USMLE STEP 1 EXPERIENCE

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They can be used as an assessment tool as well as a question bank in itself. All NBMEs are very similar. Most of all concepts are repeated and asked in essentially very similar ways. Then, what if we use NBMEs for learning? Offline NBMEs and even the online ones can be used for learning, but by the time you reach NBME 18, which is considered very predictive these days, you would have learned all the NBME questions and now, it grossly over predicts your score and provides poor feedback about your weak areas. On the other hand, these NBMEs are a huge question pool that may help you with some out-of-nowhere questions in the exam as well as your weak areas.

It is a 2 edged sword and there is no right answer in my opinion. A possible middle ground is to use them after NBME 18, somewhere close to your exam. This is what I did. I solved the difficult questions from NBME 7,12,15,17,19 towards the end of my preparation, thanks to my friends who would ask for explanations to the difficult questions they encountered in these NBMEs.

My experience with NBMEs was very pleasant.

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But, there was one problem that persisted. I realized that I tend to mark all the difficult questions correctly and I always marked the easier questions wrong. This resulted in a disparity between number of wrong questions and the assessment score when compared to others. Since it is the easier questions that carry the most weightage, do not worry about the difficult ones in the exam. For example, a total of 40 mistakes out of questions still land you a I therefore skipped it.

Unlike the 1st pass of UWorld which is used for learning and integrating with F.

A, the 2nd pass is an excellent and a very accurate assessment tool. Using UWorld 2nd pass in random, timed mode with blocks per day builds stamina and endurance. At the same time, it tests how strong your reflexes are and what are your weak areas. Always try to outperform your 1st pass percentage by a good margin. So, with lots of enthusiasm I and 2 of my friends started reading Kaplan books but that did not last very long and the next week, we found ourselves basking under the sun, chilling and watching Netflix.

Came 4th year and the only achievement that year was that I did pathoma very well.

In final year, I again started with a lot of zeal only to be put off by hectic ward routine 2 months later. Having tried starting twice and failed, I started looking towards other options but eventually decided to complete MBBS and then decide. After graduation, I decided to forego house job and sat for my step 1, this time more enthusiastic and determined than ever. A huge shout out to all the fellows out there who make do with both their professional and step exams. First 3 months April June I had listened to the lectures for some of the Kaplan books already in final year, so I began with reading the annotated books with their relevant portion in F.

I also listened to the lectures I had not covered in final year and read those books again. It was very time taking and one mistake that I made was to try to cram the material from Kaplan which unduly added to my preparation time. I gave a quick revision to pathoma during this time period as well. At the beginning of your preparation, make a plan and strictly adhere to it. This includes organizing resources, choosing a spot to study, making a time table and planning a few days off just to blow off steam. I talked to many of my friends who had given step 1, read many experiences and decided on the resources I was going to use.

The initial resources are usually the same but the subjects you find your weaknesses in, may sometimes require additional resources tailor-fitted to your needs at that moment. So ask people for advice again at that point. I prepared for my exam at my home. So I had to struggle with sleepiness in the morning and with insomnia in the evening. I had some days off to take a break which included friends coming over and family gatherings.

I wanted to be done with the exam by the end of but having wasted 2 months during my preparation, it was extended by almost 3 months. So, make a plan and follow it! Have a talk with your family and friends. This is very crucial. You need to have a very strong social support. I started a cover to cover revision of F. A which took roughly a month because I got distracted. In addition, August being a birthday month in my family, I lost a few days there too; almost adding up to a month of wasted time. A cover to cover did not seem very helpful. This is because it is so concentrated and you need UWorld to digest it.

I could save a month here, and add another revision to F. A with annotated UWorld which is far easier to understand and retain. It took me 3 months to complete the 1st pass with annotations. Reading a chapter from F. A in a day or slightly more and then solving the UWorld questions, I started slow with 1 block per day but went up to 2 blocks per day towards the end.

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There were some off and on breaks during this time. It seemed like I was wasting a lot of time writing stuff down onto my F. A and just reading explanations. I was wondering if this was the right way to go. However, I talked to some of my friends and they encouraged me to have faith and keep working this way. Although, at some point in time during this phase of preparation, I began to doubt that I was wasting time, I had a very important realization when I began my 1st revision of annotated F. In annotating all the information onto my F.

Also, a sticky note right above a topic in F. A helped consolidate the concept there and then. So, I was reading explanation of a 1 liner from F.

A and therefore understanding and memorizing it at the same time. November of was a very busy month and it went almost entirely wasted. We had our concocation. It was very distressing to realize that I had wasted almost an entire month. However, this was the time I completed the paperwork and applied for the ECFMG registration and submitted my exam application. If you are a person like me, you are definitely going to need some sort of a deadline to work efficiently.

It was the recovery period. It had been 1 month since I had done UWorld and it seemed like I had forgotten a lot of things. However, with time, albeit 1 month, I gained back my momentum and revised the 1st part of F. A with annotations, which was the most likely part that I had forgotten. It was somewhat reassuring to realize that I still remembered most of the stuff. I then continued with my revision of systems. A with annotated UWorld for the 1st time is the most important part of your preparation.

The level of effort you put into this revision sets the baseline score. So, take your time, read carefully, be meticulous and not just memorize but understand everything. Revising many times while overlooking key concepts is not a very wise approach. I got a which boosted my confidence.

At this point I realized my weaknesses were biostatistics and ethics. The time between your 1st and 2nd revision of F. A with annotated UWorld is an excellent chance for you to use additional resources to cover your weak areas. This is also the time for you to give the remaining NBMEs. For me, NBMEs were more of a score assessment, so doing a lot of them was not as helpful because I could not gauge the subject wise preparation level from them because there was a star in almost all subjects.

But, for someone with a score in who wants to improve his performance in the relevant subjects, giving NBMEs periodically can help assess the improvement in the level of preparation. Here, I could have found out that I scored a with improvement in some of the said weak subjects. I could have worked even harder. So, use NBMEs according to the needs of your preparation. Biostatistics and Ethics are the 2 subjects that will make or mar your score.

You can use additional resources as I mentioned to cover biostatistics and ethics. For ethics, I did Conrad cases and Khan cases, each in a day. The Last Month February This was a minor setback because the score had dropped by 4 points and the ethics portion still seemed weak. A plus annotated UWorld revision which continued into 1 day before exam. The 2nd pass of UWord with 10 blocks per day was the turning point in my preparation. If I could do questions in a day, on the exam day were not going to be an issue. The 2nd revision of F. A with annotated UWorld was easier. I had already done it once.

Also, the explanations from the UWorld 2nd pass were still fresh in my mind. It took me roughly 20 days to complete my 2nd revision. This was when I decided I was ready because I had been having recurrent thoughts of postponing my exam for no reason at all for the past few days. I continued revising the remaining part of F. So, save them for the last week. Free questions which I did not have time to do are extremely important too. I did not have the liberty of time to do it and this meant, on the exam, I solved questions from biochemistry which I had last revised some 20 days ago.

On the day before exam, I was very anxious and excited. I felt like I knew everything and nothing at the same time. This is when you need to calm your nerves. Go out, watch movies or just hang out with friends. Trust your NBMEs and do as little as possible. I, however did not do any of this. I have always had this habit of sleeping in the day and staying up all night. This social jet lag caused me a lot of trouble on the night before the exam.

I had been trying to push my circadian rhythm towards sleeping at 10 pm and waking early in the morning for a week but in vain. The night before the exam, I took a zolpidem 5mg and went to sleep at 11 pm. Zolpidem is really good for sleep onset and causes almost no dizziness or psychomotor depression the day over, however, it does not maintain sleep.

To my horror, I was wide awake at 2 am in the night and I spent the entire night trying every other way to sleep but ended up going to the prometric centre sleep deprived. Needless to say, try setting your sleep schedule according to the exam time at least 1 month before the D-day! Exam Day March 8, Exam day is usually less anxiety provoking than the day before with all the anticipation. I reached the prometric centre 30 minutes before the exam.

My exam started at exactly 9 am. Time went by and soon it was over. The exam had the same interface as the UWorld or free questions. Sleep deprived from the last night, I took a cold shower, wore pocket less pants, t-shirts and sandals as it helps with the check-in every time you take a break. I had a sandwich, porridge and strong coffee for breakfast. I took my passport, I. D card and permit with me. For the breaks, I took with me dates, bananas and sandwiches, some more coffee, juices and water. My experience has another important advice and that is: Always visit the examination centre to pan the route you are going to take and factor in all the traffic and other issues that you may face on the exam day.

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I, on the other hand went to the centre for the 1st time on the day of my exam, ending up at the wrong gate of the college, the centre is located in. I lost 15 minutes in driving around, reaching the correct gate. All of this got me extremely worried and my sympathetic system was on full drive. Although a scare, it was a blessing in disguise for me because it took all the sleepiness away!

The people at prometric, Lahore are amazing. They were very kind and cooperative. There at the centre, I met a wonderful soul. He was also appearing for his step 1 exam. We talked for a while and it was a huge support to have someone to talk to. So, if you can, plan with your study partner to give your exam on the same day. After all the security checks, I reached my desk and thus began a journey that passed in a blink of an eye.

But before the blink, there was a minor moment of panic on the 1st block. I was too tired to concentrate and I started marking more questions than I needed to. But, by the 10th question, the coffee had kicked in, the sympathetic system had warmed up and everything started falling in place. I marked on an average questions per block and ended up with almost minutes to spend on the marked questions at the end.

Block 5 was a little hard with an additional distraction from the fellows typing relentlessly for their GRE exam. I marked roughly 12 questions in this block with almost as many minutes to spare for the marked questions but it was still doable. I did 2 blocks and took a break for 10 minutes. Then, did another 2 blocks and took a minute break. The 5th block was a little overwhelming so took a long break, ate lunch, offered prayer and washed my face like I had been doing in every break.

After the 6th block, I took another break because I still had time to spare. I was feeling happy that just 1 block had remained. I took a walk in the garden of the prometric centre and went back to complete the final block. Completing the final block, I came out of the centre satisfied and happy.

Result Day March 28, The result is usually provided on the 3rd Wednesday from the exam date at 9 am EST. The anticipation of the result is usually very stressful so try to invest yourself into activities that take your attention away from the constant worry. For me, the wait and the anticipation was very painful. I was so stressed I almost got an ulcer. I talked to seniors and those who had taken the test and they reassured me that it happens to everyone.

So sit back and relax. Trust your NBMEs and pray. Do not make the mistake of checking if you got a question wrong. Do not try to calculate the number of wrong questions. Supress as much as you can, everything related to the exam. Follow your schedule very carefully. I tried to memorize Kaplan which was wishful thinking because you are bound to forget almost everything you read from Kaplan.

If there is something so important that only Kaplan helps you keep it in, annotate that part of Kaplan onto your F.

There are way too many distractions at home. My health took a serious toll from the constant sitting and I gained 5 inches in the 11 months that I spent in my bed or a chair. Make time for some physical activity.

Sleep deprivation results in silly mistakes which I know. There is no escaping this and each and every question needs to be solved and reviewed at least once. Initially, I would combine 2 systems together and solve tests till I had about questions pending per system. Now this number is variable as some systems have a lot of questions but others have very few.

So be judicious and careful. The last 30 tests or so that I solved were mixed, like they show up on Step1. Reviewing the tests is a task and it took me practically 4. I would practically write down every little detail form u world into my FA. I had to attach at least extra sheets per chapter to fit in the notes after there was no more space left on the FA pages. But doing this helped me a lot as my first time doing U World was very thorough and I could read up my notes every time I revised first aid. You cannot compromise your academics at any cost because they matter equally.

I did the whole of FA thrice. A minimum of 2 readings is essential. You can revise the U world tests if you want to during the last 1. If you are scoring in the lower range in your first NBME, your scores are bound to increase in the subsequent ones. The key here is to NOT get bothered, even if your scores are below your expectations. You have to work hard, keep going and give it your best shot on the main exam. There is a discrepancy between my test scores and my actual score.

This is because, while doing these practice tests, I realized that I had a crazy tendency to over analyze the questions and keep changing my answers and that actually got me a lot of incorrect questions. So I restrained myself from last minute changes and went with my gut feeling. It was a risky move but it paid off for me. So try and analyze why you are going wrong and work towards correcting them your way.

Now I could fill up an entire page again on my experience on the day of the exam. Have a well-adjusted circadian rhythm. You have to resist the urge to keep going through FA. It messes with your mind and confuses you even more. Please carry good food and enough drinks to keep you hydrated. Anything that makes you feel good.

It makes a difference. Take a break after every block if you need it. I did the same. Try NOT to skip and leave too many questions unanswered till the end because that can stress you out. Re-enter only when you feel fresh enough for another block. Have some faith in all the efforts you have put in for this one day. It will pay off in the end. Having a study partner helps you get through this exhausting process alive and breathing.

Yes we all go through them and it can mess with you. And the only silver lining at that time is the support of your family and friends who believe in you more than you believe in yourself. She plans to apply this year for interviews. We wish her all the best!

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