Ashok Chaudhary

USMLE STEP1 EXPERIENCE

Test date:26th July,2016
Score:271
Hello everyone,
I am a government medical officer working under Ministry of Health and
currently deployed at a relatively rural place of my country,Nepal.
I dont knowin what format to write this experience that would be best for
you all.but I think
It is better for me to write it in a timeline manner.
I started my preparation around February,2015,with the aim of taking step 1
by Dec 2015 or Jan 2016.But my almighty had other plans for me.I lost
about 3 months due to my familial health problems,around the same time
earthquake had struck us hard(around April May 2015) and had to abandon
the idea of applying for match in 2017.
I started with Kaplan lecture notes(except for pathology) and videos(2010)
with Anatomy first ,then physio,bchem,micro.And then I read pathology
.was in a great dilemma which book to follow for itGoljan or pathoma.so,I
watched pathoma videos and combined it with Goljan text book.Actually,this
was very helpful for meDr sattar explains things so wellthat made
reading from Goljan easier.I would suggest ..read Goljan only if u have
adequate time.Yess Goljan is an excellent book that helped me a lot ..not
only for pathology..but also for bchem,micro,physio,pharma topics. I thinkit
helped me to answer some very weird questions which I could not have done
with other sources.But this book is very frustrating toou never seem to
finish itso plan ur time accordingly.My advice isif ur xm is near..dont do
it..resist ur temptation to study it..because it will rob u off ur valuable time
which could be utilized for even more high yield sources like uworld and First
Aid.While I was going thru this book.i used to listen to his audios .for
about an hour at the sleep time.After I finished pathology,I read pharma
from Kaplan notes and videos ..followed by behav+biostats from Kaplan
notes and videos.For BS,I also read few chapters from BRS the chapters on
Doctor-patient relationship.It was quite helpful I think.If you are at the
beginning of ur preparation and are following these sources..i would advise u

dont try to memorise things from these sources(the mistake which I think I
did.that took a lot of time).Instead focus on understanding the
things.why this,how this happened,the mechanisms,the way the things are
occurring etc
After I was done with these sources.i revised all these things rapidly
again(no kaplan videos this time..except for a few topics of physio..and other
subjectsthe topics which was difficult to comprehend).I revised full
pathoma videos.it is just so awesome..that I could not skip it.For revision of
Goljan.i mainly focused on the texts given within the boxes,the images and
the text in blue..that is at the side of each page.While I was in the middle of
this revision phaseone of my senior told me to start First aid early and to
annotate imp things in First AidI complied.During this timeI read the
topics directly from First Aid.which I came across while revising kaplans
and pathomas and goljan.Like.while watching pathoma videos.i would
turn the page on First Aid for that topic..watch the videos and read it from
FA.and annotate the things and mnemonics(which Dr Sattar says) .it was
Dec 2015 already.till nowI never tried to memorize things from FA.just
scanning thru it and annotating some imp points.
My advice would bestart First Aid as early as possible..as an
adjunct.and get used to it..as much as possiblebut dont memorize
anything from FA..without understanding things.FA is approx 600 pages(the
things that u need to study).yet I think its a very concise book for step
1.Every word and sentences in First Aid.is there for a purpose.So
understand the meaning of words and sentences.Dont just memorize
it(except for some things like..the developmental milestones ,most of
microbiology etc)that will do no good.Understand it then only memorize
it.Yess..u need to memorize FA.but only after understanding.Forget those
idealistic words.where ppl saystep 1 is all about understanding
only..nahh.u also need to memorize stuffs and that sometimes need
cramming too..But keep the space in ur brain empty to accommodate the
things u learn and memorize from FA(including annotations) and uworld.Dont
unnecessarily overfill ur mind..with all the stuffs from kaplans or goljan or
some obscure sources.EVEN MOST OF THE DIFFICULT QUESTIONS ARE FROM
HIGH YIELD CONCEPTS ONLY.
I started uworld after all these(around mid December).All the seniors and all
the experiences I read from facebook forum.they all had one thing in
common.First Aid and Uworld are the two absolutely important HOLY
sources..and so was it(with my experience of xm).I was so preoccupied

with this notion.that.i wanted to study UW so well..so much so that I

could barely finish 35 questions a day..from uworld.(Of course.i was still
working at my hospital during this periodso that might be one of reasons
for such tortoise pace).it took me almost 3 months to finish it ..the first
time.UNDERSTAND UW very well.Read all the explanations..and ponder
why u got a question right..or why u got it wrong.and annotate the important
things like the educational objective in FA.if that concept is not in FA.(No
wonder my..FA was like a book which only an alien could understand ..after
all these annotationsthere was no space left in my FAeven to write my
name on it).So if..u plan to annotate things on FAkeep ur handwriting very
small from the beginning.(I wrote
later).

this big fonts early..which I regretted

Now ..i turned to my most important source FA 2015(around late march

2016) with all those nauseating annotations in it.This was the first time I was
reading FA properlywith the aim to understand it and memorize it.It took
me slighty more than 2 months in the first proper read.During these,I also
read FA 16 pdf from my laptopand added the new things to my FA 15
book..sometimes times that reqd sticky notes.
I took leave from my hospital about 3 n half months prior to my exam date
n I am glad that was such a good decision to take.now I could focus all my
time on my studies..with no tension of looking after patients and
administration.
When I finished reading FA 1st time..it was around end of May.This time I took
offline NBME 7I dont remember exactly..but I think I made around 10 or 12
mistakes.I was happy with the result.Now was the time to revise UW did
it rapidly in about 25 days..then after this ..revised FA which also took me
around 25 to 30 days.During these revision phase I did new nbmes
...nbme 11 onwards on weekly basis..i was happy with those results .on an
average..i think I made 9 to 10..sometimes 12 mistakes.
I took NBME 16,17 and 18 online
NBME 16(2 weeks before exam):269(8 mistakes)
NBME 17 and 18(1 week before exam..both on same day):
NBME 17:273(5 mistakes)
NBME 18:266(11 mistakes)

The scores were very encouraging to me.but I didnt believe themI had
a feeling,prior to the exam,that I might just cross 260,if I got lucky.Now that..i
have got the scores..i can say, my friends.they are quite predictive.Dont
know..how do they predict..but they do.
NBMES were quite helpful for the real exam.a few of photos were ditto from
there.One of my friend ..who took exam on same daygot some ditto qsns
as well from the NBMEs.I could not use NBMEs as a learning tool because of
time constraint..I used it only as assessment tool. I was happy with those
scores anyway.If u have timeI would suggest ..do all the NBMEs..if possible
and also use it as a learning tool..and try to decipher the concepts they
are asking.Ponder over all the wrong answerswhy/how u got it wrongand
also the qsns u got rightwhy u got it right.whatif the question was
slightly different,or the options were slightly different..etc etc.
I did Fred4 days prior..got 95% rightthe tutorial and the exam is ditto
the real exam.

For ECGs..no special sources.facebook posts were quite useful. Heart

sounds...i made a collection of those that are in uworld in my phone..i used
to listen them occasionally.For radiological images,uworld and Fa only.And
yes..one more thing..do learn the images u come across FA and UW,well.I
took so many screenshots of various posts on fb,and many imagesand
used to look at them when I was out for a walk..or after lunch and dinner
etc.Two of my friends from this groupI think one is staph aureus and
other usmle something(sorry I couldnt remember the name..had
uploaded UW tables to this group..which Moiz had asked forI had those in
my phone.i went thru them about 20 or 30 pages a day..while I walked to
my playing field or to gym.Thank you guysand all the Kickass members.
If u come across any thingthat is in FA and UW.which u dont
understanddont just let it go..google it,wiki it,post it on the facebook
group,ask ur friends etc etcbut understand it.

Friends,I think I was an active member of facebook group.and those

discussions,those images posted by someone else,those files uploaded.all
were helpful.Yesthere were times..when I felt so much frustratedby
someone elses posted questions..i felt.omg..i dun know this,I dun know
that..so many peopleknow this thingam I the only one who doesnt know

this??Those posts made me feel myself..idiot sometimesbut most of the

times they were inspring,knowledgeable,encouraging.Many friends s
ometimes posted their agony and insecurities and it was really so
satisfying to encourage them with some inspiring sentences.So,getting
actively involved in the fb group does help a lot.
Friends,throughout my preparation my mantra has beenstudy,sleep,stay
healthy.all 3 equally important.Resist ur desires..to compromise ur
sleep..or diet or exercisejust to study few more pages.What is the use of
studying so much..if ur brain cant remain alert and think well??Never ever
during the course of my preparation,I exceeded 12 hours of studynot even
when I was on leave.i used to sleep at least 8 hours,exercise
regularly(sometimes playing football..sometimes going to gym).I followed
these scheduleas late as 4 days prior to my examWhile I was revising FA
and UW...i made a note of those stuffs ..which was volatilein a separate
notebook..they were almost 50 pages in my register sized notebook with
font size very small.i rapidly went thru them in my final 2 days.U must
have noticed friends..during my final 7 months of prepn..there was no
Kaplan,no pathoma,no Goljan.all that was..is some imp stuffs that I had
annotated into my FAwhich sometimes required A4 sized paper to be
added in between the pages of FA.
Get urself enough sleep..prior to exam(very important).if U cant.take
medicine.i took promethazine 25 mg.One of my friends..took Zolpidem.(but
beware..of the adverse effectlike next day sedation,dizziness,etc). So dont
use it for the first timein the night prior to exam daywhat I did wasI
experimented with the drug1 week prior.
Why sleep is important??
Because step 1 exam wants u to think on ur toes.throughout the exam
there are very few straight memory questions.It wants u to APPLY those
concepts that u have understood and memorizedin the situation given in
the question.And you WILL face those out of this world questions,which
requires a CALM n ALERT brainI had many such qsns in my exam.An alert
brain..is equally important.as important as ur whole study.
N plzz..check ur documents u need to avoid last moment panic.
Exam day:I woke up..feeling refreshed.got ready for the testtook a heavy
breakfast.went to test center..i was calm I think.may me a little anxious
for initial 20 mins of the test.after that .it was like NBME for me.some

qsns were very easysome questions(like 4 or 5 in each block) very very

difficult in a sense thatI didnt even know what it is trying to askread the
qsn again.got some idea..looked at the options and applied the rule of
ruling out.this helped me a lot.I was anticipating..few wtf qsns in every
block and so was it.Moral is.dont let urself down when u see such
questionsbecause u will certainly face it.Use ur brain..n think
rationally.sometimes u will findhow simple that qsn was actually.Yes..
sometimes they give lot of unnecessary details..just to SHOWthat the qsn
is complicated ..which,in fact, is not.
Yesexam time was enough.on an avg..i finished each block about 10 or
12 mins early.that remaining time, I used it to ...go after my marked
qsns..there were on avg..10 or 12 marked qsns in each block.I took 5
min..sometimes 10 min break after each block..after 3rd block..i took so
called lunch break although I was not hungry.i took some energy bars,fruit
juice etc.
Never evereven in my dreams..i thought of getting this score.I never
deserved itmay be luck favoured me heavily,may be my parents blessings
worked for me,may be my parents dedication towards God(which they
always have been) worked.may be all ur blessings worked.
Sometimes,I feel so guilty..i am a criminal to my college friendsI skipped
some of my closest friends weddingsthat was so selfish of me.My jigris,if u
are reading this.i am sorry to u again.My colleague friends at my work
place have been so helpful.they did work extrajust because I could get
more time to study.Thank you my colleagues.
Guys.i never felt completegoing into the exam.i think..nobody does.But
yes..i was calm n confident .that I will do well.I repeatu dont need to
know everything.u dont need to memorize everythingwhat u need is
torecognize..when u see it..Rule out the wrong ones.This worked ..so
heavily for me.N stop comparing urself with others.u will always feelu are
inadequateu will always feel u dont know so many things.N this n that
person knows so much.
Guysthis is itI think.Yess.there were a lot of days.throughout my
preparation..when I felt so down.so depressed.so idiotic that I dont know
nothing.I even thought of quitting ..so many times(sometimes due to my
family health problems,sometimes due to frustration of this long
journey,sometimes due to the feeling likewhy should I suffer this much

when I am already into this government job etc etc).But then Nothing in
this life ..that is worth something is easy and Never go down.
All the best.