USMLE Step 1 Blog

My No Nonsense USMLE Step 1 Book List

2006-10-06T10:34:00.000-07:00

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. No...you 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

My USMLE Step 1 Score !!!

2006-09-28T12:51:00.000-07:00

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.
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99 / 248!

WOOOO-HOOOO!

Post-Exam Musings VIII

2006-09-27T20:35:00.000-07:00

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.

Post-Exam Musings VII

2006-09-26T20:35:00.000-07:00

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.

Post-Exam Musings VI

2006-09-25T12:25:00.000-07:00

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?

Post-Exam Musings V

2006-09-18T17:26:00.000-07:00

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...

Post-Exam Musings IV

2006-09-12T11:19:00.000-07:00

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!

Post-Exam Musings III

2006-09-05T21:16:00.000-07:00

Did I mention there was hardly any pathology and pharmacology on my exam? Well, there you have it. It's unfortunate because these were my best subjects at school, and also my best subjects in Kaplan. Oh well...can't win them all.

Behavioral Science: based on the questions I saw, I regret even studying for this subject. The questions were all situations which you really can't study for. Use common sense and perhaps think about spending more time on your weaker subjects.

Biochemistry: lots of biochem on my exam! I didn't really mind because I did actually spend a good amount of time reviewing it. You can work almost all of these out if you know the major pathways.

Post-Exam Musings II

2006-09-01T22:14:00.000-07:00

The horror! The horror! I stay up at night something thinking about random questions that I encountered on Step 1. At this point, I’m sure about 15 questions that I answered incorrectly. The list keeps growing and it’s making me agitated. It’s been 2 weeks now and I expect to see my score in a few more weeks.

What else? There were lots of photos on my exam. Most were pretty good quality. The problem was, sometimes the location of the arrows were ambiguous. For example, are they pointing to the blob, or the space above the blob? It’s an important distinction, and I had some trouble deducing what they were pointing getting at.

Math: Very little math. I was expecting more, and maybe even wanted a bit more, but I think there were less than 5 questions on my exam that involved numbers.

Dry erase board: Make sure this thing is clean before you walk in! Mine had some semi-permanent marks on it and it was annoying.

Lunch: Scope out the place before exam day and decide where you want to eat. Find a quiet corner away from the freaks studying at lunch.

Post-Exam Musings

2006-08-23T14:58:00.000-07:00

Post-Exam Musings

Ok, I’ve been done for about a week now, and I’ve had some time for reflection.

I walked out of the exam room thinking that the exam wasn’t too bad. To be sure, there were about 3-5 questions per block that I just had no idea about. I ended up being very liberal with my ‘marking’ of questions; maybe about 10-15 per block. These were distilled down to the 3-5 WTF questions that I just tried to make an educated guess on. So what else can I say? Let’s see…

Timing: I think I did Kaplan Q-bank the wrong way. Most of the time, I would finish a random block of 50 in less than 30 minutes, and I hardly ever re-checked a marked question. I also ended up marking over 800 questions as either incorrect or interesting - ie: I got it wrong, or I learned something new, and would go back and read them later – clever, right? Wrong. By the time I had finished Kaplan, there was no time to go back to these. Well, I probably could have, if it were not for an overwhelming feeling of wanting to throw the computer out of the window. After doing 2100 questions, you tend to get a little bored, frustrated, and lots of other nice adjectives that I can’t seem to conjure at this moment. Here’s the punch-line: Don’t do the questions at the last minute. Also, keep your number of resources low, don’t buy too many books, because you’ll never get through them all anyways.

Done!

2006-08-15T20:05:00.000-07:00

Ok, just took the exam...I am so pooped I can barely type. All I can say right now is that it's not as terrible as I thought it would be. Overall I think it went ok. We'll see in 3-6 weeks I guess...

It's go time...

2006-08-14T20:07:00.000-07:00

The big day is tommorow. I think I have a good plan going into the exam in terms of breaks but nothing concrete until the real thing I suppose (if you gotta go, you gotta go). I tried to spend some time going over some NBME's but it didn't really work...I just ended up watching TV and eating too much junk food. I think I'm pretty ready for this and surprisingly I'm not very nervous. Actually, more excited to be done than anything else.

Qbank Stupidity

2006-08-06T13:27:00.000-07:00

I was 8 questions into a timed block of 50 questions today when the phone rang. Instead of suspending, I hastily clicked on END and submitted my score, which produced a score of 16%! CRAP. There doesn't seem to be a way to reverse this, and now my average has dropped 2%. I hate this...

NBME Time

2006-08-02T07:14:00.000-07:00

Ok, everyone says the NBME's are good predictors for your real score. We'll see, because I'm starting them today...

Taussig-Bing!

2006-08-01T21:06:00.000-07:00

Well, after 1450 questions of random 50 question blocks, the now infamous Taussig-Bing question has reared its ugly head. Naturally, I got the question correct. With 66% of Qbank done now, I'm at 73% correct, vs 62% for the rest of Kaplan users. My last 3 blocks were 76%, 76% and 92%. I also completed the end of book review in Robbins Qbook with 81%.

Strippers or Medical Question Bank?

2006-07-27T14:47:00.000-07:00

I received my credit card bill in the mail today, and one particular item caught my attention. It was titled: "Scores! Chicago" and the price was $199.00. Now, go ahead and google it. Yep, my suspicions were correct...the first link that shows up is the self proclaimed Nation's #1 Gentlemen's Club. Now, you and I know what I paid $199.00 for, but my mother sure gave me a strange look when she saw that bill!

I think I'm dumb

2006-07-27T14:28:00.000-07:00

After 900 questions of Qbank, I fully expected my marks to steadily rise. Instead, my hours of reading are being rewarded with decling Qbank scores. My last set? 64%, compared with 63% for the Kaplan average. Granted, some of the questions included crap like M5 AML (I thought we only needed to know M3), and one really poorly worded question about the CDC definition of AIDS (I picked CD4<200, the answer was MAC). I'm trying not to let these results get to me, but it's getting harder to ignore these poor results...

Kaplan Physiology Qbank

2006-07-21T13:36:00.000-07:00

I've decided to take a break from the normal Qbank and switch over to the Physiology Qbank, which is a separate question bank that costs $75.00 (I think). After doing a few blocks of CVS and Cell Physiology, I'm really not liking it. Maybe it's because I hate physiology, but it just seems like the questions are too math heavy and are short on the clinical side. I'm going to keep going with this for today and maybe for tomorrow, but that will probably be the last time I use it.

QBank Blues

2006-07-20T11:35:00.000-07:00

Well after a few good random blocks, I've hit the wall with two consecutive blocks of 66%. My only consolation is that the Kaplan average is lower than that. It's actually a really cool feature of Qbank -- it gives you your score, and everyone else's score on that block. So now, despite feeling pretty low, I can at least find some solace in knowing that others are doing worse than me. After 300 random questions, my average is now 72%.

4 Blocks down

2006-07-19T17:57:00.000-07:00

Ok, after 4 random blocks, or 200 questions, I'm really liking Qbank. The interface is nice, I've solved the mouse problems, and it's running pretty smoothly. I find that running the test in untimed mode and checking each answer as I go along saves me much time (rather than finishing the block and reviewing each question again). I run a separate timer using another program. So far, 75% average on the 4 blocks, ranging from 68% to 84%. I'm starting to understand what some people say about their exam...they walk out feeling like they failed, but end up doing ok. My first block, I really want to stop and ask for a mulligan but after finishing, I ended up with a 76%. Alright...about 1900 questions to go...

Kaplan time!

2006-07-19T10:15:00.000-07:00

Alright, I finally put $199.00 on my credit card and it's time for Kaplan Qbank. First impression -- the interface is a copy of the new FRED style exam, but it's slightly different, and I'm having trouble blocking text and scrolling. Who really cares though? If the questions are good, it doesn't matter to me...

Behavioral Science

2006-07-18T18:04:00.000-07:00

Well ok, one day turned into two days. It was pretty painful to get through this topic, but I'm done. BRS plus a bit of First Aid. I did the Qbook questions and I've got to say, I feel as though I'm guessing on a lot of these questions. And, despite my relative ineptitude in this subject, I'm pretty sure I disagree with at least 2 of the questions. 76% on the first block, 68% on the second block. Maybe this will require another day of review closer to the real exam. Qbank coming up next!

Pharmacology Done

2006-07-16T23:14:00.000-07:00

Pharmacology is done. Just a quick review lasting 3 days using FA and my class lecture notes, which, as it turns out, was not all that bad. 78% on Qbook. Behavioral Science/Stats next - 1 day...tops.

Pathology Done

2006-07-13T23:36:00.000-07:00

Phew! Just finished Pathology. It took about 10 days to finish this beast, which was a bit longer than I expected. Mostly, the problem was having the patience to finish Robbins, which wasn't just a meal, it was the full buffet including a double helping of icecream at the end. I finished Robbins with an average in the high 70's/low 80's which I'm pretty happy with. 86% on Qbook. Now its time for Pharmacology. I'm thinking 3 days tops.