USMLE Step 1 (after Step 2 CK) Experience (Score: 268)
by Dr. Ansab Abbas Haider
I began preparing for my step 1 after I got my step 2 result. I had about 3 to 4 months for the prep. I knew I could not spare time to go through all of Kaplan books and then do First Aid and UWorld all in the given time frame, so I jumped straight to First Aid. I had taken step 2 before so I was confident I could use First Aid right away.
I began with microbiology, assuming I would be good at it and did it in about a week. Really couldn’t gain much momentum as reading First Aid was really hard. Someone advised me to use Doctors in training videos to make FA easy to read as they were mostly based on First Aid. So I started them. Although they were old videos and were based on FA of 2010 while I was reading 2014 so I found it hard to go back and forth finding stuff from the new FA but I still managed to complete FA using the DIT videos and reading all the extra stuff from the new edition of FA. Its important to mention here that I skipped completely genetics and biochemistry because I could not get a hang of them from DIT or FA at all as I was pretty weak at them. So I got hold of Kaplan and read the whole thing cover to cover in a week and then re did the subject from FA which was now easy to understand. I skipped psych and biostatistics lectures from DIT on purpose because I had done them extensively for step 2 and I didn’t need to listen to DIT for them, so I just read FA for them. Although DIT videos are meant to review the whole of FA in 14 days but since it was my first read of step 1, it took me a whole month to do the thing. I won’t recommend DIT videos highly but yes, if you have done step 2 or you are trying to read FA without having gone through Kaplan recently, it makes it a lot easier and makes FA less dry.
Next I got hold of Pathoma and did the whole thing with its lectures in a week doing 30 pages a day. Pathoma covers the pathophysiology very well but it really lacks in clinical presentation so for those who are taking their first Usmle exam really need to cover that from Goljan and Uworld. If you’ve taken step 2, a single read of pathoma should suffice.
After all of this I did a second read of First Aid, extensively reconsulting Kaplan for biochem genetics and Immunology. I had all Kaplan books but used them only when I felt that I could not understand something mentioned in First Aid.
For my step 2 prep and the experience that I shared previously, I strongly recommended online Uworld. But against my own advice I got hold of offline Uworld. The only reason for this was that I was short of time and it would have taken me forever to make notes of Uworld from online. So I did the offline thing for 16 days. I could not finish the last book which was pharma but other than that I solved it all timing it manually. I scored around 90% so that really boosted my confidence.
Then I got a study partner who was around the same stage of my prep and together we did our final read of FA. We did the whole thing in around 7 days and I believe that was the best way to do it; real fast and discussing all the important stuff.
Next we started doing NBMEs; we did the first 5 NBMEs and NBME 7 and 11, all offline just for the sake of practice. We timed all the blocks offline and discussed all the questions and tried to look for explanations of the difficult ones. I think first 6 are quite irrelevant to the present exam and the only advantage of doing them is for the sake of practice. So even if you skip them, its no big deal. Form 7 and 11 are a little better but still far from the real exam so you might want to use them but use them early in the prep.
At this point we had about 10 12 days left before the exam. And I had yet not done the online UWorld. So, I subscribed for the Uworld and did the whole thing in 7 days. Doing 7 blocks a day was like taking step 1 everyday for a week and this was what really got my stamina going. I was doing blocks in about 35 minutes a piece. Although I did 4 blocks straight with 5 minute intervals, then a good 2 hour break followed by the remaining 3, but it still really build my stamina for the real exam. I only read the explanations for questions I got wrong or I thought I had answered with uncertainty. For the rest I only read the 2 lines of summary, even left those for very obvious ones because I didn’t have time for it.
The very next day after I finished my UWorld, I took Form 13 extended version. It was a good form and I ended up having a 260 on it, which was a good boost.
Next day I took form 15 extended version which was relatively easier than 13 (my opinion only) but I ended up scoring 260 again which was quite reassuring. Although, I made some silly mistakes which I could have avoided by reading the question stem more carefully. So I knew I could do better if I paid more attention.
Next day I took the latest Form 16 extended version and got a score of 264 and at this point I knew I was in my best shape to take the exam. Not to forget I discussed all 3 online forms with my study partner in the evening. Its really important that you take the online forms so you can exactly know which questions you got wrong and which ones you got right.
Next 2 days I did the following stuff:
A real quick glance at Immunology, Gen patho, gen pharma and genetics from FA
CT scans from the web
Some electron microscopy and Gen patho images from Webpath but nothing much.
Microbiology images from the microbiology section of FA and some other images like worm eggs from google.
Limb anatomy tables (all the muscle attachments, actions and nerve supplies from Snells anatomy)
Spent the last day doing very little except for the heart sounds.
One thing very important; I still continued doing 2 blocks a day from Uworld, using my marked and incorrect pool. The only purpose for this was that during my CK exam I had done no questions during the last week and I felt that had hurt me on the exam day. So despite studying my weaknesses, I still kept on keeping my neurons wired to solve questions. Trust me on this, if you leave questions for 4 5 days, the next day it really feels hard to focus when you solve questions.
Last day had a terrible sleep like most of us do. Went to bed at 10 but got up at 2 and could never sleep again. Neverthless, I didn’t bother much about it and went for the exam the next morning with all the confidence I could gather. I took my exam during Ramadan, so a piece of advice, don’t fast on exam day if you intend to take it in Ramadan. You really need fuel to keep you going.
The exam started off well.I had really good first 3 blocks (which is rare btw). I was finishing my blocks in about 40-43 mins. And used all the remaining time to re-visit my marked questions. I think because I had practiced my mocks on 45 min blocks I had the advantage of sparing myself all that extra time to think over those hard questions which USMLE loves to throw in every block. And I really think that made a big difference. Blocks 4 and 5 were really hard and but I still managed to finsish them in 50minutes again sparing myself atleast some time to think over the hard ones. The last 2 blocks went quite smooth and that’s how my exam ended. I walked out somewhat uncertain about my performance because of a lot of questions that I had answered based only on ruling out the other options or being caught between 2 options. The only thing I was happy about was that I had not rushed through the questions and had given each of them a good thought, and I had that feeling that I would score decent even if not great for this very reason.
I know it’s a total mess whatever I wrote down but I’ll just point out the things in my prep that I feel made a difference for me:
1. Doing FA 2014 early in the course of my prep and making it my prime book.
2. A quick 1 week review of FA with a study partner within a month of the exam.
3. Doing the UWorld in a week. It sounds crazy but it built my stamina for the exam
4. Not getting out of touch with questions till the very last day.
5. Doing forms 13 15 16 extended review while discussing them with my study partner. The best forms to know what you can potentially score
6. Practising to do blocks well in time. Really important.
7. NOT talking to every other person who posts about his or her exam on the web. Trust me you have to decide whom to talk to and whom not to.
And as I write today about my exam experience, I have my score that beat all my expectations. I really thank my friends who had taken their step 1 and helped me through the prep. And my family for bearing my mood swings:P
All the best to you folks out there for your exams.