Map Gross Anatomy and Read the clinical correlate boxes. It covered every anatomy question that popped in in UWORLD and my step 1 test Total time off for study: 6 weeks NBME 11 (immediately prior to 6 week study period): 247 NBME 12 (4 weeks before exam): 259 UWSA1 (3 weeks before exam): 265+ UWSA2 (2 weeks before exam): 265+ Prometric Site Practice (weekend before exam): 270 (based on medfriends calculator) Real USMLE Step 1: 266 Prep leading up to study period: First Aid, Kaplan Videos, Goljan audio Prep during study period: First Aid, Pathoma, BRS Physio and Path, UWORLD (90% completed with 85% average), Kaplan QBank (45% completed with 84% average) I know this has been said by many successful test takers in the past, but the MOST valuable resource that you will ever have for this exam is a personalized, well annotated copy of the LATEST version of First Aid. I see dolts skimping on the $30 and using a 1-2 year old copy of FA and I want to vomit. I just can't fathom how you could value $30 over any shred of an edge that the latest info could give you. That said, I had annotated a ton of stuff into my FA 2011 during my M1 and M2 years. Early during my study period, I copied all of those annotations into the 2012 version (effectively refreshing all of that information) and then used the 2012 from that point on. The next most valuable resource was UWORLD. 90% of the value of UWORLD is in the explanations. Not only should you seek to understand why an answer is correct, but also why all of the other answers are wrong. As a test taking rule of thumb, all of the answer choices could actually be correct given a different question stem (ie. none of the answers are made up things). Thus, if you know how the stems for choices A, B, and C would look and your stem does NOT look like that, you give yourself a whole new way to whittle down the answer choices. I will say that my real exam required a lot less problem solving than UWORLD and a lot more weird recall info. Also, I wholeheartedly recommend Pathoma. I think it is definitely higher yield than listening to Goljan lectures or reading the way-too-dense Goljan Rapid Review. Finally, dont freak out after your exam if you feel crappy. I didnt feel as confident after the real thing as I did after any of my practice exams just because there were so many awkwardly worded questions that I couldnt be sure about. I think if you come out of Step 1 feeling like you killed it, you either possess true one in a million talent or (more likely) you are an overconfident tool that is about to get a rude

awakening. For the rest of us, knots in your stomach are normal. Just relax and youll be rewarded soon enough! NMBE 7: 235 (took right before started studying) UWSA1: 264 (3 weeks out) UWSA2: 263 (2 weeks out) NMBE11: 263 (1 week out) Real test: >265 Resources: Pathoma (best ever!), goljan audio (hated his book; pathoma a million times better), FA, UWORLD, BRS phys Total dedicated study time was a little over 5 weeks, although I wish I would have taken it a week earlier. I was starting to get burnt out and felt ready. My biggest advice is study your ass off during the year. I did this and when it got time for dedicated study time I felt I already had a good grasp on most of the material so it was easy just to review everything. Also, I bought a year long Uworld subscription and started doing questions around november. I started off super slow (7 questions per hour). As the year went on and especially during dedicated review I got a lot faster as my knowledge base increased so I didn't have to write everything down. I would read every single word of the uworld explaination meticulously and anything that I was unsure about/liked the way Uworld explained it I would annotate in FA or pathoma (I know a lot of people that wouldn't go over correct questions or would superficially go over the answers. My biggest advice is to meticulously go over everything even right choices you were sure of b/c the explainations often have other information that is really good. This is why getting UWorld early is a good idea IMO b/c it gives you time to do this). I finished UWORLD with about 2 weeks left and then redid another 400 questions. But after I finished UWorld my FA was annotated with all of the hard concepts of uworld so I really didn't need to redo the questions. I also did pathoma during the year multiple times and then again multiple times during dedicated review. I pretty much knew the whole book cold and this was really the best resource for the exam. If you know this book like the back of your hand you will get a lot of questions right b/c of it (start the book at the beginning of MS-2). I also had a lot of imaging/anatomy on my exam which I did spend quite a bit of time studying so I would recommend doing that as well. Pharm was a joke and everything in FA. I must say though that if you want a high score focus more on the other sources and just use FA as a skeleton. I really only ready FA cover to cover one time and skipped the path parts in it b/c I used pathoma for that. FA was good for all the drugs/biochem/micro/embryo. Other that that I used it mainly for the Uworld explaination I annotated to clarify things. Also DIT sucks. If you want a high score not get it waste your money (it might be good if you want an average score). I started it for half a day and stopped after all they do is read word for word w/o expanding on anything. Any other questions feel free to ask. FA - obvious; good in some parts, not so good in others Goljan RR - This was good. I wish I had read it during the year while covering blocks though. I skipped the heme section, however. Too long

CMMRS - I highly recommend reading this book for Step 1, if not during your micro class. I definitely got a few questions right because of this book. BRS Behavioral Science - It was OK. I'm glad I read it, as I felt weak in BS, but I don't know that it is necessary. Pathoma - I think Pathoma is awesome. That said, I think I would have utilized it better during the year as an introduction to each patho block. The lectures were awesome, and I definitely felt it was worth the 100 bucks. The heme section was clutch. The neuro section, however, needs to be supplemented. High-Yield Neuro: I didn't like it. I eventually just focused on FA for neuro. I thought it was good. BRS Physiology: Definitely use this. Like everyone has said, it's a great text. FA is NOT enough for physiology IMO. DO student here: top 5 in my class; studied my freaking butt off for the USMLE and COMLEX. SDN helped me so much so I'd like to give back. I'll write more later, but here it is for now. Studied the following: 1. Kaplan Qbank starting in January; did all disciplines but added in systems as we finished them; 70% cumulative 2. First Aid 2011 annotated with Kaplan and some class notes 3. Goljan x2 during each system and ~once more during dedicated time 4. UWorld saved for dedicated time; done by systems in untimed mode; 81% cumulative Practice exams: 1. NBME 11: 252 (5 weeks out) 2. UWSA 1: 256* (4 weeks out) 3. NBME 12: 245 (3 weeks out) 4. UWSA 2: 257* (2 weeks out) 5. Free 150: 93% (3 days out) Real deal: 255 *I felt these were more predictive since I had done UWorld by systems/untimed and not random/timed mode. Just a thought. So ecstatic; my goal was 250. I was thinking I would either be between a 235 or a 250+ depending upon whether my nerves got the best of me. Thanks to all the regular posters on SDN who give out really good advice on studying and how to tackle this beast. My score isn't the crazy 265+ that is so common on SDN, but if anyone would like any study advice or tips I would be more than happy to help. Thoughts on the exam: This exam is not about memorization. The beast doesn't care if you remember that anti-Yo antibodies are associated with cerebellar and Purkinje cell degeneration in patients with small cell carcinoma. If you can't synthesize information and think on your feet, you're toast. If you want to do well on USMLE, you need to work on understanding mechanisms behind the diseases you study. This exam is not about the what; it's about the why. Protip #1: focus on understanding the Big Picture and it will take you far. Keep studying and work hard and you can achieve your goals. Feel free to PM me if you have any questions; I learned a lot by PM'ing people around here who hit scores that were my goal.

***Edit: My MCAT was a 24 (no lie), so don't worry about any "correlation" that may exist. If you want it bad enough and work hard enough, you can achieve your goals.*** Got my score today: >265, 90 I feel so truly blessed! If anyone has any questions please feel free to PM me! My Path section was the most narrow and I did pathoma 1 time at the beginning of studying and then listened to other sections again the last few days before my test and thought he did an awesome job and was super high yield for my test. Also, practice questions! Originally Posted by BrnEYEDgrl I took the exam on monday 6/18. Had 6 weeks to study, which at about 5 weeks I was getting burnt out and starting to feel like I was forgetting stuff I had known a few weeks back. This is my breakdown and the resources I used: NBME 7, 12 weeks out to get a baseline: 219 NBME 11, 4 weeks out: 247 UWSA 1, 2 weeks out: 263 UWSA 2, 1 week out: 265 UW 1st pass: low 70s% UW 2nd pass: low 90s% I used FA throughout 1st and 2nd year so I was pretty familiar with it. I went though it in-depth one time during my 6 weeks, then would just refer when needed. Pathoma: HIGHLY recommend! I got a number of questions on my exam correct because of a few oneliners out of his book. He does an awesome job explaining basic principles to help you understand a concept, rather than just memorizing it. He was the only resource I used during my first 2 weeks of studying and my score jumped up to 247. I re-listened to a few of my weak sections the week before my exam and was glad that I did. UW: cannot stress this enough!!! I would say that more than 50% of my test on Monday was a question that I had in UW, maybe not exactly the same, the real test seems to give you more labs, vitals, etc. that you don't really need to answer the question, but they were close enough. A lot of the figures on my exam I had seen in UW too. If I had to do it again I would have gone through UW one more time, at least the ones I missed or had. marked Goljan: I listened to him throughout second year with each system course and loved him but only listened to a few lectures throughout my board studying. I would say his first few hours when he discusses cell injury, hypoxia, etc. are the best, but if you really want to understand a concept then pathoma is better, in my opinion. I also went through all of the questions in the Red robbins questions book. I think these are a good representation of the real test questions in terms of length and the fact that they give you a lot of extra information that you usually don't need to answer the question, such as BMI, BP, pulse, etc. Pharm: FA is definitely all I needed. All of the drugs on my exam were 1st order questions and super high yield, nothing tricky.

Micro: Most of the micro on my exam was high yield, straight from FA. There was one parasite question that you had to know what it looked like to answer the question. I looked it up on wiki after the section and the picture on the test was straight from wiki, but probably not worth stressing over for 1 question. I am absolutely terrible at biochem and just went through the UW biochem questions a few times and felt very prepared for the questions on the test. My exam was pretty heavy on cardio and respiratory but other than these subjects it had very little emphasis on concepts. I think I had 3 embryo questions, all I recognized from UW or FA. I had quite a bit of anatomy, maybe like 2-3 per section, many were easy points that everyone knows but there were a few difficult questions, overall I would say 1-2 that weren't in UW or FA. The night before my test I went through the rapid review section in FA which is SUPER high yield. I would say at least 50% of the test can be easily answered if you know this section cold! There were probably 10 questions on my test that I had absolutely no idea what was going on and that couldn't be answered using FA. Around half of these were ethical type questions, which were very subjective or just terminology that are not in FA. The other 2 were molecular biology/lab technique questions that I may have learned in undergrad but haven't seen since then. I am a very slow reader and I finished most of the blocks with 12-15 minutes left, which gave me plenty of time to go back and look back over the questions I had marked, which I don't know if that was really a good thing because I know of a few that I changed from the right to wrong answer... :-/ Anyway, I will update when I get my score. Hope this helps! Good luck to everyone! Originally Posted by ipizzy Real deal: >275!! High enough to be personally identifying, so I don't want to be more specific... sorry guys What I did: 1. Gunner Training, largely finished with banking before started doing any qbanks. 100% banked, 89% mastery by test day 2. First Aid 3x, spread out over 3-4 months 3. RR Path 1x, spread out over 1 month 4. Kaplan qbank 1x, spread out over 3 months; 85% correct 5. UWorld qbank 1x, spread out over 3 months; 90% correct

Took NBMEs 7, 11, 12, and 13, scores were in 265-275 range. Most important for me was studying hard and getting the most possible out of the first two years of med school. After that, GT was absolutely essential in my case; I often got bored reading review books

and had a hard time focusing on them, but GT felt more like a game and it was kind of addictive. I also knew that 1) I tend to panic when I feel time pressure and 2) I was incapable of focusing and retaining info that I study in marathon 12-14 hr+ sessions, so I spread my studying out comfortably over the year. Thank you to everyone who has posted before; advice on SDN has been incredibly helpful for me. And big congrats to everyone getting scores today! I found SDN to be very helpful during my study time, so I guess I should contribute a little bit more than one line. UWSA #1: 240 (1/17/2012) NBME #7: 266 (2/10/2012) NBME #12: 261 (2/19/2012) NBME #13: 259 (3/08/2012) CBSE #1: 260+ (99) (3/09/2012) USWA #2 265+ (3/18/2012) CBSE #2: 260+ (99) (5/11/2012) CBSE #3: 260+ (99) (6/06/2012) Real thing: 269 (6/13/2012) How I studied: I did every single NBME I could get my hands on. There are 10 altogether for a total of 2000 questions. Then there are the ~140 questions that you can download from the USMLE's website. These questions can and DO repeat on your actual STEP1. Also questions from your schools CBSEs and subject NBME exams (pathology, pharm, physio, etc.) will also repeat word for word on your STEP 1 exam. If there's something you're not 100% sure about on those exams, make sure to go look it up. Because that saved my ass on a few I would have otherwise not known. I started USMLEWorld mid way throughout the first semester of second year. I basically tried to use it as a study tool for the subject NBMEs that we took at the end of each block. I reset USMLEWorld right before my dedicated study time. I did about 60% of Kaplan QBank. I have very mixed feelings about this question bank. I think it's worth the money if you have the dedication to go through the low yield **** they throw at you, but I personally didn't have the patience to go through it all. I did all of USMLERx once, basically alongside my second year pathology and pharmacology courses. I think it's a great bank for reinforcing First Aid, but you have to parse through a lot of low yield bull**** at times. My general strategy was to convert First Aid into digital flash cards. In the end I had a huge excel file that basically had every fact in First Aid converted into a question of some sort. It was a pretty time consuming process. I'd make them organ system by organ system throughout all of second year so it wasn't as burdensome. I watched a good chunk of the Kaplan videos once and Pathoma twice during my dedicated board time (5.5 weeks). I was listening Goljan audios my car and my ipod when I went jogging throughout the year,

but I never took notes from it or used it seriously as a primary study source. I didn't use Rapid Review Pathology or any other review book. I tried to read BRS Behavioral Sciences but gave up after 2 or 3 chapters. I hate textbooks. I need someone to be force feeding me the material to really learn. In retrospect I should have taken the exam a lot earlier than I did. I got extremely burnt out in the last two weeks and basically spent a good chunk of my days playing Diablo 3 and Mass Effect 3. A third year told me half way through second year that you shouldn't take STEP 1 after you peak. I didn't believe him at the time, but boy was he right. My last recommendation is to maybe check out some of the pathology that is in First Aid for STEP 2 CK pedatrics section. It's not the highest yield thing to do, but for damn sure I had questions that were covered by that book that aren't in First Aid for STEP 1. I think as they try to make STEP 1 more and more clinical, they're going to be drawing more and more on STEP 2 vignettes to stump the MS2s with **** they've never seen before. Good luck to all you future test takers. 262/89 I'm unbelievably happy since I'm aiming for a competitive field. FA 3x UW 1x (quite honestly I think 2x is a worthless waste of time, but each to his/her own) Goljan RR 3x (during school; I still strongly believe this was NOT a waste of time) Kaplan biochem

http://www.kaptest.com/Affiliate_Network/Feature_Content/Medical_Content/AF_marketing_USMLEs trat1.html http://www.kaptest.com/Affiliate_Network/Feature_Content/Medical_Content/AF_marketing_usmledi stract.html http://www.nbme.org/ http://www.gunnertraining.com/programs

Step 1-252 Advice: 1) Take all NBMEs with extended feedback and make sure you review all the questions and use the forums to identify the correct answers. There were def a few repeats of similar question concepts/pictures on the actual exam. Also, it is def the best predictor of your actual score and should give you confidence if you are doing well.

2) FA-Obviously the best...need to understand everything in it and make sure to remember seemingly randomly facts throughout book as some will def show up on ur exam 3) UWorld-Best Qbank by far...annotate ONLY this into first aid,Go through the bank 2x (spend the majority of first time understanding it and 2nd time focus on all missed/marked questions first then review the rest to pick any details in incorrect answer choices that you might have missed), Use it as a learning tool (Do it untimed, tutor instead of timed, random), Use the practice exams as assessments like nbme to get used to the format of the exam as it is exactly the same. Take one NBME and one Uworld a week before to get used to the format of exam. 4) Goljan RR/Goljan Audio-Excellent for pathology, book is prolly overkill but def make sure to look at mechanisms and definitely look over all the pictures esp a few days before the exam; Heard pathoma is great as well and will probably get you to the same score Other resources I'd recommend: Kaplan Biochem/Pharm Videos w/ Lecture Notes, Annotate into the book as you watch the videos. Anatomy/Neuroanatomy videos are good as well and I'd recommend watching them if you are weak in those areas. Def do this before your dedicated study period as going through videos/lectures notes takes a lot of time. Used Kaplan Qbank didn't think it was that great probably don't need it. I'd just recommend doing Uworld a second time over Kaplan. Def take your own notes on concepts/questions/whatever mechanisms you have learned, do this from the beginning of your dedicated study period and dedicate one day a week to just reviewing these notes w/ annotated first aid/uworld with no new material that day to prevent forgetting what you learned early on