mapleLeaf
01-26-2008, 01:54 AM
Hey everyone after 8 months of studying I finally passed the Step 1 !
I am writing this post to help the people who graduated from basic sciences somehow and don't have more than a passing familiarity with the material either because there was too much turmoil at their school, they didn't study etc. Whatever the reason, don't worry about it now, it's done. No regrets, just move forward. Be thankful you got out of basic sciences and recognize since you don't know anything you have to start from scratch.
First of all get First Aid and read the introduction that tells you about the exam. Now just browse through each subject material quickly. Just flip through the pages. If the material looks like alien scribblings that make no sense to your mortal mind that's a good way to confirm you need to start from scratch. If the material seems pretty familiar, you understand what they're trying to tell you, and extra facts are flying into your head around the material then you probably have a good base around the subject and don't need to worry about it too much. When I browsed First Aid the only things that made sense to me was Embryology, Behavioural, Genetics, and General Pathology . The rest was incoherent. But not to worry, by the time you're close to done studying, the whole book will make sense and you'll realize it's a glorious book that you can use to review a subject in a few hours. But until you're at a point to understand it, it really serves no purpose. One Note - I used the 2007 First Aid that was divided into systems. Although a great book, it had an insane amount of errors that I had to spend a good few days correcting from the correction made on the rumors were true (http://rumorsweretrue.wordpress.com/) . It was the first site that popped up when I put "First Aid" errors in Google.
So first, understand the core of the subjects. For this you need to study Kaplan videos, goljan, or various review books according to what you like. Remember you are not trying to know everything in the subjects, but to understand thoroughly the subset of info in the review materials you use. No textbooks are needed. If some concept in the review books are too concise for you to understand then don't blur over it, make sure you figure it out. Either search another review book for a better explanation, the internet, friends, forums, whatever. Just don't skip the material, especially in high yield areas.
First Phase:
BRS physio - took a week and read it thoroughly - excellent book you will keep coming back too. Then did Kaplan Physio video + book. The guy's awesome. I was lost on pulmonary from reading books until I watched this guy.
Neuro - First tried to read high-yield neuro. I got through some of it but a lot of it was over my head. I watched the kaplan videos while studying the kaplan neuro book and things made a whole lot more sense. Make sure you're concentrating on being able to identify the stuff you're learning about on imaging and diagrams while you're learning.
path - I used BRS path, Goljan audio/slides, Goljan Rapid Review, General Pathology (http://library.med.utah.edu/WebPath/GENERAL.html) , and Organ System Pathology (http://library.med.utah.edu/WebPath/ORGAN.html) . I stopped using Goljan Rapid Review after reading a few chapters because it was taking way too long. And just used it as a reference sometimes to look up things. I think it's kinda overkill with the other resources I mentioned.
Biochem - Kaplan videos and book + First Aid
Pharm - I studied pharm from First Aid. An understanding of the physio of autonomic receptors, kidney, and heart is also tightly coupled with your learning of pharm. Sometimes I would read a bit of Kaplan pharm or watch a few Kaplan pharm videos if I found myself getting confused or just not knowing where to focus. Honestly I learned most of my pharm while doing questions later. First Aid lists too many side effects for each drug while not telling you which are actually the most important and likely to be tested. They just throw in the really important side effects with the list of all the side effects and you would never know that they're really important and highly tested until you start doing questions. Also you don't really understand how they ask mechanisms of action and couple physio with it until you start doing questions either.
Micro/Immuno - Watch the Kaplan videos as a prep. They're short and general. After that I just memorized the specifics in First Aid and glanced a bit at some of the tables in the Kaplan book but not much. These are subjects again that questions direct your learning well.
Genetics - Did kaplan book and video. They're more than enough. I think I could have just learned from doing questions. Not much to know really.
Anatomy/Embryo - Kaplan videos are good. Taught me everything I never learned in anatomy/embryo like how to interpret ct's, mri's, relations etc. . Gives you a good guideline of how and what to study and an easy way to memorize. Then just go ahead and memorize specifics. On the USMLE you'll get atleast half of the questions on anatomy/embryo if you know common uppper limb/lower limb nerve/vessel lesions, trisomies/monosomies, and pharyngeal arches anyways. I waited until doing questions and studied around the material that was tested in qbanks because I didn't want to waste too much time on this.
Behavioural - Watched the kaplan videos. They probably have too much info and it is probably not necessary to watch all of them but I just did because they were fun and easy to watch (esp. after Biostats is done).
General: I skimmed over important lab values and physical diagnosis signs in Fundamentals Of Clinical Medicine. I don't know if it changed my score but it gave me confidence when I was reading clinical type questions.
One note: Go back and forth between your material until you understand it. Don't just read a book to complete it. The point is to understand it. If you're not understanding get another resource. Also don't read duplicates of the same material in different books just for the sake of being thorough unless it adds to your understanding. The actual material in the varied resources are largely the same it is just the presentation that is different. So whatever is conducive to you learning, go with that. The kind of knowledge you want is not just memorization where you can spit out facts but the kind of knowledge where you can interpret diagrams, graphs, imaging, and clinical scenarios on the fly. I found on the usmle the questions were a little ambiguous and you need to know the knowledge in an intrinsic sort of way such that the answers come to you kind of intuitively. There's not really that much time to struggle with conscious logic all the time its more the subconcious lightning fast type. I don't know maybe its just me, but it felt like I was kind of on autopilot for the USMLE. You just go with your gut feelings and move on.
Second Phase: This phase was kind of intermingled with the above phase. This phase is where you do questions and go over First Aid. I did both Kaplan and USMLEWorld. I would add more subjects to my pool of questions as I finished doing my Phase 1 of them. So, the more subjects I finished studying the more varied my tests were. In the beginning studying the subjects is most important so don't do so many questions that you're not getting much studying done. After you're done you're first pass on the subjects you can really get into doing a lot of questions each day. Make sure you go over the stuff you're getting wrong or don't understand in the questions. I think after you finish one qbank, you went over pretty much all the main material and it is not really necessary to go over another one. I'm sure if you do another it will help you but at this point it is just about revision and reinforcement. I guess it depends if you have any time restrictions. Also in this phase you should be studying First Aid and you should be noticing how easy it is to read compared to the First time you tried to read it. Go over it a couple of times.
Do practice NBME's every once in a while. If you're at the scoring level you want then stop studying and doing questions and take the Step 1. The point is to get the score you want on the Step 1. You don't get a medal for finishing all the questions in all the qbanks. On the other hand, also don't take the test prematurely no matter how much pressure others exert on you. Don't risk a failure if you don't have to.
This whole experience is rather painful and you live pretty much like a hermit while you're studying but don't worry, work hard for as long as it takes you to get your nbme scores up to your expectations and you will definitely succeed. You will emerge from the end of the tunnel brimming with confidence in your medical knowledge and this is the perfect way to step into your clinical years.
Good Luck everyone and may God be with you !
I am writing this post to help the people who graduated from basic sciences somehow and don't have more than a passing familiarity with the material either because there was too much turmoil at their school, they didn't study etc. Whatever the reason, don't worry about it now, it's done. No regrets, just move forward. Be thankful you got out of basic sciences and recognize since you don't know anything you have to start from scratch.
First of all get First Aid and read the introduction that tells you about the exam. Now just browse through each subject material quickly. Just flip through the pages. If the material looks like alien scribblings that make no sense to your mortal mind that's a good way to confirm you need to start from scratch. If the material seems pretty familiar, you understand what they're trying to tell you, and extra facts are flying into your head around the material then you probably have a good base around the subject and don't need to worry about it too much. When I browsed First Aid the only things that made sense to me was Embryology, Behavioural, Genetics, and General Pathology . The rest was incoherent. But not to worry, by the time you're close to done studying, the whole book will make sense and you'll realize it's a glorious book that you can use to review a subject in a few hours. But until you're at a point to understand it, it really serves no purpose. One Note - I used the 2007 First Aid that was divided into systems. Although a great book, it had an insane amount of errors that I had to spend a good few days correcting from the correction made on the rumors were true (http://rumorsweretrue.wordpress.com/) . It was the first site that popped up when I put "First Aid" errors in Google.
So first, understand the core of the subjects. For this you need to study Kaplan videos, goljan, or various review books according to what you like. Remember you are not trying to know everything in the subjects, but to understand thoroughly the subset of info in the review materials you use. No textbooks are needed. If some concept in the review books are too concise for you to understand then don't blur over it, make sure you figure it out. Either search another review book for a better explanation, the internet, friends, forums, whatever. Just don't skip the material, especially in high yield areas.
First Phase:
BRS physio - took a week and read it thoroughly - excellent book you will keep coming back too. Then did Kaplan Physio video + book. The guy's awesome. I was lost on pulmonary from reading books until I watched this guy.
Neuro - First tried to read high-yield neuro. I got through some of it but a lot of it was over my head. I watched the kaplan videos while studying the kaplan neuro book and things made a whole lot more sense. Make sure you're concentrating on being able to identify the stuff you're learning about on imaging and diagrams while you're learning.
path - I used BRS path, Goljan audio/slides, Goljan Rapid Review, General Pathology (http://library.med.utah.edu/WebPath/GENERAL.html) , and Organ System Pathology (http://library.med.utah.edu/WebPath/ORGAN.html) . I stopped using Goljan Rapid Review after reading a few chapters because it was taking way too long. And just used it as a reference sometimes to look up things. I think it's kinda overkill with the other resources I mentioned.
Biochem - Kaplan videos and book + First Aid
Pharm - I studied pharm from First Aid. An understanding of the physio of autonomic receptors, kidney, and heart is also tightly coupled with your learning of pharm. Sometimes I would read a bit of Kaplan pharm or watch a few Kaplan pharm videos if I found myself getting confused or just not knowing where to focus. Honestly I learned most of my pharm while doing questions later. First Aid lists too many side effects for each drug while not telling you which are actually the most important and likely to be tested. They just throw in the really important side effects with the list of all the side effects and you would never know that they're really important and highly tested until you start doing questions. Also you don't really understand how they ask mechanisms of action and couple physio with it until you start doing questions either.
Micro/Immuno - Watch the Kaplan videos as a prep. They're short and general. After that I just memorized the specifics in First Aid and glanced a bit at some of the tables in the Kaplan book but not much. These are subjects again that questions direct your learning well.
Genetics - Did kaplan book and video. They're more than enough. I think I could have just learned from doing questions. Not much to know really.
Anatomy/Embryo - Kaplan videos are good. Taught me everything I never learned in anatomy/embryo like how to interpret ct's, mri's, relations etc. . Gives you a good guideline of how and what to study and an easy way to memorize. Then just go ahead and memorize specifics. On the USMLE you'll get atleast half of the questions on anatomy/embryo if you know common uppper limb/lower limb nerve/vessel lesions, trisomies/monosomies, and pharyngeal arches anyways. I waited until doing questions and studied around the material that was tested in qbanks because I didn't want to waste too much time on this.
Behavioural - Watched the kaplan videos. They probably have too much info and it is probably not necessary to watch all of them but I just did because they were fun and easy to watch (esp. after Biostats is done).
General: I skimmed over important lab values and physical diagnosis signs in Fundamentals Of Clinical Medicine. I don't know if it changed my score but it gave me confidence when I was reading clinical type questions.
One note: Go back and forth between your material until you understand it. Don't just read a book to complete it. The point is to understand it. If you're not understanding get another resource. Also don't read duplicates of the same material in different books just for the sake of being thorough unless it adds to your understanding. The actual material in the varied resources are largely the same it is just the presentation that is different. So whatever is conducive to you learning, go with that. The kind of knowledge you want is not just memorization where you can spit out facts but the kind of knowledge where you can interpret diagrams, graphs, imaging, and clinical scenarios on the fly. I found on the usmle the questions were a little ambiguous and you need to know the knowledge in an intrinsic sort of way such that the answers come to you kind of intuitively. There's not really that much time to struggle with conscious logic all the time its more the subconcious lightning fast type. I don't know maybe its just me, but it felt like I was kind of on autopilot for the USMLE. You just go with your gut feelings and move on.
Second Phase: This phase was kind of intermingled with the above phase. This phase is where you do questions and go over First Aid. I did both Kaplan and USMLEWorld. I would add more subjects to my pool of questions as I finished doing my Phase 1 of them. So, the more subjects I finished studying the more varied my tests were. In the beginning studying the subjects is most important so don't do so many questions that you're not getting much studying done. After you're done you're first pass on the subjects you can really get into doing a lot of questions each day. Make sure you go over the stuff you're getting wrong or don't understand in the questions. I think after you finish one qbank, you went over pretty much all the main material and it is not really necessary to go over another one. I'm sure if you do another it will help you but at this point it is just about revision and reinforcement. I guess it depends if you have any time restrictions. Also in this phase you should be studying First Aid and you should be noticing how easy it is to read compared to the First time you tried to read it. Go over it a couple of times.
Do practice NBME's every once in a while. If you're at the scoring level you want then stop studying and doing questions and take the Step 1. The point is to get the score you want on the Step 1. You don't get a medal for finishing all the questions in all the qbanks. On the other hand, also don't take the test prematurely no matter how much pressure others exert on you. Don't risk a failure if you don't have to.
This whole experience is rather painful and you live pretty much like a hermit while you're studying but don't worry, work hard for as long as it takes you to get your nbme scores up to your expectations and you will definitely succeed. You will emerge from the end of the tunnel brimming with confidence in your medical knowledge and this is the perfect way to step into your clinical years.
Good Luck everyone and may God be with you !