Studying for Step 1 like a Pro

I’m going to try to tell you how I prepared for Step 1 and hopefully it will help others. My goal all along has been to get higher than a 260 but I will be happy with anything higher than a 240.  I started preparing while in Maine. As we were learning about each system, I would read the section in First Aid. This would prepare me not only for the step but also virtual clinic that week. I would then try to do some practice questions related to that system usually on uworld pdfs. I am a very question based learner so it helps me to solidify information by doing questions as well as sometimes I think I know the information but when I get a question about it I realize I really didn’t know it. Besides doing that in Maine, I would study almost everyday. If you get into the habit in Maine it will be a natural transition when you get home and start REALLY studying. I know some people that slacked off during Maine and I think are really kicking themselves now. When you get access to your Kaplan qbank, start doing 46 questions (1 block) in timed mode EVERYDAY.

**Little Note about First Aid. When I was on the island, students who were in the clinicals came back and each and everyone of them said "Start dictating info in your first aid now!" Well I rarely looked at First Aid on the island and honestly do not regret not looking at it or writing stuff in. So if you are in school and haven't marked up your First Aid like crazy, don't worry! Do what works for you!

During Kaplan:

It was so hard after a 8 hour day in class to want to go home and study more but I would go to the library and I seemed to get more accomplished there. It helped having friends to go to the library with. During Kaplan class, I HIGHLY recommend going through your first aid as the teacher is teaching. It is kinda annoying because everything isn’t in the same order but I’m so glad I did this. First off, the Kaplan books they give you are kinda large when you combine them all together and who has time to reread them again?! I highlighted my First Aid and would include any other important information that was in kaplan but not in my First Aid. Now all my notes are in ONE book not 8 ;) Exception: The only book I did have a hard time following along in my first aid was Physiology. That I did use the Kaplan book just because it was moving too fast for me to flip.  I then copied additional info after class into the First Aid when I had a little more time.

Ok so after class, I would do the 46 questions and then review them. I would then review what we went over in class that day (for me it was just rereading my first aid again). If something didn’t make sense, I made note and asked the Kaplan prof the next day. Never say, “Oh I don’t quite understand it but it isn’t that important” EVERY DETAIL IS IMPORTANT J You never know what type of question is going to be asked on the step. I also need to know the Why behind everything, because its very hard to purely memorize something, I needed to understand why in order for it to make sense it my mind to remember it.

**A little note about the kaplan qbank, I know lots of my classmates chose to not do the kaplan qbank and just bought uworld instead. Many said Kaplan was too easy etc etc. Let me tell you this, most medicals students across the country do BOTH qbanks. Kaplan's is part of our tuition so why would you not use it? They say the more questions you do the better you will be prepared. Why only do 2500 questions when you could do 5000?! Saying that, I still recommend buying uworld even if you're budget will only allow a 30 day subscription (which is what I'm doing) but do BOTH, multiple times if you can!

At home:

After Maine, I spent a week with my sister and had a nice little break. The moment I got home, I started the hard core studying.  I am studying 12+ hours a day in my pajamas and probably haven’t worn make-up or done my hair in ages except to go to church every Sunday :P It’s nice to run upstairs and food is on the table waiting and then I can go back down. I’m very thankful for both my parents!  I’m still doing the 46 questions a day. I also do a system a day. I’m rereading my first aid and learning every inch of it.  It takes me awhile to read each section because I’m soaking it all in not just reading it like I had before.  Other than first aid, I bought Deja Review’s Pharmacology book. It's a review book that is set up in a question and answer format. I chose to get an extra book just because Pharmacology is something that never seems to stick.  Oh and I am using picmonic. Picmonic is mnemonics in pictures, I am a very visual learner so this works well for me. I don’t use it for every disease just the random ones that for the life of me I cannot remember a certain detail, symptom etc. They are a little crazy but make learning fun!

My plan going forward:

I have set my date for October 27, 2014. This gave me 2 months after Maine to study, which I feel was an adequate time. The school recommends taking it within 3 months of finishing Maine. I knew I couldn’t go into November or I might go crazy. I am now about a month away from Victory Day! I am going to buy a 30 day subscription to uworld and complete it in about 25 days. I am doing 2 blocks daily now and every Saturday I am doing a practice exam (Kaplan comes with 2, 8 hr exams and you can buy 2 exams with your uworld subscription as well). NBME also offers 4 hr exams for $50 each.

The hardest part about studying for the step is not getting down. You can mentally defeat yourself but you have to look towards the future and know that you can do it!! God had given me strength to continue even when I have wanted to give up or feel like I’m never going to improve. He has a great plan for me and is the reason I have gotten so far already without crashing and burning.

Talk to you all after I rock Step 1,

Laura

Mainahs Love a Wicked Good time.

Hello Everyone! It looks like it has been over a year since my last post. During school, I get very busy studying and posting gets placed on the back burner. I am off the island of St Kitts now and have already moved to and from Portland, Maine and back to Iowa again. I wanted to do a post about Portland though to give you a little idea of how it works up there.

I was able to spend May-Aug in Maine. Maine is a beautiful state and reminds me a lot of Minnesota. I wish I would have been able to go up north to see more of the state but I really enjoyed being by the ocean (one thing I was very spoiled by in the caribbean). Boston is just a 2 hr drive away and NYC about 4 1/2. I took quite a few road trips to both cities. For anyone that has never been to Boston/Maine before, the accents just cracked me up. Pahk the cahr ovah theya. (Park the car over there) :)

Boston

NYC

As far as school goes, we spend 4 months at our Portland, Maine location mostly getting hands on experience as well as completing a Kaplan test prep course. The first 8 wks of the semester goes as follows:
Monday: Receive lecture on organ system (cardio, resp, MSK etc) + occasional extra lectures
Tuesday: Virtual Clinic for 1 hr and Clinical Skills Lab (Choice of Tues or Wed)
Wednesday: Sample Cases for Organ System and Clinical Skills Lab
Thursday: Preceptor or if not in one Break!
Friday: Preceptor or Break!
*There are 2 exams (besides the entrance and exit) given over the organ systems we have studied. One at the 4 wk mark and one at the 8wk mark.

Preceptor

You are assigned a preceptor in which you go weekly either the 1st 4 wks or the 2nd 4 wks of the semester. I was placed with a Pediatrician the first 4 weeks. From what I've heard from other students, I believe it is best to get your preceptor the 1st 4 instead of the 2nd 4. Towards the 2nd part, things get a little more busy and it can be a bit harder to reschedule missed times.

I had an excellent experience with my Pediatrician. He allowed me to go into the room with the patient and complete a full history as well as a limited physical exam. I would then go discuss with him what I had talked about and then he would review some things with me and we would go back into the room together. Prior to this experience, I didn't have a lot of experience in pediatrics and this allows me to change my thinking a little because the style and type of questions you ask are very different in a pediatric setting vs an adult setting.

Virtual Clinic

Virtual Clinic was my favorite part of Maine. The school has 8 exam rooms each with a fake patient (an actor) as well as either a retired or currently practicing physician. You are paired with another student doctor and both of you enter the assigned room. One of you is the Doctor and the other is the presenter. The presenter sits in the corner and writes everything down as the doctor asks the patient for a complete history and then does whatever physical exam is necessary. During the physical exam, the doctor will provide necessary lung and heart sounds needed for your diagnosis as the patients are healthy and you won't actually hear anything abnormal. After completing the exam, you are required to come up with a list of differential diagnoses you think the patient might have, as well as tests you would like to run. You will then council and suggest necessary treatment. This was the most difficult part, as you didn't have time to walk out of the room and collect your thoughts, you had to come up with everything right on the spot without notes. After you have completed, the other student doctor can ask any additional questions or perform any additional parts of the physical exam he/her thought were necessary. They then present the case and then can either agree or disagree with the prior diagnosis made by the other student. When finished, the Doctor in charge of the room discusses the case with both students and gives feedback. 

Clinical Skills Lab

We had clinical skills lab every week either on tuesday or wednesday. We learned how to insert IVs, draw blood, intubate, give injections etc. Everything was done on fake arms but it allows us to practice these skills.

Learning to intubate!

Kaplan

A 6wk kaplan review course is offered with live professors. It includes classes from 8-4ish almost everyday. You have a break in between each section such as biochem and micro but somedays your break is a monday some days a saturday etc (and yes we went on weekends as well.) Class was good, but long as you can imagine. Sitting in one location all day listening to someone else talk is not the easiest. I can't say I enjoyed all of the Kaplan professors but some I did and learned a lot from. Not only do you have the live classes but you have access to the qbank with over 2500 questions and online lectures. 

The very first day of class, back in May, we had to take an entrance exam. This was a 8 hr, 322 question exam just like the USMLE Step 1. This exam is not counted as part of a grade but I did not study for it, instead I wanted to use it as a baseline and see how much from the basic sciences I remembered. You received your score when you finished which is a percentage and it gives you about what number you would score on Step 1. I passed which was a good starting point! At week 8 of the semester, they offer another kaplan full length exam that is optional. I improved from my first to my second but not as much as I had hoped. Then the very last day of the semester, wk 16, we took a 4 hr NBME exam. Our semester we took an NBME but I think now they switched it back to another kaplan exam.

Exit NBME

The exit is the most important test of the Maine semester. You must pass (whatever the school makes a "passing" grade as) in order to register for the USMLE Step 1. The school does this because they want to make sure that you will pass the exam that matters, Step 1. As I said before, this is a 4 hr exam. You receive your score about a week later. If you do not pass, you are required to take it again and are given 3 tries to do so. Good news was I PASSED the first time! :)

Well that was a little about semester/ adventures in Maine. I will be writing another post soon regarding my preparation for the USMLE.