Advice

USMLE Step 1 Advice 2010



KATIE CARETTI



Books I used

First Aid

Step up to USMLE Step I

Board Review Series (BRS) Physiology

BRS Cell biology and Histology

BRS Behavioral Sciences

Medical Microbiology & Immunology

Medical Microbiology Made Ridiculously Simple

Rapid Review Pathology By Goljan

Pharmcards: Review for medical students By Johannsen

Lippencott Pharmacology

Lippencott Biochemistry

HY Biochemistry

High Yield (HY) Neuroanatomy

HY Anatomy

HY Embryology

To review images I used Webpath: http://library.med.utah.edu/WebPath/webpath.html





Question Bank

I only bought 1 question bank which was USMLE world. Some people bought subscriptions to two

question banks, which I do not think is necessary unless you have time in your schedule to do that many

extra questions. When you purchase USMLE world you have the option of purchasing two practice tests

which I did as well. I really liked USMLE world because the format is exactly that used on the actual

STEP I exam.





Practice Test

In addition to the practice tests I purchased along with my subscription to USMLE world, I also

scheduled a practice test at the same Prometric testing site that I would be taking my STEP I exam. I

would recommend doing this because not only do you get another practice test out of it, but you can also

become familiar with the testing area so that you will be more comfortable come test day.





Other Advice:





I have attached my STEP I schedule. It is important to allow plenty of flexibility in your schedule because

days will not always go exactly according to plan. I would wake up each day around 7:30 or 8 am. On

some days I would start the day off with a workout, on other days I would just get started studying and

save my workout for later to help break up the day. It is definitely important to try to incorporate some

break time throughout your day and do something you enjoy so you don’t burn out too early. I enjoyed

working out, playing tennis, going swimming just to get outside and be able to enjoy the day a little

before returning to study. I preferred to do practice questions at the end of the day after I had already

studied the material for the day. I tried to allow at least 2 days in my schedule to study each of the major

topics covered on Step I. So the first day I would read from one of the listed books on whatever topic I

was covering and annotate my First Aid with supplemental information. This way, on the second day of

covering the topic I could mostly study 1 source, First Aid, which I had already annotated with additional

information from the other texts. First Aid is a really great book which covers the majority of material

found on STEP I. It is not all inclusive, however, and needs to be annotated with additional information

from more comprehensive texts. So here is an example of how I would cover a topic, such as the Renal

unit:





Day 1

8 am: Wake up

8 am – 9 am: Workout

9 am- 11 am : Study Renal Physiology with BRS Physiology annotating First Aid along the way.

11 am – 12: 30 pm: Study Renal Pharmacology with Lippencott and First Aid

12:30 – 2pm: Lunch break

2 pm – 6pm: Study Renal pathology using Goljan and Step Up/annotating First Aid

6pm – 8pm: Dinner break

8 pm – 10 pm: USMLE world questions





Day 2

8 am: Wake up

8 am – 9 am: Workout

9 am – 11 am: Finish reading anything I didn’t get to the day before/ Start reviewing First Aid with the

notes I added from the day before

11 am – 12:30 pm: Review the Renal section of First Aid

12:30 – 2pm: Lunch break

2 pm – 5pm: Finish Reviewing Renal section of First Aid

5 pm – 7 pm: Dinner Break

7 pm – 9 pm: USMLE world questions





So this was the basic format of my schedule. If anyone has any questions regarding STEP I preparation,

feel free to email me at kcaretti@med.wayne.edu.





Good Luck!!

ERICA CHIMIENTI



I have written tons for you. But my most important advice is to do whatever works for you. Do not

compare how you are studying with others because it can just stress you out. Also keep some things in

your life constant, if you like working out or cooking make time for that.





Studying prior to school’s end

I was not great about this. I did about 20 questions throughout the year. I did try to read micro made

ridiculously simple the last week and that was a good idea because micro was a loooong time ago and I

love this book. Some people did questions which can be a good practice because they are very different

in style compared to wayne questions. If I could go back I would try to review micro or biochem prior to

studying because they are very big topics in FA and have lots of details to memorize. Do not stress if you

have done nothing specific to prepare for boards yet. I honestly started the week before school was out.

Some people used FA throughout the year and I wish I had done this because it could have saved time

looking topics up. I’m just not the kind of person that would ever keep up with this though.





Schedule

If you look at my schedule you will see what my plan was for each day. I tried really hard to stick to the

assigned topics each day and complete them because there was not enough time to make-up topics that I

didn’t cover. The actual schedule of how I studied each day did not happen though. I had planned to read

rapid review path for my daily topic in the morning then do first aid (FA) in the afternoon and I didn’t

have nearly enough time for this. I ended up just concentrating on FA and looking up the topics I didn’t

know or needed more information on. I scheduled my micro days later than most people and I was happy

I did this. It was nice to have a break from pathophys. My last week was review and I loved this!!

Some people left only 3 days but I am a last minute crammer so a week was necessary. The last week I

just did a quick flip through FA but I didn’t spend lots of time on any subject, it was mainly to refresh my

memory. Leave plenty of days at the end in case you need to make up for things you didn’t cover or

want to review. Catch-up days were very important for little things I needed to review and to do

questions. Some days I didn’t make it to questions. I also never took 2 hours for dinner. I would take

walks or work out listening to Goljan. Goljan is the author of rapid review pathophys and he is amazing.

It was one of the best things I did to prepare. Lots of students have bootleg copies of his lectures. There

is no video for them but they were one of the best study tools. Try to find someone who has these and get

a copy. If I could go back I would do Goljan everyday along with the topic for that day in FA.

Questions

I would definitely recommend doing questions everyday because it is a great way to review topics you

have already covered. I only used USMLE world so I don’t know how Kaplan works. I loved world.

One huge piece of advice I got was to take question sets that had all the material combined on them. You

can make practice tests on world and suspend them so that you can go back and take them whenever you

want. Before I did any questions I made at least 15 of these random tests. This was great because each

day I did my questions I had all the material on it. I did not get great scores on these but it helped me to

review old topics everyday so that I didn’t forget them. I knew people that only did questions everyday

on the topics they studied that day and then at the end they didn’t have any new questions to quiz

themselves with. It may be a good idea to do some focus questions on that days material and some that

cover all the material each day. I also liked having the full mix of topics because that is how the real

exam is and it is better preparation. For example, if you only did cardio questions one day then you know

the chest pain someone has is cardiac in origin, if you did a mix you would have to determine if it was

cardio, gi or musculoskeletal in origin. I can’t stress enough how happy I was to do my questions this

way, but I had to remind myself that I was doing topics that I hadn’t studied so questions were a learning

tool. My scores on world ranged from 50’s-70’s. Mainly around upper 60’s – low 70’s near the end on

full tests. The drugs questions are very specific and much harder than on the actual test. I did about 50

questions a day which took about 3 hours. This is because I took notes on the questions and tried to learn

the concepts. I wrote the notes in my FA. So the last week when I looked over my first aid I could glance

at these as well.





Study Books

Try not to load yourself down with too many sources. I did this at first and was very overwhelmed

because I wasn’t making it through my FA for the day. I ended up cutting back and just used FA. Like I

said before if I didn’t know a concept or needed a better explanation I would use one of my other sources.





First Aid-make sure to check online for corrections to the edition you have!! I checked for each section I

did that day and it was a good idea because otherwise I spent awhile trying to figure out a concept that

was incorrect!

Rapid Review Pathophys- this is an ok reference book but I didn’t love it as much as other people. I just

didn’t have enough time for it.

Step-Up to Step 1- This is a review book that uses lots of tables and charts. If you learn from charts then

this may be great for you. It was not as detailed as FA at all but I liked it to give another explanation of

topics. Just remember this is not a thorough book it is just a brief review on topics.

BRS physiology- This was great to have around to review topics I had forgotten

BRS neuroanatomy- I didn’t use this very much. The neuro I learned was not as detailed as it is in BRS

or in the neuroanatomy course in school.

BRS embryology- I liked another source for embryo and this was good

High yield neuroanatomy- I accidentally bought this without realized I had BRS, I liked BRS better

because it is more detailed and if I was looking something up it was because I needed a better explanation

on it not because I needed a quick overview of it.

High yield embryology- same as the other high yield

Microbiology made ridiculously simple- This is the best for micro. I tried to read it during our last week

of school/that pharm they forced on us. I would recommend this book. I didn’t use it during the year but

it was amazing for boards.

Step 1 Recall- This is a review book that just has high yield facts. It was a nice quick review. If I really

didn’t feel like studying or had to sit in a car for something it was great to flip through. I just read

random topics so that it would act as a review of things I had already learned.

Wikipedia- Lets face it, this is one of the easiest resources and I used it all day long to look up things

from FA.

Road Map to Anatomy- I didn’t use this but I know people that really liked it so it may be worth looking

at.





Test Day

This exam is not like the ones at Wayne. It is meant to be challenging to even the smartest people. I

thought it was harder than USMLE world and I wasn’t doing great on world. I am not saying that to scare

you but just to remind you that when you take it you will be guessing on questions and using your best

judgment. Trust that you have studied enough to do well. All of my friends thought it was very hard and

they all did well on it. If you have a bad section just keep going and forget that it was that hard. Also, I

did the practice test at the site which was good. I liked knowing what the room was like before. But, the

NBME exams are not as hard as world or as the real exam so keep that in mind. You will take one of

these NBME exams at Wayne this spring and when I took it I thought it was impossible but once you start

studying they aren’t as bad.





There is endless amounts of material you need to know so focus on what FA has and you will be fine. FA

seems very detailed (at least it did to me) but it is very high yield. I hope this helped some. Please come

on Monday if you have more questions or feel free to e-mail me Echimien@med.wayne.edu. Title the e-

mail step 1 advice or something similar so I know to respond.

ED SHIELDS



First Aid for USMLE step 1- Buy it and memorize it all

BRS pathology- I read sections after corresponding year II courses and annotated FA, did not read during

study period, I recommend you read it

HY biochemistry- spent 2 days during spring break reading and annotated FA

HY behavioral sciences- Read through quickly and try to pick out pertinent things

HY neuroanatomy- Read through quickly and try to pick out pertinent things you don’t already know

BRS Micro/immuno- Use more as a reference, read if you have time

BRS physiology- Pretty good, I read in one day close to exam

Rapid Review Pathophysiology- Very dense, used mostly as a reference, some of the beginning chapters

were ok about basic pathophys, fluids/electrolytes, wound healing, etc

HY anatomy- I read this a few days before exam, very dense, not necessary, only if you have time

BEN WORKMAN



RESOURCES

First Aid (FA): This is by far the most important book for Step 1. It is incredibly inadequate in itself

though. It must be annotated…heavily. Some people started annotating theirs at the beginning of first

year. I did NOT. So if you didn’t either, don’t feel bad. I started annotating mine over spring break of my

second year. Write down stuff you don’t understand, stuff you got wrong, stuff that isn’t in FA at all, and

pictures. Pictures are fun and they make you remember. This was pretty much my only resource the final

week of studying because it had been annotated with everything important from all the other books.

Goljan Rapid Review of Pathology: This is the second most important book in my opinion. The thing that

helped my studying the most was annotating my FA with info from Goljan during the time BEFORE I

actually started devoting all my time to Step 1. Every weekend leading up to the start of my study

schedule, I would go over a single body system in Goljan and supplement FA. By doing this, I had

already re-familiarized myself with respiratory, heme, renal, cardio, endo, reproductive, GI, connective

tissue/derm, and neuro. I also found it helpful to go over them in the order in which we had the courses

because I knew I would be more energized at first, which was needed for the subjects from which I

remembered less. This strategy was probably the number one reason for my success. I didn’t feel at all

overwhelmed when I started studying hardcore in May.

Pathophysiology Notes: I used these along with Goljan to supplement FA during weeks leading up to my

official study time.

BRS Series: I used the Anatomy, Physiology, Microbiology & Immunology and Behavioral Science

books as my primary resources for those subjects. I also found the Pathology book to be quite helpful. I

used the Histology and Cell Biology book a little bit. Overall I really liked the BRS books. Some people

claim that they leave important information out, but I found that they were a very good supplement to

First Aid and Goljan.

High Yield: Used Neuroanatomy, Embryology, Immunology, and Cell & Molecular Biology. The first

three were very helpful. Cell and Molecular Biology was alright, but I like BRS a little better. These are

very short reads and you can get through them quickly. The Neuroanatomy and Embryology books had

lots of good diagrams.

Step Up: I Thought that this book was pretty good for a general overview of all the systems. It has good

physiology sections, and the pharm is pretty good too. It has lots of images and diagrams, which made it

GREAT for neuroanatomy.

Lippincott: Used the Biochemistry and Pharmacology books by Lippincott. I found the Biochemistry

book to be extremely helpful. I remembered virtually nothing from Biochem, and this book helped make

sense out of everything again…and lots of things for the first time. The Pharm book was okay. Nothing

special but it helped some. I used FA mostly for Pharm and made myself flash cards that I studied over

and over again. The Lippincott book was good for some of the things I needed further explanation on, but

it was by no means necessary.





QUESTION BANK

I used both Kaplan Q-Bank and USMLE World and like them both. I just bought the one month

subscription for Kaplan, started with that, and then bought the World subscription like a week later. That

way I didn’t have to renew either one. I thought they were both very difficult and WAY more detail-

oriented than the real exam. But going through the really hard and detailed questions forced you to review

the big picture as well, so in the end they both were extremely helpful. It probably isn’t necessary to buy

both, but since I was only paying for a month of each I went ahead and did it. I got through almost all of

both of them. Overall, I think Kaplan may have been a little more focused on minutia at times, so if you

only get one, I would chose World. It also has the exact same format as the real exam.





Overall Advice

Some people say you can’t do well on this exam if you use a whole bunch or resources. This is Obviously

not true. I find that if use lots of different resources I see the material presented in different ways, and thus

understand it better. This is just my own personal preference. Whatever your method is going to be

though, stick to it if at all possible. If you discover early on that it isn’t working, bail on it and find

something that does…fast.

As I stated above, the best thing I did in studying for this test was try to spend one day each weekend

between spring break and when 2nd year ended going over one of the systems in FA. I would go over it

using Goljan and my pathophyiology notes from the year. This way I had a large portion of my FA

annotating done before my month of hardcore studying even started.

Try to take at least a few practice exams. The NBME practice exams are quite good. The downside is that

they cost about $50. Also, try to take a practice exam at the test center at which you will be taking the real

exam. This is good because A) practice questions, and B) it gets you familiar with the test site. I wasn’t

quite sure where I was going the first time and was very glad I did know on test day. You also get familiar

with the computer system, although the practice exam WAS on the older format. That may be different

this year.

Importantly, do whatever possible to preven losing your mind during this whole deal. I worked out almost

every day and there were about three Thursdays where I drove one and a half hours home to play golf in

my old golf league with my family and friends and have a few beers. It gave me something to look

forward to and kept me motivated. I even went up north for a night over Memorial Day weekend. Some

people can study non-stop for a month. I’m not one of those people.

Finally, studying for this exam is probably the most intense studying you will EVER do in your entire

life. It IS going to suck. You ARE going to get frustrated and want to break something. And it WILL

eventually be over. And when that happens, you will look back and think, how in the hell did I ever study

like that. So with that in mind, try to look at this experience as a challenge (one that you are going to

dominate), and not as the worst month of your life (because in the end it really wasn’t all that bad).