PASSING THE STEP1-
IF I CAN DO IT, SO CAN YOU!
HASEEB MUKHTAR CMH
BATCH'21
For a quite some time now, step 1 has been haunting millions
of med students worldwide. The thought of having to revisit the notorious basic
sciences like anatomy, biochem, pharm etc is staggering. Thankfully, now that
its switching to a pass/fail system, it seems like much of the tension
regarding the test shall melt away. But now the thought of needing to PASS the
test continues to scare test takers.
This post is mainly intended for future test takers that
shall be sitting for the exam after Jan 26. I have tried to make this less
about my experience (because I firmly believe everyone has their own way to go
about the exam) and hitting a “good score” (because, let's be honest, scoring
is way irrelevant now). But believe it or not, that still doesn’t take away the
essence of studying effectively for this huge test. The reasons being
1)
We don’t really know how hard they shall be
making tests after 26 Jan and whether they will move up the passing score, so the
idea of good grip on the test content always matters in contrast to just passing
2)
You might hate to hear this but about 60-70% of
step2CK is step1. So, you REALLY need that good core knowledge to smash the CK
in the future. That will be even more vital since CK is going to gain some
massive significance becoming the only test reported numerically 2022 onwards.
My name is Haseeb and I recently got my score of 261 ALHAMDULLILAH.
Having gone through this intense and somewhat grim journey, like every other
test taker, I too have learned a lot stuff from this experience. Things that I'm
sure will benefit future test takers. Here are the Dos and Don'ts of step1 laid
out for you guys
DOs
· Wisely
choose your resources and stick to them- Quality over quantity. You only
need a handful of good resources. For most people this is the classic UFAP but
you can modify it to your liking. Don’t go on to significantly changing your
resources midway since medical knowledge is more or less the same, and being
well versed in your resources is key to performing well on the exam. For me it was
mainly UFA, I had only watched pathoma videos during my 4th year and
barely consulted pathoma afterwards during my dedicated(EXCEPT FOR CHAP 1-3, we
will discuss that later). I've read about people using big books from
preclinical years and only using First aid as a “checklist book”, I seriously
don’t know what these folks are high on.
· First
Aid is gold- and you already knew that but I wanted this to be out there.
Some stuff is pretty volatile and hard to understand even (especially if it's
your first read). But that is understandable, stuff is concise, to the point and,
besides, first reads are always like
this. That is why people tend to do multiple passes of First aid. Every
subsequent pass becomes easier to conquer. I myself had done First aid about
4-5 times by the end of my prep and stuff was really easy to surf about in the final
read. And also use other resources to augment your prep. This brings us to our
next point.
· Supplemental
resources- These were BnB, youtube and to some extent sketchy for me (since
I did very little of it honestly). They help a lot. I remember having a hard
time doing cardio from first aid but that is where BnB really made stuff easy
to understand. Ive already talked about having done pathoma once. Late in my
prep I also went through shelf notes. It helps you revise some core anatomy
concepts and I think is useful.
· Youtube-
I'm sure extremely volatile topics like lysosomal storage disease get everyone.
Youtube has some amazing channels for you to nail those hard-to-understand
ideas and concepts. I found Dirty Medicine, Randy Neil and Armando Hasudungan,
for instance, to be those amazing channels and would definitely recommend them
to you guys. Ive also heard about Pixorize videos, frankly speaking I havent
done any of these but people commend about how it also helps hammer difficult
concepts.
· Kaplan-
this is literally the one book series that comes in your mind when starting
for step 1 as a rookie. I myself started off with kaplan physio. I feel like
the content is very vast and relatively low yield. I stopped doing physio
around the second chapter and felt like I should invest that time in doing
first aid. But no doubt, they have some amazing lecturers which I would
recommend. I watched Sam Turcos and Steve Whites videos for biochem and
neuroanatomy, respectively, in my 4th year and I still remember
their great concepts.
· Start
Uworld early on- you don’t need an intro to this because q banks are simply
THE MOST effective way of learning and USMLE World is the best one out there for
obvious reasons. Students are reluctant to start this early since they believe
they won’t “perform well”, when uworld isnt about performance at all. In fact,
I believe starting off in tutor mode is the best way to go about. You will have
enough time to practice time management later on, right now your main goal is
to master the concepts of uworld and makes notes about them. Now you may make a soft document, annotate
stuff or make flash cards that’s up to you. What worked for me was annotation
on my FA.
· Other
q banks- you should definitely give Amboss a go. I got their three-month
free trial and you should try that out too before deciding to buy it lol. The
questions sometimes are nagging as they like testing small precise concepts but
a healthy dose of that helps in the long run. I did about 1800 qs. I regret not
completing it but would recommend that you guys do, only if you have ample time
at hand, after all it is a secondary q bank. I haven't done Rx but I believe it
works well for those people starting off with step1 in the very beginning doing
FA alongside.
· Don’t hesistate taking the exam earlier
now- starting med school, I had thought about taking the exam by my 4th
year. But thanks to procrastination, it came down to end of final year almost.
I believe last year was a great time since we had a big Covid lockdown break
but playing PS4 had me occupied there already. What I mean to say is, the exam
is very much doable by 4th year since we have been doing
Robbins+pathoma for patho and our knowledge for other subjects is still fresh
compared to that in final year, house job and so on. AND ITS DEFINETLY
DOABLE NOW. you guys that are taking the pass fail exam, its pretty likely
that you already have the necessary knowledge. Reinforcement with some prep,
Its definitely possible to succeed on test day in your third and fourth years
(well atleast before the start of final year if I exaggerated a bit). Some
benefits in doing that -> you get even more time to concentrate on step2 CK.
Also, a lot of high tier clinical elective programs in the US require that you
have already taken step1 so doors open for you. Plus it looks good on your CV
being done with this exam during med school just like how US med students do.
· ANKI-
a marvelous tool for learning if done properly. You get a hang of it gradually
and you become more efficient at making cards. I used it to make 3
decks(questions I got wrong on amboss, some key concepts from uword that I
didn’t feel like annotating, and nbme concepts that were new for me) I studied
the decks in the last 10 days and I feel it helped a lot. Was able to do only
about a 1000 cards from Anking overhaul but would seriously recommend you guys
try it out. Best amongst the preformed decks out there
· NBME
and Free 120: its true. Shit does
repeat from these since these are made by the testing body itself. Had about 3
qs from free 120. Do go over nbme pictures pdfs online. I definitely had some
on my actual exam.
· Communication-
try doing whatever is possible- Uworld is gold for this discipline. I did some
amboss questions by the end and I think they were useful too. But I feel like
dirty medicine and randy neil helped quiet a lot on this one. Try sounding as
much patient centered as possible. Duh you know this already but that is ALL
that matters. Calmly apply every answer choice and then pick the best one.
· General
principles- Pathoma is ever renown for this part on the test. I'm telling
you, a lot came from this section and If you have done chap 1-3, these are
basically free points. I didn't watch the videos for these, just went through
the book. Also I did go over the general patho portion on FA too when I was
doing pathoma. I feel like it covers any gaps left if you when you do either
alone.
· Lab
values: no this isn’t about memorizing them. Just have a rough idea about
the main ones so that u don’t have to open the lab panel. Things like LFTs,
main electrolytes, ABGs etc. Also, for vignettes having lab values on the test
day, I found it useful to look at the labs before reading the stem. Helps you
build a good idea what the q is about from the start.
·
Biostat calculations- well isn’t the
interface calculator freaking shit! I found it more useful and convenient to do
most part of the calculation on the board they provide you for rough work and
then solving only the final fraction with the interface calculator.
·
Trust your tests scores- test scores are
estimates with standard deviations like the real test itself Believe that you
will get better score on your actual exam compared to these tests. That is what
worked out for me. Yes, you need to be ready for an unexpected outcome but only
enough as to push you further rather than add to your already high stress
levels
· Avoid
burnouts- don't stop doing things you like as hobbies, meet up, exercise,
watch shows. It feels like you are wasting time when you should be studying but
we as human have limited capacity and monotony bogs us down real bad
· Use
reddit but don’t get Carried away- Reddit was one of the useful tools for
me during my prep for a lot of different things. But it also has some
depressing stuff. For instance, people talking about how they scored pretty
much below expected. It definitely is unfortunate and our empathy goes with
them but don’t stress on it. Every one has their own way of going about like I
said earlier. Similarly don’t get carried away reading loads of people
experiences and comparing yourself to them. You do more harm than good.
· Body
language- if up until now you have felt like you never did good on academics
so how will you now. Please. Just stop. Your college grades don’t matter at
all. If you intend to dominate this test, then you damn will. All you need is a
“good enough” on college tests. Something that ensures you have adequate core knowledg
to begin with your prep.
DON’Ts:
·
Don’t hesitate on taking practice tests: This
is especially for fellow students taking the exam before 26 Jan. If you are not
meeting your target score, just relax... you will get there trust me. Personal
experience --> I started off with a pathetic score on my first, the nbme 13.
I think I had about 38-39 mistakes which roughly was about a 215 lol since the
graphs for those were pretty harsh. But I didn’t stop. I was ready for such a
score. My startegy was always USE PRACTICE TESTS AS A LEARNING TOOL RATHER
THAN TO TRACK YOUR PROGRESS. Do a thorough review and learn from your
mistakes. Take pride in the fact that if such a question comes on the actual
test, now you would know how to tackle it. I later did about 10 more nbmes.
Went from about 30 mistakes to 20-30 and by the end less than 20 mistakes per
test. So yes, progress is slow but definitely there. (Btw I only did offline
nbmes because I didn’t think it necessary to pay for each one just for a score,
just timed each block and did answers on paper)
·
Don’t delay taking UWSA1- had anxiety attacks 20 days out of my exam. I
had just taken uwsa1 and scored 261. Score was good but I read about people
scoring the same months out and people complaining how they got 20 points drop
on actual when they took the exam that close. But things panned out well
afterward ALHAMDULILLAH. I still believe its better to take the exam earlier.
·
Don’t do Uworld offline- yes I did that too.
I started serious prep around FEB 2021 that’s when I was somewhat already doing
uworld system wise pdf. Not only were the questions fewer on the pdf file but
the progress was slow. Also you cant track your progress and the questions
don’t update. Added to that, there is no way of reviewing your incorrects. So
better late than never, I bought uworld online in May. This was somewhat my
second pass since I had already gone through the fewer question pdf but I
observed I was getting the same questions wrong again. So there you have it,
the disadvantage of not being able to review incorrects and marked. So my
experience is online is 100x better than offline uw.
·
Don’t postpone your test day- feel like
you don’t know enough, a 2-4 week postponement would do no harm? believe me,
that feeling is normal. Even a day before your exam you would think you don’t
know shit but you do actually. Plus lets be honest, you cant learn everything
in medicine and a good part of your actual test will be about smart guessing
and striking out answer choices. So there is that and ofcourse the famous
Parkinson’s law- if you postpone your exam, you would still be doing more or
less the same amount of work, however now in more time sadly.
·
Don’t annotate FA unnecessarily- please fix
this in your head. I cant emphasize this enough. I did the stupid mistake of
annotating some chapters with their respective BNB videos. Not only does it
become hard to read through all that mess but it also takes up space which could’ve
been used for more imp info like that from UW.
A little bit about my experience:
just wanted to briefly talk about this if it helps you guys:
·
Off and on was doing kaplan(physio,
neuroanatomy, biochem) and first aid in 3rd and 4th year,
not until after 4th year prof that I became more serious about it.
·
December 2020 to Jan 2021 did about 10-20 uw
offline qs a day
·
Started off properly in Feb 2021 when I would do
atleast 40 qs offline a day.
·
Builded qs done a day up to about 120 by gradually
by the time I was midway in my uw ONline.
·
My dedicated period was the last 6 weeks.
Honestly im not good at sticking to schedules so didn't make one. Neither was I
spending fixed hours everyday but surely I was spending a lot more time per day
by the end of my prep(the usual of around 8-10 hours deep into dedicated)
·
Did rapid review at the end of FA in the last
week.
·
· UW (first pass online %- 86%). Second pass
online (was getting around 0-1-2 wrong in each block so getting 98% on avg) but
this wasn’t useful and I just did 11% on my second online pass.
·
Amboss- 1800qs avg%(83%)
·
UWSA1-20 days out-261
·
UWSA2- 4 days out- 256
·
Free 120- 91%
·
Did nbmes 30,29,28,27 in the last 16 days and
scored roughly 255-257(offline score conversion) Alhamdullilah. It was crazy
having to go through these nbmes in such less amount of time.
Actual test day-
I was having a hard
time putting together my sleep schedule. I was sleeping around 3-4 am everyday,
an anxiety in itself... didn’t take any meds for sleep. So please all of you future
test takers, take care about your sleep hygiene. Sleep matters a lot. That’s
all I can say. I slept around 10:30 before my test day only to wake up early at
3:30 xD. Began to stress since I had only a 5 hour sleep. But then I was like
screw it. Prayed. Had a bath, God knows after how long (just kidding), had a
good breakfast and packed some protein bars, ample water, some coffee, and some
home made food too. Do watch dirty med video for test day. Followed it and
would recommend to you guys 100%. Reached there around 7:50. Started my test around
9:00. Questions were a lot like uworld, not too short, around 1-2 very long qs.
Some were direct to the point nbme style but not that many. Had enough time
left in each block to review every q again, marked about 8-10 in each block but
that depends on your threshold of marking questions. Skipped the tutorial so
had 60 mins which I divided up into break of 10 after each block. Used the
bathroom, had water and food during that time. Overall fatigue didn’t set in
that much for me luckily. Don’t worry, your adrenaline does wonders on that
day. I remember barely finishing UWSA blocks on time at home, but the boost you
have once you’re in there taking the actual test is phenomenal.
Im sorry if I got carried away writing this. If I missed
anything, feel free to contact me anywhere, anytime. I am always happy to help
anyone within my capacity. As medical students and physicians we share a deep
bond especially when it comes to learning from each other. Do pray to Allah SWT
for He is immensely kind beyond what we can imagine and always help and reach
out to fellow students in whatsoever way. All for one, and One for all. Cheers
to life!
Email: haseeb_mukhtar@live.com
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