Step 1 USMLE Study Secrets

Maybe this post seems misplaced in time and space–but I am trying to recall how I passed USMLE Step 1. I am attempting to figure out how to study for third year shelf exams. Every forum and thread offers its own two cents: a little Case Files here and lots of UWorld there. Some wise tutor center coordination advised that I bring it back home! How did I study for Step 1?

To call my initial attempts as “studying” would be generous… a struggle-fest ensued after my last exam of second year as I volunteered and visited friends and did all sorts of things for which people studying for Step 1 do not have time.

Failing two NBME practice exams got my attention.

Thankfully, a kind professor redirected my energies and, together, we created a 5 week plan beginning with my weakest subjects and working up my way towards confidence. The hardest sections received three to four days effort whereas the others received a few days. Only one day was spent for each of biochem, immunology, infection, and biostatistics. Here’s a week in the life–

  • Weekday, for example, Cardiology Day 1 of 3
    • 6 A.M. Wake up. Read my Bible. Eat. Turn on Goljan lectures.
    • 8 A.M. UWorld (UW) 44 Cardio questions in timed mode
    • 9 A.M. Review questions putting missed question and answer in a journal, read Cardio chapter in First Aid (FA)
    • 10 A.M. UW 44 Cardio Q in timed mode
    • 11 A.M. Review Q&A etc, read Cardio in FA
    • LUNCH Listen to Goljan Pathology lectures. Laugh. Eat outside.
    • 1 P.M. Kaplan Q bank  44 randomized/mixed questions timed
    • 2 P.M. Review etc.  and read Cardio in FA.
    • 3 P.M. Kaplan Q bank 44 randomized/mixed questions timed
    • 4 P.M. Review etc. and read Cardio in FA.
    • WORKOUT Turn on Goljan while driving to gym. Turn off. Read 30 pharmacology flash cards while biking.
    • DINNER. Walk with mom. Play with dog.
    • 8 P.M. Finish the rest of pharmacology cards if I didn’t want to look at them at the gym. Listen to Goljan while making lunch.
    • 9 P.M. Call boyfriend.
    • 10 P.M. Read through notes from the day’s Q&A.
    • SLEEP
  • Saturday
    • NBME practice tests (one for each of 3 Saturdays leading up to the test week. Review and write Q&A afterwards)
  • Sunday
    • FREE. Freedom never felt so great!

If I had to do it all again, I wouldn’t.

But really, if I had to change anything, I would have gone home first thing after second year and study for Step 1 in complete anonymity. Also, I would have used Kaplan subject by subject in the morning and then used UW for my randomized questions in the afternoon. I began with 3 sets of 44 UW questions then went to 4 Q sets which necessitated buying the additional Kaplan q-bank for one month. Since my initial UW scores were abominably low, those initial questions essentially provided no marker for performance or even learning. Also, the only way to reset UW is if you buy a one year subscription… which I didn’t know! After it was too late, a friend explained how you can simply “reset” your Q-bank by red-flagging the questions missed or those you weren’t quite sure on. Your second “reset” round, you will select questions solely from the marked/missed questions.

There’s my fool-hardy plan. While third year doesn’t offer time for the same quantity of work, I am open to suggestions as to how to duplicate its quality!

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