Tag Archives: first aid

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.

Power-Annotatation
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 Step 1 Series: The 7 Essentials of a Solid Study Strategy

To kick off the USMLE Step 1 advice, we present the big picture overview of studying. Some of the below are well known strategies, but we hope to present some clever caveats that have been compiled by a number of med students along the way. Over the next few weeks, in depth articles will detail more of the little tricks that offer that competitive test taking edge. For now, let’s stick to the basics.

Figure Out Your ACTUAL Strengths and Weaknesses, with Evidence.

Early in the study process, you will be bombarded with different strategies and study practices. The problem will always come back to figuring out what works best for your specific learning style and knowledge base. Before you even decide where to start, you should have a basic idea of big-picture learning goals. After all, it would be silly to dedicate the same amount of time to a topic you despise as one you already know really well. Don’t guess. That’s an easy and common mistake. Get evidence.

The National Board of Medical Examiners (NBME), the same guys who bring you the Step 1 exam, have created a number of helpful exams for this goal called the Comprehensive Basic Science Self-Assessment (CBSSA).  They use Step 1 style questions and provide performance profiles (above) similar to that found on your actual Step 1 assessment. It lays out a visual representation of strengths and weaknesses. Hopefully your med school provides them to you for free (if they don’t, petition for it).

It is recommended that you take an untimed enhanced CBSSA exam early on or even before you start studying. Assessing your Step 1 knowledge before studying, and seeing the score and performance profile early on will definitely sting, but the purpose is to push you in the right direction. It can serve as a strong motivator, and has been shown to increase board scores at certain med schools by 1/4 of a standard deviation.  If desired, take another one about 10 days before the actual exam for comparison and reevaluation of focus. Using a question bank to accomplish this goal is an alternate option, but they are focused on teaching topics, and nothing is as authentic and insightful as an exam coming directly from the NBME.

Get a Plan, and Stick To It.

Once you figure out strengths and weaknesses, creating a study schedule is the next essential step. We’ll cover the various types of plans more extensively in future posts, as there are many out there. The big picture point is that it should keep you focused but remain flexible. This can be a large stress-inducing topic for med students, as gunner plans will require no sleep and IV hydration. Construct something right for you that also maintains sanity.

Get a Copy of First Aid for the USMLE Step 1 2012

First Aid USMLE Step 1 2012 reviewIt has been reviewed and highly recommended on this site, and even given away in a contest. This should be at the core of every med student’s study plan, and can be purchased confidently, regardless of your individual study strengths. However, this absolutely cannot be the sole source of information for Step 1 studies. Every commercial question bank and review course will cite some arbitrary number that suggests First Aid doesn’t hold 100% of the needed knowledge. They’re right.

The proper way to use First Aid for the USMLE Step 1 is as a guide. The sections corresponding to the subject of your focus should be lightly overviewed first. This should then be followed by in-depth learning from a dedicated resource. Some students like returning to review First Aid after that, and/or in the days just before the exam. Either way, it should be used as your starting marker to point you in the right direction, not your end point. Furthermore, it should be annotated thoroughly, which will be discussed with tips in an upcoming post.
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Stock Up on the In-Depth Books NOW

Now that we convinced you that First Aid won’t make you a Step 1 superstar by itself, let’s look at what else to consider. You will find that there are about three million medical books out there. After narrowing down the list to those designed specifically for med students studying for the USMLE Step 1, you will find yourself left with about 43,943 books. Pro-tip: you can’t read them all.

Feuds have started over which books present the highest of yields. You could sink a lot of time into researching every title, and fall prey to the gunners and trolls of the SDN forums, never wanting to hear the term “high yield” ever again. Here at MedStudentBooks, we like to keep things simple. Below is a list of recommended titles to support various Step 1 topics. As always, we highly recommend using the titles you already know and love to jog your memory. But if you don’t have a favorite, the following is a list of highly recommended titles from the MedStudentBooks team, surveyed med students, and med school administrators that you should consider first:

MedStudentBooks Recommended Step 1 Resources
Lippincott’s Biochemistry (full review here)
Q&A Review of Biochemistry
Clinical Microbiology Made Ridiculously Simple (full review here)
Q&A Review of Microbiology and Immunology
Lippincott’s Microcards
BRS Physiology (full review here)
BRS Behavioral Science
BRS Pathology or Goljan’s Rapid Review Pathology (full review here)
Robbins and Cotran Review of Pathology (question book) (full review here)
MedMaps for Pathophysiology for true visual learners
Lilly’s Pathophysiology of Heart Disease (full review here)
High-Yield Gross Anatomy with your favorite atlas for reminders
High-Yield Neuroanatomy with this gem

Clearly you should not seek out every book on this list. In fact, purchasing too many books can stress you out if you have a large pile of materials you feel you must get through, without the time to actually do it. These are just top recommendations for the subjects with which med students tend to need extra help.   The key is to figure out what topics need to be strengthened as mentioned above, and focus on them from the above list appropriately. We’ll go over general question and case books in another post.

Do not be that med student who waits until the day before they are scheduled to start reviewing a topic to buy the associated book. You should not dedicate any brain power on bookstore trips or figuring out why the postal service didn’t deliver your Amazon order in the middle of your studying. Added stress is not welcomed. Figure out what books you need from your self-assessment, and purchase them early.

Use a Question Bank to Complement Your Studies and Track Progress

Your med school may host an obligatory Kaplan lunch talk, or notify you of a USMLERx “scholarship” (?). Maybe you’ve heard some rumors about a new and upcoming question bank weapon for gunners. Like books, there are several options out there, but this choice is even simpler than books: use USMLE World.

USMLE World Step 1 Question Bank

Much like First Aid, this is not a question of learning style. If you’re a visual learner, use UWorld. If you’re an auditory learner, use UWorld. If you work for Kaplan…  use UWorld. We’ve previously mentioned that we’re not a fan of their company policies or prices, but the high quality of their question bank is undeniable, which is why they are the gold standard. Unless your exam is scheduled within the next 8 weeks, get a 3 month subscription. We’ll discuss question bank strategies and alternatives in upcoming posts, but for now rest assured that you don’t need to worry about other companies unless you’ve blown through UWorld and come out hungry for more. Again, the price is unfortunately high, but it is an absolute necessity.
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Learn by Rote Memory Over Time

So far we’ve covered basic science subjects that are largely conceptual. Unfortunately, Step 1 (and the rest of your career) will require straight up no-thinking-through-it memorization. By this point in med school, you’ve probably created lists that you’ve stared at for so long that you not only remember the factoid, but the irregularities of the paper as well. This will most likely come up for Step 1 in pharmacology and microbiology. It is an unfortunate necessity, however it can be improved slightly. Just remember that large amounts of rote memorization are best retained with spaced repetition. In other words, you should identify the long lists somewhat early, and continue to review them in short bursts throughout your study schedule instead of dedicating large chunks of time without returning to the information.

(Try to) Relax

A lot of us really neglect this one, and it can have devastating effects on productivity and exam scores. We’ll be discussing burnout in greater detail soon, but you should start thinking of things that keep you sane now. Step 1 sucks, but you are awesome.
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First Aid USMLE Step 1 2012 Errata Posted

First Aid USMLE Step 1 2012 reviewFor those interested in making corrections to information in your copy of First Aid for the USMLE Step 1 2012, the official FA errata is now posted to the FirstAidTeam.com website.  You can check out the webpage to learn more about the process, or RSS subscribe for updates. If you’d like to bypass the site and just go straight to the errata, the document can be found here (pdf).

Contribute to First AidKeep in mind that you can send in a correction for any mistake you find by clicking on the “Contribute” button on the right side of their site or this post (both bring you to the same place on their site). While they promise $20 Amazon gift cards for new information, someone else has probably already beaten you to any given correction. Nonetheless, making any submission will get your name printed in the preceding version of Step 1.

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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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Sneak Peak at First Aid for the USMLE Step 1 2012

First Aid USMLE Step 1 2012 reviewMedStudentBooks.com got a hold of an early copy of the upcoming First Aid for the USMLE Step 1 2012, and we are proud to offer the first internet review.

The 2011 version of First Aid for the USMLE Step 1 was previously reviewed on this site as the must have gold standard of Step 1 board review, and this only builds on it. Reportedly the “world’s bestselling medical review book,” First Aid 2012 continues its long line of teaching with a noticeable update. As the rainbow bar on the cover suggests, First Aid is now in full color. The company also reports approximately 20% new content across the additional pages.

There are a good number of benefits that come with the color upgrade. Previous versions stored a small section of pages near the back of the book with certain must-see color images. In 2012 however, they are blended seamlessly around the relevant text, allowing users to go directly from text to image without page references. The color also seems to make a number of the images pop a bit more. Drawn diagrams are easier to encode into memory, and line graphs are easier to trace (although this may be difficult to appreciate in the below image).  There also appears to simply be more color pictures in general, complementing the text more completely than previous versions.

First Aid for the USMLE Step 1 2012 sizing

Pages without images still have subdued hues of blue and red around the border. Bolding is now in a dark blue, which seems to conflict with one of the improvements many people liked between the 2010 and 2011 versions: bolder, darker font.  Nevertheless text remains easy to read.

First Aid for the USMLE Step 1 2012 QR CodeThe other noticeable addition to the book is the use of QR codes found at the start and end of every chapter, linking the user to updates, errata, “and more.” They all actually appear to be the same QR code throughout the book, and come with a link to the title’s associated question bank. As an aside, that same link is where students can submit errors or recommendations to improve the subsequent version, and get their name printed in it as well. While it is difficult to see the practical use for this electronic QR connection, board-study-psychosis can produce erratic behavior in medical students, and it certainly isn’t a detracting feature.

In general, First Aid Step 1 2012 also does a better job with spacing and sizing, as seen in the above image, although this comes at the expense of smaller margins. As mentioned in the previous 2011 review, most students annotate the book’s blank space.  Because of this, margins have historically been important, although a good amount of white space still remains.  In regard to the physical size of the book itself, it is surprising to see the dimensions to be about equivalent to the 2010 version, despite an additional 50 pages. The downside to this is that the pages are very thin and don’t hold certain inks or highlighting as well as prior versions.

Compare First Aid for the USMLE Step 1 2012

Overall, it is highly recommended that every second year medical student has access to a personal copy of First Aid for the USMLE Step 1. Unfortunately, it is generally contraindicated to obtain a used copy of this title due to the annotation produced by most users. The color update with a reported 20% increase in content represents an improvement that should not be overlooked for a new copy of a previous version. Therefore, we strongly recommend picking up a new copy of First Aid for the USMLE Step 1 2012. As we get further into Step 1 season, MedStudentBooks.com will post any discounts or deals on purchasing this title online, and possibly give one away for free. For now, shop around the below links to find the best price, and be sure to look for the color version.

 

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First Aid for the Psychiatry Clerkship

First Aid for the Psychiatry Clerkship, by Latha Stead

First Aid for the Psychiatry Clerkship, by Latha Stead

Latha Stead’s First Aid for the Psychiatry Clerkship is the only high yield resource that is needed for the Psychiatry rotation, and the best book for the Psychiatry shelf.  While the Diagnostic and Statistic Manual of Mental Disorders (DSM) will offer in depth criteria for each individual mental illness, it is best used in the clinical setting as an overview and diagnostic tool to confirm clinical suspicions. It also contains a ton of diagnoses that just aren’t needed for a medical school clerkship or shelf exam. First Aid Psych however goes over the core topics of the Psychiatry rotation, highlighting the criteria that will be on the NBME shelf exam, as well as up-to-date treatment options for any given disorder.   Furthermore, it is incredibly easy to read, and relatively short, making it the best 218 pages you could purchase to ace the Psych shelf exam.  Whether you love psych or find it incredibly boring, this is the book for you.

As with other books in the First Aid series, this one has a number of mnemonics, helpful hints, easy to understand algorithm charts, cases to prepare you for the wards, and general tips on how to succeed and impress your attendings.  It can be used for preclinical courses, the boards, and the wards.  Chapters specifically cover: Examination and Diagnosis, Psychotic Disorders, Mood Disorders, Anxiety and Adjustment Disorders, Personality Disorders, Substance-Related Disorders, Cognitive Disorders, Geriatric Disorders, Psychiatric Disorders in Children, Dissociative Disorders, Somataform and Factitious Disorders, Impulse Control Disorders, Eating Disordes, Disorders, Sleep Disorders, Sexual Disorders, Psychtherapies, Psychopharmacology, and Legal Issues.

 

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Must Buy: First Aid for the Wards

Tao Le First Aid for the Wards, fourth edition on Med Student Books

Tao Le First Aid for the Wards, fourth edition

First Aid for the Wards is another Tao Le book that every medical student should own.  It provides a comprehensive overview of each core clerkship, including what to bring, how to write progress notes, and common abbreviations.

Before third year of medical school, most med students study a little bit throughout a course, and pick up time dedicated to studying as the end of the course approaches.  It makes sense, as that is usually where the evaluation is, being an exam.  It is easy to be similarly fooled into thinking the strategy should be the same for clerkships, especially because there is still an exam at the end.  However, medical students are evaluated from the very first day on the floor.   Furthermore, the way in which they are evaluated on the exam (factoid-based) is usually different from how they are evaluated by their team (practical working knowledge).

To prepare for that new setup, the highly recommended strategy is to read through the corresponding section in First Aid for the Wards the weekend before starting a clerkship, not to commit everything to long term memory, but just to skim the information and become oriented to the vocabulary and mindset of the specialty.  Shelf exams will never ask about the ALLHAT trial, but every student guaranteed to have a patient on the first day of Internal Medicine that it will apply to.  Simply dropping that trial name appropriately because of readings the previous night is sure to impress.  With that in mind, more in depth resources should be used for shelf exams.

Up until now in your education, most people study a little bit throughout a course, and pick up time dedicated to studying as the end of the course approaches. It makes sense, as that’s usually where the evaluation is, being an exam. It is easy to be similarly fooled into thinking the strategy should be the same for clerkships, especially because there’s still an exam at the end. However, you are evaluated from the very first day you step onto the floor. Furthermore, the way in which you are evaluated on the exam (factoid-based) is usually different from how you are evaluated by your team (practical working knowledge). As obvious as that may sound, it took me a while to truly understand that and react accordingly. My method, which I highly recommend, is to get a cheap used (or free) version of First Aid for the Wards:
http://www.amazon.com/gp/product/0071597964/ref=as_li_ss_tl?ie=UTF8&tag=itemcontent-20&linkCode=as2&camp=217153&creative=399349&creativeASIN=0071597964 

 

 

 

 

 

 

 

 

 

 

 

I suggest reading through the corresponding section in Wards the weekend before starting a clerkship, not to really commit everything to long term memory, but just to skim the information and orient yourself to the vocabulary and mindset of the specialty. Shelf exams will never ask you about the ALLHAT trial, but I guarantee you that you will have a patient on day 1 of Internal Medicine that it will apply to, and simply dropping that trial name appropriately because you happen to have read it the night before will score you major points. As such, you do NOT need the latest version of the book (or any other quick overview), because the attendings don’t pimp heavily to the latest info. Again: FA Wards for short term memory. Study for-serious with another source as the clerkship nears its end.

 

 

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