DESPERATELY SEEKING HELP

[doctorbones]

HI EVERYBODY!

My name’s Andrea, 25 yo, from Italy, last (6th) yr medical student planning to get his degree on MAR 2005 and sit on STEPS 1 AND 2 somewhere IN THE FIRST SEMESTER OF 2005.

In the last 2 weeks I have been surfing the web in a nearly useless way, trying to find a place where someone could REALLY help me preparing to live these “nightmares”. I was very near to depression when I suddendly met TOMMYK’s posts (an alien from Mars, in my opinion) and an active, economically purposeless forum named VALUEMD. A few hrs after I registered!

I really, REALLY hope you can give me an hand fighting my fears and my doubts, and I’m absolutely sure this is the right place.I read a lot of Tommy’s posts and found them very interesting and, most important, focused on REAL questions.

Getting through both STEPS is a question of concepts.There are things you are BOUND to know in Medicine, whatever you want to become. If you know them, you’ll pass these tremendous exams. The only problem is that there are SO MANY concepts!

Anyway, let’s start speaking about my worst fear: WHICH BOOKS SHOULD I PREPARE THESE EXAMS ON? Great question, IMPOSSIBLE answer…too many books around and everything’s so PERSONAL. I mean, I could say FA sucks and was completely unuseful while someone else just studied on it and took 95. These books are just SCHEMES, MEMORANDUMS and whatever else. I thing that If you don’t “fit” the author’s method, no way you’re going to learn something..and you can’t know this till you don’t read it? And I can’t buy every single book on earth dealing with USMLE!

So, I’d like to use Kaplan notes as “final reference books”. Do you agree? Is there something else you think I should use? I mean, something which is missing or not well done on these notes? PLEASE TELL ME!

Just know that I have a lot of books at home (Katzung, Robbins, Harrison, Sabiston, GRAY’S ANATOMY, Nelson’s Pediatrics, Novak’s Gynecology,…), I could say I have the “reference” book for EVERY medical discipline. And in the end, I was wondering about this: WHY DOES NO ONE ON EARTH USE REFERENCES BOOKS TO PREPARE USMLE EXAMS? I mean, which is the problem about studying Internal Medicine on Harrison’s book? Too big, I agree, but we are supposed to become DOCTORS, and doctors are supposed to know something more than just SCHEMES learned on hyper-concentrated books…or not!?

Then, QUESTIONS: even more difficult to choose, so…which are in your opinion the books/CDs/online questions RESEMBLING more USMLE ones? Just to get the most precise idea of what I’ll be in front of! Then? NMS, BRS, QBANK, what else? Tell me!

Wrote too much, my brain is nearly fried, it’s just 10am and I have an hard NEUROLOGY book to study in front of me…depression is getting BIGGER THAN EVER…HELP ME!

[Anonymous]

Hi doctorbones. First I'd like to say welcome to our family of brothers and sisters who are helping each other reach a common goal of passing these exams so we can all become good docs some day. In that sense, I agree that you came to the right place.

I also very much agree that Tommy's concepts (1200+) are an excellent source and Tommy himself is a great inspiration to us all. Everyone talks about buying this or that question source before realizing that Tommy has provided us with an invaluable free source of questions. But more importantly, he provides us with an understanding of the concepts as well as inspirational advice. I highly recommend his work here.

As you said, the prep for the USMLE requires a good understanding of many, many concepts. That happens to also be the answer to your question about why people do not use big reference texts as their primary study resources for the USMLE. It's assumed that you've already studied from those types of detailed texts in med school (over several years). But it would be nearly impossible to get a very good understanding of every very detailed large reference textbook. The USMLE will ask clinically based questions which tie only the most important and relevant concepts together. But if you only have 350 questions to ask in any given test, would you waste one of those on an insignificant fact only found in the fine print of a 1000 pg text, or would you ask an important concept which is clinically relevant and requires an good understanding of whatever concept? The review books used for the USMLE basically takes the most important concepts from all of those texts and very briefly explains their relevance. But if you don't understand any particular concept from your review books, you're encouraged to look it up in one of the big text references for further details. In this case, it's better to know the important things very well than it is to know everything (whether important or not) not so well. A good way to look at it is by this example. Would you rather do a 1 hour, 50 question, open book timed exam with all of your big detailed reference texts available, or would you rather just use a few high yield books/notes? Do you really have the time in that situation for the detailed texts?

You also hit the nail on the head when you said that some review books are good for some, but not for others, and vice versa. But there are some that the majority will find useful. That still doesn't guarentee that it will work for you, but your chances are better. I've noticed that most of the people who don't like first aid (most people love it since it is the gold standard for step 1) either try to use it as a primary source, or try to use it too early in their studies. First Aid is a very high yield book containing straight facts (lots of memorization, mneomonics, etc), not concepts or any other type of learning methods. It's meant to be used as a supplement once you have a good understanding of the material. It is not meant as a learning tool. If you try to use it as a learning tool, you will be disappointed. If you use it as a review of high yield material you've already learned from other sources, you might find it useful.

Kaplan lecture notes are meant to be used with the lecture. Lots of people try to use them without the lecture and find them difficult to follow. This is because the lecturer will provide additional explanations about the various graphs, etc that helps explain the concepts. For example, from a chat the other day, we were discussing ACE inhibitors vs Angiotensin receptor blockers. The notes will tell you that ACE causes cough and show you the basic diagram of the pathway. The lecturer would probably add that ACE also works in a reaction involving the bradykinin. The only relevance of that reaction is the clinical side effect it produces from taking ACE inhibitors. So the details of the reaction itself are not so important that it would need to be included in the notes, but the concept is better understood if you know this. So the lecturer basically uses some unimportant facts (not ususally included in the notes)to explain the important concepts (included in the notes). Of course you can probably get these unimportant facts from a huge reference text, but isn't that less efficient? So the lecture notes are very good, but they are better if done with the lecture.

As far as questions, I think that almost everyone will agree that online qbank is the best question source and an absolute must. It covers both the format of the test and learning. In the online timed mode, you will get a feel of what the real thing is like. Practice in this mode in blocks of 50 to build up your endurance closer to test time. It also provides answers and explanations to help learn the material. The CD version of Qbank is only good for learning the material since it is not in the same format of the test and is not timed. Still good for learning, but you will need to do the online version to get a better feel for the real thing.

BSS and NMS are good alternatives if you have a long prep time and want to do extra questions. But do not do these in place of online qbank. If anything, try to do them in addition to it if time permits.

An important concept that may help you figure out which study material to use is that "repetition is the key to learning". When comparing a person going over a bunch of detailed texts once versus going over fewer high yield review books 3 times, the latter is almost always more sucessful. This is because the brain works like a filing cabinet. You can store loads of info in a filing cabinet, but without a good indexing system, you will never be able to find any particular info again. So reading the info will store it in the filing cabinet, but repetition will index the material so that you can easily retrieve it when needed. If you realize this important point, you will see that learning the high yield concepts very well is much more important than try to barely know everything there is to know about medicine. Then you can fine tune your material from there. If this is still not clear, I highly recommend Dr. Daugherty's (Kaplan instructor) lecture on how to study for the USMLE.

I hope this helped clear up some of your questions. Best of luck!

[doctorbones]

Thank you SO MUCH Step1! :wink:

You infos are really great and helped me better understand what to do/choose.

Just one more question to you and the other guys in the forum.

I read a lot about Goljan material: notes, audio, questions and whatever else.

Would someone please make some order and tell me:

- What does the material deal about

- What is essential and what not

- What I can buy on Amazon and what on eBay

THANKS!