USMLE STEP 1 The Facts, Resources and Past Experiences Matthew Feldman – GEM 2017 NIMSA VP A presentation by NIMSA in association with MedSoc

Presentation Outline ■ The Facts ■ Resources ■ Study and test-taking “strategies” ■ Past experiences ■ Questions

THE FACTS

The Facts – What is it? (in case you forgot) ■ The Step 1 is 1 of 4 licensure examinations required by the National Board of Medical Examiners (NBME) for all physicians who wish to practice in the US – Step 1* – that’s why you’re here – Step 2 – Clinical Knowledge and Clinical Skills – Step 3 ■ Tests you on all concepts from basic sciences and (very) basic clinical medicine

The Facts – Registration 1. https://iwa2.ecfmg.org/appforcert/onlinedocs/afcoverview.aspx 2. https://secure2.ecfmg.org/emain.asp?app=iwa 3. Instructions all on this page: https://iwa2.ecfmg.org/overview.asp ■ But because NIMSA cares…we have all the steps outlined for you on our webpage:

http://nimsa.ca/booking-your-usmle-exam/

The Facts - Fees

■ Extra $180 to write outside of North America (obviously this means Dublin) ■ Visit http://www.ecfmg.org/fees/ for more information and links

The Facts – Exam Breakdown ■ 308 MCQs ■ 7 blocks composed of 44 questions each, lasting 60 minutes each ■ Tutorial block to start exam – 15 minutes (can be skipped and added to break time) ■ Break time to be used throughout exam (or all at once) – 45 minutes ■ Exam – 7 hours ■ Any additional time at the end of a block or time left from the tutorial is ADDED to your break time (ie. 8 total hours to write the exam)

The Facts – Exam Breakdown

The Facts – Grading Scale ■ You are graded based upon your comparative performance from pass data ■ It is based on a normal distribution with a set pass score of 192 ■ The average in the United States is approximately 229 +/- SD of 20, so do your best to be on the “right” side of this mean ■ Your 3-digit score is the only thing seen ■ Once you have passed (ie. any score ≥192), you may not re-write the exam

The Facts – Your Score Impacts Your Match

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

The Facts – Your Score Impacts Your Match

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

The Facts – UCD Support ■ Continues to change from year to year ■ 2015 – Microbiology Rapid Review – 3 Saturdays in June (during baby res for 4th meds) – Biochemistry “Review” – 1 full day of 320 biochemistry questions ■ NIMSA continues to work with administration to upgrade this course and deliver a USMLE-focused review for students as taught from USMLE materials ■ 2016 – Dr Holloway will be coordinating these sessions – February to March sessions as well as Dr Chan’s Manic Micro Review in June

The Facts – UCD Support ■ Students will be reimbursed for the following: – NBME Practice Exams ■

50 Euro will be reimbursed per score report up to a maximum of 2 reports

– USMLE Score Report ■

50 Euro will be reimbursed for this one report

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Anonymized score reports must be submitted to [email protected]

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In the works – reimbursement (even partial) for UWorld question bank

RESOURCES

Resources ■ So so so so many! ■ Ready? ■ Set? ■ GO!

Textbooks First Aid for the USMLE Step 1

Textbooks Goljan’s Rapid Review Pathology

Textbooks Pathoma

Textbooks Clinical Microbiology (made ridiculously simple)

Textbooks USMLE Step 1 Secrets

Textbooks Board Review Series (BRS)

Textbooks Kaplan medEssentials

Audio Goljan

Video Kaplan

Video Pathoma

Video SketchyMicro and SketchyPharm

Video Picmonic

Video Doctors in Training

Question Banks UWorld

Question Banks UWorld

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Question Banks Kaplan

• Diagnostic Exam • QBank • 2x Full-Length Simulated Exam

Question Banks Kaplan

Question Banks USMLE Rx

QBanks and NBMEs ■ Question banks serve primarily as a learning tool rather than an evaluation tool – Each question has a detailed answer explanation ■ Full length practice tests (NBME questions and UWorld Self-Assessments) serve primarily as an evaluation tool as opposed to a learning tool – NBME exams do not provide correct answers or explanations – NBME score reports provide a general idea as to strengths and weaknesses but overall do not provide detailed results

Practice Exams UWorld ■ 4 blocks ■ “Self-assessments”

Practice Exams NBME ■ 4 blocks ■ An absolute MUST

NBME Self-Assessment

NBME Self-Assessment

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NBME Score Report

■ If my point is not yet clear…… – Practice questions from the above QBanks and assessments are your best indicators of your grasp of topics, understanding of material and equally as important in many ways, your knowledge of the layout of the exam

STUDY AND TEST DAY STRATEGIES

Study Strategies ■ Organize small groups of students to run through/present on/simply study various topics presented throughout study materials ■ Use First Aid alongside current courses – You have to study for it sometime so may as well have it help you now ■ You have made it to this point already – you know what suits you best, you know your own stress levels and you (hopefully) know how to maintain your sanity – Personal perspective – human interaction is helpful and important BUT when it really gets to crunch time, don’t let anyone else’s schedule dictate yours!

Study Strategies ■ Start Early! ■ – – –

QUESTIONS, QUESTIONS, QUESTIONS At the low end, you should be completing 1 QBank before the exam à ~2,500 Qs At the recommended level, you should complete ~5,000-6,000 Qs At the high end…you think there is a limit to the number of Qs you should do?

■ Self assessments should be additional to these question banks ■ 2 NBME Assessments – 1 mid-way through study or ~3-4 weeks before exam – 1 towards end of study or ~1-2 weeks before exam

EXAM DAY

Exam Day – what to expect ■ A lot of nervous people ■ Depending on your location, there may be many others writing the exam or few ■ Not everyone is writing the same exam as you ■ You will need to sign in and out during each break that you choose to take (take that time into consideration)

Test-Taking Strategies Example 1 ■ Register at exam center – don’t be late…they get grumpy and no one needs that – Tutorial – skip through it (you’ve seen this so many times from all of the practice blocks and exams you did, right?) ■ Blocks 1-3 …………you’re getting sleepy – BREAK - ~10-15 minutes ■ Blocks 4-5 – BREAK - ~30-40 minutes à eat, coffee, collect your thoughts ■ Blocks 6-7 ………….Brain. Is. Melting. ■ Survey (optional) ■ END!!!!

Test-Taking Strategies Example 2 –

Tutorial – skip through it (you’ve seen this so many times from all of the practice blocks and exams you did, right?)

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Block 1 and 2 BREAK – 10min (coffee, snack, stretch)

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Block 3 BREAK – 5 mins stretch

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Block 4 BREAK – Lunch 20mins

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Block 5 BREAK – 5min stretch…slaps face a couple times

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Block 6 BREAK – 10 min...snack, drinks

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Block 7

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END

Post-Exam ■ You will receive a confirmation slip stating you wrote the exam ■ Relax ■ Celebrate ■ You’ve just completed a milestone ■ “Come what may” ■ Results come in 3-4 weeks (typically the 3rd Wednesday after your exam date at 9:00am US Eastern time)

AFTER

WEBSITE www.nimsa.ca

Brief Overview

to help you find all the info you saw today ■ Dave Chetrit – NIMSA webmaster

PERSONAL EXPERIENCES 3 GEM 1 UEM North American and Irish students

Johnny Krasinkiewicz ■ North American GEM

Cathal O’Leary ■ Irish UEM

Megan Melland-Smith ■ Canadian GEM

Rob Clayden and Adam Karevoll ■ Canadian and American GEMs

Contacts ■ Matthew Feldman – Canadian GEM 3 (res year) – [email protected] ■ Megan Melland-Smith – Canadian GEM 3 (res year) – [email protected] ■ Jonathan Krasinkiewicz – Canadian/American (dual) GEM 3 (res year) – [email protected] ■ Cathal O’Leary – Irish UEM (final med) – [email protected] ■ Adam Karevoll – American GEM 3 (res year) – [email protected] ■ Rob Clayden – Canadian GEM 3 (res year) – [email protected]