How To Score High In USMLE STEP I Exam

Hi all for the first post I have decided to re write a post which I had written for my friends who were preparing for USMLE STEP I.

After having gone through scores of posts of people who took their exam, I felt the need to share my attack plan for the exam.

This exam is unique in some aspects as compared to other exams:

1) No proper syllabus

2) Very long exam – 8 hours

3) Each Candidate gets a unique paper.

4) Results some how are inconsistent with the candidate’s past track record in academics.

Time Frame for preparation:

I prepared for 3 months studying on the average of 4 hours per day and for the last 3 weeks prior the exam date took leave and studied whole time.


Few points about my exam:

1) Most of questions were very clinical
2) They were very long
3) Pathology and anatomy were well tested
4) CT scans & electron microscopy were asked
5) There were lot of solid questions from Pediatrics (Inborn errors + genetics) & medicine.
6) Time was just enough
7) Some of the questions did test objective facts, so u need to memorize a little.

Tips from my side:

GENERAL:
1) First aid is high yield, you should master it well with the last week devoted exclusively to revising it.

2) What ever you read see the clinical implication of it and see how it can be framed as a question
3) BSS question bank and Kaplan Q bank were found to be very useful. Overall Kaplan Q bank is better.
4) Sleep well before the exam, exam is long and tiring. In case you need to go to another place to take the exam reach the place at least the previous morning.
5) Some of the questions do have a seemingly correct choice as the first choice, so read through all choices.
6) Try to finish the first 25 questions in 25 minutes OR u will run short of time.

ANATOMY:
For Anatomy the best review series is the high yield series. I particularly liked the High yield Gross Anatomy and Neuroanatomy. The high yield anatomy has an excellent foreword covering all the important topics to be read.

For embryology use Kaplan notes if available. Or just read the tables from High yield Embryology. Go through the pictures of Histology from JayDoc’s interesting web site.

Learn to read CT cross sectional cuts, I used material from the web Path website for it.

The base of skull is often tested; hence I used pictures from Keith L Moore Text book of anatomy.

PHYSIOLOGY:
Kaplan notes are a good source of review if available. If not use BRS physiology. The MCQ’s at each chapter end in this book are high yield.

CNS from this book is high yield.

MICROBIOLOGY:
Kaplan notes + tables & MCQ’s from Medical Microbiology & Immunology Examination and Board Review by Warren Levinson & Ernest Jawetz.

Immunoglobulin structure is high yield so read it well.

PATHOLOGY:
Goljan review of pathology is a very good book for review. First aid too has a decent review of pathology.

Learn all the standard pictures from Web Path. By standard I mean go through pictures of conditions you learnt in your text book.

BEHAVIORAL SCIENCE:
Every IMG'S nightmare can be best tackled by reading BRS Behavioral science well. Try to do as many questions as possible on this subject. Doctor patient relationship is highly tested.

For the AMG the High Yield Behavioral science may be enough.


PHARMACOLOGY:
Kaplan notes + plenty of questions, supplement your knowledge from any book on topics which u do not know. Try to understand all the concepts in pharmacodynamics / kinetics.

If you do not have Kaplan read First Aid and for reference use a book like K D Tripathi.

BIOCHEMISTRY:
First AID review is enough. Concentrate on all inborn errors of metabolism and enzyme kinetics from any book you are comfortable with. Moreover Biochemistry is low yield.

I found the questions on this web site very useful especially if you have time -- USUHS Medical Biochemistry Exams.

Another useful web site is by a professor from India -- Dr. Kusum K. Nagda, Ph.D.

This web site even has a weekly quiz based on USMLE model questions.

NetBiochem Topics: http://www-medlib.med.utah.edu/NetBiochem/titles.htm

This site has all the tables of enzymes which are heavily tested on the exam.

What to revise in the end:

1) First aid
2) Physiology, Pharmacology and Enzymes from Biochemistry. These are the most volatile high yield stuff for step 1 exam.
3) Selected pictures from Web Path i.e. those topics which are discussed, liver is high yield, DO NOT TRY TO SEE FULL WEB PATH
4) Do USMLE CDS at least once though it is not at all like the real exam
5)Relax & pray to God that your exam goes well.

Some useful Web sites for Step 1 preparation:

1) Microbiology and Immunology On-line from university of South Carolina: http://pathmicro.med.sc.edu/book/welcome.htm

2) Histology-World: http://www.histology-world.com/

3) Online Pharmacology exam from Kansas medical center: http://www.kumc.edu/research/medicine/pharmacology/CAI/menue.htm

4) Atlas of Histology from University of Illinois: http://www.med.uiuc.edu/histo/large/atlas/slides.htm
I like the section on electron microscopes.

5) Jay Doc Histoweb: http://www.kumc.edu/instruction/medicine/anatomy/histoweb/index.htm

6) Whole Brain atlas from Harvard: http://www.med.harvard.edu/AANLIB/home.html
I used it to study cross sectional anatomy.

7) Neuroanatomy from University of Utah: http://library.med.utah.edu/kw/animations/hyperbrain/pathways/
An excellent source to review and test your concepts in this topic.

8) WebPath from Florida State University College of Medicine: http://medlib.med.utah.edu/WebPath/webpath.html

9) Urbana Atlas of Pathology: http://www.med.uiuc.edu/PathAtlasf/titlepage.html

10) Genetics case studies: http://bob.usuhs.mil/biochem/problems/gencase/

11) NetBiochem Topics: http://www-medlib.med.utah.edu/NetBiochem/titles.htm
This site has all the tables of enzymes which are heavily tested on the exam.

12) Eukaryotic Gene Expression Problem Set: http://www.biology.arizona.edu/molecular_bio/problem_sets/mol_genetics_of_eukaryotes/eukaryotes.html Good MCQ’s worth going through.

13) An online text book of Biochemistry: http://web.indstate.edu/thcme/mwking/home.html

14) USUHS Medical Biochemistry Exams: http://bob.usuf2.usuhs.mil/biochem/exams/exams.html

15) Nagda’s Biochemistry Study Centre: http://home.123india.com/nbsc/index.htm

16) NBME Step 1 self assessment site: http://www.nbme.org/programs/sas/sas.asp
They only give a feed back but do not even tell whether our answers were correct or not.

17) Kaplan medical: http://www.kaptest.com/Kaplan/2/Medical_Licensing

18) Prep4usmle – a forum for clearing all your doubts: http://www.prep4usmle.com/