Hi Friends! I am a long-time lurker who has found the contributions of others on SDN to be invaluable in preparing for both the MCAT and USMLE Step 1. I wrote up a brief summary of my experience with USMLE Step 1 during the week after I took the exam but hadn't gotten around to posting it. For whatever reason, it popped into my head today - I hope it's helpful!
Numbers
2/27/2017 CBSSA 17 - 180
3/31/2017 CBSSA 15 - 209
4/14/2017 UWSA 1 - 245
4/15/2017 CBSSA 16 - 230
4/22/2017 CBSSA 19 - 223
4/25/2017 CBSSA 18 - 232
5/18/2017 CBSSA 13 - 234
5/25/2017 UWSA 2 - 245
5/26/2017 Free Online - 88% 90% 88%
5/31/2017 USMLE Step 1 - 248
Background
I really struggled with studying for Step 1 - although I don't know too many people who didn't. I felt that my school's curriculum was far from "teaching to the boards," and that I had to learn a LOT of material during dedicated study time. It is also important to mention that I am a non-traditional student, and I believe that how you prepare for this exam is very dependent on your background and your innate strengths. So, to give this study guide context, here is my background.
I am a non-traditional student who majored in music and computer science and eventually ended up working at a hospital in biomedical informatics. I decided I wanted to go into medicine and did a 2 year post-bacc program to complete the prerequisite courses (I hadn't touched biology, chemistry, or physics since high school).
I finished the post-bacc in mid-August, studied for the MCAT for 1 week, and got a 29. I applied late and received no interviews that cycle. I took the MCAT again the following winter, after taking a leave of absence from work to properly prepare, and scored a 37. I mention this only to give context, because I am one of those lucky people who are generally pretty good at standardized exams.
I struggled more with medical school than anything in my entire life. I am fortunate to be at a pass-fail school. Although I never failed an exam (and was usually within a point or two of the mean), I had never worked so hard to be average.
It's also worth noting that I wanted to take a research year, and put a lot of time into an HHMI grant application in the months leading up to dedicated study time. Otherwise, I would have spent more time on UWorld and First Aid during that time.
The Schedule(s)
At my school, we get 6 weeks of dedicated study time - except that it's really only 4 weeks. You will see the classes marked out on my schedule. I wasn't great about sticking with the schedule, and I believe it was too ambitious. I stopped running, didn't really take many breaks, and would usually go until about 11p. I also didn't have a good plan in the days leading up to the exam, which probably contributed to me freaking out and deciding to push the test date back. I also felt that, while I was getting a lot of "difficult" questions correct (questions >50% of people missed on UWorld), I was missing too many "easy" ones. I was really bothered by the idea that I was going into the exam not knowing things that I knew I should.
I also discovered pretty late in the game that the visual mneumonics worked really well for me. Sketchy, in particular, is amazing. I used only Sketchy for micro and pharm - I did not use First Aid at all. This is not to say Sketchy is comprehensive, but I chose to master Sketchy rather than try to incorporate First Aid at the risk of half-assing both. I think Picmonic is very hit-or-miss. Some of their images worked well for me (metabolic disease, immunologic disease, leukemia, lymphoma, CNS tumors) and some of it felt unusable. Still, it was really helpful for me to have the visual anchor.
It's also worth mentioning that the way I used Sketchy and Picmonic was a little unique, in that I imported the images to an Anki deck. I watched all the Sketchy videos one time, and them made cards containing the image and each unique fact, annotated with what was said in the video. I did the same for Picmonic, except I didn't watch the videos. All said, that was about 2,500 cards for Picmonic, 1,600 for Sketchy Micro, and 3,000 for Sketchy Pharm.
I also want to take a moment and say that, despite Sketchy Pharm having some really long and sometimes convoluted images, I absolutely loved it. I initially found the number of facts per image really intimidating. But, I hit a rhythm with it and ended up being very solid on physiology because of how thorough they are with the explanations of drugs.
In the days leading up to my first exam date, I made the painful decision to delay, and took the weekend to relax. The following Monday, I began my second study schedule.
I applied a lot of the lessons I learned from the first time around to my second study schedule. I took a lot of mini-breaks to keep from burning out. I was consistent with getting some exercise in every day, and also put together a plan for days leading up to the exam, so that they were productive rather than wasted fretting.
FAQ
1. Is it worth it to do UWorld twice?
Yes, for me it was. My understanding of the material between the first and second pass was significantly improved. I think it's a bit of a chicken and egg problem: you need to start somewhere, and no matter where you start, you will be missing some important context. By doing two passes, you get to see the material again but with a fresh, and more sophisticated, perspective.
2. What do you think about USMLE Rx?
When I studied for the MCAT, I used Berkly Review (loved it) and Exam Krackers (hated it). I did horribly on Exam Krackers, but it was necessary for drilling basic facts. I thought Berkley Review was great for learning how to process the questions and arrive at a good answer, whereas Exam Krackers was good for drilling basic facts. In the context of studying for Step 1, UWorld = Berkly Review and USMLE Rx = Exam Krackers.
3. What do you think about Kaplan Qbank?
I used Kaplan Qbank throughout my first and second year. Like others have said, I thought the questions were a bit nitpicky. It wasn't my favorite pool of questions, and I have never really been a big fan of Kaplan (I am not really sure why, it has just never resonated with me - whatever that means). That said, there were a handful of really choice diagrams and explanations of physiology and pathology that I liked. I felt using Kaplan as my "throw-away" bank worked well for me.
4. Wait, how many resources did you use?
I used First Aid 2017, Pathoma, UWorld, USMLE Rx, Kaplan Qbank, Sketchy (micro and pharm), and Picmonic. Yes, that is a ****-ton of money. It's a bit hard to justify, but I had money saved from a previous career.
5. What do you think about saving UWorld for dedicated study?
I think this is a terrible idea. I am firmly in the camp of using UWorld as a learning tool, not an assessment tool (except, of course, for the assessments - but those are also really just more UWorld questions...). It takes a long time to get through UWorld questions when you are really reading the answers and taking time to follow up on the concepts you aren't as solid on. For example, for every question, I went back and annotated First Aid with the information it was missing.
6. Aren't you worried you're just remembering UWorld questions when you're doing them a second time?
Yes! I was freaking out about this for a while. Here is where I ended up: you may remember a few questions, but you will probably not remember most. And, even if you remember all of them, that's pretty awesome because you have memorized at least 2,500 facts.
7. What was your take of the real Step 1 exam?
I know this is much debated, but I honestly felt like they could be been another series of UWorld questions I had never seen before. The stem length and pacing were pretty much the same. I was absolutely terrified of this exam going in; I was convinced I would be marking every other answer. It was much more reasonable than I expected. That's not to say it was easy, just that it was not so terrible as I expected. Also, in talking with other students, it seems pretty normal to get at least one or two absolutely ridiculous questions about something you might only know if you had been doing research on some specific protein or pathway for the past 2 years. Expect these questions, take a best guess, and move on quickly.
8. What did you do the day before the exam?
Mostly, I got myself worked up. I then spent most of the afternoon on the phone with friends who had already taken the exam. They calmed me down, convinced me that life was going to be okay, that I had done everything I possibly could to prepare, and that I just had to go in with a clear head. Obviously easier said than done, but I am really greatful for having such a great support system.
9. Did you sleep the night before the exam?
Not really. It was pretty ****ty sleep. In fact, pretty much everyone I have talked to got ****ty sleep, or took something to make them sleep. I toyed with the idea of a sleep aid, but everything I tried made me feel very hazy well into the next day - not remotely worth it. Instead, I got pretty good sleep in the days leading up to the exam, so the ****ty night of sleep before didn't really hurt me too much.
10. What was your test day strategy?
I of course skipped the tutorial (after checking headphones) to get my 60 minutes of break time. I planned to do 3-2-2 but to be flexible for bathroom breaks or nerves as needed. I ended up doing 3-2-1-1. I was getting a little excited about being on my last block, and took a few minutes to collect my thoughts and try to treat the last block with the same diligence as the first. I did not eat lunch but rather had light snacks (pretzels, granola bars), water, and coffee. I used the restroom at every break, regardless of whether I felt like I needed to. On my last two breaks, I went outside the test center and jogged around in the parking lot.
11. Looking at your scores, it doesn't seem like much changed during your last month. In retrospect, would you still have pushed back your exam date?
It is a little strange to look at those numbers and feel like the extra month was time well spent. However, for me, it definitely was. First, and most importantly, I was completely burnt out and psyched out in the days leading up to my first exam date. I am pretty sure I would have massively underperformed, for that reason alone. Secondly, while my scores don't seem to reflect it, I feel very confident that I solidified many concepts and strengthened weak areas (like anatomy) during the extra month. Whether that is just the way I felt, or if it was actually the case, is hard to say. However, I think the way you feel going into the exam is a MAJOR factor. So, for me, it was absolutely worth having a plan I was confident in, sticking to it, and getting to a place where I felt I had done everything I could.
