Study Tips

Annotation Nation


By Tim Durso

Annotation NationOne of the greatest challenges in studying for Step 1 is deciding what information is worth trying to remember. In an ideal world, you’d be able to memorize every bit of information you come across the first two years of med school, but if you could do that you’d be playing blackjack in Las Vegas with Tom Cruise instead of cramming your brain full of lysosomal storage diseases (that’s a Rain Man reference for those less movie-inclined). One of the best ways to machete your way through the thicket of medical knowledge out there is to annotate your handy-dandy version of First Aid (see here for the latest and greatest version).

While everyone agrees that annotation is an essential part of the sacred rite that is Step 1 studying, everyone seems to have a different approach. I’m going to try to help analyze some of these different approaches, and hopefully you’ll come away with a better understanding of what might work for you in your preparation. To accomplish this, I’m going to borrow elements from the famous children’s tale of “Goldilocks and the Three Bears.” If you haven’t heard of this story, call your parents and ask them why, and then Google it before reading further. (more…)

Start Early and Do Lots of Questions: Acing COMLEX and USMLE Prep


By Ryan Nguyen

Many osteopathic medical students at the beginning of their second year struggle to come up with a game-plan to prepare for the COMLEX Level 1 and USMLE Step 1. With a disturbing number of resources and study plans to choose from, how can students determine what strategy will maximize their board scores?

Early in my second year, I scoured the depths of the internet pouring over the study schedules and tips of past test takers. I was looking for “the one,” a study schedule that would get me the scores of my dreams. The dirty secret to success? There was no one study plan that triumphs above all. While they all varied in their day-to-day plans, study plans from top scorers all echoed the same two principles: start preparation early and do lots and lots of practice questions.

This post is dedicated to when to start preparing and how many practice questions to do. (more…)

Study Timing: How Soon Is Too Soon?


By Tim Durso

Study Timing - How Soon Is Too SoonThere’s one age old question that inevitably creeps into the forefront of the (admittedly neurotic) mind of many medical students during the pre-clinical years:

“When should I start studying for Step 1?”

For a question that seems so universal, the answer is far from it. I’ll give you my perspective on the issue, and granted it it’s a sample size of one (great time to review study power in your handy-dandy copy of First Aid), but it’s a strategy that put me in a position to exceed even my own expectations on test day. (more…)

Feeding your Long-term Memory


dan heckman picBy Dan Hekman

First Aid Express Lecturer

MCW Dermatology Resident

Over the past couple of years, countless second year medical students have plagued my inbox with questions regarding USMLE Step 1 advice and studying strategies. After contemplating for a while about whether to just ignore them all, I ultimately decided to be a good guy and provide them with a studying strategy that I discovered during my time in prison—I mean—second year of med school. Through a great deal of trial and error, I finally stumbled upon a pretty solid plan of attack that has helped quite a few students and may also help you. If not, then forget what I’m about to tell you (pun intended)! My strategy was designed specifically for med students, but I also feel that it could be applied to broader topics ( Now…are you ready for the most memorable (hopefully) experience of your life??! Too bad! Here we go!


Step 2 Clinical Skills PROtips


By Jocelyn Compton

Step2CS4thEdStep 2 Clinical Skills is the final national examination we take as medical students. It is required for most medical school graduations.

According to the USMLE website, “Step 2 CS uses standardized patients to test medical students and graduates on their ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues.”

On test day, you’ll see 12 patients for 15 minutes each and then have 10 minutes to write a note. Many medical schools will provide mock exams to help prepare their students; others encourage students to use a clinic day at a primary care physician’s office to simulate test day. However, inevitably Step 2 CS will present a few surprises that are unlike the real world clinic patient. This is entirely because Step 2 CS is not the real world clinic.


How to Not Freak Out While Prepping for Step 1


By Luke Murray

How to Not Freak Out While Prepping for Step 1So, you’re sitting down to start studying for Step 1 and you’re freaking out. That’s understandable. I sure as heck did. It’s the most important test that you’ll take on your journey to becoming a physician.

The problem with worrying was that it hurt my chances of not just success on the test, but on my quality of life and attitude surrounding all things Step 1. I remember getting overwhelmed with information and so concerned that I hadn’t read enough that I would just bang through material without understanding anything. I also remember being a nervous wreck whenever I wasn’t studying, making me a burden to be around. I even pouted about not doing as well as I’d liked despite all the worrying I’d done, while others did better and seemed to stress less. It was as if putting myself through all that (unnecessary) mental anguish made me feel like I deserved to do better.


How NOT to Take Step 1


By Jocelyn Compton

test anxietyI’d scoured the internet for every last dribble of advice for Step 1 test day. I’d even read some blog posts about MCAT test day mixed in with Step 2 test experiences. I thought about braving the subway versus taking a cab to the test site, a pump-up play list, hydration, food, wearing lucky scrubs, and timing out my blocks perfectly to optimize the adrenaline surge I knew I’d nurse through the seven hour test.

I had anticipated everything. Or so I thought…

About 150 hours before my exam, I knew I had a problem. My study plan had been to generate thousands of flash cards and cram them all in the final week. For the record, this is not a good idea for Step 1. Looking around my apartment, I realized there was no way I would get through the piles and piles and piles of neatly stacked notecards. Anxiety gripped my brain. I was paralyzed.

100 hours before the exam, I got myself together. I tore through flashcards. At t minus 50 hours, I knew I wouldn’t be sleeping before the 8 AM start of the exam. This was also not the best idea I’ve had in my academic career, but I was committed at this point.

But another, more pressing problem had been brewing. The day after Step 1, I’d planned a grand trip to Costa Rica and started taking malaria prophylaxis the week leading up to the trip. What is the major side effect of mefloquinolone? Gastrointestinal distress. GI distress is certainly distressing. Every 40-45 minutes, I was running to the bathroom to eliminate what little matter was in my bowels. I couldn’t make it through a single question block. I was shackled to the toilet. What could I do? Who could help me with this personal problem?

I called my mother for advice. She counseled me thusly: “You already paid for the exam and for your trip. You can’t stop taking the pills, you can’t move your exam, and you can’t cancel your trip. Put on your big girl pants, buy a bag of Depends, grit your teeth and bear it.” Diapers. Could my situation count as a testing anomaly? Could they kick me out of the test site if I continued to experience full force GI distress? These, and many other questions ran through my mind. Throughout the night, flash cards flew as my exam approached.

I made it to the test site 45 minutes early, the last pile of flash cards in hand, haggard, tired, anxious, and dehydrated. Halfway through the exam, my calf cramped… which I, of course, assumed was a DVT. My plans for taking breaks were totally out the window. However, I am proud to report that, in a show of stunning bowel control that I think I learned on my surgery rotation, I did not need any unauthorized breaks or get marked for testing anomalies. Whew.

So, even the best laid plans often go awry. It’s doubtful that your test day will go this painfully, but be ready to change your strategy and adapt to your testing situation. You never know what the universe will throw at you.


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