USMLE STEP1 EXPERIENCE 246
BY DR RICAURTE CRESPO T .
STEP 1 EXPERIENCE – YOU KNOW NOTHING, JON SNOW
First of all, before you scroll down to my practice exam scores, thanks to the community for all your help. I didn’t interact as much during studying, but I religiously read this page and got great ideas, tips, knowledge, and words of inspiration by doing so, so THANK YOU!
The title of this post is because when you are studying, you feel like you know nothing (at least I did), but trust me: you do know a lot and the farther you go on your journey, the more knowledge you accumulate, so keep it going.
TARGET: Above 230, would love >245.
BACKGROUND:
Non-US IMG (yes, another one) from a private medical school in Mexico (we have private and public medical schools here). Finished my 6thyear ranking 18 out of 114 of my class and currently doing my social service, which is an obligatory 7thyear to give back to your community as a doctor. In Mexico there isn’t a big “basic science orientation” in the medical schools’ programs and are mostly focused on clinical science, so I knew that doing step 1 was going to be a struggle. In some schools in Mexico, the 6thyear is for an internship, but I had an opportunity to change this year to an observership program in the US, which helped me learn a lot, meet great doctors, and convince myself that I HAD to do the STEPs. I always felt as an “average student” and always thought that my grades were just good luck, so I knew that doing step 1 would be a great opportunity to really know where I was standing.
PREPARATION:
- August 2019 – December 2019
TEST DATE: 19 of December 2019
RESOURCES (what helped and what didn’t)
· I watched some Kaplan videos that were circling around, probably from around 2014. Spent around 2 months watching them and taking notes, even though upper classmates told me that they didn’t work. Looking back, I do regret spending this much time watching them, since I only gained little knowledge (only biochem was good) and of course I didn’t see my notes after writing them.
· B&B – I seriously think this is HY for IMGs specially. I learned a lot thanks to these videos and owe my life to him specially in biochem, biocell, and stats which I did not know anything (seriously, zero). I did annotations of the videos on my FA and do suggest you do it, if writing stuff down helps you.
· USMLE-Rx – I bought a three-month subscription and did the Qbank. It has its fair-share of wtf qs and helps you memorize FA, which is great. Took both of their self-assessments and got: 55% on the half exam, and 59% on the full exam (yikes)
· ANKI – God save the guy who did this app and all the people who take time to do the decks. I started literally 6 mo before my exam and did it ‘till the end. The decks I used:
o Lolnotacop for micro
o Anatomy HY and 100 concepts for anatomy
o Self-made: lysosomal storage diseases, signaling pathways, X-linked diseases
o Zanki pharm
o Zanki step deck (only used 41% for systems I was weak like cardio, GI, endocrine)
· 100 concepts – reading through reddit, I stumbled upon a pdf of a PowerPoint of 100 anatomy HY concepts, which helped me a lot. If you SUCK at anatomy, this will definitely help.
· FA – the first of the UFAP. FA helped me not only to memorize major info, but also to organize better the information. I have some photographic memory (I think) and when a disease was asked, I could pin-point the part of the page it was on and some HY points that was in that section, which helped me a lot. I read FA, 25 pages a day, 3 times throughout my studying.
· PATHOMA – the P in UFAP (you already know how HY this is). Same as other test taker, great course, chapters 1-3 EXTREMELY HY!! Watched it once and did annotations in the book, read the book from start to finish once, and re-watched chapter 1-3 two weeks before my exam on x1.75 speed.
· Youtube (specially DirtyMedicine, formerly DirtyUSMLE) – I used youtube mostly in the last month. Whenever I had trouble with a concept (like anesthetics pharm) or hard time memorizing stuff (like images or pharyngeal arches), I went to Youtube, searched, and watch the first video that came up. Whenever I saw DirtyMedicine video was available for that particular topic, I went straight ahead and watched it. One of the unspoken heroes of step1 preparation.
· Goljan audios – funny, concise, and great HY points from these audios. Mostly heard them while I was driving.
· Sketchy – God bless them. Sucked at micro, and this really helped. Did only micro once and lolnotacop anki helped me hammer it in. Zanki pharm helped me with pharm, so I didn’t watch them.
· InsidetheBoards podcast – Heard it while I was driving. It’s free, they have good questions, and explanations. What I liked the most was them talking about their thought process, which helped me answer Qs better.
· UWORLD – Words cannot describe how important UW is. Period. Did it twice, random, 40 q blocks, and the second time I did my incorrects.
· NBMEs – Did all of them. Why? You get exposed to new questions, feel the rush you are going to feel in the exam, and help you see where you are at.
· Amboss – bought amboss for 1 mo at the end just to read more info on topics I was hurting (cough anesthetics cough). Pretty nice library, not going to lie, wish I heard from it sooner.
WHAT A DAY LOOKED LIKE
Did Kaplan videos, B&B (1.5 months) and USMLE-Rx in my observership intermittently.
Formal studying started after my last exam of my 6thyear, which was august. My social service is an ophthalmology clinic for underprivileged people, where we give free services (all of them) and I only go 5 hours a day. After that, got home, ate, and started UW 40 q block, review it, read FA and anki. It was like this throughout my first pass.
During my second pass (started mid-October) I wanted to do 2 blocks per day. I went to the clinic from 1 pm to 6 pm so this is what my day looked like.
Wake up 7 am
7am – 9 am: read 13 pages of FA and did some anki
9 – 10: UW block
10 – 11:30: review UW
11:30-12:30: lunch (in Mexico we eat at 2:30 PM, so this sucked), shower, etc.
1 – 6: clinic, where I did anki between patients.
7 pm – 8 pm: back home, UW block #2
8pm – 11pm: UW review 20 q, dinner, UW review last 20 q.
11pm – 12 am – finished anki if I hadn’t finished it, and watch pathoma, Youtube videos, Sketchy.
12 am: sleep, finally.
DAY BEFORE EXAM:
Woke up at 6 am (to be tired by the end of the day), did anki and memorized a list of stuff I wanted to memorize (pharyngeal stuff, formulas, CNS derivates, etc), and watched some videos. Was done by 12 PM. Ate, packed for a trip I had next day, and was freaking out the rest of the day. Played some FIFA20, watched movies, and tried to relax. I prepared some food for next day (high protein and fat, low carbs snacks), water, printed my permit, packed my glasses, eyedrops for lubrication, and ID, and was in bed by 10:30 pm
DAY OF THE EXAM:
Woke up at 6:30 am, had half a cup of black coffee (you don’t want to be peeing yourself in the first block) and ate some oatmeal. Went to the test center and arrived by 30 min earlier, as instructed. One friend told me: go in as if you are going to beat the shit out of the exam, and that is what I did: went in pumped-up, used 5 min of the tutorial to write down formulas, and started the exam. From there on, I felt my spirit plummeting down (which is normal). I thought I was making stupid mistakes, marked easily 20 Qs per block at least. My test center had issues, so my exam stopped two times for all step takers due to system issues, so this was a major setback. My exam ended being 45 min longer do to this. And I had to wait in my computer while they fixed it. Lowered my spirit even further. When I finished, I seriously thought I failed it and even told my dad to buy the prep material for the Mexican board exam (I actually felt like this throughout my practice exams too, so no surprise there). I felt so relaxed and proud of myself for taking the beast (pass or fail) and I opened a well-deserved beer (just one, early flight next day).
Breaks: - 1-2: 1 min break in table
- 2-3: 7 min break outside (bathroom, coffee, water)
- 3-4 1 min break in table
- 4-5: 10 min break outside
- 5-6: 20 min break outside (lunch)
- 6-7: 12 min break outside
PRACTICE EXAM SCORES
Rx half assessment (6/24/19) – 55%
Rx full-assessment (6/24/19) – 59%
Kaplan 1stdiagnostic exam (7/3/19) – 73%
NBME 16 (offline) – around 228
UW first pass (2 mo out) - 67%
NBME 21 (7 w out) - 234
NBME 22 (6 w out) - 232
NBME 20 (4 w out) - 225 (thanks to the community for the heads up on how horrible this one is)
UW second pass ( 3 w out) - 85%
NBME 23 (3 w out) - 240
Free 120 (2.5 w out) - 83%
UWSA 1 (2 w out) - 254
NBME 24 (9 days out) - 244
NBME 18 (5 days out) - 242
UWSA 2 (2 days out) – 249
Kaplan simulated full exam (3 days out) – 80% (did this to practice break time, food, bathroom breaks, etc)
STEP 1 SCORE: 246
FINAL WORDS: As I said it is normal to feel like you know nothing. Trust your scores and preparation, you have worked hard and that will show in the exam day. Everyone told me that and I didn’t believe them, but it is true: TRUST YOUR SCORES. The exam is doable, it is meant to be hard and make you feel like shit, but trust me: scores aside, you will feel AWESOME after you take it.
Thanks again, best of luck to all, and questions welcomed!
PS. Sorry for any grammar/spelling/writing mistakes