Preparation for usmle step 1 agreement form

PREPARATION FOR USMLE STEP 1 AGREEMENT FORM

STUDENT NAME_______________________ __________________ DATE_____________

(Please Print)
After reviewing all of your options for Step 1 preparation please complete the appropriate section below. Your preparation plan must be reviewed and approved by one of the learning specialists. Additional guidance and suggestions for your plan may be provided. You are required to complete the plan for which you are approved. Return this completed and signed agreement form to the Counseling and Education Support Services Department (G012 Dykes Library) by Friday, January 20^th, 2017.


_______ #1 – KU Step Prep Course:

Course dates: April 10^th – 28^th

Campus attending: Kansas City Salina Wichita

Program includes 2 NBME practice exams, 3-months of USMLE World Q-Bank, and 2 USMLE World self-assessments for small group work

Payment Options for Step Prep: Personal Check, Visa or MasterCard, or direct bill to your Student Account

_______ #2 – Other Live or Online Program:

DIT Kaplan HY Becker Integrated Cases USMLE Rx

_______ #3 – Self Study:

Question Bank(s) Being Used:
If doing an online program or self-study plan, you must attach a calendar showing your study plan. Please specify how you are going to prepare for your USMLE Step 1 exam - note any Question Banks, study group activities, preparation course(s), study aids, etc. that you will be using. Please provide your target date for your USMLE Step 1 exam, knowing that you must sit for the exam on or before Sunday, May 21^st, 2017.
USMLE Step I Target Exam Date: _______________________________

Signature: Date:

Approved: Date: ___________________

Appointments may be scheduled online at https://medconsult.kumc.edu or calling 913-588-6580