I’m Tabeer Taseer from Batch of 18’.
Quick bio - Year of graduation: 2019, Finished house job end of may 2020. Started studying mid July, didn’t kick off until I finally got a flight back home in September.
Total study time: 13 months
(I wrote this for reddit so this will be a relatively long post, to the point nonetheless. Jump to headings for each phase/ assessment scores)
Part of it is cathartic on my end as a way to close the door on my step1 journey and if it can help other students along the way that would be a nice way for me to pay it forward since I benefited tremendously from exam write ups. I'm going to explain my thought process, decisions I made along the way as I prepared.
General Advice: For anyone thinking about starting prep. You can do it. Take care of yourself and trust the process, choose resources that fit you. Self-doubt and anxiety creep in from time to time, which is normal.
-Make a ‘cheat sheet’ for things you need to look at daily for 5-10 minutes, things you need to burn into your memory. For me it was the developmental milestone table from uw, pharma equations, factoids for biostats, Neuro tracts/strokes, brachial plexus, circle of Willis.
-Set your timeline (deadlines for when to finish 1st pass of all the content, for UW, review period and final months )
-Don’t wait a few months before the exam to get your permit, do that early to avoid added anxiety in the final months.
-Start NBMEs early, factor them into your prep.
-I did Kaplan during med school as it’s a comprehensive place to start, but during prep its wiser to start with BnB and then go back to Kaplan if you feel like you have some gaps to fill.
-Avoid littering FA with notes, keep them very concise and neat so you can revise them easily. (I got the new edition when it came out and started clean because my old one was annotated beyond comprehension, I started again and copied only important things to keep it cohesive). Extensive UW notes can be screenshot and dumped onto Anki. It saves time and energy.
- Save time where you can; sketchy/pixorize are solid for their respective topics
Topic wise resources besides UW+FA+BnB+Pathoma:
Bnb covers everything basic, some resources covered certain topics in more UW/NBME appropriate detail, most of these I would discover along the way as I was reviewing concepts.
(All of them are available on the telegram threads for usmle)
Anatomy:
High Yield anatomy (book); used this as a main reference for any UW/NBME anatomy question.
Anatomy shelf notes (pdf) all in one review for commonly tested anatomy
Embryology: Uworld covers all. Physeo videos/BRS embryo for reference.
Physio:
BRS
Physeo Videos for selected topics
*very underrated– its basically pathoma for physio/genetics/biostats (Watch at x2 speed) covers things simply, used this where Bnb felt inadequate
Biochem:
Pixorize (for GSD/Lysosomal/peroxisome disorders/lipid disorders)
Beckers biochem videos: Golden resource that’s less talked about (by Dr Lionel Raymond - integrates everything beautifully, I did that where I felt Bnb fell short, genetics/molecular/cellular biology. Tried Turco but felt this one was better)
Micro:
Sketchy
Virology from BnB
Lolnotacop AnkiDeck for revision
Immuno:
BnB
Kaplan immuno 1 month before the exam (x2 speed) to make sure I wasn’t missing anything.
The cytokines, class switching, immunodeficiency syndromes are all HY and I had almost all of those on my form.
Pharma:
Sketchy (for most of pharm except some)
Kaplan Pharm (Dr Lionel) for ANS/CVS/Renal only
Biostats:
- Amboss qbank
- Randy Neil yt
Ethics/Communications
- Amboss, quality and safety/ethics articles
- Conrad fischers 100 cases (not a must)
- Dirty Usmle: covers the communication style questions quite nicely but is scarce.
This section of the exam was quite ambiguous, you can cancel out the options that are clearly wrong and then be left with two seemingly right options. From these two the more you learn to cancel out and look for the least wrong answer instead of one that immediately clicks, the better. They ask for ‘the initial best response’ Check for options respecting autonomy, showing empathy and having open ended statements these would be the most likely answer.
Pathology:
Goljan rapid review is a great supplement I used throughout med school and for some topics that needed a more thorough read
Goljan audio for selected topics (Renal, CNS, Endo, Pulmo) while breaks/daily walk
Whenever you feel stuck somewhere head to dirty usmle/Amboss articles/step1 subreddit for more guidance. Move on a resource if it doesn’t work for you.
Study plan:
Beginnings:
7-10 days/system in which I would cover bnb/pathoma/FA
UW for 3 days for related system (I would try to do a few blocks system wise)
I started Amboss side by side to focus on specific topics (Continued amboss for 2 months) at this point I was done with 68% UW.
Took me 6 months to get through a first round of all the main content (Bnb/pathoma/FA)
Once finished I did UW solely, random, timed, and finished my first round.
Daily schedule looked something like this:
-First phase: Wake up at 6/6 30
Start videos,
Get done by 9 pm max, breaks included.
After 6 pm productivity waned.
Anki reviews before sleeping, sleep at 11-12
-Second phase: 8 am start UW, review, revise, rewatch
-Third phase (After first pass):
Mornings 6-8, Anki/review materials from bnb/pathoma
8:30-9 am: Start UW.
Second pass was quicker with 2-4 blocks/day depending on how much review was needed. Afternoon siesta (for an hour or less).
After 6 pm I did just content review from different sources
Do what suits you, there’s no best hours/day. Around 8-9 hours work for most people.
Know your limits and set realistic goals. I was doing 10hrs/day for the first 6 months not taking care of sleep, burn out was a consequence, had a month and a half of not wanting to do much/lagging behind schedule. Overused but relevant: It’s a marathon, not a sprint.
Question Banks/FA:
First round: one block a day (initially system wise then random)
My reviews would spill to the next day in the beginning, took a lot of time going through explanations/annotating/making flashcards.
Second round: System wise. Finished it in a month and a half (exactly a month before the exam) UW kept adding new questions during this time.
AMBOSS: did it for systems I needed more exposure in. But I would not recommend it if you have not finished UW and are behind schedule. Some folks do it before UW, to each their own. Needless to say, UW is all you need.
First Aid: basically the checklist of what you need to know, use it side by side with UW. Avoid passive reading FA except in your final study weeks
Flashcards/ANKI:
Used the flashcard feature in UW to make my own cards during first round.
Anki
for starters; it’s a great tool to keep organised and revise. If the interface seems daunting, a simple yt tutorial is a good place to start. Use it to make your own decks, that’s where it’s most useful. I didn’t mature any decks besides the self mades ones.
Used these decks:
Self made UW, NBME incorrects+important questions
Lolnatocop for micro, it has sketchy + UW + bnb combined and it’s a great deck overall
Zanki for selected topics – pharm,repro, cards (did not follow this one through till the end)
Extra decks: Apple neuroanatomy deck: good for brain cross sections/had NBME style pictures which I found helpful (did it in the last two months)
Dorian anatomy/anatomy shelf notes deck: This was a great compilation of most commonly tested anatomy, having the 100 concepts pdf + relevant notes from other hy sources.
Youtube channels/websites:
MRImaster.com: radiology that commonly shows up
Pubmed/amboss articles
medpix.nlm.nih.gov: is a free open-access database of medical images, teaching cases/topics
Nikolays genetics, medicosis perfectionalis, dirty usmle (youtube)
Assesments Timeline:
NBME 15: 217 (6 Jan)
Amboss SA: 221 (24 Feb)
NBME 16: 232 (11 April)
NBME 17: 235 (11 May)
Rx SA: 232
NBME 20: 251 (June)
NBME 19: 222
NBME 21: 248
NBME 22: 245
*Use them to learn and practice test taking strategy; practice question reading, cancelling out options, that’s essentially what allowed my score to climb, it wasn’t content review I was lacking but test skills that I worked. That being said Identify your weak areas and hammer them down as you go along.
NBME 23-30(July): I did two NBMEs/day to simulate the real deal – with timed breaks as planned in the exam.
(One day of full length exam simulation is enough tho)
UWSA1: 256 (after finishing first pass)
NBME 24: 243
NBME 23: 250
NBME 25: 255
NBME 27 : 248
NBME 28: 250
NBME 29: 247
NBME 30: 258 (2 weeks before)
UWSA2 : 258 ( 2 weeks before)
NBME 18 : 253 (1 week before)
free 120: 86%. (1 day before)
Day before the exam:
Woke up at 9 am, Took the free 120, reviewed it. (got two somewhat similar questions from it on the exam)
Watched Pathoma 1-3 at x2 speed.
Read the Immuno, Path section from FA.
Scrolled through the ‘Legendary NBME pics’ pdf – NBME pictures show up on the real deal.
Listened to murmurs one last time
Make sure you have your permit ready. Pray.
Tried to sleep but was mentally prepared that I won’t. (Avoid taking sleep aid/anti-anxiety you haven’t tried the day before the exam, I’ve heard plenty of horror stories about experiments going wrong) I used to take melatonin for days I needed to fix my sleep cycle so I took that.
As a generally troubled sleeper, managed to get 2 hours of sleep (Yikes). At the end of the day adrenaline takes care of it all but try to sleep for *at least* 4 hours.
Exam day ( Aug):
Compose yourself and know you did your best
Total break time plan: (skip the 15-minute tutorial) divided after each block as;
5 min + 5 min+ 7 min+ 5 min + 10 min+ 7 min+ 5 min
Spent three minutes or less making my ‘cheat sheet’ for equations/biostats stuff (None of which came in the exam)
Drank water/redbull. granola bar during breaks when needed.
1 minute per question so I had 20 minutes left at the end of each block. This can be a double-edged sword if you go back and second guess your answers. Went over flagged questions during this time. Only changed answers where I felt like I misread the question and was sure of it.
Was wide awake.
Last two blocks were when the fatigue kicked in so I spend longer to read the questions to compensate for brain fog. Had 5 minutes left at the end of each block then. And I avoided going back to see my answers then.
Post test syndrome/results:
It was the most amazing feeling walking out of the prometric centre, as time went by couldn’t help but think about the questions, 2 weeks of the crushing wait.
Overall the exam was fair and ofc like most people assure - doable, my form was genetics/immuno/biochem heavy and had a mix of UW/ NBME like short stem questions. Some tough, some straightforward. Some weird anatomy qs. Obviously the major chunk was path/diagnosis. MRIs/CTs from GI and CNS. The biostats and communication questions were particularly challenging/NBME style vague, around 3-4 qs each per block, had no calculations for biostats but heavily worded study interpretation questions.
The exam just felt like one big NBME block with the extra pressure. There will always be that pang of uncertainty clicking an answer for some questions, stick to your practice, trust your gut, click and move on.
Got the result on the second Wednesday after the exam Predicted had me at 254 with 7SD, my score was on the low roll of my predicted range. Trust the predictor, Keep that in mind when you book the test, your lower bound be safe.
At the end of the day be grateful. Whatever your score is, it’s the plan and will lead you exactly where you need to be.
(If you have any questions feel free to reach out to me; tabeerahmed@hotmail.com)
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