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Lucy May
11-19-2008, 06:45 PM
Quick facts for those not interested in reading the dribble.
Step 1 score: 206/85
Step 2 score: 237/98 Exam date Monday Oct 27th Score report, Wednesday, Nov 19th.
UW average: 53%
Usmlerx Step 2 CK qbank: 71%
NBME 2 one week before exam: 227
Prep time: Started Mid June, but had to deal with full-time school as well.

This is for all of you remedial med students just like me who don’t believe that you can improve on your step 1 or even get a decent score!

A little encouragement…
I wasn’t horribly disappointed in my Step 1 score. I was thrilled and thankful to have passed and get over a 200 on the first try when I know plenty of people who haven’t passed Step 1. And even though I don’t want a competitive residency, I knew that I’d be more reassured if I showed that I could improve on my Step 2. Plus, being an IMG already knocks you back a few notches, and our USMLE scores are really the only leverage we have. My Step 2 goal was a 99, the three digit score didn’t matter much to me even though I dreamed of an elusive 250. And though I didn’t make a 99, I really never truly believed I was capable of a 98. Some people just have this genetically set test-taking intelligence level where they basically do nothing compared to the work I put in and just “happen to get a 260!”
I am NOT one of those people. Some students would have wanted to slit their wrists over a 237, I bawled tears of joy.

So here’s what I learned from Step 1 and what I did differently for Step 2. I’m a huge believer that there is NEVER one magical study plan. You have to know what works for you. This is simply what worked for me.

1. Not doing enough questions: I was so terrified of Step 1 that I thought doing questions was silly if I didn’t feel comfortable with the material. But that’s the secret to these exams. We can all memorize material needed for a short time on a simple exam in school just from making notecards or memorizing charts, but the only way to make a large amount of material stick longer is learn it in the form of questions. Be happy in the beginning when you get them wrong, because you’re on your way to learning not just the right answers, but WHY they’re the right answers.
What I did different
This time around, from day one I did at least 50 questions when I started out. I gradually increased the amount I did. By the time I took the exam, I’d probably done over 6,000 unique questions. If I included repeating questions over and over, not just the ones I got wrong it’s probably closer to 10,000 or so questions that I did. Plus I realized that even when I wasn’t in the mood to study, I knew I was still putting in quality time by at least doing questions.

2. Not changing my study prep even if it wasn’t giving me results: I was too scared to abandon a study plan even when it was wasting time. I thought for some reason that it would be too late to change gears, or I’d somehow be rewarded for studying that much harder. For example, instead of spending a whole day reviewing cardio from books and making notes, I should have been doing questions (You learn and retain more in half the time). It really does not make sense to put in hours of reading or listening to lectures when it’s simply passive learning.
What I did different
I mapped out exactly what I was going to do months in advance and I found myself adapting constantly and changing my weekly goals because sometimes I set unrealistic goals, sometimes I realized what I was doing was wasting my time and sometimes a study method I chose was just plain boring me so I’d scratch it out and modify the plan. I didn’t beat myself up for not “sticking” to a goal. If you don’t at least enjoy a teeny bit of your studying time or feel deep down “this is going nowhere”, it’s going to just burn you out.

3. Too many resources: it can be overwhelming the study aids out there and I spread myself too thin for Step 1 between FA, Kaplan, BRS, Step-Up, Pathology Flashcards, Underground Vignettes, etc. My suggestion is to pick 3-4 resources and commit to them. They become like your best friends and you start to develop a photographic memory for where information is.
What I did different
I spent money on four resources. I chose self-study Kaplan books and 2001-2002 videos as a foundation. Then I chose UW as my chief study tool (NOT assessment too). Next-- even though a lot of people said First Aid CK wasn’t that great-- because it was my ONLY review book, it turned out to be awesome because I was using it so much that I could close my eyes and picture what it said in certain sections. I knew exactly where to go to look up an answer because I became that familiar with it. Find your best friend. It doesn’t have to be FA, but find something and commit to it. As my last study tool, I used the brand new First Aid usmlerx ck Step 2 qbank to assess myself the last three weeks before my exam.

Lucy May
11-19-2008, 06:49 PM
What my study plan looked like
1. Kaplan: At the suggestion of someone generously posting their experience here on ValueMD, I took their advice. I read through all the books once as a test drive to orient myself and did around 25-50 questions in the Qbook a day to see sort of where I was starting at. Then I watched all the lectures and read through the books again taking notes. Some of the lectures were good, others were “meh,” but I was committed to watching all of them because I wanted to glean everything I could. When I was finished I read through most of the books a third time and compared them to what was written in First Aid and had started to do UW questions also. It took me about 2 and half months to get through Kaplan.

2. UW: I tried to reassure myself that I was using UW as a study tool and NOT assessment tool, but I would still read forums of people posting these awesome UW scores and even the last 10 blocks, I only managed to score an average of 54%. This was about a month and half before my exam. Before you buy UW, if you’re as obsessive as I am, make a firm decision as to how you’re going to use the qbank-otherwise you might start to freak out like I did at times. My scores dipped down into the low 30s for a few of the blocks. 30s!! My dog could have slapped his paws on the answer choices and done better than that. But when I was finished answering all the questions, I started the qbank all over again. I wouldn’t allow myself to skim a question even if I recognized the right answer. I talked through in my head why it was right why the others were wrong. (I almost always did random, 46, not-timed at first and then the last half of the questions all timed).

3. First Aid: a lot of people dogged this as a resource. I think they do because it seems to lack details and organization, but I was determined to stick with it and I’m glad I did. It’s horribly weak in surgery though, but Kaplan more than made up the deficit for me. Otherwise, after the real exam I found that a lot of the answers could easily be found in FA. Some advice I took as form of active learning was to go through each FA section and write out my own questions. It was a bit time consuming, but worth it because even when I was walking around doing rounds in the hospital, I’d pull out my obnoxious list of questions and just drill them over and over. Plus, it was fun to ask the residents if they knew any of the answers.

4. First Aid usmlerx Step 2. This qbank was my ASSESSMENT tool the last three weeks before the exam. I did at least 3 blocks every day so that I breezed through 2300 questions in 2 weeks. The qbank is rusty because it’s so new, but not to the point where I wouldn’t recommend it. The concepts are very similar to the real exam. Be aware that it is easier than UW. I didn’t want to become over confident, but it was great for drilling myself on how to answer questions FAST. I finished that bank with a 71% and then repeated the questions I got wrong the last week.

Lucy May
11-19-2008, 06:53 PM
Actual exam
Half of the blocks I finished with time remaining even after going through the flagged ones. I really became adept at answering the questions quickly from the practice of doing timed blocks on qbanks over and over until it became pure habit. Instead of going over the questions again, I realized that I had to trust my gut and move on even if there were a few minutes remaining. However some of the blocks I barely had time to look over the ones I flagged, time ran out and that was a confidence killer. I did three blocks, took a 10 min break, three more blocks, 10 minute break and then finished the exam. Part of me wanted so badly to just get out of there, but I also had to remind myself that each answer was important and not to rush.

I felt like I got slammed with cardio and gyno which ended up being my worst scored. I had been doing bad in renal and surgery in my previous assessments so it was good to see that I scored decent those. I guess one or two subjects are always going to be sacrificed for another. You want to believe that you can know everything, but that exam will find a way to remind you that you can’t!

The worst thing I did was second guess myself on a few answers. I remember a question asking about underlying problem in a certain skin condition. I immediately clicked malignancy for some reason, but then talked myself out of the answer. It ended up being the right answer from looking bad in FA. If you find yourself doing that on the exam—GO WITH IT! Don’t change the answer unless you misread something. Remember too, that answering a lot of the questions is about eliminating the wrong ones even if the choices you have left seem ridiculous. For example, I knew the treatment for a sleep disorder was with a stimulant, yet I had never ever heard of the drug choice they were offering. The other answers were stupid, but I still picked one of the stupid answers because I didn’t know what the drug was. Again, don’t doubt yourself! Turns out the random drug I’d never heard of was a stimulant.

Everyone walks out of there shell-shocked. The people that score 260 will tell you they feel like they failed. You can’t possibly go through 368 questions and not feel like half your brain oozed out of your ears along with all of the right answers. I had convinced myself too that I failed and began preparing myself mentally of how I was going to get through it and how I was going to tell everyone that I failed. The wait was probably just as bad as the days leading up to the exam. I made myself sick with anxiety.

So good luck, I hope that maybe I was able to reassure at least one person that YOU CAN DO IT!

One more tidbit that might help motivate you: Plan for something really cool to look forward to after the exam. For example, I’m going on vacation for Christmas with my family. I kept that in mind whenever I didn’t feel like studying. I pictured myself relaxing and enjoying myself knowing that it would be all over. :D

dxtran
11-20-2008, 07:46 AM
Hi there,
Congratulations, great score. You and I are in very similar situation. I took my ck very recently, last week. Very anxious on the result, because I ran out of time for the last 2-3 questions on a few blocks. You said u avg. 53% on UW, is that first time around, or including repeats? My first time around, my average wasnt so hot (lower than yours)...it was purely a learning tool for me. I took my time learning from the questions, both right and wrong, and did a lot of note additions to my Kaplan notes. Second time of doing the qbank, I averaged 80%. How do u think that will translate to the real test? You are right, the questions are a humongous source of information. Thanks for your input, i'm losing sleep thinking about that hard exam...

Lucy May
11-20-2008, 01:29 PM
Hi there,
Congratulations, great score. You and I are in very similar situation. I took my ck very recently, last week. Very anxious on the result, because I ran out of time for the last 2-3 questions on a few blocks. You said u avg. 53% on UW, is that first time around, or including repeats? My first time around, my average wasnt so hot (lower than yours)...it was purely a learning tool for me. I took my time learning from the questions, both right and wrong, and did a lot of note additions to my Kaplan notes. Second time of doing the qbank, I averaged 80%. How do u think that will translate to the real test? You are right, the questions are a humongous source of information. Thanks for your input, i'm losing sleep thinking about that hard exam...

Yup, 53% first time through. If you averaged 80% second time through and really understood the concepts, I think you`re headed for an awesome score!

devildoc8404
11-20-2008, 03:35 PM
Wow, Lucy May... that was an awesome, well-written, insightful, and incredibly useful poopload of information!

Thank you. You have inspired me, and offered some great tips as I start my preparations for Step One. Best wishes on the rest of your clinicals!

Hey, you mentioned that you used UW as a study tool... what did you use on Step One for your assessments? Thanks again, and great job. That 98 speaks volumes.

Lucy May
11-20-2008, 05:41 PM
Wow, Lucy May... that was an awesome, well-written, insightful, and incredibly useful poopload of information!

Thank you. You have inspired me, and offered some great tips as I start my preparations for Step One. Best wishes on the rest of your clinicals!

Hey, you mentioned that you used UW as a study tool... what did you use on Step One for your assessments? Thanks again, and great job. That 98 speaks volumes.

I used this (http://www.usmlerx.com/USMLEFlash/step2.aspx).

dxtran
11-21-2008, 07:20 AM
hi Lucy May, thanks for the response. May I ask how u did second time through on the UW qbank, like what u were averaging.....just so i can have a better perspective....thanks again

Lucy May
11-23-2008, 04:05 PM
hi Lucy May, thanks for the response. May I ask how u did second time through on the UW qbank, like what u were averaging.....just so i can have a better perspective....thanks again

I've tried to respond like 4 times and VMD keeps messing with me...grr.

Anyway. I don't think I can really give you an accurate answer. Probably around 60%? When I didn't have any incorrect answers left, my overall score was a 70%, but because you can't control which questions are generated, you get some of the same ones over and over which scews the percentage if you recognize the question. I only hoped by doing more and more blocks, eventually I'd hit all of the questions again and understand each concept.

I think my best predictor was the NBME. The questions were similar, and I tried to recreate the exam conditions so I'd have more confidence in what my predicted score was.

I also did the 3 blocks of the FRED software that you can download from the usmle website and scored 83% which may or may not be an accurate predictor as well.

mada amo
02-21-2009, 03:59 PM
Congrats. Lucy May...You made it..and just proved that beyond those genetically gifted,you made your strong Motivation your Gift ..Way to go,i hope to Succeed just like you did!;)

Grazie
02-26-2009, 04:27 PM
Wowo Lucy,
Thank you very much for telling your experience, I will definitely set it like my guideline :)
Blessings for you.

cydephx
08-26-2009, 01:19 PM
This thread kept me going while studying.
Just wanted to show that this kind of improvement is not a freak incident but rather the product of hard work.

208/86 on step 1... I am not a stellar student but I knew I was capable of more.

For step 2 I used FA, did the Kaplan Q bank months before, UW almost twice (60% first time thru), and read the kaplan notes once.

NMBE 2- 230 3wks before

Step 2- 240/99!!!

I hope this helps others realize that they can achieve this kind of improvement too!