Sunday, October 28, 2018

Studying for Step One

Studying for the USMLE can be a daunting task, especially when you're an International Medical Student/Graduate. Coming from a different background - culturally and educationally - the questions asked in these examinations reflect the health system and health needs of the US's population. Apart from the questions, the financial aspects of attaining residency in the United States may also be a setback for some. Overall, this journey is a test of patience and dedication to the profession and one's career goals.


If you are considering pursuing a residency in the States, there are significant advantages to making this decision early on in your training. For starters, you can prepare your family for the move and hustle that comes with this pathway. You might need to save some money to finance your journey as it will most definitely be more expensive than a home country residency - albeit it may be all worth it at the end. Another advantage is rotating at American hospitals while you are still a Medical Student. Rotating as a Medical Student is known as an 'elective' or 'clerkship' which allows the student to get hands on experience - an absolute requirement for most residency programs regardless of scores. Apart from these, knowing your goals early on gives you more time to study!

As an IMG, studying for the USMLE after graduation - unlike AMGs - is stressful for many reasons. Taking 3 exams while being unemployed, dependent, and possibly alone in the US is not an easy task. Of-course some may be lucky with lots of family support but that's besides the point because as an IMG, the pressure is higher no matter what. However, you can be a competitive applicant with some hard-work and planning. Hard-work is on you but planning can be made easier with the right kind of guidance and advice. In this post, I’d like to share my study resources for the USMLE Step 1:

Foundation: Just like any skyscraper and even a small home, the foundations are the most important aspect of successfully building anything – in this case, its your knowledge. I didn’t know what would work for me, so I collected multiple resources to see which ones would stick. I would recommend the following resources (although I didn’t use all of them, I do know some of my peers who did):

Kaplan tutoring: Expensive but it will lay the base for you quickly and efficiently (although I can’t speak for effectiveness since everyone learns differently)
Kaplan Videos: This is the resource I used. I went through all the videos in a few weeks at 2x speed.
Kaplan Books: Very extensive and unless you can read quickly, it might take a longer time to complete these books.
DIT Videos: Although I did not use these videos, I have heard promising reviews.

Subject specific: It’s important to supplement your weak subjects with extra resources specific to that subject. The following are ones that I found helpful:

Pathoma: Highly recommended to gain a good, basic understanding of Pathology. In my opinion this book and the videos that accommodate it are sufficient for the exam.
Goljan Pathology: Can be used for more in-depth knowledge into pathological
BRS Physiology: I used this book for all my physiology needs. It provides succinct information on fundamental physiological principles.
Ethics: 100 Cases by Conrad Fischer: Although it may not have every scenario, it gives you an idea on how to answer ethics questions from a USMLE standpoint.
Anatomy Shelf Notes: You can find these on the Facebook forums, however, they provide minimal insight into Anatomy and most probably don’t help. Try to dig up your own notes from medical school or ask someone else for theirs if you are weak in this subject.
Sketchy Microbiology and Sketchy Pharmacology: If you remember through imagery then this resource will be invaluable to your learning. Both subjects are adequately covered.

UWORLD: Along with FirstAid for Step 1, this resource is your holy grail. The questions in this Qbank will prepare you for the real deal. It covers every high yield subject you will encounter in the exam. It is pricy, but it is well-worth it at the end. Use every question and repeat if you have the time.

First-Aid for Step 1: It’s called First Aid for a reason, it gives you everything you need to be saved from this exam. I felt like every question I got on my exam came from a point in this book. Read and re-read every letter. The authors have spent years modifying this book so that it can be the best resource for you. They also have information on statistics and other resources that you can use. Don’t forget this one!

NBME’s and other self-examinations: These provide extra questions for you to practice. They also assess you and provide a score for you to gage your knowledge level. This can be a double-edged sword so don’t let low scores discourage you and don’t let high scores make you over-confident! Continue to study the best you can till the exam!

Google: Don’t understand a word/topic/ECG/your life? Google it!

There’s innumerable amount of resources out there that you can use. Take the time to reflect on your weaknesses and work on those. It is extremely pertinent that you understand the basics behind every topic in order to build your knowledge on it. USMLE is tough but it’s more than possible so give it your best shot and take it from there!

Submitted by Sindhuja Palle

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