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USMLE Step 1 Strategies

April 7, 2014

The following is a guest post from my friend Kene Mezue, MBBS, MSc who is a graduate of University of Nigeria and Anglia Ruskin University and who successfully matched in internal medicine in 2014. Thank you for this post Kene.

Step 1 Exam Experience.
1. Map out a workable plan/schedule right from the beginning based on your pace (from previous experience). Note that a 2000 item Qbank usually takes at least 200 hours to finish. A First Aid read can take about 10 days depending on your speed. Aim to read First Aid in detail at least twice.
2. When doing questions in practice, cover the answers (using your hands if necessary) first. Try to guess the answer to the question before looking at the options.
3. When you have long questions, read the last sentence first. Then read the whole question…then paraphrase the question, note as many aspects of the question as possible…think this way – if I was the one who wrote this question, what am I actually looking for?
4. Note the trigger words in the stem – the “CLUES”…they could be Age, Gender, Ethnicity, Pathognomonic characteristic, etc. USMLE questions tend to stay true to character and reality…very unlikely to have red herrings and that is a plus.
5. When doing question banks, do them random, timed.
6. Choose the obvious answer if it is there…most times, there is no “catch”.
7. Use a piece of paper to note your thoughts as you read through a question (a writing pad is provided at the exam centre for the same purpose).
8. Avoid fixation. When you read a question, don’t get stuck on ONE detail amidst others. Take the whole picture. If one detail stands at odds with the vast majority of details or the overall trend of thought of the question, ignore that potentially misleading detail.
9. A good number of questions and their options boils down to making “bets” and playing “odds”. Learn the art of making intelligent guesses…it helps.
10. Use the NBMEs both as a learning tool and an assessment tool. It is a learning tool because the concepts from the NBMEs are very frequently retested on the exam. Use online forum discussions to see the trend of thought of your other colleagues on the more difficult questions. The NBMEs are also the most reliable tools for assessment of your progress during study and your readiness for the exam. Do at least two of them and the last one at least two weeks before the exam to give you time for corrective study.
11. Use the commercial question banks as learning tools – not as assessment tools. Read through the explanations as thoroughly as you can. Remember that the exam is about concepts and trends of thought and not really about random facts.
12. Build your stamina…Step 1 is a marathon…8 hours is a LONG time…it really is.
Indispensable – First Aid, USMLEWorld Qbank, NBMEs, Discussion forums
Very Helpful – A second Qbank (e.g., USMLE Rx QBank, Kaplan QBank), Goljan Audio and Book, Pathoma.
May Be Helpful – Kaplan videos, Review programs (e.g. Falcon, DIT), WebPath slides.
Avoid – other mediocre Qbanks (waste of time), reading big textbooks (check only the most important stuff up), too many mnemonics (insist on understanding concepts).

The views expressed on this post are those of Kenneth Christopher, MD and do not necessarily reflect the views of his employer Partners HealthCare, his hospital, department or division. I have no relationship with any commercial entities associated with this post.

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