My experience with Step 1 taught me a few important things that I would like to share with my fellow medical school mommas.
1. Start prepping on day one of medical school or set aside several weeks of dedicated prep time in the summer between MS1 or MS2. This might seem like overkill but I honestly wish I had paid more attention to Step-1 and less attention to my coursework during the pre-clerkship phase. We are on a pass/fail pre-clerkship curriculum but you would never have known it if you saw how hard I studied during those years. For me it just did not feel right to be okay with simply passing. I was a 4.0 student in undergrad and wanted to keep that level of achievement regardless of whether or not it would show on my transcript. I was repeatedly told that if I do well in pre-clerkship, my board scores would reflect my hard work. This could not have been more untrue. I am not an experienced standardized test taker and I have a learning disorder that hinders my speed on highly timed tests. Additionally, I am in my mid-thirties so my processing speed is already slower than the students who are at their peak in their 20s. But irrespective of these issues, I still do not feel that my diligence in my pre-clerkship period gave me any advantage on the USMLE Step 1 exam. In order to do well on Step 1 and not have a miserable dedicated Step study period it is essential to have completed at least one question bank and 2 passes through First Aid prior to your dedicated prep period. For parents, particularly mothers, you are much better off starting early. Because I had too little prep prior to my dedicated period, I ended up studying 12-15 hours a day with ZERO days off. My son's school performance slipped considerably because he missed his Mom. I was unhappy and didn't have time to workout or do anything for myself - I even had Pathoma videos playing while I showered. In the end I did well (not as well as my pre-clerkship grades) but it was not at an incredible expense to my family and my own mental and physical well-being.
2. Had it to do all over again I would have done 3 FULL question banks. I liked USMLERx Qmax as a starting question bank. UWorld was great for the dedicated period. Your score will directly correlate with the number of practice questions you do so get started early....re-read number 1.
3. Five full passes through First-Aid. One as you go through your blocks, one the summer prior to your MS2 year, a third during your MS2 year and two passes in the dedicated prep period.
4. If you have done 1-3 as I listed you prep period will be much more efficient. You will be much faster as you work through the UWorld questions which will enable you to study 8 hours a day and even have a day off.
5. Use your day "off" to take a practice test. They usually take about 4 hours. I would avoid trying to look up answers to your practice tests for the ones you missed. It is very time consuming and you will get little return for the hours that you spend hunting for the solutions and explanations. 5-6 practice tests is plenty. You may want to add a few blocks of questions from uworld or another bank as you approach your test day just to get a feel for the endurance you will need on test day.
6. Your school may encourage you to be okay with a lower score that is "just passing". Keep in mind that state (public) medical schools may have incentives to have a few top performers who go on to competitive residency programs and raise their Step-1 mean, whilst a bulk of their students pass and go into a primary care residency. These schools receive funding according to the number of primary care slots that they fill which includes: family med, IM, Peds and OB/GYN. If you desire to go into one of those fields, no problem, but if you are interested a field that requires a more competitive score you may feel a disconnect in the support that you receive during your Step prep. As a Mother, sometimes there is an implicit bias that you should fit into the primary care group and that is the frame of mind in which the administration will counsel you for this important exam. Don't be fooled.
7. Have help from someone you love on your test day. I had my husband take over all childcare duties, drive me to the test center and pack my lunch so that I didn't have to waste my headspace with logistics. He left me a sweet little note in my lunchbox that really cheered me up during one of my exam breaks. This is a small thing but it helps. My husband is my partner. We have been married for 10 years, lost a child, lost a parent, endured poverty, lived abroad, you name it. It was nice to have his support in this way on the day of this test, which would impact not only my life but his as well. There is enormous pressure when you have more people on the hook, more years of debt and fewer years to get to practice medicine. When I found out that my husband had to travel for work on the week of my originally scheduled exam, I insisted on changing my date to when he was back in town - 5 days later. It wasn't easy and there was a ton of pushback from my school (another story for another day), however, it was the best decision ever! Know your rights.
8. Physiology, Pathoma, Goljan. I listened to the Goljan audio lectures during my commutes too and from school throughout the pre-clerkship period which enabled me to do 2 full passes. Some kind soul uploaded them into 5 videos on Youtube so you can go there to listen to them. Physiology is very high yield and often not well-taught in med school. I really liked the Pyseo.com lectures and you can watch them at 1.4x or 2x to cover the material quicker. Pathoma is a staple. I'd try to make 2-3 passes prior to step one. If you are an auditory learner you can watch, if you learn better from reading, you can watch once and then read his study guide twice.
All for now, I will continue adding to this list as I think of more things...
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