So I wanted to keep this light, as detailed as
it possibly could be and simple. My name is Dr. Sana Gurz, a graduate of MBBS
Class of 2019. I started my USMLE journey after I graduated in March of 2020. I
sat for my STEP1 in February of 2021 and scored 245+. I would like to address a
few things under appropriate headings below for any of you interested in my
journey (albeit less impressive than the rest of the brilliant and gifted
constellations on this page) -
Studying
Schedule-
Total actual studying time- 8 months
Resources-
I adopted the method of keeping my resources to a
minimum and doing them super well.
Videos (total time-
2.5 months)
- BNB
- Sketchy
Micro
- Pathoma
- Youtube
(certain topics- Dirty USMLE)
- Sketchy
Pharm (Note- I did them- waste of time for me- would not recommend)
Books-
- First Aid
(FA)
- Pathoma
(2020)
Question
Banks-
- Uworld only
- BNB review
questions after videos (I had the online subscription)
Tests-
- 5 NBMEs (
20, 24, 22, 18, 21) - online
- UWSA1 - 1
month prior to test date
- UWSA2- 10 days prior
- Ecfmg 120 -
10 days prior
Predictive
- Bolded (NBME 18 - lower limit, UWSA- upper limit, Final Score- Exceeded UWSA2
score)
|
Start- May 2020 |
BNB + FA (CramFighter for Video scheduling) Sketchy micro Pathoma videos (1.25x) |
|
Break- 1 month and 10 days |
Inclusive of all break days |
|
20th July 2020 |
Remaining videos + FA |
|
1st September 2020 - Uworld |
1.5 months, 2-3 blocks/day, 20 blocks topical, rest mixed, pure
annotation |
|
AFA (annotated FA= FA+Uworld) |
2x (1st AFA pass- 25 days, 2nd pass 18 days) |
|
Last 45 days Total 5 NBMEs (online) NBME scheduling- weekly (to check progress)- Study FA in between UWSA1 - 1 month prior to exam UWSA2 + ecfmg 120 - 10 days before exam |
NBMEs + Dedicated + UWSAs FA at least 4 times Uworld - 2nd pass - ONLY Marked questions (around 1800 - 7 days) Pathoma 1x ( first 5 chapters 4x) |
|
Exam date- 9 february 2021 |
FREEDOM |
How do
I make my FA into AFA?
Preparing your FA - Divide
FA into 2 or 3 parts and get it placed into BOX files (more chunky and sturdy
than normal ring files)
Advantage of dividing FA- More manageable,
seems less daunting, you wont run out of space for annotation and you wont need
to hide the text with sticky notes. You can simply write a note on a piece of
paper and slip the paper into your box-filed FA in the relevant area.
Annotating your FA with UW to make AFA
This is by far the most important and time
consuming step. The pressure of solving questions right and then annotating
details on to FA can make anyone’s head spin.
This is how I did it-
1.5 months to finish around 3500 UW questions.
I was purely annotating onto FA, I was less concerned with solving the
questions right or learning FA because I wanted to study a completed AFA in one
go later. (the 25 days I had set aside)
2-3 blocks a day to finish the questions in
1.5 month. As I was trying to manage 2-3 blocks a day I was not reviewing or
learning FA simultaneously.I was simply ‘filling in FA’s blanks’.
How I annotated… TUTORED and UNTIMED
2 blocks a day- 2 weeks Topic wise
Rest of my annotation was Mixed. I would not
recommend doing mixed blocks for annotation.
It was so time consuming trying to find the
relevant topics for annotation from one question to the next.
For those who don’t have 1.5 month to spend on annotation- incorporate your uworld annotation into your daily schedule. E.g.
Spend 3-4 hrs on videos while reading FA. Do 40 questions of Uworld and
annotate them. It will take longer of course- But you'll have completed your
entire first pass of uworld, BNB, pathoma, sketchy micro, FA and made your AFA
in 3 months total.
Note- ANNOTATE TOPIC WISE. It will be so much easier. Trustttt me.
Mark
questions on UW- wrong questions and those difficult
questions that you got right but you took way too long to solve them or that
confused you (even if you solved them right)
While
annotating- You don’t need to rewrite every single
detail in the explanation. FA has most things. If something is already in FA-
Underline and write a U next to it. So you know it’s a High Yield fact tested
in uworld. When you are going through AFA you’ll find yourself focusing more on
the U marked points which are basically the most high yield.
Whatever you annotate from UW onto FA- mark it
with a U. One only learns HOW to study FA once they have done 20 or so blocks
of uworld.
If you
are concerned about timing- You only need around 20
mixed blocks to practice managing your time. You can do those during your
second pass or as you see fit.
So getting my long and drawn out schedule out
of the way- I’d like to impart a few words of wisdom. By the time most of you
are reading this you won’t have the amount of time I had to leisurely sit back
and study for the exam. You guys are in either of the 2 predicaments:
You have till December to get that coveted
numerical score or are taking the exam when it becomes Categorical (Look at me using
Biostats terminology- meaning it becomes Pass/Fail) in january 2022.
If you
are one of the lucky people taking their exam after january 2022. 4 months is all you should need to get a passing score in Step1.
Minimum resources should be your go to. Don’t flail around or waste time
comparing yourself to others… You just gotta pass that ‘ish’. Build concepts
through regimented studying but you don’t need to worry about shooting for
Pluto. Minimum resources and do them so well you know them back to front.
Step 2 is going to determine your fate. (no
pressure, ofcourse)
If you
find yourself 4 months from your exam date-
Focus, maximise quality and efficient
learning, do questions. Make a schedule and stick to it like glue.
Notes-
Monthly schedule. Broken down in daily and
weekly goals.
Select your studying space carefully.
Schedule breaks and off days. (very important)
Remember that there is not one correct way to
study. My method of quality studying may not be the same as yours.
Feel Free to use ANY resource that you may
find helps you understand a concept better. If you like something explained in
kaplan, always take that point and annotate your FA with it. Always come back
to your AFA.
Having your information in ONE place will help
you stay focused.
(e.g. If you have set yourself 4 days for CVS
from AFA. Finish CVS in those 4 days- including your daily goals like 40 uw
questions a day. Think to yourself I only got these 4 days for CVS. I simply
have to finish it. If you finish early- reward is you get the rest of your
scheduled time off.)
Give yourself incentives to study. Reward
yourself and condition yourself to want to finish your work.
Learn mnemonics- for
‘select’ difficult concepts. Don’t over do it- You can’t learn one for every
detail or fact. FA provides you with a LOT of mnemonics. Learn those that you
need to. Collect them and later compile a cheat sheet.
How did I tackle difficult concepts and subjects?
Here is the list- (seems like I listed half
the units right? Because I just did)
- CVS
- CNS
- Psych
- Biochem
- Biostats
- Genetics
- Immuno
- pharm
- CVS - repetition. Efficient
fact learning. Focus on physiology. Learning entire tables is difficult.
Graphs and formulae are important in figuring out pathology. So if you
know the physiology, pathology is easy as pie. Focus on general trends and
then learn the outlier rules e.g.
Murmurs -
Systolic murmurs- AS,
(MR,TR, MVP), VSD
Diastolic Murmurs-
AR, MS
Continuous murmurs-
PDA
RILE (RI-LE) Right
sided murmurs increase on inspiration and left sided murmurs increase on
expiration. (increase means worsen or become louder)
Valsalva and sudden
standing increase only HOCM and MVP murmurs and decrease the rest. (preload
decreases and worsens HOCM and MVP).
Now do we need to learn the entire table written in FA? Not really. With these few
outlier rules you’ll be able to solve quite a few questions.
- CNS- Anatomy and
pathophysiology are interlinked. If you know your anatomy well you can
figure out the pathophysio easilyyyy.
I drew and redrew important anatomical diagrams over and over
again. Googled images of gross specimens, line diagrams and learned to
label - circle of willis, blood supply of brain, Cavernous sinus, superior
and inferior orbital fissures, basal Ganglia, dorsal brainstem for CNs so
that if an image came up in the exam id be able to label what is what
immediately. The one thing that evaded me were the brainstem gross
specimens- I chose to learn the RULE OF 4 and general method to recognise
which section was which with a few main features. Application of the rule
of 4 resulted in me being able to solve anatomy AND pathophsyiological
questions with relative ease.
If you aren't a drawer- You could print and
photocopy these googlable unlabelled images and label them like a worksheet to
help you remember. Make enough photocopies for graphs and diagrams that you
could solve them over and over again. (this can be applied for any and every
diagram you find difficult committing to memory not only from CNS)
- Psych- Well acquaint
yourself with the terminologies. Repetition and solving uworld psych
questions 3 times helped me pick out the subtle differences between
disorders.
- Biochem - draw and redraw
the cycles. FA has that one page with all the metabolisms in one chart- I
would redraw that entire chart every time I started to start a new
metabolic process. Slowly as I covered more and more processes- my unified
interlinked metabolism chart started getting more and more detailed to
make a MEGA chart.
- Biostats -I wrote down all
the formulae and concepts every third day only using FA to confirm a fact
or formula or check them in the end.
- Genetics- Hardy Weinberg
equation is not properly explained in FA. I would recommend using a Youtube
resource to understand how to solve the questions. Otherwise genetics was
mostly straightforward.
- Immuno- I made a chart and
put it up in my room. All from FA and BNB I did not use any other
resource. Promise.
- Micro- Sketchy micro once
was enough. The rest I focused on FA. made a chart and put it up on my
walls with sticky tack (UHU sticky tack doesn’t destroy the wall paint and
you can put ANY info up on the walls that you may want constant repetition
of)
- Pharm- I would do pharm
with respective systems every time I’d study a topic. I didn’t do anything
other than FA. (sketchy Pharm did not help me.) During the last 45 days I
did do 2 days of dedicated pharma- in which I learned Pharm FA without the
organ systems)
- Ethics- Conrad Fisher, FA,
BNB, UW, Youtube Dirty USMLE videos (do the entire ethics and
communication playlist that Dirty USMLE has)
CHEAT
SHEET
Before you begin your STEP1 on exam day- there
is a tutorial on how to use the USMLE examination program interface. You are
provided with a sheet of paper and a pen.
Time allocated for the tutorial can be
utilised to help you during your exam.
Make
your own cheat sheet. Practice it over and over.
What should a cheat sheet include?
Anything you want!
You can write down mnemonics, formulae,
quickly sketch out diagrams, outlier rules, rule of 4, even write a poem or a
prayer. So any facts or difficult concepts that you have difficulty committing
to memory or quickly coming up with the relevant fact while solving a question-
you can simply refer to your carefully crafted cheat sheet!
Try making a cheat sheet that you can finish
in 6-8 minutes maximum. Practice writing it in the last 30 days. Every night
before going to sleep.
EXAM
DAY
Everyone has a different experience. Take
whatever snacks with you that you want!
People legit bring everything, including
medications, water bottles and thermoses of tea/coffee.
Exam starts at 9am- once you are seated at the
table. Log into your exam. (instructions will be provided). Once logged in- The
tutorial starts. Say a prayer and write your cheat sheet.
6 minutes later- say another prayer. Take a
breath, trust your gut and start your exam.
My exam question structure was closer to
uworld than NBMEs. Yet the english was simpler, closer to NBMEs. It was easier
to cancel wrong options out on the actual exam.
High yield concepts that I had solved both in
uworld and NBMEs were tested. I somehow felt that my entire exam was testing
familiar concepts.
I marked around 10 questions every block
(confusing questions or questions that would take me longer than a minute to
solve). Finished one block in 30 minutes. Then spent the rest of the time
trying to solve the 10 marked questions. The remaining time I reviewed the
questions.
I was left with at least 10 minutes at the end
of each block. Which added to my break hour.
You can only take a break after you have
submitted a block. People take breaks after every block, or every two blocks.
Try to not let your performance on a previous block influence the next one.
Once submitted, it’s gone! No point in dwelling on how you performed- onto the
next one! Just keep swimming. It’s a test of nerves and confidence at the end
of the day. Do not psych yourself out.
Listen
buddies
If you are taking the exam in 4 months or
after january. This is the first step in a long drawn out journey. I was where
you are currently and trust me, it seems impossible. Sticking to schedules and
being my own check and balance helped me check as many boxes as I could.
Get a study buddy who helps you stick to a
schedule, use a teach back method to teach yourself important facts by teaching
someone else, teach the walls even, write on walls, read things over and
over...whatever helps facts stick.
Whether you are a graduate or in 3rd year and
starting this journey, you are medical students and are more than capable of
doing well. It is not possible to know 100% of the vast subject matter that is
tested in STEP1, you do as much as you can and then trust your gut and Allah.
Your journey cannot be compared to someone else’s. Everyone studies in a
different way. Everyone has different strengths and weaknesses; play to your
strengths, minimise your weak areas by adopting learning tools like mnemonics
and charts (add them to the cheat sheet if you want). Just because a class
fellow takes an exam before you… dont start competing and comparing. You take
your time, do it well.
Hope I helped, we are all on the same team.
Feel free to contact me at any time. You can do this, buddies!
Comments
Post a Comment