For those of you in 5th semester or about to take the USMLE here are my thoughts on my form. I haven't seen anything like this here yet. I passed, so this info should be good. I posted it in www.prep4usmle.com and everyone seemed to like it. It got 5/5 stars, but only 4 votes. Btw, prep4usmle.com comes highly reccomended, worth tooling around. As most of you know, every form is a little different, so those of you that have already taken it, please feel free to comment. So here's what I would have done differently:



First, make sure you know all the *basic*-basics. What I mean by that is there were a lot of questions where they asked such a basic question that you might have overlooked it in studying. You know that question on the shelf instructions, "The heart is part of what biological system" and the answer is "cardiovascular"-- well there were about 40 or so questions that basic on my form. Some so damn basic I hadn't seen since biology 101 class... Stuff like, "how many sacral vertebra are there?" or "what's tRNA wobble?" or "Which DNA is left handed?" or "What color are gram - bacteria, red or purple?" You know the type of question that just makes you go, "Awwwwwwwww damn... Are you kidding me????? Dammit..... what the heck was that???? Dammit... Craaaaaap....." Also, these questions are very unsettling becuase you either find yourself spending extra time looking for the "trick" or beating yourself up because you can't freaking remember which chromosome Fragile X is on.

You will probably take so MUCH longer to take this exam. I was taking 50 question blocks in about 25-30min on average on Qbank. But on my exam I almost ran out of time twice. I was so slow. So, my advice to you is learn how to get your 50 question blocks done in about 30-45 minutes while still taking them seriously, because you will run out of time if you don't learn to go fast.

Before I say anything about the stuff I used, I honestly believe that, on my form, if I were to have simply memorized word-for-word First-aid, listen to Goljan a few times and kept doing Q-bank over and over until I was at >90% (this of course meaning that I was repeating questions and probably had them memorized, but I knew "why" the memorized questions were right), I would have probably gotten a 240+. Seriously. I only remember a handfull questions that couldn't have been answered with First-Aid. And they were really random, esoteric crap like the pattern of injuries seen in someone that is hit by a car. I had to go look that up: waddel's triad- ipsilateral femur fractur and contralateral tib-fib fracture, abdominal injury and head injury. Which is really a "quatrad" but I think the LE fractures are counted at one. Luckily, I guessed right on that one.

Ok, I believe this will raise your score about 20-40 points and if I had failed I would have gone back and did this: Go to <A href="http://www.stepprep.com/" target=_blank> and do the all First Aid quizzes. For each one you don't answer 100% correctly make a note card, even the "oh-yeah-that's-right-I-knew-that" ones. If you missed it, make a note card. Yes, you will probably end up with about 300-400 note cards, if not more. Drill yourself over and over and over until you memorize those bad boys cold. Keep going back to them over and over.

For pharm, I highly recommend the BRS pharm cards. I had those cards memorized cold (not just the answer, also the little factoids, too) and I would run through them about once every other day. This was my only resource for pharm, except for the formulas in FA. There was not a single question on the boards I did not know about pharm. Unfortunately, there was not a lot of pharm on my exam. Believe it or not, the questions weren't like qBank at all, there were a lot of stupid ***, random graphs.

For micro, I highly recommend the MICROCARDS by lippincott williams. Just like pharm I had these memorized cold and because of it, all of my micro questions were pretty easy, I felt. Oh, yeah, memorize every diagnosis decision tree for micro. There were a lot of those 'clinical picture of Influenza' and the answer is "helical, enveloped, - sense, segmented, ssRNA virus" type of questions. Also, know all the toxins and how they work. There were a few 'clinical picture of tetanus' questions and the answer is something like "bacteria whose toxin prevents GABA from being released" or something like that. You will have to use another source, like FA, for bacterial genetics, though.

The "High-yield molecular biology" book is beyond ******, almost required reading. I highly recommend memorizing the last chapter which is on second messengers. There were a lot of "NO exerts it's activity by activating which of the following: " then you would have one of the following: Cyclic GMP or cGMP or PKG or some crap like that as one of the answers. You need to know every second messenger and whether they are cAMP or cGMP, IP3, TK, TK associated, serine threonine, steroid or TK Phosphatase and how each of those pathways work down to the nitty gritty. They are all in FA, but I like the way they were presented in HY better. That just might be me. I even had a random question on insulin and the son-of-sevenless protein. Come to think of it, I had a lot of molecular biology.... lotsa biochemical tests and stuff. Not, a lot of "biochem" per se, however (like enzymes and pathways).

As for physio, in the same vein of the last paragraph, know every hormone's function. My exam seemed like the physio was 90% endocrine and renal. I can't really remember a lot of respiratory or cardio. Maybe it's just that I suck in renal and endocrine, I don't know. Get to know all those physiology graphs well, with the arrows and crap. Those are my worst; I freaking hate those. If I had failed this bastard, it would have been because of these type of questions. They are everywhere on my exam. Maybe like every 8th or 9th question. It was almost comical, but not really since it was my exam.

Finally, listen to the Goljan lectures until they are just about memorized. **AT LEAST** 3 times. I would say I got at least 30-40% of the path questions right simply because of those lectures. The Lange path cards are awesome, too. I would say another 30-40% were straight from them. Either Goljan's notes, Kaplan or BRS are more than sufficient as a review text, almost overkill. To be honest you could skip probably the Kaplan or BRS path or Goljan's text--- FA, Lange cards, Qbank and Goljan audio is more than enough *if* well memorized and understood.

Anatomy was mostly a joke, but I did have a 2 really picky questions on random muscle insertions.

I wouldn't worry about any images that much at all. Maybe like about 2 or 3 days on webpath right before the exam. Seriously, I had maybe 20-30 pictures total and 2/3 of them you didn't even need the picture. Only one picture was a "What in the heck is that?" picture. Also, the pictures tend to be really small.

Also, the CD that they send you, make sure you know those 150 questions cold. Someone posted that on one of the bulletin boards, so I really studied them. I swear I think 3 or 4 questions were the exact same questions. They say on the CD that they are not so maybe I'm imagining things. But I swear....

Which questions were closest to the exam???? I would have to go with the NBME. I only took one of them and got a 510, I would recommend taking both of them if you want to afford it. My Qbank scores started out at about 55% (50-60%) and were about 70% (65-75%) towards test time. I made a note card for every missed question and drilled myself over and over until I knew them. I studied lightly for about 4 months (0-3hrs day) during my classes and hard for about 1 month (8-12 hrs/day). Hopefully I didn't fail.

K...if you have any questions just ask. Oh, yeah, yes, before I get flamed, I do know that Fragile X is on chromosome 16.