“Anthropologist Margaret Mead was once asked what she considered the earliest evidence of civilization. She answered that it was a human thigh bone with a healed fracture that had been excavated from a fifteen-thousand-year-old site. For an early human being to have survived a broken femur, living through the months that were required for the bone to heal, the person had to have been cared for – sheltered, protected, brought food and drink. While other animals care for their young and injured, no other species is able to devote as much time and energy to caring for the most frail, ill, and dying of its members.”
—Ira Byock, in The Best Care Possible
Step 1 Testing Strategy
A few thoughts about test day:
- Don’t get creative with your answers. Stick to what you know. Better to get burnt by those impossible details you couldn’t memorize than to hurt yourself by trying to outsmart the exam.
- Read the whole question stem. The key to an answer may be the detail you just ignored.
- Be ready to guess. A lot. If UWorld is any sort of accurate measure, then a passing score is around a 50%, the median (220s) is around a 60%, and the best of the best (260+) is 80% and up. So if you have to guess on a lot of questions don’t let it bother you.
- Timing. I think it best to take an aggressive approach to each section. Give yourself about a minute per question and you should finish each section with plenty of time (60 minutes for each set of 46 questions). Use the extra time to go back over questions you marked, or you can use it as extra break time.
- Don’t mark questions if more time won’t help you answer them. It’s better to relax and get ready for the next section.
- Take a short break between every section. Powering through seven straight hours of exam seems like a bad idea. It’s a test of endurance as much as knowledge.
- For me I get particularly worn out three to four sections into the exam. Take your breaks, and then lean into the screen and mark up the questions to help maintain focus.
- Bring food. Don’t drink too much. Or at all.
- Relax! You’ve studied hard and when it comes down to it Passing = MD. And you’re gonna pass.
“Eu vou mostrar pra você, que mesmo negando, ainda é o melhor pra mim. Que mesmo negando, é a pessoa que me faz feliz. Que mesmo negando, a pessoa que me tira sorrisos fáceis. Vou mostrar pra você, que o que eu tenho aqui, está guardado só pra você. Vou mostrar que é você que eu quero pra vida toda. Vou mostrar pra você, que eu te amo e estarei enfrentando qualquer obstáculo só pra te mostrar isso. ”
—Eu vou mostrar pra você. (re-tificar)
If I had to take Step 1 again, I would focus almost exclusively on two things: (1) memorization and (2) practice questions. In order to do well on an exam that is so broadly comprehensive you need both extensive knowledge as well as a honed clinical mind. An aggressive approach to memorization (with mnemonics, diagrams, pictures, etc. followed by frequent repetition) will help you retain the information that will just never stick from passive reading. Then practice questions will further cement facts and concepts in your mind, as well as teach you the all important skills of deduction and pattern recognition.
So just two things: memorization and practice questions.
