Tuesday, 7 February 2012

Studying for the USMLE steps 1, 2 and 3

My scores:
Studying for the USMLE steps is a tremendous challenge. It requires time and commitment to a great extent and the outcome of the exam decides largely the outcome of your residency dream. I scored well in my exams, step one and two CK were 255 and 254 respectively. Step 3 score was not as good because I was distracted with preparing for my thesis and doctoral defense. In addition, I was working with the slightly misguided notion that it was enough to pass the step 3 exam, which is correct, but poor score-pass step 3 can still stand out on your CV. These are some tips for folks who are preparing for steps.

Steps 1 and 2:
Preparation for step 1 and 2 was hard-core effort with spending 6-10 hours at least every day reading for 4-5 months. It is a good practice to mix the mode of learning as you can develop sensory fatigue with any one medium (print versus audio versus video). Read for two hours and then listen to videos or audio lectures. First aid for the steps was a constant companion and is must to know from cover to cover. I used Kaplan online question bank for the questions and took the practice exam NBME 3 months before and 1 month before the actual steps. This allowed for identification of subjects and topics that needed extra help and enough time to focus my energy on these topics to score well.

Step 3:
My preparation for step 3 was rigorous. In brief, Usmleworld online was good for both questions and clinical case scenarios. This time the approach was different.  While preparing for step 1 and step 2, I did forty-five questions together all the time (like one block session in the actual test) from all the specialties and subject questions pooled together. For step 3, questions were answered based on the subject to identify weak links right away. Subjects that were lacking were surgery (quite surprising), psychiatry and behavioral medicine. Extra attention was paid to questions and topics from these three. Four months before my test I took the NBME to evaluate my strengths and weakness and used the next 3 months to hone the skills I was deficient in.

As for books that were referred to, CMDT and Washington manual of therapeutics were a staple, along with a multitude of random books from the library like step 3 secrets, blue prints, step 3 Q and A. FIRSTAID was read in the beginning and then read again just before the exam. read about on the best time to take step 3

Forums like usmleforum; SDN etc were a decent source of questions.

Useful tip:
White board makes a wonderful tool
Here is a very practical tip for those studying for step 1, 2 or 3! Buy a big white board with some dry erase markers (blackboard and chalk will suffice just as well). When every you are reading about a topic, make a flowchart or an ideagram. Drawing an algorithm or flowchart will consolidate your knowledge. After it is complete, take a picture of it with a digital camera. That way, all you have to do is look at the pictures of these concepts that you had drawn for easy recall. An entire chapter conceptualized concisely in the palm of your hand!

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