How I passed my USMLE Step 1
MY USMLE STEP 1 EXPERIENCE (269)
I’ve been waiting since forever to write my experience. Here is my detailed experience. I have tried to be as specific as possible.
Resources: It is a highly subjective matter to talk about. Everyone has their own preference. I’m listing resources which I used and found them to be extremely useful ( Note: This list is arranged in chronologic order from most useful to somewhat less)
1) Boards and Beyond: So you might be surprised that why BNB tops my list when It should be F.A. BnB compliments FA so well and it explains everything written in First Aid. The lectures are short, to the point and contains almost everything that is tested on USMLE step 1. I am more of a binge-watcher than a binge-reader, I binge watch T.V series all the time 😛 .
That practice came into play and I binge watched Bnb 3 times, first time at the beginning of my active phase of prep at 2X speed, 2nd in the middle(2.5X) and 3rd in last 15 days or so ( 3X). To me BnB is the single best resource. It contains all the important stuff from FA, Uworld as well as NBME’s. And the way Dr. Ryan explains all the stuff sticks better in your mind than any other resource used alone.
Plus those minor details that Dr. Ryan tells do show up in exams so familiarize yourself with bnb well. If I could meet Dr. Jason Ryan I would personally thank him for this series, which is the life saver for students like us
2) First Aid: AKA the Bible for Step 1
It has 95% of everything you need to know. The layout of the book, the diagrams, the histology pictures everything is just perfect. But the stuff is very volatile and concepts are hard to understand if you do not have basic knowledge. This is where Bnb comes in and it is the perfect companion to be used with First Aid. Do familiarize your self with all the tables, charts and histology pictures of F.A. So now to answer the burning question that is asked most often: Do we need to know everything that is written in F.A and the answer to this is: Absolutely not!
The Exam test your concepts, your understanding and your grip on pathophysiology. It does not need that you know on which chromosome what genes are located on or every single step in every metabolic pathway. Try to prioritize things do all the important stuff first disease presentation, enzyme defects and their clinical consequences, important lab anomalies, USMLE buzz words and stuff that screams that“ I’m high yield” Do not waste your time and energy on remembering stuff like TSC 1 gene is on chromosome 9 or so. I’m not saying there is no chance you will get a question on those.
All I am saying it is less likely, the probability is lower and if you utilize your time and resources on mastering concepts you will get a higher score (Do remember the chromosomal translocations for leukemias and lymphomas that stuff is high yield and you get qustions on them all the time)
Uworld: The most expensive resource I used 😛
To be honest when I started Uworld, I thought all the questions in the exam will be straight form Uworld. But this is not the case. There was not even a single question straight from Uworld. And the number of questions that were based exactly on Uworld question was also low. DO NOT USE UWORLD AS YOUR PRIMARY LEARNING TOOL.
Do not take me wrong and don’t skip uworld as a study resource. It is a great Qbank, it supplements your knowledge well. It simulates the exam environment and this is the most important thing.
It forces your mind to think. The practice of doing Uworld question daily makes you very time efficient in solving the blocks. My Uworld subscription was about to end during my 2nd pass and I used to solve 7-8 blocks per day with review and it made very efficient in solving the exam blocks.
All the stuff that is high yield in Uworld is already present in F.A and BnB. Just focus more on uworld disease algorthms, table and figures.
It is a relatively easy Qbank. You would have no issue solving Uworld if you have some basic medical knowledge.
Undoubtedly one of the best resource for pathology. I did pathoma in my med school abut 5-6 times with lectures so I didn’t felt the need to do it again during my Step 1 prep.
Though I went through the book in my last week of prep in about a day or so. I had all the important points from the lectures written so I didn’t go the lectures again.
Amboss: The most underrated resource
I didn’t plan to use Amboss because I was already using Uworld and I though it would be a waste to invest money in some new Qbank. I casually applied for scholarship and got the 3 months Amboss subscription for free 😛.
I decided to take a look and to my surprise it was a great resource. The interface of the exam mode is much closer to the real exam than the Uworld and the additional tools that you get sets it apart from Uworld.
Radiology overlays, attending tips and the huge collection of Amboss library is just ❤ Although I didn’t had much time because I was already in my last stage of prep so I went through it once superficially
Bottom line: Amboss is a great supplemental resource to your main resources and it has much more advanced learning tools than Uworld. The content is a little immature, difficulty level is little higher than the Uworld and the real exam but it will help your studies well.
Kaplan: Using Kaplan for Step 1 is a bit controversial these days. It’s lengthy and too time consuming so here is my take on it
DO NOT USE entire Kaplan series if you plan to take USMLE step 1 in 6-8 months. It is extensive and even if you manage to do it. You will miss other high yield resources and will perform poorly in exam.
Still the following sections are highly recommended to be done from Kaplan because you get questions extensively from them and other sources cover them poorly
BIOCHEM by Dr. Sam Turco: Undoubtely the best resource (Although Bnb is good too) The enzyme kinetics, metabolism, population genetics and molecular genetics are tested extensively in exam so do watch Turco at least once. ( Dr. Turco is a great guy, he will inspre you alot to study better)
Pharma by Dr. Raymon : Although the videos are about 10 years old now, to me it is still the best resource for Pharma. From general pharma to systematic pharma everything is explained beautifully
Protip: you will get a lot of question from Michealson-Menton kinetics, Lineweaver-Burk plot, Competitive, non-competitive antagonist , half life, pharmacokinetics and stuff like that so do watch his videos once.
Dr. Raymon makes strong connection with biochem and patho during his lectures and by watching his lectures you will feel like you are reviewing 3 subjects at once
Neuroanatomy by Dr. White: The exam is loaded with tons of neuroanatomy question like tracts, strokes, INO and aphasia and stuff. Everything is high yield. Dr. White explains everything beautifully and shows how to recognize brainstem and spinal cord sections which is a super high yield stuff for step 1.
DirtyUSMLE: I found about this channel quite late in my prep. It is a good resource freely available on youtube. It is a student-student guide with mnemonics, USMLE “buzzwords”, and exam day tips and tricks. I recommend that you checkout his channel once
100 cases of ethics by Dr. Fischer: I went through the book once and I didn’t found it to be much useful to be honest. It had some weird scenarios like sperm donation and I don’t know what. Didn’t help me much.
Anatomy Shelf notes: Went through them once. Didn’t find them to be much useful
NBME’S: Use them as assessment tool that’s it. The older NBME’s poorly correlate with the score and I have no idea about the new one’s since I used them offline 😛 But they are a good way to keep you in track for the exam day
That’s it. These are all the resources I used and the resources that I recommend. I am a Medical graduate and I have already done MTB for step 2 and Kaplan CK lectures in my med school. These resources helped me in the exam to some extent. I DO NOT RECOMMEND THAT YOU GO THROUGH THIS STUFF FOR STEP 1.
All I am saying that your prior medical knowledge that you gained in the med school is the single best resource in acing this exam ( I have used Goljan, Robbins, Kaplan, Pathoma, and First Aid extensively in my med school and that’s why I found this preparation for step 1 relatively easy)
I am not sure about exact preparation time because I have used Kaplan, Pathoma, First Aid extensively in my med school. I have done both 2010 and 2014 kapaln videos once along with the entire Kaplan series in my medscool. Did Pathoma around 5-6 times with lectures. And did F.A multiple times. But I wasn’t serious about the Step 1 exam. Never Used a Qbank ( which was the single biggest mistake, otherwise I would have been done with step 1 about 2 years back). Bought Uworld on 28th August 2019 and from there clock kept on ticking I knew that I have to be done with Step 1 within a year and so I stared taking things a little seriously.
At that time I was doing my House Job (Aka Internship) with 6-8 hours of daily work as houseofficer with a on call duty of 24-30 hrs every week or so. Manging USMLE step 1 with House job was a difficult job but I got great collegues who helped me a lot through this. I took my exam within 5 months of completing my housejob and scored a 269
My advice is to be done with step 1 early in your medschool (ideally in 3rd-4th year) when everything is fresh in your mind and you don’t have to work 6-8 hrs a day, which will adversely affect your preparation.
My recommendation for study plans varies depending on when you want ta take the exam
Those who are still in their 1st and 2nd year of medschool: Go thorough the entire Kaplan series (I used the older 2010 and 2014 videos, so can’t tell anything about the newer ones) after Kaplan you can follow the sequence below
I recommed 6-8 months are enough for step 1 in your active learning phase (with 2-3 months of dedicated period included in this active phase). Do not prolong the active phase to more than a year or else you will get exhausted and the scores will fall
Start Using Uworld (or anyother Qbank; but I recommend UWORLD because it is considered gold standard) from day 1 with First Aid, BNB and pathoma. DO NOT WAIT for completing F.A first. When you purchase a subscription the clock keeps on ticking and keeps you in right track in your preparation.
You should be done with the 1st pass of the these in 3-4 months max. When you are done with the first pass I recommend you give UWSA1 and Start doing weekly assessment with NBME’s. Now comes the dedicated phase reset the uworld and do the 2nd pass. Use additional Qbanks like Amboss if you are scoring good in the 2nd pass of uworld. Otherwise stick to the Uworld only. Go through BnB and F.A again it will take 1-2 months.
Now if you’re scores are good and you feel confident you are ready for the exam. I went for a 3rd pass of F.A and BnB this time with AMBOSS and it took month or so, just to be fully prepared. You can skip this step if you need to.
Uworld 1st pass: Random, Timed, Exam mode : 90%
Uworld 2nd pass: Random, Timed , Exam mode: 98.6%
NBME 13: 26/04/20; 248
NBME 15: 03/05/20: 248
NBME 16: 10/05/20 246
NBME 17: 18/05/20: 257
NBME:19 25/05/20: 246
Note: these were the only NBME’s available for free and which I have done online. Rest of the NBME’s I did offline 😛
UWSA1: Online: 1/06/20: 273
NBME20: 28/06/20: offline 23 mistakes
NBME 21: 19/07/20 : offline 20 mistakes
UWSA 2 :26/07/20: Online ; 269 ( 12 mistakes)
NBME 24: 02/09/20: Offline: 8 mistakes
Free 120: 03/09/20: 93 %
Exam was to be on 27/08/20 but was rescheduled due to COVID-19
Exam day : 09/09/20: 269
Day before Exam Day:
I revised entire biochem, Micro, Biosats, Respo and psychiatry on that day from f.a and went through important tables and figures from other chapters. Since I had done F.A multiple times it wasn’t difficult to do so. Went early to bed at 10 p.m slept for 8 hrs straight. I had the best sleep. I am a very anxious person but I wasn’t anxious that day. May be I was happy that exam was happening after multiple reschedules.
Exam day (09/09/20):
I recommend you watch dirtyusmle tips and tricks for exam day
Sleep well the day before (8 -10 hrs minimum)
Wear pocket-less clothing ( I wore trousers with pocket and lost 30-40 secs at each sign-in after the break due to checking)
Have a decent sized breakfast to power you through entire day ( I had omelet with breads)
Items to take with you: Water bottle ( enough water for entire 8 hrs of exams because there was no additional water available), Foods (Avoid Bringing stuff with simple sugar(I,e glucose) , it makes you sleepy; There is a lot of research to back this claim. I wont go into details but avoid bringing things with glucose; bring high protein and complex carbohydrates diet only ( I brought dry fruits, protein bars, some potato chips and tea without sugar; bring disposable cups for your own ease), Your Scheduling permit, a valid government issued ID and Emergency meds if you think you gonna need them ( I brought paracetamol and some PPI’s but didn’t use them)
Reach atleast 30 minutes before exam time (Pro tip : Use 2 lockers: one for your all foods and drinks and the other one to keep your cellphone, wallet , bag and other stuff )
Do not Bring BOOKS or notes to the exam centre ( I brought F.A but it was too distracting so I just put it back)
Keep your self calm at all times, you anxiety during exam day can turn a 260 to a 206. Keep calm and keep focused
Final tips: Exam is easier than any assessment you take. It is more conceptual. No rote memorization questions at all. All the questions made sense (unlike some weird NBME’s question). Use educated guesses if you don’t know the answer to a question. Eliminate inappropriate choices.
Reserve difficult questions and question with calculations at the end of the block. Do not waste time solving questions involving calculation first, you might end up using more time and end up doing easier questions wrong in panic . Highlight all the abnormal labs, presenting complaint, age , gender and usmle buzzwords.
There are some very lengthy questions. Do not waste time reading the entire question and try to make a diagnosis. Look at the last line and the options first. Usually there key to the answer is hidden in last 1 or 2 lines and then proceed to read the full question. Finally there are many experimental difficult questions that are not counted in your score calculation so if you encounter some pretty weird experimental question. Don’t panic.
Try your best to answer it correctly even if you mark it wrong there is a good probability that it won’t be a part of score calculation
That’s it guys. My entire Step 1 experience. If you have any questions, feel free to ask in the comment section. I’ll try to answer them all
P.S: I made my own notes for step 1, they are handwritten and contain important stuff from Uworld (including tables and algorithms), BnB, AMBOSS, KAPLAN, Pathoma, Goljan and NBME’S. They should be a good companion to the first aid book. I need to scan and compile them first. Let me know if you are interested in comment section. I’ll upload them here, free for all.
Hope you guys perform well in Step 1. 😊
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Dr Manoj Kumar wrote this