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Studying for Step 1. How do you do it? What should you know before taking the exam?
Oh that’s right, I’m back. After 6 weeks of a pediatric rotation and immediately beginning Step 1 studying, I’m finally getting back to the blog.
During my hiatus I’ve come up with a lot of new ideas and topics to write about, so stay tuned! For now, I thought I’d reflect briefly on my step 1 experience and some advice I’d give to anyone who may soon face the beast.
I wanted to start with a lesson that was the most surprising during my study period.
I started my step 1 experience thinking 5 weeks to be enough to cover the material (many times) to get a really high score. While this is true, I found a fragile mental fortitude can overshadow your knowledge.
When I was taking my first few practice exams, I thought I was doing fine. I felt like my knowledge base was there. When I saw my score, however, I was disappointed – my score was lower than what I thought I had earned.
After I reviewed my test, there was a pattern. Anytime I came across a question I had no clue about, I not only missed it but I also often missed the next 2-4 questions. The worst part was that I knew the answer to those 2-4 additionally missed questions!My mindset was thrown off by the tough question and I became unfocused.
2-4 missed questions here and there may not seem that bad, but it can make a 20-30 point difference if it continues to happen over a practice exam.
Prior to test day, I told myself that there would be questions I either didn’t the know answer or forgot the pertinent fact. I, in a way, had planned for the worst. If I forgot a previously known fact I told myself it was no big deal and moved on.
Using this approach, by the end of my exam, there was a fair amount of the exam that I was comfortable with. The rest is out of my control.
This idea of mindset is not only key for test day, but it’s important to get through the dedicated period without burning out.
You may find that you’re not improving as much as you had hoped. You will have bad days where either you’re not focused or are not performing well on questions. It’s okay! It happens. Your mindset, however, will make the difference between whether the next day will be similar or not.
Positivity is key during step 1 studying.
2. Questions Over Reading:
I’ve always stressed active studying and it’s a topic I’ve spoken about extensively before. While most medical students are aware of the principle, it’s only half-practiced during step 1 studying.
A typical day during Step studying includes some first aid reading, watching a few Pathoma videos, maybe a little bit of Sketchy, and some UWORLD questions.
Out of all these resources, the questions are really the only true form of active studying.
Most study schedules, start with more reading than questions and I get that. The problem is when there is still more reading than questions in the latter half of the study period.
While it’s important to get through resources like first aid and Pathoma during the first 2 weeks, the rest of the block should focus on questions. I’ve gotten more questions right from getting questions initially wrong than I have by reading a first aid chapter again.
As enticing as it is to go through as many passes of first aid as you can, the questions will determine your final score.
Once I completed UWORLD after 3 weeks, I thought I’d go over missed questions. I quickly realized I was remembering most of them, s.o I stopped.
I then began to do USMLE-Rx qbank which I recommend if you need the additional practice (I’ll write additional posts about resources I recommend during my step 1 experience).
By test day, I had completed 2400 UWORLD questions, the 1200 USMLE-Rx I was able to get through, and an additional 1890 questions through various practice tests. This equals to almost 5500 questions I got during my 5 weeks of studying! On top of that, I completed almost 10,000 flashcards (Broencephalon + Sketchy Micro).
This was a lot of questions (and time) but I was much more comfortable on test day then if I had flipped through texts for 5 weeks. (I was guilty of this from time to time still.)
3. Be Ready To Take Unplanned Long Breaks
step 1 and rest seem to be two things which don’t mix well. To survive and thrive you’ll have to force them together.
As someone who is used to waking at 4 or 5 AM, I knew I couldn’t do that during step 1.
I aimed for 7-9 hours of sleep a night. Sometimes I had more and sometimes less, but there was no specific wake up time. Rest was more important than when I started.
Most of my days happened to start at 8 and had a long break around 12 or 1 to work out and have lunch. Other days I was exhausted by 10 AM and would go to sleep for an extra 1-2 hours to regain energy.
4. Take Care Of Yourself:
The days I felt the worst were also the days where I had more granola bars than an actual meal. Take care of yourself people!
Either make food in bulk on an off day or learn some easy quick recipes for your meals. You’ll perform better and will feel better. Corny but it’s true.
Make sure your friends can still recognize you when you come outside for the first time. 😉
5. When You’re Done Studying, You’re Done:
I tended to end my studying by 6 PM. So from 6 to 10, I did whatever I pleased.
It’s odd but med students make step 1 feel like something you’ll have to focus on 24/7 until your test day. 8-12 hours/day is what the typical student spends during their dedicated. That still leaves plenty of time to have meals, workout, and spend evenings with your favorite people or shows!
I still played Xbox during my 5 weeks, still went out with friends, went to church on Sundays, and spent time with family. You can still fit the key parts of your life during this prep!
It’s funny, I actually had more free time during my step 1 experience then I did during my pediatric rotation! Obviously, the stress makes the studying the dreaded experience it is.
Just understand that it’s important to have those core hobbies and people around you to get to the finish line!
6. Be Ready For The Unexpected:
Plain and simple, stuff happens. You will have streaks of days where no progress is noticeable. Some days will actually seem like setbacks. You may also have no motivation to study on others.I came across these at all phases of studying, beginning and end.
Dedicated studying is actually a great analogy to the actual test. You’ll have a great streak of days (questions) and then you’ll feel blindsided by other days (questions) that throw you off balance.
The better you can handle adversity and surprises during prep, the better you’ll be able to tackle the questions on the real thing.
7. Don’t Forget To Breath And Reward:
I have to be honest, I became a killer self-motivator during Step prep. My words of wisdom during test day were things of legend. 😀 My test may not have started well but I do think my last few blocks ended on a good streak.
Deep breaths and an exciting reward post-test (some delicious Indian food for me) got me through the last few blocks. I’m sure you can use them strategically throughout your study period to get you through the finish line.
These are just some unique yet simple tips I wanted to offer all my fellow peers regarding studying for step 1.
Enjoy this post? Comment below! I’d love to hear what you think + answer what question you have for me!
Thanks for reading.
Until next time my friend…
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