Hello everyone, my name is Bishoy Zaki

USMLE USMLE 1
#1

Dr: Bishoy Ashraf

Hello everyone, my name is Bishoy Zaki. I’m a 4th year medical student in Ain Shams University, Egypt and I would love to share with this wonderful community my experience throughout this gruesome journey. I hope you find it helpful like others before me whose experiences I found helpful and inspiring. And I apologize in advance for its length but I want it to be as thorough as possible.

My target score was 250+ which-thank God-I achieved in the end.

A) I’ll lay out my prep in chronological order as that’s how I remember it:

  1. I started seriously prepping for STEP1 with the start of my 3rd year (fall 2018) with the intention of taking the exam around November 2019 (LOL). I used resources such as B&B, Pathoma & Sketchy to help me decipher First Aid and get through my first pass of it. Our curriculum was taught in a systems approach which helped me study the same systems we were doing at uni from the STEP1 resources. By the end of the year, I had finished around 85% of FA with annotations from the B&B videos, read through pathoma once, and done many many sketchy videos.

  2. Summer of 2019: I started a UWorld subscription (more on that later), did a 2nd more thorough pass of FA alongside B&B videos and started solving the very old NBMEs (1 through 15) for practice as I had a goal of not taking the exam before finishing all of the NBMEs to solve as much questions as possible (more on that later). As 2019 neared its end, I realized that I wasn’t ready at all to take the exam and still had much to do so I postponed till February of 2020.

  3. Then came 4th year so my study pace became much slower. I continued UW as I hadn’t finished it yet, did some more NBMEs and studied FA alongside that. I took NBMEs 23,20 & 18 around February and found my scores unsatisfactory so I had to postpone again till after I finish 4th year and then Covid hit, which bought me a lot of time to stay home and study as we stopped going to college and the finals were postponed.

  4. During the quarantine time I bought an AMBOSS subscription and started doing it alongside UW and I went through Pathoma for a quick general reminder then I took the decision to finally book the exam as I had had enough. I went through FA a 4th and final time, did the remaining NBMEs and the 2 UWSAs which took me around 50 days then I finally took the exam.

  5. I followed some of the biohacks in this DirtyMedicine video (https://www.youtube.com/watch?v=zJgjMZk8_To) woke up early the day before and got around 6 hours of sleep before the exam and believe me, good sleep and mentality are equally as important as your study for this long gruesome exam. The prometric center was very comfortable. I skipped the tutorial and took a 10min break after each block to go for the bathroom, grab a few protein bar bites and drink some water. The feeling of finally finishing the last question of that exam and going out of the center is just indescribable so whenever you feel down or you feel like you’ve been studying for ever, just think of that moment.

:sunglasses: Resources:

Honestly, UW; FA; Pathoma; and B&B are gold, anything else is supplementary. That being said, I went through many resources but I will only list here the ones I found to be the most beneficial on the long term (i.e. the ones I kept going back to) with a few comments on each.

  1. UWorld (can’t stress how important it is)

  2. First Aid (needs keen reading to decipher what every phrase means as every page is literally packed with high yield facts, and I want to say that even on my 4th pass I kept discovering stuff that I hadn’t noticed before)

  3. Boards and Beyond videos(huge shout out to Dr.Ryan, he’s amazing and I believe that his videos are essential to properly understand the topics)

  4. Pathoma (at least try to go through it once or watch Dr.Sattar’s vids; they’re amazing as well)

  5. Sketchy micro (I wouldn’t have been able to memorize tons of random micro facts if not for sketchy but if you can memorize on your own and don’t need visual aids like me, then it’s not a must as its main purpose is to help you memorize)

  6. Sketchy Pharm was immensly helpful for me in the antineoplastics, antiretrovirals, antivirals…etc which had very specific characteristics and side effects. Otherwise, I watched a handful of other videos on the drugs that I couldn’t memorize at all.

  7. Sketchy Path I hated it except for the bone and brain tumour videos; those were excellent. Otherwise, I felt it was useless.

  8. BRS Behavioral science and Conrad Fischer’s 100 caseswere a great help in the beginning because we weren’t taught that subject well in our school so I had to study it from scratch. If you’re like me, those 2 resources plus UW questions are more than enough for behavioral/ethics.

  9. I also used BRS physiology briefly and for parts that I wasn’t good at and although I don’t believe that it is essential, I have to say that I really like how it presents info in a simple easy to understand manner.

  10. AMBOSS I only had time to finish half of the questions cuz I used it for the 3 months right before the exam as I needed sth new to answer and I have to say that it’s a great QBank for practicing your knowledge but it’s definitely not as good as UW, especially the explanations which I found to be quite frustrating in AMBOSS and needed improvement.

  11. HYNA is a really good review book for NA although I found it very hard at first, after reading on the various topics online and from FA it became much easier and I only kept going back to a couple of chapters not the whole book anyway. Don’t feel pressured to “finish” any of these supplementary resources, cuz I felt so at first then I realized I should only use them for things I didn’t understand from FA or UW otherwise I would be wasting my time.

  12. NBMEs (I’ll come to that later)

  13. DirtyMedicine which is a great Youtube channel. Just go there and check it out.

I just want to say that you can do whatever resource you’re comfortable with as long as you reach a clear solid understanding of the topic which means you can solve questions on it comfortably. BUT DO NOT USE A RESOURCE JUST CUZ PEOPLE SAID YOU SHOULD. Go through the resources yourself until you find sth that suits YOU and your strengths not others’. And of course it’s much better to have a main resource like FA which you add to, instead of spreading yourself thin trying to do as many books as you can.

C) UWorld:

Crucial resource that does a great job in explaining difficult topics clearly. I was only able to go through all UW once and then I did my mistakes and marked questions but that’s only because I’m very slow so I spent a lot of time trying my best to understand every question and making flashcards of what I thought was important. I don’t think it matters how many times you go through UW as long as you’re doing it for practice, understanding the explanations and learning how to approach questions, NOT for scores. But I think it was a mistake to take that much time in just one and a half pass of UW, so try your best to balance quality and quantity without compromising either. Also, I would recommend getting the 1 year subscription outright as I heavily regretted getting the 6 months subscription and then having to renew afterwards as I ended up paying up more than if I had just paid for 1 year to begin with.

D) NBMEs:

Many people make the mistake of using the NBMEs just for their scores which isn’t completely wrong but that way they’re missing out on a huge opportunity to collect valuable info. I used the NBMEs both as a QBank and for self-assessment by carefully reviewing each assessment and making a word file for explanations from the internet for my mistakes and for Qs that I didn’t fully understand -even if I had answered them correctly by chance- so by the time of my real exam I had a file full of explanations for the questions that I found to be difficult on the NBMEs which was very helpful.

In addition, I took not 1 but 2 simulations of the exam in the 10 days leading up to my test day. Once by UWSA1+3UW blocks and another time UWSA2+free120 which built up my stamina for exam day cuz I knew exactly how much time to take in my breaks and how to manage fatigue as best as I could.

E) General Thoughts:

-Try as much as you can not to stretch your preparation too long which is a mistake that I made and don’t wish upon anyone so although I can’t say if there’s a perfect prep time because I honestly don’t know, all I know is you need a solid clear plan in this journey with a definite planned out exam date in mind and the flexibility to accept that anything might happen and completely change that plan because we don’t control everything, I mean who would have thought a pandemic would hit us all and change all our plans, right ?

-Also, there’s no such thing as a perfect plan that you can follow blindly to guarantee a certain score because I naively thought so at first until I realized I had to adapt my plan to my study style as I tend to focus on quality more than quantity in addition to the fact that I’m really slow.

-Only compare yourself with yourself, don’t compare yourself to others because each one of us has their own strengths and weaknesses and special circumstances.

Finally, I want to point out the fact that knowing I could lean on God through prayer whenever I felt down or frustrated or even happy and thankful helped me immensely during those past two years and made me realize how small and insignificant I am in this world yet not helpless for God’s graces are endless for those who seek.

That being said, I was also very fortunate to be part of a study group with my friends in the same academic year which was a great help as we were all going through the same circumstances each with his own pace. We asked each other and helped each other out which was a huge blessing and great support as now I cannot imagine how much harder it would have been if not for their help. Especially my brother Mark Sameh who tolerated hours on the phone of nuanced study plan discussions, giving me tips and just listening to me whine. In fact around 80 or maybe 90% of my plan was actually his idea originally, based on many experiences posted on groups like this. So a huge shout out to him for his help; he deserves much credit.

NBME scores: (with number of mistakes between brackets)

NBME 13: (40) Summer of 2019

NBME 15: (39)

NBME 17: 228 (28)

NBME 23: 228 (50) Jan 10th 2020

NBME 20: 228 (50) Jan 26th

NBME 19: 242 (18)

NBME 18: 247 (22) Feb 29th

NBME 21: 244 (33) July 23rd

NBME 24: 246 (30)

NBME 22: 236 (42)

NBME 16: 267 (7)

UWSA1: 260 (29) July 27th

Free 120: 88% (14) Aug 1st

UWSA2: 251 (28) Aug 1st

UW 1st Pass 75%

I personally believe there’s no such thing as a single most predictive assessment for everybody but there is your average performance in all the assessments that you took combined which will definitely be somewhere near your real score. That’s why I kept trying to improve my self-assessment scores to get somewhere near my target score. In the end of the day all one can do is make their best effort and leave the rest in God’s hand. I hope this experience was helpful at least to one person out there and I hope the best for all of you on your exams and your careers.