Lamees Alzyoud, 6th year student/ Hashemite University - Step 1 experience

a brief intro:

I believe the ultimate goal of any  USMLE Step 1 prep should be to fully UNDERSTAND and memorize First aid and Uworld. Whatever you use down the road to achieve that is up to you.  First aid is PACKED and probably has >90% of what you need to know. But it takes alot of effort to master it and the concepts it has so never underestimate it or the time it needs. Every word in first aid can be turned into an 8 lines question. Just keep that in mind while studying.  The remaining 10% depend on your previous  knowledge, luck, your exam taking skills (how good you are with excluding wrong answers without knowing what the right answer is).

My experience:

I started my dedicated prep in May 2016, it took me around 1 year and 3 months. Most of which was during fifth year.

May-September:  first read; approximate daily studying hours: 10.

o   Kaplan  (Biochem 2014, Pharma 2010, Anatomy and Neuroanatomy 2014, Immuno 2014, Behavioral and Biostat, 2010)
For most of kaplan I annoted directly from videos to my first aid. I found this less time consuming, I only used the book for biochem and some of the anatomy. I personally don’t think studying the books makes a huge difference as long as you understand from Kaplan and annot what you think might help you understand a specific point in first aid. Your goal from Kaplan should be to mainly understand first aid, there isn’t a major amount of new information in it, UNLIKE UWORLD!

o   Pathoma (GOLD!) – every word matters.

o   BRS physiology- found it very helpful to build concepts

o   MRS for Micro- Micro in first aid is enough for the exam but I think MRS made studying first aid easier.

Sept- Jan: My first Uworld round with first aid took me around 4 months (daily studying hours 6 hours weekdays and up to 12 in weekends ) and I used to skim every subject/ system before doing its questions.   

Ø  I did it online, tutor mode / system wise; first all of biochem then systems.

-          I didnt do Uworld offline during my first read. I believed that I should finish everything before questions cause some questions overlap between different systems. I don't think it really matters but what matters is that you do it as soon as you feel you are ready . Dont delay Uworld.   START AS SOON AS YOU CAN and repeat! It has many many new information and graphs and pictures. Its an amazing source to master first aid and really understand concepts.

-          I annoted everything from Uworld on my first aid, the pro from this is I had all relevant information on the same page so it helped connect things.  the cons; it was so time consuming and my first aid was so packed it was annoying near my exam time cause repeating first aid would take double the time. I have also taken screenshots for all the graphs and pictures and saved them on my laptop in folders divided system wise, I found this helpful so I can go over them again. And to be honest it was very relieving in the last month in my prep cause I felt I started forgetting Uworld but I have no time to go over it, so the screenshots helped to revise it.

·         (Other people used to write all their uworld notes on a notebook that they will keep revising.) Choose what makes you comfortable.

Jan- April : Second read just First Aid. And I used sketchy micro during this read (it helped A LOT specially with parasitology). Took me around 3 months.

April/half may: repeated Uworld. This time it was Timed and Random. (Finished it just before fifth year finals and then took two weeks off for the finals) during this I made a notebook of a summary of Uworld. I used to write the main points of the questions and then the answer. It was like flashcards style and I used it during the last months also as a revision of uworld.  

22/5: I took my first NBME (17). I had 48 mistakes, scored 200. It was harsh and devastating. I changed plans of taking it in June and one day later I analyzed my mistakes and figured WHY I wasnt able to answer them. I realized many of them were due to memorization. Details in first aid I didn't yet memorize. That made feel less horrible but it made me realize how tiny details in first aid make a HUGE difference.

22/5-22/7: Third read. This time I was more focused on MEMORIZATION. I also listened to Goljan and did USMLE Rx. To be honest I did them just to make first aid more doable.  It did help with tiny details but if you dont have time, repeating uworld is a better deal.

22/7 another online NBME(16), had 33 mistakes scored 228. 23/7 UWSA1: 243 (many say its overestimating).

I then started realizing that I am missing many questions because I either thought too much or because I wasn't confident enough about my answers. Thats why I decided to change my strategy while doing hard questions. This is where doing NBMEs online can be of help. Its style is definitely way different than the real exam but it helps you handle questions better, thats why during the last month of my preparation I used to do NBME blocks offline: a block every other day. I did them to practice questions not for assessment.  

24/7-22/8 Last month: I did another read of first aid also directed toward memorization with revising Uworld screenshots and notebook + offline NBMEs blocks;

One week before my exam I took NBME 18 and UWSA2: scored 234 in both. I didnt yet hit my target which was >240 but I felt there wasnt else I can do and I was starting to lose focus so I went for it.

During the last week I revised the pages I believed were hardest to memorize: I marked them during my last read. I also repeated the first general subjects section of first aid. Which helped big time in the exam. They love the basics!

Exam day 31/8/2017.

On exam day I tried to be relaxed. The anxiety broke in the first block and the exam was really interesting and entertaining. Its not like NBMEs or Uworld. It feels like Uworld but its not really like it. Many questions were straight forward. The tough questions were two types either experimental; a long experiment testing a very basic concept so make sure your concepts are SOLID. Or a question that tests things we know but in a twisted way. That is why you need to be relaxed, focused and give it your all in exam day. I felt the exam was fair. It had questions on all levels thats why I was focused to get all the easy questions and manage to answer as many tough questions as possible.  

7 blocks, 40 Qs each. I did block 1+2, then 5 minutes break, block 3, a long 15 minutes break, blocks  4+5, another long break, block 6, short 5 minutes break, block 7.

Final score; 245. Higher than all my assessments.

My final tip is to never follow anyone's experience or to majorly rely on it. Step 1 is a long draining journey and self-doubt surfaces big time especially in the last months so comparing to others experience can do more harm than good. Everyone has their own experience, their own mindset and their own capabilities. There isnt a magical way to get a high score so don't waste your time looking for one. Do what you think you can do and when you get to the level you believe is your best, go for it.

Best of luck, it is a long journey but definitely worth it so stay strong J