|  If you could prepare for Step I again what would you do differently?- I would focus on broadening my study strategy to address areas of weakness that I encountered when doing UWorld questions. I tended to rely too heavily on "First Aid" alone when I should have sought out another review source.
- Step 1 is largely based on integrative knowledge with an emphasis on clinical application. About half way through second year, I began to focus less on the minute details presented in lectures and instead spent more time focusing on integration and application. My favorite thing to do for any given disease was to find a well written review article in NEJM or JAMA that succinctly covered pathophysiology, epidemiology, diagnosis, and management. This is the type of knowledge that will "stick" and is really what will be tested on step 1. Furthermore, it is what will be important in the long run and will be of great aid on your clinical rotations as an M3. If I could do it over, I would have studied with this way all year. I am in no means advocating foregoing Robbins. It is an invaluable text for second year.
- I would start reviewing First Aid during unit 5 (the Repro/GI unit right after Winter Break). It's a pretty light unit, and you'll have time to at least get through the Biochem section.
- When I wasn't being productive, I didn't pull the plug on "studying" as soon as I should've. When you're burned out, push back from the table and take a break.
- I would not have gone through the little subject review books throughout the school year. They ended up being totally worthless.
- I would have changed the order I used my review books in- I used First Aid first and then USMLE Secrets. I think that the Secrets book would have been better first because it's less comprehensive. I also would have gone back over the subjects I felt like I knew well closer to the exam. I ended up spending more time on the things I didn't know well, and therefore did better in those areas than on ones I knew well.
- I would take it sooner. There is a sense of "think how much more I could learn in that extra week" but when it all comes down to it, I don't actually think that is the case. There is a finite amount of material to learn and after that it's just spinning your wheels and trying not to forget faster than you learn. I had 31/2 weeks and 21/2- 3 weeks would have been adequate.
- I would have read over each First Aid chapter when it was covered in SBM, just to be aware of how much we had covered, and what additional material I might have to focus on in the future. I did focus on studying for SBM for most of the year, which for me was the right decision, but supplementing First Aid a little earlier might have been nice.
- I would stop paying attention to what everyone else was doing and how much everyone else was learning and focus instead on my study schedule and my goals.
- I would have focused more on the USMLE World question explanations. The questions in that qbank were surprisingly similar to the actual test.
- In my last month (the main month) of studying, I started off by doing Kaplan Q Bank questions each day, studied a little, then did more questions, but I was not scoring well at all and getting very discouraged. Doing practice questions is very important, but then I realized--why not approach boards studying the way I approached studying for SBM? In SBM, I always strove to learn the material as comprehensively as possible and as systematically as possible. So I went back to the basics--for each Step 1 subject, I did the chapter in First Aid, the corresponding BRS or Goljan chapter, but also the corresponding sections in Robbins were always open in front of me to supplement my review. Then at the end of the day, I did a block of 20-40 questions. It was very stressful switching to this method after a week or so of trying others first. But it ended up being the best for me. Doing 100 questions/day may not be what works for you, and in my case, doing 20-40 each day was enough.
- Exercise regularly and eat well. If you don't, you'll break down mentally and physically.
- I wish I had known that Step 1 is a straightforward and fair test.
- I would have reviewed First Aid one less time in order to review more detailed review books (such as HY Neuroanatomy and BRS Physiology) one extra time.
- I would start doing USMLE world questions earlier. Although I studied from First Aid before spring break, I started doing questions from USMLE world after spring break. Doing well on the test is heavily dependent on understanding the format of the questions – they are completely different from SBM or SF exams. Understanding the format is extremely important. For those who would like to save the world questions until later, it would also be helpful to use an alternative source (Kaplan, USMLERX) to get the format of the questions early.
- I would have memorized ALL of the tables in First Aid inside and out: the genetic diseases, storage diseases, interleukins
- I would make the USMLE World Q Bank a higher priority earlier in my studying (starting around spring break or before). I underestimated how long it would take to finish all the questions when I went through the answers thoroughly.
- I would try to have more confidence in the study plan that I created for myself, and not get caught up in the methods of other classmates. At the end of the day, realize there are no "secrets" that your classmates have that you don’t know about. Just go about your business at your own pace, knowing that you planned out your month long ago.
- I would have scheduled the exam a few days earlier, because I think three weeks would have been enough time to study and I could've spent the fourth week resting up before M3 year.
- I would have spent a little more time studying for boards over winter and spring break. I think it's entirely reasonable and possible to fit some solid study time in while still enjoying break.
- I would have paid more attention to anatomy, public health and behavioral sciences. There were a number of questions on brachial plexus lesions, obesity, diabetes, and bioethics that were new to the boards this year and were "gimmes" if I had reviewed them. BRS Behavioral Science is a must. I'm not sure what to use for anatomy, but I would emphasize clinical correlations and imaging. If you know the BRS anatomy Q's then you should be good. Remember that pathology is of the utmost importance but it's probably only 65% of the test.
- I would relax more before I started studying. A lot of people started talking about studying really early in the year and it made me feel anxious. If I could have had the confidence to know that 4 weeks is completely sufficient study time, that would have helped. Also, starting at Spring Break I read the First Aid chapter for every unit that we covered. I would have started reading First Aid at Christmas along with lectures -- not studying (just reading to know what topics are covered).
- I would take some time to read third-year textbooks so that I could get a sense of what was important to know in the long-term. I found that when I went over the same information multiple times at the same level of understanding (i.e. basic recall of facts), I didn't learn it as well as when I actually saw how that information was applied in a clinical setting. I wouldn't go over my basic anatomy again if I'd learned it well the first time. Instead, I'd move on to a surgical textbook and learn how the anatomy could be relevant for a hernia repair, appendectomy, etc.
- I would have finished all the USMLEWorld questions.
- I would take the time to learn the material well the first time. I should have learned Neurology well during the 2 week SBM Unit. I can't tell you how frustrating it is to teach yourself things while reviewing for Step 1.
- I would focus on a few core resources and insulate myself from the study plans/progress of friends.
- I would have started reading First Aid and Rapid Review Pathology along with SBM course material.
- I would not have fretted over getting "X" number of practice questions/pages done per day. I would have given myself more time for summer break- those last few study days before the test are worthless.
- I would not write any notes into my First Aid book from SBM lectures. First Aid lacks detail and is missing a lot of the material that is covered in SBM. This is true, but 95% of what you need to know for Step 1 is covered in First Aid. I added lots of notes about abnormal EKG findings, anti-arrhythmics, etc. early on in my study. It cluttered my First Aid and drew attention away from more important notes that I added from Q bank questions. In the end, I used white-out to remove a lot of my early SBM notes.
- Take all the NBME practice tests. They are most like the real thing, and worth spending the extra $45 per test.
- I would not listen to advice from too many people without having any idea how well they actually did on Step 1.
- I would make a habit of looking at cross sections of pelvic, heart, etc. to identify different structures. Most anatomy questions I had were of this type (although anatomy is overall a very small component of Step 1 based on my exam).
- I would have tried to remember that NO ONE leaves the test feeling like they did well.
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