Advice for 2nd year medical students
Advice for 2nd year medical students
I asked UCSF medical students to give advice to students who are about to start their second year of medical school. Below were their responses.
Remember, these are submissions from your classmates. They are based on their personal experiences. Take what is helpful and leave the rest.
Student#1. ADVICE FOR STEP 1 OF THE BOARDS
I. Goals dictate advice interpretation. Whenever you hear advice for the boards, try to assess what the advisor’s boards goals were and how they align with your own goals. Whether it’s a classmate or an upper classmen, if you aren’t sure of their goals you can always ask if they were aiming to pass or if they were aiming to crush it. For those of you still reading, you should know that my goal was to pass comfortably while giving up as little of my soul as possible to a silly exam that won’t exist in 5 years. I wanted to feel enough pressure that I wouldn’t procrastinate or be inefficient with my study time, but I also wanted to have some time to relax after a long day of studying. II. Study schedules
A) General advice Don’t blow off Life Cycle. A lot of stuff from the course is on the boards, from peds to OB to geriatrics. I had a hard time deciding what to focus on when I started juggling my time between boards review and LC. I felt much less anxiety when I decided to focus on LC stuff first and then spend extra time on non-LC boards review. Also, throughout your studying I recommend listening to the Goljan Path lectures on mp3 while you’re walking around and while you’re working out. Your class reps will set you all up with this resource.
B) Goal: “destroy the exam” Start hitting up the library every afternoon by January 1st. After the last Life Cycle exam study 12-14 hour days for a maximum of 3 weeks. Sarting as early as January you should subscribe to a Qbank and start taking at least a test a day. By the end of LC, if you’ve been studying efficiently all along, you won’t need much more time to feel confident and raring to pulverize the test. Most of my super-high-aiming friends were glad (or wish that) they had taken 2 weeks post LC, and a very small handful felt like 3 weeks was helpful for their piece of mind back when they scheduled the test (even if they wanted to take it earlier in the end). If you want to crush the test but don’t study efficiently then you might consider taking more time. C) Goal: “just pass” Take your time studying for this test. A handful of my classmates took option B, which means they start rotations one block late. They either took a short vacation after LC before buckling down or they studied steadily for over a month, slowly soaking info up. If you are most concerned about failing then the mind game is a huge component for you and you need to study as long as it takes to feel confident. As with every goal and study style, take lots and lots of practice questions. If you really just want to pass I recommend buying a 2 or 3 month Qbank, finishing all the questions and then going back and re-answering all of the questions you got wrong on the first pass until you know them cold. You will end up doing way better than just passing.
D) Goal: “pass comfortably and maintain a semblance of normal life” Here is where my advice gets more personal and specific, but hopefully still useful. Where to start: I started reading a physiology review book over winter break. As my housemate described it, it was like Discovery Channel studying: it was surprisingly fun to review basic physiology principles without worrying about testing myself. I didn’t take notes in the book because I felt like that would slow me down and not add much in the way of retention through Jan, Feb and most of March. If I could do it again I would have finished reading the physiology book by January 1st instead of dragging on through week 4 of LC. Ideally, right after new year I would have transitioned to reviewing a pathology text at the pace of about a 5 chapters/week. Again, I feel like it was the right decision for me not to take notes in the path book either (a feeling reinforced when my housemates who were taking notes ditched that strategy after a few chapters). When to start taking practice tests: Just like the way we slowly integrate palliative care into our dialogue with really sick patients in the hospital (remember the two triangle diagram from FPC?), it’s a good idea to start doing practice questions about two months before the actual test. I didn’t because I was bent on finishing the path text (which took forever even without taking notes) and because I was worried about retention. If I could do it over I would have taped into the huge number of free question banks out there, starting two months out. One month before your test day is a good time to fork out some cash for an official Qbank that you can try to get all the way through (and periodically review wrong answers throughout). I’m not going to go into details about how best to use the Qbanks or which to use since you will get a lot of that information from friends and the 4th year mentors. The only other thing I’ll mention in this schedule part is that you should start memorizing drugs at a casual pace very early on. Drugs, including interactions and side effects, make up a big chunk of the exam and the best way for most of us to learn them is by repetition. The rest of my thoughts on content are below.
III. What do I need to know? One classmate explained the test to his mom like this: “basically I need to know everything about how the human body works, everything that can go wrong with it, the drugs we use to treat those things that can go wrong and the side effects and interactions of those drugs.” And that’s pretty much what it feels like to study for this test. But in hindsight I think you could break it down like this:
A) 190’s (185 is passing): Basic physiology, 80% of Susan Masters’ drug flashcards, bacteriology (including drugs) and biochemistry. Really, that’s all you need to pass this huge exam. What about the rest of pathology beyond micro and biochem? By studying the above you will cover the basics, and assuming you have at least reviewed pathology you will be able to recall answers for reasonable questions and just have to shrug your shoulders for the ridiculous questions. In one section I was asked about the molecular make-up of surfactant (shrug) and a few sections later about it’s mechanism (score). The point is that they ask a baseline of reasonable questions that you can get right and pass just knowing the stuff I listed above. Beyond that basic info there are rapidly diminishing returns on the time you spend studying (an extra month wouldn’t have led me to learn the molecular make-up of surfactant). To be clear, in no way do I recommend studying only what I wrote above. That’s just there to highlight the fact that you CAN pass knowing just that, which is not to say anything of peace of mind/confidence.
B) 220’s: All of the above plus the rest of micro (basic virology – not including the structures of the viruses, funguses and protazoa plus drugs) and knowing all of susan’s drug cards down cold. To get this score you should also be ‘pretty comfortable’ with pathology but don’t need to know obscure minutia. Remember that they ask a baseline of reasonable questions that you can answer without a jeopardy-worthy fund of knowledge.
C) 250’s and up: All of the above plus whatever else it takes to know 95% of the details in first aid, cold, and maybe additional anatomy review to be safe. Even if you want to get above 260 you don’t need to know anything beyond what is in First Aid. That isn’t because first aid covers everything that could be on the test, but because you could spend a month studying stuff beyond first aid and only add one or two points (all the while forgetting what you’ve already worked so hard to memorize). Big time diminishing returns. Sat, 9/20/08 2:48 PM
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USMLE STEP 1 RESOURCES
First Aid for the USMLE Step 1 (2010)
High-Yield Behavioral Science by Barbara Fadem
High-Yield Embryology by Ronald W Dudek
BRS Physiology by Linda S Costanzo
Clinical Microbiology Made Ridiculously Simple by Mark Gladwin
BRS Cell Biology and Histology
High-yield Behavioral Science
MedEssentials: High-Yield USMLE Step 1 Review
First Aid QAndA for the USMLE Step 1
USMLE Step 1 Secrets by Brown
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Student #2. -study hard for I3, it will be very useful for boards. -enjoy your winter break and start studying for boards in january. -start flipping through first aid to become familiar with it Mon, 9/1/08 9:59 AM
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3. I3: all you need to study off of are MicroCards. You don’t really even need to focus on the syllabus. Know I3 well, as it will save you tremendous amount of time from boards studying on the subject. BOARDS STUDYING: You honestly don’t need to start studying until January. Kaplan QBank is not representative of the actual question style, go with UWorld. First Aid and Goljan should be the main study books with supplemental subject books to fill in the gaps. The only biochem you need to know is in First Aid. Don’t take the test on the VERY last day possible. Give yourself at least a 5 days before starting class again and take a well deserved vacation. Trust me, you’ll need it!! Sun, 8/24/08 6:10 PM
4. I3: Get the microcards and start using them early. You can even take notes on them and use that as your primary study source. Pay attention in lab, you learn good stuff that comes up over and over again. Micro is something that you end up running into in every rotation and it’s best to learn it well the first time through. Clinical Micro Made Ridiculously Simple is a fabulous, information, fun to read book if you want a supplement. Cancer: Ended up being more epidemiology and than I had anticipated. Look forward to finally really understanding sensitity and specificity – be sure to go to Rebecca Jacnkson’s lectures on screening tests, etc. They’re good and the material comes up all the time on the wards. Lifecycle: DO NOT quit and just start studying for the boards mid-block. Try and use Lifecycle as the time to study ob/gyn-related topics for Step 1. The ob part of lifecycle is particularly strong and has great small groups that came in handy for review before my ob/gyn rotation. Boards: Goljan! Goljan! Goljan! Buy this man’s book, listen to his lectures and forget about the BRS pathology book. I am still annoyed I spent money on it. Wed, 8/20/08 11:23 AM
5. Do what works for you. If you are a visual learner, forget the syllabus and buy books that explain things in lots of color and images–these books tend to be more clinically relevant anyway. I can honestly say that I didn’t read the syllabus and I think I have a good–if not great–understanding of the material because I learned in a way that worked for me. In the end, you will toss the syllabus and end up using the books in your third year. If you are in a student organization that offers mentors, make sure they hook you up with a fourth year mentor. Wed, 8/20/08 9:13 AM
6. Please do NOT start studying for boards until the earliest January ‘09 Thu, 8/7/08 6:41 PM
7. board exams are hard, just study and don’t worry. Take many many practice tests as they are the most high yield. At a certain point midway through or more, just take practce tests. It will show you what you don’t know and need to study. Thu, 8/7/08 10:05 AM
8. 1) Try not to get involved with too many things. Choose based on how much time you need to study for school. By Dec, you need to either and gotten out of your committments or have a tangible plan about how to do so within reasonable amount of time. 2) When do you want to take your boards? Early or late? 3) What kind of studier are you? Long term vs Short term because this should affect when you start studying for your boards 4) Even if you dont start studying until Jan, Be sure you have your books ready sooner than that. Because the worst thing that can happen to you is start studying later and then realise that First Aid is not your ideal book. tiv 5) Dont flow with the over hypes Q bank. USMLE world is an excellent and much cheaper choice. I used both and i can tell you this for sure. 6) Be careful about who you hang out with. If you are not the stressful kind of person, then stay away from stressful people that will make you start to freak out. 7) Are you an auditory learner? then get Golgen. He is an amusing but sometimes annoying old man but those emotions make you listen to him while walking, at the gym, etc. You dont have to wait till January to make Golgen your friend. Start now as you go along with I3 and you would have listened to him about 2 or 3 times before your exam. he is kind of addictive. Good luck, if you start to freak out, email and talk to an upperclassman that you trust, dont be shy to say “i am starting to freak out”. And dont forget. FRIENDS MAKE THE PROCESS A WHOLE LOT BEARABLE. Thu, 8/7/08 9:06 AM
9. for the first two weeks of I3 you learn immunology. Abbas’ basic immunology textbook they recommend is small and extremely helpful. for the rest of I3, it’s all about memorization. I had heard this from students in 2009, but it didn’t sink in until the end of the block so I ended up “studying” a lot with low yield. come up with a system (group or individual) and memorize bugs and drugs like crazy. Micro Made Ridiculously Simple is a good study aid for coming up with memory tricks. Cancer block is a ton of reading, so try not to fall behind. Life Cycle is about the time that many of you will start (or start thinking about) studying for boards. I was stressed for the first two weeks of LC trying to decide whether to study from the Syllabus or my Step1 materials. Once I realized that LC stuff IS on the boards I made that my priority and with my left over time (which you will have during LC since you Friday’s dedicated to boards/wards is huge) I would study for Step1 in general. I felt a lot better after getting my priorities straight, and sure enough I didn’t have to do too much review of the LC material for the boards and ended up getting a lot of questions from menstrual cycle to geriatric care. Oh, and in that vein, do your best to follow the embryology lectures/demos in LC because getting it straight in your mind in class will make it stick at least long enough for some of the questions on Step1 and is way easier than memorizing a list about embryology in First Aid. Thu, 8/7/08 6:43 AM
10. Enjoy your summer. Enjoy your winter break. Enjoy every day and continue that plan into 3rd year and beyond. As for boards, trust in how you’ve studied for every previous tests you’ve taken before. It’s not that different, just longer. That said, expect to feel overwhelmed and like you “aren’t doing enough” starting sometime in January and lasting into April. Enjoy the material. Practice your oral presentations for 3rd year by going to homeless clinic or the like if you get a chance. Wed, 8/6/08 11:59 PM
11. just make a study schedule for boards and don;t start till january Wed, 8/6/08 10:28 PM
12. study I3 WELL. Know that stuff. Only study I3. Nov 1st = START OF BOARDS SEASON. I mean this. Forget Cancer and Lifecycle blocks. Every point over 70% that you get on any one of those tests equals time you shoulda spent studying for the boards. You should be proud of 70%’s and ashamed of 71% and double ashamed for 72%, and so on.. EXCEPT-> study heme/onc well (the second half of Cancer block), but as you study, go over the relevent sections in BRS Path and take notes into that. Then use that to study for your final and then you’ll be golden for that portion of the boards. Go through EVERY question on Kaplan’s QBank. EVERY ONE. When you’re done, review the ones you’ve missed. Start in late Jan after you’ve gone through BRS Phys-> BRS Path -> First Aid (in that order). Then review ALL of them again, then path again, then First Aid again, then path again. (then w/ the QBank fine tune your reading w/ a few other books.. micro, biochem, anatomy, etc) But know BRS Path so well.. that you don’t just know about Crohns Disease, you know exactly what part of the page it’s on. I’m serious. This is top gun stuff, but will get you that 260+. Wed, 8/6/08 7:35 PM
13. Keep up in I3- the micro exams require learning a lot of facts. Micro is a big part of Step 1, and the more you can retain by spreading out your studying during I3, the more you will retain in March. The Essential Core prepares us well for Step 1, especially the Organs, BMB, and I3 blocks. You will definitely have to learn some new material related to the musculoskeletal system, genetic disorders, nutritional disorders, and cancers- you will find this as you look through First Aid or other review books. Don’t blow off Life Cycle- a lot of what you learn there is key for pediatrics and obgyn, and even internal medicine, during the third year. Wed, 8/6/08 7:24 PM
14. Don’t get bogged down and intimidated with trying to read through 10 boards review books. Use First Aid, a Q-bank (Kaplan or USMLE World) and listen to the Gulyan lectures. If you need to flush out concepts use the internet or another reference book like BRS phys but don’t try to read through a separate book for each subject. Take it little by little. And give yourself AT LEAST a week of vacation! Wed, 8/6/08 7:12 PM
15. 1. Make your own or buy a set of microbiology cards early on and use them. Learn all the ID stuff really well as it REALLY helps with Step 1. 2. Try not to let your classmates stress you out too much during boards. Really, you will pass. And if at all possible, study as far away as possible from UCSF and Parnassus. Wed, 8/6/08 7:10 PM
16. Prioritize your schedule with one or two key goals in mind, and be open to most everything else being different than what you expect. Wed, 8/6/08 6:48 PM
17. For I3 buy Clinical Microbiology Made Ridiculously Simple and the immunology book by Dr. Abbas, and don’t read the syllabus at all–it’s really confusing and both these books are great. Wed, 8/6/08 6:36 PM
18. Some of your classmates (hopefully a small minority) will already be working on step 1 study schedules and planning to start studying this fall. I strongly encourage you all to simply focus on (and enjoy!) your current courses, invest yourselves in learning this new material and don’t worry about boards until January (…maybe start thinking about it over X-mas break, if you must.) There REALLY is plenty of time to review it all, and I found that acquiring a solid understanding of the material the first time around was the most valuable part of doing well. Wed, 8/6/08 6:33 PM
19. Please make sure to enjoy yourself! Take time to spend time with your friends, explore the city, etc. The blocks are much more integrative during second year, so you will find yourself drawing on all kinds of knowledge from Prologue, Organs, and BMB. Study groups can be really helpful this year, especially in I3. Get MicroCards for I3. They are a lifesaver. You will be busier, but it’s all a transition into third year. Don’t stress out too much about the lottery; it will work itself out. Do go talk to Maureen Mitchell once spring rolls around if you’re really having a crisis. And please don’t worry about Step 1 until after Christmas break. There is a diminishing return on the quality of your study time after a certain number of weeks, and you will only stress yourself out more if you are in the library for months on end before your test day. Don’t neglect Life Cycle too much; the material is really useful, interesting and all over Step 1 AND Step 2. Wed, 8/6/08 5:44 PM
20. When it comes to boards (which you should feel NO pressure to think about until after winter break), check in with yourself. I really think that getting sleep, taking breaks, eating well, and all that common sense stuff will help you perform way better!
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