Let’s get it started: Student suggestions for Step One
Pho Nguyen, MS II

As year two progresses, many of us anxiously anticipate the dreaded STEP-UhhNO.  The one and only exam which will determine the rest of our professional life, the residency programs we will apply to, what specialties we would consider, or whether Sid will be the next Nip/Tuck Christian Troy.  The Chief Complaint staff set out to interview our big sibs to seek their wisdom.  Here are a few questions that we asked and their responses.

 1) When is the school practice exam administered? They divide the class into different groups, maybe around 15+ students per group. So, each group of 15 or so students will go take the computerized test at Norris library on a Saturday.   I think the first group started sometime in April and different groups will go each week, continuing into May. You are provided with a free lunch, which the Pharmacy students will try to steal.

 The Kaplan USMLE Step 1 practice exam is administered on a Saturday (or Sunday) at the end of April towards the beginning of May, before the comprehensive exam.

For some, this is too soon to be a real indication of how well you've studied, because you haven't started studying yet.

2) How is it compared to the actual Step 1, in terms of difficulty and test-taking experience?

Well, the practice USMLE is from Kaplan, which is slightly harder than the actual USMLE.  Everyone recommends getting Q Bank from Kaplan.  What is that?  It is a bunch of USMLE style questions offered by Kaplan and you can tackle practice tests, timed or untimed, with full explanations of the answers and why each multiple choice is wrong or right.  It is very helpful in gauging areas of weakness (embryology vs. pharmacology, etc) so you can focus your studying better.  Plus, you will get used to the style of USMLE questions, and get used to taking a timed exam (USMLE is composed of 8 blocks of 50 questions each, and 60 minutes per block).

The practice test was hard because I hadn't studied anything at that point.  I think that it is comparable to Q bank, which is considered slightly harder than the actual USMLE.

It's supposed to closely approximate the level of difficulty of the actual Step 1, and it comes close to doing so. Much of step 1 is information recall and Kaplan is good in that it focuses on the minutiae which will help you gain those extra points during the actual exam.

You need to study one step further than is on that test, not just make the diagnosis, but the pathophysiology of the Dx or the Tx of the Dx.

3) Does the school provide feedback/analysis on your performance and which areas you need to improve? They won't give you the answers, but at the end of the session, they will break down the scoring into bar graphs for different systems i.e. pathology, pharmacology, cardio, renal, etc.  So you can see how many questions came from each section, and what percentage you got correct for each subject.  This is very similar to Q Bank, so get Q bank.

 Kaplan's practice exam does not provide feedback on the questions but they do provide analytic information once you complete the exam, which included the percentage of questions answered correctly in each of the 7 sections and further breakdown of the percentage obtained in each system. 

It's a breakdown by subject area equivalent to that which is on the actual exam.

4) Do they go over the questions that you miss and provide solutions? If you want feedback on exact questions you got wrong and why, get Q bank. 

They do not go over the questions that one has missed for feedback on the correct answers, part of the reason being that Kaplan administers the test free of charge and so I suppose if USC demanded the answers to the test questions then you'd have to pay to take the test.

 Nope. Like the real test, you don't ever see it again (that is unless you have Kaplan's Qbank because the questions are from that)…. 

5) Are there supportive & knowledgeable people (4th years & faculty) whom you can contact to gain better understanding of certain issues that you may not master? I don’t know since I didn't seek outside help. I just used First Aid, Q bank, and BRS Pathology and BRS Physiology, and Microbiology Made Ridiculously Simple.

Supportive faculty and students are scattered all over the place. During ICS, at the end of the academic year, each faculty member guarantees a lecture on a topic they believe is particularly challenging for students. This usually happens on Fridays. To tell you the truth, I never attended them because I study best on my own and found organized review lectures a waste of time. But the again, you can always contact faculty for one-on-one meeting if you've got particularly tricky question(s).

I don’t know. Didn't try to seek them out.  If you contacted a subject head, e.g. Dr. Garner in Neuroscience, she could help you out with a tutor.  Dr. Schechter's good for that, too.

6) In retrospect, do you think that a second practice (same format/length) would be beneficial in your actual performance on Step 1?  A second practice exam would not be of any additional help, in my opinion. You can sign up to Kaplan's Qbank where you'll find 2500 questions to wrack your brain with and gain expertise at for the actual exam.

Yes, especially if you have studied everything and are taking it "for real" practice instead of the practice test given at Keck, where you really haven’t studied anything yet.

Not likely.  It's just a bunch of Qbank questions. For a lot of people the exam was so early in the time frame of studying that they didn't even regard it seriously and just flew through the questions.

7) What review books do you find the most helpful in your preparation?

First Aid -- buy First Aid for Step One now and look at each system as you're covering the topics in lecture.

BRS Pathology and Physiology

Microbiology Made Ridiculously Simple

More info on Step-One in next issue of TCC.