USMLE-Step1 experience, Ferial Tammam Alloush ,5th year medical student , HU ,Jordan
Target : >260
Score:265 J all glory to Allah
Exam date : 8/28/2017
Performance :
Target : >260
Score:265 J all glory to Allah
Exam date : 8/28/2017
Performance :
Preparation time :10 months (14 months with 4 month break (finals, minors, travels, depression episodes 
)
though….inside the exam I realized that my preparation bagan the day I started medical school….
when to start dedicated study ?
4th year was perfect for me … there is an outstanding similarity between step1 and forth year subjects …I studied the last20 days of the year (finals ) ,some minors , couple of days before each OSCE and had almost the same GPA as previous years!
important point :try not to skip a single day in the hospital training … step1 is a basic science exam …but it’s based on clinical vignettes…. You don’t have to STUDY 4th year subjects (that’s a step2 issue)….yet,you have to LIVE them and to build a clinical SENSE out of the (I think same applies for 5th year )
“it’s all about FA and UW “ FACT or MYTH ?
Although I used to say that as an advice to everyone around me during my preparation, I apologize … turned out to be a myth 😛
In my opinion , step1 is never about knowledge ,it’s all about REASONING ….REASONING…REASONING …. Can’t stress that enough
Dealing with ideas you’ve never heard of is the most important part of a high score
The resource that can induce your frustration and curiosity the most is certainly the best… which would be a Q bank almost a 100% of the time
Knowledge can play a role during basic years… when it is stepwise … but during your dedicated study period, books are usually useless!
UW can be a great source if used smartly ,
FA? Well, it’s important to start FA early on as it makes an organized study frame … but I can hardly remember a single question in the exam where I had to remember what’s written in pageX chapterY in FA !
Best thing I did ? starting UW too early (even before FA!)
Resources and schedule ?
first read ( july2016-1/1/2017) did not study that much in summer .. then i started my dedicated study in september ..5 hours daily in the library (2pm-7pm)
The best thing i did in my first read is integrating UW with videos and FA ... it helped a lot fixing subjects into my mind…otherwise I would have forgotten everything in the first read by the time I reached its end
Biochemistry : biochem is the only subject where i will say "videos are more important than Uworld" Dr.Sam Turco 2014 kaplan videos are outstanding
Two important points that would boost your score if you paid attention to during these viseos are :
1- integration with other disciplines (for that reason i would recommend doing biochem last not first during your first read .... as a refreshment of what you've learnt previously)
2- try to steal the way Dr.Turco thinks ... he's so smart ... and his way of thinking helped me a lot dealing with questions from other disciplines ... in short (try to be inspired by him )
Then you can do First aid and Uworld (i did UW bofore FA as the first helped me to memorize the second )
Biochemistry was easy in the exam ... and the above resources were more than enough
)though….inside the exam I realized that my preparation bagan the day I started medical school….
when to start dedicated study ?
4th year was perfect for me … there is an outstanding similarity between step1 and forth year subjects …I studied the last20 days of the year (finals ) ,some minors , couple of days before each OSCE and had almost the same GPA as previous years!
important point :try not to skip a single day in the hospital training … step1 is a basic science exam …but it’s based on clinical vignettes…. You don’t have to STUDY 4th year subjects (that’s a step2 issue)….yet,you have to LIVE them and to build a clinical SENSE out of the (I think same applies for 5th year )
“it’s all about FA and UW “ FACT or MYTH ?
Although I used to say that as an advice to everyone around me during my preparation, I apologize … turned out to be a myth 😛
In my opinion , step1 is never about knowledge ,it’s all about REASONING ….REASONING…REASONING …. Can’t stress that enough
Dealing with ideas you’ve never heard of is the most important part of a high score
The resource that can induce your frustration and curiosity the most is certainly the best… which would be a Q bank almost a 100% of the time
Knowledge can play a role during basic years… when it is stepwise … but during your dedicated study period, books are usually useless!
UW can be a great source if used smartly ,
FA? Well, it’s important to start FA early on as it makes an organized study frame … but I can hardly remember a single question in the exam where I had to remember what’s written in pageX chapterY in FA !
Best thing I did ? starting UW too early (even before FA!)
Resources and schedule ?
first read ( july2016-1/1/2017) did not study that much in summer .. then i started my dedicated study in september ..5 hours daily in the library (2pm-7pm)
The best thing i did in my first read is integrating UW with videos and FA ... it helped a lot fixing subjects into my mind…otherwise I would have forgotten everything in the first read by the time I reached its end
Biochemistry : biochem is the only subject where i will say "videos are more important than Uworld" Dr.Sam Turco 2014 kaplan videos are outstanding
Two important points that would boost your score if you paid attention to during these viseos are :
1- integration with other disciplines (for that reason i would recommend doing biochem last not first during your first read .... as a refreshment of what you've learnt previously)
2- try to steal the way Dr.Turco thinks ... he's so smart ... and his way of thinking helped me a lot dealing with questions from other disciplines ... in short (try to be inspired by him )
Then you can do First aid and Uworld (i did UW bofore FA as the first helped me to memorize the second )
Biochemistry was easy in the exam ... and the above resources were more than enough
Molecular biology :
This was a really tough and high yield topic
I think the best approach is to try challenging yourself with as much molecular biology questions as possible ... Uw , kaplan ,NBMEs , Rx ... Then try to study the detailed explannation of each choice ...trying to understand what's going on in the question writer mind
Also understanding the detailed genetics behind neoplasia section in first aid is pretty helpful .... The mutations page in particular ... You should look up for the detailed pathway downstream or upstream from the corresponding mutation ... Not just the mutation itself ..
most of the questions in the exam were experimental in nature .. i answered them by exclusion rather than knowledge ...
This was a really tough and high yield topic
I think the best approach is to try challenging yourself with as much molecular biology questions as possible ... Uw , kaplan ,NBMEs , Rx ... Then try to study the detailed explannation of each choice ...trying to understand what's going on in the question writer mind
Also understanding the detailed genetics behind neoplasia section in first aid is pretty helpful .... The mutations page in particular ... You should look up for the detailed pathway downstream or upstream from the corresponding mutation ... Not just the mutation itself ..
most of the questions in the exam were experimental in nature .. i answered them by exclusion rather than knowledge ...
Behavioral science : (in order)
1-Dr. Daugherty videos (kaplan): i did them twice (no need but they were really touching for me so i repeated them in the second read when i was so bored ) ... key point here is not to overwhelm yourself with details ... cuz almost 75% of what you need is in FA,UW ... just try to get the sense and the bigger pictures ... don't memorize a single word (the remaining 25% are not in Kaplan anyway)
2-100 cases in ethics ( not that important )
3-UW biostatistics subject review ( gold)
4- FA (rapid read) then concentrated read after UWorld
5- UW : great and more difficult than the real deal ... gold for ethics and in my opinion much more important than 100 cases (my exam was heavy in ethics , i had about 2 ethics questions in each block .. and although i used to perform low in ethics in NBME ,ethics questions were a comfort zone for me the exam day ... why ? Well,I reviewed all uworld ethics questions 5 days before the exam .. and almost every single question was covered there! )
Can't stress that enough... UW is best for ethics
Biostat was silly and few ... epidemiology was from outside the planet but you can manage them by exclusion if you have practiced enough nbmes
1-Dr. Daugherty videos (kaplan): i did them twice (no need but they were really touching for me so i repeated them in the second read when i was so bored ) ... key point here is not to overwhelm yourself with details ... cuz almost 75% of what you need is in FA,UW ... just try to get the sense and the bigger pictures ... don't memorize a single word (the remaining 25% are not in Kaplan anyway
)2-100 cases in ethics ( not that important )
3-UW biostatistics subject review ( gold)
4- FA (rapid read) then concentrated read after UWorld
5- UW : great and more difficult than the real deal ... gold for ethics and in my opinion much more important than 100 cases (my exam was heavy in ethics , i had about 2 ethics questions in each block .. and although i used to perform low in ethics in NBME ,ethics questions were a comfort zone for me the exam day ... why ? Well,I reviewed all uworld ethics questions 5 days before the exam .. and almost every single question was covered there! )
Can't stress that enough... UW is best for ethics
Biostat was silly and few ... epidemiology was from outside the planet but you can manage them by exclusion if you have practiced enough nbmes
Microbiology and immunology :
2010 kaplan videos followed by FA , kaplan Q bank(for memorization) and UWorld
*no i did not do sketchy ! I did not like them
In the exam micro was the most difficult subject ! I was surprised by how difficult and how plenty micro questions were ! ...and i did many mistakes in micro .. but ended up with high performance in micro ! .. the take home massege ( if you had a difficult exam don't panic ... your margins of error would be wider)
2010 kaplan videos followed by FA , kaplan Q bank(for memorization) and UWorld
*no i did not do sketchy ! I did not like them
In the exam micro was the most difficult subject ! I was surprised by how difficult and how plenty micro questions were ! ...and i did many mistakes in micro .. but ended up with high performance in micro ! .. the take home massege ( if you had a difficult exam don't panic ... your margins of error would be wider)
Physiology ,Pathology , pharmacology :
Did them systemwise ...
1-kaplan2010 +pathoma (for path) followed by BRS
2-FA rapid read
3- uworld
4- FA concentrated read
Kaplan videos are bad for renal physiology so i recommend doing renal physiology +nephrotic and nephritic from Dr.Najeeb videos ( i did them during my basic years so did not need them in the first read )
In general i recommend Dr.najeeb videos for all basic years students ... and i think he boosted my score a lot without me even being conscious about that as i did his videos too early ( in second and third year )
Pathophysiology was hard in the exam with many many many new ideas ... pharm was silly and direct from first aid
*and no .. i did not do goljan
Did them systemwise ...
1-kaplan2010 +pathoma (for path) followed by BRS
2-FA rapid read
3- uworld
4- FA concentrated read
Kaplan videos are bad for renal physiology so i recommend doing renal physiology +nephrotic and nephritic from Dr.Najeeb videos ( i did them during my basic years so did not need them in the first read )
In general i recommend Dr.najeeb videos for all basic years students ... and i think he boosted my score a lot without me even being conscious about that as i did his videos too early ( in second and third year )
Pathophysiology was hard in the exam with many many many new ideas ... pharm was silly and direct from first aid
*and no .. i did not do goljan
Anatomy :
Kaplan2014 (gold for neuro) + shelf notes + FA + uworld
The exam was from none of these ... yet it was doable .... i remembered a lot of ideas from dr.raith second and third year lectures .. i owe him a lot here
(p.s. i thought before the exam that i have forgotten every single word i learnt from the slides of second and third year ... but the adrenaline rush inside the exam was able to boost my memory in a way that i couldn't believe ... all glory to god…. So just believe in your brain under stress
Kaplan2014 (gold for neuro) + shelf notes + FA + uworld
The exam was from none of these ... yet it was doable .... i remembered a lot of ideas from dr.raith second and third year lectures .. i owe him a lot here
(p.s. i thought before the exam that i have forgotten every single word i learnt from the slides of second and third year ... but the adrenaline rush inside the exam was able to boost my memory in a way that i couldn't believe ... all glory to god…. So just believe in your brain under stress
Second read:
1/1/2017-1/6/2017 (lots of interruptions here)
Nothing new ... basically FA and UW review(online ,tutor mode) .... with annotations of FA with UW ideas (key but time consuming) , also i did 2/3 of usmle RX offline (useless )
3 important issues here :
1- Spaced repetition(google it) : the second read consisted of 2-3 reads by this method ... which helped me alot memorizing FA word by word
2- use things that keep your mode up because much of your time will be on FA which is so boring ... i tried DIT videos ..they were time consuming and boring as well ... at the end loud music worked best (special thanks to Witney Housten , Melhem Barakat ,Dalida and Zeyad Rahbani here )
3-don’t pay attention to your UWORLD percentage … it is a pure learning tool and your score will be determined by how much information you got at its end , not by how you started it … so don’t panic
Third read :
FA ,kaplan Qbank (nice but not that important ) i would recommend it over Rx as it has some new ideas
Fourth read (and last )
1-FA with comparison to FA2017 as i used 2015 (that is a big mistake ... i should have done that earlier )
2-60% of Uworld (timed mode, randomized)important to do uw till the exam day as it keeps your mind on the track of critical thinking and problem solving
3-NBMEs 6through 19 (1 every 4 days) also a big mistake and i should have begun them earlier ... as important as UWORLD ! But much much more stressful
(although the exam is more similar to UW in its format and looooong questions that could not fit the screen 😛 , the pattern of thinking required for the exam is more similar to NBMEs !)
1-FA with comparison to FA2017 as i used 2015 (that is a big mistake ... i should have done that earlier )
2-60% of Uworld (timed mode, randomized)important to do uw till the exam day as it keeps your mind on the track of critical thinking and problem solving
3-NBMEs 6through 19 (1 every 4 days) also a big mistake and i should have begun them earlier ... as important as UWORLD ! But much much more stressful
(although the exam is more similar to UW in its format and looooong questions that could not fit the screen 😛 , the pattern of thinking required for the exam is more similar to NBMEs !)
Assesment tools : (UWSA>>160Qs, Nbmes>>200 Qs)
UWSA1>> 28 mistakes >>🤓266🤓 >>2.5 months off(overpredicts a lot)
Nbme13>>13 mistakes >>1month off
UWSA2>>12 mistakes >>🤓269🤓 >>1month off
Nbme18>>19 mistakes >>🤓252(online )>>1 month off
Within the last month
Nbme11>>7 mistakes
NBME15>>10 mistakes
Nbme12>>9mistakes
Nbme16>> 13 mistakes
Nbme17 >>7 mistakes (1 week off) >>🤓265 🤓online(most predictive for me ! But too harsh in ethics)
Nbme19>>7mistakes
Nbme6-7 >> i did like thousand mistakes they are really based on memorization and made me feel like i'm gonna fail so i would recommend doing older Nbmes earlier as a learning rather than an assesment tool
Note : i allowed myself 1hour instead of 1h15min for each block to train myself on time managment ... as exam questions are longer ... and that helped me a lot the day of the exam
UWSA1>> 28 mistakes >>🤓266🤓 >>2.5 months off(overpredicts a lot)
Nbme13>>13 mistakes >>1month off
UWSA2>>12 mistakes >>🤓269🤓 >>1month off
Nbme18>>19 mistakes >>🤓252(online )>>1 month off
Within the last month
Nbme11>>7 mistakes
NBME15>>10 mistakes
Nbme12>>9mistakes
Nbme16>> 13 mistakes
Nbme17 >>7 mistakes (1 week off) >>🤓265 🤓online(most predictive for me ! But too harsh in ethics)
Nbme19>>7mistakes
Nbme6-7 >> i did like thousand mistakes they are really based on memorization and made me feel like i'm gonna fail so i would recommend doing older Nbmes earlier as a learning rather than an assesment tool
Note : i allowed myself 1hour instead of 1h15min for each block to train myself on time managment ... as exam questions are longer ... and that helped me a lot the day of the exam
NBMEs learning or assesment ?!
In my opinion they are both
Assesment tool in that they are so so predictive )at least for me )
Learning tool ?! No no wait 😛 .. i don't mean that you have to look up for the explannation of each question and memorize the new info .. that's for UW
What i mean is that they are the best tool to learn reasoning ... they teach you on what to do when you are stuck in the corner ( which would be the case in more than 20% of exam questions ) that's why i would say NBMEs are key to high score
How can i learn that from them ? Well , you should look at your mistakes +questions you were not confident with ... then try to analyze what was going on in your mind When you solved that question
If you've got that question right then take it as a pervasive pattern of thinking and apply it for all similar questions
If you've got that question wrong then try to analyze the question again and find out the best concept \trick to get it right
Don't go for google and look for the right "scientific" answer ... you won't get the same question on the exam but you may have questionS that require the same way of analysis
Another important point is that they helped me to stay calm and confident in the exam
Why ? Well, in my first NBME i marked like 15Qs per block and thought that i would get 40 mistakes by the end of the exam but ended up with 13 mistakes only ... i thought i got them right by chance .. but when it was repeated with each nbme ( marking like tones of Qs and ending up with most of them right ) i realized that uncertinity is the rule .. the exam is not designed for you to be familiar with every question .. you will see new ideas .. new concepts ... new domains
NBME is the only tool to be ready for that
That’s why I felt I was doing well in the exam when I was actually marking around 15 Qs per block
In my opinion they are both
Assesment tool in that they are so so predictive )at least for me )
Learning tool ?! No no wait 😛 .. i don't mean that you have to look up for the explannation of each question and memorize the new info .. that's for UW
What i mean is that they are the best tool to learn reasoning ... they teach you on what to do when you are stuck in the corner ( which would be the case in more than 20% of exam questions ) that's why i would say NBMEs are key to high score
How can i learn that from them ? Well , you should look at your mistakes +questions you were not confident with ... then try to analyze what was going on in your mind When you solved that question
If you've got that question right then take it as a pervasive pattern of thinking and apply it for all similar questions
If you've got that question wrong then try to analyze the question again and find out the best concept \trick to get it right
Don't go for google and look for the right "scientific" answer ... you won't get the same question on the exam but you may have questionS that require the same way of analysis
Another important point is that they helped me to stay calm and confident in the exam
Why ? Well, in my first NBME i marked like 15Qs per block and thought that i would get 40 mistakes by the end of the exam but ended up with 13 mistakes only ... i thought i got them right by chance .. but when it was repeated with each nbme ( marking like tones of Qs and ending up with most of them right ) i realized that uncertinity is the rule .. the exam is not designed for you to be familiar with every question .. you will see new ideas .. new concepts ... new domains
NBME is the only tool to be ready for that
That’s why I felt I was doing well in the exam when I was actually marking around 15 Qs per block
The exam day ?
One of the best days of my life
I went to the exam having only 4-5 hours of sleep for the previous 72 hours
In the morning i opened the prometric website thinking of postponing the exam ,then i thought that 240 is okay and would get me an IM residancy and decided to go on .. took some snacks and cofffee and wore comfortable clothes
I started my exam at 7:30 .. i was so nervous .. but the first block was the most easy and my heart stoped racing
Blocks were then getting harder , with each block being harder than the one before
With longer questions and newer ideas ... but i was comfortable with that
I did not lose energy at any point ,although I used to do at the 3rd block in nbmes
Breaks ?
Block1/2/3>> break >> block4,break ,block5, break , block 6 , break , block 7, freedom
I did not consume all my break time (had 10 minutes left ) ,.. time was more than enough (had 7-20 minutes left with each block ) i felt i was doing well ... the only bad thing i did is changing 5 answers ( all from right to wrong ) .. but thanks god i ended up with 265 after all of that
Take-home massege ? Trust your NBMEs + it is normal and physiologic to have insomnia the night before the exam(or the nights) .. the adrenaline rush will do its job
One of the best days of my life
I went to the exam having only 4-5 hours of sleep for the previous 72 hours
In the morning i opened the prometric website thinking of postponing the exam ,then i thought that 240 is okay and would get me an IM residancy and decided to go on .. took some snacks and cofffee and wore comfortable clothes
I started my exam at 7:30 .. i was so nervous .. but the first block was the most easy and my heart stoped racing
Blocks were then getting harder , with each block being harder than the one before
With longer questions and newer ideas ... but i was comfortable with that
I did not lose energy at any point ,although I used to do at the 3rd block in nbmes
Breaks ?
Block1/2/3>> break >> block4,break ,block5, break , block 6 , break , block 7, freedom
I did not consume all my break time (had 10 minutes left ) ,.. time was more than enough (had 7-20 minutes left with each block ) i felt i was doing well ... the only bad thing i did is changing 5 answers ( all from right to wrong ) .. but thanks god i ended up with 265 after all of that
Take-home massege ? Trust your NBMEs + it is normal and physiologic to have insomnia the night before the exam(or the nights) .. the adrenaline rush will do its job
Can i skip Kaplan ?
You might do that for some subjects that you are familiar with ... but in my opinion ... Kaplan is crucial to high scores ... it builds a strong base that you can't "see" but you will "feel" it the day of the exam ...
P.S. I did Kaplan videos not books… and I think that videos are enough
Best thing you did in basic years of medical school ?
Dr.Najeeb
Things you regret ?
1-Not doing the exam 2 months earlier ( 95% of your score is determined by first and second reads + your base from basic years) repetition of FA in the last 2 month did nothing to me … I was just trying not to forget what I’ve already learnt
I should have started NBMEs in January and did the exam in June
2-the last read of FA
3-not completing the last pass of UW
You might do that for some subjects that you are familiar with ... but in my opinion ... Kaplan is crucial to high scores ... it builds a strong base that you can't "see" but you will "feel" it the day of the exam ...
P.S. I did Kaplan videos not books… and I think that videos are enough
Best thing you did in basic years of medical school ?
Dr.Najeeb
Things you regret ?
1-Not doing the exam 2 months earlier ( 95% of your score is determined by first and second reads + your base from basic years) repetition of FA in the last 2 month did nothing to me … I was just trying not to forget what I’ve already learnt
I should have started NBMEs in January and did the exam in June
2-the last read of FA
3-not completing the last pass of UW
Special thanks :") to :
Dad .. who stood by me day by day ,and was the best decision maker i would ever have .. you was the furthest from me in distance but the closest by heart .. and you would be forever in my Heart ... i have nothing if i don't have you teko ❤
Dad .. who stood by me day by day ,and was the best decision maker i would ever have .. you was the furthest from me in distance but the closest by heart .. and you would be forever in my Heart ... i have nothing if i don't have you teko ❤
Mom♥ ... i know i could have never performed like that without your prayers supporting me all through the way ... and i wouldn't be in medical school in the first place without your kind hands holding the pencil for me when i was too lazy to write the alphabet myself... i have the best mom in the world .. thanks widoo
saga ... well, that is the most strange delema in my life 😛 ... i have no idea what good things I did in my life that she is still tolerating me as the worst friend of her lifetime .... thank you so much Saga .. i couldn't be there without you supporting me day by day by different scientific, emotional , nutritional and logestic means ... sometimes I feel like you desrve to be called Mama Saga
I love you more than words can describe
I love you more than words can describe
Heba and Marwa ... my year at the library wouldn't have been like that without both of you ...
Heba ... the most kind and Deep heart of all times ... you and your "maftool" tabarwers are so precious to me ….wish you a life that is as pure as your heart ❤
Marwa the person i have to talk to every time i decide to do a crazy step in my life 😛 .. words cannot describe how beautiful you're inside out
🤓My Bro ( khalood) ... you did a perfect job being jealous of me .. you believed in me more than i did saying "كذابة من يوم يومك بكرة بتجيبي ٢٧٠" every time i said that i am late or i will do bad
I'm perfectly in love with all your perfect imperfections khaloody
I'm perfectly in love with all your perfect imperfections khaloody
Lamees the study partner of NBMEs and last month disasters ... i wish i have known you for longer ...one of the kindest and most clever people i've ever met
4th clinical group (Saga , heba , ebtehal , haifa , mohammad , abd , ashraf and ahmad ) thanks for tolerating my anxious mode the whole year ... it has been a great year with you all
Good luck J
ENJOY THE JOURNEY
ENJOY THE JOURNEY
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