Friday, April 8, 2016

Dr. Thinker: USMLE STEP 1

Ideal Duration: 6 months (But, remember it varies from individual to individual)
Resources: Kaplan notes, Kaplan Videos, First Aid, Uworld
 Alternative resources:  If  you are aiming for high scores    
1.       Pathology: (also gives a stronger foundation which would help for Usmle step2 and 3)
A.      Golijan, Golijan lectures (OR)
B.      Pathoma, Pathoma videos makes it easier – Easier to study and remember compared to Golijan
2.      Behavioral Science/Ethics:
A.      High yield
B.      BRS
C.      Conrad Fischer’s  100 Ethics cases
3.      Biostatistics:
A.      Take the uworld’s additional 25$ subscription for biostats

Practice tests:
1.      USWA: Uworld self assessment forms 1 and 2
You will get it for a cheaper price if you buy it along with the usmle question bank.
It will be available for access for only 14 days from the time of activating it.
Uworld question bank activation and uwsa form activation are two separate things.
So, you can buy it along with the question bank, finish doing the q bank and then activate UWSA only when you are ready to give an assessment exam.

2.      NBME:  Numbered as form 1, 2, 3 and so on. Higher the number – newer the form
There are many forms. You should do most of them online and then at least 2-3 latest ones online.  The latest forms correlates better with your final score. So, it’s advisable to the latest forms online.

Strong advice: Do all the nbme forms and uswa forms. The more you do, the better your final real exam score would be. It will help you in managing time, gives you new information and also helps you how to think fast in tricky situations. If you are lucky, you can see a couple of similar questions in your real exam.

3.      OPTIONAL – You can try Kaplan Qbank if you want, but not necessary as the pattern of questions from Kaplan is totally different to that of final exam. You can do it if you have a lot of time and if you want to gain more knowledge. I have seen people getting 260s even with avoiding Kaplan q bank.
4.      OPTIONAL – Flash cards for USMLE Step1 – Again it’s not compulsory but a good way to memorize subject and especially during breaks.

From my experience:
1.      UWSA over estimates your final real exam score and NBME underestimates your final real exam. So, ideally your final score would be between UWSA and NBME avg scores.  Now, this is how it is usually correlated. This doesn’t mean your final score shouldn’t be more than that of NBME or less than that of UWSA.
2.      Ethics and Biostats questions have more weightage compared to other subjects. So, practice these as many times as you can. Do the same questions again and again, giving importance to the explanations until you get a hang of it.
Eg:  X and Y had each answered 10 questions wrong overall.
        Out of those 10 questions, X had answered wrong for 2 Ethical questions,
        whereas Y had answered wrong for 5 Ethical questions. The final score of X will        
        be higher than that of Y, as X did better with ethical questions.
3.      Final real exam questions are more closer to that of NBME than UWSA.

Common mistakes/misconceptions: Most of us give step1 after final year medical school. So, when we first open biochemistry or microbiology we don’t remember a bit and hence, we end up studying the notes for days. DON’T DO THAT.
1.      Don’t waste your time reading Kaplan/other notes for days or months.
2.      Don’t waste time on Kaplan videos for each and every topic or subject.
Step wise approach to USMLE Step1:
1.      Just give one quick reading for all the subjects.
2.      Use Kaplan videos along with the notes if you have trouble understanding or remembering some concepts.
3.      After the first read, go through First Aid for USMLE step1. Read it once or twice depending on your individual grasp of information.
You should ideally do this all within 2 months
4.      Take a 3 month (ideal duration) subscription for Uworld.
5.      Do at least 1-2 whole blocks per day. You can do it subject wise or random. You can use tutor mode.
6.      Write down the concepts and explanations that are new to you. Go to and fro between Kaplan/first aid and uworld if you forget some topic or if you feel you need to read it in detail again.
7.      Mark the questions that went wrong or those you think must be done again for sure.
Ideally, you should finish all the questions atleast once in 1 n half months to 2 months.
8.      Start the 1st revision. Start using timed mode. This is going to be faster than your first time. Do more blocks per day. At least, 3-4 blocks or more per day and simultaneously read the notes you prepared.  You can do all the questions or those you marked during the first time. (I would suggest do them all, as even those you got it right the first time may confuse you now.)
You should finish the 1st revision in 15-20 days.
9.      Start the 2nd revision. Definitely, use the timed mode. This is the revision where you should focus on managing the time. Do  5-6 blocks per day or more.  You can even do 8 per day, which would help you big time with managing the time (of course it depends on how strong your first revision was). As with 1st revision, do only the questions you marked during 1st revision or do them all in random.
This shouldn’t take you more than 10 days.

10.  The last month is very crucial.
Day 1 and 2:
Start with UWSA form 1. Give it within the time without taking any breaks.
Read the explanations once the exam is done. You will get a lot of new info and new questions. So, read them all and note the important points. Spend two days in total for reading explanations along with previous notes or FA.

Day 3 and 4:
Do UWSA form 2. Again you can expect a lot of new information and questions. Go through the explanations, take notes and take it slow.
I suggest starting with UWSA and not NBME because, UWSA gives explanations and NBME doesn’t. So, you can use UWSA as both an assessment tool and a reading tool.
                      From Day 5 onwards, start doing NBMEs. Do, one per day.
Finish all of them or how many ever you want by 2 weeks prior to your final real exam date. Your last couple of NBMEs must be given online. As I earlier mentioned, NBME doesn’t give explanations, so have a reliable group of friends who can help you find the answers quick.
2 weeks prior to exam:
1.      Don’t over stress. You have done it all. You did everything you could.
2.      Revise the notes you made from Kaplan, Uworld, UWSA and NBMEs.
3.      Read First Aid – On the day of the real exam, the things you remember are mostly from first aid and the notes you made and not from Kaplan text books or anything else.

2 days prior to the exam:
1.      Relax as much as you can. Watch a movie or tv shows.
2.      Sleep as much as you can. Especially the night before the exam.
What to expect during the preparation?
1.      Starting with Kaplan could be boring – but, don’t lose interest and give scope to long gaps between studying.
2.      Since, we usually start studying after final year, most of the knowledge from 1st and 2nd year subjects is already lost. – So, don’t be scared that when everything appears as new information.
                    When you start Uworld:
3.      Be prepared to know that what you read from Kaplan will be a lot different to what you are going to be tested.
4.      Use Uworld as a LEARNING TOOL. – It’s a very common thing that most of the people get scared and doubt their talent when they answer wrong for most of the questions. Remember, everyone will be on the same page. Don’t be scared.
5.      Just as above, your first experience with Uworld shouldn’t be assumed as a test to your knowledge. Just take it as a LEARNING tool. Think it as another text book. Just learn from the explanations given for every question. I am saying this twice because I have seen a lot of people who got scared and lost hope when they got most of the answers wrong.
6.      Depending on a person’s IQ  the percentage of the questions you get right during your first time with Uworld can be anywhere between 30% to 80% or more. But, this doesn’t mean that a person in the 30% category can’t score same as the person in the 80% category, if not more in the final exam.
7.      During the first REVISION, the % of questions that are correct should be atleast more than 60% - This depends on your hard work during the first time.
8.      If even during your 1st Revision your % of correct answers is less than 60%, don’t lose hope. It just means that you would need more revisions later on. You can still get to 90%+ right answers by 3rd or 4th revision.
Resources for Individual subjects: Uword + FA is common for all the subjects
1.      Physiology – Kaplan
2.      Anatomy + Neuroanotomy – Kaplan
3.      Biochemistry – Kaplan
4.      Microbiology – I would suggest not to waste time with Kaplan. First aid is more than enough
5.      Pharmacology – Kaplan in my experience. But, some do it just from First Aid.
6.      Histology – No need to stress from Kaplan. You will learn it from Pathology and Uworld.
7.      Genetics – Try genetics questions from Kaplan Qbank too.

      KEY: PRACTICE – it’s the only thing that determines your final score. Do as many questions as you can and as many times as possible.  Don’t waste too much on reading Kaplan text books. STEP 1 score is very important.


  1. Hi :) Thank you for the guidance, its very helpful. What do you think of taking Step 1 while in medical school? Would you say its advisable to prepare during third and fourth years and sit the exam at the end of fourth year, or is that just setting yourself up for low scores? Would appreciate any input, thanks!

  2. Hey! You are welcome. I don't know how much time you would be able to spend during 3rd and 4th year for step1 preparation. Ideally its better if you can finish at least one step by the end of final year, but it's difficult and can affect the score. I don't know about your capacity either. Also, it might be a better option to study Step2 ck during 3rd and 4th year and sit the exam at the end of 4th year as the subjects are same. You would just need some good basics in step1 subjects.

  3. Is it advisable to give Step 1 after your 2nd year or wait till after your final year of med school?


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