NRMP: Ranking program tips 2016!

1) Place new programs at the bottom as its difficult to get into fellowship from new programs (especially competitive ones).

2) Place flint programs down because of water crisis and lead poisoning in water ( heard it may take 15 years for cleaning/ correction).

3) If you have 2 programs of same standard then take area, living cost, crime rate, gut feeling about program, family ties to area into consideration while ranking.

4) Place university programs at the top as they give an edge for fellowship.

How to make rank order list for residency programs - Some thoughts

How to make rank order list for residency programs - Some thoughts

Dr. Ragu

Rank order list

I have been asked several questions regarding the match. Complimenting to what Raja Chandra posted today, wanted to do some additional worthy points

1. Should I rank a program as number 1 that sent me a nice follow up reply to my thank you email after interview?
A: NRMP designed the match to give you the best chance to go to a program where you want to go. Your ranking should absolutely depend on where you would like to go, regardless of how competitive the program was or how you performed in interview that day. Many program directors do clinical work, meetings along with residency interviews and wont have time to reply to your thank you emails. Many would reply generically like “It was pleasure to have you here, good luck” etx. Those may or may not be really true. Don’t get carried away if a smaller program replies well to you and says how good a candidate you are and would be a pleasure to have you. Go by where you think you best fit in.

2. What should be the main factors determining rank order?
A: First and foremost is your career plan. For medicine, are you planning to be a hospitalist, primary care or planning fellowships. If you are planning fellowships after IM, regardless of where you do residency, 95% will match if you apply to endocrine, rheum and 100% will match in nephro, ID, geriatrics(they have lesser number of applicants than spots). The most competitive one is GI, followed by cardio, hem onc and pulm critical care in that order. Consider programs with in house fellowships first. Even if it is a small program, having in house fellowship will allow you exposure to fellows for academic research and boost your CV. You have high likelihood of getting better letters in programs with in house fellowship.

Another important factor to consider is family. Remember that residency is very stressful and you have to survive in that town for 3 years minimum. You will have days where you need a lot of support from friends and family. Some programs are incredibly well united where residents have good support systems and gel along well for fun and moral support. If you have close family member close to a program, you should probably consider it strongly. Also programs in small towns away from big cities can be very boring. If you are a city type of person, you may have to rank such programs higher. Of course, there are a lot other priorities for others. This is a general outline.

3. Should I go for second look to programs that in top 3?
A: It may or may not be helpful. You can request the programs to come for second look but remember if they say yes, you absolutely have to go. If you are planning to go back to home country after interviews, don’t risk requesting second look and not being available to go if they say yes. Some programs rank these candidates higher but those were the days when very few ppl went for second looks. Given volume of requests these days, programs may not really consider it as strongly. Some programs give second look to select few who they ranked higher.

4. J1 vs H1 program in ranking?
A: eternal debate. I am not gonna go into full details. If you are very career oriented and want one of the competitive fellowships, go for J1. If you are considering only a career in hospitalist or primary care, take H1. That being said, waiver jobs are still available on J1 in plenty for primary care.

5. Should I rank highly a program with no in house fellowships but gave me better vibe on my interview day vs a better community/university program with in house fellowships but I didn’t feel the connect that day?
A: This is a difficult answer. Do the vibe on interview day really matter? Probably not. Should you base your rankings on it? My personal opinion – def not. There are some programs where residents would say there are lot of internal issues and you probably are better off avoiding ranking them high. But your interview day experience can vary from poor to excellent depending on subtle things that you may not realize(like commute, no one welcoming in the morning, truncated tour of the facility, poorly made lunch sandwich). It is not in your best interest to make a huge decision based on that single day. Second looks may give a better opinion if you are confused whether to rank that program high or not. But you should go with your career goals and rank programs that fit in your criteria






ROL - Rank order list entry starts tomorrow and the final submission is on 24th Feb. There seems to be a lot of misconceptions. So, here you go.
1. Your match probability won't be affected by when you make your list. You can make it on 24th Feb itself too.
2. Can you rank programs that didn't offer you an interview? Yes, you can.
3. Does ranking programs which didn't offer you an interview increase your chances of matching? No, it doesn't. Let's say you wanted to marry Angelina Jolie and created your wedding invitations accordingly. On the day of the anticipated marriage you can suit up and go to the venue with friends and family, but Angelina Jolie wouldn't turn up. Because, she had no clue that you exist!
4. Should you rank based on where you want to match or based on where you think you have higher chances of matching? It's advised to rank programs based on where you want to match.
5. What is the difference between ranking based on where you want to match and based on where you think you have higher chances of matching? Either way, It won't affect your chances of matching overall. But, it decides where you would end up matching. So, rank the program you like the most at the top even if it is Harvard and you are an Img with bad scores.
More simplified explanation: Let's say you had 2 interviews, one from Harvard and another one from a community hospital. Scenario1: You love Harvard and so you ranked Harvard as 1st choice. If Harvard ranks you high enough then you will match there. If Harvard doesn't rank you, then the algorithm would check if the community hospital ranked you high enough. If you were ranked high, you will match or else you won't match at all.
Scenario2: You love Harvard but you ranked community hospital as 1st choice since you thought Harvard wouldn't rank you. Now, if the community program ranks you high enough then you will match there and you will lose an opportunity to match at Harvard even if Harvard ranks you number 1 on their list.

USMLE‬ ‪‎Step1‬ Experience Score: 256

USMLE‬ ‪‎Step1‬ Experience Score: 256

Study Materials:
• Kaplan videos and lecture notes for all subjects except Pathology.
• Pathology: Pathoma videos and lectures + Goljan audio and Goljan 125 page transcript.
• First Aid 2013.
References: (used on an as needed base for topics not understood from study materials)
• Goljan's Rapid Review of Pathology
• BRS Physiology (Board Review Series)
• Lippincott's Illustrated Reviews: Pharmacology
• Google Images (seriously!!)
• Others:
o Medscape, NEJM, Wikipedia
Question Banks:
• USMLEWorld QBank: Online QBank for 5 months (3 months are fair enough, however I had several interruptions so I subscribed for 2 extra months because I didn't finish my first pass in the first 3 months)
• Kaplan QBank offline:
o Most of: Biochemistry and Genetics, Microbiology and Immunology
o Few of: Pathophysiology, Pharmacology, Statistics
o None of: Pathology, Physiology, Anatomy, Embryology, Histology and Behavioral)
NBMEs (CBSSA): All forms taken online.
• Form 15: 18 October 2014 - (251) – performance profile included.
• Form 13: 26 October 2014 - (254)
• Form 16: 1 November 2014 - (251)
• Form 7: 12 November 2014 - (254)
UWSA: online.
• UWSA 2: 12 October 2014 - (257)
• UWSA 1: 21 December 2014 – (265)
Actual Step 1 Exam: 28 December 2014: (256) – performance profile included.
Timeline: I prefer not to mention this because it might be disappointing. I wasted too much time due to multiple interruptions during my preparation plus a bulk of time wasted at the beginning, when I used large, exhausting, low-yield resources until I read recent examinees' experiences (in this group) and followed them.
Tips and Advices
(The next part summarizes in points what I learned during my preparation; my mistakes and ways to avoid them in my opinion)

Advices Regarding Study Materials:

1. Before starting, choose among the study materials mentioned in the various experiences in this group. They are more than enough. Big text books are never good for exam preparation. Using Lange for physiology or Lippincott's illustrated reviews for biochemistry and pharmacology are probably terrible ideas, unless you have done them already during coursework.
2. The choice of your study resources should only be based on your own personal preferences. Pick up a resource you feel comfortable with, a resource that you feel more friendly. Avoid studying from a resource that you don't like or can't handle just because it has more recommendations. A good example is pathology. I've read many experiences (in this group) about people who scored 250+, and each one of them studied pathology from a single resource whether Kaplan, Goljan or Pathoma. So pick up the one that "appeals" to you the most and "master" it.
3. Avoid using more than one study material per subject. If you use other materials for reference only, that is fine. Mastering 100% of the material in Pathoma alone is better and more time efficient - in my opinion - than accomplishing 90% of Pathoma and 75% of Goljan (as in my case).
4. In your first read, start with foundation subjects (physiology, anatomy, immunology, biochemistry). Leave pathology till the end. During your revision (i.e. your second read), start with your weakest subjects and topics first.
5. QBooks (I am not talking about QBanks here) could be used best – if any – only during your first or second read. Kaplan QBank, First Aid Q&A and Robbins Review of Pathology are all good QBooks to aid the consolidation of important concepts. But they are NOT good at all to prepare you for the actual exam. To be honest, I barely used any of these.
6. Do not even try to memorize anything during your first read. Your first read has only one purpose: to understand the concepts. Spend time on understanding rather than memorization. Refer to text books, lectures, YouTube, Google Images, Wikipedia, Medscape, NEJM, etc. to understand any concept that seems hard.
7. Get the First Aid book. Regardless of whether you like this book or not, it is a treasure. I didn't like it myself. I used it as a review tool, as a study guide and as a curriculum reference.

Advices Regarding Online Question Banks (USMLEWorld)

1. QBanks – especially USMLEWorld – focus on high-yield concepts tested on the real exam. They make you able to "highlight" important principles and focus on them while doing a second reading of the syllabus. Without starting solving QBanks, you would never know what to focus on. So start solving UW early; after your first read if possible.
2. When solving question banks online, you should do them at least twice. Please do your first pass in a subject-wise (physiology, pathology, microbiology, etc.) rather than system-wise (neurology, cardiovascular, gastroenterology) manner. My first pass was system-wise and I really suffered because I had to learn new materials about every single subject in each test block I solved, so I felt messed up rather than focused on one subject at a time).
3. USMLEWorld QBank is a MUST. If you are doing only one QBank (which is more than enough by the way) it is USMLEWorld for sure.
4. How to study the UW QBank is what makes a big difference - in my opinion. You must master the contents of this bank. To do this, for every question you solve you should:
• know why the correct choice is correct.
• know why all the other choices are incorrect.
• read the question stem itself and get used to the "key words" and how to interpret what they mean in a flash.
For example, in the exam they are less likely to tell you: "the patient is in shock", but they are more likely to say: "blood pressure is 90/60 and pulse is 120".
They are less likely to say: "the patient is complaining of proximal muscle weakness" but are more likely to say: "the patient finds it difficult to get up from a chair or comb his hair".
• read other information provided in the explanation of each question even if they seem "irrelevant" and have nothing to do with the concept of the question.
• Solve full blocks (46 question per block) in a "timed" setting to practice timing.
• Memorize by hard – in my opinion – the ranges of normal values for the following lab values. These lab values are provided in the exam of course, but it would be really time-wasting to look for these values, especially if you are looking for two or more values:
i. Glucose, triglycerides, cholesterol, bilirubin, albumin.
ii. Sodium, potassium, bicarbonate, calcium, phosphate.
iii. pH, PO2, PCO2.
iv. Bleeding time, platelet time, PT, PTT
5. So to summarize: Do UW QBank two or three times. First in a subject-wise, then system-wise, then random and read thoroughly the explanation of each question.
6. If you are doing other question banks as well, remember this rule again: studying 100% of questions on UW is much better than doing 80% of the questions of two or more QBanks. I recommend using other QBanks only to repair certain defects. In my opinion, if solving more QBanks is going to distract you from USMLEWorld, please don't do it. Ensure your mastery of UW then do any of the other banks you want.
7. If you are that kind of person who likes to take down notes from the QBank, please, try NOT to do it during your first pass. You are likely to encounter these facts you are writing down over and over again and they would "stick" to your memory while doing more questions, so by the end of the first pass you would end up with notes that you are already familiar with. Take down notes during your second pass, writing down things that did not "stick" to your mind during the first pass. This will make the notes shorter and well organized. I took notes during my first pass, and ended up throwing them away and taking down new notes during my second pass!
8. No one is perfect, so don't try to be so. Start practicing USMLEWorld even if you don't feel you are fully covering the syllabus. The QBank will repair your defects.
When I say you should "master" the material, I don't mean you shouldn't miss anything. We all miss things. Just don't neglect concepts or lessons that seem boring.

Advices Regarding NBMEs and Real Exam

1. The best predictor of your actual score is a "consistent NBME scoring". If you get two similar NBME online scores, that's your most likely score if you take the real exam (in shaa' Allah).
2. Never engage in a discussion regarding an NBME question on this group unless you have done it before. NBME is meant to assess your actual level and their test forms are limited in number. Solving an NBME test, which contains many questions that you have "seen" and "discussed" before might overestimate your NBME performance and give you a false high score.
3. This advice is intended for those who are anxious and get their brains blocked sometimes. It worked somehow for me. If it doesn't suit you, please ignore it. If you decide to use it, please start applying this advice during your early online QBank practicing to make sure it is OK for you and has no negative effects:
When you are confronted by a hard question, do not waste time rereading it over and over again. Do not get driven to despair just staring at the question wishing it didn't exist. Decide quickly that this question is not doable now, make a good hunch or even a random guess and pick up an answer, then mark the question, and move to the next question.
When you are done with all questions in the test block, return to your marked questions and try again. You will find out - in most cases - that your brain figured out a good way to deal with it.
Applying the above principle seems easy, but you must ensure you have enough time to review all of your marked questions. This depends greatly on how much time you spent to decide to postpone solving this hard question and move forward.
4. No matter how well prepared you are, you will make mistakes, even silly mistakes, so don't demonize yourself if you discovered you picked up wrong answers when it is too late. Do not let anything bring you down, you still can score high. We want to minimize – not to eliminate – our wrong answers. Always stay in focus. Always stay in good mood during the exam.
5. The USMLE is meant to test your endurance. It is an 8-hour exam with 322 different problems, each of which you have to decide a correct response in less than two minutes. The USMLE is meant to stress you out. So don't freak out; don't panic. The exam will seem harder than you expect but you will do well with good preparation in shaa Allah. There are always new experimental, hard questions that do not affect your score but could freak you out for nothing.
When is it good time to panic? NEVER!
Always cheer up and keep moving forwards.

At the end, I wish you all the best for your preparation, your exam and your life.
May Allah guide you.
Best Regards,

USMLE Step 1 Preparation Group Member
Dr. Karim Adel

USMLE STEP 1 Experience Score 262 - American Medical Student AMG

#USMLE #Step1 Experience - 262 - American Medical Student

I wanted to share my experience in hopes that it will help some others who are still fighting the good fight. This thread helped me a ton in prepping for this test and kept me motivated in times where I was feeling pretty down about all the studying.

I also want to preface this writeup by saying that I am a very average student by what is considered for a U.S. medical school applicant; I attend a small medical school that is primary care focused and is ranked somewhere around 100 in terms of annual NIH funding for research. I had a 31 mcat and feel lucky that I even got into medical school. I also know plenty of other people who had mcat scores less than 30 who destroyed this test. Natural intellect and a strong history of doing well on standardized tests is not what is necessarily needed to do well on this test--Step 1 is a test that rewards those who work hard. If you grind it out and actually learn your basic sciences well in the first two years of school, this test will reward you for it.

Resources: First Aid, Pathoma, USMLE Rx, Goljan Audio, UWorld, and ?DIT videos?

To begin with, nothing can compare with gaining a solid foundation by fully learning and understanding the material the first time around during courses. This has been stated countless times on this and other threads, but it is the truth. Taking all of your classes seriously and doing well will ultimately be the best preparation of all for doing well on this exam. Many students do not realize this until it is too late, and waiting until the last semester of 2nd year to prepare for this test is simply just not enough time to cover all of the information you’ve learned in the first two years. Additionally, when you start doing questions in the qbanks you will be shocked by how often the only reason you are able to answer some of these questions is by recalling or recognizing things from your classes, because all of the info is NOT covered in the review books.

With regard to resources (other than Rx and Uworld), I believe that the Goljan audio and Pathoma were key to my success. Some people say that Goljan audio is outdated and too old to worry about using, but I swear that dude’s audio recording was freakin gold for me. It is ridiculous just how high yield it really is. I never sat down or took time out of my classes or pathoma to listen to it, but throughout 2nd year I routinely listened to him when I was driving or on a flight or anything where I could get a solid 20-30 minutes at least of listening. Some people recommend listening to him in the gym, but depending on what you call “working out” I would advice against this. Passively listening to Goljan is a waste of time; you need to be able to listen and pause regularly to answer his questions and stay actively engaged in the lecture. I was seriously able to probably answer between 5 and 10 very challenging questions on my exam thanks to that audio, and many other straightforward questions.

I don’t have a lot to say about Pathoma that hasn’t already been stated by everyone else. The whole book is amazing and insanely succinct. Sattar is an incredible teacher, and I would argue that anyone who hasn’t gone through this text and videos is doing themselves a huge disservice in terms of prepping for this exam. I used this book as my primary means of actually learning pathology, and then I would go through my school notes once or twice prior to the exams just to memorize enough to do well on the test.

DIT: unless you have time to waste, I wouldn't bother. I went through some of the videos but most of it was pretty superficial. I would use it for areas you feel your school courses were weak in, or areas that you are struggling with. I just had some of the videos, not the big workbook and all that stuff.

USMLE Rx: I ended up completing 68% of the qbank with an overall end average of 74%, with a predicted score of 261 +/- 20 for the 95% Confidence Interval (It happened to end like this, but be aware that my “predicted score” typically fluctuated anywhere from 242 to 262). This was done on total random for the large majority of the qbank. I did a few blocks before the micro shelf just strictly on micro. I always did blocks on timed mode however. When I started the qbank, my averages were typically in the low 60% area, sometimes getting down into the mid-low 50s, and every now and again I would hit around a 70. By the end my run with Rx, I was averaging high 70s and sometimes low 80s, and only occasionally getting anything below a 70%. As many have stated, I would recommend using this qbank along with FA, and the two should basically be a single unit. For me, reading FA was a total waste of time and I pretty much never just read FA alone. 95% of the FA “reading” I did was in the context of going over it along with the questions I was doing in FA.

UWorld: I only ended up doing 70% of the qbank, and did every single block in timed random mode. My overall ended up being an 83% average for Uworld, and it really didn’t fluctuate much from when I started the qbank. I think after my first 10 blocks my overall average was 80%, so it only ended up coming up a few percentage points. I largely attribute Goljan and Rx for the reason why I was able to come into this qbank and make decent scores from the beginning. Uworld really is an amazing qbank and I wish I had more time to have finished it.

Overall, the golden ticket is this: UFAP + Goljan (do NBMEs to tell you where you are score-wise)

Practice exam scores:

· NBME 13 (~6 weeks out): 258

· NBME 15 (4 weeks out): 249 ßte fuq?

· CBSSE (given by the school 4 weeks out): >260

· UWSA1 (3 weeks out): 260

· UWSA2 (2 weeks out): 262

· NBME 17 (2 days before step1): 260

STEP1: After all the horror stories I heard about the test, I was sure I was going to get in there and it was going to be an insanely challenging, long test with huge stems and tons of data and graphs everywhere, but it wasn’t really anything like that. My test overall felt like a mix of uworld and nbme exams. It really wasn’t THAT bad. At least half of the Uworld blocks I had taken felt harder than most of the blocks on my exam. Some questions were extremely straightforward first-order questions, and some I literally had no clue on and just had to guess. If I could break it down for an average block I would say that about 20 questions on each block were pretty straightforward and as long as you had been an average student you would probably answer most all of these correctly. Another 15 or so required a bit more integrative thinking or required some little detail you had to know in order to answer the question, and then another 5-10 were pretty tough and I basically had to completely guess on anywhere from 3-5 of these. The biggest challenge I faced on my test was the ambiguity in the questions or answer choices. It was exactly like NBME practice tests on so many of the questions; you know the disease they’re describing, you know the pathophys behind it, and you know how to treat it, but then the way they phrase the question kinda leaves you thinking “well wtf do they mean by that”? Or, if its not the question, you look down in the answers and you swear that 2 or 3 of the answers are right, and then you basically end up blindly picking between two. Unfortunately it felt like this was happening pretty consistently throughout the test. You could easily narrow the answers down to two choices, but from there you just had to go with your gut. So despite knowing the majority of the diseases and pathology behind them on each block, I still on average marked like 15-20 questions per block, and almost never had the time to actually go back through all of them. I do want to also state that I tend to mark a LOT of questions in general; on Uworld for instance I routinely mark around 10-12 questions per block.

Additionally, the ethics/patient interaction bull**** was honestly some of the stuff that bothered me the most my test (luckily there wasn’t just a ton of it). Half of the answer choices sounded correct, and I just had to guess. It was not a comforting feeling at all. I also had 2 or 3 epidemiology questions that required graph interpretation and I was never able to figure out exactly what was going on and had to guess. When I left the test center, I felt confident that I passed the exam, but I still felt sick to my stomach because it seemed the score could basically end up anywhere from a 220 to a 270. I tended to feel this way after the 3 NBME tests I took as well, so I was just hoping everything turned out ok and was at least somewhere in the vicinity of my practice test scores. Overall, I want you guys reading this to realize (at least from my experience and others I know) that the test will not be that different from things you’ve already seen. Trust your uworld scores and nbme exams. Just about everyone who takes this test uses those resources too, so your percentile on uworld and scores on nbme exams will likely correlate pretty well with how you will do on the real deal. Best of luck to all of you.

Took Step 1 on June 15-- actual score: 262

USMLE STEP 1 Experience: Score 259

#USMLE #STEP1 259
Here's my experience, hoping it may help someone elase:

Exam date: June 2015
Score: 259 
Mean (SD) of US med students at the time of my exam: 230 (20)
Background: IMG (over 10 years since graduation), did a Master’s and PhD after med school and currently a postdoctoral research fellow
Total prep time: just over 800 hours scattered over 7-8 Month
Details of prep time line: I took the Kaplan diagnostic test at the end of Sept ’14 but did not get into studying till the end of Nov or early Dec’14. I am doing my postdoctoral fellowship, so have to work full time. I logged my study time and did an average of ~ 5 hrs a day summing to a total of 825 hrs over this period.

Study material:
Kaplan lecture notes (1x after watching the videos and annotating FA to some degree)
Kaplan classroom anywhere lectures of 2014 or 2010 (watched once at 1.5x or 2x speed while annotating the notes).
For physiology I did BRS + Kaplan videos by Dr Wilson
For Neuroanatomy I did High Yield + Kaplan videos by Dr White
For pathology I did Pathoma + videos (1x)
First Aid (2x overall)
Note about Kaplan videos: I mixed and matched the lecturers as some of them where better in 2010 version and some better in 2014 lectures. For example: Biochemistry: Sam Turco 2010, Behavioral Science: Steven Daugherty 2010, Pharmacology & Physiology: same lecturer and both good, etc.

Question bank:
Only Uworld
Note: Did it once in timed random new mode, barely finished it and did not get a chance to review my mistakes or go over marked questions. I started in January and continued till my exam day. My score started in the 50% and rose to over 80% over time (average 75%).

Study order:
Kaplan books + videos
Pathoma
FA x2
Mock Exams:
Kaplan Diagnostic Test (- 9 Month before starting prep): 54%
NBME form 7 offline (- 3 month): 84%
NBME form 15 (- 7 weeks): 260
UWSA form 1 (-5 weeks): 265
NBME form 16 (-4 weeks): 247 (really pissed and postponed exam from June 1 to 17)
NBME form 17 (-2 weeks): 260
UWSA form 2 (-2 days): 265
Note: I did not have time to review any of these exams. I just went over my mistakes and found the right answers. Also did not have time to do the free sample questions on USMLE webstie.

Good things:
Uworld is very helpful. Make sure to read ALL the explanations.
BRS physiology is a brilliant book.
Pathoma is an excellent book.
First Aid has most of the things you need for the exam (>85%), but you need to understand all the concepts and not memorize it. I have seen people claiming to read it 5 times or more for the exam. Personally I think quality is much more important. I just did two reads which I think was sufficient.
NBME forms are HIGHLY predictive of your performance.
Mistakes:
I don’t think you need to get into the details of Kaplan notes or annotate FA with Kaplan. I tried it initially but gave it up since it was just too time consuming.
NEVER postpone the exams! I did it and regret it. At the end my score did not change.
I think I should have reviewed marked questions in Uworld.
I sort of slacked off in the last 3-4 weeks before the exam because I was just too tired. Maybe if I had pushed it further I could have scored in the 260s. Such a shame to miss 260 by 1 point.
I think doing more question banks is superior to reading more.
Final thoughts:
Step 1 is a challenging and weird exam, the stems are much longer than Uworld and there will be questions that you have no clue about. I don’t know how to face these. Just don’t panic. It’s also a test of your exam stamina. You must plow through the questions and try to keep focused. Red bull is very helpful. Keep it in your locker and take a sip on your breaks. You need enough caffeine in your system to keep you alert but not too much to get you agitated.
That’s all! Hope my experience help the others on this forum and hopefully you can score better than I did. It’s an exam of being smart and focused, it’s not about being a book worm.

USMLE Step1 Experience - 261

#USMLE #Step1 Experience - 261

Hello everybody, My name is Hesham Mohammed Ezz. Im a 6th year medical student in Tanta Uni. in Egypt. I took step 1 exam on 15th October 2014 (Wednesday) and got my score report exactly 21 days later on 5th November 2015 (Wednesday).
I'd like to thank everybody on step 1 preparation group who provided help to others by answering questions , posting his experience and providing guidance to his/her fellow colleagues .. you are the real heros and may Allah provide you with those who will help you as much as you helped others .

So as you sow so shall you reap.

First of all I d like to confirm that I dont (and I think No one) has the ultimate right path for preparing and acing step 1 but eventually you just examine and evaluate the experiences of others and have your own experience and hope for the best.

I dont consider my experience a good one to follow as I did A LOT of mistakes in my preparation so I will only write some tips to take into consideration and some mistakes to avoid so that you may have a better preparation.

Sources:
1-Anatomy: Kaplan videos(and yes I liked the kaplan Neuroanatomy vids!!) , a PDF called ”anatomy shelf notes” someone uploaded it into the group, FA14.

2-Physiology: Kaplan videos, BRS physiology , FA14.

3-Pharmacology: Kaplan vids , FA14.

4-Microbiology: TA7 videos , Kaplan HY videos , FA 14

5-Immunology: Kaplan vids , FA 14

6-Behavioural, statistics and psychiatry: Kaplan vids , BRS behavioural , physician patient relationship and defense mechanisms from High Yield (tables of quoted examples) , 100cases of dr.Fischer , FA 14.

7-Pathology: Pathoma vids and book , Goljan slides PDF , FA 14 , Goljan tapes in hematology and musculoskeletal.

8-Biochemistry, Molecular biology and Genetics: Kaplan vids and LN , FA 14.

Q. Banks:
1-USMLE World 2014.
2-Kqplan Q bank (but not pharma and pathology).
3-rx Q bank (only biochemistry, Mol. Bio. & Genetics)

Study strategy: I would listen to videos or read a book and annotate into FA and if a topic was quite large or not written at all in FA I would write the page number or take notes from the video or take screenshots and revise it every time with FA and I did the same with UW I would take notes or write a Q number so that I revise it later, I followed this method in all subjects and in the end I had the ultimate study source (annotated FA with a huge load of extra notes and sticky notes + certain topics from pathoma or BRS or Kaplan LNs.... + number of UW Qs + a lot of screen shots from different sources)

NBMEs:
Form 7 - 620/254 - 4+ months away
Form 11 - offline , 11Qs wrong - 2 months away
Form 12 - offline, 12Qs wrong - 4+ months away
Form 13 - offline, 13Qs wrong smile emoticon - 4+ months away
Form 15 - 630/256 - 3 weeks away
Form 16 - 620/254 - 7 weeks away
Real deal - 261

Score report : http://imgur.com/vjsJ0XN

Here is the most important part in my experience ; the mistakes I ve done and how to avoid and some tips and tricks:

1-Start preparing seriously from the beginning don't procrastinate. put a plan and stick to it but also try to be flexible not to lose hope , this is to avoid taking a very long time in the 1st read that will make u feel bored , overwhelmed and disconnected from the subjects you did earlier.

2- the main goal of the 1st read is understand everything (NOT memorize) , annotating FirstAid and adding extra notes to make your ultimate study source that will be the main source of revisions to avoid the need to re-listen and re-read kaplan vids and LNs again after the 1st read.

3- Solving UW and reading the detailed explanations helped A LOT in the exam so dont deprive yourself from this amazing source of explanations and try to solve it multiple times (I did it 4 times) to truley grasp the concepts and how to reach the aim of the question.

4- The ultimate determinant whether you are ready for the test or not is the NBMEs self assessments especially the latest ones 15 & 16 not the number of reads , If you can get your goal score in 2 or 3 self assessments then you are ready.

5-The path is really long and tiring so try to remain motivated , refreshed and confident that you can do whatever anybody could do....and may be better.

Some Tips regarding subjects :

Anatomy - The 1ry source I did is Kaplan and then revised FA and remained to revise Kaplan (with FA) till just before the exam as FA is deficient in anatomy.

Biochemistry - also the 1ry source was Kaplan and it helped me A LOT especially in molecular biology and genetics and even in metabolism and nutrition I wouldn't have understood FA without studying Kaplan and also kaplan videos were super amazing.

Neuroanatomy - Despite what everybody said , I did kaplan videos in neuro and actually it helped me a lot, the guy might not be the best but he is ok, if u listen to the vids and directly annotate into FA and try to understand everything then solve UW I think you will be fine (at least thats what I did and I had absolutely no good base in neurology)

Pathology - Pathoma is super amazing especially if u have a weak background knowledge but also I would advice listening to goljan's tapes he is much more experienced and familiar with the board concepts more

Pharmacology - Kaplan videos are extremely important , every word said by dr L. Raymond is very important , I ve met so many concepts explained only by kaplan ( not in FA)

Biostats - Try to understand biostats not only memories the equations but also know what relative risk =5 means and what to conclude when OR is 4 ...etc.

Behavioural - I actually still dont know what's right and what's wrong regarding behav. I ve always got borderline/low performance till 3 weaks before the exam in it in the NBMEs (you may notice that Ive read almost every available source because it was my persistently weak subject) but in the exam I felt that the Qs are easier in behavioural than nbmes and I got high performance in the score report....may be Im just lucky.

Kaplan Q bank - it was kinda helpful ( any Qs solving is definitely helpful) but also it has large number of super wierd questions that you shouldn't waste a lot of time in.

NBMEs - try to solve all the nbmes especially those on the online site to give u an idea of how the board Qs are layed out and they are about 1200 Qs , that is a really good practice...(UPDATE) Offline NBMEs I didnt consider them accurate assessment , just to give idea about the general performance and also a great practice material ... It is advised that you do 2-3 online ones to actually assess yourself.

(UPDATE) Slides : Goljan slides pdf helped me a lot in the exam ..also did slides in FA14, Pathoma and UW... and also did Slides from HY neuroanatomy book

(UPDATE) Time management : Every Q shouldn't take more than 1 min and ofcourse there will be Qs needing more time u should just mark the answer of your initial thought and mark it then revised it in the last 10-15 min of the block , I used to mark 14-18 Qs each block and revise later and by this aproach I never had less than 12min (and in some blocks 18min) at end of the block to revise.

Finally Im not posting how long I took preparing not to disappoint any body as I did alot of mistakes in early preparing and almost total 2 months stops but If I would do it again it wouldn't take more than 10-12 months.

USMLE STEP 1 EXPERIENCE: Score 261

#USMLE #STEP1 EXPERIENCE

Exam score – 261
AN ADVICE – Everyone is different with different strengths and weaknesses make your own experience but do learn from others.
Study Time – 5 months
STUDY MATERIAL (Subject wise):-
Anatomy – Kaplan + FA + Uworld + Snell review for pelvic anatomy ( only blood supply, nerve supply and lymphatic drainage of pelvic organs and muscles)
Physiology – BRS + FA + Uworld
Pathology – Pathoma vidoes (excellent)+ book + FA + Uworld
Biochemistry – Kaplan videos + kaplan book + FA and Uworld
Genetics – Kaplan Videos + Kaplan book + Kaplan Q bank questions + FA + Uworld
Microbiology – only FA and Uworld
Pharmacology – only FA + uworld
Immunology – Kaplan + FA + Uworld
Behavior – only FA + uworld + nbme questions
Biostatistics – Uworld bistat subject review
THE BEST THING I DID was using NBMEs as a study material in addition to assessment purpose. I made their notes as well. I even pondered on my correct questions in nbmes if I was confused during solving them.
STUDY METHOD:-
WHAT IS MOST important thing about USMLE is understanding
about the High yield Things and leaving behind low yield. Stuffing your mind with too much info makes you forget high yield things. That is the reason most people with much hard work can’t score very good.
Kaplan books have too much knowledge and they don’t differentiate between Very high yield and very Low yield material and we give equal time on knowledge of no importance for exam. Actually I didn’t like Kaplan too much Except for BIOCHEMISTRY and GENETICS. They take a lot of time in preparation as well. My methodology was to study Kaplan once and did the same portion from FA, and then did same topic questions from Uworld and added important Points to my FA. Another example is I did pathoma chapter of CVS and then read pathology of CVS from FA and then solved uworld questions of pathology of CVS and noted imp. Points on FA. This helped me know that what was High yield. I didn’t revise Kaplan again except for Biochemistry and genetics and I don’t think there is any need.
LAST MONTH before EXAM (IT IS THE MOST IMPORTANT PART OF YOUR PREPARATION YOU CAN LOSE SCORE OR GAIN IT) -
> I READ FA TWICE JUST KEPT ON SCREENING THRU PAGES. DIDN’T WORRY THAT I AM REMEMBERING THINGS OR NOT.
> I SOLVED WHOLE UWORLD ONCE IN LAST 10 DAYS ONLY READING THE EXPLANATION OF WRONG QUESTIONS THAT HELPED ME BUILD THE TEMPO. 7 BLOCKS A DAY.
> I SOLVED ALL THE NBMES AND READ THEIR EXPLANATIONS MADE THEIR NOTES, SPECIALLY THE MISTAKES . I ALSO GAVE A THOUGHT ON QUESTIONS EVEN IF I WAS CORRECT.
SCORES IN NBMES AND WHAT I REALIZED FROM THEM :-
UWORLD – 1ST GO TIMED MODE SUBJECT WISE – 81%
2ND GO – 96%
NBME 15 1 MONTH BEFORE EXAM – 249 (MANY SILLY MISTAKES BCZ OF NOT READING QUESTIONS PROPERLY)
SAME DAY UWSA 1 – 254
THEN I DID NBMES AT A GAP OF 1 DAY
FRED 150 – 122/132
NBME 7 – 186/200
UWSA 2 (ONLINE) – 261
NBME 13(ONLINE) – 254
NBME 11 OFFLINE 183/200
NBME 17 ( 15 DAYS B4 EXAM ) 251 – I MADE 9 MISTAKES THE ANS. OF WHICH I KNEW VERY WELL BCZ I DIDN’T READ THE QUESTION STEM PROPERLY AND JUST RUSHED UP, DIDN’T REVIEW MY QUESTION. I CLOSED SOME BLOCKS MORE THAN 25 MIN. REMAINING. WAS DEPRESSED HERE. FELT I DIDN’T IMPROVE IN 15 DAYS BUT I WAS DETERMINED THAT WILL READ QUESTIONS PROPERLY NEXT TIME. I PERFORMED BORDERLINE IN BEHAVIOR. READ A COMMENT on this forum THAT BRS IS GOOD FOR BEHAVIOR. WHAT I REALIZED THAT USMLE EXAMINERS LIKE OPEN ENDED QUESTIONS AND THEY LIKE TO ASK MORE ABOUT THE “MOST APPROPRIATE RESPONSE”. I JUST GAVE 2 HOURS ON EXAMPLES OF OPEN ENDED QUESTION IN BRS BOOK NOTHING ELSE AND THAT HELPED IN EXAM.
NBME 16-5 DAYS B4 THE EXAM – 256 (SAME CARELESS MISTAKES , COULD EASILY SCORE 260+ IN IT). (CLOSEST TO EXAM IN DIFFICULTY).
REAL EXAM:-
BRAIN WASN’T WORKING IN THE FIRST FEW QUESTIONS (ANXIETY MAYBE) AND THEY WERE ALL GENETICS AND PSYCHIATRY LEFT THEM UNTIL I FOUND EASY QUESTION TO BUILD SOME CONFIDENCE.
FINISHED EVERY BLOCK IN 40- 48 MIN. MAX. AND THEN LOOKED AT ALMOST ALL THE QUESTIONS I THOUGHT I CAN GET WRONG. FOUND OUT A LOT OF SILLY MISTAKES I WAS MAKING IN A RUSH. (THIS HELPED ME IMPROVE MY SCORE FROM NBMES IN WHICH I WASN’T REVISING THE QUESTIONS)
TOOK A BREAK AFTER EVERY BLOCK.
LAST 2 BLOCKS I HAD 27 MINUTES OF BREAK LEFT. TOOK LUNCH AND SAID MY ZUHAR PRAYERS.
LAST BLOCK I WAS EXHAUSTED I DIDN’T USE ANY STIMULANT MAY BE THAT’S WHY. BUT ALLAH HELPED ME FINISH THE LAST BLOCK. I WAS TOO TIRED IN IT.
SOME OF THE QUESTIONS COME FROM NO WHERE ( 4-6 QUESTION IN EVERY BLOCK YOU WILL HAVE NO IDEA JUST ANS. THEM AND DON’T WORRY). WHAT MATTER’S MOST IS DOABLE QUESTIONS. DON’T WORRY I DIDN’T GET MOST OF THE “VERY TOUGH QUESTIONS” RIGHT. EVEN IN EXAM I MADE SOME SILLY MISTAKES, WAS WORRIED ABOUT THEM TILL THE RESULT.
SOME TIPS:-
> DON’T WASTE TOO MUCH TIME ON KAPLAN. FA AND UWORLD COVER ALMOST ALL OF THE EXAM
> NBMES ARE VERY IMPORTANT. SOME QUESTIONS ARE DIRECTLY REPEATED FROM NBMES AND SOME PICS ARE USED DIRECTLY FROM NBMES.
> USE QUESTION STEM OF UWORLD AS A SOURCE OF KNOWLEDGE FOR E.G. THERE IS A QUESTION IN WHICH 5 SYMPTOMS OF A DISEASE ARE GIVEN IN UWORLD , PONDER ON ALL 5, BCZ ONLY 1 OF THOSE SYMPTOMS MIGHT BE GIVEN IN EXAM . GO THRU UWORLD PROPERLY EVEN IF YOU GET QUESTIONS RIGHT. MANY TIMES INFORMATION GIVEN IN OPTION E, WHICH IS NOT AN ANSWER OF A UWORLD QUESTION, HELPS US ANSWER A QUESTION IN REAL EXAM.
I SHALL LIKE TO HELP YOU AS MUCH AS I CAN. BUT PLEASE GIVE ME TIME. I SHALL TRY TO ANSWER ALL OF YOUR QUESTIONS BUT IT MIGHT TAKE SOME TIME.
SPECIAL THANKS TO SOME OF MEMBERS WHOSE EXPERIENCE HELPED ME A LOT.