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.

Robbins Chapter 14

2006-07-09T14:05:00.000-07:00

Ok, holy crap. Robbins Chapter 14 WBC, LN, Spleen and Thymus is killing me. I've managed to do most of the chapters before and some after this chapter with around 75-85% correct. So what did I get on Chapter 14? 49%. I want to scream, so I did, and it felt good. Next, I wanted to tear the chapter out of my book, but I decided it would do me no good. Instead, I opted to direct my sense of frustration at my pen. I got it free from the drug company anyways. I put on my favorite safety glasses (I got those free too when I bought my chainsaw) and smashed that little Fosamax pen to bits. It felt good. Incidentally, I used Kaplan notes for this section of pathology which, as it turns out, was completely useless. Go suck it Barone!

Micro Done

2006-06-30T14:23:00.000-07:00

Micro is done. The guy who wrote CMMRS is now officially my hero. I needed a full week on this because my school absolutely sucked at teaching us this, and the content was heavily deemphasized. 74% on Qbook. Starting patho next week.

Physio Done

2006-06-20T14:20:00.000-07:00

BRS Physio was a nice and easy read. I just finished the comprehensive exam at the back with an 82%. There are 99 questions in this exam covering all the topics in the book. I wonder why they couldn't have just thought up 1 more question to make it an even 100. Weird. 88% on the Qbook phys section as well. I think I'm ready for this section.

Anatomy and Neuro done

2006-06-15T14:16:00.000-07:00

BRS Neuro is done now. I just finished the Anatomy/Neuro Qbook section with a mid 70%. I guess that's not terrible but there's definitely room for improvement. Physio is next. Did I mention that I hate neuro?

Biochemistry First

2006-06-06T14:02:00.000-07:00

So here's the strategy. Start with biochemistry. It's the topic that is the least fresh for me. I'm using BRS and it's turning out to be a bit of a meal. Then, it's on to Kaplan Qbook. From what I'm hearing, getting consistently over 70% on these types of questions are a pretty good indication of preparedness, so I'll aim to do that or slightly better. Hopefully, a lot better. We'll see.

Studying Begins

2006-06-05T13:57:00.000-07:00

Yep, today is D-Day, H-Hour, S-Second. Wait a second, no it's not. We'll reserve that title for my exam date. Actually, today is just June 5th. Studying begins now. I've decided not to take the well trodden path using a pre-made X number of week schedule. People swear by the Kaplan 6-week schedule or similar facsimiles but who cares what other people thing? Who better to set the pace than the person writing my exam (that’s me in case you’re not sure). I’m the only one who knows my strengths and weaknesses so I’m know exactly where to spend that extra few days on my problem topics.

The Scheduling Permit

2006-05-14T22:50:00.000-07:00

I finally had a chance to see my real scheduling permit - the one I used to schedule my prometric date was a scanned version emailed to me from home. It's pretty bizzare. A bright orange piece of paper, longer than the usual letter and legal sized paper, that has been folded to double as the mailing envelope! The most important piece of paper in this entire process and they can't even mail it to me in a proper envelope? I can just imagine the heads of the ECFMG driving around in their shiny new BMW's, bought solely with the money they saved by pinching us poor IMGs. Jerks.

The Deed is Done

2006-04-28T17:47:00.000-07:00

Well, not the real deed, just the scheduling part of the deed. It's actually an easy process, just check the prometric website, enter your info and pick a date. Me? Early to mid August. That's me. I might just be the one sitting beside you at the test center. Now that the exam is actually scheduled, I'm going to have to step it up and start studying soon...

Free Flash Based Flashcards for USMLE Step 1

2006-04-09T02:54:00.000-07:00

This is a link to a site containing lots of free flashcard questions. It looks like the questions are coming straight from First Aid.

Histology Practice Test

2006-03-28T15:25:00.000-08:00

Here's an online histology test.
Bon appetit!

First Aid 2005 Correction

2006-03-24T10:41:00.000-08:00

I'm not sure where I got this, but I found an errata sheet for First Aid 2005. Here is the correction:

On page 269, the topic “Polyarteritis nodosa” says “Not associated with P-ANCA” This should be changed to “Can be associated with P-ANCA.”

The Return of the Chicken

2006-03-14T11:23:00.000-08:00

Ok I did it! I scheduled my exam date! Yay!

Ok, fine...I admit, I haven't scheduled it...yet. But I did actually visit the prometric site, and I perused the potential exam centers where I could write the exam. I'm debating between 2 different locations, but at least I have some choice here. My friend is from a smaller city, and there is only 1 location, so I guess it pays to be in the big city.

I also learned that you can switch your date up to 5 days before the actual exam, for free. Given this new information, I really don't have a great reason for why I have yet to pick a date. It's not like I'm dumb. I'm consistently in the top 10 of my class, and multiple choice tests seem to be my forte. For now, I'm just going to tell myself that I'm too busy with school to think about other things.

Big Time Chicken

2006-02-21T03:53:00.000-08:00

So now that I have my scheduling permit, I could, in theory make a quick visit to www.prometric.com and actually schedule an exam date. This would be the smart move, as all the good dates tend to get gobbled up by some of the more keen medical students. I, on the other hand, am a big time chicken. Up to this point, aside from having to apply twice to the ECFMG, it has been a relatively pain free process. But actually setting an exam date? That makes it a bit too real. And real is scary. A lot of people go into medicine thinking that they can be, or do anything, they want once they are in medical school. Is that really true? Maybe. But in many cases, your final specialty is often chosen for you, and not the other way around. It's called your Step 1 score. You do crap on it, and you're destined to become a GP, or even worse, a pediatrician or psychiatrist. Do really well, like crazy well (we're talking over 98), and you can start applying for ENT or plastics. No pressure.

Scheduling Permit

2006-02-09T08:40:00.000-08:00

Good news! My scheduling permit has finally arrived. The next step in the process is to call the local prometric testing center and actually schedule a date within my 3 month testing window. Phew, it feels good to get to this point. Just to recap, I submitted my (second) application on Jan 6, so it took 1 month and 3 days to get to this point. Not great turnaround but not bad either. I will keep you informed.

6 Week Study Schedule

2006-02-01T14:43:00.000-08:00

I found this 6 week USMLE Step 1 study schedule. The link can be found here. I have around 6 months until I have 6 weeks to go. Enjoy :)

Lippincott Pharmacology

2006-02-01T14:26:00.000-08:00

For those of you thinking about purchasing the Lippincott Pharmacology book (2nd edition), think twice before moving forward. I recently ordered same online through Amazon and received the book, in what appeared to be excellent condition. However, after 3 weeks of constant usage, the spine broke and all the pages came loose. Okay, that didn't really happen. The truth is, my book was missing 15 pages, from 435 to 450. Go ahead and check yours. I got a full refund from Amazon but they can't send me another book because the replacement also has the same defect! Buyer beware.

Flesh and Bones

2006-01-31T13:27:00.000-08:00

Question: Has anyone used the Elsevier site "Student Consult." It's an online Q-bank, similar to Kaplan, containing 2000 questions. I haven't tried it, nor do I know anyone who has. If anyone has some experience with this Q-bank, please post it here!

BTW, I am thoroughly dissapointed with the lack of understand with the preview message. I am, of course, making reference to Darmok and Jalad. Just in case you've been sleeping under a rock for the past decade or so, here's the translation: My Step 1 application has been approved! I'm now anxiously waiting for my scheduling permit to arrive in the mail. The next step will be to contact Prometric and schedule an actual date to write the exam.

Eureka! (Darmok and Jalad at Tanagra)

2006-01-26T14:45:00.000-08:00

ECFMG, with fist closed.
Me, with fist open.
Me, on the ocean.
ECFMG, on the ocean.
Me, on the island.
ECFMG, on the island.
Me and ECFMG, on the island.
ECFMG, its arms wide.
Me, with arms wide.
Me and ECFMG, on the ocean.

ECFMG Website Maintenance

2006-01-20T16:07:00.000-08:00

Due to scheduled maintenance, ECFMG's on-line services will be unavailable beginning at 12:00 noon on Tuesday, January 31. These services are expected to be available no later than 5:00 pm on Friday, February 3. All times are calculated using Eastern Time in the United States.

First Aid for the USMLE

2006-01-12T15:19:00.000-08:00

There is a lot of discussion these days about which version of First Aid to buy/use. Lots of people have hand-me-downs from recent years. Well, the news is, everything up to the 2005 edition is similar, obviously, with subtle changes and error corrections. However, the 2006 edition is pretty different - at least in layout. I don't actually have my 2006 edition yet, but the word on the street is, all of the pages have been re-organized so the information is now presented as a system based resource. This might be good for some people, bad for others, and even still, some might not even care. Personally, I'm the traditional rigid and conservative old school type. I liked the old version, and have never been a fan of these new age system based teaching fads. And yes, it is just a fad. The next big thing will show up and the deans of all of the schools will be tripping over themselves trying to keep up with the trend. The truth is, intelligent people will excel in any environment, whether it be old school or systems based. Bottom line, if system based is for you, go for 2006. If not, stick with 2005.

Progress schmogress

2006-01-11T07:02:00.000-08:00

Got an email from ECFMG stating they received Form 183. Less than 10 days to go before they approve me :)

Ok, enough with the procedural stuff for now. Let us begin the first segment in our series of discussions on USMLE study books. I recently purchased the Robbins Review of Pathology 2nd Edition. A 419 page tome of titillating material composed of case-oriented multiple choice questions. It's pretty comprehensive and compared to the Pre-test pathology book (which I also have, but wouldn't quite call titillating) I would say the Robbins questions contain longer cases, more pictures, are slightly harder and are more detailed. However, the Pre-test answers are often more detailed. Robbins has different chapters on male/female genital pathology, while Pre-test combines the two topics. Robbins also has a section of Micro, which I thought was pretty brutal. But then again, I sort of suck at Micro anyways. In contrast, Pre-test has an entire book just on Micro. Pre-test has some high yield notes at the beginning of the book, but to be honest, they are not that good. Check your local book store to see for yourself.

Talk About Snail Mail

2006-01-09T12:52:00.000-08:00

Guess what? I just received the rejecting letter for my initial ECFMG Step 1 application TODAY. Thats Jan 8 2006! It took them about 3 weeks to get the letter to my house (my home mailing address is in a 1st world country, with no postal strikes at the time). Talk about snail mail. In the mean time, I have already corrected the problem, and resubmitted my application (from scratch). Incidentally, they address the letter to Dr. My Name (as in me), which is always a strange feeling.

Starbucks Hack

2006-01-08T14:11:00.000-08:00

Here's a little secret that Starbucks doesn't want you to know: They will serve you a better, stronger cappuccino if you want one, and they will charge you less for it. Ask for it in any Starbucks and the barista will comply without batting an eye. The puzzle is to work out why. Read more here.

Snail Mail and E-Mail

2006-01-06T06:22:00.000-08:00

Good news! The application is finished. I just printed out Form 183, and went to the school to get their stamp and signatures on the form. I told them my situation and they were very sympathetic. They even offered to mail the forms the same day! Hopefully, I’ll be hearing back from ECFMG with good news very shortly. Also, I just received an email from ECFMG confirming my online portion of the Step 1 application. Now, they will wait for Form 183 to arrive before moving forward.

Starting Anew

2006-01-03T11:21:00.000-08:00

Happy New Year! Phew! I’m back at school after more than 15 hours of plane travel, delays and layovers. I’m just about to start my Step 1 application, but I find myself a bit apprehensive. I’m going to grab my roommates and have them read over what I’m typing. I’m not risking any more clerical errors.

The Birthday Phonecall

2005-12-28T14:02:00.000-08:00

I called the ECFMG today. I was predicting that some haggard old hog of a woman would pick up the phone, probably the type that has over 100 cats lying around at home (some dead, some alive, and some…not too sure) reeking of feces, urine and rotting cat carcasses. This was my mental picture of the folks at the ECFMG, directly proportional to my level of frustration. Instead, I was greeted by quite a pleasant young man. He was quite helpful and quickly verified that my fax had been received and my birthday was now entered correctly. I can now look forward to restarting my application. Yay!

Birthdate Verification

2005-12-23T13:14:00.000-08:00

Ok, so I faxed them copies of my drivers licence and passport to prove my date of birth, and I'll check with them next week to see if they have updated my records...When that is confirmed, I can *start* the process of reapplying for Step 1. The stupid thing is, it would actually be faster, and less painful, to create a new "pre-"application record, compared to waiting for them to receive my fax and update my records, but they would most certainly find out. I'll let you know how it goes in after the weekend.

ECFMG Blues

2005-12-22T06:42:00.000-08:00

Ok, I checked online at OASIS last night and discovered that my application for Step 1 was rejected. I called ECFMG this morning, and learned that I had entered my birthdate incorrectly, somehow reversing the month and date. Sounds like a simple thing to change, right? Wrong. I have to send a copy of my birth certificate, passport and now I have to wait for them to manually change it in my records. Then, I HAVE TO RESUBMIT EVERYTHING AGAIN! EVERYTHING. INCLUDING FORM 183 (Which will be identical to the last one). It's so frustrating. I can understand that the ECFMG has to be ever vigilant and verify everything -- we can't have a bunch of phony docs out there. But at the same time, there is no need for this asinine, power hungry attitude, forcing people to redo applications from scratch with only MINOR (and I mean minor) discrepancies. I heard someone had to resubmit an entire application because he was missing a "-" in his school name. It's this sort of bureaucratic red tape that makes the licensing procedure unnecessarily long. And it’s not like I’m asking them to license me...yet. All I’m asking if for the privilege of writing the exam. The next time you complain about the doctor shortage in your area, or how long the queue is to see your doctor, think about who you should complain to. Here we go again...

Dr. Hwang Dropped from Scientific American 50 for Faking Research

2005-12-16T17:16:00.000-08:00

"With considerable disappointment, the editors of Scientific American are immediately removing Dr. Woo Suk Hwang from his honored position as Research Leader of the Year on the 2005 Scientific American 50 list."

read more | digg story

Hey, what's your number, baby?

2005-12-16T15:55:00.000-08:00

Ok, this is hardly USMLE Step 1 related, but it's pretty freaky nonetheless. By the way, no news on the application. Just going to take it easy for a bit and think about what date to write it. In the meantime, try this out:

1. Grab a calculator. (you probably won't be able to do this one in your head, but if you can, holy crap)
2. Key in the first three digits of your phone number (NOT the area code)
3. Multiply by 80
4. Add 1
5. Multiply by 250
6. Add the last 4 digits of your phone number
7. Add the last 4 digits of your phone number again.
8. Subtract 250
9. Divide number by 2

Do you recognize the answer?

House's House

2005-12-14T08:45:00.000-08:00

House, Season 1, Episode 6, Actress Stacy Edwards plays a schizophrenic who turns out to have Wilson's Disease. Funny how she played Dr. Lisa Catera in Chicago Hope, and one of the first things she diagnosed was Wilson's Disease in one of Dr. Wilkes' patients. Anyone notice this or do I just watch too much TV? Also, did anyone else notice that House's address is 221B? Yes, it's Sherlock Holmes' address!

The 12 Days of Anticipation

2005-12-12T06:55:00.000-08:00

I awoke from my deep slumber, ever so anxious as to the status of my Form 183. After all, I had put my faith in a group of strangers at the medical school office, whose efficiency, based on previous experience, has been somewhat questionable. As I typed the user name and password of my email account, I fought off images of my precious Form 183 being mailed to the wrong address, somehow ending up deep-fried in a Shanghai McDonalds or floating serenely down the Vltava River under the Charles Bridge in Prague. And so, imagine my surprise when, less than 2 weeks after submitting the form to the med school office, I received the following in my e-mail inbox (Huzzah!):

We are pleased to confirm that the Certification Statement (Form 183) of your USMLE application has been received by ECFMG. ECFMG typically processes on-line USMLE applications within 10 business days of receipt of both the on-line part and the Certification Statement. You may track the status of your application by using ECFMG's On-line Applicant Status and Information System (OASIS). Access OASIS on the ECFMG website at oasis.ecfmg.org.

What the hell do I do now...?

Is There a Doctor in the House?

2005-12-08T16:34:00.000-08:00

Ok. I'll admit it. I'm addicted to House. No, not a physical structure serving as a dwelling for one or more persons, or that once popular musical genre that the kids used to dig. I'm talking about the tv show House. It's a new medical drama from the USA about a doctor who hates seeing patients and employs a team of well manicured, youngish doctors to do his dirty work.

What sets House about from other medical dramas is that it's actually about medicine. They take on a new case every week, generally an unusual condition, and spend most of the episode trying to decipher the mystery illness.

My only beef is the many hats worn by the same characters. For example, how many times will you see the same doctor perform a lumbar puncture, ultrasound, run an ELISA, and then break into a patient's house to investigate what kind of shampoo they use, all in the same day? Anyways, it's good entertainment. And the fact that you actually feel a bit smarter at the end of the episode alleviates some of the guilt you feel after spending the hour not studying.

All's Fair in Love and War

2005-12-05T17:28:00.000-08:00

Today I learned that US (and Canadian -- Canadians are people too!) medical students only pay $455.00 to write the USMLE Step 1. In contrast, I, IMG, have to pay $695.00. I’m curious as to what they will be doing with the extra $240.00. It certainly can’t be used to provide test facilities overseas since I’m writing the exam in North America. And, when you register for the exam, there is a $120.00 surcharge for writing the exam outside of North America. So basically, if you are an IMG, and you are writing the exam outside of North America, you get kicked where it counts, and then while you’re down, you get kicked once more, just for good measure. We’re all equals, right? It’s just that some people are more equal than others. Do I sound bitter? Yeah. A little bit. But it’s just going to make me want to study that much harder. Ain’t nobody gonna hold me down.

The (Mis)Adventures of DrMom

2005-12-03T11:33:00.000-08:00

Dear Fellow Step 1 Blog Readers:

I recently posted a message on an online forum (SDN) with a link to this blog. I was shocked to discover, that, within hours, not only was my message deleted, but my account on that forum was also removed by an rather heavy handed moderator with the screen-name DrMom (I can only assume this is not her legal, given name). In my defense, I posted another message on the same forum, which, within minutes, was promptly deleted. It reads:

Dear DrMom,

Thank you for bringing this to my attention. I do, however, take offense to your removal of my SDN account without any notification or method of appeal. It is this sort of heavy handed moderating that makes the sharing of information unduly difficult.

Granted, my original post had a link to my blog, which for all intents and purposes has no products or services for sale, and serves only to provide timely information for students such as myself who are currently in the process of preparing for the USMLE. This is where I believe the SDN policy is inconsistent. What difference does it make if the link to my blog is within the message itself or within my signature? In both cases, users are still able to reach the same end point. Furthermore, the content of my original post contained no offensive, libelous or defamatory comments, and was well within the spirit of this forum.

I registered on SDN because I have found it to contain valuable information in many areas important to the medical student. I also registered in order to share what information I have gathered, in this case, with respect to the USMLE, and not simply to “register on SDN in order to promote my own website”. Unfortunately, I have been denied a means to make further contributions to SDN.

Kind Regards

------------------------------

DrMom's explanation for the deletion was as follows:

SDN's policy is to close accounts of anyone who registers for the sole purpose of advertising something in the regular forums. We do not give warning because it is a blatant violation of the Terms of Service for the site. We consistently count webpages in the same category as a product or service. I don't even usually send an email, so you got more consideration than most.

As you can see, she fails to understand the underlying issues at hand:

i) What difference does it make if you post a link in your message or beneath it, in your signature? Why does one constitute a violation of the terms of service, while the other, is an acceptable practice?

ii) How can you determine if the sole purpose of registering to the SDN was for advertising if you summarily deleted my account, denying me the opportunity to make any contribution, advertising or otherwise?

However, I do feel quite humbled that I, a lowly medical student, deserved the consideration of an electronic correspondence from her magnificence. How privileged I feel to have received this email from DrMom (according to her publicly viewable signature, a 4^th year student from the world renowned Oklahoma State University-College of Osteopathic Medicine, and… the “Official Mom of SDN”).

Update from ECFMG

2005-12-02T05:30:00.000-08:00

I received an email from the ECFMG today confirming they had received my online application. Oddly, they address me as "doctor" which makes me feel a little weird, since I haven't graduated from medical school yet. The standard form letter continues to state, in that charmingly personal way that the ECFMG does so well, that once they receive Form 183 in the mail, they will review the entire application within 10 calendar days and will send me written notice of the outcome of my application. It's just a waiting game from here. Hopefully the mail won't get lost on its way to Philly, providing the medical school office has even posted the letter. (I should really check on that). You can track your status using your unique Application Identification Code on the On-line Applicant Status and Information System (OASIS). Or can you...? Please refer to the image below.

Apparently, someone isn't using my $695.00 very effectively.

More on the now Infamous Form 183

2005-11-30T15:39:00.000-08:00

As a starving medical student with only the merest of provisions, I was forced to venture into the much dreaded public computer lab, aka germ central, to print off a copy of Form 183. Sounds simple enough, doesn't it? Well go ahead, try it. See if it works for you. I printed the page 3 times and each time the right margin was cut off. After fiddling with the page settings, I was finally able to print the now infamous form. Phew.

Now for the passport photo. Conveniently, there was a coin-operated photo booth on campus and for the low low price of US$9.00 (using today's exchange rate and rounding up to the nearest dollar) I was able to obtain 4 glamour shots that you might just see on the next cover of Vogue (or GQ. Am I a man or a woman?) I glanced at my watch and noticed that the time was suspiciously close to the end of office hours at the medical school. Running frantically towards the opposite end of campus, I reached my destination, hair still immaculately coiffed. My skill in arts and crafts, acquired during my formative years in grade school, served me well as I dextrously taped (not stapled or paperclipped! -- read the instructions carefully) my photo onto the page. I was surprised at how receptive the administrator was to completing the form, even offering to mail it directly to the ECFMG in Philly. I am not sure what the next step is. I will keep you informed.

What is Form 183?

2005-11-29T10:31:00.000-08:00

That's correct, says Alex.

Form 183 is the next bureaucratic hurdle in this game we call "Who wants to be a US certified medical practitioner", sometimes referred to as "Who wants to make $250,000 / year?" (It's not about the money. It's not. Seriously. It's not.) It is a certification statement that needs to be signed by your medical school and then needs to be sent back to the ECFMG in Philadelphia, USA, along with a passport photo, saliva sample and some fingernail scrapings. Ok, I made the last one up. It needs to be mailed within 4 months (I think) of submitting the credit card payment of US$695.00. I'll go to the medical school office tomorrow. Let's see what their turn around time is like.

Registration Continued

2005-11-28T09:56:00.004-08:00

Ok, I'm glad to report that I received my confirmation number from the ECFMG today. This means that I can now BEGIN the application process. Everything else before this was just part of the pre-application to see if you're eligible to write this exam. Isn't it comforting to know that you're just an average Joe? No express line in this operation. No pre-boarding, even if you're that obnoxious kid who doesn't deserve to get on the flight before everyone else. This is the ECFMG baby! The last bastion of egalitarianism on this thing called the internet. Ok, gets back on track here. Focus. It took about 20 minutes to fill out all of the forms with my details like my address, phone number, name of medical school...etc. I thought I might have to pick an exact date for the exam but it's actually pretty cool: you get to pick a 3 month eligibility period, so pick wisely. I picked the Jun-Aug period. You never know, I just might be sitting beside you while you are sweating it out trying to remember how many ATPs come out of Krebs cycle. Anyways, after all of this anticipation just to get the application started, I got the big reward: a $695.00 charge to the credit card of my choice! Nobody said becoming a doctor would be cheap.

Happy Belated Thanksgiving

2005-11-26T02:23:00.000-08:00

For the Americans who visit here...Happy Belated Thanksgiving!...gobble gobble. We don't have turkey where I am (where am I anyways? -- that's the point! I'm not telling you. But if you keep reading you'll see clues hidden in the message. Maybe at the end of all of this, I'll publish my google earth co-ordinates) I celebrated thanksgiving with saag aloo and rolo icecream. I'm still waiting to hear from ECFMG...

ECFMG

2005-11-24T13:58:00.000-08:00

Ok, I finally got the nerve to go to the ECFMG site. For those of you unfamiliar with the ECFMG, they are the Educational Commission for Foreign Medical Graduates, essentially a clearing house for the applications that flood into the USA every year. After selling my soul to the...emm...I mean..registering my contact details, they've said that they'll check out my info and get back to me within 1-2 days. It's all uphill from here on!

First Post!

2005-11-24T12:14:00.000-08:00

Hi,

I'm starting this blog to record my progress as I prepare to write the USMLE Step 1 as a foreign medical student. What will make this different from all the other USMLE blogs out there? Hmm...well why don't you read it and tell me? If you want me to spoon-feed your opinions to you, maybe you'd be better off watching Oprah or Dr Phil. Actually...well, for one, I actually tell you about the hell that is the administrative / application process, as well as the studying. I'll be doing all of this while I balance a baby seal on my left foot. (since this is the year 2005, one could theoretically expect it to be non-clubbed. Now...am I talking about the baby seal or my left foot? You'll never know. muaahhh! Keep reading and I may tell you)

I was saying boo-urns.

QED :)