Step 2 CS - Failed/No Pass - How to study/What to do - help USMLE Clinical Skills 2013

Many more students are not passing the USMLE Clinical Skills exam, as the ECFMG have recently in July 2013, increased the passing standards, targetting especially Foreign Medical Graduates. As someone who has witnessed first hand a repeated experience with this exam, I can provide a unique view of how to deal with this test.

• First and foremost, realize that US Grads have an advantage since a lot of programs provide patient actor feedback since year 1 of medical school! So they are 2 years ahead of you if your first clinical experience is in 3rd year. If your school has lacked this type of training, it would be wise of you to bone up on some basics. https://www.youtube.com/watch?v=RckmVLdHKtk
• You MUST read the USMLE Step 2 CS official handbook http://www.usmle.org/step-2-cs/  and well, read the whole thing, but more specifically, read two very important sections towards the back of the pdf. Here's the 2013 Pdf link: http://www.usmle.org/pdfs/step-2-cs/cs-info-manual.pdf
• 1) Read the grading requirements for the ICE, CIS, and SEP English Proficiency portions
• 2) read the Patient Note instructions/examples. ***(Pages 12, and pages 17-21)***
• Understanding the grading criteria is really the most important advice I can offer. This is a 3 part exam, and if you fail ANY ONE part of it, you DO NO PASS the whole thing. Remember this fact througout your practice/studying for it. You must be adequate in all three areas, in order to pass this exam. For example, focusing on getting a perfect patient history, while neglecting patient care/empathy (the CIS) requirements will fail you. Taking a half thought out history, and writing just an OK note while making the patient feel relatively comfortable (although this sounds like you're not using the best clinical work ethic), WILL PASS you.  This is NOT the image you want to see.
  
  btw you are also given a visual "xxxxxxx" score breakdown in the traditional NBME score reporting style, but it offers NO specific feedback. This is as much feedback as you get.  
• This is an expensive exam, about $1400, plus hotel fees, plus transportation, plus flights... Taking this exam twice is twice as expensive. It might be a deal breaker for some of you!
• For some reason, and this may not turn out to be true, but the Philidelphia testing center has seen more failures according to forum posts and word of mouth. This was the original, and only, Step 2 CS testing center and whether it recieves more strict patient actors, requirements, or more highly trained US Grads, or if its just a fluke, I would advoid this testing center if possible. If not, just don't let this hoopla cloud your judgement. As much wiggle room as there is in the format of this exam, it really is pretty standardized, and I can attest to that having taken the exam months apart at different centers. My experience was essentially the same. 
• Look up the testing periods and the respective Score Reporting periods to make sure you have your score in time for interviews. For me, I took first in April, and by that time all slots are booked until November. There are mailing lists on the OASIS website that can email you when spots are freed up by someone who cancells their spot. You must be in good practice, and  ready to go at the drop of a hat and ready to book a last minute flight as well, in case you have to retake. I retook in Late August, and recieved my score in October in time for interviews.
• This brings up a big point, take the exam as early as you are ready to do it. Because, if you don't end up passing, you will need to A) re-register, B) re-pay for the exam, and C) re-schedule the exam during a time which may be incredibly booked. 
• PS, taking an EMERGENCY MEDICINE or outpatient FAMILY PRACTICE elective where you are taking patient histories solo, you should really do this before taking your exam. Taking OBGYN and PEDS also are hugely helpful since you will definately get a case from one or both these specialties. 
• Look at the programs you are applying to for residency. Many do not care if youve taken CS or not, so why risk it? Many of them want you to pass the exam before you start on day 1 of your residency. You can STILL MATCH!! 
• Don't bother with a score re-check, especially if you did not pass the CIS portion. There is no reviewing of your performance, only re-tallying the check boxes in case someone miss counted, which is highly highly unlikely. 

***UPDATE***

• If you took ANY USMLE Exam late, and you finally recieve your score/results, and it is AFTER you have already submitted your ERAS Applications... you must go back to eras and to the Transcript section and CLICK RE-SUBMIT!!! Otherwise your new scores will not be included in your application, this applies to Step 2 CK AND CS. 

If you do not pass the exam, there will be limited information online, you can scour the internet full of super-negative reports from (mostly) FMG/IMG's who didnt pass for whatever reasons, and this will scare you. You will get little sympathy from the ECFMG or the USMLE and you may feel abandoned. You will feel miserable, full of self-doubt and contempt for the ECFMG and contemplate giving up medicine maybe, you might feel inadequate, and finally, ISOLATED. You might be embarrassed to mention this fact to anyone, especially your colleages in fear of being looked at as unfit to practice medicine. 

Well DON'T. I have a better way to look at it. 

• First and foremost, stop using the word FAIL. From now on, you will use the words "NOT PASS". You must find positivity in this experience and prevail, both for your future career, your mental health, and for your Interviews!! You must explain your experience in a positive light eventually to someone who can see your transcript. So wipe all that negativity out of your head and accept it. You did not fail, You simply did not pass, this time.
• Next, you need to do some self-evaluation. What portion of the exam was weak? Go back and review the grading criteria for that section, and try to remember what your testing performance lacked. Be objective, but not super critical of yourself. You are capable, and have the opportunity to improve yourself! If you had barely passed with a borderline score, you wouldn't have taken this time to better your bedside manner and clinical skills!
• Third, try to find out if anyone else in your situation didn't pass, and try to have a discussion with them. Work out your frusterations, and concerns, and work together to persevere. You might not want to practice with this person, as they won't be a good partner, no offense to them, but you need someone who knows how to pass. Wish them luck in their journey in your struggle. 
• Practice with a stranger. Online dating is actually a pretty awesome avenue here... Find someone who doesn't know you, who is coming ready to judge you in their first impression of you. Do a case with them! Get honest feedback! This will be SUPER valuable for you, and maybe you'll find love too. Or just find a friend who's not in the medical field. 
• Practice writing the note out in the format that is described in the official handbook. Focused note. No findings that don't entertain any of your differential diagnosis. Only pertinent information. You are trying to prove to another physician that you were thinking 3 differentials, and that you were trying to rule them in or out with your questioning and exam. Thats it. No fluff or excess Rewview of systems or exam findings that have nothing to do with that just because you were trying to look like you do a thorough job. You want your note to tell a story titled, "what were you thinking was going on?" ... not "I decided to do everything under the sun and look really thorough and maybe if I do that, ill hit some pertininent postitives and negatives that I can use". You want your grading MD to say in his/her head "ah... i see why they did that, and ah I see why they included that, they must have been thinking about ____ diagnosis". 
• In terms of your english skills, just check in with the patient! That's one of the criteria in the grading in the official handbook anyway, which you should be doing even if you have perfect english. BUT, if you have limited english skills, all you need to do is constantly ask "Do you understand what I mean?" and if they say no... then explain a different way until they do! That's good medicine! Who cares if you don't have a textbook vocabulary. If the patient understands you, thats all that matters.
• Finally, Don't take this exam as a measure of your ability to be a doctor. IT IS NOT. It is a hoop you must jump through to pass to the next stage. No one works under the stress of getting everything correct the first time, without time to correct any mistakes. In Medicine there ARE second chances, there are colleagues with which you can discuss clinical gestalt and judgement, AND you have more than 20 minutes to evaluate and document a patient case and explain to the patient whats going on with them. If doctors worked at the pace of the Step 2 CS exam, we would have the most effieient doctors in the world! In the real world, ideally it would be great to work like this, but its just not this way. I think you know this is true already. Remember, it is just an exam, to see how you perform under stress. 

I don't know what else to say at this point. 

Overall, the whole process, even just taking it one time, is stressful enough. Prepare yourself by knowing the format of the exam, the grading, and practice with someone who can evaluate you using the official step 2 CS grading criteria. Make it realistic, and do the same thing with your actual patients in your clinical clerkships and see how they react to you. 

I wish you all the best of luck and that you may prosper with your careers. 

USMLE Step 2 CK "free 150" Questions - 2013 +USMLERx

Like for Step 1, Step 2 CK has a handbook, which you should be aware about, and it contains a 3 block - 131 question exam at the end with answers. Some people call this the "Free 150", i think, unless there is another exam I am unaware about. But this exam is OFFICIALLY released by the USMLE on their website and you shouldn't neglect it.

Here you go!
And great luck!
http://www.usmle.org/pdfs/step-2-ck/2012--13_FINAL_S2_GSI.pdf

If this link doesn't work, try going and clicking the "handbook"
in the right margin HERE.
http://www.usmle.org/step-2-ck/
Same thing. Cheers!

Also!  USMLE Rx offers a 20 question Free trial of their question bank (and so do others... but its a nice little review quiz for Step 2CK material... here is the link:

http://m.qmax.usmle-rx.com/user/testdrive.aspx?step=2

Step 2 Study Prep - Brian Jenkins Authors Step Up - DIT - New Book! April 2013

For those who criticized DIT for Step 2 in the past, Brian Jenkins, the brain behind the DIT USMLE Review Courses has co-authored the newest version of the Step up to Step 2 book, which is the book the review course follows. Just like how DIT step 1 followed First aid... its nice to have a resource to follow allong with, otherwise it just doesn't give you full learning potential.

I haven't gotten a chance to review this new book in person yet, but I will be headed over to the library today to check it out. Will add criticisms accordingly.

Here has been my assessments in the past about the different books available for Step 2, there are a lot of them and all slightly different.
http://www.doctormuggle.blogspot.com/2012/12/first-aid-2013-basic-science-rotations.html

A lot of people are using the Step up to Step 2 book, so hopefully it Steps up to its own expectations. ha!
in the meantime... here it is!

How to Prepare for Step 2 CK -... update coming later

so far, I am in the process of shelling out >$800 for the registration and determining the best resources to use during clerkships so that I am familiar with 1 book full of my notes come study time. I don't have much time to dedicate outside of work to study, and it would be nice to do this efficiently.

So far, there are some EXCELLENT reviews on this forum, of a guy who got 260's, and another who got 206. They describe very much in detail how they studied and what they studied, and it really shows the two extremes that you can take in order to pass Step 2.

More to come later... for now... read these. Goodluck!

http://www.aippg.net/forum/f26/my-step-2-ck-104325/

USMLE Step 1 Review - What to choose?

Let me help you find a few options. none of these are in any particular order.
Of course, ill give you my opinion in another article after I've finished my Step 1, but you should check out these sources and decide what's best for you. By the way, most of the Question Banks have free trials, so check them out for FREE! before you buy anything.

Live Prep Lecture Courses

• Kaplan High Yeild Review
• Doctors In Training
• Falcon Step 1 Review (w/ Goljan)
• Princeton Review Step 1
• Pathoma
• Pass Program (North)
• Self Study - this is also an option
• these are not all, but these are the main ones I know of

For those at SGU, Kaplan offers a special discounted course. It's the liveprep or retreat lectures either on the SGU campus or elsewhere depending on your class date. ONLY for August classes, they offer on-campus housing and an optional mealplan in May-June. If you are in the January starting classes, they have offered a discounted liveprep courses in various locations in the US. For us, they had New York, Dallas, Miami, Pasadena, and Montreal.

How to decide/What things to consider

• The Rumors Were True - USMLE Advice

Question Banks

• USMLE WORLD
• USMLERx (w/free trial)
• Kaptest QBank (w/free trial)
• USMLE Consult (w/free trial)
• Gunner Training (w/free trial)
• NBME Self-Assessment********Estimate your Projected Score

Books
Many resources reccommend the following as MUST HAVES for step I preparation:

• Goljan - Rapid Review Pathology
• BRS Physiology
• High Yeild Neuroanatomy
• BRS Statitistics
• First Aid (most current edition)
• Kaplan LivePrep Lecture Notes - these are only available through taking Kaplan's LivePrep Course, however, older and current editions are being sold on EBay and are a great high yeild resource if any (according to many forums) - and perfect for self studying I've heard. 

Here's a link to find these popular picks:  http://doctormuggle.blogspot.com/2011/09/books-essential-for-medical-school.html
Here's the link to my Full Medical School Reccomended Books: http://doctormuggle.blogspot.com/2011/06/books-for-medical-school-usmlesgu.html


Goodluck all! 

Official 2013 USMLE Sample Questions -138 free questions

The Federation of State Medical Boards and the NBME (National Board of Medical Examiners) release a pdf on their website with all the information regarding the test, from Content, which you can think of as objectives, rules, test procedure, etc.

At the end of this pdf, there are 138 full color official practice questions. I'm sure they put the same questions every year, more or less, but its a good feel for the type of questions

these do correlate with your predicted score, so maybe wait till closer to the real thing to take it if you're wanting to gain that benefit.

ANSWERS ARE INCLUDED. so don't worry about it being a waste of time, you can learn something if you want.

HERE IS THE PDF:
http://www.usmle.org/pdfs/step-1/2013content_step1.pdf

HERE IS THEIR WEBSITE for STEP 1:
http://www.usmle.org/step-1/

USMLE World QBank App - Uworld Questions fast and easy

Finally, the famous USMLE World Qbank for Step 1 is for Ipad and iphone. Go out and get it.

This is your fastest way to do questions, for some reason it just is faster, and you can be anywhere! Just don't forget that you'll need to get used to the Fredv2 format for the exam on a PC computer, but for practice this is excellent.
     The app is quite nice, like the kaplan qbank, offering complex feedback and explanations. One thing that's better than the Kaplan Qbank, they allow you to review and look at tests older than the last one you did, which is super helpful.

Hoping for a USMLERx app for valentines day!

Done with Step 1!! My Experience and some universal advice

Just finished the infamous Step 1 exam!
all 368 questions! 8 Hours.

Okay. I've thought a lot about what kind of advice to give from my experience. I realized that telling about what I studied, whats best, and how gives very little benefit to anyone because of A) I only had enough time to study one way, and I have no way to form a comparative opinion, and B) because what works for me may not work for you. There are many good resources, and we all start from different starting points. So, I'd like to give some more universal advice that everyone can appreciate instead, anything else would feel irresponsible and arrogant. My way was not necessarily the best way for you. If you want to ask me directly, feel free.

However, here was what I thought was (and sorry if this is repetitive from other sources) the best use of my time.

*Uworld, the Doctors in Training Program, and Of Course First Aid*
*The NBME exams and simulating test day was essential, and making it 8 hours was really the hardest thing for me, and I think it would have been no matter how prepared I was. It's just a long exam!
*The way I feel about these are if had I done without ANY one of these things, I would not have been ready for the exam. Period.

But everyone knows to do some sort of comprehensive review and a question bank or two, you can find that advice anywhere. Here's my more general advice:


1) General Advice

• Make sure you pick Something, whatever feels right for you and STICK TO IT. You pretty much only get one chance before you burn out (also it would be nice to nail it the first time) and so trust that the choice you make is the best one, and use it to your benefit as best you can. After going through my review process, I was extremely fatigued, tired of studying and ready to be done, and I can only guess you will be too. Going another round NEVER crossed my mind as an option, I think I would have lost it. 
• Avoid Burning out! Studying for 5-10 weeks i think works for about everybody. It's fairly widely accepted that 6-8 weeks is enough time to prepare. I agree 100%.  I think timing is so important when making a study plan because you start forgetting things after a while, and mental fatigue or burnout can negatively impact your performance on the exam. You should try to tackle the Step in your prime. Some people I know moved their exam a little earlier so as not to burnout before taking it, remember its a LONG exam, and fatigue really does play a big role in your performance!

• Find some source of motivation early on. Be it someone else to study with (preferred), imagining what you plan to do after its over (haha, or not do), or just periodically closing your eyes and imagining the feeling of the moment you step outside the testing center when its all over... something to keep you going. It will undoubtedly be a lengthy, uncomfortable, and agonizing process to prepare, but its only a couple months of your life, and you'll get through it. That is if you decide to dedicate the 10-12 hours that some sources say the top students reported doing. I tried it, and this is really an in-humane way to live for 6-8 weeks. So you need something to keep you going if you want to stick with it. 
• Some people take longer and a more relaxed study schedule, but I agree that studying everything efficiently in a shorter amount of time, and focusing completely on your ultimate goal of Rocking This Exam is the absolute best way to go!!

3) Picking an Exam Date

• One thing I learned from Kaplan is that you should ONLY take the exam when you KNOW you will be ready for it. If youre barely passing the assessments, don't take the Step! Its that simple. You can use the NBME exams, or a number of other practice assessments to measure this, Kaplan, Uworld, the USMLE website etc have assessment exams for example. I can't responsibly comment on what I took or what was my best assessment, because I couldn't do all of them and I don't trust the online forums completely. Again, pick one or more, and trust its the best choice for you. Just make sure you do one! If you don't assess yourself, how will you know you are ready? The more the better probably. 
• Practice taking over 300 questions atleast Once!! I recommend more than once, and doing it in the fashion of the exam. No water, no food except on breaks, limit your break time.. You want to feel that endurance effect, and to live out the exam anxiety so it is not foreign to you on test day.
• This is important!! KNOW your prometric center in the US. Let me clarify some things: Each center offers different exam times. The center I went to offered 8am, 10:30am, and 1:30pm exam start times! Also... Know that these centers are NOT just for Step 1. There are people tackling the GRE, MCAT, Tech exams, Law, .... and a variety of other exams, and depending on how busy of an area the center is in, depends on whether or not you will have a lot of available spots to register for. 
• This is important because you may want to change the date of your exam while you prepare. I did. Many people I have spoken to did, and so may you. You do not want to be confined by the availability. Note the first bullet, you want to take the exam when you are ready, not when the test center is ready. Don't mind the date change fees either, your bank account doesn't know when you are ready to take the exam either. Get familiar with the testing center you plan to use, (or even have a backup if youre an indecisive person). On the Prometric Testing Website, you can check the availability often and see how availability of days and/or exam times change, and don't wait too long to change it, your exam time slot, or day can be lost if you don't act!
• Its also important (especially if you are preparing in Grenada and plan to travel to take the exam to different time zones). Good news! you may not have to change your sleep schedule to take the exam during your optimal performance time, say if you are waking up at 8am in Grenada, and sign up for a 130pm spot on the westcoast you will be just fine.
• Not that important, but just be aware of time changes like daylight savings, I actually had my exam very close to the time change and you want to be ready for it. Even while anticipating it, it took some time of adjustment. 

4) How to study

• Please don't take this advice as God's gift to studying for the USMLE, I am just offering what I thought helped me, and hopefully it may help you.
• Ok, Rule #1: Get answers wrong. This is a great thing. Each time is an opportunity to learn something you didnt know, or better yet, something you thought you knew well, but still got wrong, and FIX IT. This is good. embrace this. That's why doing as many questions as you can really helps you.
• Don't wait to do questions all at the end. Example, you think you know everything about statins. Now its 2 weeks before the exam, you're hauling full speed through a question bank and what do you know, youre getting questions about statins wrong!!! Now you feel like a dope and getting anxious that theres 2 weeks left and you still are getting things wrong you thought you knew! The solution. DO QUESTIONS EARLIER. This is the overall principle: You Will be tested on topics that you know, and you can easily anticipate this, I mean... Most ALL the high yeild stuff is in First Aid!. BUT HOW THEY WILL BE TESTED will be different, and if you do not do the questions in order to anticipate all the different ways a piece of information can be manipulated and asked from different angles in questions, you'll be caught off gaurd. Example: Huntington's disease. You could probably tell me everything about this disease, triplet repeats, chromosomes, symptoms, age of onset, blah blah blah, you probably also know it causes caudate atrophy. Like I said, you know it. But can you point to the caudate on a CT Scan of the brain? That's the likely different angle the USMLE will use against you. You must practice, and practice early as you review to get exposure to as many of these types of questions as you can. 
• Although I thought it was helpful going through all of my fully annotated first aid the few days before the exam, it was terribly painful.  It is incredibly frustrating spending hours reading/studying things you (at this point) know very well, but its an invaluable review. 
• I also made a list of things from day 1 of things I didn't know, don't know well, or probably wouldn't remember. I enjoyed going over this much more because it felt fresh and much more accomplishing to read. I would review it before going to bed everynight as the list got longer until it becomes part of me. When I was tired of reading repetitive things, I would go over this list to see if I was retaining it.  
• For each Question bank you use... Use them as a learning tool. You may feel compelled to use it as an asssment tool with all the numbers and percentages and whatnot, but commit to reading the explanations of the right answer, AND the reasons why the answer you thought was right, was in fact wrong. This will be a lot of the learning you'll do. Use the NBME and other resources for assessment. 
• Take Days Off!! Your mental health depends on it. Do fun things. Loosen up. Don't be all work and no play. You've been studying in medical school for 2 years already, can you seriously admit that you have studied for 6-8 weeks straight without going out? If your answer is no, then you already know better and know this advice is important. Take breaks. You deserve them. Especially the day before. It feels good to give that day of rest to kill the momentum of the anxiety and anticipation you feel for this great exam, and take the edge off. I thought it was invaluable to help me sleep that night.

5) The Exam Day

• I still feel that theoretically, if I knew Everything for the exam, enough to get 100%, I still think I would have fallen short because of this: The hardest part of the exam for me was how long it was, and dealing with mental fatigue can affect your performance. The physical endurance of performing, deducing, and reasoning for that long is part of the exam. You have 8 hours and 368 questions. It is very long. Anticipate this, and do what you can to keep yourself as alert and functional as possible during those 8 hours to do your best! So...
• Know yourself, and plan your breaks out ahead of time (you can do this by using the assessments)
• See when you need to goto pee from all the coffee you drink, or start to lose focus or what and plan for it!
• Get a good night sleep
• Eat long-lasting energy foods, and don't overeat! Eat light (you can snack on your breaks between blocks)
• Register for an exam time that works for you (if you can help it). 

Finally, and most importantly, Goodluck! Some of the questions you will endure will seem foreign to you. You should expect some bogeys. Some of the questions you do get, will, in part be luck. But a lot of them are anticipatory. Believe in yourself, know that the effort you have put in will pay off, and know that if you did what you planned to do in the first place, you should feel proud and ready to do the best you can. 

Great luck to you all!

Difference between First Aid 2010 and 2011 - Student Doc Network

If you don't know about student doctor network by now... well... oh well. But you'll understand why you should after seeing this post. They have some really helpful people over there.

Here are ALL the changes between the 2010 and 2011 versions of First Aid, in case you were wondering.

http://forums.studentdoctor.net/showthread.php?t=785943

Looks like 2011 dropped a lot of material, rather than added. Some seems important, but not all. Might be worth while annotating the dropped/added topics to your version to make it complete, just in case. It doesn't hurt having more, but I agree, slimming down the new version is probably making it just a little more high yield.

Waiting on the 2012 version as of January 6th, 2012, to see what kind of changes happen there. I am expecting a lot more changes since 2011 wasn't much of anything new. 

USMLE Practice Questions 60 Free

if you get bored... http://www.mommd.com/usmle1to10.shtml

60 free USMLE style questions with explanations.

Embryology - Memorize it

No one seems to like embryolgy, well I stumbled on a pretty cool website with some good quick memorization software and good facts to know for the Test.
Enjoy!

http://memorize.com/embryology/shraddha226

Ipad - USMLERx Flash Cards - Great!

This App is SUPER good for reviewing First Aid. It's like having the study partner who pays attention all the time ask you questions about the book you think you know so well, First Aid.

Really well planned out app. You can build cardsets from any modality you choose out of over 11,000 Flashcards!!!!! The app is free, but you have to purchase the card sets individually within the app itself.

I have found a couple free sets but, and after trying out a few sets of cards, I am tempted to buy the whole set. You get to see the question, and try to remember the answer, then touch the screen, the card flips over and shows you the answer. Then you get to give it feedback, whether you got it right or wrong. Swipe to the side, and on to the next card. This is a great review resource while on the bus, or during any situation. It's so fast. Also, it keeps track of what you remember and don't remember so you can go back and review those things you have trouble with later. There's a timer included as well, so you can add that element of pressure, that's good to get used to.

Highly recommend this one as one of your Ipad USMLE starter kit.

Kaplan Qbank Ipad App - Questions on the Go

So, Kaplan offers a fantastic application for doing your usmle testprep anywhere, and anytime.

The app is free, granted you paid for a questionbank subscription. At the moment they have a good deal of offering upto 12 months for only $200. You get 2500 questions, a good deal in my opinion, especially compared to other Qbank prices I've seen.

The good:

• The app is fast.
• You can Pause, and resume as many times as you want, and quit out/come back to the application.
• You have the option of choosing to create custom tests just like the online website
• You can choose unused questions, or questions youve previously gotten wrong, or a combination
• The full explanation, how many seconds it took you to answer, and why the wrong answers are wrong are provided after each test you complete.
• It's up to date with the new questions, downloaded straight from your Qbank. 
• You can review your total subjective scoring, and overall percentages. 

The Bad:

• The app is Iphone/Ipod/Ipad compatible... however it is written for Iphone/Ipod format, so when you expand it to 2X size... its not as crisp as you would expect it to be on your Ipad you spent so much money on. 
• You can't review past tests you've taken in the past. 
• You can only work on, and review one test at a time. 
• You cannot make tests longer than 45-50 questions. 

Overall though, I've found this more than useful! I even do questions during lecture when it gets slow... and then pause it immediately when the lecture picks up speed.

Kaplan Videos + Lecture Notes 2010

If you get the Kaplan 2010 videos, I suggest you get copies of the 2010 Kaplan LivePrep Lecture notes as well. These follow along Exactly, and the videos point out extra *usually important* learning points and let you know what the pertinent information is and HOW it can be asked in a USMLE style question. However the lecture notes themselves are organized and straight forward and very easy to follow, and the videos themselves are a great audio/visual review, I've learned the combination of the two make for the best learning experience with these materials.

You can buy the videos from Kaplan, however, they are available online illegally.
Kaplan suggests you do the honest thing and purchase from them for a couple thousand, in which you will be given "a diagnostic test, 9 subject-based assessment tests, a full-length Simulated Exam and a 7 volume set of our high-yield Step 1 Lecture Notes". In addition, the lecture notes can be found online in pdf format, and also purchased for a reasonable price on www.ebay.com, although I'm not sure about the legality of selling such items.


********** I think these are pretty good extra resource for reviewing everything during 5th term, and a great thing to have for Step Prep if you're planning on NOT doing the Kaplan liveprep course. 

Books Essential For Med School + Getting Ready for the Step

These are your MUST haves according to a lot of sources, for the Step. They are also a really good idea to get a copy of for 5th term, since you'll want to get acquainted with the books that you're planning to use for the coming months for Step Prep.

The first 3 are recommended by Doctors in Training, students, faculty, and more and the last 2 three are recommended by students pretty consistently. Of course, first aid is recommended by everyone and their mother (make sure you get the edition most consistent with the year you're taking the Boards).


If youd like to search for more books, you can use the amazon search engine or click on the "bookstore" tab to see the ones i've compiled if you think you need others.

USMLE Step 1 - SGU Blogs Recommendation - The Rumors Still Are True

Let me say this right now. If you hate blogs, but you want to pick ONE (probably even better than mine, maybe)... this is the one you want to read:
The Rumors Were True - WordPress Blogger - SGU Student

This guy has such a great outlook on the SGU experience, so much valuable and straight forward advice and wisdom somehow. I have made so many decisions based off of his writings, and they have helped me at some critical points during my time at this school, including whether or not to Drop Out, if I could transfer schools, and How to prepare for the journey to the Step. Quite inspirational and motivating indeed.


The thing i worry about is giving some people the wrong idea, obviously we all study differently and have different expectations, and thresholds to maintain our focus, so I will not post a "garunteed to ace the exam" article. I won't. But, if youd like to see why I made the deicisions I am making, I'll be glad to post them. 

Which Pharmacology Flash Cards To Get for USMLE?

Okay, so there are tons of these. And I've heard that some people buy them, never use them and sell them and others say you definately need them. Recently I visited the Stanford Bookstore, which has a huge Medical Section, and I got intimate with about 6+ of the many flash card sets.

This is what I concluded:

****update**** having been through most of pharmacology by now. I've realized these cards may not be super helpful. There are so many cards that aren't in the class, and so many drugs/supplements/alternatives that are in the class and not in these card sets. Overall i think it might be a better idea to make your own flascard set or get someone's that made it specially for your schools pharm class. The lange + BRS card sets are great though since they test you vinette style + rapid fact fire respectively. However, continue reading if you're interested. 

These cards by Brenner are straight forward. They have the name printed on front in a couple colors, and organized information like type of drug, action, complications, uses, etc on the back. They are color coded by system, so you can group drugs that work in similar areas together, but the card info is not overly stimulating in terms of color. They are simple to look at. *****UPDATE *** okay, so I bought these cards for my 5th term Pharmacology class, and they are NOT helping. A lot of drugs, organic compounds, agents, toxins, and other things on our objective drug list that are not covered in this set. I've found that building your own flash card set from your notes are the best set of cards possible. This may help for the step as a review, but im rethinking an index flash card set.

I guess you can use these cards as a reference to turn to in order to make sure you dont miss any important information. They are not overwhelming with information and seem to give the most important details.



Lange Pharmacology Flash Cards. **These However** I think are a much better resource.  I have seen these highly recommended, and I understand why now. These cards are different. They have a clinical vignette on one side, and then the name of the drug, along with high yeild information about the drug on the back.

I didn't see anything else like this. I avoid owning more than one set of flash cards, but honestly these looked like a question book in flash card form rather than an index of cards. Great practice for the USMLE.






Rang & Dale Cards. These cards I won't forget. They gave me a headache. These cards have absolutely everything on them. Diagrams on every card, drugs with arrows of inhibition or activation of pathways. In the diagrams, they show drugs that work on the same pathway or nearby, so multiple drugs on each diagram. They are color coded, they have all the info on the back about each drug/card that the brenner cards have including mode of action, side effects, etc etc. These are in multi colors too.

To me, this set seemed like it was a textbook in card form. It was way too much information to me to process at once and it gave me a headache. These are probably perfect for a super complete, compiled, thorough review of biochem and Pharmacology, and best for those with photographic memories for all the diagrams in there. To each their own.


The Johannsen Cards. I feel like I might regret not buying these. They are two-toned. Blue and black. Very easy on the eyes. All the information is there, side effects, mode of action, type, class of drug, etc, etc and there are diagrams occasionally as well.

Unlike the Rang and Dale Cards, these diagrams are straightforward, simplified, and focused on one or two important regulatory points. A lot easier to read at a glance.
I got a good feeling from these cards. They combine the simplicity of Brenner Cards and includes diagrams such as the Rang & Dale for some extra visual learning.
This style pushes more towards a learning tool, rather than a review deck of cards.
Whatever you plan on using the cards for, learning, review, or both.



BRS Pharmacology Flash Cards. These are VERY DIFFERENT! However, I have seen these highly reccommended for the USMLE. This is the 2nd edition.

These are your classic recall flash cards. They have a high yield fact on one side, and a drug name on the back. That's it. Simple, quick, flash cards.

I don't understand why you need to buy this in card form, this could easily be typed up by someone, and shared online on an excel file or a Quizlet Set.
In fact, i just did a quick Quizlet search, and I haven't looked this over carefully by anymeans, but it looks like some one has made what looks to be similar to this set of cards. http://quizlet.com/12023/brs-pharm-flash-cards/ check it out. Not sure if this is the actual BRS content. This is also from 2007, so its not that upto date. Just saying.



Kaplan USMLE Flash Cards. These have also been highly recommended by some sources. I believe these are similar to your Lange Flash Cards, expressing a USMLE style question on one side, and the answer along with high yield info on the back. They are fairly great, but designed for Step 1, 2, and 3. A lot of this information IS tested for the steps but you will come across these high yeild facts else where, these cards are merely redundant and superfluous study material. If you are in New York, Kaplan holds regular meetings at their homebase and hands out these card sets for free.

Not good for learning the drugs, but good for testing yourself for the step.



=========  ==========  =========  =========

These are available online, remember lots of people buy these sets and pass them on. They are available on the island, just ask your PEERS!! and in the bookstore on the island. Check the post! LINK: SGU POST

THERE ARE OTHER SETS OF CARDS!!!!! There are literally so many. These are the main ones I can remember looking at for a while in the bookstore. Please don't take all my opinions as solid fact. There are many many item REVIEWS for each of these and more sets on Amazon.com... at the bottom of each page.
Click the set and see what people have to say about them for additional comments to confirm things or contest things I have said.

Thanks everyone. Enjoy!

Errors! Master the Boards Errata Step 2/3 - Kaplan - First Aid CK, CS Mistakes!

Of course, if you read my "two biggest advices for medical school", you'd agree that you never trust what other's tell you, why? because we are human, and we make mistakes. A lot of people are really liking the Master the Boards MTB series for Step 2 and Step 3 studying, and of course these are without exception. Even the might Dr. Conrad Fischer makes booboos. But like responsible adults, we take responsibility for our mistakes and graciously post the Errata online so you don't walk into the Test believing the mistakes are true.

So just be aware. The errata are posted here for Master the Boards and Kaplan's Books, just scroll down to the medical section and fix them:
http://www.kaptest.com/publishing

Probably more important is Step 1: 
In the past I posted about First Aid, and how when studying for Step 1, you should scour the errata and FIX THEM! In 2011, there were 11 pages of errors in the sacrad First Aid book! Well, there are errors in all the books for CK, CS, Step 1, Step 2, Step 3... And of course they have posted the Errata as well. Before its too late and you commit them to memory wrong...

you can find and fix them here:
http://www.firstaidteam.com/updates-and-corrections

Don't learn from your mistakes, you don't get second chances on the STEP!
Better to prevent them from ever happening!!!

Cheers!

My goto guys when confused by Lectures

Often times our lecture material is not organized. You would think after all that money we poured into our school, that's the least they could do.

So, check out this website. I use it quite often to get the Epidemiology, Facts, and Correlations for most of everything when I need it. Enjoy!

http://d3jonline.tripod.com/

Pick a Specialty Quiz

There's A website that usually you need membership to use, which is a questionaire to help you figure out which specialty is right for you.

I'm not sure how accurate it is, but it's kind of fun to see if you have no idea. Check it out.

http://medpathway.wustl.edu/main_menu.htm