Pre-dedicated phase:-


Hi friends ! I am lokendra thapa from nepal . i graduated in may , 2015 from sylhet MAG osmani
medical college , bangladesh . I feel the need to write this because i owe so much to this
awesome group filled with so many generous , hardworking , supportive people .
After i graduated from college , i had to work in government hospital for 2 years as a
mandatory contract that we had signed after we got the scholarship for MBBS .During those
years at work , i had managed to go through kaplan biochemistry ,physiology ,kaplan 2010
videos for physiology,few systems of goljan ,70 % of first aid. I used to take a peek most of the
days in this group about questions , discussions & explanations . If i found anything useful , i
wud take screenshots of it & make annotations in FA. I used to try to answer whatever
questions that was posted . Seeing the very long questions posted in this group about genetics
,biochemistry etc, i used to wonder if i ever wud get past them correctly.
It was only after the contract finished that i was able to fully focus upon my dream which was
around january 2018 .i decided to take NBME to know where i stood in the following order :-
NBME 2-151/200 49 mistakes (1st week of january)
NBME 3- 152/200 48 mistakes (2nd week “ “ )
NBME 4 -155/200 45 mistakes (3rd week “ “ )
NBME 5 - 167/200 33 mistakes ( january 30 ,2018 )
As you can see i had a steady improvement after each NBMEs especially nbme 5,this was a
major boost to me because before that i wasn’t so sure that this journey was for me .After each
NBMEs i used to analyse the why /how /what of mistakes i made.i used to see the relevant
sections of first aid & make annotations on it .
In the beginning of April , i got to meet my senior from school who had already matched the
previous season . He advised me to start Uworld & accordingly , i took 3 months subscription
which i regretted later because i hadn’t done uworld offline previously and 3 months of
subscription proved to be just enough for 1st pass and very short for making good 2nd pass of
uworld . Consequently , i could only revise marked & wrong questions in a hurry .
This led me to extending the eligibility period from june-august to september-november.My
advice about uworld subscription is take it in such a way that it lasts right up to your
exam date which has many advantages like you can practice straight 7 hour blocks
before exam days to build your stamina ,you can make rapid 2nd/3rd pass revision
before exam time such that information can last refreshed right upto test date .
Biochemistry+cell biology+genetics:-for somebody who always struggled in this subject , Dr
Turco proved to be an angel . With his witty , engaging ,funny teaching style , one of the most
boggy subjects turned out to be very interesting ,insightful . Next ,obviously FA + UWORLD . I
vaguely remembered kaplan biochem textbooks ,though occasionally i used to turn over them
for reference .
Physiology:- kaplan textbook + kaplan 2010 videos +FA+uworld
Pathology:- Dr sattar videos(I really enjoyed his live explanation,feels like music)+ general
pathology from goljan ( i am glad i turned them few months before exam as few concepts in
exam was answerable only because
Pharmacology:-kaplan 2014 Dr Harris videos (he does quite a good job explaining practical
aspects of drugs ) + FA+uworld
Anatomy+neuroana+embryology:- FA+uworld + kaplan 2014 anatomy+neuroanatomy videos
(Dr white is fantastic .He makes the difficult subject very comprehensible)+GOOGLE images.
Make sure you‘ve general idea about muscle groups,course of important nerves .
Microbiology:-FA+Uworld is mostly enough . i didn’t feel much problem remembering so never
turned sketchy .My idea was to understand bugs on the basis of disease they caused .
Immunology:-FA+Uworld +kaplan 2014 videos ( not the very best ,but it covers enough for
boards )
Biostatistics+behavioural science:-FA+uworld+Dr Randy neil + Dr steven daugherty +100
cases by conrad fischer ( though i was confident about biostats,biostat turned out to be
nemesis for me as is evident from my score report .In retrospection, I’ve to admit that questions
about biostats were unusual in the sense that i felt FA+uworld didn’t cover the stuff. Make sure
you practice as many questions as possible ).
Some websites i consulted :- i used this site after my online uworld
expired because this site has some interesting collections of questions & also to maintain a
mode of active learning. i used to watch videos that were short and also had most number of likes &
I had subscribed Dr alex palmerton(man behind ) weekly newsletter , i really
enjoyed his newsletter .i could personally identify myself with his methods . I wish I had found
him way earlier.
There are lots of other pretty useful resources which i didn’t cover but I made sure
whatever the source , I understood the most fundamental concepts about that topic.
Concisely put by screenshot taken from score report :-
THE FIRST AID:-everybody knows it ‘s the main lifeforce of USMLE STEP 1;Above
certain level of memorisation of FA ,it’s only conceptual understanding of FA that will
take you far . Make sure you can integrate different things in FA. I used to annotate my
FA with pencil ,this way i could erase whatever information i felt was kind of unimportant
and also redundant so that i can have a FA that is only stuffed with high yield points and
which felt smooth while reading .
UWORLD:- best resource for building upon FA ;understanding different terms in FA that
would otherwise be just rote memorisation,best source for practicing time management .
overall, i had managed to go through FA 3 times:-
1st-during pre-dedicated phase
2nd-along with uworld
3rd-after uworld , this time with annotations ; this took almost 2.5 months for going cover to
cover.This phase was the most depressing because i felt i was very slow .I used to manage
reading around 10-15 pages at the most .Often i used to waste days or even weeks not studying
at all.In total , i had wasted about 3 months in 11 months of dedicated phase. luckily i had few
very supportive persons to help me maintain my calm , composure . I also had few online SPs
during this phase but it didn’t last very long as sometimes SPs would’ve different plans or
different study styles or even unusual accent (^_^) . IF you find SP with similar study styles
at the similar phase of preparation ,you should consider yourself very lucky 1 in 1 million
odds !! lolz
Time & again , i used to take NBMEs to know where i stand .Though i had planned to do NBME
18,19 online , i already knew few questions & related stuffs,so i decided to take them offline.
NBME 6-174/200 26 mistakes ( may 26 2018 )
NBME 13-174/193 19 mistakes ( june 12 2018)
NBME 15-177/199 22 mistakes ( july 12 2018)
Uworld 1st pass-82 %
UWSA1-266 ( 7th november 2018)
UWSA2,Nbme 16,17-not taken due to shortage of time
NBME 19- 185/199 14 mistakes (10 november 2018 )
Free 120-85 % ( 19 november 2018 )
NBME 18-175/200 25 mistakes ( 23 november , 2018) ( i had anxiety attack while doing the 4th
block & ended up making 10 mistakes from that block )
REAL DEAL-258 ( 27 november ,2018)
1 day before test-day:- The morning before the test day i had just reached kathmandu with my
dad . I had some errands to do in kathmandu ,so i didn’t study at all which i felt was a good thing
because i hated thought of being anxious & neurotic before exam . I managed to visit the
prometric the same day . There i talked with guards who were very friendly.I am not sure why
but it was such a huge relief after the visit . That day i just read for 3-3.5 hours at the evening
then slept around 10 pm as i was tired walking all day long .
Test-day :-Next morning , i woke up at 3:15 am ,opened FA ,quickly skimmed highly forgettable
topics only .By 6 am , i started preparing for break-time lunch (few bars of chocolates + bananas

  • berry tea ),took breakfast (2 boiled eggs ,bread , tea ) . I reached the prometric 1 hour before ,
    was mildly anxious but soon adapted to the ambience . Check-in was smooth . After I calibrated
    the headphone sound levels , i went few slides of tutorial to make sure it was the same as
    FREE 120 . Then , i skipped the remaining tutorial which saved me 13-14 mins .Before i started
    the block , i closed my eyes , relaxed & said to myself whatever happens , it ll help me improve
    as a physician then carried on with the block. I took the blocks in following order 1-2-1-2-1.
    During breaks , i used to take a sip of tea ,bites of chocolate . I always preferred to ve a light
    stomach .Only after the 3rd break , i took banana when i felt hungry enough. First few blocks
    were kind of easy that i once started daydreaming about getting super-high score(which i feel
    very funny now …lol ) but quickly i focussed towards the goal . 4th block was kind of rough
    because there were some unusual questions .During the break after 4th block , i found myself
    ruminating over those tough questions ;immediately i realised my earlier thought that whatever
    happens , will help me improve me as a physician .Then washed my face , relaxed and took two
    straight blocks again . then took few mins break , then tackled the final block .When i finally did
    all blocks , i had still 10 mins of break-time remaining .
    Overall i felt that 80-85% of stuffs were straight from FA ,5 % of stuffs not covered by
    FA+uworld ,10-15 % of stuffs touched by FA but inadequate.I used to mark 5-12 questions per
    block .One important strategy (esp for long questions ) was going through the last couple
    of lines ,then going through answer choices and lastly reading through the main
    question stem ;this technique helped me finish the block upto 10-15 mins earlier .I used to use
    the remaining mins for reviewing marked or tough questions that i had skipped earlier . But only
    after the exam I realised there s one serious catch about this method . We tend to over-analyse
    the marked questions and end up second-guessing which might not be a good choice. I had
    made few mistakes because of it . So my advice ,never change your answer unless you are
    100 % sure .
    Post-test moments:- Leaving the prometric , i felt good in general . But soon i started
    searching for the tough & confusing questions that i had marked .By the end of week , I had
    counted confirmed 10-15 mistakes .This was seriously depressing because vicious thoughts
    wud spiral eg:-if i made 10-15 confirmed mistakes out of half of questions i remember, i wd
    surely make >30 mistakes out of 280 ,that wud mean well below 250s !!! . So , i decided to
    suppress those urges & diverted myself to family & friends .
    Result day:-As the EST 9 am was approaching which is around 7:45 pm here in NEPAL , I had
    that unusual feeling of excitement & fear .With great courage , i straightaway logged into my
    ECFMG OASIS account . There it was a thumbnail of adobereader pdf file . My heart was
    palpitating as i clicked the file . As i scrolled down the score report , first came the word “PASS
    “.Then i knew few inches below was that combos of number which wd determine the whole path
    of my life for years to come .By this time i had made up my mind ,whatever happens , i shall
    suck it up . With great courage, i scrolled down & felt very relieved , happy & slightly sad ( as i
    had hoped to get past 260s ), when i saw the moment of truth . Immediately , i convinced myself
    that 258 was really as close to 260 … (^^)
    lastly i thank first & foremost the almighty ! the omnipotent ! the omnipresent ! the omniscient !
    for making this happen in reality & my beloved parents for bearing up with my days of laziness ,
    supposed unemployment ( ^
    ^)& also support at times .Last but not the least , all my friends
    who have contributed directly or indirectly to this score .