USMLE Step 1 Experience by Abeera Ali (Class of 2012) - Score 254

USMLE Step 1 Experience by Abeera Ali (Class of 2012) - Score 254

Salam, I just got my usmle step 1 score and since reading about my seniors’ experiences helped me a lot, I want to share mine with you.
Material used:
Kaplan series
Goljan pathology
First Aid 2012 and 2013
High yield biostatistics
Conrad fisher ethics cases
Internet resources: Webpath and neuroanatomy3d
Videos: DIT
Qbank: Kaplan and uworld
I started studying step 1 books as my textbooks during my studies so by the time I had graduated in March, 2013 I had given at least one read to:
Whole Kaplan series(except biochem), Goljan pathology, First Aid 2012, High yield biostatistic, conrad fischer ethics, patho and pathophysio from offline Kaplan Qbank (I didn’t use the rest.)
I don’t know how useful that was since I didn’t start my official prep till August, 2013 3 months into my housejob. By that time I am sure I must have forgotten most of it but I guess I was more confident and comfortable then so I didn’t review much of it again.
I started with FA 2013, adding a bare minimum from Kaplan and web resources, annotating it properly with uworld offline. It took me a little more than three months. I also tried to review what topics I had studied with my study partner, discussing and comparing our FA notes. It was a lengthy process but one that I found extremely useful and continued till the end. In mid of October I took 2 month subscription of online U world, did  1 to 2 blocks in random timed mode each day, read all explanations of incorrect and marked questions and tried to review my now-quite-hefty-but-all-encompassing-FA for my weaknesses. I used DIT videos to read through FA in topics that I found too boring or elaborate like HIV, Biochem, neuro and US healthcare system.  Then I started with NBMEs taking them offline quite regularly. Finding a reading room buddy to discuss all answers with was a huge boost to the overall efficacy of the nbmes. I took my exam date after taking online nbme 13. I spent the last week before exams trying to review my weaknesses like hereditary and storage diseases in biochem, immunity, onco genes, formulas and stuff but in truth I mostly complained, watched movies, checked out the photographs in FA2014, reversed my nocturnal cycle and did nbme 15 online.
I found it extremely useful to ask seniors about their assessment scores to estimate my own prep, so I recorded my own as well for others. Don’t look too deep into it, results vary from person to person and situation to situation.
DATE                                     EXAM                                                                                    SCORE
13/11/13                              nbme 2 offline                                                                  172/200
17/11/13                              nbme 1 offline                                                                  168/200
24/11/13                              nbme 3 offline                                                                  174/200
03/12/13                              nbme 4 offline                                                                  177/200
18/12/13                              nbme 11 offline                                                                                176/200
24/12/13                              nbme 5 offline                                                                  174/200
05/01/14                              nbme 13 online                                                                 610         247
10/01/14                              nbme 7 offline                                                                  177/200
14/01/14                              USWA 1 online                                                                  740         260
15/01/14                              nbme 6 offline                                                                  174/200
20/01/14                              nbme 12 offline                                                                                178/200
22/01/14                              USWA 2 online                                                                  770         263
26/01/14                              nbme 15 online                                                                 640 254
29/01/14                              USMLE STEP 1                                                                    254
I am terrible at reading any book more than once no matter how bad my understanding was in the first read, so I found extremely difficult to review FA again and again which is of utmost importance. I tried to compensate my weakness by doing all nbmes. That helped me in:
Lowering my expectations of scores, building stamina, getting in better shape for real exam, not freaking out on seeing out-of-the-blue questions and timing my breaks
But in reality only reviewing FA again improves the score.

Actual Exam Experience:
I spent the last day before exam resting, packing food for an army, arranging schedule permit and passport and fretting about totally unrelated things. At 10 00 pm I took a panadol for my stressed out aching neck and shoulders, took zolpidem 6mg to fall asleep, imposed silence and curfew on my household and fell asleep. I had tested zolpidem a few days back to ensure I didn’t feel any daytime drowsiness. Alhumdulillah I had a good night sleep, woke up at 6am , said my fajjar, prepared more food(I wasn’t taking any chances!), said two nafals, set all my family on prayer mode from 9 to 5 esp. my mom and went to prometric centre in FC college.
The actual exam felt like an extension of nbme 15. There were a lot of repeated questions from earlier nbmes some in style, some exact word to word. Exam centre environment was okay. There was this new carpet smell that somehow always manages to get inside my eyes instead of my nose but I persevered.  The repeated power supply shortages were annoying, the system didn’t shutdown but the emergency lights and sirens caused disturbance so I kept my noise cancelling headphone on at all times. The glare from the screen got too much for me esp near the end. I’d recommend all those who wear spectacles to get anti-glare glasses…they help.  In my case I used teardrops to ease the strain during breaks. The time for each block was sufficient to complete it once but not to review marked questions later so I’d recommend you do each MCQ well the first time. I expected to have no clue of 4-7 questions per block so the fact that there were weird anatomy questions that I had never read, some population genetics questions that I could not even grasp or questions from facts in immunity that I knew at some time but had forgotten to review before the exam, didn’t undo me during exam.
From my nbmes I knew I was incapable of doing 2 blocks in a row so I took a break after every block. The signing in and out, plus the long distance from the cupboards that stored all my precious food wasted most of the break time so that I had to take 7 minutes out of my last block to get my much needed last break. I utilized my breaks to eat(of course), walk in the sun, use loo, and pray a short version of zuhr and asr. I was quite drained by the time I reached last block even with my early morning coffee, panadol extra after 2nd block and nestle cold coffee after fourth.
In conclusion, I believe that the fact that nothing went disastrously wrong during the exam or the night before was solely a blessing of Allah Subhanutaalah. In the days before result I was expecting a score in 240s with just a tiny part of me hoping to touch 250s. Allah has been most gracious to bless me with 254.  
Things I did right:
·         Having a well tested (azmooda from prof preps!!) study partner throughout the preparation.
·         Annotating FA with uworld and using it as sole resource in last 2 months
·         Having a study partner for offline nbme answer discussions
·         Studying in reading room and not taking breaks for more than 3 days at anytime
·          Regularly hanging out with friends and family to de-stress even sometimes against their wishes J
Things I did wrong
·         Procrastinating on biochem, delaying it to the last month thus wasting precious time and energy though I don’t think it affected my biochem prep much
·         Not taking nbme 15 extended version, which points out your incorrect answers, even when I was advised to. You need assurances for your correct answers but you don’t have time to discuss all mcqs with anyone in the end
·          Not eeviewing highyield immunity and biochem facts in the last three days. I was just too tired and bored
·         Not reviewing Conrad fischer ethics book in the last month. I had done it during my mbbs when my basis of ethics weren’t really strong. It had a lot of shady questions in which every answer seemed the right answer. Nbmes ethics questions were more straight forward. I think there were a few questions in exam I could have attempted better if I had checked this book out again.

I hope this helps you guys out …though it sounds a lot like rambling of a raving mind to me. If you have any questions feel free to ask me and best of luck for your exams! 


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