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  1. #1
    Anonymous is offline Unregistered Guest
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    HOW TO PASS USMLE STEP 1

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    I have recently passed the Step 1 USMLE and thought I should share my experience. My advice may apply more to the IMG but others may find it useful too. The advice also assumes that you have at some stage in your life had a reasonable exposure to basic sciences.

    Just a few words on my background. I graduated from Medical school in Nigeria in 1990 so my contact with the basic sciences is very distant. Indeed while reading a lot of the stuff was totally new to me and never existed when I went to medical school. I am a resident in cardiothoracic surgery in the United Kingdom and only want to go to the States for a year to do a fellowship. For this reason I just need a pass mark for the USLME. My advice would therefore not be useful for those who require a high score but only those who are struggling to pass or just need a pass. My advice might be slightly tainted because I have been a clinician for over 10 years and taken many exams in my time.

    Sources/material
    I used exclusively 3 sources for all my study for USMLE
    1) First Aid 2000 edition which I bought second hand on the net for $8
    2) Crashing the boards (Yeh) 1999 edition which I bought 2nd hand for $10
    3) Qbank 1 month $150 for online version
    I did not own or use any other books. I think this is the most important aspect of preparation – RESTRICT YOUR READING MATERIAL. There are always books to read, Anatomy, Biochem, Path etc containing 100s of pages each. The list of books and sources is limitless and you could spend the rest of your life reading for this exam. I think the key to time management is not to waste time on things that yield low output. There is noneed to read a biochemistry book when 1st aid can provide you answers on 80% of the questions in exam. Reading big books is for those who need to score 99. If you want to pass there is more than enough in first aid (or any good review book). Also bear in mind that the objective is to pass and NOT to acquire knowledge, so if first aid tells you that NSAIDS preferentially constrict the afferent arteriole reducing the GFR then that is all you need to know. There is no need to find a big pharmacology book that will explain the precise mechanism or why the efferent arterioles do not dilate in response to PGE….now that is time wasting. Move to the next fact, don’t be greedy and try to get all the marks cos the time you spend, maybe 30 minutes consolidating on one aspect that might yield you one correct answer (or none) in 350, you could have used to cover a broad topic that would answer you five questions. Also ignore the questions and recalls you see on discussion forums; don’t even read them– those serve only to panic you. Nobody posts the easy to moderately difficult questions which constitute over 70% of the exam. The questions people post never reflect the real exam but the 10 or 20% that defines those who will score 99 and those who won’t. Remember even if you fail 20% you will still pass with a very good score.

    Time for preparation
    I sat my exam 17 September 2003. I started preparation August 1 2003. Prior to this my last exposure to any basic sciences was in 1993 when I did my basic surgical exams. So it was all new to me and if I had taken the exam in August I would definitely have failed. I was working full time as a resident in cardiac surgery and worked all through my preparations except for a week off in August and a day off the day before the exam. As you can imagine being a cardiothoracic resident is very busy, working over 80 hours a week. So depending on how busy my day has been I would study for 0 minutes to 2 or 3 hours maximum on weekdays. The only reason I include this is to illustrate to you that it is possible to PASS this exam with minimal effort provided you use the right approach. I think rather than preparing for months and then putting in for the exam you should put in for the exam immediately leaving a SHORT period of preparation, maybe 2 months, 3 months max. You will then focus your preparations. You can then understand why I did not read big books…I simply could not afford to as I just had 6 weeks and was working full time. Big books is for people who have the time…but then even if you have time why waste it?. Use it for something better.

    Sequence of preparation.
    In the first week of August I read the two books (first aid and yeh) cover to cover once. I then registered for Q-bank which would become my ONLY method of study for the 4 weeks up to the exam.

    QBank
    QBank to me is the MOST IMPORTANT contribution to my passing the exam. My advice to you is to buy the online version. It is well worth the 150 dollars. If you pay for a month's access you will be forced to work hard and finish the 2000 Qs in a month and take the whole thing seriously as you don’t want to waste your hard earned money. If on the other hand you had a free disc you probably would not finish or would pace yourself and spend the next 12 months studying. Also the online version gives you better feedback on your progress. If you are concerned that 150 dollars is a lot to pay, I would say it is much cheaper than the 800 dollars it would cost to retake the exam. Other question banks may serve the same role but I only have experience in QBank.

    QBank has 3 main roles, it gives you concentrated knowledge in a manner that is easier to retain (compared with reading a book), it offers you self assessment, and it prepares you for the real thing. To dismiss the last point first, if you have done loads of QBank tests the real exam would not overwhelm you, your time management will be precise, your marking methods will be spot on, you will learn your own limits, how to guess, when to change and not to change etc. In other words you will know how to play the game…it is a game and while knowledge is important, probably more important is how you play. For every person the optimal approach to answering questions differs, for example the traditional teaching is not to change an answer unless you have a good reason to do so. My experience from Q-bank was that when I did change answers, it was from incorrect to correct in 65%, correct to incorrect in 20% and incorrect to incorrect in 15% so this gave me the impunity to change responses in the real exam. So QBank will help define the best approach to answering questions for YOU.

    NEVER do QBank in a tutor mode (or you lose on the latter 2 objectives). Always set yourself tests of 50 questions so you would have done so many simulated exams that the real one cannot faze you. Don’t despair when you fail questions. Indeed it is better to fail questions because it points you to your areas of deficiencies. No point wasting time on things you know already. After each QBank test review all the answers…study Kaplans explanations and read the relevant areas in First Aid. As you go along you will get better and learn the art of question answering. You will never get all questions right…some of them are stupid…some require too much effort. If it requires too much effort leave it and accept you will fail it if it comes out in the real exam. Like the difference between a GLUT 1 and GLUT2 receptor or FAB1 and FAB5 – there is absolutely no way of knowing that other than cramming and it will get you one mark in 350 at the most. Forget it and move to the next. Your performance should increase over the 4 weeks; I started at about 56 to 62% and ended about 65 to 75%. Overall average was 67%. Also QBank will tell you your strong subjects (forget them) and weak subjects (read relevant first aid chapter again). By the time you have finished QBank there will be few things they can ask in the exam that you have not dealt with in one way or the other. First Aid is useless for the ethics questions and doctor-patient relationship questions of which there are loads…for this QBank will prepare you.

    The exam
    I will not go into the exam in detail because previous discussion threads give a very good insight into the exam. Only comments I will make is that you do it as if you were doing QBank. If it worked for QBank it will work in main exam. Just imagine your USMLE was another test on the QBank…if you passed the last 10 you did with over 60% you will pass the USMLE too (provided you answer in exactly the same manner). Remember USMLE is set by human beings too and they can’t be much different from the human beings setting Kaplan so not many new things they can think of. Don’t think too hard…there is no problem with failing one question…indeed there is no problem with failing 100…you will still pass. As you go on you will realise from present questions that you failed a previous question in an earlier block…just smile or laugh and move on. Remember there is an element of competence based testing so performing ‘badly’ on a block doesn’t mean failing. Also be prepared for many strange questions, some I doubt anyone other than the person who wrote it knows the answer, smile again, mark B, C or D and move on. The question probably won’t even count to the final score. There is another type of question though which is very long and seems to ask something you know nothing about; don’t bother reading those, mark them and then come back to them if you have time. When you come back you may find the question has a workable answer (but only work them out at the end as might require up to 3 or 5 minutes).

    After the exam
    You will remember loads of questions you failed. You will hardly remember any you passed. That is human nature. Smile and get on with whatever else you have to do.

    Hope you find this advice useful. I think the reason most people fail any exam has nothing to do with knowledge but all to with their approach to preparation. Follow the path of least resistance - get rid of those big books, read first aid, do QBank! Months of preparation won’t make that much difference…it is how you prepare that matters. For most people, provided you have been through medical school okay (without struggling), it should be possible to PASS without excessive effort. I don’t think it is risky either; using the above approach my score was 90/221 so there is plenty of safety margin.

    Best of luck

    Ani

    ani90@btinternet.com

  2. #2
    Anonymous is offline Unregistered Guest
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    reply

    thanx 4 these great advices
    they r of great help
    goodluck in everywhere u turn

  3. #3
    Anonymous is offline Unregistered Guest
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    thanks!

    thanks ani so much for taking the time to help others even after u finished ur exam. the info seems very helpful. especially the extended advice about qbank. i've been doing the pirated qbank version and its just not as good. i agree that the online version done in the timed mode is well worth the $150 and the best thing to simulate the real thing. i had never thought of the concept that u will be forced to complete the 2000 questions in 30 days. good thinking. thanks again and best of luck to u.

  4. #4
    neilc is offline Permanently Banned
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    my thoughts exactly

    i still don't know what my score it, but i totally agree with the study plan. i actually began my studies a bit earlier, and was using lots of books. in the end, first aid, pathophys for the boards and wards and brs path were the only books i used.

    i have been telling people to study like this, and they just look at me like i am crazy. people have been brainwashed into thinking you need months and months of review. well, that is just so low yeild it is foolish.

    i found the test to be a LOT of fairly simple questions covering a HUGE base of topics. to do well, you need to not make mistakes on the simple questions. screw the toughies...just make sure you get all the easy one's right and you will likely do very well. and all the easy ones are covered over and over again in qbank.

    good luck to all!

  5. #5
    Anonymous is offline Unregistered Guest
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    Great Advice!

    Thanks a lot Ani for taking the time to write this GREAT advice. After reading it I realize what I have done wrong in the preparation. I failed the exam and have been trying to figure out why and how I should study this time.

    Your advice should be place to the top for everyone's benefit!

    Thanks again and good luck!

  6. #6
    stergs is offline Member
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    Great advice!!

    I agree with you one hundred percent. I had gotten suckered into buying so many books only to find that they state thesame thing but in different ways. Find what works for you and stick to it. Thanks again.
    "The question is, 'Do I have a God complex?' .... You ask me if I have a God complex? Let me tell you something. I am God." - Alec Baldwin as Dr. Jed Hill, from the movie Malice

  7. #7
    Anonymous is offline Unregistered Guest
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    do users find recalls useful?

    Also ignore the questions and recalls you see on discussion forums; don’t even read them– those serve only to panic you. Nobody posts the easy to moderately difficult questions which constitute over 70% of the exam. The questions people post never reflect the real exam but the 10 or 20% that defines those who will score 99 and those who won’t.
    I was wondering then...do users find the recalls useful? I always find they make me worried

  8. #8
    Anonymous is offline Unregistered Guest
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    ani qbank

    I THINK ANI IS FALSE AND SHE SITS IN WASHINGTON AND WORKS FOR KAPLAN. SHE PUT THIS MESSAGE MANY FORUMS, SAME THING OVER AND OVER AGAIN. BEEEEEEEEEEEE AWARE OF HER KAPLAN WORKER. ADVERTISEMENT HOOOOOOOOOOOOOO.

  9. #9
    Anonymous is offline Unregistered Guest
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    looks like ad for Kaplan

    I totally agree with saga. I saw this experience on many forums. This is an advertisement for kaplan Qbank. If you belive it, you can try.

  10. #10
    Anonymous is offline Unregistered Guest
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    Why do people always try to bring others down?

    The last 2 contributors suggest that I am false and an agent of QBank...it is now a common thread in this forum for people to rubbish others claims and experience saying they are faking it. They did this a while back to Ana Paula and others. I think if this behaviour continues people should stop sharing their experiences on this forum.

    Really I have better things to do with my time. I am neither the first nor will be the last to have benefits from Qbank. Indeed if they did read my submission, a lot of it concerned preparation and exam strategy and not Qbank. They have not accused me of working for First Aid which I also promoted. Also I did say in my submission that other question banks may fufill the same role as QBank. If my submission is on other forums it must be people pasting it there, as I do not use other forums.

    I am real and am sitting my Step 2 on 19 November and CSA on 21 December. Indeed you may see my contributions on those forums and as far as I know there is no QBank for the CSA so I wonder what I am advertising there. I have passed Step 1 but like many others still come back to this forum just to see what is going on and help others in the same way we were helped (by this forum) when preparing for our Step 1 exam.

    Saga and fmg can continue spending their time reading big books and doing recall questions...that is fine as they probably either have the time, want to score 99, or are just too big to accept their approach may not be the best. But they should not discourage or frighten others, some of whom have had great difficulty with this exam, from taking up what may be good advice from contributors. All I was saying is that for those who are struggling, don't have the time, or just need a pass there are easier ways.

    You may chose to learn the hard way and waste months of your time studying, reinventing the wheel, seeking the holy grail, and making the same mistake hosts of others have made in the past; or you may learn from others' experience, and hence avoid their mistakes and grab their secrets of success, use your time and money more effectively and maximise your score. Nothing I wrote is original and unique to me but things I learnt from others' experience. Incidentally, I learnt about QBank and its usefulness from this forum...without this forum and the advice from others I may have been telling a different story. Think whatever you wish.


    Sorry to bring this to the forum. I do know saga and fmg are in the minority but I do find their accusations very upsetting and such voices if continued will end up destroying what we are all here for which is to help (and not bring down) one another.

    Thanks

    Ani

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