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USMLE Step 1 Advice for the Second-Year Medical Student

By Tsoni Peled (6th Year MD/PhD student)  Albert Einstein College of Medicine  

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Preparing for USMLE Step1

Top 10 Tips and Advice for

studying for the USMLE Step 1

1. The thing that will allow you to do well on the boards is the fact that you've been a med student for two years, not a chunk of studying you'll do in the next few weeks. So, relax! You'll do fine.

2. The secret is not to re-learn everything, but rather to focus on high-yielding material.

(So how do I know what the high-yielding material is? See #3)

3. Kaplan, Kaplan, Kaplan. In my experience, Kaplan Q-bank is almost identical to the boards. The more Q-bank questions you do, the better off you'll be. Measure Kaplan questions you will have done by the thousands (~ 1,500 ~ 2,500).
The one exception to the similarity between Kaplan and the exam is that Kaplan places a little more emphasis on nit-picky memorization (e.g., details of glycogen storage diseases) and a little less emphasis on conceptual problems (e.g., interpret this graph). This is good as your ability to synthesize data and interpret graphs is not going to change in the next month. But you do need to review those genetic disorders!

4. Do not fall into the trapof "I'll do questions after I finish going over this material first." Actually doing questions is the way you will study. You've already learned the material once ad nauseum, remember? Go ahead and spend a few hours reviewing. But the bulk of your day should be spent on questions.

5. Take notes on the answers to the Kaplan questions. Anything you don't know from those explanations -- write it down. This is what you will study from in the final days before the test.

6. Make a schedule; and schedule in enough days off and several catch-up days because you will need them. Do not put off all important life events during this month. Your sister's graduation, etc. Schedule one of your days off for those events.

Above this line are the 6 universal suggestions I stronly urge every medical student to follow, regardless of your own study style.


Below this line are four things that I did that worked for me; you may or may not like them.

7. When I made my schedule, I put systemic topics that affect everything else early, and memorization-intensive topics late. For example, Pharm, CV, and Renal were early. Micro and Rheum were in the final days.

8 . I took my First Aid to Kinko's, where they have a machine that 3-hole punched the book and another that sliced the binding off. I stuck it in a 3-ring binder and then I was able to insert pages of notes (including key charts and tables I had prepared during MS1 and MS2). I have seen many people coat their First Aid with post-its or flood the margins in tiny writing. This was a solution that worked for me.

9. A buddy and I met every morning 8-9 AM and quizzed each other off of Underground Clinical Vignettes. This probably wasn't directly high-yield, but it was great because it forced us to get up on time, and our ability to diagnose random cases from across the gamut of medicine was helpful for our morale.

10. Pharm cards were a waste of time. Way too much info. The hidden gem is in Katzung's Pharmacology: Examination and Board Review-- it has an appendix of Key Words for Key Drugs. I made my own flashcards based entirely out of this appendix and memorized them-- and it was the perfect amount of detail for the exam.

Good luck!!!

Relax; you'll do fine.

Two pieces of advice for MD/PhD students:

(A) Don't be tempted to take extra months to 'relax' or 'study'. Take the boards at the same time the med students do; you don't need to take more time than they do. Remember #1 above and think about the law of diminishing returns. After 3-4 weeks of full-time studying you will have hit the asymptote of the curve (score vs. time spent studying) and you will be putting in a lot of effort for very small payoff. Take the damn test, then take a vacation, and go start your experiments!

(B) Don't you dare think for a moment that your board score doesn't matter. PhD will not compensate for an anemic board score in residency matching. And the fact that your Step 1 scores will be five years old by the time you apply for residency will be irrelevant to the residency program secretary who hands applications to her boss in two piles: those above a certain score and those below. Make sure your application ends up in the right pile.

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