I have a question for all you NS’s/future NS’s who have taken step 1...how long and intense did you study especially if you got over 250. I will be taking step 1 this summer and am already starting to worry. I have read first aid along with classes this year (probably 2-3 times through each system but only the systems covered in courses) and the short version of BRS, and listened to goljan a few times through for each class. I have done nothing formal though (like set aside extra time to study for past subjects). When did you start doing that? How much time per week did you study during the spring semester with classes? I also have extracurrics I do (so I am worried that I might have to drop a bit this spring or at least the time I spend on them). Any advice?

prettyinpink - 20 December 2008 10:47 AM

I have a question for all you NS’s/future NS’s who have taken step 1...how long and intense did you study especially if you got over 250. I will be taking step 1 this summer and am already starting to worry. I have read first aid along with classes this year (probably 2-3 times through each system but only the systems covered in courses) and the short version of BRS, and listened to goljan a few times through for each class. I have done nothing formal though (like set aside extra time to study for past subjects). When did you start doing that? How much time per week did you study during the spring semester with classes? I also have extracurrics I do (so I am worried that I might have to drop a bit this spring or at least the time I spend on them). Any advice?

I really hate being the uncleharvey police, but I can’t say enough times that you should check old posts before asking questions that have been answered a number of times… We’ll work on making a wiki with answers to some of these questions, but before you make a post, do a quick search.  Within the course of 5 minutes, I typed in the words “step 1” and found numerous posts that answer your questions.

http://uncleharvey.com/index.php/forums/viewthread/219/
http://uncleharvey.com/index.php/forums/viewthread/1274/

Lots of opinions on how to study for step 1 - lots of people that have gotten above a 250 did it in different ways. 
I would memorize 1st aid.  Know that shit cold.  Read Goljan path cover to cover.  I didn’t read BRS phys and did fine on physiology questions, but lots of people swear by it.  Do all of Qbank and all of USMLE world.  I took 2 months, but only did 6 hours a day.  don’t study too long or you’ll burn out.

agree with GoodToHook, know First Aid cold. every word is quite literally something you should know/memorize. same with USMLEWorld; i took notes on most of the answer explanations since some of that information hadn’t been taught to me before. listen to goljan wherever you go. once school ended for me, i studied 10+ hours every day, but this is variable from person-to-person and is dependent on how long you can sit still and focus.

there really is no magic answer for this. you just have to learn, memorize, understand, and apply—and repeat. do the material and do plenty of questions (especially all of USMLEWorld). find out how you learn best and stick with it.

goodluck.

I think the links above cited by injinjay contain some very fine tips.

For myself, I used a few strategies. I don’t consider myself unusually smart or a particularly stellar test-taker. I was starting out with an MCAT of 32, (I think only marginally above average for admitted medical students) after perhaps suboptimal preparation (studied pretty much exclusively from the thick Kaplan review book in the midst of a heavy class load with lots of extracurricular activities). Knowing I wanted to keep the neurosurgery option open, I knew my performance would need to improve. I did work pretty hard during the first 2 years (get up, study, class, study, bed, repeat, and got honors in all available classes--except genetics, from which I took time off to get married and go on a honeymoon). I traveled overseas (without books) during the 1 month we had off between required summer classes and MS2. I had good intentions of using board review books during the MS1&2 classwork but was minimally successful - doing well on the exams always seemed more important than picking up yet another book.

My study strategy during classes was to attend lectures armed with last year’s notes co-op notes that I had read and marked up ahead of time, and during lecture jotted down the few new points for that year in the margins. When studying for each exam, I did make several pages of high yield notes - not of what I considered necessarily to be the most important info, but the key info I figured I was most likely to forget (formulas, weird words, etc). Suffering more from evaporative, rather than photographic memory, I also made a few rather OCD excel tables (ended up spanning a large percentage of wall space with small print) for microbiology to try to memorize names, virulence factors, clinical manifestations, treatments, etc - I then quizzed myself by systematically covering up columns). For pharmacology, I made my own pharm cards during each unit (never seemed like the bought pharm cards quite worked for me). And the brute force of repetition was for me very helpful. Though they were painful to make, it was comforting to go to bed the night before each exam knowing I had exhaustively quizzed myself on the details of every last drug. The flash card concept eventually spilled over into a few other topics. Prior year’s exams were also available at our school and proved gleefully valuable for our non-standardized exams.

Collectively, my self-made resources proved extremely valuable when it came time to sit down and study for Step 1. I did additionally utilize a select array of the board review books that, at the time (2001-2003), seemed to have earned the most favorable reviews per First Aid: BRS physiology and pathology, High Yield anatomy, neuroanatomy, behavioral science, embryology, Lippincott’s illustrated reviews for microbiology, biochemistry and pharmacology. I also used Robbin’s pathology to ensure I could eyeball key pathology/histopathology images that may come up. I placed a premium on memorizing these specialized review books to the extent possible, feeling this to be a safer approach than relying upon first aid. A moderately neurotic highlighting scheme allowed me to skim these review texts on subsequent occasions, and quickly recap what I considered to be the the most forgettable information. I did read through the appropriate sections in First Aid after the more comprehensive reviews to re-emphasize key points and ensure I hadn’t missed anything. I used Q-bank (I don’t think USMLE world was on the radar back then) and made it through most, if not quite all of the questions, jotting notes from explanations in appropriate locations of my reviews. I did some full length exams for endurance practice, with the next couple of days after each spent going over the explanations.

I set aside about 6-8 weeks for study (~12-14h/d with regular short scheduled breaks), generally emphasizing the most concept-oriented subjects like physiology first, and working my way up to the more short-term memory material such as pharmacology, micro and metabolic pathways, so that I would hopefully peak on my personal factoid retention curve at the time of the exam. This kind of got blown out of the water, however, when I arrived on July 3 for my exam (which I had booked months previously), only to be told I would have to reschedule, as they closed at 1pm that day prior to the July 4 holiday (!!!) As we had just bought a house and were about to move, I thus spent the next 2 weeks surrounded by piles of boxes in the basement of our new house, scrambling to perform damage control reviewing random things I knew my brain was busily trying to off-load. In the end, though not stellar, I think I probably did the best I realistically could have done, with a 248. The person who sat next to me in class never underlined a single thing, and scored 265 after 2 weeks of study. Thus, understanding your baseline ability and personal study style is always going to be a necessary consideration when planning your step I attack strategy. Just be sure not to schedule your exam for July3!

I scored a 32 on the MCAT, and was a slightly above average student during M1 and M2 year. What worked for me was doing as many questions as possible. Some of the previous posters mentioned knowing First Aid cold, I on the other hand could not recite a single line or mnemonic in First Aid. The way I saw it was there are going to be very few original questions on the USMLE, meaning questions that have not been asked in some form before. So if I could get a preview of those questions ahead of time, I’d do well without having to be an encyclopedia. I did around 6,000 practice questions between spring break and early June (Kaplan Q bank and USMLE World among them). I used First Aid purely as a reference. I scored a 262. This is what worked for me. Everybody will have a different strategy. The best strategy is the one that works for you. Good luck!

My philosophy for the exam is If you cant beat the best, then you have to BE the test. Do as many Qs as you can and then memorize them all – >250 guaranteed.

You know I had this whole expansive philosophy on preparation for step 1, I’ve typed it up and sent it to some friends younger than me thinking I had the test “beat” so to speak (I made in the 260s after 6wks studying), but then I proved myself wrong b/c I only studies 10days for step 2 and made in the 270s.  Therefore I think it just comes down to mostly busting you ass in the preclincal years, reading as much as possible and then relying on a bit of luck.

So far, we have only heard from those who professed to do quite above the neurosurgery average. In the scientific spirit of desiring “controls,” I wonder if any of you good souls who perhaps scored below the neurosurgery average of ~236 (itself already way above the national average of ~218) might also be willing to share your experiences? Did you use a strategy similar to those above with more “normal” outcomes, or are there perhaps things you feel you should have done differently that others could learn from? I understand possible reluctance to post a sub-stellar score given the lack of fully anonymous posting capabilities, but I imagine any such input could be highly valuable so we know what things everyone does, regardless of outcome, and what things may be more unique to those who do really well?

I definately like hearing from people who scored above 250 because that is my goal (above that). I have worked (somewhat) the first two years and have gotten all honors (very high honors, usually 96-99% in classes) but I still feel like I know nothing for the boards. Hopefully all of the advice of doing well the 1st 2 years pays off. One thing that worries me is the whole annotation of first aid and looking at your class notes. I can never locate all of my class notes once they are done, and was hoping to rely on BRS, first aid, kaplan, goljan, and question banks as my source. It’s scaring me because I started QBank over the summer and did very well on the courses I had already completed. I tried to do them again the last few days and there is soooo much I don’t remeber!!! Thanks people for all of the advice!

There comes a point where some kind of baseline ability plays some factor I’m sure, and it’s just finding that right study style to maximize that. But I agree that your studying should definitely revolve around doing as many questions as possible, and learning as much as you can from both the ones you get right as well as the ones you get wrong.

prettyinpink-

don’t worry, everyone feels like they forget everything----its a universal sentiment. The basic fact is you will have to re-learn a ton of micro and pharm, period. But i think You will suprise yourself by how much you actually remember.  Also, I don’t advocate annoting First Aid with class notes.  Leave that space in FIrst aid to annotate notes you will make from your Qbank/USMLE World Stuff.  You will need the room.

Lastly, If you want a more honest assesment of where you stand, take a practie NBME form online.  They are 4 blocks (200Qs) and you get a mini “boards score”.  It costs like $50 bucks a pop on NBME.org but I think its well worth the piece of mind.  Just to give you reference.

My pre-study score: 230 form 1
2 weeks in: 242 form 4
4weeks in: 250 form 3
3 days prior to test 258 form 2
actual: >260.

I think this is a better way to know where you stand than “converting” you Qbank score.  Others may disagree.

I agree that all the advice here is good.  Just be careful that you don’t start comparing yourself to the people who post here.  There is a huge amount of selection bias in the people who are willing to say their scores, so it is easy to get discouraged when you read posts of people who talk about the method they used to get 260+.  There are a lot of ways to study for Step 1 and the hardest part wasn’t figuring out what to do, but figuring out what not to do from the thousands of tips that I got from everyone.  You’ve gone through 1.5 years of medical school, so you should have a good idea as to what style would work best for you.  Gauge the advice you hear by thinking about how effective it would be if you actually tried it.  If it sounds like a bad idea for you, it probably is and you shouldn’t try it.  The worst thing you can do is derail the plan you laid out for yourself by adding new things in the middle.

For those curious about less stellar scores - I posted my study plan as the first response in the first link mentioned in injinjay’s post above.  My routine was pretty similar to what people have posted here, but I was within a couple points of the average for what matched my year.

blah blah i made a 260 i’m awesome

gay thread

BRAIN_SURGEON - 05 January 2009 06:59 AM

blah blah i made a 260 i’m awesome

gay thread

No I don’t think this is a “gay” thread. I appreciate people with high scores giving advice because that is he advice people look for (if they want great scores). It should not really bother you.
In update I have been reading first aid and listening to goljan, doing Q bank as I go (only the subjects I have covered though at 81% at 18% completed) I plan to finish Q bank before school lets out, then do USMLE world and NBME tests with the time off that school gives us (like 8 weeks).
thanks a lot guys/gals!