Introduction



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Part I is a series of high yield study questions delivered to your customized dashboard along with concise video answers provided by physician educators (total of 340 questions).

  • Part II consists of focused high yield videos that incorporate active learning principles and MD educators. Each video comes with a corresponding study guide, which contains study questions, notes, diagrams, study hints, and quizzes.

    Finch Program – Cognitive Processing-Based Review for Step 1 (CPR-1) http://www.rosalindfranklin.edu/DNN/home/CMS/EducationalAffairs/USMLE/Description/tabid/2423/Default.aspx

    • Classroom instruction for USMLE Step 1 and 2

    • Location: Rosalind Franklin Medical School in North Chicago, Illinois from January – April (14-week course).

    • Tuition: $6,000 (housing not included). Student housing is available for an additional fee on a first come, first serve basis.

    • Course is designed for students who have been unsuccessful in passing Step 1; especially students with multiple attempts. Not intended for students who have not taken the exam.


    USMLE Tutor

    http://usmletutor.com/

    • Online one-on-one tutoring available for USMLE Step 1 and 2

    • Location: web-based learning and Skype tutoring sessions

    • Tuition: Rate information not available.

    • Students must have a webcam and be able to use Skype

    Med School Tutors

    http://www.medschooltutors.com/usmle.html

    • One-on-one tutoring available for USMLE Step 1, 2, and 3

    • Tuition: Rate information not available.

    • Program dates and timeline is based on student’s need and a diagnostic test undertaken by the student to assess strengths, weaknesses and goals.


    Fox Tutors

    http://www.foxtutors.com/subjects/USMLE_Tutors.html

    • One-on-one tutoring available for USMLE Step 1 and 2

    • Location: Students can arrange for tutoring across the country with availability in Boston and a various other cities.

    • Tuition: Rate information not available

    • Offer medical tutors, medical school tutors, medicine tutors, surgery tutors, and test-taking tutors.

    Kaplan Live + Center + Online

    http://www.kaptest.com/Medical-Licensing/USMLE-Prep/step-1.html

    • Offers three featured programs with varying weeks of Live preparation course, continued tutoring at a local center and online access to Qbank Plus

    • Location: For the Live portion, students can arrange for tutoring across the country with closest availability in New York City. Center locations also across the country with closest availability in Boston.

    • Customizing plans also available with varying weeks, LivePrep (6 or 7 weeks, or 14 weeks), CenterPrep (3, 6, or 9 month), and Qbank Plus access (1-12 month).

    • Tuition: Between $3,699 - $11,499. Does not include housing.

    ADVICE FROM YOUR PEERS
    These words of wisdom are from your peers in previous classes who have successfully surmounted the challenge of Step 1:
    From MD14

    1. Stick to your schedule. Everything could always use more time, but the more you keep with what the schedule says, the calmer you will be and the greater chance you will feel prepared for the date you


    planned.
    2. Do more NBME exams. World was fine, but I wish I had spent less time trying to get through that Q- bank and more time doing NBMEs, which were so very similar to the actual test (I even got the same
    question).

    3. Find a study buddy. I started studying with Joe in December, so we were able to see that we worked well together. We ended up creating a strict daily schedule and held each other accountable.  I also didn't feel lonely and knew that I had someone to talk to who knew exactly


    how I felt.

    * * * * * * * * * * *

    Would spend the morning and early afternoon doing things I enjoyed, specifically being outside, reading non-scientific books, etc., while maybe skimming notes over breakfast. Made sure to exercise and meditate each day. In the afternoon, would go to school or a library for 8-10h and spend time outlining First Aid but most importantly answering Qbank questions and going through the answers, writing down the concepts I was unsure of. Best advice I received was to keep the studying patterns that worked for you so far in the pre-clinical years. Enjoyed studying around but not with others to stay disciplined but not distracted. Listened to Goljan in the car at times and found this helpful in spite of his personality.

    Think the schedule was important, putting weakest (neuro) and broadest (micro-ID) areas first. Included several flex days for more time on a subject or a half-day off. 6 weeks was plenty of time-- more time would've been detrimental, because would've lacked motivation early on. Bought extra books (BRS neuroanatomy, micro made simple) but wish I hadn't, Qbank and First Aid were plenty. The 2 practice tests from Qbank very accurately predicted my score (taken within 10d of the actual exam).
    * * * * * * * * * * *

    1. Stick to your schedule no matter what. If you can get a little ahead do it.

    2. Do the big topics first: Bio, Neuro, Micro, Drugs. Doing it early helps you save some time and energy for when you burn out at the end. I would also try to do subjects you feel weaker on in the beginning to allow time to boost your score in those areas. 

    3. Do questions every day! Some people try to get through all of UWorld. I didn't but getting through at least 60% is probably a good goal. I also would aim for average or better than average on each test.

    4. Keep reviewing drugs and micro every day. These were topics that repeatedly came up in all subjects so it's best to just keep reviewing and not wait until the end. They all sound the same and you'll just get them confused if you wait too late. 

    5. I made sure to exercise 3-4 times a week just to have some time to myself. It was a great stress relief and a nice break. Within the last 2 weeks I wasn't able to exercise as much, but at that point it was crunch time. I also tried to take Sundays off to do life things: shop, cook, laundry, etc.

    6. Don't wait until the last week to do practice tests because it will freak you out. I wanted to wait until I got through most if not all the material before taking full practice tests, but I wanted to leave enough time to adjust. 

    7. NBME undershot my score by a lot. World Bank Assessment was the closest predictor of my score but was still under.

    8. I thought I could have used 7-8 weeks in total to prep for the test, but mentally 6 was my limit. I was so burnt out and stressed by the end that I just wanted to take it and get it over with. There is no need to prep any further because it'll just tire you out. If anything, getting a head start on drugs and/or micro may be useful.

    * * * * * * * * * * *

    Practice exams (NBME) predicted my score really well, within 1 to 3 points. The UWorld assessments were within 10 points.

    I only took 4.5 weeks, and it was plenty.

    UWorld, First Aid, Goljan path and lectures, were the key things. As for anatomy, it was helpful to go over some key CT scans / X rays, but anatomy ends up being kind of low yield.



    * * * * * * * * * * *

    In full disclosure, I did within a standard deviation below the mean. This is pretty consistent with my preclinical exam performance. 

    What worked was making a schedule, which I'd never done before but helped remind me I was making progress. I didn't leave space for time off, but took time when needed and had left some days at the end for questions only as was advised, so I ended up covering everything. I also treated it like a job as advised, used the study rooms in the new building which worked out great except for the first year exam week. I would have liked more time with just doing qbank questions, re-reviewing my wrong answers, etc. I probably had 20% left. I loved the progress bars by subject, even though it was dismal at first. For numbers orientation (for those who find that helpful), I was hitting in the 30s when I started reviewing, by the end I was averaging 70s. 

    What didn't work was all those extra textbooks. There just wasn't time to use those before the study period, nor even during. Mine were free from a friend, but I would otherwise have spent hundreds better spent on another month with the Qbank. I was never one for textbooks. Don't change horses mid-stream was good advice. 

    My CBSSA score was pretty close to my final. I took it 3 days before the exam. I would probably have done that earlier in retrospect, but all of that costs money. For that amount, you'd get more value from the qbank because it tutors you, while the practice exam just slaps you in the face for $50 and 4 hours of your time. It's also emotionally costly, and though I was usually not one to sweat exams, your self-confidence is not something you want to mess around with close to the date by taking and re-taking practice exams. 

    In retrospect I could have benefitted from more prep time, which was also in line with my preclinical routine. 5 weeks would have been enough were it not for some unforeseen family drama, so it ended up being more like 4 weeks. Still, I'm glad I didn't keep pushing it off. I needed that time afterward to see my family and re-group before third year. 

    I bare bonesed it: First Aid, Lange pharm cards (should have just started reviewing these bedside before sleeping in January), and the UWorld Qbank. I would not have had time to review another resource in the 6 weeks, so no regrets there. I may have benefitted from buying UWorld sooner, but every additional resource comes at a price. 

    * * * * * * * * * * *

    What worked?  Looking at sample study plans, reviewing plans with admin & older students. Having a set study plan.   

    How did you maintain sanity/balance?! Took Daily Breaks for lunch, dinner and to work out. Also took 1 half day or full day off to hang out with friends or family. 

    What would you do differently knowing what you know now? I would have started mixed Q banks earlier than the 6 week study period 

    How closely did your practice exam (CBSSA or Q-Bank) predict your actual score? My actual score was ten points higher than the CBSSA and around the same as the USMLE WORLD QBANK. 

    What resources were most helpful? First Aid, BRS Physiology, Goljan Pathology. USMLE World Q Bank. pharm flashcards  Least helpful? Having more than 3 books is unhelpful. 

    What advice that you received was most/least helpful? 1) Questions Question Questions. 2)having Day off Days 3) Knowing yourself and your study habits so you can create a realistic and feasible study plan

    How long was your prep period and was it long enough? 6 weeks - the length was perfect. 

    * * * * * * * * * * *

    What worked?  What didn't?

    I found that the strategy of simplifying my sources of information worked well. I only used First Aid and USMLE world Q bank. Reading through First Aid a week before the test helped consolidate a lot information that I hadn’t quite understood fully. Definitely try to go through world more than once (I got through it about 1.5 times).



    How did you maintain sanity/balance?!

    I tried to do something fun at the same time every day. For me developing a fixed routine was key and I’d go to the gym or play soccer before dinner every day.  I also treated myself to good food the whole time, which didn’t do my sanity any harm!



    What would you do differently knowing what you know now?

    6 weeks is a tad too long. I would have taken the exam halfway through the fifth week. Before you hit the 6 week study period, it’s hard to believe that anything other than the maximum amount of studying time is ideal, but given the sheer volume of information you want to take the exam when you feel like you know the most (you can’t know it all) and I found 5 and half weeks was my peak.



    How closely did your practice exam (CBSSA or Q-Bank) estimate your actual score?

    I took both Q bank practice test and two NBME exams. The first Q bank test was 3 weeks into studying and it was 10 points less than my other scores. I got the same score on the other Q bank practice test, the two NBME tests, and my actual exam – yes, the SAME score 4 times in a row!



    * * * * * * * * * * *  

    I studied for 5.5 weeks and would have been happy with 4.  My NBME double average was 3 points shy of my actual score, with a spread between the two NBME tests of about 25 points, which seemed like a lot.

    The best advice I received was to focus only on First Aid and World Q bank; the worst was that the highest score you could make only using those was in the 220's.  You can probably get in the 270's with those resources alone.  They are more than enough, and keeping your resources thin allows for a second pass.

    I liked to keep track of things in first aid that I thought I wasn't going to be able to remember: each day I would write a list of questions down on a piece of paper and scribble out answers.  I'd go back through that list the next morning.  Sometimes a detail would make it in on the list three days in a row, but in that way it allowed me to remember the more tedious facts.  Taking real structured notes, however, is just too time consuming for such a short period of time.



    * * * * * * * * * * *

    What worked?  What didn't?

    What worked: reading the sections of first aid for the subjects that I was weaker in, or found intimidating - i.e. Neuro and Micro. It’s not a matter of covering ALL of it, but rather some of those pages in good detail.


    What didn’t work - trying to study 12 hours a day. I studied 8 hrs. a day in the beginning, and closer to ten at the end. Always say to yourself, "it is better to spend 6 good hours than 12 unproductive hours on google/fb/email".
    How did you maintain sanity/balance?!

    I took one day off a week. period. this turned into a half-day off 2 weeks prior to the exam.


    I also went to the gym. Between leaving, running, showering, and getting back to the med school, this took about 2.5 hours. I did it 5 days a week. I STRONGLY recommend this tactic as it did wonders on alleviating my stress level.
    I also took 20-30min naps, whenever I was tired. This may sound counter-intuitive, but it came under the category of making my study-time of the 'highest quality' possible.
    What would you do differently knowing what you know now?

    Honestly? Nothing! I got engaged, I spent 1 day a week with my fiancée, and I stayed physically fit and slept 8 hrs. a night. I was within 4 points of my goal Step1 score.


    How closely did your practice exam (CBSSA or Q-Bank) predict your actual score?

    I took CBSSA Forms 11 and 12 ten or eleven days before the exam and it was 16 points LOWER than my actual score. I heard that the WORLD forms were labor intensive and more stressful.




    What resources were most helpful?  Least helpful?

    I used FirstAid, Goljan Pathology, WORLD, and online pharmcards. I found that I barely had enough time to review Goljan - I ended up reviewing chunks of it as needed, more like a reference – never mind any other materials.


    What advice that you received was most/least helpful?

    most helpful - DO NOT get caught up in your numbers. You can generally track how you are doing on WORLD, but remember that some people take WORLD Q bank as a review after studying all the material, while others use it as a learning tool. I highly recommend that students use WORLD as a learning tool, not a confidence booster/shaker. You can trend your own numbers to see generally how you are doing, but don’t get stressed about being at/above/below the average for your Qbanks.


    least helpful - that you should be studying 12 hrs. a day, and take 1/2 day off every 2 weeks. That would have seriously burned me out.
    How long was your prep period and was it long enough?  Too long?

    I would have liked 3-4 more days - who wouldn’t?! - but in retrospect I think it was enough time. Perhaps an extra week would do more to decompress the situation and allow for the 1 day/week off while still having 2+ days for each major subject.


    Friends of mine who intensely studied and then, last minute, decided to take more time, did not seem to be better off for it. Instead, they just seemed unnecessarily stressed for a longer period.
    * * * * * * * * * * *

    1. My Biggest Mistake: Spending too much time reading ALL of the UWorld Explanations. People told me to do this, and I did. But the explanations are dense and you don't retain a lot of it. Better approach - try to take away one key high yield fact from each question. Otherwise, you will spend too much time with this and not using your other resources (this is why I had to take more time than the allotted study period). Key to this period is efficiency. Be efficient.

    2. Timing on the Real Exam - The trend on the USMLE is for longer, more complicated clinical vignettes. Longer than World Blocks. I was finishing with 15-20 minutes left on world blocks, but was down to the wire on the actual test. Just more to read. Be prepared for that.

    3. NBME's 11, 12, and 13 are more challenging. These were released in the last two years and are more reflective of the changing nature of the test. Buy the "Expanded Feedback" option ($10 extra dollars) so you can review what you got wrong. If you need the answers (they don't give them to you), google it. Some group of med students on some forum is talking about it and through crowd sourcing you can figure it out. The answer choice structure at least were identical to some on my actual test.

    4. Don't isolate yourself. If you study better alone, check in with a fellow test taker every week for one hour. It makes you feel less alone.

    5. Devote some time to subjects Brown doesn't cover that much on, like Ortho. Know everything about the Rotator cuff.

    6. I liked the Goljan Path book because it explains more "why" which is what the boards are about instead of just FA where it is facts. But at the same time you can't ignore FA because it is more comprehensive of other subjects.

    * * * * * * * * * * *

    What worked?

    Surprisingly (or maybe not so much), staying off Facebook was crucial. I chose not to deactivate my account just as a test of my resolve; instead, I deleted the app from my phone, turned off email notifications, and literally changed my password to “DONEWITHSTEP1” so I would think twice before typing it in prematurely. I saved so much time by not logging onto Facebook – and I stayed much saner by remaining in my state of studying bliss instead of finding pictures of all my undergrad friends going on spring break to exotic places.


    And, of course, focusing on questions was the most valuable thing I did. I went through the entirety of USMLEWorld’s question bank once and subsequently went through all of my incorrect answers once. I then used the software to find the categories where I had done poorly and redid question blocks from those categories repeatedly. Doing so helped me master those categories and also helped me psychologically – there’s nothing like running up your score to make you feel like you’re going to ace Step 1!
    What didn’t work?

    The study schedule that I had created earlier that year. I’m still glad that I created one (it helped me plan out what areas I needed to review and how many days I could take off), but I ended up completely changing my order around in several places. Don’t get stressed if this happens to you! I ended up spending a few minutes every weekend re-calibrating my study schedule based on what I had done the previous week and what I wanted to get accomplished in the coming week.


    How did you maintain sanity?

    Having a daily routine was very helpful for me. I went to the gym every afternoon, even the afternoon before my exam – doing so helped me feel like I was in control. I tried to get up at the same time each morning and I tried to go to bed at the same time each evening. That way, even though my study schedule (the schedule that I had planned months before and then unceremoniously abandoned) was changing constantly, I still felt like I was in charge.


    The day before the exam was definitely the most nerve-wracking for me. To keep my sanity that day, I only looked at pictures from Goljan Rapid Review / First Aid / online that entire afternoon/evening instead of trying to cram in more details. I definitely would recommend this to all of you – cramming the day before Step 1 isn’t worth it!
    And of course, Alex and Emily have no reason to lie – if you push your exam back instead of taking a week afterwards to celebrate, you’ll just feel miserable. I was part of a 13-person delegation to Cancun in the week after we took Step 1, and I’ll be honest that it was the most relaxing and enjoyable week of my life!
    What would you do differently knowing what you know now?

    I wouldn’t have bought so many prep books! First Aid, Goljan Rapid Review, med school notes, and USMLEWorld were more than sufficient for me.


    What resources were most helpful? Least helpful?

    USMLEWorld was by far the most useful resource, followed closely by First Aid and Goljan Rapid Review Pathology. I ended up buying a few other test prep books but barely looked at them because First Aid and Goljan provided me with more than enough material.



    How long was your prep period and was it long enough? Too long?

    I actually think I was the first person to take Step 1 in my class, and I would argue that our prep period was adequately sized. More important than the number of days you take is the study style you use – are you being an active studier (taking notes, highlighting, etc.) instead of just reading? Are you being a productive studier instead of trying to study with Facebook/CNN open? Are you transitioning to a purely practice-question state of mind in the week before the exam? And most importantly, do you have a vacation or something epic to look forward to after the exam? And in case you don’t think you have anything to look forward to afterward, I’ll tell you now – Step 1 studying is awful, but you’ll love your clerkships and you’ll love being a real “student doctor” instead of just a “medical student.” Good times are ahead, promise!




    From MD13


    • “My one major piece of advice would be to emphasize the U World questions over attempting to memorize First Aid. Going through the World questions slowly and reading the explanations completely is something I wish I'd done more of. Now that I'm thinking about it, one other thing would be to take more time off. Going into the test with a clear head is much more valuable than a couple of extra study days would be. … our coursework in the first two years is really the best preparation. I wouldn't advise anyone to do too much preparation before the actual study period, unless it's to get comfortable with some of the resources like First Aid that will eventually be used during the study period as you study for each block.”

    • “One immediate thing comes to mind:  On test day, bring your NSAID (anti-headache) of choice for just-in-case.”

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