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Thread: My long path to passing that Exam and the Exam Experience

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    gebbils is offline Member 515 points
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    My long path to passing that Exam and the Exam Experience

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    just got the score in the mail today:

    Exam Taken: 3/27/07
    Score Reported: 4/18/07
    Received the score in the mail: 4/20/07

    202/83,

    I know it's not that high, but I am so grateful to G-d that I passed this.

    My UW score cumulative, unused, untimed was 52%
    NBME Form 3 - 370 (3 weeks before the exam)
    NBME Form 4 - 430 (1 week before the exam)


    Thanks to this forum and all the people who are posting the questions and helping others out.

    Good luck to all and G-d Bless you!!!

    Well here is my exam experience, before you go any further, itís really really long, because I wanted to give the whole picture, instead of just saying how it was and what was tested.


    This is my second time sitting for this exam, the first time, I came out of Basic Sciences and just took that Pass Program and was so confident in myself that I knew all the tricks and all the buzzwords, but that was my mistake. As I realized there are no buzzwords on the exam, and basically Pass Program was just a simple waste of time and money and it led me think that I was ready, where I was not at all.
    So the first time around, I was close, I got 176, so I took a few days off to feel bad, but then got myself together and started going over Goljanís notes, read them through. And then I decided to take Kaplan Prep. Course, luckily there was one in NY, and I did it for 6 weeks, my confidence went through the roof. It taught me basics that I either forgot or never understood fully from Basic Sciences. At the same time I signed up for USMLE Rx and as it turned out, it was the big mistake to do so, so I just stopped using it after 5 days. And I heard a lot about USMLE World, and decided to give it a try.
    I wonít kid you, I was so depressed getting those 50ís and 40ís in the first month of USMLE World ( I was doing 50 questions a day), so what I started doing, I started writing out the wrong questions that I got and the explanations to them, and then when I would take a break from studying, I would just sit and read through those concepts that Ive written out from USMLE World.
    So I finished USMLE World with a 53 average unused and untimed. I know thatís not a high score, but I extended the subscription and started doing Incorrect Questions. And I was amazed myself how much material there was and how quickly I would forget some things, so I kept doing Unused questions and reading my notes that I made from USMLE World, which by that time I had about 60 pages of notes.
    Oh forgot to say that the first time around I did Kaplan Qbank and I would say that it was helpful to LEARN the material, but not to get yourself ready to be able to recognize what they would ask on the step, as the format of the questions on the real step is nowhere close to Kaplan Qbank.
    Anyway, after getting done with Kaplan, I took NBME Test Form 2 and I got 460 on it, I was happy, but not yet confident, since it was my second time taking the step and I would need to give myself a safe margin, because the first time around I scored 420 on NBME Form 1 and ended up failing the exam.
    Anyway, back to my boring experience, so I went to Atlanta for 4 weeks of FP rotations as my school required me to continue, or I would have to go on Leave of Absence and I didnít want to waste time. So while in Atlanta, I kept redoing incorrect questions of USMLE World and reading through my concepts that Iíve written out from USMLE World. And I started listening to Goljan again, this was my second time doing, as the first time I was studying I just listened to him once and didnít finish. You donít understand what a difference it was listening to Goljan this time, where I was understanding much better because of Kaplan Course and USMLE World. Suddenly things started to make sense of what he was saying and tying all these concepts together.
    While in Atlanta, I took NBME Form 3 and before that I read that itís supposed to be one of the hardest ones, where Form 4 is actually the hardest and there is a lot of experimental type of questions with all that Molecular Bio stuff. I got 370 on Form 3 and I was crushed, I didnít know what to do, I thought I understood that and as it turned out, I had to study more.
    I finished listening to all 40 or so hours of Goljan while I was in Atlanta and then I got back home and started reading his book right after that (the book that he gives in the Live Course Lectures by Kaplan), so I started to remember more material as I just learned it while listening and now I was just reviewing it. Oh, also, I was going by my weakest areas on the evaluation sheet from NBME.
    I always had problems with Molecular Biology and the whole concept of second messengers (cAMP, cGMP, protein kinase system) well you know what Iím talking about, and also after hearing how heavily itís tested, I started to freak out, and I found High Yield Molecular Bio book on the internet in pdf format and printed it out. I started reading it, and not just reading it, but slowly to understand the concepts. USMLE World covers these concepts to the great extent, so I kept going over my notes from UW and again, I never stopped doing questions, as I had quite a few incorrect questions, and I had enough questions to keep me busy
    So anyway, I went over that high yield twice and memorized all these messengers and stuff like that that whole JAK/STAT Kinase, MAP and other stuff like that. I understood that now, where and which hormones and how they act.
    So I took NBME Form 4 and I got 430 on it. I was surprised because it was supposed to be the hardest one of all of them, so I was happy with that, since it was full of that Molecular Bio stuff.
    Then what I decided to do, I scheduled the test date and it was the best thing to do, because without scheduling that date, you can study and study, but once you have that date in mind and you know you got 3 weeks left, you just push yourself to the limit.
    I started reading First Aid, as everyone keeps saying that itís full of those details and I agree, BUT you MUST have understanding of that material before you can move on to First Aid, since First Aid will only abbreviate stuff and pick out the buzz words and other stuff, but you would have to understand that beyond those 2 liners that are in First Aid. So a lot of people keep saying that as long as you know First Aid, you are good. I agree, but you must know the material behind that, if you donít have a clue, and all you will do is memorize those terms in First Aid, that will not be enough. Because they will not ask you direct questions, they will try to pull out the WHY concepts, not WHAT.
    Wow Iím in such a writing mood, itís crazy and I didnít even get to Exam Experience yet, sorry, I just want to give as much detail as possible, as I know how it is to study and FREAK OUT, because I went through that.
    So as my date was coming up, I kept going the same pace, going over the Incorrect Questions, reading my notes from UW and also reading Goljan book (in total I read it probably 4 times), then I finished First Aid and what I also did, went back to Kaplan Books for the areas that I felt I was weak in, and I would just read that chapter, nothing else.
    On the day of the exam I got to the test center in Brooklyn at 7:30 and they let me start the exam at 7:45, I brought 2 sandwiches that my wife made, some Iced Tea and a Almonds with Dried Peaches (trust me that stuff is such a brain food).
    I opened up my first block and my heart was pounding, as I always tend to stress myself out like crazy. I swear to G-d, the question type was EXACTLY THE SAME as of USMLE World. I knew right away what they were talking about, and what they were asking, all I had left to do is know the answer to the stuff, as I was able to take that question and break it down and then just answer it. The questions on the Step are designed to confuse you and if you train yourself and thatís what USMLE WORLD does, you will be able to pick out what they are talking about.
    I finished the first block and just put my head down and took a few minutes of rest right at the computer. Then I moved on to the second block, but after the second block I really wanted to eat that Egg and Tomato Sandwich that my wife made, so I took a break and went out of the room.
    Then up until block 4 I was taking a 5 minute breaks and would just close my eyes and rest. So after block 4 I went outside to get some fresh air and washed my face with cold water, it really helps to get that exhaustion of looking at the screen for such a long time and it will give you that kick of energy.

    So here is the breakdown of what I had on the exam: wow, you must be saying, it only took this guy 2 pages to get to what is on the exam J sorry, I just want to give as much as I can, as I know a lot of people can relate to things and sometimes it might give you that boost of confidence after reading that some people are going through the same thing and youíre not the only one. So NEVER GIVE UP!!!

    Alright back to the break down:

    Behavioral Science Ė I swear I had probably 10 questions of Ethics in each block, questions were similar to USMLE World and made you think as some answers really seemed similar.
    Biochemistry and Genetics Ė had probably the most basic biochem questions where you had to know what happens if one enzyme is deficient and stuff like that. Genetics there were some questions where you had to remember what type of inheritance it was, but even if they gave you disease, they would explain everything in the question stem, and you would have to only answer some tiniest detail about that condition.

    Gross Anatomy and Embryology Ė had a few questions on just basic stuff with some X-rays of the bones, but they wouldnít ask to identify it, but instead it would be some question about the condition. I honestly donít remember anything super crazy hard about Anatomy, it was more straightforward.

    Pharmacology Ė had a few questions about a person being on a certain drug and then it would talk about the combination of another drug that would affect the whole p450 concept. So you must know what inhibits and what induces p450. Also they would not tell you to give them the name of the drug, they would letís say tell you that the guy is treated with Warfarin, and then they would ask what is the mechanism of the drug that the patient is on for letís say some fungal infection, and there would be choices like inhibits ergosterol synthesis, epoxide reductase, so basically you MUST know which drug they were talking about, but again itís WHY and HOW, not WHAT

    Physiology Ė a lot of questions with diagrams and graphs, like enzymes that are competitive inhibitors and agonist and other stuff like that. Basically you must know how a competitive agonist would look like on a graph and what stays constant. Like if an agonist is competitive, then what happens to Vmax and K. This material is greatly explained in Kaplan Physio and then UW will ďengraveĒ that stuff in your memory. Again, no direct questions, some were mixed in with Path, but also A LOT of simple questions where you needed to have a basic understanding. And thatís what would happen, I would simply forget some basic stuff. Also must know how to calculate and know the whole concept of GFR and if they gave you Plasma Flow, but they would give you the number for Inulin and creatinine clearance, and you would need to recall which one you measure for Plasma Flow (as I remember Inulin is for Plasma Flow). So stuff like that. So remember the formulas.

    Pathology - THANK YOU DR. GOLJAN!!!! His notes and audio are amazing for this and USMLE WORLD, has kicked my butt in learning new concepts in Pathology and all these conditions that you though that you knew, but had to know more details about it. Like they would give you a patient with Eczema, Respriratory Problems and you would need to know what that disease is (Wiscott Aldrich). So Goljan, USMLE World is amazing for Pathology.

    Micro and Immuno Ė must know all those Interleukins and the drugs that you give to suppress, and how those drugs work. Also quite a few easy questions but you had to remember which one is Catalase Positive, and Coagulase or Oxidase Positive or Negative. Basically that diagram in First Aid you must know cold. Also MUST MUST MUST, know and understand that pathway about Leukotrienes and Prostaglandins and you must know what inhibits what in which step, like Glucocorticoids inhibit Phospholipase 2 and that whole thing about COX 1 and COX 2 and Thromboxane 2. So basically know it all and which drug inhibit what. Like aspirin, clopidogrel must know the differences if a patient is on COX 1 or COX 2 and what would you give to the patient if he is on Aspirin to prevent Gastric Ulcers (remember that Prostaglandin Agonist).

    Histo and Cell Bio Ė didnít have that much of 2ndary messengers, mostly basic stuff, no HOX Genes, because I know everyone is freaking out about it. Just basic stuff, did have a lot of slides, but they were all connected with Pathology, like you had to know what Signer Ring Cell looks like or Plasma Cell (with a nucleus pushed to the side) and they would give you a simple diagram of that and you would need to know what the condition is, if the patient has bone pain and is elderly (Multiple Myeloma). So stuff like that so Slides would help you differentiate, so Goljan has a new book for Path which is like 700 pages, and itís only 35 bucks, I would definitely recommend that, as itís packed with slides and has much more material than the stuff that is floating on the internet.

    Neuro Ė had a few MRIís and CT scans, and a few Cross Sections of the brain stem, so you must know where the cranial nerves are on that cross section of the brain stem. There was exactly the same Gross Picture of the medulla with pons as in either Form 3 or Form 4 of NBME. So had to identify which nerve it was.

    So anyway, my exam was all spread out evenly among all the systems, but again Behavioral Science Questions there were about 10 in each block, so that was the heaviest part on my exam.

    Now Iím just waiting for that score, hopefully I did well.

    Thanks to this forum, it would give me much of the inspiration every time I would feel depressed about the exam, every time I would see a similar score in UW or NBME of people who posted their exam experience and a good passing score, that would give me that boost of self confidence and lift my mood up.
    So those of you who are still studying and feel like this exam is not doable, TRUST ME it is. I never honored a single class in Basic Science, and sometimes managed to just pass the classes, but after coming out of Basic Sciences, I felt that I had so much material to learn and understand. Because you simply forget stuff after youíre done with that class, because you concentrate your attention on the classes that youíre taking. So it was good that I took that KAPLAN Live Prep. It definitely explained a lot of concepts and of course, if you donít get to take KAPLAN course, then just do the books, but donít just read them, try to understand.

    And of course USMLE World. Without it I would NEVER pass this exam, and thatís because you think you know material, but they can ask you the same question in many different ways and you would get confused. So USMLE World definitely by far is the best Question Bank out there. And even if it was 300 bucks a month I would take any day over any other QBANK. As I said before Kaplan Qbank is good and itís an amazing LEARNING tool and that will help you LEARN Kaplan material. But USMLE World will train you to UNDERSTAND the concepts of USMLE Exam. Usmle World, will wear you out and depress you at times, when you get that low score, but trust me if you take that question that you got wrong and break it down and understand how and why it was that answer, then you will do just great.

    Good luck to all of you that are studying either for the first time or will be retaking that exam. Do not give up, yes itís hard and at times seems impossibly difficult. But trust me put your time and effort into it. Take it one day at a time, try to understand why it is like that, read more about the stuff that you donít understand. Donít just memorize the facts, know why itís like that. I canít stress more about it.
    Study study and KNOW that there will be that day when you take that exam and pass it and get through it. I know itís very easy to say, but it is possible, I probably lost 10 years of my life waiting to find out if I passed that exam.
    But you will pass it, as long as you put your time and desire into it. There is no turning back if you got this far, itís just not going to be fair to you or your family if you give up at this point.

    So G-d Bless all of you and Good Luck on your Exam!!!!!


    P.S. I can post a link to the file with my USMLE World notes that I took if anyone wants it.
    Last edited by gebbils; 04-20-2007 at 04:26 PM.

  2. #2
    AmericanIMG's Avatar
    AmericanIMG is offline Ultimate Member
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    congrats bro.

    you couldn't mention me as a study partner in ATL!??!?!
    but remember that, even when those who move you be kings or men of power, your soul is in your keeping alone. When you stand before God you cannot say "but I was told by others to do thus" or that "virtue was not convenient at the time." This will not suffice. Remember that.

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    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    That is so inspirational and beautiful, that I will make it a sticky.
    Thanks for sharing with details your experience.
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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    MDTOB's Avatar
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    Very inspirational! Congrats again to you on passing and thanks for sharing your experience. Good luck in clinicals




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    gebbils is offline Member 515 points
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    Quote Originally Posted by AmericanIMG View Post
    congrats bro.

    you couldn't mention me as a study partner in ATL!??!?!


    Yes, we were all studying together in Atlanta during our rotations with AmericanIMG and another girl who passed Both Steps, we were testing each other the concepts that I wrote out.
    American IMG and MDTOB, guys now this is your time to kick butt in this exam. It's doable, you both know what kind of student I am

    Good luck guys!!!!

  6. #6
    Unregistered122222 Guest

    UW notes

    Quote Originally Posted by gebbils View Post


    Yes, we were all studying together in Atlanta during our rotations with AmericanIMG and another girl who passed Both Steps, we were testing each other the concepts that I wrote out.
    American IMG and MDTOB, guys now this is your time to kick butt in this exam. It's doable, you both know what kind of student I am

    Good luck guys!!!!
    Congrats!

    can you please share your uw notes with us? Thanks!!

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    MDiva's Avatar
    MDiva is offline Member 511 points
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    Your story was a trip to read (in a good way)! You fought a hard fight and came out victorious in the end, very inspiring.

    I'm sorry to hear that Pass didn't work out, was it only because of buzzwords? Please elaborate. And I can relate to UW question depression! It's a good feeling to finally see the scores climb, that's the truth!
    I used to pray and pray for a bike and never got one. Later I learned that God doesn't work that way... so I went out and stole a bike and asked God for forgiveness.

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    gebbils is offline Member 515 points
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    Quote Originally Posted by MDiva View Post
    I'm sorry to hear that Pass didn't work out, was it only because of buzzwords? Please elaborate.
    See the thing is, if you have a strong background in Basic Sciences it would be a good review, but there is so much wrong material that the guy has in his notes and in his lectures and plus, he was making everything look general, like you could answer the questions just by seeing a few buzzwords or CLUES as he says. But that's not how it is on the real step, you need to know the mechanisms and WHY it is like that.
    I'll just put it this way, out probable 20 people from my school who took the program with me, only 3 passed and those are the ones that didnt really need the program anyway.
    I posed my thoughts on Pass elsewhere, but if someone is choosing whether Pass or Kaplan, it's definitely Kaplan hands down.
    Don't you think that it's ridiculous that one guy can teach all of the subjects for Step 1 and plus he was teaching Step 1 Step 2 and Step 3 at the same time, I dont think that's possible, do you?

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    Dr. X's Avatar
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    inspiring indeed. i wrote that you deserve a klondike bar in ur other post (UW 60 page notes) but after reading this.. you deserve two.

    im sure many can relate to ur experience and it def. gives hope. could you be kind enough to list ur resources and the time u took on them. 1 reason: I have HY Mol. and considering about not going through it in depth because of time. I found it interesting how you wrote pharm/biochem concepts under physio title, and arachidonic pathway under micro. of course they're all interconnected but boy.. did UW hit you hard or what. good stuff.

    i have a feeling my post-exam post will be similar to this in exp. but i'll try to make it more original.. good luck in clinicals.
    SJSM.

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    gebbils is offline Member 515 points
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    Quote Originally Posted by Dr. X View Post
    did UW hit you hard or what
    It hit me so hard that I'm still bouncing off the walls
    I was just trying to make it somewhat organized, so I guess I messed up a few things.
    As for the books, I used Kaplan because I took the course, Goljan's Book that he gives in his lectures, High Yield Cell Bio (AMAZING), Usmle World (if you don't do these questions, that will be the biggest mistake) and I did all 4 NBME Forms first online to assess myself, and then the last week I downloaded them from the internet with answers and just went over it.
    Never did USMLE CD, I only did Kaplan Qbank first time around that was last summer, but haven't touched it this time.
    For my last week, I was doing Goljan's Slides and was reading the explanations that came with it. It was good because it was a revision of the material as well, not just the slides.
    Also I did Goljan's Audios twice, you need to do it more than once, because there is alot of material and what I would recommend listen to him once as you are starting to study or in the middle, and definitely after you're done with UW, his notes, because you will see it will make so much sense.

    Dr. X as for High Yield Cell Bio, I think it's only 120 pages, and it's full of diagrams so less to read , I would definitely do it, it will take you a few hours to go through that, as it's all revision, but the chapters on 2nd messengers and other stuff was amazing and explained it really well to me at least.

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