General Starting Thoughts
First: I thought about the score I wanted. Then I looked through this thread and others on SDN, looking for trends in schedules, study materials, and scores. I suggest everyone take some time, around fall of MS2, and just go through all of these experiences. Look to see what rings true for you. A lot of this exam is knowing yourself - your study style and the amount of effort you know you can put in. I knew I could focus for 12+ hours a day,
if it was for a short time, so I planned accordingly.
Second: Use this gestalt of what worked for everyone else and add it to what you think you can accomplish, the effort you think you can put in. If you think you can do it in 6 weeks, then see how other people did in 6 weeks. Build a schedule to fit you. Have some rest/catch-up time built in. I've attached a draft of mine (below).
Third: Make a list of the different materials people recommend, and go to a bookstore to read some of them. Don't buy the materials I (or anyone else) used until you take a look for yourself. If flashcards work for you, great. Maybe a dense text helps you, or maybe a lot flow charts is your thing. Whatever your tactic is, figure out which of these materials fit your learning style.
Fourth: I was an average or below average student all the way throughout MS1 and MS2. I didn't attend lecture for most of MS2. Heck, I'm a three-time re-applicant. Forget any inferiority you may feel about yourself, because those thoughts don't help you study. Anyone can do well on this exam if they plan things right and work hard.
Schedule
For various reasons, I wanted to take 5.5 weeks to study. I used Taus's method of starting with lots of reading for understanding, tapering to reading for review at the end. This was balanced by increasing amounts of question sets. This helped in that I had could first learn all of the material with a transition to testing my knowledge. A real benefit of this structure is that by the end, I was taking nearly a mini-USMLE every day. Keeping up concentration for the real 8-hour test didn't phase me because I had maintained it a bunch of times before.
I never tried to schedule time for specific topics. My materials and questions really weren't arranged that way, so I just plowed through my materials repeatedly, as fast as I could go without losing understanding. If fit in flash cards at odd times when I was doing something brainless - like doing dishes, housework.
Lastly - I didn't delay my test, but some folks I know did. If you think you need it, do it, but don't use it a as a crutch 'cause you're scared. And don't be afraid to change your study schedule if you're not getting the results you think you need (more below).
Study areas
I know I need to be free from distractions. So I staked out a spot in my school's basement where I had internet access for my Qbanks. Every day I'd come up and have lunch in the student lounge before hitting the books again. Often I'd run into other students, and sometimes they'd be upset about some pretest result. Don't let another student's freak-out get
you anxious. Have your own study plan, trust it, and be cool.
Materials
Goljan: I was fortunate to have received a bootleg copy of both his lectures and his notes. The lectures, while dense, are incredibly well presented and tie pathophys to clinical presentation, which I believe is key to this exam. I walked to class, so I listened to these daily from halfway through MS2 to test day. NOTE: They did not help for class.
I printed off his notes and combined them with an unbound copy of First Aid. I don't remember the year, it was not the newest (which is another thing - medical science doesn't change so fast that you
have to get the latest version of things. Go used, go cheap). This allowed me to write notes in margins, mostly of connections I made, but also some facts I learned from USMLEWorld. I paired Goljan's sections with the corresponding section of First Aid (i.e., Cardio with Cardio). This helped me rapidly read and review much of the same material, but with two different presentations.
First Aid: As above, I ripped off the covers and put it in a 3-ring binder. You don't need the latest version. Good info, but no something to learn off of. The connections I need to understand the material mainly came from Goljan.
Pharm Cards, Micro Cards: I don't like pharm or micro, and I thought both fields were filled with mindless minutiae that had no internal consistency. So I used
Pharmacology cards and
Microcards because the only way I'd "get" these is by repetition. These cards (esp. Micro) were good prep because I started with a partner giving me with the clinical scenario, and I'd have to name the bug. As I got better, they'd read a random section, and request another (i.e., gave S/S and asked for how to characterize the bug).
The lesson here is to know what your strengths and what your weaknesses are. Mine were micro and pharm, so I made adjustments to account for them.
Random others: I used Costanzo's Phys for the occasional concept or two. Not much else.
Question Banks
I used both USMLEWorld and Kaplan. Kaplan was paradoxically the easier and the more nit-picky of the two. As I was doing my prep, I became frustrated with Kaplan, dropped it, and focused on USMLEWorld.
Question structure: the USMLE has progressively gone from simple recall to 3rd order questions. That is, instead of asking what structure is damaged in Parkinson's (1st order), they started putting Weigert's on the exam and asking you to point to where the lesion is (2nd order). Then they added another level of required knowledge, and didn't say Parkinson's, they described the clinical features of someone. Or gave a drug regimen (3rd order).
Most of the questions in USMLEWorld are 2nd order. The remainder are 3rd. In my opinion, there is no better tool for training your mind to deal with 3rd order questions than USMLEWorld. USMLEWorld's questions
are harder than the real thing, but it will train you to deal with hard questions so you aren't flustered on the real thing.
How to use question banks: I did random blocks of 46 untimed. I did untimed because the few blocks I did timed, I was well under the 50min time limit. I didn't do tutor mode because I found that it dragged me down. It took me usually ~40min to do a block and ~1.5 to review it.
Many people swear by doing cardio studying and then cardio questions. I believe that half of the challenge of a question is knowing
what system is being effected. The real thing does not tell you this is a "Immuno" question or a "Path" question. However, most questions on the real thing start off with a patient complaint +/- symptoms. USMLEWorld questions all start this way. This helps train your brain to link a clinical description to pathology to a diagnosis, treatment, or work-up. As I said above, Goljan explains all of the material in this fashion.
% of questions correct: I started in the 40's and ended in the high 60's. Some 80s, some 50s, overall 67%. Don't get scared of low starting percentages because again, USMLEWorld is training you to work with a new format of question, as well as how well you know the material.
Pre-Tests
I used USMLEWorld's half-length pre-test about two weeks before the exam (I believe it's on the schedule). I didn't get one of the NBME ones because I didn't want to spend a half a day taking an exam without getting the answers to the questions I missed. Then again, it's not written by the NBME, so you there's some trust involved.
My estimated score based on the USMLEWorld half-test was 230. That gave me confidence that I was on the right track. Note that USMLEWorld gives you results broken down by subject. That way I knew what subjects I was weakest in after ~2 weeks of study, and so I changed my study focus accordingly.
Day before test day
Mostly light studying. I drove to the center and made sure I knew where it was. I tried to sleep as best I could the night before.
Test Day
I packed a lot of snacks so I could eat between blocks. I believe I went 3 or so blocks, then ate a small lunch (now is not the time for a post-prandial alkaline tide coma). I did most blocks in under time, and used most of the remainder to go over the few questions I wasn't sure of. About 70% it was read it, make best guess, and "click" on to the next. No agonizing.
I left around 3pm and felt like I was in a fog. The next couple of days I felt like crap because I didn't know how well I did. I didn't feel like I knocked it out of the park, and I didn't feel like I completely failed it.
Summary:
Do what you think is best. You're the expert in your learning style. These are my thoughts, and if they help you, good, but they may not fit you. Study in a place that helps you focus. Minimize interactions where you get distracted by others, or where another students' anxiety make you doubt yourself. Have a plan, have confidence in your plan, but feel free to adapt that plan if you discover you have some weaknesses. USMLEWorld is hard, but it is a great tool, and cheap. Goljan has the best summary of the medical sciences out there. First Aid is a good supplement.
Weeks studying: 5.5
Money spent: $90 UW + $40 FA = Cheap
USMLEWorld overall average: 67%
USMLEWorld pre-test score: 230
USMLE score: 248
Definately. In my 2 months of studying, I haven't done a total readthrough of FA until the last 2 weeks. I felt that everything came together the last 2 weeks and that the final 2 FA readthrough helped tremendously.
