So I was holding off on making this until I got my score report, which fortunately arrived in my inbox this morning. First off, a note to those on the island:
Start studying now. The only students who should be partying and laying on the beach are the ones who are getting straight As. If you are not part of the aforementioned, go read a book. If you scrape by during your tour of duty on the island, you are going to be in for a world of pain when you register for the Step1. I pulled decent grades, and though my Step1 prep was still a horrible experience, I was able to keep it to a relatively short 7-8 weeks. With that said, I'll start by describing what I did.
I decided to save 6000 dollars and forgo the Kaplan retreat, which was packed with AUA students. A very large portion of my class enrolled in this program, which is completely useless in my opinion. From what I've heard they simply hand you the Kaplan lecture notes series and read out of it during 8 hours of class per day. You're then expected to go to your hotel room and study an additional 8 hours. Rinse and repeat 6 days a week for 6 weeks. I doubt I could share a crappy hotel room with another person and study that long. If you practice good study habits you should be able to get through a lot more material on your own and see much more significant returns.
So I moved home from 5th semester in Baltimore around the end of April and started the Step1 registration process. It's imperative to start this as soon as possible because you won't be able to select a test date for the turnaround time, which is 4-5 weeks. I wasn't able to pick a date until the end of May, and the earliest available date was the towards the end of June. I ordered First Aid 2009 and chucked my 2008 version, ripped it out of the binding and stuck it in a binder at the advice of Matt. I then took a self assessment to get a feel for where I was and scored a 185, which is the minimum passing score. I realized I had a lot of work to do and started working through FA.
After about 2 weeks I managed to get through the subject based portion of FA. For those who aren't following, this covers behavioral science, biochem, embryo, micro, immuno, pharm, and path. I was putting a solid 6-7 hours a day and cross-referencing everything with Wikipedia. I took another NBME and scored a 212, which was better but still below my target. 2 weeks later I had finished the entire book and took another NBME, hitting 231. During this month I was spending 3-4 hours a day reading and 2-3 hours during questions in USMLEworld, which is a decent question bank somewhat close to the actual Step1 questions you'll see.
At this point I felt more confident with the material and stopped reading FA, devoting my time to doing a buttload of questions. I first subscribed to USMLERx, which is a question bank based on FA's material. The explanations include a page # in FA containing a relevant topic, so it turned out being extremely useful for drilling core concepts into my head and exposing myself to very high yield common vignettes. I tore through the 3400 questions in USMLERx in close to 10 days. After that I subscribed to Kaplan Qbank, which featured questions significantly more difficult than Rx, a ton of media-based Qs, and questions geared on straight recall rather than concept-based puzzle solving. In my opinion the actual Step1 was an eclectic mix of UWorld and Kaplan style questions, so I found it worthwhile to do both. I completed the 3200 or so Kaplan Qs in another 10 days. I took an NBME on June 2nd and another one on June 19th, scoring 247 on both, so I figured I had peaked.
During the last few days I just chilled, relaxed, and fixed my sleep schedule. On exam day I woke up at 9am after about 10 hours of sleep, had breakfast, showered, and watched TV. I had a full lunch at noon and went to my test center for my 1pm start time. I brought some powerbars, powerade, and vitamin water. The exam allots 45 minutes of break time for you, to be used between blocks at your discretion. If you finish a block early the remaining time is added to your break. I finished each block with about 10-15 minutes to spare, and managed to take a 15 minute break after each block to listen to some music, take a few sips, and focus. Its quite nerve wracking when you're in the hot seat, so its crucial to stay calm and relax yourself between blocks.
The exam itself isn't worth mentioning, because the question distribution is skewed across every test. For instance, my test was predominately cardio, endo, and repro. I could have skipped over all of renal and GI and done about the same. The only sound advice is to know everything. I got trashed by anatomy because I neglected it and saw a ton of questions on pelvic muscles and lower limb blood supply. I also lucked out by skipping embryo because I only had 3 questions, and they were all on fetal alcohol syndrome. Ask someone else what their test was like and they'll say something entirely different. 95%+ of the questions were covered in First Aid, however.
If you are on the island these are the books you should be reading:
Anatomy: the Moore book was quite good. CTs and MRIs are big so look over a few of those from every level.
Histology: Ross is sufficient. There is a lot of cell biology on the test these days so its worth going through the first few chapters in Robbins.
Biochem: Lippincott covers everything.
Physio: BRS physio is extremely high yield and I advise reading it
Neuro: High yield neuro or Road map has all the CTs/MRIs/gross sections you'll encounter.
Micro: I used Lippincott but everyone swears by ridiculously simple so choose at your own discretion.
Pharm: Kaplan lecture notes are great. Dr. M shamelessly plagiarized the Kaplan book and sells it to you guys for like $60 so it would behoove you to print out the pdf in the library rather than pad his pockets for stolen work.
Pathology: Goljan Rapid Review path is a must read during 3rd and 4th semester. If you don't read it you are disadvantaging yourself immensely.
Behavioral: For some reason they neglect biostats, which comprised 80% of the behavioral questions I saw. Therefore you are obligated to learn it on your own. I used BRS behavioral.
I should also mention that I didn't touch any of these books after 4th semester. I exclusively used First Aid and the various question banks listed during my prep time.
UWorld: 68% 100% completed
USMLERx: 76% 100% completed
Kaplan: 74% 100% completed
UWorld self assessment #1: 185
NBME 6: 212
NBME 2: 231
NBME 3: 247
Free 150: 260
NBME 4: 247
Final score: 247/99
If anyone has any questions I'd be happy to answer them.