HAKUNA MATATA : Story USMLE from 135 to 239 Alhumdulilah.

This post is for you if, you:

• Have been preparing for the USMLE step 1 for over 2 years
• Have had several breaks and had to pick up from scratch again every time
• Have other responsibilities that you cannot excuse yourself from (by this i am pointing towards desi married girls)
• Were not an academically exceptional student in medical school

I always told myself that when i score well on the Step 1, i shall reach out to everyone who maybe (even remotely) are in a place similar to mine. I want to encourage you to keep working at it, to not lose hope and to know it will pay off.

Before i start off, i want to stress that Step 1 is NO JOKE. It’s an exam that truly tests you on every level. It tests your memory, understanding, concepts, concentration and patience.

Do not take it lightly, do not disregard an mcq or topic thinking less of it (for lack of better words lol) or thinking it’s beyond your comprehension. That said, also engrave it into your mind- there is NO shortcut to getting a 210+ (an exaggeration, cause i couldn't go beyond 200- read on for details)

This is how i started off my preparation (NOT RECOMMENDED):

I asked what the secret was to getting a perfect score on Step 1 from 250+, 260+ scorers. They all said unanimously UWORLD + First Aid and that going through Kaplan doesn’t hurt.

A year after graduation, thinking I could pull off step 1 while handling my household chores i started off with dreams of taking it in 6 months max. I thought i would make a shortcut and just dive into the real stuff. So i went through kaplan Physio only and hastily started off with reading First Aid.

Reading that book was a nightmare. Took me 6 months to give that book a read, would look up the difficult topics online, watched videos, skipped pages. All in an attempt to get done with the exam soon. I would do my social duties and chores in the day and study at night for 4-5 hours.

It helped me get over my fear of the book, but i was still far from ready.

Intention: Finish FA and UW and take exam in 6 months like a pro, cause i am a medical graduate, how hard can this be?

Problem: I didn’t build my base.

Break: 1 month social break, 1 month electives break,1 month travelling break, 1 month move break.

End result: by end of 10 months- Zero recall of FA (that i had spent 6 months trying to understand btw).

USMLE score: NBME 70/ 200 approx usmle- 135

Shifted gears- Online UWorld

Mistake. If you don’t have the financial background to spend all that money, don’t. I have friends and colleagues who have been smarter than me and pulled off the exam without online subscriptions/ minimum subscriptions.

Took me 5 months to finish the first go, chapterwise. It was a struggle since my basic knowledge was weak and i was struggling with concepts and terms. Specially in Genetics, Neuro, Renal. I think i finished with an average of 40%

I then heard that the ‘trick’ was to learn uw by heart and that that will get me through. So that i did. I started learning the answers in the second round. BIG MISTAKE.

I went through UW 2nd round in a month, learning the answering (correct options). Sigh.

Went through it a 3rd time. 4th time.

By then i had a very good recall of all the answers. And was pushing 200 mcqs per day.

Intention: Learn all uw answers, get a 240+ in nbme and take exam in 3 months like a boss B-)

Problem: I wasn't understanding the concepts and idea behind the difficult mcqs.

Break: 1 month social commitments break. Throw in a couple of days in breaks here and there because of family drama :P

End result: I had made my uw useless because i had memorized most answers, since i didn't know the reasoning/ concepts behind hard ones, my scores were consistently around barely pass. :(

Score: nbme 120-130/200 (barely passing)

Wake up Call!!! Kaplan from scratch :’(

By now i had spent more than 1 and a half year trying to “prepare for step 1 quick and get done” and failed miserably at it. I had been hasty because of social pressures, would make 3 month plans at max to “just get done” and ended up being unproductive..

I had been consistently in touch with my seniors and high scorers to guide me on how to improve. For most part i felt like i couldn't do it. I think that reflected and people around me started getting that vibe off of me as well.

It is very painful to talk to someone about your lack of progress and hear them say “why don’t you take another path?” or “maybe it’s not meant to be for you”. Or “you aren't making much progress, what do you do all day?”

I was blessed when i finally connected with a colleague who had been in the same boat as me. He was had passed most of his med school re-taking exams. And finally after graduation when he started prepping for step 1, he ended up scoring 250+

This colleague advised/ knocked sense into me, and suggested i start from scratch and do kaplan videos again. That i did. Took me 2 whole months, but i loved every bit of it. Things started falling into place, questions made sense. Answers made sense. Pure bliss :)

Intention: take exam before end of block (whole subscription ends)

Problem: i had barely pass scores

Shifting gear: Started kaplan from scratch and took it seriously

End result: I started feeling like i knew stuff. I felt more confident.

Score: scored 205 usmle on online nbme 15

A new me: Review and score jumps

After kaplan i had a 2 months break due to social issues going on. But in the back of my mind i was calm knowing my score had crossed 200 at least.

I started again, this time read First aid, followed by uw, and then switched to Rx in search of a fresh qbank since my uw was useless for evaluation.

Intention: Since my registration had ended (money gone out the window) i re- registered for the exam and planned to not extend the block and take it.

Problem: i wasn't confident / happy with my score. Had to take another 2 months break.

End result: I extended my block

Score: 217 on nbme 17

FINAL RUN:

This was it, do or die. By now i had a good grasp of all concepts. I had gone through First aid a couple of times. I had countless annotations in my book. I had/ new screenshots from RX. Hand written notes from uw. Usmle grassroots file wasn’t a scare. I was doing okay. Anxiety, social pressures, household drama were still high, but i started feeling like it was a memory recall issue for me now, not a concept.

I was fed up of FA by now, so i started doing nbme’s and whichever question i got incorrect, i would read up the topic. I was studying from 8-8 daily. With breaks on sunday. Stopped taking full days off in last 6 weeks before exam. Would just take a couple of hours off late on sunday.

This gave me the jump- doing nbmes from 1 onwards. All the way up! My incorrect fluctuated between 40-50 mcqs. On bad days i had 53 :(

On good days i got 37 or so incorrect.

In the las weeks/ months of exam:

I went an unconventional way, sharing it so you guys can take something from it. Or if you are in a similar situation you know it happens.

• I did NOT do any UW (cause i knew the answers and pictures heart)
• I did not complete rx, kaplan etc or any question bank
• I DID do all nbme’s and explanations (that was my saving grace)
• I DID do all first aid thoroughly as much as my mind would permit. When i couldnt i got study partners and read with them.
• I did however all screenshots of difficult questions of uw, rx, my notes.

Intention: Take exam before extension ends

Problem: Stamina re-reading FA and UW was lost.

End result:

NBME 16: offline 226

NBME 18: online 236

NBME 19: offline 230

My profile:

SHARING USMLE SCORES:

Started off with a 135

Consistently at 180-190 for 3 months

Consistently at 200 for 3 months

Stuck in 210-220 for 3 months

Score jump in final 2 months of prep

Final score- 239

Things that stayed with me:

• Step 1 demands Respect and time. If you cannot put in the effort needed to understand a concept and get it’s mcqs right- don’t expect a decent score (this pinched me and felt hurtful when it was said to me but it is true)
• You have to be consistent. Start your day early and have the same study hrs ( this was said to me when i would start by day at 10 am and sleep at 3 am).
• Each exam MCQ is an nbme or uw question hidden in fancy words
• Take Kaplan seriously. Understand what they are saying and take notes to review later.
• Do not follow someone who has had a different (higher) academic record than yours. We all want the perfect 260, but if you havent been a 260+ student your whole life, then don’t follow the advice of people who have been. Follow path of someone who started off like you at a 135 (that was my first usmle score) and built it up.
• There are NO SHORTCUTS. If you read about my journey, I started off with the wrong mindset and suffered. I was hasty and wanted to “get done” with a good score “quick”. You can’t have both. Engrave that.

My take home message for you: ( specially to married desi girls/ people with other responsibilities):

• Do not exhaust yourself pre-maturely with studies. Wait until last 3 months of exam
• Do not skip social/ family time pre-maturely. Wait till last 3 months or so.
• It will be hard; preparing for the exam is a difficult and depressing process. There shall be tears. And anger tantrums. And anxiety attacks. Worst part is the helplessness one feels when you don’t improve and you can’t find a motivating supportive person to lean onto. Find a friend, FB group, read posts on this group. Find a purpose why you are doing this - escape from a certain lifestyle is a great motivator, imo :) Find a reason to help you get up on bad days. Know it’s a part of the process. You will be a better, stronger and more learned person at the end of this. :)
• Build you base! U cannot stress enough on this. Understand everything you read. Pay attention to kaplan!!
• If you are getting fed up of first aid (like i did) and re-reading it doesnt increase your score, then get a study partner who has written annotations in FA (like you would have obviously) and read with them and share notes. Questions and answers:
•  How did you revised Kaplan in 2 months? Do ank i cards help? I'm exactly suffering same now as you were?
• Ans: Kaplan videos are 70 days lectures. 
  4 hrs lecture for each day
  I skipped microbiology and pathology (did micro directly from FA and pathology from pathoma)
  So that left me roughly 50 lectures to go through in 50 days. 
  Did them like that. 
• I tried doing Anki cards, but they weren't for me. It didn't suit my study style. 
  I know people who used them, but I didn't use them at all.