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nollid:Step1 272 考经
作者:USMedEdu
发表时间:2015-09-01
更新时间:2015-09-01
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发信人: nollid (nollid), 信区: MedicalCareer
标 题: Step1 272 考经
发信站: BBS 未名空间站 (Thu Jul 16 00:56:12 2015, 美东)

长期潜水员,AMG一枚。以下是发在SDN上的我的272考经。实在没力气再用中文写一遍
了。但是要着重感谢各位前辈的奉献精神,让我们后来人少走很多弯路。祝麦地年年大
卖!

Background: Non-traditional student (did research for a while, got a master
’s degree, worked a bit before starting medical school), mid-tier state
medical school, pre-clinical class ranking ~top 2%

Pre-dedicated study time: No study during the summer before M2. Did research
instead and am very happy about the decision.

Main Prep Resources:

Aug 2014-April 2015---- USMLE-Rx Qbank First pass, organ system specific
along M2 courses: 90% correct

Aug 2014-April 2015---- Kaplan Qbank First pass, random mixed/organ system
specific along M2 courses: 80% correct

Jan-April 2015---- UWorld First pass, random mixed/ organ system specific
along M2 courses: 83% correct, 94th percentile

BRS Physiology, Pathoma, Goljan audio---- finished along M2 courses.

Lippincott’s Microcards----used during M1 micro block.

FirstAid 2014----organ systems briefly reviewed along M2 courses.

Partially Used:

FA Organ Systems (selective chapters for clarification)

Lange Pharm flashcard (selective chapters along M2 courses)

Rapid Review Pathology (selective chapters along M2 courses)

Kaplan Physiology Review Book and Physiology Qbank (mainly Cardiovascular,
Pulmonary and Renal)

Barely touched (but frequently mentioned on this forum):

Firecracker (wasted $350+…only used about 1%)

Anki (collected quite a few decks but didn’t use any)


Dedicated Study Time: Mid May-Late June 2015, 6.5 weeks

UWorld second pass: mixed random timed, 94%, 99th percentile

UWorld marked/missed final pass (during last 5 days)

USMLE-Rx Hard level about 250 Qs and Kaplan Hard level about 200 Qs (during
last 5 days)

FirstAid 2014/15 First time serious pass (highlighting and annotating)

FirstAid 2014/15 Second pass (reviewed mainly highlighted parts and
annotations-during last week)

FirstAid 2014/15 Final quick pass (only highlighted parts-the day before
exam)

USMLE Step1 Secret x1

Pathoma x1.5 (second pass: highlights only during last week)

Robbins and Cotran Review of Pathology (all questions)

Katzung and Trevor’s Pharmacology Examination and Board Review (Chapter
questions + Comprehensive exam + Texts from selective chapters)

Lange Review of Medical Microbiology and Immunology (Comprehensive exam only)

BRS Behavioral Sciences, Neuroanatomy, Pathology, Physiology, Embryology,
Cell Biology & Histology, Biochem/Molecular Biology and Micro/Immunology (
End of Book Comprehensive Exams only, except for BRS Physioloy)

Rapid Review Pathology (only blue texts, selective chapters)

Practice Exams:

In School:

April 2015 Offline NBME Form 5 missed 16, Form 7 missed 16

April 2015 Free 132: 93%

End of April UWSA1 265 (87%)

May 1 2015 Offline Form 11 missed 15

May 10 2015 Form 15 missed 13, 262 (Baseline)

Dedicated Study Time:

May 17 2015 Form 12 missed 6, 273

May 24 2015 Form 13 missed 10, 266

May 31 2015 UWSA2 265 (93.8%)

June 4 2015 Kaplan Sim 1 (7 blocks), 85%

June 5 2015 Kaplan Sim 2 (7 blocks), 87%

June 17 2015 Form 16 missed 7, 271

June 24 2015 Form 17 missed 7, 269

Real deal:

272

Impression of exam:

Overall, I’d say it felt like an upgraded version of the most recent NBMEs,
with significantly more questions that have longer stems. There were more
questions involving complicated experiments requiring very solid
understanding of physiology and molecular biology, uncommon pathologies
requiring very broad knowledge base, rare side effects/ uncommon application
of common drugs that you may never heard of and of course the odd anatomy
and behavioral science questions which you cannot really prepare for (or
just learn anatomy really well during M1 and think like a normal person).
One major theme across the board is integration of knowledge, combining
imaging, lab techniques, genetics, anatomy, etc in a clinically relevant way.

I usually finished NBMEs with 25 mins left to check my answers but on the
real deal I was constantly left with only 15 minutes to check my answers. It
was due to both the increased difficulty in ~1/3 of the questions and me
being more careful on picking answers. I usually mark about 8-12 questions
per block on NBMEs, out of which I usually end up being not a 100% sure
about 2-4 per block. On the real deal, I was marking between 12-18 questions
per block before second pass and in the end was not a 100% sure about 4-6
per block in the end.

I was feeling pretty good about the first 5 blocks as I took a break between
each block to drink water, eat bananas/yogurt/granola bars, go to the
bathroom, stretch and even go out to get some sunshine. I finished the last
two blocks without a break in between and found the last block to be
considerably more difficult than the first 5 or 6 blocks. However, after
going through my 18 marked questions, I was able to reduce the number down
to 6. Therefore I think fatigue could be a main contributing factor when you
feel a certain block is much harder.

Walking out of the prometric center, I knew I probably killed it coz I know
the curve is more lenient than NBME and I was well conditioned and more
concentrated than usual. Coming home although tired I jogged down about 25
questions that I marked and remembered in the end and started looking for
answers. I ended up being correct about 50%, missed about 40% and still not
sure until today about 10% of the 25 or so questions. Therefore I think to
answer the often seen questions on this forum, you probably need to have no
more than 2 incorrect questions per block to safely land above 270.

Advices for preparation:

General advice:

My dean gave us a piece of advice in the beginning of second year for Step1
preparation: doing good in M2 courses is the best preparation for Step1. I
would extend that suggestion to all pre-clinical coursework. Seriously don’
t study too practically for boards or only focus on the so-called ‘high-
yield’ facts, sometimes please study for the sake of curiosity. Google
whatever that come across as unknown to you and try to learn a little bit
about new stuff every day, from news, facebook or even Netflix. Just as an
example, if you don’t know most of the exciting discoveries that won the
Nobel Prize in Physiology or Medicine, maybe take an hour or so to browse
the list and I guarantee you if they test you on molecular biology, the main
concept will be from the list.

Timing:

Don’t start too early when you know nothing, you’ll get frustrated and
waste your time and resources. A good time to start is usually the beginning
of second year. You’ll have almost a year to explore what resources fit
you the best and make a plan before dedicated study time comes.

I have no recommendation for the length of dedicated study time as it really
varies based on knowledge foundation, goal and endurance. I would recommend
, however, pushing your limit a little bit, learning a little bit more as
you’ll need most of these stuff to survive the pimping on third year
rotations and of course to become a competent doctor.

Material:

UFAP: Yup, no secret here. Of these three, FA is the king. Buy the latest
version, the new things are not added randomly. Actually, pay extra
attention to the new stuff. UWorld is good for learning, but kind of bad for
training your test taking skills as it makes you overthink too much.
Pathoma is great for path foundations and some integrations but I personally
think Goljan had more integrations and his teaching style reaches you
better.

Rx Qbank: good to use with courses to build a solid foundation. Suggest
starting early on this one but don’t need to use during dedicated time.

Kaplan Qbank: also pretty solid and actually after recent updates, having
better pictures and explanations. Suggest using together with Rx if you have
the time or choose one of the two along M2 courses. (I personally would
choose Rx since it’s based on FA). Don’t use during dedicated time except
for the hard questions to pick up some zebras (those are really hard:
average pct was 40% or so).

Red Robbins (the pathology Qbook): super long question stems and covers
almost all common and quite a few uncommon pathologies from the big Robbins.
It’s actually better to use along coursework but I decided to do it during
dedicated study time and I think it trained me well for long stems with
lots of labs and really helped me on differentials within single organ
system.

BRS Physiology: Worth going over it at least twice. The best book for
physiology review. Physiology can get really tricky on Step1 and a good
foundation here is key to success.

Other BRS series: don’t use them in dedicated time except for browsing some
of the questions. Generally not great questions that simulate step1 but can
help fill some gaps.

Goljan audio and Rapid Review Path: the audios are great to listen to while
jogging, working out or driving. However the RRP book is kind of too dense
to review and I would recommend using it along coursework instead of during
dedicated study time.

USMLE Step1 Secrets: A great book that use cases to integrate concepts. A
perfect companion for FA. I usually read a chapter in Secrets before I go
over the corresponding chapter in FA. Dense to read but worth it in my mind
even during dedicated time.

Microcards: a must have if you don’t use picmonic or sketchy micro I guess.
Constantly referring to these cards during my dedicated study time and they
are a great expansion of FA micro chapter.

Katzung and Trevor Pharm: a great book with very nice concept figures and
tables. Actually a few NBME questions and quite a few UW questions are
derived directly from the figures in this book.

For Biochem, Genetics, Nutrition, Cell and Molecular Biology, Immunology, FA
is enough. However they do find new ways, especially integrating lab
techniques with other concepts with very long stems to test you. Be careful.

Advices for Exam Day:

Arrive early and dress comfortably. Bring enough food and water as you’ll
need it. Take breaks often as time permits: I highly recommend taking a
break after each block to clear your mind and give yourself a morale boost
looking into the mirror in the restroom! Keep yourself hydrated and
motivated. Your neurons work much better in a good mood!

Final Words:

Bath yourself in questions. I did probably over 10, 000 question combining
all the Qbanks, NBMEs, Sim Exams, Question books and Questions from review
books. The whole idea is to see as many as possible to expand your knowledge
base and to also employ the active retrieval method of memory consolidation.

In the end I don’t think any specific resource is a must have except for
FirstAid as I don’t really remember any specific question that I wouldn’t
know if I didn’t use certain resources (again except for FA), which means
they all cover things pretty good.

Finally, understand stuff, don’t just memorize them, as has been iterated
so many times by the previous high scorers.

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