1. Tao Le, MD, MHS Associate 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

2. Relax.

3. 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 Updates on First Aid/USMLERx n Q&A

4. USMLE Step 1 - The Basics n 8 hours total n 308 questions in 7 one hour blocks n 44 questions per block n 45 minutes of break time Lunch

5. 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?

10. Scores and Passing Rates n Passing is 192 n Mean is 230 n 20 points is 1 SD n Allopathic med students u 97% pass on first try u 99% eventually pass n Osteopathic med students u 94% pass on first try n IMGs u 79% pass on first try

11. Defining Your Goals n Just pass the exam  210 – 230 n Beat the mean  231 – 250 n Ace the exam  251+ n “ROAD to Riches” u Radiology/Radiation Oncology u Ortho/Ophtho/Otolaryngo/Urology u “Aesthetic” Surgery u Dermatology

12. NRMP: Charting Outcomes in the Match

14. 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

15. 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

16. 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

17. Behavioral Science n Mix of biostats, psychiatry, psychology, sociology, psychopharmacology n Biostats and epidemiology is very high- yield n New emphasis on patient safety and QI n Personality disorders n Doctor-patient interactions

18. 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

19. 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

20. 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

21. 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

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

23. 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 Videos u Mobile apps

24. 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)

25. 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

26. 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

27. www.nytimes.com

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

29. Test Day Tips n Less coffee on test day n Layered clothing n Read lead in first for long questions n Manage the clock – 1 minute rule n Light lunch n The “C” reflex n P = MD/DO

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