My Step 1 Experience in Final Year MBBS: Raza Shahzad (Class of 2016)

Exam Date: Sept. 7, 2016

NBME 11 offline: 248 (4 months out)

NBME 17 online: 254 (3 months out)
NBME 16 online: 243 (6weeks out)
NBME 13 online: 254 (4 weeks out)
UWSA 1 online: 260 (4 weeks out)
NBME 15 online: 262 (2 weeks out)
UWSA 2 online: 251 (2 weeks out)
NBME 18 online: 256 (1 week out)
Know what you are going to get yourself into. Quoting Conrad Fischer, if you have a wife, divorce her; children, sell them. :P
 Organize your study material and choose a study place. I’d highly recommend that you take your triad early in your preparation if you are 100 percent sure that you’ll be taking this exam within graduation. That helps set a deadline for you which is crucial given how tight on schedule you’ll be in final year. The ideal time to get done with STEP 1 is August/September of final year. Buy a six month subscription of uworld online as early in your preparation as possible. I bought it right after I got done with fourth year exams. Don’t waste time on the crappy offline version. Do FA subject wise or system wise (I prefer subject wise approach because it makes you think outside the box across different systems) and then do the relevant portion from UW. Annotate only the most important stuff from UW onto your FA. Do not torment yourself by jotting every petty detail from UW onto FA. Once you are done with FA, UW and aforementioned resources, revise FA in a couple of weeks along with annotated material on FA. See every diagram/graph on FA because each and every thing contained in there is holy. By this time, you’re all set to take an NBME. Don’t beat yourself in case you fail to procure a brilliant score :P With the passage of time, things will improve. See what areas you struggled with in NBME and specifically try and strengthen those weaknesses.
The D-Day: I was feeling a bit low because I couldn’t sleep properly the night before and I think it cost me a bit compared to what NBME 18 predicted. It’s important to stay calm and get a proper night’s sleep. Exam was more or less like UW. Time whizzed by and there I was leaving the prometric feeling ambivalent as to how I performed. But trust thy NBMEs average. Thank your family for bearing with your mood swings and enjoy because you deserve every bit of it.
Best of luck!

Real Deal: 250

Timeline: I hadn’t made up my mind to take this exam within graduation until the middle of fourth year. So after getting done with 4th year exams, I studied from February through August, a total duration of seven months. Having studied microbiology, immunology and pharmacology from Kaplan lecture notes in 3rd year and the Kaplan series for remaining subjects in fourth year, I had a firm grip over the basics. I wouldn’t delve into the specifics regarding where I stood with regards to my preparation each month leading up to the exam because it is subject to interpersonal variability in terms of retention and speed, but ideally 6-8 months are more than enough to best this exam. After this, you will burn out so refrain from prolonging unnecessarily. Try to get done with Medicine and Surgery wards earlier in your prep.

Major study material: FirstAid plus UWorld plus Pathoma

Subject wise division of resources utilized:

Pathology: Pathoma wins hands down. Cram this book well in fourth year because it’ll literally nail professional exam for you and will come in handy even for final year medicine. Try annotating extra topics from FA onto pathoma or the other way round so that you have pathology consolidated at one place which will save you the hassle of juggling between resources.

Pharmacology: FA and UW are more than enough for pharmacology. If you know the drugs well, you’ll find this section the easiest on exam.

Physiology: I’d recommend paying a listen to Kaplan Classroom lectures by Dr. Britt Wilson. This subject requires a sound understanding and application of basics to tackle questions and can be tricky with regards to up and down arrows, graphs and curves. Kaplan, UW and FA should do.

Microbiology: FA and UW only.

Immunology: FA and UW. Give Kaplan a read too.

Biochemistry: I thought FA was more than enough for biochemistry. It’s a pretty volatile subject so you’ll have to reference it back and forth as you read along. If you’re struggling with this subject, add Kaplan to the list.

Genetics: Probably one of the most feared section on the exam. Try practicing pedigrees well from other question banks if possible in lieu to FA and UW. Supplement it with Kaplan.

Anatomy: The most unpredictable section on the exam. There’s not really a single resource (or even a combination for that matter) that will completely cover anatomy portion. I studied Kaplan, FA, UW, Anatomy Shelf notes and Snell’s review. FA for histology and embryology would do. For neuroanatomy, Kaplan, UW and FA should suffice. Do watch DIT(Doctors in Training) lectures on localization of lesion. It’ll make that horrendous looking table on strokes in FA very palatable. (Lateral Medullary Syndrome, anyone?)

Behavioral Sciences: This subject is a deal maker or breaker. Most of us don’t know the US ethics that well and this can compromise one’s score badly. Strengthen ethics from as many resources as possible- Conrad’s 100 cases, Khan’s cases, BRS (questions/answers only), FA Q&A book, Kaplan Qbank etc.

Biostatistics: I read high yield biostats prior to my community medicine written and it helped me a lot. The Kaplan section is good too. Add UW and FA as usual. Get a subscription of UW biostats review (online/offline) because those questions are the closest to what one gets on the actual exam.

Psychiatry: FA, UW and UW Step 2 Psychiatry.

Months prior: 

Subsequent months: Keep learning FA and taking NBMEs intermittently to gauge your performance. Try doing as many as NBMEs as you can. Review NBMEs because I had around 2 questions in exam straight from NBMEs. Redo UW. I didn’t do the whole of it. Made blocks of questions I had marked or gotten wrong.

One month prior: FRED free 120 questions on the USMLE website are a must do. The software is exactly what you’ll find on the test day, the questions are more or less of the same difficulty and length. Revise FA front to back in the last month, take remaining NBMEs and preferably take an NBME and UWSA form on the same day to simulate the exam condition as much as possible. You brain needs to be wired to think 7-8 hours straight and you need to sort a way out to waiver the fatigue creeping in. Redo UW.

Last week: Save NBME 18 because it’s the most predictable these days. Revise all the UW tables, anatomy specimens, histo slides etc. Flip through those pages of FA that you have a hard time committing to memory.

Day before exam: While anxiety is common, talk yourself out that you have put your everything into this and that now you are well equipped to take any challenge by storm. I listened to heart sounds the day before exam and that was about it.