How To Study For USMLE Step 1

I’ve been getting a lot of messages on Instagram about how to study for USMLE step 1 so figured I would put all of my answers into one concise blog post. First off, take my advice with a grain of salt. Actually, you take anyone’s advice on how to succeed in medical school with a grain of salt. What worked for me might not work for you. That being said, I hit my goal of getting a +240 score on USMLE step 1 and this is how I did it.

 

 

Step studying starts day 1 of medical school

I struggled a lot my first semester of medical school because I had to learn how to learn. Everything you see from day one of medical school can show up on your USMLE’s. So my biggest advice on how to study for step 1 or step 2 CK is to learn everything right the first time around. Remember that at the end of the day you aren’t studying to pass your classes. You’re studying for your step exams.

 

 

Start using question banks early

I’ve previously written about how to study in medical school, my favorite resources in medical school and my favorite resources for USMLE Step 2 CK. A recurring theme is question banks. Again I will reiterate 2 things: (1) that question banks are meant to challenge you to apply your knowledge and find gaps in your knowledge to then go back and study and (2) UWorld is the gold standard. Save UWorld for when you are truly in your two months of intense step 1 studying. But when you are in medical school I encourage you to use other question banks like Kaplan. I used Kaplan as a second year medical student while I tutored gross anatomy to supplement my knowledge base and show me the scope and depth that I truly needed to know for the test. Incorporate question banks as early as possible.

 

 

Use your resources consistently

Just like question banks the rest of your study resources are important tools for success. The more you use them the more valuable they become. For instance, if you plan on using Picmonic you should start using it early in medical school. It loses its value if you only start using it in the months leading up to USMLE step 1. Similarly, don’t stop using whatever resources you found valuable during medical school. If you used Pathoma then keep using it. If you used FirstAid then keep using it! And if you found that you didn’t like certain resources then don’t use them!

 

 

My background

If you don’t already know, I went to Ross University School of Medicine. Back when I started at this Caribbean medical school it was strictly an accelerated program. We did the first two years of medical school in 18 months (they now have a ‘slow’ track too). This gave me 2 full months of strict step 1 studying before I started third year clinical rotations. On top of those two months, we finished our last semester of 2nd year a month early to allow us to study for a comprehensive exam that we had to pass in order to leave the island. So I was refreshing my knowledge for one month before I started my non-stop, pedal to the metal step 1 studying.

 

 

My resources

I used everything that helped me succeed in medical school. That included the following:

 

 

Overall and daily schedule

I had 2 months of strict step 1 studying time. I used Doctors in Training (DIT) which acted as the backbone of my study curriculum. DIT created an awesome two month calendar for me. Inside that timeline I put one true weekend off for a snowboarding trip. Other than that I isolated myself and didn’t really go out much.

My daily schedule consisted of the following:

  • 730am – 745am: review Picmonic
  • 745am – 8am: review notes from yesterday
  • 8am- 9am: 1 full UWorld question set
  • 9am- 12pm: reviewing UWorld
  • 12pm-1pm: lunch break
  • 1pm – 5pm: 4 hours of DIT videos
  • 5pm – 8pm: exercise, dinner, relax
  • 8pm – 10pm: relax and passively review topics

I hope this helps! If you have any more specific questions drop them below. As always don’t forget to subscribe so you don’t miss my next post!

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How To Learn More, Faster in Medical School

It’s been awhile since I used Picmonic. It was my go to medical school resource when I was a first and second-year med student and was even more valuable while I was studying for USMLE step 1 and step 2 CK.  The more I used it, the more valuable it became. It is still to this day one of my three favorite medical school resources, which is why I was so excited to team up with Picmonic to help spread the word!

 

 

What is Picmonic?

Picmonic is an online app that helps make studying easier, more efficient, and a little bit more fun. Let’s face it; medical school challenges you with a relentless barrage of information that requires absolute dedication to memorizing. And the worst part about studying in medical school is a simple fact that some stuff doesn’t make sense. You just have to memorize it. I’m talking about subjects like biochemistry, nutritional deficiencies, pharmacology, and microbiology. That’s why Picmonic is so amazing. It uses vivid pictures, stories, and wordplay to get all of that expensive medical school facts that you just have to know into your brain!

 

 

Let me just show you what I’m talking about

Each subject has a unique Picmonic ‘card’ that uses visual storytelling and pictures as mnemonics to help you remember more. They’re even better than flashcards! This is the Picmonic card for erythema nodosum, and I still remember it and use it to this day during residency. Inevitably during morning report, noon conference, patient presentations, or when I’m teaching my medical students this subject pops up. And my co-residents are just as shocked as my friends in medical school were when I rattle off the disease associated with erythema nodosum, represented by the Nodosaur with red bumps on its legs.

 

What I also love about Picmonic is that its cast of characters stays consistent throughout the Picmonic universe. For instance, take a look at the erythema nodosum card again down below. You’ll see a ‘cock (rooster) at sea’ representing coccidiomycosis circled in red.

 

 

Now check out the card for coccidioidomycosis. It’s the same rooster at sea, again circled in red.

 

 

Now take a second look at the coccidiomycosis card, but this time check out the granny-llama representing granulomatous inflammation, circled in yellow below. Now check out the same granny-llama circled in yellow on the Picmonic card for granulomatosis with polyangiitis (Wegeners).

 

 

And again, we see the same granny-llama representing granulomatous inflammation on the card for granulomatosis with polyangiitis (Wegeners).

 

 

 

Buy Picmonic Now!

Ultimately, I wholeheartedly believe that Picmonic helped me pass and succeed in medical school and helped me ace USMLE Step 1 and USMLE Step 2 CK (and even bails me out every once in awhile during residency). The more esoteric and difficult to memorize a subject is the more Picmonic flexes its muscles.

 

 

So if you’re tired of reading about Picmonic and ready to try it out, here is what you should do:

  1. Go to https://www.picmonic.com/redeem and enter KittyKatzFree for 2-weeks of free access to Picmonic!
  2. Once you’re ready to purchase: use my link to get 30% of any fixed term subscription!

 

 

My Favorite EKG Resources

These are my favorite resources to help you learn EKG’s proficiently and efficiently without breaking the bank.

A cardio rotation!

Okay I know this isn’t a resource. But my favorite month of med school was during my cardio rotation. A month of ‘hey this EKG looks weird. Mind reviewing it with me?’ and then BOOM a cardiologist was personally going over EKG’s with me. Your attendings, fellows, residents, and yes…even some interns, are great resources of knowledge so be curious and ask them questions!

Read EKG’s!

Every patient’s EKG that you read is practice for the next. If you want to get better at interpreting EKG’s then read EKG’s! You should look at every patient’s EKG that you can get your hands on. First get a systematic methodology of reading objective EKG’s down pat (see below for more). Next you should work on interpreting the EKG’s. This is the part that takes years to perfect and is why cardiologists exist. Practice makes perfect so check out the following website and books for more practice!

Life In The Fast Lane

This is my favorite website by far. It gives you longer but succinct explanations of almost everything cardiology related for people in medical school and residency.

Dr. Dubin’s Rapid Interpretation of EKG’s

This wasn’t my first EKG book that I ever read but it should have been. It’s perfect for beginners at any stage of medical school. It goes back to the basics of cell membrane conductivity and slowly walks you through the process of understanding the biological basis behind EKG’s. It then provides you an easy and systematic process to reading those squiggly lines. By the end of this book you should be able to read EKG’s proficiently. Interpreting them will take more time and much more practice. This book forces you to be active in how you process the information and should be the first EKG book that you read.

 

Clinical Electrocardiography: a Simplified Approach (8th edition)

This one is a little more advanced and I liked it for that reason. Better suited to someone who has a little bit more background in EKG’s (e.g. has read Dubin’s) and wants to know more about the minutia. This book also comes with a code for an e-copy that can be linked to your tablet and smartphone through a common app. LPT: download chapters on your smartphone to read during downtime (much more conveneient when on-the-go). 

EKG Wave Maven

Great website purely for EKG’s. Their goal is to increase your level of ‘ECG literacy’. This website gives you a short clinical description and then asks you a relevant question about the rhythm strip. It’s my new favorite site for EKG’s because it’s a quick and easy way to increase your exposure to EKG’s.

 

Learn the Heart- Healio

This site is a huge resource. It’s probably the best all around website that I’ve found for EKG’s and more. It has everything from beginners all the way to advanced stuff. It goes into more detail than EKG maven. It gives you more information on the topic besides just an EKG. Check it out to learn about EKG’s and other detailed cardiology topics

 

Heart Matters: A Memoir of a Female Heart Surgeon

This ones for leisure. A well written memoir of what it was like to train as a female cardiac transplant surgeon in a seemingly male predominant arena. She juggles a family and career as she shows us how she has found her way toward a rewarding and uplifting career and managed to make her personal life work too. It’s not easy but her family makes it work. Worth the read for anyone who has ever wondered if it’s possible to have a rewarding career and also have a family. Or if you just wanted to know what it’s like to be a heart transplant surgeon.

If you want more medicine related books to read for leisure then check back next week. I’ll be reviewing my five favorite medical books to read for leisure. Subscribe so you don’t miss it!

Study Tools During Clinical Years

Your two years of classroom basic sciences are drastically different than your clinical years. Studying in your first two years is somewhat easier because your primary responsibilities are all geared towards taking tests, culminating in the USMLE or COMLEX. Third year sucks because you are still studying for step 2 but fourth year hits that sweet spot between ‘done studying for tests’ mentality and ‘almost got a job’ swagger. These were my favorite resources that I used outside of my step studying.

 

 

Maxwell Quick Medical Reference

Super small and lightweight. This is great for beginners on the wards. It comes with a pocket eye chart which is probably the only place you will find eye charts in hospitals. Also comes with good on the go guides for shorthand notes and labs.

 

 

Pocket Medicine

The purple book is an intern’s favorite friend and mighty helpful too for med students. I don’t know when the new version is coming out but I didn’t feel like waiting for it. If nothing else, it’s a quick reference guide to everything you will see in the hospital. Differential diagnoses, work-up, treatments, etc. Pocket guides are also available for surgery, OB/GYN, peds, and such. I am going into internal medicine so I chose not to get any other pocket guides but google away if you want them.

 

 

Journal Club App 

Just buy it. It is the best $5.99 I spent in med school. This app provides concise and easy to journals that changed patient standard of care. You can also check them out for free online at Wiki Journal Club. Cardiology Trials is also a good site specifically aimed at cardio stuff.

 

 

UpToDate

It’s like Google for doctors! Okay, I’m starting to be redundant but its a great site that I’m sure you use already.

 

 

Moleskin Classic Notebook

 

 

Did I miss anything? What apps or resources have you used s/p step 2?

Best Resources to Destroy USMLE Step 2 CK

*Disclaimer: Below are my favorite resources with associated links. If you like my blog please use the links to buy any books on Amazon or services (Picmonic, OnlineMedEd) as I receive a small referral fee that helps me keep this blog up and running! I only listed products I trust or and/or used*


Question Banks

The purpose of doing practice questions is to find your weaknesses in order to guide your study process and  to get you inside the head of question writers. Hopefully you figured this out already since you most likely already took step 1. However, I found studying for step 2 CK to be more difficult than step 1 because of the other obligations that MS3 requires. Question banks are also great on the go. Long subway to your friend’s apartment on the upper east side? Do a question set on the train. Bored in between lectures? Practice questions. Lost your resident and don’t feel like going back to the floor? Practice questions. Practice questions? Practice questions! Here are the practice questions I used.

USMLE World

Still the gold standard when it comes to practice questions. There is no way around it. You can read the message boards on Student Doctor Network and they all reiterate what I find to be true. That UWorld is the end all and be all when it comes essential resources for Step 2 CK. Some students will argue that UWorld and a review book are the only resources you need for step 2 CK and for the most part that is true. I completed UWorld in its entirety once. Then I completed all of the questions I got wrong (which was nearly half of them). Then I continued to do full question sets until test day so I ended up doing UWorld two and a half times. I highly suggest it.

Kaplan

Kaplan is the other major question bank out there. I used to do Kaplan questions with my friend who preferred not to ‘waste’ UWorld when he studied for his clinical clerkship exams. Just like step 1, a major advantage of Kaplan to UWorld is that they tell you exactly where this topic or subject is located in the most popular review books. I enjoyed using Kaplan but chose not to invest more money in another review book when I could borrow my friends’ PreTest books instead. That being said, I haven’t heard terrible things about Kaplan.

PreTest

I took step 2 during the second week of my first elective rotation in cardiology. So the bulk of my serious step 2 studying was done during my 8 week surgery core and subsequent 4 week surgery elective. I took a practice test and I did terribly. Like embarrassingly bad. And my worst subject was surgery. I had completed all of the UWorld surgery questions and ran through them all a second time. I wasn’t being lazy either. I read through and studied the answers to each question but I just wasn’t making any progress. My friend suggested I try pre-test and I loved it. Pre-test gives you over a thousand questions for each clerkship exam. In some regards they go into far too much detail than you actually need for your step exam and cover a much wider scope of subjects than UWorld alone…but that’s exactly why I used it. You can finish all of the UWorld or Kaplan questions for the smaller subjects like psych and pediatrics quite quickly. These books expose you to a lot more pathology that other qbanks don’t cover. I highly suggest using this resource for in between lectures, after you finish a specific section of UWorld, or if you just want more high quality practice questions. Just beware that they are not NBME format. So I would shy away from them when it comes closer to test day

Practice Tests

The purpose of practice tests are to find your weaknesses and to exploit them in order to maximize your score. Basically, study what you suck at! That’s the point of doing practice questions and that’s the point of doing a practice exam. So you can tell if your study process is working or not. For instance, after I started dedicating more and more time to study my weakest subject, surgery, my score began to creep up. I found that the number of questions I got wrong in other subjects continued to stay relatively stable but I was able to decrease the number of surgery questions I got wrong from 20, then to 12, then to 8, and on my last practice test I literally got zero surgery questions wrong. My point is that you can’t just keep taking practice tests to see what score you would get on step 2. That’s great and you should do that but you have to remember that the purpose of taking a practice test is to evaluate your weaknesses and to strategically focus on them. Okay, now I can get off my soap box.

NBME

NBME is the gold standard because they are written just like the real test. You have to use these wisely because there are only a limited number of them. Additionally, I believe that it is worth the ten extra dollars to purchase the expanded feedback. This option grants you the ability to see which questions you got wrong. Annoyingly, they don’t tell Sure you can screen shot every single question if you really want to (unlike UWorld Self Assessment) but this is so much easier and also doesn’t mess with your ability to recreate test day.

USMLE World- Self Assessment

The only reason this resource isn’t above the NBME practice exams is because there is only one USMLE World Self Assessment (UWSA). Both the NBME’s and the UWSA are only half as long as the real thing but the advantage of the UWSA is that they are like UWorld question sets. You are given full UWorld style explanations of each question, both the questions you get correct and incorrect alike. I chose to make this my last practice test because I was able to utilize these four individual question sets like they were new questions that I was able to review afterwards.

Review Books

I encountered a few problems when I chose which review book to utilize. My ideal review book would have everything in it already. Explanations from UWorld, differential diagnosis categorized by both chief complaint as well as pathophysiology, best initial test, most accurate test, best initial therapy, maintenance therapies, and alternative therapies. I never found that type of book. So go to the book store and check them out for yourself before you buy them.

Master the Boards (MTB)

I liked MTB for the same reason why I disliked it. Its brevity is nice when you just want a quick and dirty answer but it leaves you hanging at times when you want more detailed UWorld style explanations (seriously, why can’t someone just put UWorld in a book format already?!). Between UWorld and MTB you are guaranteed to pass step 2 because they cover all of the high yield stuff but be prepared to annotate the shit out of it. Bonus tip: use MTB for step 3 instead of the step 2 CK version. It’s got a few extra gems in there and it’s really not all that different from it’s step 2 cousin. This way you won’t have to start all over again for your next step.

First Aid for the USMLE Step 2 CK

First Aid was my step 1 bible but I didn’t use it for step 2 CK and I regret that decision. I borrowed this book a few times from my friends and I liked it. It mimics the step 1 version quite well. Again, I did not use this as a primary resource but I would encourage you to check it out.

Step Up to USMLE Step 2 CK

I used Step Up to Medicine (SU2M) for internal medicine only and did not use Step Up To USMLE CK because I disliked SU2M so much. If MTB has too little information then this is the complete opposite side of the spectrum. It has long winded explanations of every subject in bullet format. Some people liked that but it wasn’t for me.

Lecture Material

Lectures were less valuable to me for step 2 than for step 1. I just didn’t have enough time to sit down and watch video lectures. My favorite way to study was to simply review whatever disease my patients had that day. Every once in a while however I just didn’t know something and needed someone to spell it out for me. These are the resources I used for those moments.

Online MedEd

This is by far my new favorite resource that I utilized for step 2. Online MedEd uses a reverse classroom style of teaching with whiteboard based lectures. Lecture videos range in length and subject matter but are amazing resources for both step 2 and for the wards. For instance, one day I was feeling a little lost about fluid management so I went to the library and threw on the fluid management videos. I went back to the floors with a better grasp of what I was doing and didn’t feel like such an idiot. I especially liked the algorithmic way of thinking they employ. I watched every video and would do it again in a heart beat.

Doctors in Training (DIT)

I loved DIT for step 1 but it just didn’t do it for me for step 2. I didn’t have hours and hours to watch videos everyday, nor did I have the energy for it (that’s why I liked OnlineMedEd a little bit more because their videos were short and to the point). What I still loved about DIT was that they remind you of what you may have forgotten. The pre-lecture and post-lecture quizzes are gold. It wasn’t for me but doesn’t mean you shouldn’t at least check them out. Not to mention they’re great guys to follow on Twitter.

Kaplan Lecture Videos

I got my hands on these videos and they were fantastic. Conrad Fischer at his best. If you liked Kaplan for step 1 then you will like them for step 2.

 

Miscellaneous

The other stuff that doesn’t fit into a pretty category like the stuff I already mentioned.

The Successful Match: 200 Rules to Succeed in the Residency Match

This book is pure gold and I highly recommend it to anyone and everyone going through the match process. It provides analytical data on the match. The author provides objective data on a subjective subject like what characteristic traits different program directors like to see in their candidates the most in each respective specialty. This book provides advice on everything from writing your personal statement, the most commonly asked interview questions and the best way to answer them, what type of programs you should be applying to, who you should be asking for letter of recommendations from, and so much more. It was my most valuable resource before and during interview season. You won’t regret this investment. In fact, your friends are going to want to borrow it. Mine did.

 

UpToDate

Most medical schools provide this for you and it was easily my most often used resource during my third and fourth year of medical school. It’s like Wikipedia for medicine when Wikipedia doesn’t do a good enough job at explaining something. Or when someone points out that Wikipedia isn’t ‘a reliable resource’. Anyway, it’s amazing and I love it. Bonus tip: click the ‘summary and recommendations’ tab to get a quick snapshot of the article you’re checking out.

Picmonic

If you used Picmonic for step 1 then you should keep using it for step 2. I talked about Picmonic before and it still rings true. Every time I thought about brain tumors, tumors of the bone, any vasculitis, developmental disorder, and everything from biochemistry my Picmonic note cards would pop into my head. I’ll probably be that one resident who puts a Picmonic mnemonic in the presentation slides for morning report. I don’t ‘like like’ Picmonic. I love them.

*Use my link to get 30% off your Picmonic subscription!

Blueprints

Blueprints is like PreTest because they are good for shelf exams but not so much for dedicated step 2 CK studying. I highly disliked Blueprints because it was so long but others liked it for that exact same reason. Each chapter gives you a few bolded key words, tables and figures and explains the topic in great detail (again, too much detail in my opinion). The book ends with 100 NBME style questions with long explanations. I liked PreTest more because of how succinct it was but I have friends who, again, had the complete opposite opinion. To each his or her own.

Tablet > smart phone

If you don’t have a tablet already I would highly recomend purchasing one. If you are short on cash you do not need to purchase an iPad. There are tablets out there for under $100. Sure they aren’t as pretty but all that you realy need them for is accessing UWorld. Yes, you can simply use your smartphone instead of buying another piece of technology but unfortunately every time you have your phone out people will think you are texting. I remember once when I was on my phone doing a UWorld question set while I waited for the operating room to be cleaned and a nurse called me out for ‘texting instead of taking care of my patient’. Said patient was actually sitting next to me in her bed on her phone playing ‘2048’. She was trying to beat my high score and was failing miserably. Anyway, my patient kindly told the nurse to ‘kindly fuck off’. She was one of my favorite patients ever. Moral of the story: if you are on your phone people will think that you are texting no matter if you are using it to cure cancer or are actually texting.