Long time reader, first time poster.

2nd year who loves nsurg.  Been doing research for awhile in the field and tend to sacrifice a lot for it.  Grades have been good to excellent in a program not teaching for Step 1.  However, I have a long-standing history of trouble with these standardized tests.  I know that programs look at the whole package, but I also know a lower score will hurt my chances. 

I plan on taking two months to study (note: I heard FMG’s take 9mos to study and come in with 240+) and I have all the classic prep books.  What I’m looking for is some clear advice either on scheduling or personal study success stories to get me through this hurdle. 

Any responses will be greatly appreciated and good OR karma will be bestowed upon them.

Though it’s a little late in the game if you’re not already doing it, I think the biggest thing is to learn the second year material well as you go along.  Most people I know, myself included, have a tendency to rely on cramming a little bit from time to time, which might not hurt your test scores as you go along, but doesn’t do much for long term retention.  So, try to get over doing well on tests and get down to learning the material well - which usually results in good test results.  Also, the things that separate really good scores from good scores on Step 1 are detail oriented questions.  The better you know the main concepts the more time you can focus trying to master all the little details and the higher your score will go.

That being said, I didn’t do as good a job of it myself as I would have liked.  It was more of a hindsight observation.  My method was to do a Q-bank question set on a particular subject, then read the corresponding chapter in Step Up, BRS Path, BRS Phys, and First Aid, in that order.  Then I’d do another set or two of questions and move on to the next chapter/subject.  After I got all the way through everything once I went back through each book individually and spent a lot of time doing Q-bank questions.  After all of that I ended up with a score right in the average of what matches in neurosurgery, despite not being as prepared as I could have been when I started studying.  Also, I studied for 5 weeks and probably averaged about 8-10 hrs a day. 

That worked for me.  In your case, and in general, I think doing a lot of Q-bank questions is worthwhile.  I forgot to say above that I’d take a test and then go through and review the answers to each Q-bank test I took.  Anyway, I think the best way to try to get more comfortable with taking these tests is a lot of practice and Q-bank does a reasonable job of approximating the test.  The one big difference between the two is that Q-bank tends to ask identifying type questions; such as they present a case and ask you to identify the disease.  On the exam, though, a lot of the time they might give you the same info you’d get in the Q-bank question, but instead of just having to identify the disease the question would be something like “What’s the inheritance of this disease?” or “A common histologic finding of this disease is....” So, the test forces you to trust your identification of the disease and reach into that second-level set of knowledge.  That’s where the knowledge of the details can make a difference in your score.

That’s my take on it, but I’m certainly open to corrections/criticisms.  Hope it helps.

i basically agree with everyone else on the following things: definitely use Qbank, and use it liberally because there’s a ton of questions. First Aid is a good resource but not enough, and I also did what David mentioned and took notes from my other board review books within the blank spaces of First Aid, so eventually all I had to do was go through that.  Definitely actively learn the charts in that book; they were pretty high yield.  For the other review books I tended to use a mix of BRS, high yield and old Kaplan books, which were things that I had used to study for the shelf exams during the whole first two years so they were somewhat familiar (probably whatever you used is fine).  Another piece of advice would be to be aware of how much you are actually absorbing; 15 hours of blankly staring at books won’t help you, so just pay attention to how much you’re learning and if you’re becoming less effective, switch to another study method or new location, take a break, etc.  That’s basically what I did.  I studied for a month, about 12-14 hrs a day, got a 246.  Good luck with everything and remember that 3rd year is SO much better than what you’re doing now.

Thank you all for your quick feedback.

My advice for “ace’ing” (whatever that means ) is go through First Aid at least 4-5 times, go through QBank at least once, reading all answer explanations (including ones you’d answered correctly) and once you’ve gone through 2/3 of the total questions, do new questions PLUS old missed questions. Besides those two, I used BRS Path extensively as well.

I believe Step I is a test of endurance, and in the end, people generally get the score they’ve worked hard for.

For other general Step I tips, I would recommend browsing StudentDoctor.net, but after you’ve gotten some ideas/strategies, stop reading these forums and start studying

A person who performed very well on Step 1 gave me this guide to tackling the Step 1 boards, which I have attached to this post. I was impressed because it carries the ominous title “the System.” I found it very helpful and I got a very good score. Also, it encouraged me to drink during Spring break. Use as you wish, with no guarentees of outcome. Any attempts to determine the source may lead “the System” to take you down.

Also, in the future, this site may be useful for correlating your Qbank scores or MCAT scores to predicted Step 1 score. It was fairly accurate at predicting my score, but the margin of error is not small.

http://www.medfriends.org/step1_estimator/

Below are my own opinions about preparation:

I very strongly suggest using Qbank. The other resources available from Kaplan (books and lectures) did not seem as helpful (I was a shill for Kaplan so I got free access to all their materials and I only really used Qbank). Take the time to do all the qbank questions. The Kaplan questions are a little bit harder than the real USMLE questions, so I felt very prepared for the exam. I suggest starting each day with two blocks of 50 randomly selected questions. This will prepare you for waking up early and thinking in terms of multiple choice boards questions (especially important for someone like me who usually sleeps from 4:00-12:00). Two blocks of 50 a day will allow you to finish the questions in approximately 3-4 weeks. Also, I only ever took randomly chosen questions. I think this is superior to selecting questions by subject, as you will get used to jumping from one subject to another. Most importantly, read all of the explanations, even the ones for the questions you got right; otherwise you aren’t going to learn much. I saw my percentages consistently improve over the 4 weeks of studying and my average of the final 6 blocks of 50 questions very closely matched my actual score (see score estimator above).

I want to reiterate my belief that it is not necessary to study for the Boards before the end of school, if you are willing to put in the time after finals are done. Here is a list of the books I chose. I studied about 6 days a week, 10 hours a day for 3.5 weeks.

First Aid - I read the entry on a topic in first aid, then reviewed books that were more in-depth and wrote notes of important facts not in First Aid in the margin. By the last week or so, after you have read your other books, First Aid will be filled with notes and can be used for a final review. The goal is to be reviewing only First Aid at the end of your preparation so that you don’t have to be searching through numerous books.

Blue Book (NMS Physiology) - I started with this book and covered it in 3 - 3.5 days.

Red book (NMS Pathology) - Great book, which I covered in about 5 days. I suggest knowing this book cold.

Microbiology Made Ridiculously Easy - My favorite source for micro, which I think took about 3 days to cover. I also read some of the Bug Cards, but I don’t remember which ones and I didn’t feel they were all that helpful.

PreTest Pharmacology - a lot of people used pharm cards, but I found them to be really frustrating because they were either way too detailed or too basic. I think First Aid does a good job as a general review, and Pretest is excellent for reinforcing important mechanisms and side effects, though it is vital to read all the answers if you want to get the benefit.

The above are the most important. These next books can be added on to supplement areas that you are weak in or to give more depth if you have extra time left to use for studying.

High Yield Embryology - my test seemed to be heavy on embryology. This book seemed to be a good, quick review to supplement First Aid.

Netter - Anatomy

High Yield - biochemistry, neurosciences, and behavioral sciences

Anatomy, histology, biochemistry, genetics, neurology, behavioral sciences, immunology - I just read First Aid. Remember that these are not worth all that much on the exam and could take a lot of time to review. I did borrow someone elses anatomy and neurosciences recall books to review blood supply and nerve supply for the limbs. In general, it is important to look at the make up of the exam so that you don’t spend a lot of time reviewing low yield topics. Histology may be important, but not so much on this test. High Yield books seemed to be good for biochemistry, neuroscience, and behavioral sciences that you can skim or read if you feel weak in one of these subjects.

Also, take the last day off, watch a movie, and relax. Cramming will do nothing but stress you out and keep you from getting sleep.

The new trend around the country from the west to east coast has been really ambitious. Soon to be third-year med-students are trying to finish QBank and USMLE World before they sit for step 1, meaning they were using one or the other to prep during the second year. Skoanz, your score will vary depending on the difficulty of the test (that used to be an extremely controversial issue before they stopped reporting what your score meant percentile-wise). 2 weeks away from dancing with the gorilla huh? Although you’re really doing well, you’ve got to thoroughly examine your percentage distributions on QBank to see exactly which niceties in certain topics you don’t understand or simply haven’t learned yet (I’m sure by now you’ve realized that you are one of the best teachers you’ve ever had). I don’t simply mean getting the answers right about a certain topic, I mean being confident in your mind that you’d do the same with ANY question they could possibly ask about a topic. Unless you feel that you know about every single topic in every single subject down cold, you have at least 5 points to pick up before your date. Stuff like EACH presentation of the notorious glycogen storage diseases, when to expect to be diagnosing a patient in the question with Shy-Drager, and other knit picky things of the like. Make sure you review stats the day before (same with ethics) also, unless you’re an MPH. Those questions will be so easy it’s insulting, but if you did not take the time to review a little before the exam, they screw you over.

Also, I’m in agreement with Swanson. You study for step 1 AFTER second year not during because then you handicap your greatest asset in the exam which is a strong second year. It’s a marathon, not a sprint. You’ve never heard of a pro marathon runner running 3 or 4 23k’s to prepare for one! This is the time to be picking up points and not focusing on numbers. It’s obvious you’ll do well, your work ethic and obsession with the topics for this exam will take you further on the right of the Gaussian curve. Kick some ass boiz.