Step 1 Study Guide

For the Class of 2010

University of Colorado at Denver
Health Sciences Center
School of Medicine
Office of Student Affairs










Examinations are formidable even to the best prepared, for the greatest fool
may ask more than the wisest man can answer (Colton).
A Special thanks goes to the following class of 2009 students for their work generating
the survey data and their work in helping develop the study guide from those results:

2009:
Liz Wilson
Josh Sykes
Nate Lane

This document was edited by Brian Harry, Barbara Wilson, and Shin Kamaya, class of
2010.

The information contained in this handbook was gathered by the Office of Student
Affairs as well as by current/former medical students at the University of Colorado
School of Medicine and is meant to serve as a guide. Gracious permission has been given
to use the information in the handbook by the following entities allowing our students to
benefit from their work.
Albany Medical College
Baylor College of Medicine
Boston University School of Medicine
Boston University School of Medicine
Brown Medical School
Case Western Reserve University School of Medicine
Creighton University School of Medicine
Dartmouth Medical School Educational Commission on Foreign Medical Graduates Emory
University School of Medicine
J efferson Medical College
J ohns Hopkins University School of Medicine
Keck School of Medicine of the University of Southern California
University of California, Davis, School of Medicine
University of California, Irvine, College of Medicine
University of Iowa Carver School of Medicine
Loyola University Chicago Stritch School of Medicine
Mayo Medical School
Mercer University School of Medicine
Mount Sinai School of Medicine of
New York University
Rush Medical College of Rush University Medical Center
Saint Louis University School of Medicine
The Brody School of Medicine at East Carolina University
Vanderbilt University School of Medicine
Wayne State University School of Medicine
Yale University School of Medicine
www.usmle.org
www.nbme.org
www.prep4usmle.org
www.studentdoc.com
2

Table of Contents:

page

Introduction to the USMLE Step 1 4

Studying for the USMLE 5

Sample Schedules 12

Study Resource Information 16

Class of 2009 Board Survey Results 18

Class of 2010 Board Preparation Calendar 27

Frequently Asked Questions 28
3

Introduction

OK, so you're approaching the end of your second year. Having gone through about
a thousand pages of Path, and countless lectures of Micro, you are so ready for a
major break from the books, right? Well there's still one hurdle to cross before you
reach the promised land of clinical medicine: Step I of the USMLE, or "the boards."
Although this examination can seem pretty intimidating, a logical and well thought
out approach to studying helps the great majority of students. So first and foremost,
don't panic! Believe it or not, our students do very well on the Boards and if you
have done well in the first two years, you should look at this as nothing more than a
review session.
This guide is meant to provide a framework and some simple suggestions for
studying for Step 1. Remember, these are just suggestions and no one
approach to studying is right for everyone. The key to success is to think
about the topics and issues that need to be covered, make a realistic study
plan, and then do your best.

What is the USMLE Step 1

The three Steps of the USMLE assess a physician's ability to apply knowledge,
concepts, and principles, and to demonstrate fundamental patient-centered skills,
that are important in health and disease and that constitute the basis of safe and
effective patient care. Results of the USMLE are reported to medical licensing
authorities in the United States for their use in granting the initial license to practice
medicine. STEP 1 assesses whether you understand and can apply important
concepts of the sciences basic to the practice of medicine, with special emphasis on
principles and mechanisms underlying health, disease, and modes of therapy. Step
1 ensures mastery of not only the sciences that provide a foundation for the safe and
competent practice of medicine in the present, but also the scientific principles
required for maintenance of competence through lifelong learning. The USMLE Step
1 is split into a variety of sub disciplines, similar to the curriculum of most medical
schools. Within each subtopic, an attempt is made to test knowledge on "Normal
Processes", "Abnormal Processes", Principles of Therapy" and "Psychosocial,
cultural and environmental considerations." The basic disciplines include topics in
biochemistry and molecular biology, cell biology, genetics and development,
pathology, psychiatry, physiology, pharmacology, microbiology, immunology, and
statistics. The NBME further specifies the topics to be tested within physiology,
including systems biology (neurobiology, immunology, general physiology, etc.).

USMLE Step 1 Question Format
There is only one question format for USMLE Step 1: "Single question best answer".

4

Studying for the USMLE Step 1

USMLE Step 1 is usually considered the hardest of the USMLE exams to do well in.
As a result, this is the test that everyone studies the most for. The basic techniques
for studying for USMLE Step 1 are straight forward:

1. Sample questions. Sample questions. Sample questions.

2. Focus on your weaknesses.

3. Study for the USMLE as you study your medical school course.

Review Courses/Options

Keep in mind that there are also many review courses that can help you organize
your studying if you are willing to spend the time and money. If you feel you may
benefit from a review course, the best thing to do is to ask someone who has taken
these courses to see what they are really about. Kaplan offers a range of products
that can help one prepare for the boards. These include Q-Bank ( 2000 test
questions that simulate the boards format- a web based product), Intense Prep (live
lecture review done in three weeks which also includes over 1000 exam like
questions), MedPass (video set lecture series that also includes over 1000 board
questions), and other web based products (WebPrep, Qreview). The strength of the
Kaplan assets is the simulated tests, which have very similar questions to the
boards and have a format that is similar to the boards. Many students find the Q-
Bank questions to be particularly useful, as they provide the opportunity to simulate
the setting that will be encountered on test day with a computer-based exam.
Kaplan also offers a series of review books are part of the above packages. Ask other
students who used them if they found them to be effective. The www.kaplan.com site
offers more specific details about any of their products.
If you are looking to attend a live review course, our office has had success referring
students to these (3) locations listed below. Our office is not endorsing these
programs over other programs.

PASS Program, Champagne, IL, 217-378-8018,
http://www.passprogram.net

Institute for Professional Preparation, University of Missouri Kansas City,
www.umkc.edu/ipp

Falcon Review, Dallas, TX www.FALCONREVIEWS.com

What are students telling us about their strategies for studying?

Most Effective Techniques

Attend class! This is where you learn about clinical medicine. Youll be
grateful you did next year.
Use practice exams!
5


Doing tons of sample questions and understanding all the right and
wrong answers; studying with one or two people; using only one review
book for each topic.
Going through review books, taking notes on stuff to memorize and doing
questions.
Concentrated studying in a group for allotted time.
Stay away from stressed out classmates!
Make a realistic schedule and stick to it.
Do questions in bulk.
Take a pretest to identify your areas of weakness. Then, create a study
guide/schedule based on your needs, not the needs of your study group.

Least Effective Techniques

Not paying attention to the material in the course then trying to learn it
later on your own.
Drinking too much coffee; going over all the notes from the first two
years.
Listening to other peoples advice as to what was important to study.
Hysterically running around in despair.
Trying to study from too many books. Stick to one major resource
supplemented with smaller specific subject books.
Studying with too many people.

What topics are more/less emphasized on the boards?

While some of you have started studying already, some may not even be sure what is
on the exam everyone is so nervous about, so lets start at the beginning. Step 1
covers material from the following categories
anatomy,
behavioral sciences,
biochemistry,
microbiology,
pathology,
pharmacology,
physiology,
interdisciplinary topics, such as nutrition, genetics, and aging.

The above material is tested as basic science questions, or as questions referring to
individual organ systems. The general breakdown is:

40%-50% General principles
50%-60% Individual organ systems

The individual organ systems are:
hematopoietic/lymphoreticular
nervous/special senses
6

skin/connective tissue
musculoskeletal
respiratory
cardiovascular
gastrointestinal
renal/urinary
reproductive
endocrine

The test can also be broken up into normal vs. abnormal processes:

30%-50% Normal structure and function
30%-50% Abnormal processes
15%-25% Principles of therapeutics
10%-20% Psychosocial, cultural, occupational and environmental considerations

Step 1 has approximately 350 multiple-choice test items, divided into seven 60-
minute blocks, administered in one eight-hour testing session. The current passing
score is 185. This corresponds to answering 60-70% of the questions correct for the
exam.

The most heavily emphasized subjects are Physiology, Pathology, Microbiology,
and Pharmacology. Pathology is probably the most important single subject, since it
ties in all of the other topics. By devoting the appropriate time and energy and
utilizing the right resources, conquering all of these subjects will be well within your
reach. Also, don't forget the basics of Biostatistics, as sensitivity and specificity and
positive and negative predictive values are favorites for the USMLE. Just knowing
these will be worth several extra questions answered correctly.

How important are sample questions and practice exams?

Generally speaking, doing practice questions and exams is definitely helpful for
many reasons: it directs your emphasis towards certain topics, identifies your
strengths and weaknesses, and gets you in the right frame-of-mind for taking this
exam. Many people have found it helpful to do 25-50 questions each night to review
the subjects they studied earlier in the day. As the test day approaches, you should
definitely take some longer test blocks back to back to build up your mental stamina
for test day.

Kaplans Q-Bank has been a favorite of students here and all over the country. It is
favored for providing a good simulation of a computer based test (CBT) and for
having a comprehensive database of questions. With the proper preparation, youll
find your Q-Bank scores and confidence peaking as you near test day. Two other
question banks that are highly recommended in First Aid are USMLERx Step 1
Qmax Test Bank and USMLE Steps 123 Step 1 Question Bank. Both are less
expensive than Kaplans Q-Bank, although Q-Bank has a longer history with the
USMLE Step 1.

7

Most of our students couple practice questions with First Aid for the USMLE Step 1.
The Office of Student Affairs also has a plethora of other Step 1 study prep guides
which you may check out.

Regardless of how you approach it, practice questions of the proper caliber will be a
big help in your review, especially in regard to timing and mental endurance. Also, if
you count yourself among the computer/testing-phobic, it may be wise to get some
other computer testing resources just to get used to reading off a screen rather than
a book.

What is the testing day like?

There is no denying the fact that the testing day is long. Just be sure to remind
yourself that it used to be two days!!

There are seven one-hour blocks of 50 questions, and you are allotted eight hours to
complete the test.

In addition to the exam blocks, your test experience begins with a 15 minute
computer tutorial. However, this is identical to the one on the CD sent in your
packet, so it is best to skip it on test day and take the 15 minutes as break time. If
you do this, you begin with 1 hour of break time, which you are able to take between
sections at any point during the day.

Some people complete a couple of sections at a time and then take a prolonged
break, while others choose to take a 5 minute break at the end of each section. You
can always access a screen on the computer which tells you your total time
remaining both for your current section and for the test day as well as how many
sections you have left, so time management is not a major issue as long as you pay
attention.

Remember, for the exam, you are not allowed to have any of the following with you
during the exam:
mechanical or electronic devices, such as cellular telephones, personal digital
assistants (PDAs), calculators, watches of any type, electronic paging devices,
recording or filming devices, radios;
outerwear, such as coats, jackets, head wear, gloves;
book bags, backpacks, handbags, briefcases, wallets;
books, notes, study materials, or scratch paper;
food, candy, gum, or beverages.

You can have food and drinks outside of the exam room, or in your locker for
breaks. Bring high energy food and drinks to the exam so you can have little snacks
throughout the day to keep your energy up and avoid eating big meals that will
make you tired.

When you come to the exam, you need to bring your scheduling permit and a form of
legal identification:
passport,
8

driver's license with photograph,
national identity card,
other form of unexpired, government-issued identification,
ECFMG-issued identification card.

Important Note: Your name as it appears on your Scheduling Permit must match
the name on your form(s) of identification exactly. If the name listed on your
Scheduling Permit is not correct, contact your registration entity immediately.

Applying to take and scheduling the USMLE Step 1

1. Go to http://www.nbme.org/
2. Click on ENTER NLES SITE
3. Click new first time user and create a login name and password

When applying for Step 1, you must select a three-month period, such as January-
February-March or February-March-April, during which you prefer to take the
examination. A Scheduling Permit with instructions for making an appointment at a
Prometric Test Center will be issued to you after your registration entity processes
your application and determines your eligibility. The Scheduling Permit specifies the
three-month eligibility period during which you must complete the examination.
During peak periods, allow up to approximately four weeks for processing of your
application. On receipt of your Scheduling Permit, you are able to contact Prometric
immediately to schedule a test date.
http://www.prometric.com/default.htm

Remember:
You must have your Scheduling Permit before you contact Prometric to
schedule a testing appointment.
Appointments are assigned on a "first-come, first-served" basis; therefore, you
should contact Prometric to schedule your exam as soon as possible after you
receive your Scheduling Permit.
You may take the test on any day that it is offered during your assigned
eligibility period, provided that there is space at the Prometric Test Center you
choose.
Prometric Test Centers are closed on major local holidays.

This means sign up early because the process takes time but remember you can
only sign up six months in advance!

Rescheduling

People have different thoughts on whether this is wise to do or not, but regardless, if
you are going to reschedule, be aware that you will have a rescheduling fee if you
do it less than 5 business days in advance.

9

Putting Together a Schedule

Obviously, the more time you put into studying, the better the results you will most
likely see. So if you are organized enough and willing, spend as much time as you
feel necessary, and simply alter the schedule we are suggesting based on your own
desired preparation time.

Keep in mind that this time of studying is really just a comprehensive review of
material that you already know. You will not learn many things for the first time,
though you will notice that as you synthesize information they may seem new since
you finally make sense of them! At first it may seem as though you need to go
through everything again and this may very well be true, especially for biochem, but
the rate at which you relearn things is quite rapid, so don't panic.

As you plan your study time, it is important for you to establish your goals for the
boards-to borrow terms from First Aid, do you want to just pass, to beat the mean,
or to go for the gold. Your decision will be important in deciding how intensely you
approach your studies. The following is a schedule for someone who wants to do
well, but who wants to have a reasonable study schedule for about 3 weeks.

Before we begin, let's just lay out a couple of general principles:

Make your schedule and stick to it. Many have benefited from approaching
studying for the boards as a job. Punch the clock for a set number of hours
per day and then, provided you actually worked in that time, let yourself leave
it behind when the time is up.

Include breaks in your schedule. Schedule an hour a day for exercise, time to
hang with friends and family, or whatever else you want to do. Your
motivation level and overall efficiency will be enhanced by adequate rest
periods.

Get plenty of sleep and good nutrition.

Remember that First Aid for the USMLE Step 1 is your gold standard!
Before you study each subject, spend a brief time reading over the high yield
facts in First Aid, and return to it again when you are finished to emphasize
the important tidbits. KNOW THIS BOOK INSIDE AND OUT!!!

If you used a review book during the class, use it now. There are so many
books from which to choose, so if you have one with which you are familiar,
use that one.

Be sure to hit the large, important subjects (path, pharm, micro, physio, and
biochem) more than once during your preparations. Hit them hard in the
beginning for two days or so, and then come back at some point in the last
week for a 1 day speedy, thorough review. You will be amazed how much you
pick up that second time through.

10

As has already been said, use practice tests to your advantage. Schedule
them into your evening time or use them whenever you get tired of studying
during the day. As the test approaches, try to do several back-to-back one
hour blocks to ready you for the exam.

Don't completely blow off any subject. It is silly to miss some easy points in
something like Biostatistics when the information can be picked up in just a
little bit of time. At the minimum, at least read the high-yield facts in First
Aid.

One last time for emphasis -- especially during those last couple days, be sure
to come back to First Aid.



11

Sample Schedules

The samples below may or may not be representative of what will work for you.
Please use these as a way to think about creating your study schedule.

Sample Schedule #1

Day working: 19.5 days 25.5 days (not counting days off and review)

This schedule does not differentiate between basic science and system-based
studying

Topic Estimated
Time
Comment
Behavioral Science 1 to 1.5 days Actually tested and fairly easy questions you need to cash in on,
but you have a book, Fadem (BRS), which is short and has
questions.

Biochemistry 3-4 days Perhaps the most tedious of the subjects review early (1-2 days)
and late (1-2 days), saving the questions for the later time.
Lippincott is a heroic effort, but an excellent resource, particularly
if you used it before.

Physiology 4 days High yield. Perhaps the most important subject. Again, review
early and late. Know Costanzo, shockingly effective.

Anatomy/Histology 1-1.5 days Honestly low yield. The focus should be on clinically useful stuff:
which fractures relate to which nerves, winging of the scapula, etc.
Radiographic images can be emphasized but generally stick to the
basics; i.e. you see an x-ray with fracture at the midshaft of the
humerus, what nerve is at risk? KNOW the basic X-rays in High
Yield Anatomy

Embryology 0.5 days Don't neglect it, but don't blow it out of proportion. First Aid stuff
high-yield.

Pharmacology 3-4 days Enormous volumes of material. Remember to think categorically.
You have to know your autonomics. Know major side affects if
they are bad, i.e. agranulocytosis, cardiotoxicity.

Microbiology 2-3 days Sorry guys, it's in there, even the worms, but not enough to justify
slaving over them. Know the parasites in First Aid. Try to combine
micro with your antibiotics review, they are related in real life and
surprisingly on the boards too.

Immunology 1-2 days Fairly good yield. Glance over immuno- deficiencies-in First Aid
the day before the exam. Principles more than details.

Pathology 4-5 days One of the big-hitters on the exam, should also be a big-hitter in
your prep. Another subject you want to hit both early and late. The
BRS path book (Schneider) is a time-tested favorite.

12

Sample Schedule #2 (Lippincott Williams & Wilkins)

Assumption: 28 total available days, including the day before the exam.

General apportioning of days:
Wrap-up: 2-3 days before your exam
Days off: schedule as rewards for keeping to your schedule; 1-2 days
Full study days: 24

Days by subject:
Pathology: 4 days
Physiology: 4 days (might be fewer if you are strong in physiology)
Pharm: 4 days
Micro/Immuno: 4 days
Biochem: 3 days
Behavioral Sci: 1.5 days
Gross/Embryo/Cell/Histo: 1.5 days
Neuroanat: 2 days

Systems Schedule:
Nervous: 3.5 days
Cardiovascular: 3 days
Respiratory: 2.5 days
GI: 2 days
Renal: 2.5 days
Reproductive: 2 days
Musculoskeletal: 2 days
Heme/Lymph: 2 days
Basic Concepts/General: 2 days

Note: a day means an 8-hour day. An hour means a full hour with 5-minute
breaks as needed. In addition, you will do 2 hours of questions daily.
13

Sample Schedule #3

Total Study Time: 32 days
# Wrap up days= 4 days
# days off= 2 days (take as half days)
Total Study Days= 26 (minus wrap up days +days off)

Days Per Subject
Path =4.5 (consider BRS)
Pharm = 4.5 (consider Lippincotts and First Aid)
Physio = 3.5 (Consider BRS)
Micro/Immun = 4.5 (Consider Micro Made Ridiculously Simple and Lange-immuno)
Biochem and Molecular Bio = 3 (consider BRS and High Yield)
Behavioral Science = 2 (Consider High Yield)
Neuroanatomy = 2 (Consider High Yield Neuro)
Gross Anatomy and Embryo = 2 (Consider First Aid and High Yield)

Typical Study Day
8-12 Study
12-1 Lunch
1-5 Study
5-8 Dinner, Exercise, Family Time
8-11 Questions
11:30 BED!!!
14

Sample Schedule #4 (40 Days of Navy Seal Training)

Topics:
1. General Principles/Biochem
2. Behavioral Science
3. Hematopoeitic/Lymphoimmune System
4. Nervous System
5. Dermatology/Connective Tissues Disease
6. Musculoskeletal System/Anatomy
7. Respiratory System
8. Cardiovascular System
9. Gastrointestional System
10. Renal System
11. Reproductive System
12. Endocrine System

Daily Grind:


Day 1: Biochem
Day 2: Biochem/Genetics
Day 3: General Principles
Day 4: Behavioral Science
Day 5: Heme and Lymph
Day 6: Heme and Lymph
Day 7: Catch-up
Day 8: Nervous System
Day 9: Nervous System
Day 10: Skin and CT Disease
Day 11: Musculoskeletal and Anatomy
Day 12: Musculoskeletal and Anatomy
Day 13: Anatomy/Microbiology
Day 14: Catch-up/Microbiology
Day 15: Respiratory
Day 16: Respiratory System
Day 17: Cardiovascular System
Day 18: Cardiovascular System
Day 19: Cardiovascular System
Day 20: Gastrointestional System

Day 21: Catch-up
Day 22: Renal System
Day 23: Renal System
Day 24: Reproductive System
Day 25: Reproductive System
Day 26: Endocrine System
Day 27: Endocrine System
Day 28: Catch-up/Full 8 hour practice
test
Day 29: Review: Skin/CT/Musculo-
skeletal
Day 30: Review: Cardiovascular and
Neuro
Day 31: Review: Endo/Repro/and GI
Day 32: Review: Respiratory/Renal
System/Microbiology
Day 33: Review: GenPrin/Micro/Drugs
Day 34: Review: Biochem/Anatomy
Day 35: Full 8 hour practice test
Day 36: Review
Day 37: Review
Day 38: Review
Day 39: Do nothing related to USMLE
Day 40: USMLE



15

The Right Resources

As you embark on your studies for the USMLE Step 1, choosing the appropriate
study materials is crucial to your success. There are tons of review books and
sample test question books available for your preparation but money and time are
two factors you must consider. Many of these review books cost over $25 and take a
significant amount of time to go through. So, here are some recommendations for
books that may maximize your study success.

General
First Aid for the USMLE 1 by Bhushan. Le, and Arnin

Sample Questions
Kaplan Services (Q-Bank, full length practice tests)
Retired NBME Basic Medical Sciences Test Items by NBME
USMLERx Step 1 Qmax Test Bank
USMLE Steps 123 Step 1 Question Bank
(Be sure to make time for sample questions!!!)

Anatomy/Embryology/Histology/Neuroanatomy
Anatomy: Review for the New National Boards by Johnson
High-Yield Anatomy by Dudek
High Yield Embryology by Dudek
High-Yield Neuroanatomy by Fix

Behavioral Science
First Aid know the First Aid chapter
High-Yield Behavioral Science by Fadem
BRS Behavioral Science by Fadem
(Be sure to have a decent understanding of the main topics in biostats.)

Biochemistry
BRS Biochemistry, Marks
Lippincott 's Illustrated Reviews: Biochemistry by Champe

Physiology/Neurophysiology
Physiology by BRS, Costanzo

Microbiology/Immunology
Medical Microbiology & Immunology: Examination and Board Review by
Levinson
Clinical Microbiology Made Ridiculously Simple by Gladwin
High-Yield Immunology by Johnson

Pharmacology
Lippincott's Illustrated Reviews Pharmacology by Harvey
Pharm Cards: A Review for Medical Students by Johannsen
Pharmacology: Examination and Board Review by Katzung
16

Pharm Companion
First Aid know the section in First Aid!

Pathology
BRS Pathology, Schneider
First Aid
Goljian audio recordings
17

Class of 2009 Board Survey Results

A survey conducted by a panel of students, the Office of Student Affairs, and the
Department of Educational Development and Research was designed to assess the
following with respect to USMLE Step 1 preparation:

Time spent studying
Perceived usefulness of the curriculum
Perceived usefulness of study resources
General wellness

This survey was administered in the spring of 2007 following the exam season for
the Class of 2009. Overall, these data should guide your USMLE Step 1 preparation.
Keep in mind that the MCAT Physical Sciences and performance on the practice
USMLE Step 1 administered 4-5 months before the exam were found to be good
indicators of actual USMLE Step 1 performance.


18

Zoomerang | Board Study Survey: Results Overview
Board Study Survey
Results Overview

Date: 9/27/2007 5:35 PM PST
Responses: Completes
Filter: No filter applied

2.
Please indicate when you first began to seriously study for Step1?
Summer after
first year
7 8%
Fall Semester
Second year
3 4%
Early Spring
Semester
(January-
February)
27 32%
Late Spring
Semester
(February -
March)
13 15%
After classes
finished March 9,
20007
35 41%
Other, please
specify
0 0%
Total 85 100%
http://www.zoomerang.com/web/reports/PrintResultsPage.aspx (1 of 8)9/27/2007 6:36:16 PM
Zoomerang | Board Study Survey: Results Overview

3.
Please rate the intensity of your studying during each of the periods below
Top number is the
count of respondents
selecting the option.
Bottom % is percent
of the total
respondents selecting
the option.
Not at all Low Medium High
Summer 2006
58
69%
22
26%
3
4%
1
1%
August - October
2006
46
55%
32
38%
5
6%
1
1%
November-
December 2006
27
32%
42
49%
13
15%
3
4%
January-
February 2007
8
10%
38
45%
28
33%
10
12%
March 9 -March
6, 2007
2
2%
0
0%
5
6%
78
92%

4.
How many hours per week did you exclusively devote to studying for the exam?
Top number is
the count of
respondents
selecting the
option.
Bottom % is
percent of the
total
respondents
selecting the
option.
0 <5 5-10 11-20 21-30 >30
Summer
2006
59
70%
18
21%
5
6%
2
2%
0
0%
0
0%
Fall
Semester
2006
39
46%
33
39%
12
14%
0
0%
0
0%
0
0%
Christmas
Break 2007
26
31%
24
29%
17
20%
12
14%
1
1%
4
5%
January -
early March
2007
7
8%
31
37%
19
23%
11
13%
8
10%
7
8%
http://www.zoomerang.com/web/reports/PrintResultsPage.aspx (2 of 8)9/27/2007 6:36:16 PM
Zoomerang | Board Study Survey: Results Overview

6.
On average how many hours per day did you study during this designated study
period?

0 0 0%
<5 2 2%
6-10 39 46%
>10 43 51%
Total 84 100%

7.
How well do you feel that the first year curriculum prepared you for this examination?
Top number is the
count of respondents
selecting the option.
Bottom % is percent
of the total
respondents selecting
the option.
Not at all helpful Somewhat helpful Moderately Helpful Excellent preparation
Human Body
5
6%
30
35%
37
44%
13
15%
Molecules to
Medicine
34
41%
36
43%
12
14%
1
1%
Blood and Lymph
4
5%
29
34%
37
44%
15
18%
P&D
8
9%
44
52%
29
34%
4
5%
CVPR
2
2%
6
7%
42
49%
35
41%

8.
How well do you feel that the second year curriculum prepared you for this
examination?

Top number is the
count of respondents
selecting the option.
Bottom % is percent
of the total
respondents selecting
the option.
Not at all Somewhat helpful Moderately helpful Excellent preparation
Nervous Systen
2
2%
14
16%
33
39%
36
42%
DEMS
2
2%
11
13%
39
46%
32
38%
ID
4
5%
9
11%
35
41%
37
44%
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Life Cycle
3
4%
22
26%
35
41%
25
29%

9.
How often did you attend class during first year when it was NOT required?
Rarely attended 1 1%
About half of the
time
5 6%
Most of the time 24 28%
All of the time 55 65%
Total 85 100%

10.
How often did you attend class during second year when it was NOT required?
Rarely 7 8%
About half of the
time
19 22%
Most of the time 29 34%
All of the time 30 35%
Total 85 100%

15.
Did your sleep habits change during the 4 week study time?
Slept More 23 27%
No Change 41 48%
Slept less 21 25%
Total 85 100%

16.
How much protected study time do you believe is adequate for good preparation?
Less than 4
weeks
8 9%
4 weeks is about
right
28 33%
5 weeks 35 41%
Greater than 5
weeks
14 16%
Total 85 100%
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17.
Did you reschedule your examination date?
Yes 22 26%
No 63 74%
Total 85 100%

18.
If you rescheduled your examination date was this due to
Anxiety about
being ready
19 86%
Personal, health
or family
problems
3 14%
Prometrics
(Testing Center)
problems
0 0%
Other USMLE
problems
0 0%
Total 22 100%

19.
How did you spend the majority of your study time?
Studying Alone 76 89%
Studying with
Others
4 5%
Balance between
alone and with
others
5 6%
Total 85 100%

20.
Did you interact with other medical students during the study period? (eg in person
meetings, email, etc)

Yes 65 78%
No 18 22%
Total 83 100%
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21.
If you interacted with other medical students, was this
Helpful 29 42%
Anxiety producing 21 30%
Other, please
specify
19 28%
Total 69 100%

22.
Please tell us how helpful the following study guides were in your studying
Top number is the
count of respondents
selecting the option.
Bottom % is percent
of the total
respondents selecting
the option.
Did not use Not at all helpful Moderately helpful Very helpful
First Aid
0
0%
2
2%
19
22%
64
75%
Step Up
44
52%
6
7%
17
20%
17
20%
Goljan Path
35
41%
1
1%
14
16%
35
41%
Goljan Notes
58
69%
2
2%
16
19%
8
10%
Pharm Cards
25
29%
9
11%
28
33%
23
27%
Langmans
Embryology
62
74%
12
14%
9
11%
1
1%
Wheaters
Functional
Histology
65
77%
8
10%
11
13%
0
0%
BRS series
11
13%
4
5%
28
33%
42
49%
High Yield series
61
73%
7
8%
11
13%
4
5%
Rapid Review
series
73
87%
1
1%
5
6%
5
6%
Ridiculously
Simple series
64
77%
6
7%
10
12%
3
4%
Microbiology
Made
Ridiculously
Simple
42
49%
3
4%
22
26%
18
21%
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Zoomerang | Board Study Survey: Results Overview
Micro Cards
54
64%
4
5%
14
17%
12
14%
Kaplan Review
Books
67
80%
5
6%
11
13%
1
1%

23.
Please tell us how helpful the following commercial resources were in your
studying.

Top number is the
count of respondents
selecting the option.
Bottom % is percent
of the total
respondents selecting
the option.
Did not use Not at all helpful Moderately helpful Very helpful
Qbank
9
11%
1
1%
30
36%
44
52%
USMLErx
72
87%
1
1%
3
4%
7
8%
First Aid Qbook
76
92%
3
4%
2
2%
2
2%
Kaplan Books
69
83%
6
7%
6
7%
2
2%

24.
Please tell us how helpful the following review sessions were in your preparation.
Top number is the
count of respondents
selecting the option.
Bottom % is percent
of the total
respondents selecting
the option.
Did not use Not at all helpful Moderately helpful Very helpful
Pathology with
Dr. Shikes
20
24%
7
8%
44
52%
13
15%
Pharmacology
with Dr. French
38
45%
14
16%
22
26%
11
13%
Embryology and
Biochem with Dr.
Besessen
49
58%
5
6%
15
18%
16
19%
Immunology with
Dr. Cohen
41
49%
10
12%
21
25%
12
14%
Reviews
provided by 4th
years
60
71%
5
6%
12
14%
7
8%
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Zoomerang | Board Study Survey: Results Overview
Study Skill
Review with Dr.
Doyle
59
70%
13
15%
11
13%
1
1%

26.
How much of your study time did you devote to USMLE, Kaplan or other questions?
Less than 10% 14 16%
About 25% 27 32%
25-50% 34 40%
Greater than 50% 10 12%
Total 85 100%

27.
How much of your study time did you devote to content review?
Less than 10% 0 0%
About 25% 1 1%
25-50% 26 31%
Greater than 50% 58 68%
Total 85 100%

28.
What was your state of mind as you entered your clinical training?
Poor 12 14%
Fine 25 30%
Good 26 31%
Excellent 20 24%
Total 83 100%
Thank you for taking the time to fill this out. We hope that the results will help your class
for Step 2 and other classes that follow you. You will be entered into a drawing for Gift
cards.

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Class of 2010 Board Preparation Calendar


October 2007:
Class of 2009 board preparation survey and Class of 2010 strategy and outline
for the 2007-2008 year
MSIII and MSIV panel for questions about the boards

November 2007:
How to tackle questions from on the boards: overall test taking strategy
Setting up a study schedule
Ongoing fall and spring: USMLE Step 1 trivial pursuit
o Barbara Wilson has been turning First Aid into flash cards and will be
developing game-based group learning sessions as a fundraiser for the
class (e.g., $5 per person to play with perhaps 5 games going on game
night)

December 2007:
1
st
option for mandatory basic science shelf exam
o Results to test takers will be available over break
Possible session on wellness/relaxation/stress relief

January 2008:
2
nd
option for mandatory basic science shelf exam
o Results will be available to students around the end of January
Content sessions each approximately 3 hours, probably Fridays from 1-4
o 2 physiology high yield
o 1 pathology high yield
Ongoing wellness session

February 2008:
Content sessions
o 1 pathology
o 2 pharmacology
Ongoing wellness sessions and individual fitness activities (group
rides/hikes/etc)

March 2008:
Final exams for Infectious Disease and Life cycle
Begin the 5 week break for the boards/vacation/relaxation
Ongoing wellness sessions and individual fitness activities (group
rides/hikes/etc)



27

Frequently Asked Questions (answers from student affairs and current 3
rd

years)

How important is the score anyway? For better or for worse, residency programs
do look at your USMLE scores as part of their evaluation of resident candidates. It is
however just one aspect of your application, which will also include your clinical
evaluations, letters of recommendation, basic science grades, and Dean's Letter. The
more competitive the specialty (i.e., Neurosurgery, ENT, and Dermatology), the more
likely the scores will be used as part of the initial screen students for interviews. If
you are leaning towards a particular field(s), ask residents or attendings about the
relative importance of Step 1 and check the available data posted on Blackboard
Charting Outcomes in the Match. Overall, just keep in mind that while your score
does matter, it is only one of many criteria that will help determine your success in
matching at the residency of your choice, so keep things in perspective.

When should you start studying? The truth is that you already started studying
for Step I the first day of medical school, since this exam is basically a cumulative
exam of the first two years. In terms of focused studying for the boards, however,
most students find that 3-4 weeks is sufficient.

Is there enough time in the 2
nd
year to study for the boards? You should study
for class as you have been and review when you have time. Christmas break is a
good time to get in a little extra review. Dont sacrifice your coursework for the
boards, that material is on there too, especially infectious disease that is placed
conveniently right before boards. (- 3
rd
year med student)

What is the best way to use the review books? One thing I wish I knew, and
someone probably even mentioned at one time but I ignored it is that review books
are for REVIEW! I spent much of my winter break trudging cluelessly through the
ID section of First-AID before we had even had our ID course. I thought it would be
good to put a decent dent in first-AID and that it would also help give me an edge in
our upcoming ID class. However, I just numbed my mind trying to memorize list
after list of bugs and drugs without any scaffolding to support this information.
Needless to say, these short-term memories collapsed quickly, and I walked away
from this time-wasting experience with only a fine dust coating of familiarity with
some of the ID terms. (- 3
rd
year med student)

What do you think about pushing back your test date? Don't push your step 1
date back; pick a time and stick to it. You will do nothing more than stress yourself
out by prolonging the agony. If you don't trust yourself, then do what I did - book a
flight to Las Vegas two hours after step 1 four months in advance. (- 3
rd
year med
student)

What worked best for you? Following what works for you and ignoring what
everyone else says - it will only make you panic and waste time in the end.

What are some things that kept you sane? Taking time for myself. Take a few
hours every now and then to get out and get some fresh air.

28

How did you make time for friends and family? You have to eat sometime!

What are some tips for getting through the test day? It's not as bad as it
sounds. Take good food with you, bring a little sugar, and some Gatorade. Take
small breaks every hour if you need them. Don't stress over a bad section. And
remember that everyone walks out thinking they failed.

For other frequently asked questions, visit:
http://www.usmle.org/FAQs/faqusmle.htm





-Good luck and happy studying!!!
29