How I got a 254 on the USMLE
People keep asking me how I got a 254 on the USMLE. After all, I'm not a particularly smart person and when I got junior AOA, my classmates Let out a communal gasp. What was my secret? I knew how to study intelligently. Starting my M1 year, I employed a few fundamentals of learning theory, I had learned in Psychology undergrad (and my mom said it was a useless degree! p'shaw!). What did I do? Read on:
First of all, don't me fooled by blogs and USMLEforums telling you how to organize your time. Look inward. Studying is such a personal thing, that only you can decide what works for you. Just ask yourself these questions:
QUESTION 1. What is my personal learning style: Auditory, Visual, or Finesthetic?
First of all, I hate auditory learners. They can sit in a lecture and remember every word. They insist on group study sessions, they actually use the class podcasts, and they swear by Guillon audio files: "Don't you have those yet? How can you NOT have them?" Sigh. The kinesthetic (or tactile) learners uses hands-on learning and dives head-first into the anatomy lab. As for me, I am a visual learner. Draw me a mind map and I will never forget the information. Never. Visual learners are awesome. I love us. I am a pure visual learner, but many people are a combo of one of these three styles.
QUESTION 2. How much time can I realistically spend in a day studying without driving myself nuts?
The brain has its limits. My limit is 6 hours - split any way. I can do 4 in morning, 2 in afternoon, or 2 hours in the morning, afternoon, and evening. After that, my attention wanes, and I start to YouTube Twilight trailers If you were to be honest with yourself, how many good hours of studying can you really do? Often people overestimate their brain's attention span and this leaves them staring blankly at the computer, wasting many, many hours pretending to study. Like those people who "stay at home to study" on Friday nights. they don't study. Their brain forces them to creep Facebook for pictures, living vicariously through their friends who have chosen to have lives.
QUESTION 3. The big question: What study materials will I use?
If you think that in the week before the USMLE, you are going to go back to your textbooks and finally spend some good quality time with the Kreb's cycle, you are nutso. Now is the time for word-associations, not prose. There's no question here: Use First aid for the Boards. If you memorize every word of that book, you will do well. Augment First Aid with two other more books: (1) Microbiology Made Ridiculously Simple, and (2) BRS Pathology. Then pick a question bank (USMLE World or Qbank). The rumor is that Qbank is superior for step 1, but it doesn't matter.
QUESTION 4. Don't just read information... VIOLENTLY SHOVE information into memory. How do I do that?
There is no sense spending time studying unless you are using techniques to help improve memory retention. I like the three-exposure technique:
Exposure #1: Read and highlight First Aid
Exposure #2: Study in-depth. Within 24 hours of your first exposure, shove that info into memory by forming associations using graphs (visual learners), rehearsing flashcards (auditory learners), and manipulating the information (kinesthetic learners) until every piece of info is connected to another (i.e. giardia causes fatty diarrhea... and so does pancreatic insufficiency... how interesting).
Exposure #3: Test retention with practice questions. People who pontificate over question should aim for completing half of a question bank. People whose strategy is speed, may complete 80% or more. Keep track of the topics in which you are performing poorly. And then try these retention techniques:
(1) Review these topics more in-depth, seeking primary resources... now is the time for the book chapter.
(2) Reorganize your study material (i.e. put all of the causes of diarrhea together and compare them in a graph),
(3) Repetition, repetition, repetition.
QUESTION 5. How should I lay out my schedule for the weeks leading up to the USMLE?
Make a list of all the topics you need to cover - basically this is the table of contents in First Aid. Then spend a day, clocking your hours and doing some math. If it takes you 2 minutes to read a page from First Aid, and the Cardiology chapter is a 30-pager it will take an hour. Double that time for in-depth learning (3 hours total). Then time how long it takes you to do 50 questions... or even 25 if you haven't built up your Q&A stamina. If there are 300 questions in Qbank and you are a pontificator, aim for 150. I spent 3 hours doing and reviewing 50 questions. So I can study for 6 hours a day, which means cardiology will take me 2 days: one hour for Exposure #1, two hours for Exposure #2, and 9 hours for 150 questions at 3 hrs/50 Qs... that's twelve hours. Using this information, estimate a weekly study schedule. Plus give yourself 1.5 bonus days a week for those topics that you needed some extra time on.
Yes, the math is irritating, but it is worth it to have an organized and realistic idea of how the next few weeks will be and if you are giving yourself enough time before the exam.
Feel free to use your scores from both available NBME practice exams to readjust your schedule. If you are doing well on a topic, stop studying it for goodness sakes. Use that extra time on topics on which you are not performing as well. For instance, if you are scoring over 70% on the question bank questions, it is time to move on.
Viola! A personalized schedule. Most importantly study to remember and use your own study-style.
About the author: Tracy Flood is the creator of board-relevant ipad apps: www.minimicroflashcards.com or www.microbiology-made-ridiculously-relevant.com
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