Scoring well on ANY USMLE does NOT require:
- Superhuman intelligence (I’m NOT a genius)
- Reading First Aid 15x (I didn’t even finish it once)
- Living with your mother (I did all my own cooking)
Instead, there are 3 key skills that everyone is capable of developing, but few actually do. They are:
1. Learn in an integrated, applied manner
USMLE Step 1 will test your ability to apply and integrate your knowledge. Memorizing will NOT get you far, but that is what so many students resort to, derailing their chances before they’ve even started. Why do they memorize? Because learning for understanding is difficult.
Test yourself on the following, to see how much you’ve been memorizing vs. truly understanding:
- Can you use the common translocation in Burkitt’s lymphoma to explain its clinical presentation along with its response to chemotherapy?
- Does your knowledge of ion channel chemistry extend to an ability to predict the effects on membrane depolarization threshold in ischemia?
- Can you explain the pathophysiology of warfarin skin necrosis by using the mechanism of vitamin K metabolism and the half-lives of the various coagulation factors?
2. Never forget what you’ve learned
It’s great to invest the time to understand the body, but what good is it if we forget everything in a week?
If you get nothing from this website, you should know that it is possible for anyone to remember everything they learn INDEFINITELY.
How? Through the power of spaced repetition, specifically the use of a program called Anki. In short, spaced repetition is a way to never forget what you’ve learned. Most students and commercial test sites follow the short-sighted approach of memorizing straight facts, allowing them to forget all of their hard-earned integrated knowledge. The key to using Anki most effectively is to turn your hard-earned integrated, applied knowledge into a question that will allow you to remember it forever.
3. Apply your knowledge to clinical vignettes
There is a section in First Aid called “Rapid Review,” where you learn “buzz words” for conditions. Aortic stenosis is boiled down to “ejection click,” and thyroid cancer becomes “papillary carcinoma.” While these associations are an understandable starting point, many students rely on them at their peril. As Step 1 becomes based on longer and more complicated clinical vignettes, students who consistently move beyond buzz words to understand the entire clinical vignette as they go, will be thrilled when they finally open their score report.
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