Category Archives: USMLE

USMLE STEP 3 GUIDE

Hello there! I just finished writing USMLE Step 3 and felt like sharing my experiences with you. I’ll try to do it to the beat of my ability. You see, I took the exam between residency interviews and so you might find it a bit rusty.

The Actual Exam : The exam, you know, runs for two days. Initially it is pure Multiple Choice Questions (MCQs) and then on the second day it is MCQs and cases.

Content : What knowledge you have gained during your internship is what is tested in Step 3. There is nothing to beat your clinical experience. I found that out at the very first set of questions that I got to do. The questions on neonatology were difficult; at least they were for me. That was when I found that I was woefully inadequate in clinical experience.

During my interviews I had the chance to talk to a PGY-3 IM resident who had only a couple of months back (actually prior to me) had completed his exams. Has had done exceedingly well in the exams. He told me one thing about his preparation. It was minimal but what stood him in good was his clinical experience.

As far as I am concerned, typically most of the questions relate to diseases and their management. Questions in relation to prognosis were also asked. Medications, the treatment preferred and the side effects of these medication could also be asked.

Some of the questions that I came across were ..

1. What are the methods for monitoring RA?
2. Anemia n infants. I got a lot of questions in this field of study. And variations of the same question in the same set.

Multiple Choice Questions (MCQs) : The books and material that I used were

1. Kaplan QBank,
2. UWorld Qbank and
3. Kaplan Step 3 and some videos.

I finished studying all to the Kaplan books and the videos. I couldn’t finish either the Kaplan QBank or the UWorld QBank. If you intend to do the questions, do it with the intention of learning and not just for the exams. All the materials were helpful. I can’t, for the life of me, tell which one was the better one.

Summary of MCQs : Suppose I had to do it all over again, God forbid; I’d do more questions – more Kaplan Qbank and the UWorld Qbank.

Clinical Cases : Most of them were quite straightforward. The books I used were

1. UWorld Cases,
2. USMLE Steps 1, 2 & 3 (I got them off the Internet) and
3. First Aid Step 3 Cases.

I couldn’t finish all the cases. Just about 25% of all the material I had. Here’s my opinion of the material I used.

UWorld Cases : More than enough.
First Aid : Exactly what is needed. At least what I needed.
USMLE Steps 1, 2 & 3 : Decent. With the software for practice.

Summary Of Cases : That depends on your confidence on the management of real time cases. U can use either UWorld or First Aid. Get yourself acquainted with the software a week or two before the exam. Depending upon your knowledge of computers, the time to get used to the software varies.

 

see also

Complete Physical Examination : PART ONE

Thyroid examination video

Neurological Exam Part 1

Neurological Exam PART 2

Abdominal Examination

RESPIRATORY SYSTEM EXAMINATION

 

 

USMLE Step 1 Tips

USMLE Step 1 – Preparation and My Experience

Hello, everyone! I have taken my USMLE Step-1 and I had a very good experience in the preparation stage, which I am sure is going to help you for achieving a better score in your exams. I haven’t received the result of my scores yet, but I’m sure it would be a nice idea to share my experience with all of you who have their exams coming up shortly. For your convenience, I’m giving a step-by-step explanation of the entire process.

Ideal Time For Preparation 


It took me almost 6 months in preparation, which completely depends on your initial reading and also on the number of MCQs you are willing to solve later. Majority of students complete their preparation in 4 to 8 months. But of course, if you have exceptional reading skills and a sharp memory, you can do it in less than 8 months.

Books and Resources That Will Help You 

In my opinion, Kaplan is the best source for carrying out your preparation in an efficient manner. There are several other books including ‘High Yields’, but Kaplan has answers to all those question that one encounters in exams. It also has answers to subjects like behavioral science, for which majority goes for BRS.

However, you can also revise pathology with the help of Goljan or BRS.
I used following resources for myself:
Kaplan for all subjects
Goljan 500 pages for pathology
Kap videos for micro/immunology, Anatomy /physio / behavioral science/Biochemistry
First aid

 

how to prepare for usmle step 1

What Actually is USMLE Exam?
USMLE is not an easy test at all. It requires you to be present for continuously 8 hours in an ongoing exam with a minimum break of 45 minutes. It goes smooth in the beginning; but in the end, you are extremely tired and stressed out that you feel like ticking whatever sounds like a best possible answer, without giving it a second thought – all you have in your mind is getting it done as quickly as possible. So, it requires a lot of patience and stability to efficiently perform this test.

Besides examination, there are several points which make it quite difficult for most of the people. Everything is totally uncertain at all the steps of USMLE, which as an American medical residency involves several other problems that can be stressful. One has to think about expenses and exceptional performance in all the steps that are parts of this long procedure. In addition, you also have the risk of not getting a residency after clearing all of the required steps. It can turn out to be a total loss any minute. So, you have to make your way to the top along with fighting with severe uncertainty that anything could happen either in step 1, step 2 Ck / CS, in Step 3 or your interview, which also plays a very important role.

But it does not mean that only exceptionally smart students are eligible for USMLE; even if you are an average student, you should still go for it and give at least 6 months to it with your heart and soul. After first 6 months, you would know that whether it is for you or not.

How to Prepare for USMLE Exam?
Preparation for usmle step 1 can be mastered if you have a perfect plan in your mind regarding the availability of your time and doing your Qbook as well as Qbank. Moreover, you also need to decide in first place that when would you be able to take Step1 Exams because you need to apply in Sep – Oct period. It is better to start with the subject you were most comfortable with in your graduation period. It makes it easier to initiate your process and you are able to complete that particular subject easily without wasting a lot of time in thinking how to best start your preparation.

In my case, it was Physiology, and I think it is best for everyone to start with because it is entirely theoretical and you do not need to hunt for facts, which ultimately saves your time and helps you in making a solid start. However, you can select any subject that best suits you. What matters is your own comfort and understanding of the subject.

It is better to complete your first reading as quickly as possible. Spending a lot of time on first reading is not really going to do any favors; you won’t be able to save a lot in your memory even if you pay all your attention and time to your first reading.

Consider a fixed number of books and sources for your preparation, as they promise to provide you with all the required concepts. Mostly, only vital concepts are tested in USMLE, which you can find in a few defined books.

Besides, preparation requires a lot of patience. If one day does not go well enough, you still need to keep your spirits high and continue with your preparation. Next day might be the best one to help you for several upcoming days. Your self-belief is your only power here and you need to empower it as much as you can. And it is not always possible that only those students excel in USMLE test who have spent all of their time studying and preparing for the test. Common sense and calmness brings better result here than one’s brain.

Additionally, you also need to have a good sleep the night before because it will keep you calm and steady, helping you complete your blocks easily. Otherwise, you will get tired in a very short time and instead of thinking about succeeding at the test, you would be thinking about leaving the test.

My Preparation
I was done with the first reading, in which I never used the Qbook, in 3 months. Then, I did my second reading with the Qbook in 1 month. MCQs and final reading of theory, however, took just 15 days each.

My Scores

Q book…..75 % (Two months before exams)
Q bank……75% (I only completed half of the blocks and random mixed questions one month before the exams)
350 question…..73% (It was five days before USMLE exams)
USMLE FRED practice exam……40/50,46/50,37/50 (2 days before USMLE exam)

The Exam Day Experience

If there is someone else who is going with you, you should first confirm the routes which lead to your centre so you would be able to reach on time with ease. You won’t have any problems once you have reached your exam’s center because the staff at parametric center is very professional. They will immediately tell you about the DOs and DON’Ts.

The exam is really tough and takes a lot of time before it is finally over. It is divided into different blocks of which some are really tough, and some consists of average questions. Moreover, there would also be some blocks being the easiest ones.

However, unlike other practice tests, you will be short of time, which requires you to make quick final decisions so you could be able solve each block before it’s time is over. Doing so, you will succeed in saving a little time to give a second glance to all of the doubtful questions.
Besides, you also need to use your breaks efficiently. Ideally, you should relax for five minutes after each block to get your breath back as well as to gather all of your ideas and thoughts. Doing so will also give you a 15 minute break after you doing block 4 along with a ten minute break which can be taken later.

Another thing that possesses a vital importance is your passport and orange card. Make sure that you have both of these. Otherwise, everything will go in vain.

My Mistakes
I took a lot of time for doing my first reading, which can easily be done in 1.5 to 2 months.
I couldn’t meet up with my weekly / subject- wise goals and wasted a lot of time.
I also failed to finish reading first aid in the last two days of exams along with Goljan 500 in the initial 2-3 days. I could only complete reading half of first aid and even less than half of Goljan.
I focused more on doing Qback and missed numerous MCQs.
Most of my time in the last month I spent on the internet and TV, and it was extremely disadvantageous for me.

What I Did Right

I did not delay my exam more than 5-7 days. Because spending more time won’t bring any better results. You will still be having almost the same amount of preparation, and you might feel that you do not know anything at all when your exams start to near.
I never gave up. I always kept myself motivated and strengthened my beliefs with optimism.
I stopped wasting my time on the internet and TV, and gave my full attention to preparation in the last week.

I know this experience and knowledge that I shared is very scarce as compared to the amount of information and guidance required, but I hope my little contribution would bring better results for your test and help you in several possible ways

 

First Aid for the USMLE Step 1 2013 (First Aid USMLE)

Clinical Microbiology Made Ridiculously Simple

USMLE Step 1 Secrets, 3e

USMLE Step 1 exam misconceptions

Hello everyone. The following is a detailed piece regarding preparation for the United States Medical Licensing Examination Step 1. I am a final year medical student and I completed my USMLE exam on June 10, 2012; I achieved scores of 99/266.

First I’d like to introduce and investigate some of the misconceptions and prejudices surrounding the USMLE Step 1 examination which seem to be especially prevalent within overseas students

Myth 1: You should only take the USMLE Step 1 exam after graduation.

Verdict: Baseless

the idea that one should wait until after graduation before taking USMLE Step 1 exam is patently false, based on a risk that is no less present when taking the exam after graduating. No matter your level of experience or amount of preparation, Step 1 represents a risk for anyone who undertakes it given the simple fact that it is an unpredictable exam.

The benefit of taking USMLE Step 1 before graduation is that you are still immersed in the detail of your medical education, typically resulting in a score that is substantially higher than when taken post-graduation. This gives you the benefit of relying on still-fresh study habits and medical information that remains fresh in your mind and helping you to find the right tempo to study and prepare, tasks that are often lost in the fray after you enter the medical profession.

Rather than wasting your time during your medical education, spend it reviewing USMLE recommended textbooks in order to prepare for Step 1! Keeping in mind that American students take Step 1 at the end of their second year and Step 2 at the end of their fourth year, waiting until after graduation to take Step 1 can only negatively affect any competitive edge you’ve gained.
Myth 2: You must memorize the Kaplan series and know it by heart.

Verdict: Incorrect and a potential time-waster.

actually what i know for sure is that American medical students are rarely intersted in studying Kaplan in thier USMLE step 1 preparations; the appropriate books on this section of the test are mentioned further on. While Kaplan is an excellent series, the idea that it is the ultimate base for the USMLE Step 1 exam is simply untrue; the Step 1 exam does not have a well-defined syllabus, forcing most students to turn to the syllabus released on usmle.org.

Instead of cramming all of the material into your memory, much of it not found on the exam, it is a good idea to focus on key areas. Replacing the Physiology book with BRS Physiology and replacing Pathology with Golijan (you’ll need to supplement biostatistics with high yield biostatistics) are key ways to replace Kaplan with less time-consuming and far better focused material.

Remember that much of the information contained in Kaplan is vague, especially the Genetics section of Biochemistry, and it is rarely included on the exam. On the other hand, some topics require more study material than is recommended including cancer chemotherapy and lysosomal storage diseases. When it comes to mastering Microbiology, the use of Levinson is crucial..

Myth 3: You need clinical experience to fully understand USMLE Step 1’s clinical vignettes.

Verdict: Not necessarily true.

As mentioned above, American students typically take the USMLE Step 1 exam prior to graduation; if clinical exposure isn’t necessary for students in the United States to be successful in their exams, it is not necessary for students in other countries, either.

While serving in a clinical setting in hospitals will certainly help you to better understand methodology and practices leading to diagnosis, management and treatments, it is definitely not imperative that you have clinical experience before taking the USMLE step 1 exam. Most of the cases the exam will present you with can be easily understood by simply applying the knowledge of basic medical sciences that you’ve acquired through your studies; in-depth topics, such as those of radiographs and gross specimens, can be practiced with resources available freely on the internet and via your university; even the sound of a heart sounds and murmurs can be easily studied with the help of Google!

With patient management scenarios only appearing very rarely in the Step 1 examination, a basic knowledge of medical science is all you need to prepare you; the Step 2 CK examination offers a more in-depth focus on patient management.

Myth Number 4: A good study indicator is “number of reads.”
Verdict: Not necessarily true.

If there is one certainty when it comes to studying it is that each and every person has a unique method that works best for them and this makes the idea that any one style should work for everyone baseless. While more than a single read of the material will certainly be necessary, a rigid sequential study method typically follows the Kaplan series and offers little significant benefit.

I’ve been asked repeatedly by my peers as to how many reads I’ve completed and my answer is always the same: the number of reads is not the best criterion to use when judging one’s preparation – that’s the purpose of the NBME sample assessment. The truth is that you shouldn’t let the idea of the importance of your number of reads dictate how you study; some people study quickly and spend minimal time on each topic, allowing them more time to revise, while others find that an opposite method works best for them.

The above being true, a person who has completed two reads could very well be as prepared as someone who has completed seven; it is also worth noting that some subjects require more reads than other – pharmacology, for example.

So what study method is the best? That’s entirely up to you. Instead of forcing yourself into a rigid “number of reads” dominated method, work within your own already well-developed study habits instead. Always remember: if you scored well on the NBME test then you’re doing well.

Myth 5: If you score below 95 on the USMLE Step Exam, you’re done.

Verdict: Absolutely untrue.

While Step 1 is very important, it is crucial to remember that it is not the only criterion considered when judging a candidate; a well-rounded candidate will be judged on all material, including the Step 2 CK and Step 2 CS exams, electives, research experience and more. Not everyone will score a 99 on the Step 1 exam and there is no need to lose confidence in your abilities if you don’t. Like any exam, Step 1 will present challenges and not every exam can be your best.

If you do face a disappointing score on the Step 1 exam than simply study hard and compensate with Step 2; losing hope will not get you anywhere.

Myth 6: Step 1 focuses only on broad concepts.

Verdict: False; study, and study hard.

Students preparing for the Step 1 exam often work under the idea that it will not require much knowledge of particulars, focusing instead on broader concepts and ideas in preparation for Step 2. This is patently false and all students must realize that there is far more to learn for this exam than was presented in college, all in additional to new concepts. The particulars of Microbiology, Immunology and Pathology alone will demand endless information with the exam disguising many knowledge-based questions with exercises in in multiple-process thinking.

Myth 7: Up to 80% of the Step 1 exam is based on Pathology.

Verdict: False.

While it is true that upwards of 95% of the exam will contain clinical vignettes that can be directly correlated to Pathology, the subject matter contained on the exam will vary from subject to subject. For example, you may be given a vignette on Ataxia-Telegiectasia while being tested on an immunological or molecular biology concept. With the recent change on the USMLE exam to include more clinical vignettes, the variety of knowledge required to do well on the exam is more prevalent than ever.

I would recommend dividing your attention equally among all subjects in order to give yourself a good framework from which to work. There is no rule about topic inclusion and the exam itself is constantly updated to reflect current medical standards, leaving you to decide which subjects are most worthy of your attention.

Myth 8: Delaying the exam will help to increase my score.

Verdict: Potentially false; even the opposite could prove to be true.

While delaying your taking of the exam in order to provide more time for study may seem like an attractive idea when you’re feeling rushed and short on time, it is worth keeping in mind that that month could just as easily lead to a loss of remembered information.

Momentum in serious study is important and momentum can only be maintained with sustained effort towards your exam preparations. Choose your exam date and stick with it, allowing your positive momentum to carry you directly into the exam room and removing all of the risks that come with breaking your academic rhythm.

Myth 9: I’ve heard that Virology is a main focus in Step 1 so I’m focusing my studies there.

Verdict: False; exams are not standardized.

The lack of uniformity in Step 1 exams means that you cannot trust what you’ve heard as it may or may not pertain to your particular exam. Exams vary in content and even scoring method, leaving you in the dark when it comes to guessing about content.

Instead of worrying at the last minute about cramming one particular topic or another, work to split your study time evenly between all major subjects, spending extra time on topics within Pharmacology and Microbiology not because they are likely to appear more often on the exam but because they are more complicated areas of study. This will ensure that you have a firm grasp of each subject and will allow you to avoid the trouble you’ll face when your exam is full of Biochemistry and you’ve spent the past week cramming Virology.

see also

How to study for usmle step 1 exam

7 reasons make you fail in usmle step 1

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