USMLE Step 1 Intro

by Mohammad Hajighasemi-Ossareh, MD, MBA

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    00:00 Welcome to the 2nd Year of Medical School lectures. Now in this lecture, we're going to discuss the USMLE Step 1 exam. We'll talk about why the exam is important, when you should start studying for the exam, what resources you should use, how to study for the exam itself. Now let's talk about the exam. So the USMLE Step 1 exam is a multiple choice exam that students take at least in the United States after the 2nd year of medical school. The exam covers multiple topics.

    00:30 Going over them briefly, the exam will contain Anatomy, Behavioral Sciences, Biochemistry, Microbiology, Pathology, Pharmacology, Physiology, Genetics, Immunology, Nutrition, Molecular and Cell Bio, Epidimiology, Biostatistics, and Medical Ethics; a lot of content. The exam though, don't get overwhelmed. You covered these topics in the first 2 years of med school so the exam itself test the basic science material that you learned throughout the first 2 years of med school but it tests you in the form of what are called clinical vignettes and we'll come back into defining what are clinical vignettes. So the exam itself when you sit down on test day, you will have seven 60-minute blocks. Each block will have 40 questions. So, 7 blocks 40 questions each, you will sit down for a total of 280 questions on test day. Just so you are aware, prior to 2016 each block of questions actually had 46 questions instead of the new 40. So if you are reading something or you hear about some block having 46 questions, you know it's a bit of an outdated resource.

    01:40 Now, personally when I took the exam it had 46 questions and we had the same 1-hour time so you've been gifted in a way with the new exam set-up. So, with all that exam time you are going to need some breaks. So on exam day you are allotted 45 minutes of what they call personal breaktime but you can get some more out of it. So, when you go sit down on test day there is actually a 15-minute tutorial at the beginning of the exam and this tutorial just teaches you how to click the buttons, how to use a basic interface which all of you I'm sure are aware. So what you can do is actually hit skip on this tutorial and that 15 minutes will get added to your 45 giving you a new total of 1 hour of breaktime that you can use on test day. As a quick side note, you can go on to the USMLE website and view that tutorial on your own computer and take as much time as you want getting familiar with the interface so on exam day you don't have to waste time and you can just hit skip and take those 15 minutes and earn them as your own.

    02:39 There is even another way to get some more breaktime. So if you're taking a block and you finish that section early within the 1-hour limit whatever unused time gets tucked on to your total breaktime. Alright so there is plenty of opportunity on this long day of exam to give yourself adequate breaks. So where do you take the exam? So the exam is taken, in the US and actually globally, at what's called a Prometric Testing Center. This is a very uncomfortable and let me say that again an uncomfortable and sterile testing environment. Okay? We'll go into details of how this feels shortly but it's not pleasant but we have a strategy to make it better. So, describing the USMLE exam so far had all sounds pretty horrible. Doesn't it? You have to study for the exam but taking the exam can also be a fun challenge. It's not as bad as people will think. Don't let that introduction scare you. If you have the right mindset and you prepare properly studying for and taking it on test day can actually be pretty fun. So why is the USMLE Step 1 exam important? Why do people care so much? Why is it so talked about in the medical community? So, you need to know the purpose of the exam and the USMLE Step 1 exam is used for multiple purposes. Medical schools take them, they use them to gauge students on how they're learning and it assesses the school's curriculum design.

    04:03 Now, let's discuss an important change to the USMLE As of January 2022, the score reporting for USMLE step one has been changed to a pass fail system.

    04:16 As a result, this will subsequently increase the importance of USMLE step 2 CK scores and their residency application process.

    04:25 Now here's the thinking behind this comment, because it's very important for you to understand. Now USMLE step one becoming pass fail means a lot of students may think, Oh, it's pass fail, I don't need to try as hard.

    04:40 I don't need to worry.

    04:41 I can get a passing score.

    04:43 This would be an absolutely horrible idea.

    04:46 Here's why. The content from USMLE step one will literally be in every other test you take for the rest of your medical career.

    04:55 When you're taking USMLE step two, when you're taking us USMLE step three , even when you're taking your specialty boards.

    05:02 I took neurology boards and the content from USMLE step one was still there.

    05:08 Seven years later, from taking step one, that information was expected for me to remember.

    05:14 So the big takeaway here is do not let the fact that USMLE step one becoming pass fail deter you from studying the absolute hardest that you can.

    05:25 You still need to study as hard as you can because again, the content from step one will be required for you to remember the rest of your medical career.

    05:35 So these are the few ways in which the USMLE exam score is used and a world of uses also exists but these are the vital ones you should be aware of. So the exam is extremely important and you want to have the right mindset and strategy for it. So, the exam is used for a wide variety of purposes. If you search online and see what the average USMLE score is across the nation and what average scores are for students matching into different residency programs. You could do this, I could tell you this information but I'm going to argue it's worthless. I'm not going to focus on that material because it doesn't help you in any way.

    06:13 It doesn't help you plan, it doesn't help you develop a strategy or help you do well on Step 1.

    06:18 To be frank, I'm going to ignore all those numbers and I'm going to recommend you do as well.

    06:22 They're only going to distract you. There's no value in knowing "Oh, here's a killer number, I need to get to match it in dermatology." Well, I'm sure you're aware if you want to do dermatology is very competitive, let’s have the strategy of getting you the best score we can instead of worrying about numbers and stressing ourselves out. So let's do something else. Let's instead focus on learning the material well, learning how to take the USMLE exam, and perform well on it. Then you don't have to worry about score averages or NMBE score reports. You will have done well, you would have had a solid strategy, and you go on with your life. No need for extra stress. So when do you start studying for USMLE? Now, this is a debated question among medical students but I'm going to argue the answer is very simple. When you're a 1st year medical student, don't worry about USMLE Step 1. It's going to be an unnecessary distractor. Focus on developing strong study skills, reading skills, having a healthy lifestyle of good eating, sleeping, and exercise. These lifestyle habits and study habits take a long time to develop and to get them deeply in grain takes effort and time. So during the 1st year focus on growing yourself academically, mature-wise, and physically and mentally then you'll have the perfect platform for going into 2nd year. So when you start the 2nd year of medical school that's when you start to plan out the resources for USMLE Step 1 and start to develop a study schedule. Now let's break it down per month. This is based on the typical US Medical School schedule and yours may vary but in general here's how it goes. In the month of February this is when students start to study for USMLE, is not dedicated USMLE time but they study for Step 1 simultaneously while studying medical school courses. This is a balancing act. It's when you start getting your foot, dipping it into the pool, getting a little wet while still being in medical school curriculum. Now in March, the next month, this is the transition point of medical school final exams also called shelf exams and the transition into a full dedicated USMLE study mode. Now in April, most students across the nation will have an entire month, 2 to 6 weeks, depending on what school you go to in April for dedicated, hardcore, nose to the grindstone USMLE study time. This isn't true for all schools, some schools have it, it's a different amount, it's a different times in the month but in general in April that's when you'll have dedicated Step 1 time and then in May that's when most students will actually sit and take the USMLE Step 1 exam. So, you've learned about the exam, you've learned the overall timeline and its importance so the real important question becomes "What resources should you use for the exam?" Now, the amount of resources available to study for USMLE Step 1 are now, for better or for worse, innumerable. This is a problem. Students have too many resources to pick from, they buy too many, they become overwhelmed. So let's not have that happen. What you want to do, the goal here is to purchase a set core of resources that you study well with and are also high-yield gold standard resources. Pick a few and those few are going to be strong good ones. Now, you may be in the process of buying resources that you don’t like and you'll have to ignore some but this is a process and it comes with a territory so there is going to be some loss, some ___ cost, you'll buy some resources, you don't like them.

    09:56 Hey, better to throw them away and not be distracted than be distracted with all these unnecessary resources. Find what works for you and we'll discuss them. So, what are the overall types of resources available for USMLE Step 1? These include but are not limited to: 1) Books. Go to a classic books, now digital as well, using flashcards, there are prerecorded video lectures, there are video animation companies, and also question banks. Let's go through them. So for books, many resources are available and these are also the most historical resources. USMLE resources started off in books and they're still on books today. So the single book that we are going to argue and no one's going to argue against us because it's a national agreeing that the First Aid for USMLE Step 1 is a must-have book. You can also use the Lecturio Bookmatcher app on any popular book including First Aid for USMLE Step 1 and just take it and scan the book and find relevant videos. So, hopefully during your 1st year of medical school you obtained a video lecture series to follow along with your medical school lectures. If you're watching this video, you'll likely purchase or hopefully about to purchase some Lecturio videos and good job for picking what I'm going to very biasly tell you is the best resource out there and that comes with my genuine opinion, extremely high quality high-yield videos. So what you need to do is keep watching these videos during your 1st year of med school and if you didn't that's fine, watch them during your 2nd year of med school, get on the train as early as you can. These videos are going to be the foundation for your understanding of Step 1 material. So, question banks.

    11:42 Kind of an interesting topic. These are the core resource used when the basic science learning is complete and now you're focusing on studying for the actual USMLE exam itself. Now question banks really come in 2 forms. Those that help you learn the material and those that separately help you prepare for the USMLE exam itself. So, the resources you will use will be categorized into 2 forms. The first, the material helps you learn material throughout your 2nd year of med school. That will be the first style of things you want, getting and learning the material. Then the second form of resources will be material that then reviews will be called high-yield test relevant material that you learn during the first 2 years of med school and you actually need both. Those that teach you the material and those that then say "Hey, here are the highlights or high yields of what you need to know for clinical practice and going into standardized exam.

    12:39 So, how do you actually study for the exam? So, we previously discussed the resources and the content present on the USMLE exam. Now let's talk about how to actually study for it. First things first. I want all of you to really focus on the 2nd year of medical school courses. The 2nd year of medical school topics in school are the most heavily tested on USMLE Step 1 in comparison to the 1st year of med school. Let me say that again, it's that important. The 1st year of med school is important. You will learn how to study and become a good student and the material is foundational to understanding everything during your 2nd year. When you sit for the USMLE Step 1 exam and take that test, a lot of the material is going to be from that 2nd year but for you to know that material well in the 2nd year it's rooted in 1st year content. So if you're a 2nd year student or a 1st year student really focus on the content, it'll come in handy when you're trying to learn the high yield and study for USMLE itself. So, this is what it comes down to. The key concept to performing well on the USMLE Step 1 exam is a 2-stage principle, gaining knowledge, what you learn during your first 2 years and your high-yield review then applying that knowledge to the actual test. So what you need to do is finalize your resources that you wish to use to study for the exam. These resources will then be incorporated into the study schedule that you will develop. So when we go on to the video that shows you how to develop a study schedule, you need to already know what resources you want so you can plug them in and have a clean schedule to follow. So, speaking of studying for the test. Studying for the USMLE exam requires developing a very strict study schedule and understanding then how to answer, how to read and understand how USMLE questions are created. This is what we're going to talk about in the next 2 lectures.

    14:42 So let's summarize what we've talked about here. We talked about how the USMLE Step 1 exam is a multiple choice exam that covers the material from the first 2 years of medical school in the form of clinical vignette. The Step 1 exam is important but I don't want you to worry about national averages and residency score averages. Come up with a solid study plan, study extremely hard, do the best you can, move on. No need in giving yourself extra stress. You're going to start studying for the Step 1 exam during your 2nd year of medical school. Now studying for the exam requires knowing the basic science material and then reviewing high-yield test relevant material from the 1st and 2nd year. You will need to pick your key resources that you'll use.

    15:29 Books, videos, and Qbanks are the general categories. Now studying for the exam requires that you carefully plan out the resources you're going to use, understand how questions are composed, and then you will use a strict study schedule. Thank you.

    About the Lecture

    The lecture USMLE Step 1 Intro by Mohammad Hajighasemi-Ossareh, MD, MBA is from the course Med School Year 2. It contains the following chapters:

    • USMLE Step 1 Intro
    • What Is USMLE Step 1 Exam
    • Why Is Step 1 Important?
    • When Do I Start Studying?
    • What Resources Should I Use?
    • How Do I Actually Study for the Exam?
    • Lecture Summary

    Author of lecture USMLE Step 1 Intro

     Mohammad Hajighasemi-Ossareh, MD, MBA

    Mohammad Hajighasemi-Ossareh, MD, MBA

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    Must Watch!
    By Gabrielle G. on 14. December 2020 for USMLE Step 1 Intro

    We all have to get ready for this behemoth and this gives a detailed enough overview of what the exam consists of and erases the mystery around the exam. Helps with test anxiety for sure.