Step I Support Session - Moderated by Dr. Regina Mitchell Office of Learning Resources and Support August 14, 2018 at 6pm-7:30pm TMEC Amphitheater ...

Step I Support
                  Session
                            Moderated by
                      Dr. Regina Mitchell
Office of Learning Resources and Support

          August 14, 2018 at 6pm-7:30pm
                    TMEC Amphitheater

Step 1 and 2CK
∗ Apply via the NBME Application website
∗ During the application process, select a 3-month eligibility period during
  which you wish to test.
∗ You will receive an e-mail notifying you that your scheduling permit is
  available.
∗ Visit the Prometric website to schedule your test date.
     ADDITIONAL INFORMATION:
∗ You may be able to schedule your test date up to 6 months in advance.
∗ If you are unable to test within your eligibility, contact NBME to inquire
  about a one-time eligibility period extension; a fee is charged for this service.
∗ If you do not take the examination within your eligibility period, you must
  reapply with a new application and fee.
∗ Your application fee is nonrefundable.

Step 2 CS

∗ Apply via the NBME Application website
∗ You will be assigned a 12-month eligibility period, which begins upon
  acceptance and verification of your application
∗ You will receive an e-mail notifying you that your scheduling permit
  is available.
∗ Visit the USMLE website to schedule your test date
    ADDITIONAL INFORMATION:
∗ Once assigned, your eligibility period cannot be changed
∗ If you do not take the examination within your assigned eligibility
  period, you must submit a new application and fee
∗ Your application fee is nonrefundable

USLME Examination Fees
For Students and Graduates of Medical Schools in the United States and Canada
Accredited by the LCME or AOA

                   2018 Fees   Effective Dates for 2018 Fees

       Step 1         $610*    Three month eligibility periods beginning November 1, 2017 - January 31,
     Step 2 CK        $610*    2018 and ending October 1, 2018 - December 31, 2018
    Step 1 and
       2CK
                       $70     Eligibility Period Extension (requests received starting January 1, 2018)

     Step 2 CS        $1,285   For completed applications received starting January 1, 2018.

2019 Fees                                           Effective Dates for 2019 Fees
 Step 1 $630*                                        Three month eligibility periods beginning November 1, 2018 -
                                                     January 31, 2019 and ending October 1, 2019 - December 31,
                                                     2019
 Step 2 CK $630*

                                                     Eligibility Period Extension (requests received starting
 Step 1 and 2CK $70                                  January 1, 2019)

                                                     $1,290 For completed applications received starting January
 Step 2 CS                                           1, 2019.

Test Accommodations

Test accommodations include but are not limited to the following;

∗ Assistance with keyboard tasks

∗ Audio rendition

∗ Extended resting time

∗ Additional break time

∗ Enlarged text and graphics

∗ Permission for assistive devices

   ∗ Detailed information about test accommodations while taking a USMLE
      examination is available at the USMLE website.

Test Accommodations cont.

USMLE Accommodations Links in Detail

∗ http://www.usmle.org/test-accommodations/

∗ http://www.usmle.org/test-accommodations/requesting-

  accommodations.html

∗ http://www.usmle.org/test-accommodations/guidelines.html

∗ http://www.usmle.org/test-accommodations/forms.html

Step I Exam Content Links

∗ Practice materials updated March 2018
  ∗ Content Description and General Information Booklet (PDF)
  ∗ Sample Items (PDF) Tutorial and Practice Test Items for Multiple-
     Choice Questions (For best results, launch in Chrome browser.)
   If you have questions or issues, check out the Frequently Asked Questions:
   Practice Materials.
   If you do not find the answer you need, please fill out our contact form.

USMLE Computer-based Testing (CBT) Practice Session
∗ Practice Sessions are available, for a fee, for registered examinees who want
  the opportunity to become familiar with the Prometric test center
  environment. Register for a CBT Practice Session »

NBME Self-Assessment Services

∗ The NBME provides a variety of web-based self-assessments to US and international
  medical students and graduates through the NBME Self-Assessment Services
  interactive site.

∗ Comprehensive self-assessments allow you to evaluate your readiness to take
  USMLE® Step 1, Step 2 Clinical Knowledge (CK) and Step 3. Target your studies
  using diagnostic feedback highlighting areas of strength and weakness. Use your self-
  assessment score to estimate your approximate score on the USMLE score scale.

∗ The Clinical Science Mastery Series assess your medical knowledge or understanding
  of the clinical sciences . Target your studies using feedback that provides a
  breakdown of incorrectly answered questions by content category. Translate your
  self-assessment score to an approximate score on the NBME subject examination
  score scale.

NBME Self-Assessment Services cont.

∗ The NBME offers self-assessments to evaluate your readiness to take the
  International Foundation of Medicine® (IFOM®) Clinical Science
  Examination (CSE). Get familiar with questions that appeared on IFOM
  CSE. Target your studies using diagnostic feedback highlighting areas of
  strength and weakness. Use your self-assessment score to estimate your
  approximate score on the IFOM score scale.

HELPFUL INFORMATION

FAQs about Self-Assessment Services

Self-Assessment Services Information Guide

USMLE Minimum Passing Score

∗ USMLE results are reported on a 3-digit scale.
∗ The minimum passing scores are as follows:
                   Step 1: 194
                   Step 2 CK: 209
∗ Step 2 CS: A pass/fail examination.
Examinees are scored on three separate subcomponents. All subcomponents
must be passed in a single administration, to achieve a passing performance on
Step 2 CS.
   ∗     Communication and Interpersonal Skills (CIS)
   ∗ Spoken English Proficiency (SEP)
   ∗ Integrated Clinical Encounter (ICE)

HMS Mean Scores

∗ The HMS overall mean for 2017 = 245*

∗ The HMS overall mean for 2016 = 240*

∗ The HMS overall mean for 2015 = 243*

*Data reported by USMLE in annual report.*

General Self Care/Study Tips

1. Make a schedule and try to stick to it.

2. Try not to schedule any big events during your study time.

3. Take frequent breaks

4. Be sure to exercise

5. While studying, getting a good night’s sleep is important to feeling
   refreshed and ready to study

General Self Care/Study Tips : The Week Before
∗ Focus on the Qbank
∗ Try to wake up around the time you would on test day, to prevent
  feeling drowsy during the test.
∗ Take a trip to the center to see how long it takes you to get there.
∗ The day before, do things that are relaxing (ex. watch a movie, go
  shopping, go for a run, etc.)
∗ Try not to take any sleeping pills as this might affect you the next
  morning.
∗ Have your meals and snacks planned out.
∗ The day of the exam- breath, relax, think about a nice breakfast and
  then a healthy lunch. Know you are well prepared.

HST STUDENTS!

  Please be sure to check in with
   your HST Advisors and HST
  Students, since your experience
     really has been different.

Student Panelists

Panel                   Support from Afar
∗   Damari Croswell     ∗   Dana Callahan
∗   Luis Fandino        ∗   Margaret Hayden
∗   Aditya Karhade      ∗   Henry Su
∗   Nayan Lamba         ∗   Khin-Kyemon Aung
∗   Emma Meyers         ∗   ISA- Standardized Exam working
∗   Vihang Nakhate          group (Galina Gheihman, Andrew
                            Maul, George Agyapong, Khin-
                            Kyemon Aung, Saksham Gupta,
                            Darshali Vyas)

ISA – Standardized Exam Working Group
ISA Working subgroup on Step 1; 25 current 4th year Pathways students were
polled.
What resources did you use or like the most?
Top Resources
∗ UWorld,
∗ First Aid,
∗ Pathoma,
∗ Sketchy Micro,
∗ NBME Practice Exams
   ∗ These were all consistently cited by students as being favorites and
      essentials for studying, with particular emphasis on UWorld, First Aid, and
      Pathoma.
   ∗ Less frequently cited resources included the following: Boards and Beyond,
      USMLE-Rx, Sketchy Pharm, Anki, Kaplan Pharm, Goljan Audio
      Lectures.

ISA – Standardized Exam Working Group cont.

Were you happy with your performances?

         Satisfaction with Performance: 22/25 (88%) students were happy with their
performance.

What thoughts would you share with others preparing for Step 1?

∗ Have a systematic, but adaptable approach that plays to personal study-style
  strengths with built-in catch-up time.

∗ Less is more: focus on the resources that you find easiest to learn from and supplement
  with those you find less useful.

∗ Self-care: schedule time (1 day per week off cited most often) to spend away from
  studying.

Aditya Karhade
Step I Prep
General Approach to Step 1 Prep
∗ Studied for 5 weeks and focused on doing as many questions per day
  as possible.
∗ I studied from 8-noon, took a break for two hours for lunch and
  then studied from 2-6.
∗ As my test approached, I also reviewed any questions I got wrong
  after dinner. Resources
∗ Used UWorld,
∗ USMLErx - will discuss
∗ First Aid.
∗ Used the NBME sample tests to prepare for the day of the exam.
  Spaced them out over my study time.

Damari Croswell – Scheduling and Repetition
Scheduling Tips
∗ Break your day up into blocks (ex: 9am-12noon; 1pm-4pm; 6pm-9pm)
∗ Be specific with your scheduling
∗ Take breaks.
∗ No really, take breaks.
∗ …and they should be real breaks. Do something that 100% gets your
  mind off of studying (workout, go on a trip, hang out with friends and
  not talk about studying)
∗ Remember questions are often second-order, and involve a subject
  (cardio, GI, pulm, etc.) and a discipline (biochem, path, micro, etc.). Try
  to plan your schedule so that you get longitudinal exposure to these.

∗ You’d better study micro…

Damari Croswell
Schedule

Emma Meyers
Step I Schedule Excel Spreadsheet

Nayan Lamba
Study Schedule General Information

∗ Basic plan was 3 weeks of FA/Pathoma in the morning and
  80 UWorld questions per day to correspond (topic by topic).
∗ Each night, I spend 2-3 hours on review via Sketchy Micro
  and brosencephalon or some similar/flashcard review source
  for rote memorization and concept consolidation related to
  topics from the day.
∗ After 2-3 weeks of having gotten through all of FA as a first-
  pass, I focused on questions, NBMEs, and weak areas.
  Questions in morning, content review in afternoon.
  I continued Sketchy Micro and flashcards at night.

Nayan Lamba
Study Schedule General Information cont.

∗ The blocks refer to a certain amount of content; for First Aid,
  for example, they referred to about 40 pages, and for UWorld,
  they referred to about 40 questions.
∗ Allow yourself some flexibility to modify your schedule as you
  go, but also to set some hard rules for yourself (otherwise, you
  may fall behind!).
  ∗ For example, as much as I wanted to spend more time on
     Microbiology, I knew that if I spent too much time upfront
     on this topic, I would end up falling way behind on
     everything else. So, I really pushed myself to keep going
     even when I did not feel 100% satisfied with my mastery of
     a certain subject. I flagged these concepts and knew that
     once I got through everything once, I could return to the
     more challenging concepts again towards the end and
     dedicate extra time to them then.

Nayan Lamba
Study Schedule

Nayan Lamba
Study Schedule   cont.

Henry Su
    Step I Schedule             DEDICATED STUDY TIME: 7 WEEKS TOTAL.

          Week 0: Prior to Studying
∗    UWorld Practice Test
∗    NBME Practice Test
∗    Took both without any preparation to identify starting point and weak areas
∗    Found my worst subjects were Microbiology, Pharmacology, and
     Biochemistry.
          Weeks 1-2:
∗    Kaplan Qbank + Video Lectures x 6 days
∗    Budgeted time to cover:
∗    Kaplan Q's on Microbiology, Pharmacology, and Biochemistry
∗    SketchyMicro videos
∗    SketchyPharm videos
∗    Dr. Najeeb video lectures on Biochemistry
∗    Catch-up x 1 day

Henry Su
    Step I Schedule cont.
           Weeks 3-6:
∗    UWorld Qbank x 6 days
     ∗ Organized by Pathways blocks:
     ∗ ID/Derm/Optho/Rheum
     ∗ Cards/Pulm/Heme
     ∗ Renal/Endocrine/Repro/GI
     ∗ Neuro/Psych
     ∗ Other
∗    Approximately 1 practice NBME per week
∗    Catch-up x 1 day
           Week 7:
∗    Final review and catch-up
∗    Flashcards to cram certain topics into short-term memory

Dana Callahan
  Step I Reflections
Resources Used:
∗ UWorld Step 1 Qbank (did through until all questions correct x 2)
∗ USMLERx (did questions through once until all questions correct)
∗ All 6 NBME practice tests (once each)
∗ Sketchymicro -- I watched the videos through once then occasionally self-tested with
  the labeled scenes.
∗ No other resources - No Anki, No Pathoma, etc.
Summary of Approach:
∗ I did an entire question-based approach. (I.e. No separate reading, highlighting, note-
  taking, or reading through First Aid or other resources.)
∗ I bought First Aid but ended up not using it. Essentially, I just did a large volume of
  questions and read the answers as provided by the Q bank.
∗ I studied for about 5 weeks, total .

Dana Callahan
 Step I Reflections cont.
General Thoughts:
∗ Try to set up study time as you would a work day (e.g. 9-5 with an hour
  break for lunch).
∗ Many students will be studying many many hours, but remember that more
  hours doesn't necessarily mean better studying.
∗ Be intentional about choosing evidence-based test prep strategies.
∗ I.e. I strongly suggest NOT trying to read through or memorize First Aid.
∗ I suggest only using First Aid if you're really struggling on a certain content
  area even after lots of practice questions -- at that point, First Aid can be
  helpful to find a strategy to make that info stick.
∗ Then, I'd say go into First Aid with a targeted question (e.g. "I need a
  mnemonic to remember which growth factors use CAMP signaling pathways,
  since I always get those questions wrong and there are only 2 more weeks
  until test day"), and look up that mnemonic.

Dana Callahan
  Step I Reflections cont.
∗ I strongly suggest high volume question-based learning -- do non-stop
  low-stakes testing (Make It Stick-style!) and then take the practice
  exams in the last couple weeks.
∗ Take breaks, take weekends off, get good sleep, exercise, and spend time
  with friends and family, travel to visit family or non-medical school
  friends if possible (and if that's your style!).
In summary: Questions, questions, questions! No reading, highlighting,
note-taking, or study guide-making.
∗ And as a caveat to all of the above: Experiment to find the study
  strategy that works best for you, then stick with it and try not to
  worry about how other folks are studying.
∗ QBank x2 (plus the included practice exams)

Margaret Hayden
Step I Schedule: Weeks 1 - 2

Margaret Hayden
Step I Schedule: Weeks 3-4

Margaret Hayden
Step I Schedule: Weeks 5-6

Margaret Hayden
Step I Schedule: Week 7

Vihang Nakhate
Practice Exams
My experience:
∗ I took 5/6 NBMEs and 2 UWorld practice tests.
∗ First test at end of week 2. Then one test ~every 7-10 days.
∗ Took NBMEs individually, UWorld back to back to simulate full-
  length test.
∗ Devoted one full day to taking each test and then going over all
  questions and related topics.
Thoughts:
∗ Newer NBMEs (17, 18, 19) resemble real test more closely than older
  ones.
∗ UWorld tests are very useful for learning as answer explanations are
  provided, but questions not as reflective of real test and scaled scores
  seemed overly generous.
∗ Consider taking a baseline practice test before you start studying.
∗ Get comfortable testing in sub-optimal environments/noise levels,
  e.g. without your favorite noise-cancelling headphones.

Vihang Nakhate

     Managing doubts
       and worries

Khin-Kyemon Aung
Resources
On the topic of resources:
∗ Sketchy Micro and Sketchy Pharm (both!) were
  lifesavers.
∗ I recommend copying each image and putting it into a
  word doc and printing it out into a little book.
∗ I wrote all over my sketchy “books” as I was watching
  each video and even incorporated answers from
  UWorld into the book.
∗ I used this book for Step 2 so investing upfront time
  pays dividends down the road.

Khin-Kyemon Aung
 Words of Wisdom!
Words of Wisdom:
∗ A translation of a Burmese proverb from my parents on
  managing stress:

       “Don’t use all your arrows before the war starts.”

∗ It means don’t get worked up and worried about all the potential
  situations and things you can’t control (eg. what if I get a bad
  score and can’t get into the residency of my dreams).
∗ Don’t use all your arrows early because that battle/war that
  students can be so nervous about may actually never come and
  even if it does, you can’t use all the arrows (stress, anxiety,
  mental energy) before that battle starts (you have to save some!).
∗ Just work as hard as you can and control the situation before you
  now.

Luis Fandino

          Maintaining
         Accountability

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