need support from fellow opms...

alright guys - you’ve got me through thick and thin. i’m calling on you now, once again, to be there for me. i’ve got two weeks to go before the usmle and i feel utterly lost. i don’t have much support here at school and i feel like very few people understand what it’s like to go through this. but i feel so lost and unprepared. the answer is, of course, to keep on trucking. beyond that, i’m hoping that someone out there can tell me that it’s possible to pull this off. i’ve been a mediocore student in medical thus far (though watch out world, once i get into the wards!). i’ve just barely squeezed by in my courses and now i find myself unable to break 50% on qbank. i completed a kaplan course several days ago and i’m now starting to study on my own. the plan is to spend an hour or two each morning doing qbook questions, spend six hours or so studying first aid (trying to make it all the way through) and then spend three hours or so a night doing qbank. i’ve done 25% of the questions and just don’t see improvement. i got the equivalent of a 160 on a practice usmle two weeks ago. can i do this? anyone have suggestions?
your very scared kelly

I’m taking the USMLE tomorrow and I’m having my own varieties of freakouts… but here’s a couple of things I wish I had done:
1. After taking QBank blocks, take some “incorrect” question blocks. Although your scores will be lower, consider that every one of those questions you get right is one you had got wrong before.
2. When you’re doing the review from QBank, sit there with your books and actually review the material–don’t just look at the answers like I did.
3. Don’t panic. (Easy to say. Hard to do. Still important.)
4. Beyond that, in terms of your chances re: this test, I have less perspective on that than anyone right now, so, hopefully others with more distance from this will be able to chime in!
Good luck Kelly. We’re rooting for you.

I’m taking my Step 1 in two weeks also (June 23), and I am right there with you. Do not worry about the Q-bank scores, just do as Joe said and use them to learn from them. My scores haven’t been great either, and my classmates and study partner are all scoring in the same range.
You can do this. 91% of the first time takers pass, and even if you’ve done “mediocre” in the first two years, if you’re around your class average, the odds are in your favor! I know how overwhelmed you’re feeling. I’m feeling it too. I’ve done a stupid thing and changed my date several times-- and the silly thing is from the earliest date I had to the latest only spans 5 days, but I changed it four times, I think. Silly, silly, silly of me, but just shows my anxiety. So I’m with you. But you CAN do this! Two weeks is plenty of time to solidify and bring to the front of your brain all the knowledge that IS in there.
One of the things I’ve found, sort of a lightbulb clicking while I was taking a practice exam, was that I was trying to swallow the whole question and make the leap to the answer right away. And then I’d get panicky, because I wouldn’t recognize all the answer choices. I realized I have to read the question, and then take each piece separately. For instance, if they give you a long question and you make a diagnosis (for which you feel good), and then realize they want to know the side effects of the drug for that condition, I found that if I first make the diagnosis, and write it down, and then think of the drug for that condition, and it’s side effects, and then look at the answer choices, it’s a little easier. I realized I was trying to jump too quickly, rather than thinking logically. I don’t know if you’ve had that problem but maybe this will help.
Here are some strategies:
The American College of Physicians student newsletter put out an article about proven study strategies. One of the things it said was that the five highest yield systems are: CNS/PNS, cardiovascular, renal/urinary, GI, and endocrine. In the last three days of studying, they recommend only studying these, and of these CNS/PNS, renal/urinary, and cardiovascular are highest of all. I plan to take their advice and focus on those during the last few days of studying.
Also, they highly recommend that your learning be as active as possible. You’re doing the right thing doing questions. Do you have anyone you can study with and quiz each other? Or even someone who will sit for an hour a day with you and quiz you and let you explain stuff to them (even if they have no clue what you’re talking about?) Draw things. Color them in pretty colors. If you have access to a chalkboard or a whiteboard, draw things on those-- it lets you move. Talk outloud. Go for a walk and take your flashcards. The neighbors will think you’re nuts talking to the air, but so what.
Finally, don’t let negative self talk interfere with your studying, or more importantly during the exam. ACP points out that feeling discouraged and angry during the exam takes up lots of needed energy and will cause you to do worse. Remember, too, on the exam scores that would be failing in class will pass USMLE. Accept that it isn’t necessarily going to feel good while you’re taking it, or even after since you may think you failed, but odds are that you didn’t.
I hope these things will work-- I’m depending on it. If you need to talk, or share frustration, I’m here. Let me know what day you are taking the exam. Tara is taking hers around the same time, too, I think.
We’ll get through this!

Oh, I forgot in the last post-- Good luck, Joe!

I am there with you and Kelly. My date is the 24th. Thanks to you and Joe for the advice. I will definitely heed your advice and focus on those topics in my final days. Good luck Joe!! I know you’ll do great
I too have been doing lots of Q-bank. My scores fluctuate based on the mix of topics in that question group. I have accepted that there are some questions I just don’t know, especially when they ask the random details in immunology (i.e. which DR is on such-and-such a cell). If it’s not one of the common ones, I usually just pick a letter and move on. Fortunately, my weak topics don’t seem to be the main ones.
I’m starting to feel the anxiety that I won’t have enough time to review everything that I want to “right before” the exam. I have to trust that all of the studying I have done for te past two years will help me know the right answer or work through the options provided so that I can make an educated guess.
Fortunately, in two weeks this part of the journey will be over.

Hi Kelly,
Forget about being a mediocre medical student! You have made it to USMLE Step I and you have done just fine. Fifty percent on Q-Bank is definitely in passing range as Q-Bank is pickier than the real thing. Right now, I would concentrate on just reviewing with Q-Bank. Use the Tutor mode and read each answer. Understand why the right answer is right and the wrong answer is wrong. Don’t fixate on any score but rather keep getting that “Aha!” feeling as you read the answers to each question.
Make a little card for you formulas. You need about 4 pharm formulas and about 4 epi formulas. If you need to take a break, look at the photos in Robbins and read the captions. Just read them and don’t try to memorize them. Again, you are in good striking range now so don’t panic. You are almost home! Put your formula card in your locker at the test center along with a sweatshirt or two, a thermos of coffee/hot chocolate and a Power bar or crackers. Don’t forget some water too.
Do your fine-tuning and relax. Picture yourself sitting in front of the computer and reading every question all the way through. Remember that you have been accumulating the knowledge to pass and do well on this exam for the past two years. Put any of your performances in your classes out of your mind. You have been consistantly reviewing and now you will peak on your test date. You have learned far more in your coursework than your exams show. Now, put that knowledge to work for you. You are going to apply your knowledge of basic pre-clinical science to clinical situations. Above all, don’t panic but analyze each question. Topics arranged in order of yield: Path (highest), Pharm, Physio. Next level Behavioral science/Epi, Micro, Biochem, Histo and Anatomy is dead last. If you didn’t study anything except Path, Pharm (Autonomic, Antimicrobials and Chemo Agents), Physio (Cardiac, Respiratory, Renal/GI), you would be fine.
It is an absolute truth that you don’t need to know anything more than what is in First Aid for USMLE Step I.
I have lots of faith in you. Often, the students who have struggled with first and second year really shine in clinicals and on USMLE. The questions are well-written. Also, don’t forget that 50 of the questions are experimental so if you get something that is totally off the wall, don’t panic, it is probably one of the experimental questions that don’t count.
If the time is running out, pick a letter and fill in the blank. Don’t leave anything unanswered. If you can’t answer a question right away, skip it and move on. Come back after you have answered all of the questions that you know. I can’t emphasize this more: Read every question completely and read every answer. The correct answer is the BEST answer so read on. A later answer may be more correct than the first marginially correct answer.
Look at the graphs on the test and make sure that you are looking for the correct information. This is especially true of respiratory physiology and cardiovascular physiology questions where you might have to interpret a graph.
Kelly, your future patients are going to be fortunate to have you as their physician because you have struggled to become a good one. Once you have finished the exam, go out and celebrate. Don’t try to re-hash the test or second-guess yourself. Like I said, fifty percent on Q-Bank is striking zone for the real thing. Pace yourself and don’t spend too much time on any one question. They all count the same. If you have no idea, guess. You have nothing to lose and you have a one in four chance or less of getting the right answer.
Above all, don’t talk yourself out of doing well in this exam. Again, I think you are going to be amazed at how much you know because the USMLE folks have written the questions well. Knock them dead! Celebrate hard, once you are done. Get some sleep the night before the exam. If you are feeling saturated, you are right on track. The last couple of days before the exam, I just couldn’t look at another Q-Bank question.
I know you are going to be just fine and I am sending positive thoughts so that you have lots of energy to finish this exam and get ready for clinicals.

Being a lowly MSI, I don’t have much advice. I just wanted to say “good luck!” to Tara, Joe, Epidoc, and Kelly this month. I’m sure none of you need it.
Kelly, although I don’t know much about USMLE, I do know that having a great, positive attitude is crucial for standardized tests. Be confident and don’t let it freak you out on test day. That goes a LONG way. Freaking out beforehand is totally acceptable. Glad to see you getting it out of your system.
Pam (who will probably be posting the same thing next year)