Tag Archives: boards

USMLE Step 1 Series: What Does My Step 1 Score Mean?!

Navigating Step 1 Scores

So it’s Wednesday afternoon. After weeks of waiting, you’ve been checking your e-mail today Q3minutes or hitting refresh on the NBME site repeatedly, and finally find what you’ve been seeking: the link to the PDF that you think determines everything.

You hastily open the file to find….   a large block of text. After the second it takes you to realize the date and your USMLE ID number at the top have nothing to do with your actual score, your eye catches a glimpse of the following:

Passing the USMLE Step 1 Exam

A good sign! You’ve joined the >90% of MD students (and about 80% of DO students trying for an allopathic-residency program) who passed. Congratulations! Chances are though, the page opened up just short of showing the box directly underneath the pass/fail: your score. In your excitement, you struggle with getting the mouse accurately (or was it precisely?) to the scroll bar to find…..  two numbers?  One of them a three digit score, the other a two digit score.  So…  you were aiming for some three digit goal, but now that you have passed and your score is permanent, what does it actually mean?!

In med school, the right answer usually starts with “it depends.” Let’s start with the three digit score, as that’s the important one that gets sent to residency programs with your application. As you know by now, certain medical specialties are more competitive than others. We’ll discuss interpreting below expected or failing scores in another post, but for now, you should start by checking out The National Residency Match Program (NRMP) and Association of American Medical Colleges (AAMC) document on charting match results.  It comes out around September each year and gives a breakdown of the previous year’s match statistics.  Right now, you’ll be most interested in the section that shows the average and distributions of Step 1 scores by specialty.

Is my Step 1 Score good?As for the two digit score, this is the number that is most likely to be misinterpreted. The first thing to know is that this is NOT a percentage nor a percentile. The former refers to the number of questions correct on the test divided by the total, and the latter (percentile) refers to how well you scored in relation to other students. The two digit score is neither. Don’t feel too confused – if you got this far, you already know you’re pretty smart. The two digit score is a near-arbitrary number, whereby the National Board of Medical Examiners deems the number 75 to be the cutoff for passing. This roughly corresponds to a three digit score of 188. Is it useful?  Not really.  It’s more historic than anything, and the confusion surrounding it is the reason why it is no longer sent with residency applications to program directors.

If you are interested in learning more about USMLE Step 1 percentages and percentiles, we strongly recommend checking out the MedStudentBooks.com USMLE Step 1 Percentile Calculator to help make some more sense of your score.

Congratulations to all those who passed – you’ve quite literally taken your first step to becoming a physician.

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USMLE Step 1 Series: Making a Withdrawal at the Question Bank

How to Choose USMLE Step 1 Question BanksYou’ve heard whispers around your medical school of a variety of question banks to use during boards, and there are a lot. To be specific, this article is going to hit on the main points of question banks only, not to be confused with the variety of coaching or training programs out there.

As mentioned in the opening article of the USMLE Step 1 Series, choosing a question bank has little dependence on your individual learning style. Before we get into the individual options, it’s important to note that this can be one of the largest detriments to your student loans for the Step 1 exam, outside of the exam itself. While we always encourage smart purchases, this is not a time to be frugal. You should purchase a question bank, and round up on the time compared to your exam (e.g. if you exam is 1.5 months away, get a 2 or 3 month subscription). Never try to “exact fit” a question bank with your pre-determined study time. Overestimate slightly.

This is our top recommendation, without question. When groups of medical students are surveyed about resources, this is consistently rated the highest of the question banks, with around 95% of students who used it rating it “Very Good” or “Excellent” after taking the Step 1. (Evidence for the win!) Buy it.

Review: The interface and question types are the closest approximation to the actual FRED2 format you will find on the actual Step 1 exam. More importantly, the question stems and content are in a similar style. Difficulty overall is slightly higher than the real deal, but at an appropriate level that doesn’t feel ridiculous like some of the other question banks. Answers are comprehensive, high yield, and fulfilling. Performance is tracked by subject and topic, but overall analytics leave something to be desired at times as improvement-graphing is not a feature. While tracking progress can be reassuring during this stressful time, it’s not why students should purchase a question bank. This is a large cost, so as a (repeated) point of disclosure, MedStudentBooks receives absolutely no benefit or compensation from USMLE World.

USMLE World Step 1 Question Bank

Usage: You should do questions every day you study, with a heavy focus on the topic you just reviewed. Some questions every day should be general (randomly chosen) questions. This number should increase as you get closer to the exam date. Number of questions should be tailored to individual learning style. However, if you find yourself burning through the question bank quickly and expect to finish it early, we recommend saving approximately 300 for the very last week of studying. Purchasing a second question bank (see below) is only recommended for this scenario for those who really excel by doing questions.

USMLERx comes from the group that makes First Aid for the USMLE Step 1. Questions are true to the exam in content and difficulty, with great answer breakdowns. This corresponding question bank to First Aid does extend past the book’s knowledge and can be used as a true supplement (not just rehashing the exact same content), which is why it represents our runner-up question bank recommendation. When surveyed, about 60% of students who used this question bank rated it as Very Good or Excellent. One money-saving tip is to use the corresponding book First Aid Q & A for the USMLE Step 1 (often referred to as “paper USMLERx”) and/or First Aid Cases for the USMLE Step 1. This last title is actually not a question book, but rather goes over cases with multiple questions that could come up for any given question stem. Unlike question banks, this is usually self-selected by those whose learning style works well. Furthermore, either of these titles can be picked up used or borrowed from friends. Keep a lookout for your medical school hosting a USMLERx “Scholarship” which is code-word for “promotional free qbank subscription that coincidentally creates free advertising.”

Kaplan tends to get extreme opinions. People either love it or hate it. When a class of med students were surveyed, 30% of those who used Kaplan Qbank rated it as Very Good or Excellent. As opposed to the above two options, Kaplan takes a different approach, by asking questions that do NOT approximate the Step 1 exam in style. Questions usually focus on specific factoids, and are sometimes perceived as being detailed minutia. Nevertheless, some people swear this is a helpful method of studying. If you are curious about this option, you can use the above link or below banner ad to check a free trial before purchasing it. Either way, it shouldn’t be your first choice.

NEW Step 1 QBank- Only $99-$199!

Other Questions Banks to Mention

What about the NBME?! As we mentioned in the opening article in the Step 1 series, everyone should take an initial Comprehensive Basic Science Self-Assessment (CBSSA) exam to get some hard evidence of performance. While these are great at providing a big picture of strengths and weaknesses, these exams unfortunately do not provide great answer descriptions or aid in learning. The NBME has started rolling out exams with “Enhanced Feedback” but they still don’t match up to any of the above as learning tools, and wind up being more expensive per question.

USMLE Consult: This is the question bank famous for being backed by the Great Goljan. We love Goljan’s teaching, but we don’t have enough evidence on USMLE Consult to say it’s necessarily a strong choice. Without the Goljan stamp of approval, this option would probably fade into the background with many other countless banks. 

Exam Master: Many med schools provide this to students for free. The price tag reflects the quality. This has a lot of negative reviews and responses associated with it. Questions are unfocused, unclear, and often times have poor answer explanations. Learn from med students who came before, and avoid dedicating time to this option. If you are interested in free questions, hit up the question banks that come with many new books (check for scratch-off areas on the inside cover) or use the Lippincott free 350 question set.

USMLE Weapon: This Pittsburgh startup gets a curious honorable mention as a rising question bank gaining popularity. While USMLE Weapon has not yet stood the test of time or produced a lot of evidence regarding its perceived value, it has impressive analytics and may yet give USMLE World a run for their money one day. At this point though, MedStudentBooks cannot endorse this option, but we will be following it for future years.

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USMLE Step 1 Series: The Right Way to Use First Aid for the USMLE Step 1

There comes that point, usually midway through first year, when every medical student hears about First Aid as the magical end-all Step 1 study book. “Everything I could possibly need to know for the largest exam of my life in one book?! Sounds too good to be true!”  It is.

First Aid for the USMLE Step 1, reviewed here previously, is absolutely essential for the first board exam experienced by medical students. However, it is incomplete. Before discussing the manner in which it can be fortified, let’s address the first question that usually arises: When do I actually buy a copy of First Aid and start studying from it?

You will likely encounter several gunners in your class who bought their copy of First Aid as soon as they finished the MCAT. This is not recommended. In fact, going through all of first year med school without ever seeing First Aid is probably a good thing. The summer between first and second year is the gray zone, and depends on your personal learning style. No medical student should start studying for boards at this point. However, some people find it helpful to begin familiarizing themselves with the layout and teaching style of the book. It can be especially helpful to students taking organ system based courses to skim through corresponding chapters of First Aid. However, study time should be dedicated to medical school classes, not the boards at that point. If you decide to use this method, try to find an older copy of First Aid that costs little or no money. If you purchase the latest version during the summer after first year, a newer version will come out by time you take the boards.

First Aid for the USMLE Step 1 Remove the CoverRegardless of whether you “pre-skim” or not, purchase a new copy of the latest edition for the start of your dedicated USMLE Step 1 study period. Your job, over the subsequent 6-8 weeks, is to fill in all the information left out of First Aid. How do you know what you don’t know? Other resources, namely question banks. As you begin to read through the list of in-depth support books we previously mentioned and take Step 1 styled questions, you’ll find the factoids and concepts First Aid missed. While the tradition has historically been to write these high yield ideas in the margins, each revision of First Aid has produced less and less white-space on a page.

This has been addressed in a few ways. The simplest is to simply shove extra loose pieces of paper between pages of the book. Unfortunately, dropping the book once produces a disorganized mess of notes. The recommended option is disassembling the book. While harming the Step 1 bible may seem sacrilegious, it has many benefits. First and foremost, it makes transportation much easier, as grabbing an individual chapter is a lot easier than lugging around the entire book along with all your other study materials. More importantly, it can keep things very well organized.

As seen above, a standard three ring binder allows for easy organization and insertion of extra pages.  Some people prefer spiral binding or similar plastic ends that have easy open and close mechanisms. It’s up to you. As for getting your copy of First Aid into these states, we don’t recommend doing it yourself. You can usually get anything you’d like done at your local Kinkos or Staples for less than $5.

There are a lot of opinions on what should be placed on extra pages, without much consensus. Some people insist on putting sources to their facts for later reference, others don’t care. All we advise is to use your usual study practices, with one exception. There are a few of us who never take notes. You know who you are. Step 1 does not afford you that luxury, regardless of how amazing your short term memory is. There’s just too much information. Bottom line: annotate First Aid.

Alright, you’re all set to get the most out of your copy of First Aid. Don’t forget to check out the back of the book for common buzzword associations. You should have all of them down by time you hit the exam. Happy studies!


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USMLE Score Percentile Calculator, Now Live

USMLE Percentile CalculatorAnother online Med Student Books application has been recently added to the site!

Has a scholarship or program been asking for a USMLE Step 1 “percentile” even though no such number can be found on your Step 1 score report?  Perhaps you’re simply interested in tracking progress of USMLE World practice tests. Whatever the reason, head over to our new USMLE Percentile Calculator to convert between three digit score and percentile.

It uses some recent national data, but can be customized for your specific needs, and extended for Step 2 percentiles. Have a look, and if you find it useful, be sure to share with friends!

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Grab this FREE copy of First Aid for the USMLE Step 1 2012!

Congratulations to user Buding, an MS-II at Kansas City University of Medicine and Biosciences! He is the winner of the below free copy of First Aid for the USMLE Step 1 2012. This contest is now closed.

First Aid USMLE Step 1 2012 review

We’ve gotten so much traffic and positive interest in our First Aid Step 1 2012 review that we just couldn’t hold onto it. For those of you taking Step 1 closer to the spring, this offer is definitely for you.  All you need to do is to leave your e-mail address in the comments section to win a free copy of First Aid for the USMLE Step 1 2012 (now in full color). You can say whatever you’d like in the comment itself, but the winner of this giveaway will be selected completely at random. We do however request that you click one of the social buttons below, although this is not necessary to win.

Be sure to subscribe to the RSS feed or check back on the site over the next few months as we expand our posts dedicated to Step 1 tips, schedules, calculators, and online applications.

As with previous contests, this is open only to US students, and e-mail addresses are never displayed on the site, used outside of contests, or given away (we’re all med students and understand the value of spam-free inboxes). Limit 1 entry per med student. The contest follows our usual rules and will close in one month, on February 15, 2012, so drop your comments by then.  Good luck!

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USMLE World QBank Group Discount!

USMLE World Question Bank (Qbank) group discounts for the USMLE Step 1 and Step 2 exams have historically not worked out.

Here’s the typical scenario: Someone from your med school tries to organize a group of at least 50 students to band together and take advantage of a group discount from USMLE World. 70 people express uncertain interest because they don’t know the timing or what they want. 30 sign up, and despite the majority of your class eventually gets USMLE World QBanks, everyone pays full price.  Meanwhile, individuals chase down google searches for USMLE World discounts and coupon pages, none of which are legit. At this point, the only way to pay less for USMLE World subscriptions is in group discounts.

In line with this site’s collaborative mission, this page was previously dedicated to providing a sign-up whereby medical students from different schools could come together as a larger group.  We unfortunately found out  that this too is not allowed. The minimum of 50 students must come from the same school and have the same domain in their e-mail address (yourmedschool.edu).  USMLE World representatives have also confirmed that no other discount exists anywhere for any reason outside of a minimum of 50 students from the same school. Sorry everyone.


Don’t forget to check out these other resources from the USMLE Step 1 Series:

How to Choose USMLE Step 1 Question Banks
Sorting Through Confusion: Making a Withdrawal at the Question Bank The 7 Essentials of a Solid Step 1 Study Strategy

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Must Buy: Goljan Rapid Review Pathology

Goljan Rapid Review Pathology: a Must Have Pathology book for the USMLE boards

Goljan Rapid Review Pathology: a Must Have book for the USMLE boards

It is finally time to review Goljan: Epic King of Pathology.  All of the legends and rumors you heard were true.  He’s an arm wrestling champion, rides a white stallion around his massive pathology fun house, and can break a man’s finger clean off during rectal exam.  Indeed, some believe that the mere act of saying his name aloud increases their board score by one point every time. If you don’t understand these things, it is simply because you are not yet enlightened.

Edward Goljan is a world class Pathology Chair from Oklahoma State University.  Back in the day, he began doing pathology review courses for his medical students, which have been condensed over the years into the most comprehensive yet concise pathology review available.  More importantly, it is perfectly tailored to the USMLE Step 1, USMLE Step 2 CK, and even USMLE Step 3 boards exams, as Dr. Goljan has further refined his teachings based on constant feedback he receives from students after they take the boards.  As he states:

These notes took 25 years to put together over time.  And it dwindled down to the absolute quintessence. It’s like espresso.  You just have a little drop and you’re already fixed.

At some point, one of his students recorded his epic lecture series, which continues to float around the internet and med school back-alleys to this day, obtained and abused like crack for the boards.  To complement his lectures, he handed out his condensed notes, mentioned above.  Over time, these notes coalesced into Edward Goljan’s Rapid Review Pathology book.

The book itself is newer than the audio and has undergone further revisions, whereas the audio remains in its temporally frozen preservation. 

Edward Goljan, Pathology Review Expert and Arm Wrestler

Edward Goljan: Pure Pathology Intimidation

Specific chapters of Goljan’s Rapid Review Pathology include: Cell Injury, Inflammation and Repair, Immunopathology, Hemodynamic Disorders (Acid, Base, Electrolytes, Water), Genetic and Developmental Disorders, Environmental Pathology, Nutritional Disorders, Neoplasia, Vascular, Heart, Red Blood Cells, White Blood Cells, Lymphoid Tissue, Hemostasis, Immunohematology, Upper and Lower Respiratory, Gastrointestinal, Hepatobilliary and Pancreatic, Kidneys, Lower Urinary Tract and Male Reproductive Disorders, Female Reproductive Tract and Breast Disorders, Endocrine, Musculoskeletal and Soft Tissue, Skin, Nervous System, and Special Sensory Disorders.

Goljan’s Rapid Review Pathology also comes with Student Consult, the online portal and electronic copy of the book, giving you access to all of the text remotely, as well as the images (which come in handy for powerpoint presentations).  Student Consult for Rapid Review Pathology also comes with a little over 400 USMLE style pathology questions related to the book itself.  However, to truly lock in the information with a fantastic complementary USMLE style pathology question bank, Robbins and Cotran’s Review of Pathology (reviewed here) is the recommended book of choice.

For more information on Goljan and to view his other books, see his publisher profile, or download the Pathology Rapid Review Errata (word doc).



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Must Buy: First Aid for the USMLE Step 1 2011

First Aid for the USMLE Step 1 - 2011, by Tao Le

Must Buy: First Aid for the USMLE Step 1 - 2011

First Aid for the USMLE Step 1 2011 by Tao Le is the best way to study for the step 1, and an absolute essential for every single medical student.  It provides the basis for your studies and covers about 85% of what will be on the boards, to be complemented by other books and question programs such as USMLE World. First Aid for the USMLE Step 1 starts by overviewing boards logistics and planning, right down to approximate timelines and test taking strategies.  The bulk of the book however is dedicated to individual topic overviews, broken down by medical system.  The first half of the book have General Principle chapters that are specifically dedicated to Behavioral Sciences, Biochemistry, Embryology, Microbiology and Immunology, Pathology, and Pharmacology. The second half is organ system based, and covers: Cardiovascular, Endocrine, Gastrointestinal, Hematology and Oncology, Musculoskeletal and Connective Tissue, Neurology and Psychiatry, Renal, Reproductive, and Respiratory systems.  The end of the book also has sections on Rapid Review of helpful terminology and buzz words on the boards, High-Yield pathology images that are likely to pop up, and a review of other good boards resources.

The best way to utilize First Aid for the USMLE Step 1 is to annotate the margins or notes sections with high yield points or topics that should be further explained.  Many students actually prefer to take the book to a printer to have the binding cut off and have holes punched into the pages so that everything can be added to a binder.  With that setup, additional pages can be easily added, and specific sections can be removed as needed, making the book more portable.

A cheap copy of First Aid for the USMLE Step 1 can usually be found on Amazon.  This is unfortunately one of those books you should get New or Like New, as you will want all the margin spaces clean for your own annotation.


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