Friday, October 06, 2006

My No Nonsense USMLE Step 1 Book List

Now that I've received my score, I have some time to reflect on what went right and what went wrong during my summer of study. Here's the best piece of advice I can offer: less is more. I started out buying so many books and didn't have the chance tor read half of them. Pick a few, really good resources and get to know them well.

First Aid for the USMLE Step 1: 2006 The essential resource. Use it early during second year and annotate it as you go along. By the time I wrote my exam, it was my ONLY resource. Anything missing in the book was carefully handwritten in the margins. The 2006 edition is systems based, so if you're old school like me, try the 2005edition. won't fail if you're using the older edition . The glossy photos in the middle of the book are pretty good, but beware the buzzwords list at the end of the book. They are pretty useless, as the boards no longer use any buzzwords. Updated 2008 Edition

Kaplan USMLE Step 1 Qbook This book contains 850 questions in the USMLE vignette style. The questions were close to, or at a slightly easier level of difficulty as the online Qbank. Questions are arranged by subject, and they are great review questions to do after you've read up on a subject. I did the entire book before starting Qbank and only found a few questions that actually overlapped. Obviously, many concepts will be repeated but the questions were mostly unique. Do these questions and the online Qbank and the Robbins question book and you will be more than prepared for Step 1. Updated 2008 Edition

Robbins and Cotran Review of Pathology, Second Edition This is *the* multiple choice test book for pathology. After reading whichever pathology book you choose, follow up by doing these questions. The book is organized by system, sometimes with multiple chapters on one system. Be warned that some of the questions are extremely detailed and even unreasonable. However, if you don't get bogged down in the details, it is an invaluable resource.

BRS Pathology This book provides a good overview of the important points in pathology, but without pictures, the book at times starts to feel as though you are just reading lists of facts. The best strategy is to use this book while simultaneously looking at pictures in another book or online. At the end of each chapter, there are a few pages of multiple choice questions which help solidify what you've just read. However, for better practice, do the Robbins book I've mentioned above. Updated 2008 Edition

Clinical Microbiology Made Ridiculously Simple, Edition 3 I loved this book. My school, in its infinite wisdom, spent less than 3 weeks teaching us all of microbiology. Accordingly, I was clueless in the subject. This book was a life-saver. The pictures, which consist of crude, hand-drawn cartoons are actually quite good, and are great for visual learners. The little anecdotes, seemingly silly, are also very useful in helping you remember the multitude of organisms and the diseases they cause. Definitely buy this one. Updated 2008 Edition

BRS Physiology After slaving through Guyton in the first two years of medical school, I quickly realized that I required a more succinct physiology review book for Step 1. This is the book. It covers everything you need to know without extraneous detail, and it's small enough to read in a couple days. Like other books in the series, it has end-of-chapter multiple choice questions and a 99-question (why couldn't they come up with just one more?) comprehensive exam.

BRS Behavioral Science (Board Review Series) I hate behavioural science. And stats for that matter. In this book, you get a summary of both. It's good for certain things that First Aid was weak in, for example, developmental milestones and some of the personality disorders. Many of the behavioural science questions you will encounter on Step 1 are of the common sense-type that you can't really study for. However, the ones that you can study for will be found in this book. Updated 2008 Edition

Lippincott's Illustrated Reviews : Pharmacology : Special Millennium Update Ok, to tell you the truth I didn't really study pharmacology much for Step 1. Why? Because it's my best subject, and I had just finished pharmacology at school 2 months before my exam. I did peruse the pharm section of First Aid, which was pretty good and lots of people say that just first aid was enough. If you feel like you need more, this is your book. I used it during school, and it has a nice clean consistent presentation for all the drugs which makes it easy to use. If pharm is your weak subject, I suggest you use this resource. Updated 2008 Edition

Neuroanatomy: An Illustrated Colour Text with STUDENT CONSULT Access (Illustrated Colour Text) If you hate neuro like I do, this is the book to use. Don't even think about getting BRS Neuro -- it's a meal and a half. Instead, get this book. It has some really nice pictures with all the important pathways, and clinical correlates that go with disruption of the pathways. I used this book in med school and also during my Step 1 review.

Biochemistry: Board Review Series If you really need help on Biochemistry, use this book. However, a word of caution. There are LOTS of pathways here in heavy detail. If Biochemistry is a weak area for you, start off by getting the basics using just First Aid. Then you can supplement any weak areas with this book. Note: there is a new edition (BRS Biochemistry and Molecular Biology 4th edition) coming out in Dec 2006. I haven't personally used it, however, I don't really think biochemistry has changed much in the past 20 years. Updated 2008 Edition

Thursday, September 28, 2006

My USMLE Step 1 Score !!!

I have been waiting all morning and the mail has finally arrived. I sort through the mail, palms sweaty, heart pounding, knees weak, sensing that today is the day. Amidst the pile of credit card bills, junk mail, and magazines...there it is! This is what I've been waiting for...the much anticipated envelope from none other than the ECFMG! I run through several scenarios in my mind. I've failed. No I haven't. I actually studied for this exam. Failing was never an option. I started this process working towards a 99, and I feel as though I have a legitimate chance at achieving this goal. I turn the envelope over and over with my shaking, sweating hands, attemping to muster the fortitude to open it. Ok, it's time. The moment of truth has arrived. Usually, I would open my mail with a blunt letter opener, but this time, I opt to do away with my normal mail opening ritual in favour of a more animalistic approach. I tear the envelope open with all the vigor of a child opening presents on Christmas morning. Inside, I find a rather unimpressive piece of paper, my future printed casually yet firmly on it. This is my golden ticket and the ECFMG is my Willy Wonka. And there it is. My score. Gasp! I rub my eyes. Is this for real or am I hallucinating? Am I holding the page upside-down? Is Elvis still alive? Nope! It's real!

The summer of hard work has paid off.

99 / 248!


Wednesday, September 27, 2006

Post-Exam Musings VIII

The mail has come and yet there lacks a certain envelope containing my score from the ECFMG. I thought today was my day. That's a mega boo-urns.

Anatomy: With the exception of the odd MRI, these were really easy. Just remember the major nerves and what happens when they are injured. No need to memorize every page of Moore. It's mostly clinical anatomy, so take advantage of the history given. There are clues everywhere.

Question length: Believe it or not, there were some really long questions. Like 7-10 lines in some cases. Thankfully, there were a bunch of 1 liners to balance things out. Without these, I surely would have run out of time on most of the blocks.

My score is coming tomorrow. I know it.

Tuesday, September 26, 2006

Post-Exam Musings VII

Ok, my friend, who wrote on the same day as me, got his score today. He passed. Nothing spectacular but he doesn't want to do anything competitive anyways.

Timing(2): Going to the test center early paid off. I actually got there an hour early and was able to start 45 minutes early which was nice.

Neuro: I feel as though there was a disproportionate amount of neuro questions on my exam. Not that I wasn't prepared for it, but I would have appreciated a wider spread of questions. The questions were pretty reasonable, and some of the questions that included pictures could actually be deduced simply from the history alone.

Physio: These were pretty easy. Lots of hormones and questions asking what would happen to compound A given situation B.

Monday, September 25, 2006

Post-Exam Musings VI

Where the hell is my score? I called ECFMG and they told me the letter was mailed on September 15. How can it possibly take this long for a letter to go from the USA to, hmmm, where I live. Where do I live anyways? This is getting really annoying. Most of my friends now have their scores, and, so far, everyone has passed.

Timing: I took a break after almost every block. For some reason, I had to pee during the entire exam. I had a swig of coffee just to get me going in the morning, and, combined with a bit of pre-exam anxiety, the perfect storm for pee formation was created. As I've mentioned before, Kaplan random blocks of 50 took me less than 30 minutes, most of the time. On the real exam, I found I went a lot slower, and had less than 10 minutes remaining on every block. Some blocks, I only had 4-6 minutes remaining at the end. Given my liberal question check-marking strategy, this was some cause for concern -- getting through 15 marked questions in 4 minutes was something of a task. The actual process of going pee took several steps -- signing out, running down the hall, flashing my passport and signing back in. Even though there were over 15 people writing Step1 or 2 at the same time, I never encountered any queues during the sign-on process (save the initial process at the start of the exam)

Where the hell is my score?

Monday, September 18, 2006

Post-Exam Musings V

Holy crap! I just remembered I actually had a question on Digeorge syndrome! I couldn't believe it. I almost started laughing during the exam when I saw it.

Talking to some friends recently, I discovered that I completed my exam relatively unscathed. Two people either had complete or partial mouse failures during the exam! For the price we're paying, you would think they could buy some resonably new equipment.

First Aid: everything on the exam is NOT in First Aid. However, if you just want to pass the exam, FA will have everything you need, just not everything you want. But as the philosopher Jagger once said...

Why can't ECFMG just provide our scores online??? It's been over a month now and nothing from ECFMG yet. Starting to get anxious now...

Tuesday, September 12, 2006

Post-Exam Musings IV

How similar was Kaplan to the real thing. Hmmm, lets see. Overall, I think the real thing was harder than Kaplan. I think the real thing tended to make you think a little harder, and after a while, Kaplan really does repeat lots of questions/concepts. There weren't any really rare diseases on my Step 1 exam, but Kaplan had a fair bit of esoterica which I don't think was relevant for me.

Goljan: Ok fine, the dude know's what he's talking about, but when he says stuff like "this is definitely on the exam", it's more than likely not. I didn't have a single question that he talked about. Also, all of those high-yield lists are mostly low-yield. No buzzwords on my exam at all.

It's almost time for my scores to arrive. Won't be long now!