Quoted: Need Help Passing Step 1

[SoCuteMD]

I have taken step 1 without any success few times. I have put in the time and have taken some private help but my practice test scores are not showing results. I have taken uw and kaplan. I am really frustated and don't want to talk about it with friends ..... so I decided to ask here.
Could someone advise me on how to handle the situation. Please feel free to ask me any other questions.
This is my last time taking this exam, so I really need to pass it.
Any help would be greatly appreciated. Thank you in advance.

It's hard to give concrete advice on how to approach Step 1 because you don't mention what you've done before. It sounds like you've had a difficult time with Step 1, and the one thing you should be conscious of is to NOT let yourself get into a panic cycle over this test. Take each day one day at a time!

The one piece of advice I've given all of my friends as they've started med school is to find what works and stick with it. On the other hand, if something DOESN'T work - don't hesitate to throw it out! Now might be a good time to sit down and evaluate your study methods for your past attempts at Step 1. Make a list of how you studied and spend some time considering whether those were good investments of your time.

I have a friend who is in a similar situation to you regarding Step 1, and I'll give you the same list I gave him. If you are struggling I think it's REALLY important to find a few good sources and stick to them. For me those would be:

First Aid (especially for pharm)
Goljan Rapid Review Pathology
High Yield Cell and Molecular Biology (1st edition, much shorter than the 2nd edition!!)
Clinical Micro Made Ridiculously Simple OR Microcards
BRS Physiology
High Yield Neuroanatomy
BRS or High Yield Behavioral Science
USMLEWorld

I used USMLEWorld throughout my studying - I did about 100 questions/day and reviewed the answers carefully. I highlighted everything I got wrong in a unique color in First Aid (I used green) and made notes. I did try to keep my notes concise, though, as FA is supposed to be a high yield book.

I would make flashcards based on the pharm in First Aid (including the adverse effects - VERY IMPORTANT!) and go through those a few times a week. I did this while studying and it took me about an hour even when I was upstairs with my family and half-heartedly watching TV. It shouldn't take you more than a day to make the flashcards and another day to review the principles of pharmacology. The rest is just pounding those drugs into your brain!

My next source would by High Yield Cell and Molecular. Spend 2-3 days with the book. Cross-reference with another book (Lippincott Biochem was helpful) if needed.

The next subject to tackle is neuroanatomy. My test was very neuro-heavy. I'm not particularly in love with HY Neuro as a source, but it was the best one I could find (BRS Neuro is just TOOO much). Don't forget to study the Neurophysiology chapter in BRS too! Neuro should take 4 days or so.

Now it's time for the big stuff. Goljan paired with BRS Physio. This is how I went through it - I read the chapter in BRS Physio, did the questions, and moved on to Rapid Review right away. This is a project - allow at least a week!

At some point when you are nearing your test you will want to spend a few days on Micro. I did - 2.5 days on bacteria, 1 day on viruses, another day on fungi and protozoa. I ignored helminths and there were none on my Step 1 - although this was not the case for everyone I know.

I saved behavioral for a day or two when I was feeling BLAH. I like BRS better than HY for this, but it might depend on time and how comfortable you are with behavioral.

My last few days before the test were fairly high yield. I spent a lot of time with First Aid - pounding in the random facts that I have since forgotten. I had a good framework for the information from my previous studying. I always kept FA open and on the pertinent section while I was studying, so nothing in it looked new during that week. I spent the day before the test doing a quick run-down of micro in the morning and pharm in the afternoon. I used UWorld and made a test of every behavioral question available (50 or so) and did them all, reading the explanations carefully as I tend to be easily tricked by behavioral questions.

I hope this helps. My timelines are only meant as guidelines - you will have to adjust them to your strengths and weaknesses. My other suggestion is to use the NBME Self Assessments once or twice throughout your studying. The score is helpful, but even more so are the breakdowns of strengths and weaknesses it gives you. I used those to guide my studying after I took one of the NBMEs.

I hope this helps - don't hesitate to post any questions as they come up (they won't show up with your name, so don't worry - we'll erase that before we post your question).

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[MSmentor010]

Hi! I may need a little bit more information from you, but I'll try to help you based on how I studied for the USMLE Step 1 so that I would pass. Of course. you may have tried all of these things, so feel free to tell me more information if you think that would help. First of all, I took the Kaplan course which I found really helpful in pacing my studying to get through all of the information. I am not quite sure if you are having trouble getting through the material or getting through the questions, so I'll try to answer both ways so that hopefully one will help you. Hopefully something can help you.

First, I would contact your local Kaplan, and see if they are giving a free USMLE Step 1 exam. I am not sure if other companies do something similar. You can do in online, but I would not take it in the comfort of your home. Take your laptop to school or somewhere else that isn't as familiar and take the test (of couse, you kind of have to go where you have internet to download the test - I didn't do this route, so I am not quite sure how it would work). You just want to take the test in an unfamiliar location because when you take the test, the location won't be familiar. People score better in places where they are all of the time. Any of these options, will give you your score report telling you what areas you need to improve. Whichever onces are the worst, start with those. If pharm is your lowest, I would make sure you have the cardio, renal and psych drugs down like the back of your hand. Those were all over my test. For micro, I would just go through some micro cards and do a little at a time. That seemed to help my score go up. For pathology, I just made sure that I went through the whole Kaplan information and then did Goyjian (sp?) since I knew prior to me taking a practice test that pathology would be my worst subject. Biochemistry/molecular bio was my best subject since I did research and my undergrad degree was in biochemistry, but I would just make sure that you know all of the major pathways: glycolysis, Kreb, electron transport chain (make sure you can relate which drugs and poisons and can shut this down), know where amino acids feed into the cycles (you shouldn't have to know all of the amino acid pathways in full detail) ie. alanine feeds into pyruvate --> gluconeogenesis. The USMLE pretty much seemed to test on the rate limiting reaction enzymes, so focus more on those especially if you have trouble keeping enzyme names straight. Just don't memorize any review books because you need to be able to apply the information together. What I did, was buy the First Aid Cases book and then just went through that section of cases as I was studying. It did a pretty good job of integrating information together from other topics even though the main topic was ie. pathology.

Now for questions. I did these two different routes. I first would split up my studying time. No more than 8-9 hours a day where half to a little bit more would be only questions. The other would be book studying. Of course, you may not have to do any more studying - you're probably doing fine in med school or you wouldn't have even made it this far in your studies; therefore, it is probably more of an issue with applying information on questions than opening another book. But, that is just a guess. I would really have to know what kind of studying you have tried and how you have scored on the questions to tailor my response more. Anyway, as for questions, you are going to have to be careful if you put it in tutor mode all of the time. Some people do this, and it works but you have to do it the right way. Everytime you answer a question, you need to read why they said the answer was correct - even if you got the answer correct you probably should do this. The reason is because you may have gotten the answer correct for the wrong reason -- this happens to me sometimes. Then you need to also read through the incorrect answers. Sometimes these would help me answer other questions. Also, if you haven't tried, you can study one subject and do questions from that subject. Also, Kaplan qbank has cases that you can answer. That may be a good resource. I would just do 'x' number of flashcards and then do some questions and study that way. Then have a review day where you see if you remember the things and answer more case questions.

I hope that has helped you at least a little bit. Sorry for the long response. If you have more information, feel free to state it and I can see if I know anything else you can try. I would also talk to your advisor at your school to see if they have any advise. I understand you not wanting to talk to your friends, but they will understand and help you get through it. Try not to be embarrassed around your friends, they may be able to give you emotional support. But, if not, go to your advisor or to your family for support. Just remember you are not a failure. You have made it this far in your studies so you just have to figure out how to adjust your studies, and you'll get through this hurdle. Remember there is always light at the end of the tunnel . Good luck!