In the Name of Allah, the Most Gracious, the Most Merciful

USMLE USMLE 1
#1

In the Name of Allah, the Most Gracious, the Most Merciful

{… And [He] has taught you that which you did not know. And ever has the favor of Allah upon you been great.} Qur’an [4:113]

Hello, everyone : ). My name is Muhammad Mahmoud. A 5th grade medical student from Egypt.

I’ve scored 249 on USMLE Step 1, and this is my experience.

Before starting and throughout my preparation, I read a lot of experiences. Which really helped me, esp. in terms of the psychological aspect xD. So, I think it’s my duty now to continue what our USMLE-er friends have once started … to help each other out.

At the beginning, I want to quote from the experience of a Sudanese doctor (252) I read, before even buying the books. He wrote: “THIS THING IS DOABLE”. Always keep that in your mind. Always.

I am an a-bit-above-average student in my school. That’s because I am really frustrated with the educational process in school. And, actually it is the main reason I decided to study for the USMLE exams. So, if you consider yourself an average or even a below-average student, this thing is for you. To build your knowledge with a fresh start and be a good doctor.

Quick stats:
UWorld 1st pass: Offline
UWorld 2nd pass: Online, 93% correct

Assessment exams: All were in timed mode, except 17 & 16.
NBME 17 offline: 21 mistakes (3 months out)
NBME 16 offline: 17 mistakes (3 months out)
NBME 15 offline: 14 mistakes (1 month, 3 weeks out)
NBME 13 offline: 16 mistakes (12 days out)
NBME 18 ONline: 252 (10 days out)
NBME 19 offline: 12 mistakes (5 days out)
Free 120: 14 mistakes = 88% correct (2-3 days out)

Duration of preparation: 18 months (with 3-4 months off … school exams)

Sources and Study Material:
Kaplan, Pathoma, Uworld Qbank, UW BioStats review, and First Aid were the core of my preparation.
Easyauscultation.com for Heart sounds. And the NBMEs for assessment.

EVERY EXPERIENCE YOU WILL READ, INCLUDING THIS ONE, IS THE PERSONAL OPINION OF ITS WRITER, SO, DON’T TAKE THEM AS FACTS.

  1. Kaplan Videos: (all disciplines, except Pathology): The sole purpose of these is to give you a general idea about the discipline and to build core concepts. Just understand and grasp the concepts being explained as much as you can, but don’t waste your time on them, i.e. don’t take notes, watch them twice, or try to memorize details, etc.

the videos are good, but they are not that high yield.

Consider watching Boards and Beyond videos, instead. I didn’t try them, but did read good reviews from students who have.

  1. Pathoma: the best about it is that Dr. Sattar integrates pathology with other disciplines, like histology, anatomy, and esp. physiology, which was great for me. Again, pay attention during the lectures and try to grasp concepts as much as you can. If you think you are weak in some system, re-watch it, but not the whole series. Take notes in the book, as you might need some of them later.

  2. UWorld Qbank: This was THE ESSENCE OF MY STUDY. UWorld is great. You must do it at least twice. The first run is to learn, and the second is to test yourself and to discover your weak areas.

My first round was through the 2016 (YES, 2016!!) offline version (screenshots of the Qs with their explanations), then, my second and third rounds were online. UWorld was the main source for me to understand concepts and MEMORIZE information. Yes, you will have to memorize details, but DON’T WORRY, it’s fairly easy. You won’t have to cram by heart, instead you will RETAIN what you learn through REPETITION. When you are tested on the same concept over and over, you’ll eventually remember it, even solid information.

I used to solve the Q, read the explanation, read it in FA, take notes, and re-read the Q to make sure I got the idea behind it.

UW Biostatistics review is great. You must do it, since it addresses concepts not mentioned in the Qbank. I got a Q in the exam about a concept that was in the review, but not the Qbank.

  1. First Aid (The MAGNIFICENT): I have to say that I hated this book at first, as I thought it was very deficient and had many low yield stuff, but when I started doing NBMEs, I realized I was wrong. I remember having 2 Qs in the exam whose answers were in FA, but were not mentioned in UW. These Qs were solvable, but I got the answers by exclusion and guessing. This also happens in the NBMEs. Anyway, you have to add notes to FA from UW, as some important info. and explanations are not mentioned in FA. Think of it as if FA and UW complete each other.

Focus on the point that are addressed in UW, but, don’t completely ignore the points that are not … at least read them … just read … don’t memorize.

  1. The NBMEs: these are 200-Q exams to assess yourself: predict your score, and determine your weak areas. I did the forms 13-19. The thing about them is that they are very similar to the actual exam in terms of the percentages of easy/hard Qs.
    Use them in timed mode to get used to the exam stress.
    And regarding the predictability of NBMEs, they are very good. BUT, to be most accurate, don’t rely on just one, instead, take as many as you can, and see the RANGE of your scores across all of the forms you did. In my case, after calculations, I predicted my score to fall in the range between 247 and 253 from my NBME scores.

I didn’t do the UW self-assessments.

Timeline of my preparation:

First of all, you should know that I am a SLOW reader. So, it took me a looong time to study. You can do it in much less.

  1. 1st read (from Oct., 2017 to Oct., 2018 [with a 3-month gap for my school exams]): To avoid boredom, I used to watch Kaplan vids in each discipline, then flip through FA, then solve UW Qs in the same discipline with annotating in FA. For instance, Immunology, I watched Kap vids, read FA, then solved UW … then, Biochemistry, vids, FA, UW. And so on, till I finished all the discilines.

  2. 2nd read (2.5 months, from Oct. to Dec., 2018): I did 2 reads of FA. The first was a THOROUGH read from cover to cover, finished in 2 months. The second read was a fast one to make sure I didn’t forget the details, finished in 12 days.

  3. Did my first NBMEs 17 & 16 (late Dec., 2018) in a non-timed mode to know where I stand. I was content with the results, so, I began registering for the exam and subscribed to online UW.

  4. I did online UW almost twice (Jan., 2019 till late Feb., 2019):

  1. The first was the whole bank, 4 blocks a day. Took me about 3 weeks. Then, did the Qs I got wrong and marked ones. After that, I did NBME 15.
  2. Then I did about 1900+ Qs again, to make sure I was good.

  1. Then, I revised FA for the 3rd time (late Feb. & early Mar., 2019) in about 2-3 weeks, then, did NBMEs 13 and 18.

  2. The last 10 days before exam, I was DRAINED. Tried hard to revise the whole FA again, but hardly revised most of it. I revised heart sounds and some forgettable points, and did NBME 19 and the Free 120 Qs 3 days before the exam to keep my mind used to solving Qs.

  3. The day before exam, I was rather anxious. Studied till 3 pm, felt a mild headache, so, I stopped and tried to relax. Slept for 7-8 hours that night, and woke up feeling calm and refreshed, Alhamdulillah.

The exam day:
I wore comfy clothes, had some sandwiches, and a bottle of water. Trust me, it’s gonna pass just fine. I was worried about A LOT of things (waking up & arriving to the exam center in time, the exam itself, time management, etc.). But, it was over in the blink of an eye. Seriously, when I stepped out of the exam center, I felt as if life has been paused for an instant and resumed again xD.

The people at prometric are great. They were very kind and cooperative. The place was just fine and calm, helped me to focus and relax.

Some fellows in the exam room were doing other exams (e.g., GRE), and kept typing and clicking, so I used the noise-canceling headsets, which helped, btw.

The exam itself:
I arrived at the exam center, passed through the security checks, been placed in front of the computer, and began the exam. Just like that ?!! Yup, just like that. I was perplexed at first, the first Q popped into my face suddenly, and I felt like OMG, HOLD ON, I’M NOT READY YET!!! This was for the first 8 Qs, but then I got used to the situation and regained my balance.

I did 2 blocks — 10-min break — 2 blocks — 25-min break — 2 blocks — 15-min break — the last block — back to LIFE.

I used to mark 9-12 Qs per block to revise if I had time, and used to leave 2-4 Qs to solve at the end of the block, as they were tough.

I finished each block with 7-16 min.s left. Solved these tough 2-4 Qs and then revised some of the marked Qs.

The Result:
Before receiving my score report, I was too nervous, as I counted many Qs I got wrong in the exam. Thank god I could distract myself from time to time, or I could have went crazy xD.

You gotta know that this is completely normal, just trust your NBME scores. And bear in mind that the Qs you’re gonna recall after the exam will be the hard ones 95% of the time, simply because these are the Qs you spent a lot of time with, trying to figure them out, so, they are the most likely to be remembered.

Before you go:

  1. The USMLE is doable because study material like Kaplan, pathoma, Uworld, first aid are out there. If it weren’t for these, the journey would have been much much tougher. So, if you can’t purchase the original copies now, for any reason, be noble, and have it in mind to compensate these people when you can, even after years.

  2. Keep/save the experiences you like (not necessarily this one xD) in a folder to read them later when you need, at whichever step of your preparation. It helped me a lot.

  3. Group study: has its pros and cons, as follows:

A) The mentor: A great deal. You should look for somebody who is done with Step 1, and ask them to mentor you. You WILL need advice someday. Follow up with more than one, get various opinions, and decide what works for you better. And, again, don’t take any opinion as an indisputable fact.

B) The timeline: The good thing about a common schedule is that it spurs you to finish you job in time. On the other hand, it doesn’t work well for everyone, cuz people are different. We have different styles, paces, and abilities to get the job done. So, group with students who you think are similar to you.

C) The community: If you can, get a study partner from the start. The journey is long and exhausting. I realized that towards the final months when I was under immense stress and doubt. A friend who supports and reassures you, when doubt begins to creep into your thoughts, can be necessary sometimes.

Also, the help you give and receive is great. When you explain a concept to a partner, you, in fact, get a deeper understanding of it. You can get a concept explained to you, as well, if you couldn’t get it on your own. Which saves time and effort.

  1. You should identify your priorities. And you might need to make sacrifices. Sacrifices in time with family and friends, time for some hobbies, sometimes sleep, … etc. But, you shouldn’t spend your entire preparation in solitude. Balance between your study and other aspects of life, don’t overwork yourself, and rest when you feel burnt out.

  2. Don’t ever lose hope, keep pushing yourself. We all felt hopeless and that “this way is not for me”, at some point. Thousands have done it before, and can, too. Don’t forget that.

  3. ALWAYS help others when you can. Write your experience when you’re done (Yes, you’re gonna NAIL THIS THING!! XD). And remember, whatever the blessings you have in life (knowledge, money, … etc.) use them for the good. They are only the favor of god upon you.

  4. And, finally and most importantly, be close to Allah, He is your greatest source of confidence and tranquility. Always pray and ask Him for patience, strength, and the fortitude to keep moving.