“Live as if you were to die tomorrow. Learn as if you were to live forever.” – Mahatma Gandhi

Tao Le, MD, MHS Assistant Clinical Professor Chief, Section of Allergy & Immunology University of Louisville Senior Editor First Aid Board Series USMLERx Test Bank Series First Aid for the USMLE Step 1: The Really Short Version

Overview n USMLE Step 1 – The Basics n Defining Your Goals n Timelines for Study n Approaching Each Subject n Choosing Prep Resources n More Tips n Overview of First Aid/USMLERx n Q&A

Relax.

USMLE Step 1 - The Basics n 8 hours total n 322 questions in 7 one hour blocks n 46 questions per block n 45 minutes of break time Lunch

Question Types n One-best answer items n Sequential items n A few with multimedia n Clinical vignettes u 70-80% of exam u Multi-step reasoning A 32 year old caucasian woman presents with a 5 day history of occasional double vision and ptosis. What is the most appropriate diagnostic test?

Scores and Passing Rates n Passing is 188/75 n Mean is 221 n 22 points is 1 SD n Allopathic med students u 95% pass on first try u 99% eventually pass n Osteopathic med students u 77% pass on first try n IMGs u 71% pass on first try

Defining Your Goals n Just pass the exam  200 – 221 n Beat the mean  222 – 244 n Ace the exam  245+ n “ROAD to Riches” u Radiology/Radiation Oncology u Ortho/Ophtho/Otolaryngo/Urology u “Aesthetic” Surgery u Dermatology

NRMP: Charting Outcomes in the Match

Timeline for Study n The “Just Pass” Schedule – 1 to 2 months u First Aid High Yield Facts u Crammable subjects u Review questions – 1 question bank n The “Gunner” Schedule – 2 to 6 months u In addition to above u Less crammable subjects u More review questions – 2 question banks

Choosing Study Strategies n Structure and characteristics of the subject n Structure and characteristics of your curriculum n Time assigned to a particular subject or system n Your style of learning

Anatomy n Traditional anatomy is low yield n Know anatomy for specific diseases, traumatic injuries, procedures, and common surgeries n Neuroanatomy, embryology, basic cross sectional anatomy is high-yield n Be able to identify structures on X-rays, CTs, MRIs, electron micrographs, and photomicrographs

Behavioral Science n Mix of biostats, psychiatry, psychology, sociology, psychopharmacology n Biostats and epidemiology is very high- yield n Personality disorders n Doctor-patient interactions

Biochemistry n Crammable!! n High yield topics include vitamin deficiencies, diseases of genetic errors, key regulatory enzymes n Understand the “pathobiochemistry” n Be familiar with medically relevant laboratory techniques

Microbiology & Immunology n Crammable!! n 40% bacteriology, 25% immunology, 25% virology, 5% parasitology. So don’t fixate on bacteriology! n Focus on distinguishing characteristics, target organs, method of spread, and diagnosis n Know the immune response, vaccines, immunodeficiency diseases n Know viral structures and genome

Pathology n Huge but important topic n Know hallmark characteristics of each disease including signs and symptoms n Look for clues in age, sex, ethnicity, activity n Know descriptions of “trigger” words n Most questions with gross specimens and photomicrographs can be answered from the history alone

Pharmacology n Crammable!! n Focus on prototypic drugs; forget obscure derivatives, trade names, dosages n Major categories are ANS, CNS, antimicrobial, cardiovascular, and oncology n Mechanisms, clinical uses, and toxicities are high-yield n Review associated biochemistry, physiology and microbiology

Physiology n Concept oriented n Diagrams work well in physiology n Know basic physiologic relationships, hormones n Many clinical vignettes incorporate pathophysiology

Review Resources n Text reviews n Test banks n Self-test reviews n Case-based reviews n Review courses n Other media u Flash cards u CDs/MP3/Videos u PDA

Picking and Choosing Resources n Buy books/resources early n Buy only what you can use n Don’t blindly buy a whole series n Check out the book reviews in First Aid for the USMLE Step 1 (Section 4)

Study Tips n Establish a study schedule and stick with it n Alternate study methods for variety n Save “crammable” subjects for the end n Focus on high yield material and previous learned material n Allow time in schedule for breaks, exercise and personal issues n Stay relaxed and grounded n Use our checklist to keep you on track

CBT Tips n Be very familiar with the CBT tutorial n Know the keyboard shortcuts n Use computerized practice tests in addition to paper exams n Mix Q&A throughout and at end

CBT Practice Options TypesSuggested Use USMLE Sample TestFormat familiarity NBME/CBSSABenchmarking Commercial Test BanksPractice/study Simulation

Test Day Tips n Less coffee on test day n Layered clothing n Read lead in first for long questions n Manage the clock n Light lunch n The “C” reflex n P = MD/DO

Now a word from our sponsor… USMLERx Step 1 Qmax n high-yield USMLE Step 1-style questions in FRED v2 format n All new sequential and multimedia questions n Integrated high-yield facts from First Aid for the USMLE Step 1 n Select questions by difficulty level n Accurate USMLE score predictor

Now a word from our sponsor… USMLERx Step 1 Flash Facts n World’s largest Step 1 flash card bank n 10,000+ flash cards covering all the First Aid high- yield facts n Integrated with First Aid for the USMLE Step 1 online n Searchable by organ system, discipline, and topic n Discuss, annotate, and mark your favorite First Aid topics n Now available as an iPhone/iTouch app!

First Aid Team 2.0 n Visit our blog – u Download the presentation u Get First Aid/USMLERx updates n Follow us on Twitter – n Join our Facebook group u Click link on Firstaidteam.com n USMLERx –