MY USMLE step 1 experience...
Lets lay some ground first...before I blow off some steam...
Undergrad GPA: 3.4
ROSS GPA: 4.0/4.0
Kaplan Qbank (85% complete): started ~mid 70s, ended around 80s
Kaplan Qbook (100% complete): avg 70s
Basic science comprehensive given by ROSS: 74
NMBE 3: 530 --> 226 (2 months out)
NMBE 1: 660 --> 250 (2 weeks out)
NMBE 4: 620 --> 244 (1 week out)
Released USMLE CD: 88.7% (45/50, 42/50, 46/50)
NMBE 2: 600 --> 240 (1 day out)
USMLE: taken today
HOW do I feel: LIKE crap!!!...man that was AN ALL out spanking I got...I was not prepared for such an integrative test. Difficulty level equal to greater than the NMBES!!!
TO begin..i studied for 2 months non stop..everday 9AM-10PM (w/ lunch break 15min & workout break 1 hr).
1st month: i finished all KAPLAN videos (except pathology b/c I was listening to GOLJAN on my downtown from school), annotating in FA, Q book
2nd month: did Kaplan Q bank (read ALL explainations, even Qs I got right), finished Q book, and read BRS path & FA
THE TEST: It's like no other...maybe I got a hard version?...but they were very hard compared to NMBE questions. I felt like this was a test for practicing Doctors!!! Very CLINICALLY oriented, stuff you don't really think about unless you saw it in question. You have to really understand the pathophys of stuff. You have to visualize what they are talking about, and then figure out the mechanism of defect. Maybe they were the experiemental questions? who
knows...All i know is that the questions were longer, more convoluted with distractors, and much more integrative than the NMBES....The inventors of the test are brilliant. They ask all types of questions, half being very general, and half being detailed. So the tests covers all types of students, those who know details, and those who understand concepts. But students who KNOW & UNDERSTAND will do the best. There seemed to be 4 types of questions:
1) Straight up recall (20%)
2) moderate (2nd-3rd order questions, 40%)
3) Hard (stuff you have to think critically, rulling out and in dz based on minute details, labs, sx, 5 columns of labs w/ arrows pointing up/down in every feasible combination known to man... 20%)
4) Random crap you have never seen before (but I guess your supposed to logically deduce the answer based on "basic science" 20%)
TOPICS: were well distributed...everything was covered (10% molecular, 10% biochem, 10% immuno, 10% micro, 5% genetics, 10% pharm, 20% anatomy/neuro, 5% epi/stats, rest was pretty much path/phys or combo.)
WHAT WOULD I HAVE DONE DIFFERENTLY: Looked up DIAGRAMS online, drawings....stuff to help me Understand integrative pathophys rather than rote memorization (which is hard to do cuz you always crammin, esp. when learning it in med school).... You really have to know your stuff inside out....Hopefully it was just a harder version. I shouldve went through GOLJAN notes....i started doing this..but i felt it was too detailed.....honestly..I don't think I could have went through all of it b/c of the level of detail in such restricted time. I should've started learning GOLJAN through the 2 years of med school so I could apply it. Definitely go through the NMBEs...they are easier than the real deal, but they are MOST SIMILAR Qs to the STEP1 i've seen yet.
BOOKS to live by in order from MOST IMPORTANT: (IF you have Kaplan lecture notes, its good enough for everything, but way in depth)
1) FA: I shoud've known this cold...spend at least 1 full week near ur test date going over FA. I only spent 5 days...If I could do it again, I would spend 2 weeks. FA is more than enough on: PHARM, MICRO, ANTOMY, EPI/STATS, EMBRYO) Note: that on anatomy they did expect me to know names of bones (to make my point,but not actual Qs: navicular, lunate, capitate....man..i had to dig deep into my mamillary bodies to remember anatomy parts) and find em on Xray. In that aspect, FA is not enough (only damn good med school studying helped me there).
WHen I say more than enough: I mean you have to understand it..not just memorize it.. FA is enough to memorize..but you have to be able to apply FA facts to Qs and be able to handle manipulation of Qs, renaming of "buzz words", and topics taken out of context. This, I feel can only be aquired through Qs, and looking up words that we medical students "think" we understand, yet If we were asked by a layman to explain it....we wouldn't be able to. For ex: "What is a mitochondria?" 1st thing that pops up is .."Oh that's easy..its in the cytoplasm of a cell, makes ATP via Ox phos, has circular DNA (i think)"...but We forget so many other aspects that they might test us on...how is the mito related to necrosis? What biochem substrates enter the mito for urea cycle? TCA? ..so forth? Remeber the theory on how our mito came from bacteria, are there more mito in Type I or II fibers (da hell are type I/II fibers????!?!) ahhaha...
...I know I am guilty of this too, but what do you expect...we are only HUMANS!!
2) BRS path: I read this once....shoud've spent more time on BRS path, than stupid Q bank (GOD i hate Q bank now..though it did give a few (2, i think) similar Qs on the STEP, I wasted alot of time learning minute which was never tested on)...It also gave me the wrong idea of the type of questions that I was going to see on the STEP.
3) HY cell & molecular bio: Just hit up the DNA experiment crap, (SNOW DROP, Restriction enz, etc.), KNOW the G proteins & other receptors (TK, lingand gated, zinc fingers, leucine zipper, jacket buttons, chicken fingers...who the hell makes up these names...etc..) and their full secondary messenger systems downstream. IF you have time, go through the whole thing.
4) If you have time: BRS phys, Pathophys B&W (just as good for HY as FA if not better for path)
Videos: I loved the Kaplan videos (watched all while I took notes in FA & followed along in their PDF notes)..Some Qs came right to me during the test b/c of the the stress the profs in the videos emphasized on certain topics...(behavior sci, genetics)
Q bank: If I had to do it again, I would not have choosen Q bank or Q book. They are too focused on too much details, which I already knew most of from medical school. WHat I lacked most was integration. I have yet to find a q bank to provide that level of thinking...maybe USMLE world? i dunno..but definitely NOT Q BANK...(esp. not for med students who already know the dzs, the details, mechanisms).
On the other hand..If you have not been exposed to Path, pharm, phys for a while, or have been out of school...I think Q bank would be more helpful to you guys.
OVERALL: who knows..I might pass, do well, or fail....BUT man...it was tough!
PS: I aways think I failed tests...or do bad..but end up doing well.(for ex, I thought I failed the COMPREHENSIVE but got above avg)..I just don't like taking tests on topics I've never seen before b/c it lowers my confidence level. So with that being said: I might have made the the STEP1 seem harder than it really was, but to me it was TOUGH...take it however you like..but I did do well on NMBEs...and I thoguht those Qs were fair.
LEARN IT IN MED SCHOOL RIGHT!!!! main point is to understand mechanisms, then you can pretty much answer any question they throw at you.
Update: Oasis trick works!!! 3rd Wed after your test @ 12 midnight!!! I passed....so few more days till score report!
Score came in 3 fridays after the test date: 233/94
Last edited by Captainwada; 11-06-2006 at 09:34 AM.
For strength and honor.....
Done until I walk!!!!!