KhayriShalhoub,

USMLEStep1Experience.

WhoamI
?
Afreshgraduate.GraduatedinMay2014fromAnNajahNationalUniversity\Palestine.
Durationofpreparation
:

Istartedstudyingsolidandconsistentlysince
September2014
.Istartedreadingabout
howtostudyfortheUSMLEsinJune.IstoppedeverythingduringJuneasIwas
arrangingformyengagementandallthat.Inthebeginningof
July
Istartedbytryingto
desensitizemyselftotheMONSTERIhadsincebackinmedschool,
[[BIOCHEMISTRY]]!IstartedoffjustbywatchingthevideosofMetabolicbiochemistry
fromKaplanClassroomanywherevideos.Itdidn'ttakemealot(maybeaweekorso),
asmygoalwasonlytogetridofthefear,andIhadacoupleofnotesonFAfromthe
videosonly.InthemiddleofJuly,IwassupposedtotraveltoCanadaforanelective
there,andhadsomanyissuesatthebordersandetc,soitallstoppedsincethemiddle
ofJuly.IfinallygottoCanadaandfinishedtheelective,andaquickvisittothestatesby
theendofAugust.Duringthattime,
IwastryingtofamiliarizemyselfwithBacteriology
.
Theelectivewasheavyandwewerebusydailyfrom8:00amtill5:00pmcontinuous
andtripsonweekends.Ionlygot
12hrs\day
justtofamiliarizemyselfwithMicro.Iused
Microcardsatthetime.Letmetellyou,theyrecompletelyuselessandInevertouched
themagainaftercomingback.
Bottomline,IstartedstudyingwhenIgotbackin
September.

Journeyandmaterials
:

IwouldliketonotethatIdidntaddalotofnotestomyFA.
IbelieveFAisareview
bookandshouldstayassuch
.Ididntwannafillitupwithnotesandannotationsand
overwhelmmyselfwheneverIjustwannaReview.IaddedsomethatIthoughtare
veryveryimportant.Imainlyaddedpictures,usinggoogleimages,makingthemsmall
justlikeFAusuallydoes.Ilookedatalotofpictures,andithelpedalot.

IstartedoffreadingFirstAid14,tryingtofigureoutwhatisStep1isabout.Iwould
googleanythingthatIdidn'tunderstand.Ihadtoknowwhyeverywordwasthere.Ittook
meaboutamonthandahalforsotocompletethewholething.Ithensubscribedto
USMLEWorld.Istarteddoingablock\day.Iwasdoingfine,butIwassoweakin
micro\biochemasIdidn'treadanyaftermyreadingsinJune\July.Aftercompleting
about20%,IdecidedtogobackagaintoFAandreadcarefullytheBiochemistryand
Mircobiologyparts.Thattookmetwoweeksorso.Sameapproach,usingwikipedia+FA.
Thenbacktothequestionbank.Butthistimewasdifferent.IwasintroducedtoFlash
cardsusingtheapplicationAnki.Iwilltalkaboutthisinthenextpoint.

IrememberusingBRSforcardiovascularandRespiratoryphysiologyatthebeginning
becauseIhadsometroublewiththem,butskippedrapidlythroughthebook.
IskippedrapidlythroughsomeHYNeuroanatomychaptersbeforeIstudiedthe
neurologychapter,justquicklyin45days.Nevercamebacktoit.Justfamiliarizing
myself.Didnttakenotesoranything.JustacoupleofpicturesIsavedandlateradded
themtotheFA.

BacktoAnki.AsIsaid,IdidntwannafillmyFAwithalltheextrainformationfromUW.
IdiscoveredallaboutAnkiandwasfascinated.Ilovedit.Thiswebsiteiswhatintroduced
metoit
Yousmle.com
ImadeallmynotesfromUWintoAnkiCards.Ifsomeoneis
goingtodothis,
pleasemakesureyougothroughthewebsiteandreadallthe
instructionsonhowtobestmakeacard
.ItriedtominimizetheamountofnotesIam
takingbecauseUWishuge.Iusedtoreviewthecardsdailywhilewalking,gym,bus..
anywhere.

Pathomavideosat1.7speedandslowingdownwheneverIfeelhesdiscussing
somethingnewtome.IusedthemafterIfinishedFApathologypartandaftergoing
throughmorethanahalfoftheQbank.SimplybecauseIhadotherstufftodo.Videos
aregreatandveryhighyield.

ThewayIdidUWwastocarefullyreadeverything.Iwouldgooglethetiniestthingthat
Ididntunderstandandfindananswer.Ididthefirstfewblocksinatimedmode,but
didnthavetroublewithtimesoIswitchedtotutoruntimedtoreallyuseitasalearning
tool.Andofcoursealltheblockswererandom.
IusedtoconstantlyvisitmyFAduringtheQbank.Butmostofthedaywouldbedoing
Questions\explanations.Mypacewasaverage2blocks\day.

Aftercompletingabout6070%,thetimeIwasplanningtogivemyexamwasgetting
close,about6weeksleft.IdecideditstimetoassessmyselfandseeifIamontheright
trackornot.IdecidedtoquicklyrevisemetabolicbiochemandmicrobiologyfromFA
beforegivingmyfirstassessment.Tookmeaweektohavethecouragetofinallygive
myfirstassessment.IchosetogowithNBME7asitwouldprobablybetheeasiestand
wouldntdestroymyselfesteemifIdidntdowell.
AftercompletingitonJanuary14th
,Igot269
.Iwasshockedandwaslikethisisnowaytrue.Itoldmyselfthisisprobably
duetothefactthatitsoldandmostoftheinfoisgonnabeincludedinFAorso.ButI
wasrelaxedbecauseIknewIwasntonthewrongpathwaytosaytheleast.Anyways,I
gotbacktoUWtofinishitoff.Finisheditbefore23weeksofmytestdate.
Thenstarted
redoingthesameoldblocksIdidbefore,ExceptthistimeIwouldntredo
questions,justreadingmyannotationsandtryingtointerpretquestions
.Ionly
repeatedtheonesIgotwrong.
Atthattime,Iwasgoingreallyquicklydoing45blocks\dayasitsjustrapidlyreviewing,
andmostofthestuffIknowbecauseoftheflashcards.Ifinishedabout50%oftheQ

bankatthattime.Iwouldalsogive23hoursdailytoreviseFAchaptersquicklytoo,just
skippingasbythattimeIwasfamiliarwitheverything.

IdidUWSA1with265+before2weeksofmyexam.

Afterthefirstassessment,IwasoverwhelmedwiththeamountofcardsbecauseIhad
somanyinashortamountoftime,soIswitchedofftotakingnotesfromUWonasmall
book.
4daysbeforemyexam,Februrary14th,IdidNBME16andgot262
.Iknew
thistimeitwasrealandthatIwasreadytotaketheexamsincenumbersdontlie.Every
partofmewastellingmetodelaytheexam,butIamgladIdidnot.

ConradFischer100cases:Inthelastfewdaysofmypreps,Ifeltguiltyofnotreading
anythingaboutethicsotherthanFA\UWwhichveryminimal.Ididthecasesonlyand
readtheirexplanationsinatotaltimeof1day.

IdidntuseanyoftheKaplanbooks\videosexceptfortheonesmentionedabove.Itwas
moretimeefficientandbetterformetolookforanswersandcreatequestionsmyself.I
onlyreadthelipidmetabolismpartofKaplanBiochembookbecausetheyalways
buggedme.IdidthatbeforegivingNBME16andtooksomenotesandonlyrevised
theselater.

Iprobablyusedandreadstufffromgoogle\wikipediamorethananybookand
morethanFA

IusedtowatchalotofyoutubevideosonconceptsIdidntunderstand.

EXAMDAY:

MyexamwasonFeb18th.Inthefirstfewquestions,Ihadahighheartrate,butafter
feelingitsthesameastheNBME16,Ifeltfineandtriedtoenjoytheexperience.Ididthefirst
twoblockswithoutanybreaksandthenhada10minutebreak.Idecidedtodothesamewith
thenexttwoblocks.
Thatwasamistake
.Myconcentrationwentreallydownbythemiddleof
thefourthblock.Ishouldvetakenatleasta5minbreakbetween3dand4th.AfterthatItook
about10breakbetweeneachblock.
Questionsweredoable.SimilartoNBME16.IhadquestionswhereIhadnoideawhat
theyaretalkingabout,triedtosimplifywhattheyareaskingaboutandtrytogivemy
bestguess.
Ihadareallyhighthresholdformarkingaquestion.ThequestionIknowishardandI
wouldnotchangeanythingificamebacktoit,Iwouldansweritandmoveon,
anddidnt
markit.
Ihadanaverageof10minutestimelefttoreviewmarkedoneseachblock.Ihadabout
17minutesinthefirstblock,andabout89minutesinthelastfewblocksbecauseIwas
exhaustedandfeltlikemyconcentrationwassolowcomparedtothefirstblock.
IwentoutsohappythatIwasdonewithit.IhadagoodfeelingbecauseIknewifi
studiedforawholeotheryear,Iwouldgetthesamescore.IknewIwouldgetthesame

questionswrongbecauseIwouldn'tthinkofstudyingaboutwhattheywereaskingme
about.

ThingsIthinkIwouldhavedonedifferently
:
IwouldhavedonealltheotheroldNBMEsofflineasalearningtoolearlierinmy
preparation.Ionlydid7and16.IdidntdoanyotherNBME.
Iwouldhaveusedcardswayearlierinmypreparation

ThepageImade
:
Inmylast45weeksofpreps,ImadeapagecalledUSMLEAbusers,whereIpostedsomeof
myHighYieldnotes.Feelfreetocheckitout.Iwillkeepupdatingitregularly.Hereisthelink:
https://www.facebook.com/pages/USMLEAbusers/1555609858011167

Miscellaneous
Firstofall,usingthiswayofstudyingworkedforme,itmightnotworkforothers.Using
flashcardsbyusingthespacedrepetitionmethodhasbeenscientificallyproventobea
goodwaytostickinformationinyourmindforever.AlotofpeopleaskedmeformyAnki
cards,andmyanswerwasthesameforeveryone.
Mycardsarenobigdeal,alotof
themwerebadones,simplybecauseIdidntreadalotabouthowtomakeagood
card.Becauseofthat,Igotoverwhelmedattheendofmypreparation,andhadan
extra1000newcardthatIdidnthavethetimeormotivationtostudyanymore
.
Step1isfullofnewanddetailedinformation.Thiswasthethingforme.Iwasstudying
onethingtoday,andIknowitwillbegoneinaweek
becauseIamnotagenius
.This
buggedmeandthatswhyIlookedforothermoreeffectivemethods.Somepeoplehave
agreatmemoryanddonotneedsuchmethods.Iwasnotconvincedthatrepeatingand
memorizingagainandagaintheFAwouldtakemeanywhere.Ididnotbelieveinin
doingUW23times.Ifeltthatthiswaswaytoooverwhelming.Iaskedmyselfwhyallthe
timeandIusedthecards.
IdidnotevencompleteUWforthesecondtime
.

Ankiisjustanapp.Thereareseveralotherappsoutthere.ThethingIlikedaboutAnki
isitsprogrammedalgorithm.Itiswellknownandverymuchusedamongstudentsinthe
states.IlikethealgorithmithaswhichisthemainreasonIdecidedtouseAnkicards
insteadofhardclassiccards.BecausebyusingAnki,IwillberepeatingstuffIfind
difficultmoreoftenthanstuffIfindeasy,whichcantbedonewithclassiccards.

Foranyonewhoisconsideringusingthecards,Ihavesomerecommendations:
Cardsgiveyouthebesthelpwhenyoumakethem.Donotdownloadpremadeonesand
donotbuyany
.
Ifyouareatthelastfewweeksofyourpreps,Idonotrecommendintroducingsucha
newthingtoyourpreps.Sticktoyouroriginalplananditwilldoyoufinehopefully.
Pleasegothroughthewebsiteandreadcarefullyabouthowtomakeacard.Donot
makehugecardswithlistsandallthat.Justreadwhatsinthereandyouwillknowitall.

Kaplanseriesaregreatseriesforsomeonewhohasthetime.Ithasalotofinformation
thatareextraandwellknowntobelowyield,butthatsfineifyouhavetime.Ididnthave
timesoIdidntstudyfromthem.Iusedmytimemoreefficientlybycreatingquestionsin
mymindforanythingthatcomesupandusinggoogletotakecareofit.

Answerstoquestionsasked
:
MyUWscoreafterfinishingthefirstroundwas87%,9596percentile.Notexactlysure
causeatsomepointIdidntcareaboutitIjustuseditforlearning.
Mymedschoolperformanceiscompletelyirrelevant.Foragraduate,thelasttimeIread
Biochemandmicrowas45yearsago.Atopperoraregularstudentwouldhave
forgotteneverythingbythattime.Mypointis,preparingforstep1islikenothingelse.if
youhaveanaverageGPA,youcantotallygetahighscoreifyoupreparedwell.
Myschedule:wasprettyhardcore.Iwouldwakeupandgotothelibrary,packedwith
foodandfruitsandwater.Wouldstartat89amandstudyfor60minandthena10min
break.Ithenhitthegymatabout45pm.Gohomeandrelaxandeat.Totalbreakof23
hours.Readagainathomefor45hoursbeforegoingtobedagain.Ihadsomedays
whereIwasveryproductive.However,IhadsomedayswhereIjustcouldntdoitand
knewwhatitreallyfeelsliketobeburntout!Ihadtotakesomedaysofftorechargeand
gobacktosolidwork!
Forthereasonsmentionedabove,andforpersonalreasons,Iwillnotbesharingthe
cardsImade,whichareabout45thousands.MainlybecauseIbelieveyoushould
makeyourownifyoureallywanttousethismethodthebest.
Imademyowncards.Ididnotbuythecardsthemselves.Eventheguywhomadethe
websiterecommendthis.
Idonotrecommendbuyinganythingonthewebsite
.I
personallydidnoteventrythefreeonesthatareofferedthere.
Iusedtoreviewthecardswhilewalkingtothelibrary,cominghome,goingtothegym
etc..Ialsogave12hoursdailyforcards.Atsomepointyouneedtogivemore,thats
whereIgotoverwhelmedbecauseIdidntusethemfromtheverybeginningofmy
preps.Iusedtoreviewabout150200cardseachday.Rememberthatalmosteachcard
wastalkingaboutaquestionfromUW,whichwasmywayofconstantlyrevisingit.
Ifollowedwhatsrecommendedonthewebsiteandfounditveryuseful.Ionlymadetwo
decks,oneforpharmacology,andoneforeverythingelse.ThePharmaparthelpedme
stickalltheseSideeffectsandbadnamespermanentlyinmymind.
Ididnotread
Goljan
,butIskippedthroughsomepapersatthebeginningandfoundthat
thereisjusttoomuchdetailsforme,almostlikehavingauniversitycourse.ThatswhyI
switchedtoPathoma.
Theappisforfreeonandroidsandmac\windows,andyougottapaysome$forthe
appleone.Ihaveamacandanandroidphonesodidnthavetopayanythinghehe.

AllmypreparationwasonmyMac,IdidnotuseFAhardcopy.Themainreasonforthat
isbeingabletoeasilyaddpictures.Thisisasampleofhowitlookedlike,Page
583of
FA14
.

Iusedtolistentomotivationalvideoseverymorning.Theguynamed
EricThomas
helpedmetremendously.
AtnopointinmypreparationIstoppedgoingtothegymexceptinthelastweek+.
KeepingyourselfonadiskdayandnightwillgetyounowhereIbelieve.Findsomething
whereyoucanvent.Whetheritsthegymorwhetheritsamovie,justdosomething.

Summary
:
Preptime:
5months
.
Studymaterial:
Wikipedia+UW+FA
NBME7(4+weeksout):
269
NBME16(4daysout):
262
Realdeal:
266

Thankyouallforallofyournicewordsandwishes.IbelievethatIfIdidit,
anybodycandoit.Keeppushing.Dotheeffortsrequired.Setyourgoalshighso
youcanalwayshavesomethingtogetto.Dontsettleforaverage,andbeallergic
toaverage.Goodlucktoeveryone
.

KhayriShalhoub