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 (https://www.youtube.com/watch?v=oBnLTUIDjjQ). Now…are you ready for the most memorable (hopefully) experience of your life??! Too bad! Here we go!
By Jocelyn Compton
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.
By Luke Murray
So, 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.
By Jocelyn Compton
I’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.
By Patrick Sylvester
Alternately titled… what to do about topics you just don’t feel comfortable with!
From my own experience, and from talking to other students, a common theme that comes up during Step 1 studying is the nagging feeling that “I just can’t remember X,” or “How long did you spend on Y topic?”
Let’s take a moment to talk about what happens if you feel “stuck.”
By Luke Murray
“The hard part about writing is not the writing. It’s sitting down to write.”
- Steven Pressfield, author of “The Legend of Bagger Vance”
When it comes to studying, or any endeavor requiring great physical, mental, or emotional effort, having momentum on your side can make the difference between victory and defeat. It can also make the difference between enjoying the process and dreading every lap, every page, or every conversation, because momentum in either direction will self-perpetuate. If you’re building it in the right way, then things will keep moving that way for you with less and less effort – especially compared to the effort required to get going from a standstill (remember how the coefficient of static friction is always greater than the coefficient of kinetic friction?…well, you did when you took physics).
By Mark Ard
In the immortal words of NCAA legend John Wooden, “Practice does not make perfect. Only perfect practice makes perfect.” When it’s time to hunker down, lay the pedal to the metal, chug coffee, skip showers, and generally do things that compromise your sociability to prepare for Step 1, it’s important to remember how to study. You’ll find great resources here at FirstAidTeam.com, including books, banks, and example schedules, but here’s some tips, adapted for Step 1 from Practice Perfect: 42 Rules for Getting Better at Getting Better