Saturday, January 27, 2007

Step one experience

#105575


acedit - 07/28/06 13:44


Step 1 experience…I better start by thanking God and all of you in this forum who have been participating on this so lively and sharing your Qs, experience and worries. Yes I did take the step 1 exam on Thursday/ the 27th. It was quite an experience. What I am writing targets mainly the middle strata people like me. For those who are destined to be 99ers, this may look like a bunch of silly advices. So you may stop here and save your precious time. This is probably much more useful for the very old IMGs like me. I am not here to post questions or give specific answers to your troubling Qs. But to share my experience in general. You will find some of your answers between the lines. I have divided them into exam experience and how to study sections…so choose whatever you want to read or if you feel that it will take your time, disembark as it is going to be a really long ride….Let me say a few things about the exam itself. Well, the exam was good, but a bit tough. Harder than USMLE CD Qs and close to or similar to Kaplan, and looks like NMBE type of Qs. I was taking it with God and every time I face the difficult ones or Qs which I was not able to decide upon, I wud say…What do you think God? Then no mater what I answered I tried not to look back.I got a mixture of Qs, patho, micro, physio (many), pharm, histo, embryo and behave, some anatomy Qs. biochem was all about molecular biology, except the very few. What makes you unhappy about the exam is it is designed in such a way that you well know the subject but either you need more time to find the answer for the convoluted Qs, very long phrases and sentences, or plenty of lab results, or very few sign/symptoms, or unrelated vignette where the Qs can be asked directly. But you will some how figure out what will be the best answer if you cleverly approach it. In a nutshell, it is more like a bell curve. You will find easy ones (not many)…medium (can answer them if you don’t panic), harder (still possible to answer if you are witty), touch Qs for those…you know…What to do: From the start -have a goal ...pass, above 90 etc...If you have a goal you will reach it one day...Always imagine yourself being succeful no matter what happenes in the middle of the road...1. Before the exam: if you feel like you are not prepared, postpone but don’t do it repeatedly. You have to have to have some confidence before you decide to face the exam. 2. Avoid or as much as possible reduce panic. Believe me you can do it (with God). If you know how to do it use breathing exercise. Think of it, this is just an exam to test your knowledge and if you have spent some time preparing for it, you can pass. Try to look beyond the exam day, one day you will talk about it as if it was just another day of exam. So why worry too much and panic. You are larger than the exam. 3. Sleep well for the last three days before the exam. Don’t take too much caffeine in any form, coffee or coke etc…before the day of the exam and during the exam time. Just good enough to keep you alert. 4. Plan: plan what you will be doing on the exam day…meaning your breaks and what refreshments you are going to take with you. 5. During the exam: it is good to get to the exam place early..like 30 minutes before the start time…some times you will be lucky to get a good corner that will keep your concentration in the max (I was seated right next to the door and every time some one wants to take a break or returns from a break has to check with me…well I am not complaining…)6. Even though you already know it from the CD sent to you, it is god to spend 5 or 10 minutes on the practice session, as it will take away some of the panic and tremors…so take it as an eye opener and warming up time.7. Concentrate! And try to visualize the situation in your mind set. Then think of the best possible answer and go to the choices. You may get it right away but don’t answer it before you see all the remaining options. If you were not lucky enf to get it, go back to the stem of the Qs and see what you may have missed…it could be an “except” or “isn’t” Q.8. Be organized in responding to Qs. Don’t jump from the stem of the Q to the choices before you finish reading it and understand what is being asked. I read from some one’s posting that was not a clever way of answering Qs and it didn’t help me….it was like… “for the long paragraph Qs, you better read only the last line.” Please, don’t do that. It will disorganize you and you will more likely miss a good part of the concept being asked. You will end up spending more time on a single Q.9. If you don’t understand the Q, or you haven’t come across the concept before or didn’t cover it in your study.. or it is way far in the back of your mind, try to make an educated guess and go to the next Q. Don’t dwell on it more than 1.2 minutes unless you want to make research study about it. 10. Decide. Don’t brood too long on a Qs after you have already made up your mind or know what you are likely to choose as an answer. That is the number one killer of your time and exam score. Final answer and click to the next as much as possible within the 1.2 minutes allotted for each. After the exam: try to be with those whom you feel are closer to your heart. You will more likely feel down because what comes to your mind after the exam is what you have missed, or was difficult to answer. There is nothing you can do about but try to relax. You have done something that is all what matters. You will feel as if those 8hrs were so special or very important but that is only for you the test taker for the person next door it is just another day!Study tips…these should have been dealt with first but most people won't have the time to read such a long story so only for those interested….1. Plan! Plan! That is very crucial. If you don’t plan…life will plan things for you! And you may not like it. Try to plan even the minutest details. If you haven’t done it before and you’re in the middle of the preparation, you still need to take a few hours off your study and plan. Be specific. List down all (ALL the very minute details) the things you will have to do…reading…how many times…revision how many times…Qs which type Kaplan NMBE, etc…when to do what…Estimate how much time you will need for each and when you think you will do it. 2. Be flexible in changing your plan but not too much too often…replanning is as important as the initial planning. If this is the second time taking your exam, your plan should be different from what you have done before otherwise your bound to get the same score or not much different from the previous.3. Have a definition of what studying means for you! Is it just going through the pages? Recall half of what you read? Memorize? Conceptualize? Or is it to have a frame of the whole thing in the first round and details to follow on repeat visits? For me (though not practically so) it should be like building a house. You can’t just put every damn thing (roof, wall, windows, doors and floor) on the same day. In fact, you have to first have the plan. Then the framework. Then obvious details of the framework. Then a bit more details of the details …it goes like that till you reach the interior decoration and posses the whole of the house. If you go on through the process like that you can even remember when you did what and where you did place what. You know what I mean. Our problem is we want to gobble up every thing in one go! As pappy (Goljan) said we paintbrush the book as soon as we open it. So it all means you may have to read the book 3 or 4 times and each and every time you will surely find something new and that is not strange or you are not the only one. 4. Visualize what you are reading rather than memorizing it. Try to create a scenario. A question of your own. A patient who will have these signs and symptoms or situation…Or do some questions related to that particular subject. Questions are like staining/fixing materials.... they fix the slide of study for you. So you can create the questions while you are reading/studying. It is like seeing a case/patient with the symptoms of a disease…you won’t forget that easily.5. Review!! As much more important as the initial reading of the material and the sooner you do it the better. Best at the end of each chapter, at the end of each system, at the end of each book you are gone through. Then may be 3 or 4 weeks then after…6. Integrate. Remember, you are building a house and it is not about constructing the individual parts in several places but to place them, make them fit and create the desired end result…a HOUSE. Same thing applies in your study…you will find out that the different chapters in the same subject or the different subjects with each other are all inter-related and you should be able to integrate your knowledge. Otherwise just reading and reading won’t be meaningful….you should be able to roam around your house from one room into the other so you have to have a door linking each…7. Do lots and lots of Qs (my weakness)…and start as early as three months before your exam date. Don’t always compare your performance. Because that is not why you do the Qs. The issue here is to learn! The more mistakes you make the more you learn! So getting 75 or 85 in Kaplan may build up your confidence but it shouldn’t be the goal! The goal, as I have tried to outline above, is to make your knowledge concrete! To make you think that what you read in the books is going to happen in the real world. Finally, for those who have a family (like me)..include them in your plans...allot time for family and your study as it will eventually affect your study concentration and effectiveness. Don't forget that nobody will understand the situation you are in like you do and you shouldn't be disappointed if they don't feel your burden (friends or family)....I will add more when I remember…I will be around for the next 30 minutes and will be checking once in a while …tomorrow and then after…Hope, with some grain of salt, you will find these to be helpful...I apologize for the long posting and not being short and precise. I wish every one GOOD LUCK.

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#393080

coke - 07/29/06 01:10


thanks for the info:)

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#393053

raptor22 - 07/29/06 00:00


Acedit,thats was a good post pal,it helped me a lot!......i was tired of looking at 99ers posts....u r 1 was a PRACTICAL post!.....good luck dude!..... i wish its 98 for u :-)(not 99...i began to hate that number)....just kidding dude!

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#392984

acedit - 07/28/06 21:49


Hey sorry Saan didn't mention yours..and also to shortly answer your Q never be frustrated about forgetting what you have read already..it happens..but as I said try to visualize what you actually reading. Hey, we are dealing with disease and the disease comes in the form of a patient with compliants which could be symptoms/signs or side effects of a treatment...That should be how you study not just the subject ..got to give it some life...and that is why doing Qs helps a lot in fixing your knowledge. and you can create a scenario directly while you are reading and solve that problem as a way of revising your study...Hope that clears it for you...(I wish i have done exaclty as I am saying now...easy said than done..you know!)

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#392993

ljx2000 - 07/28/06 21:56


acedit, thank you so much for your detail, warm, helpful advice. your experience encourage me lots lots. I am a very old IMG. i graduated in 1992 and also from public health. I am so depressed these days and can't sleep last night, because I am so silly to tell my boss I plan to take board exam. and he told me to stop my work next month. It means I will get fired. Actually I even do not know yet whether i am eligible by ECFMG to take step1 becuase of the public health specialty. I really really need your help. Can you tell me how many years you studied in your medical school? which country is your medical school? would you mind sending me your triscript? I just want to know what subjects are included in your transcrip and how long time of clinical cleckship needed for the exam eligibility. Would you mind giving me your email? Maybe I will contact you in the future when I meet questions, because I believe you are warm-hearted person according to your so detail poster. I am so scared that I will be not eligible for the test and my job already lost that time. my email: xuelj2000@yahoo.com. Thank you again.

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#393001

ljx2000 - 07/28/06 22:06


acedit, thank you so much for your detail, warm, helpful advice. your experience encourage me lots lots. I am a very old IMG. i graduated in 1992 and also from public health. I am so depressed these days and can't sleep last night, because I am so silly to tell my boss I plan to take board exam. and he told me to stop my work next month. It means I got fired. Actually I even do not know yet whether i am eligible by ECFMG to take step1 because of the public health specialty. I really really need your help. Can you tell me how many years you studied in your medical school? In which country is your medical school? Would you mind sending me your transcript? I just want to know what subjects are included in your transcript and how long time of clinical clerkship needed for the exam eligibility. Would you mind sending me your email? Maybe I will contact you in the future when I meet questions, because I believe you are warm-hearted person from your so detail poster. I am so scared that I will not be eligible for the test and my job already lost that time. My email: xuelj2000@yahoo.com. Thanks.

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#392978

acedit - 07/28/06 21:43


Hey guys (sao, nickmle, raptor, espoir, dgm24, courage, cd45) I am back from my post-exam dinner party..it is late but i just wanted to say a few words regarding some of the Qs you posed. And thans for all the good wishes and encouraging words and appreciations..Important issue: we all have trouble reading back the same topic, chapter or subject i.e what we call revision. By all means do revise..read it again and again. If you don't revise, you forget. My friends, most knowledge in medicine is Acute...if you have read it yeterday....you fare better than the senior who has read it read it a month ago. And the mother of study is repetetion...and don't get bored about because you will soon see the reward and even if you have read it last week you will still find something new...and that applies for everyone ..you are not alone. Always think of your accomplishments...not your faults or failures. The only time you should think about your failures is when you are planning to improve your weak areas. That helped me to win over my anxiety.but most of all I told myself that I am going to the exam with God and if i panic that will be an insult to Him...You will never feel that you have finished studying for the exam..and am sure that is common for everyone. But make sure that you are familiar with the most important and high yield concepts. by the way it doesn't mean i have a good time in the exam because I wrote too much about it but i felt that I have to give back something for those who haven't yet gone through it so that they won't have the same problem...One last thing...there seems to be too much to download and read and go thru that is coming thru this forum..you may have to limit your reading materials as it disbalance your plan and disperse your energy. Good luck for all of you...

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#392929

saan - 07/28/06 20:56


thanks for a detailed exam experience.u must have done well in exam.i wish u a wonderful score.good luck.i m taking exam in sep or oct .when i do a subject i feel strong in that sub but when switch to next sub i feel like i have forgotten the other.i make scheduel but i get easily frustrated oh i m forgetting other n i start doing them .now i m doing systemwise like i m doing renal from patho.pysio n emryo n anatomy.what do u think is that a good planning?

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#392932

raptor22 - 07/28/06 21:05


that was a GOOD MOTIVATION dude!...goodluck to u.

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#392942

cd45 - 07/28/06 21:15


ohh acedit u seem to have had a brilliant test.. i am soo happy for you.. i hope u ace it!!!thanks for spending so much time writing such valuable advice.. goodluck

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#392914

espoir - 07/28/06 20:22


thanks so much for sharing ur experience. it's so helpful!wish you a good score!

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Firstly i would like to thank all the guys who posted nbme 3 answersHowever, i disagree with some of the answers. I want some opinion on the same.An acute b/l lesion in ret. formation of the tegmentum of the midbrain would cause_1 Insomnia2 Pain3 Loss of consciousness4 Rem sleepThe answer given is 4 but i think it is 3. i checked it out in ganong. Pontine ret. formation is asso with REM sleep.I will post some of the other questions later

A 23 yr old woman presents to her new primary care physician for her annual physical examination. The patient's history is significant for hypercholesterolemia and a father who had a myocardial imfarction at 38 yrs of age. Her previous primary care physician had encouraged a diet low in both cholesterol and saturated fat; he also prescribed a statin because her LDL cholesterol was 290 mg/dL. On today's fasting cholesterol panel, her LDL cholesterol is 200mg/dL, her HDL cholesterol is 50 mg/dL and her triglycerides are 100 mg/dL. Which of the following would be the most effective change to her daily regimen?A) Add cholestyramineB) Add gemfibrozilC) Increase the statin doseD) Remove the statinE) Return to a diet without restrictions