I Scored 258 on Step 1 in 6 Weeks. Here’s How You Can Do Better.
Scoring 250+ on Step 1 is a huge challenge. It’s even harder when you have a limited dedicated study and want to match into a super competitive specialty. When someone does it, it’s always impressive.
In this article, Daniel reflects on his journey that will take him to a top dermatology residency in the midwest. (Disclaimer: I tutored Daniel from early in his first year of medical school, and he was part of the Yousmle Online Course.) He gives his advice on not only how to score well on Step 1, but also how it fits in your overall medical training. Unlike other top scorers, he also shares his missteps along the way, so you can build on his success.
Here is Daniel:
I scored 258 on Step 1, despite having less dedicated time than most students. (We had only about 1.5 months). Delaying wasn’t an option. Plus, my goal was always to match into dermatology. (I ultimately matched into a top dermatology residency, without taking extra time). Thus, to get a high Step 1 score, I needed to be efficient, both before and during dedicated studying.
Here are some pieces of practical advice for preparing and taking Step 1. Take it with a grain of salt and take away the bits and pieces that resonate with you.
1. Step 1 = Excellent Clerkship Preparation
Many students told me that Step 1 was nothing like clerkships. They told me none of the things I’d supposedly memorize would matter in clinical practice.
I couldn’t disagree more with those who say Step 1 is unrelated to clinical practice. In fact, the keys to success for Step 1 and clerkships are the same:
- Learn things well the first time (i.e., not cramming)
- Be curious about everything you learn, even if you don’t think it’s high yield
These are the comments that residents and attendings put in positive clerkship evals. They’re the same things that will help you score high on shelf exams.
Develop good habits now, and they’ll stick with you for the rest of your medical education.
Preparing well for Step 1 sets you up for clerkship success.
2. Teaching Others Improves Mastery
Most high scorers I know agree: you have to master the material. Memorization doesn’t work on the USMLE.
To master material efficiently, find one or two people who you can teach concepts to and who can teach you. If you can teach something, you will have mastered it.
3. QBanks: Best (And Bad) Practices
Everyone uses QBanks, but not everyone does it well. Here are my recommendations.
Use Anki With Your QBanks
First off, have Anki open as you review QBank questions. Make simple cards with the answer to the fact that you didn’t know in the item. A lot of people make the entire question into an Anki card, but this isn’t very helpful – it takes too long to review. (Same thing goes for full second passes of a QBank – this is useless.)
Save these Anki cards to review during your dedicated study period. You will have forgotten the answer to most of these questions by then, a few months after the fact.
Start With Kaplan the Winter Break Before Boards
Start Kaplan at the beginning of winter break before boards. Do 40 questions a day on weekdays and 80 a day on weekends. Don’t miss days. You should finish around mid-February.
Sometimes, this is around the time that your school may administer their NBME exam. That’s good. Kaplan will teach you many of the little distinctions that are tough. (E.g., brachial plexus injuries, biochemistry. Basically, anything that has a table in First Aid).
(To read The Best Winter Break Step 1 Study Plan, click here).
Do UWorld After Kaplan, and Continue with Anki
Once you’re done with Kaplan, start UWorld with the same rhythm. You will finish by the beginning or early into dedicated study period. At that point, start reviewing your Anki cards and give First Aid a read over once.
(To read UWorld: Is Your Strategy Wrong? (I Scored 270 By Ignoring The Dogma), click here).
Don’t Use USMLERx
When I finished Kaplan and UWorld, I started doing QMax/USMLERx. USMLERx was horrible.
Scoring 250+ on Step 1 involves mastery of the material. Useful questions force you to apply the knowledge you’ve learned. Instead, USMLERx made me feel as if the key to answering questions was memorizing details. (As it did with many friends and me).
My take: Rx’s questions disincentivize good interpretation.
USMLERx May Have Hurt My Score
USMLERx wasn’t helpful. In fact, it may have actually hurt my score. Let me explain.
I completed the Kaplan and UWorld QBanks and saw my NBMEs rise consistently. At this point, I felt good on question interpretation. However, I felt a little short of details, so I decided to try USMLE Rx for a few weeks. I did the majority of the medium and hard questions and during this time saw my NBME score flatten out and then drop.
My scores went down when I used USMLE-Rx. They went up when I stopped.
Perplexed, I went over my recent NBMEs with Alec. Many of the questions I was missing were due to misinterpretation. In other words, I knew the facts well, yet was still getting items wrong.
Our hypothesis? USMLE Rx overemphasized facts and caused question interpretation atrophy.
I quit Rx. Instead, I worked exclusively on question interpretation for the last few weeks. I saw my NBME scores return back to normal. My final score was higher than any previous NBME I’d taken.
4. First Aid: Use Early, Often
There are many things I wish I had done differently in my preparation. One is that I wish I’d reviewed the material in First Aid for a unit while I was studying that in class.
There are lots of topics that you may never learn in class but that you have to know for Boards. (E.g., renal tubular acidosis for me). It’s way easier to learn something complex when you’re immersed in that organ system. In contrast, learning later during your dedicated study period is much more difficult.
My advice: read through the First Aid section for that unit by the end of each school unit. At the least, you should have a decent understanding of the material within it.
First Aid: A Quick “Pass”?
I took the last weekend right before the test and read through First Aid. I’m not sure if this helped on any specific questions. However, I think it helped me make a few more connections that I had missed during my studying.
(To read The Worst Mistake Students Make with First Aid for the USMLE Step 1, click here).
5. NBMEs: Use a “Bonus” Self-Assessment as Baseline, Familiarity
The NBME often retires a self-assessment every year in March. In other words, the oldest NBME will no longer be accessible after around late March. If you haven’t taken it yet, you won’t be able to.
If you want an “extra” NBME, take the oldest one right before starting back after winter break. This will give you a rough sense of where you are and see what the test is like.
If your school offers an NBME, you’ll be able to take up to 8 NBMEs during your studying. (The “Extra” + 6 others + your school NBME).
Also, take the last two NBMEs together, back to back, about a week before your test. It’ll be tough but will give you a sense of what the timing will be like for the test.
(To read NBME Self Assessments: Ultimate Guide for the USMLEs and Shelf Exams, click here).
6. Test Day: Relax, You’ve Been Here Before
Roughly 40-50% are simple, straightforward questions. Probably not as easy as some of the “Really?” questions on NBMEs, but not much head-scratching is required. Remember, they’re not trying to trick you. Sometimes the answer really is that obvious.
About 30% are more complicated. You will have seen variations of these before in things like Kaplan or UWorld. For example, some of the questions with 12 answer choices with ↑/↓/⟷ in 3-4 columns.
Very few depend on you truly random knowledge that does not appear in First Aid or any common resource. (Around 3% – 5-10 questions total). For example, I had a question about a random gene mutation which only appears (very briefly) in Robbins.
In other words, the “WTF” questions are few and far between. You shouldn’t stress about them; chances are no one else has seen them either.
The Most Important Questions Force You To Synthesize Knowledge
The best, most interesting questions are the remaining 15-20%. The ones that make you synthesize knowledge to understand an essential clinical point.
Just like Alec’s cards, they force you to integrate medical knowledge. These integration-type questions also make QBanks like UWorld so valuable.
These questions made me so glad I followed Alec’s advice. He told me to try to truly understand concepts and go beyond just First Aid and Sketchy Micro.
As much as you can, question everything. How does the natural function of Vitamin C help explain why we can use it for methemoglobinemia? Which GERD medication would be contraindicated in someone with osteoporosis? Which osteoporosis medication would be contraindicated in someone with GERD? Why can ondansetron potentiate serotonin syndrome even though it’s a serotonin antagonist?
These are the kinds of questions that Alec taught me to seek to understand.
(To read The Secret to Scoring 250/260+ You Can Learn Right Now: Question Interpretation, click here).
Questioning everything helps when you need to synthesize knowledge on Step 1.
7. My Most Important Advice for Preparation
Learn the material well the first time (in class), and be curious about everything that you learn. This is the highest yield of any of the advice I can give.
When you sit down and take Step 1, you can’t be processing these questions for the very first time. You can’t even be thinking about them for the second time. To do your best, you will want to have seen these questions 3 or 4 times before. That means that you’ve been processing this material for as long as possible.
Master as much material as possible early on in medical school and commit it to long-term memory. It’s tempting to cram for your tests and kick the can down the road. However, don’t expect to relearn everything during your dedicated study period.
Right before I pushed the start button on Step 1, I had a mild panic attack. I was finally going to see the questions I had spent the last 2 years anticipating. But then I thought about the fact that I had spent 2 years preparing, and that I was as ready as ever.
I’ll tell you what Alec told me right before I took the test:
When you get there on test day, don’t change a thing from what you’ve already done the last 2 years.
And in the wise words of Goljan, just play the odds.
What do you think? What are you happy about with your Step 1 preparations? What would you change? Let us know in the comments!
Photos by Mathew Schwartz, Martin Brosy
USMLE RX Step 1 Qbank 2021 Free Download
In this blog post, we are going to share USMLE RX Step 1 Qbank 2021 free download using direct links. In order to ensure that user-safety is not compromised and you enjoy faster downloads, we have used trusted 3rd-party repository links that are not hosted on our website.
At Medicalstudyzone.com, we take user experience very seriously and thus always strive to improve. We hope that you people find our blog beneficial!
Now before that we move on to sharing the free PDF download of USMLE RX Step 1 Qbank 2021 with you, here are a few important details regarding this book which you might be interested.
Here’s the cover image preview of USMLE RX Step 1 Qbank 2021:
FILE SIZE: 7 GB
Here’s the complete overview of USMLE RX Step 1 Qbank 2021:
The only comprehensive digital exam prep product created by the authors of First Aid, designed for use alongside First Aid. All 3 tools in the Rx360 study system connect with each other—and with First Aid—to help you master the content you’re learning and OWN the USMLE Step 1. Once you review a subject in one tool, Rx360 lets you explore it further it in all the other tools.
For instance, imagine your instructor introduces the topic of bacterial genetics in class. To dive deeper, you watch the Express Video—where a senior student explains it clearly and crisply. At the end of the video, you see links to the topic of bacterial genetics in both Flash Facts and Qmax.
You might also be interested in:
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USMLE RX Step 1 Qbank 2021 Free Download
Alright, here you will be able to access the free PDF download of First Aid USMLE Rx QBank 2021 using direct links mentioned at the end of this article. This is a genuine PDF (ebook) copy of this book hosted to 3rd-party online repositories so that you can enjoy a blazing-fast and safe downloading experience.
Please use the direct link mentioned below to download USMLE RX Step 1 Qbank 2021 for free. Just select the Qbanks from USMLE-Rx that you want to download now, without any redirects at all, in PDF Format:
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When it’s time to start studying for Step 1 you may be deciding on whether to use USMLE-Rx or Boards and Beyond. Maybe even both. We’re here to give you the rundown on how well the two resources have helped some students prepare for their own Step 1 exam. Specifically, we received input from two of our Campus Heroes on this question.
First, let’s dive into a comparison of USMLE-Rx and Boards and Beyond in terms of what the two services offer. USMLE-Rx primarily is known for offering a Step 1 qbank of 2,300+ questions along with two practice assessment exams. In addition to the qbank, USMLE-Rx offers video modules as an extra cost add-on for supplementing the qbank with relevant content. In contrast, Boards and Beyond is recognized for its database of 440+ videos for Step 1 content. Like USMLE-Rx, Boards and Beyond also covers multiple study approaches by including a 2,300+ question qbank. As of December 2020, USMLE-Rx offers a 12-month Rx360+ package for $349, which includes Express videos, the Qmax qbank, Flash Facts flashcards, the Rx-Bricks library, and a digital version of First Aid for the USMLE Step 1. The cost is $249 for the USMLE-Rx qbank alone. Boards and Beyond content, including both their videos and qbank, is $199 for 12 month access.
We heard from Shawn F., an M3 at St. George’s University, that working with both USMLE-Rx and Boards and Beyond can be helpful. In fact, he used both to prepare for Step 1. Shawn found that the USMLE-Rx qbank was a helpful supplement to questions from UWorld. According to Shawn, sometimes he would “get burned out with UWorld” and felt like he needed “questions that are a bit more fundamental… I feel like the USMLE-Rx qbank really helps with solidifying the knowledge base,” he said. What stuck with Shawn about Boards and Beyond was the product’s “incredible library of videos, as well as questions after each video to solidify the information.” He mentioned how Boards and Beyond does “a great job in explaining every single concept in the First Aid book” and that they “go into just the right amount of detail for information on Step 1.”
However, Shawn noted that it was important to balance the respective strengths and weaknesses of the two resources. With USMLE-Rx, he sometimes found the questions a bit too broad and general; Shawn cautioned that using just USMLE-Rx alone may not be challenging enough to adequately prepare for Step 1. Because of the impressive depth of Boards and Beyond, Shawn found that “it takes a long time to go through all of the videos.” He emphasized that it’s important to be diligent with planning how to work through the Boards and Beyond material, and that Cram Fighter was valuable for helping him stay on track while working through all the videos.
Daniel, a 3rd-year student at NYIT, also used both USMLE-RX and Boards and Beyond. He said that USMLE-Rx’s key strength was that “it is a good Qbank for strict recall on First Aid. Any answer you may look for will be found in the Step 1 First Aid book.” At the same time, in his experience, the key weakness of USMLE-Rx was that “the questions tend to not be worded well, and instead of a question bank that helps the student learn the concepts, USMLE-Rx tends to be more of strict recall.”
If he had to pick just one of the two resources to ready for Step 1, Shawn indicated that he’d have to go with Boards and Beyond. “Now that Boards and Beyond has a few Step 1 style questions for each video, I really believe it is superior (the videos and questions) over USMLE-Rx,” Shawn noted. That being said, he did say that “[t]hey both have their own uses.” He thought that it was great using Boards and Beyond for M1 and M2 years to “explain concepts in First Aid” since it “goes into a bit more detail for understanding the basic knowledge” and said that he recommends using Boards and Beyond “for a good foundation and then add on USMLE-RX for their question bank.”
Daniel’s opinion is similar to Shawn’s. He suggests choosing Boards and Beyond over USMLE-Rx “because it dives far deeper into the natural knowledge that every clinician needs to work up and treat pathological pathways instead of just pure fact recall. The questions are great for solidifying the concepts just learned.” The sentiments from both our Campus Heroes are similar to what we’ve seen on Reddit and the Student Doctor Network Forums, where discussions from multiple users affirmed that combining both sets of materials can be helpful, but for different reasons. Boards and Beyond received praise for their comprehensive video resources covering topics from First Aid for Step 1, while USMLE-Rx is favored for its qbank as a complement to First Aid.
No matter which resources you choose, Cram Fighter can help you organize them into a manageable Step 1 study plan that will keep you accountable. Sign up for a free trial today, no credit card required.
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