How NOT to Take Step 1

0

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.

 

USMLE-Rx Step 1 Qmax Challenge #3265

13

Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #3265A 26-year-old recent immigrant from China presents to the emergency department with a 3-week history of fevers accompanied by night sweats and chills, weight loss of 2.3 kg (5 lb), and cough that is often productive of blood-tinged sputum. Bronchoalveolar lavage is performed and an acid-fast stain of the sample reveals the organism shown in the image.

Which of the following should be included in this patient’s therapy to prevent a common toxicity of treatment?

A. Cobalamin
B. Pyridoxine
C. Vitamin B1
D. Vitamin C
E. Vitamin E

———————–

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

So You Need to Reschedule Step 1

2

By Mark Ard

Every year, students schedule their Step 1 exam in high (anxiety-ridden) hopes that they will be able to coalesce and synthesize two years of knowledge in just one to eight weeks of dedicated prep time. It’s stressful. In fact, you may not have known how stressful it was when you scheduled your ideal test date months in advance so you could enjoy three weeks of vacation and work on your tan before rotations. Maybe you need more time to study, and that’s ok. Don’t let people drag you down for wanting to work harder.

Or maybe you got to the testing facility and they called your name (game time!) only to tell you to go home, the security camera isn’t working, you need to reschedule. After you salvage your heart from its resting spot on your pyloric sphincter, you need to deal with Prometric in a cool calm and collected way.

(more…)

USMLE-Rx Step 2 Qmax Challenge #21025

8

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 2 Qmax Challenge #21025A 2.5-month-old boy is brought to the emergency department for evaluation of fever. Two days prior to admission the patient developed a fever to 39.1°C (102.3°F) and became irritable with nasal discharge and decreased oral intake. His birth history is unremarkable. He lives at home with his mother and 6-year-old brother, who attends elementary school where several kids have been absent recently for illness. His heart rate is 137/min, blood pressure is 72/48 mm Hg, respiratory rate is 35/min, and rectal temperature is 39.3°C (102.7°F). Neurologic examination is remarkable for a lethargic-appearing child who is responsive to stimulation. His anterior fontanel is open and bulging. The resident caring for the patient is certain that he has acute bacterial meningitis and orders a lumbar puncture.

Which of the following cerebrospinal fluid results from the lumbar puncture would be most consistent with acute bacterial meningitis?

A. A
B. B
C. C
D. D
E. E

———————–

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

Perseveration, or Perseverance?

1

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?”

As we’ve discussed before on FirstAidTeam.com, including this post by editor, Walter Wiggins, an important part of studying for Step 1 is setting a schedule and sticking to it!

Let’s take a moment to talk about what happens if you feel “stuck.”

(more…)

USMLE-Rx Step 1 Qmax Challenge #3243

32

Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #3243A 72-year-old man with a chronic cough comes to a local clinic complaining of a sharp pain in his ribs that started this morning after he had an episode of severe coughing. He notes that he has also been feeling very fatigued lately and has lost 10 lb (4.5 kg) in the past 3 months. The physician orders a chest x-ray, which reveals a rib fracture on the lateral view. Suspicious, the physician then orders a bone marrow biopsy. The results are shown in the image.

Which of the following additional pathologic findings is this patient most likely to have?

A. Aplastic anemia

B. Hypercalcemia

C. Hypocalcemia

D. Reed-Sternberg cells

E. Severely elevated prostate-specific antigen level

———————–

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

 

 

Finding US Clinical Electives for IMGs

3

By Fady Akladios

As an IMG who has been through the residency application process in the US, I have learned the importance having US clinical experience (USCE) firsthand. I have almost always been asked the same question in every single interview: “where have you done rotations in the US?”

Having USCE not only gives you more exposure to the health system in this country, but it also gives you more of an edge as an applicant by enabling you to meet program directors and obtain letters of recommendation from American programs.

(more…)

Go to Top