QBank and Step 1

Hey guys,
After a long period of procrastination I’ve finally kicked into gear for studying for the step 1. I’m QBanking and using the Kaplan Organ Systems/General Principles 2-book set, and the BRS pathology to some extent. Anyway, I’ve been noticing some improvement in my Q Bank scores as I go, which is nice, but it’s hard to know how much improvement I need. What percentage on Q Bank do I need to start getting in order to feel like I’m going to pass? (Passing is my main goal. It’d be nice to reach the mean. Beyond that I have no ambitions.) And any other advice from folks who’ve been there?

Joe, my scores varied hugely in those 50-question blocks. I’d hit a stretch of 60%+ or even 70% and think wow! I am doing great! and then would get 40% on a couple and conclude I was in deep doo-doo.
I think I ended up averaging in the low 60s on Qbank and I passed comfortably, a little below the mean.
hope that helps!

Howdy Joe!
Ug. Step I. Shudder, squel, convulse madly.
Deep breath. OK, I’m better now. Sorry about that. These are troubling memories.
Anyway, the general concensus is between 50 and 60% is a comfortable pass. Like Mary, I found the whole QBank experience to be like a rollercoster. In the end, I found it to be pretty useful practice.
I’d really recommend the BRS path and physiology (especially path). The exam I took was very heavy on cell biology so you might want to hit that too.
Good luck!
Take care,

I just talked to my best friend who is also preparing for the step I. She is Q-banking and said everyone does.

Is there anyone on OPM that didn’t use Qbank? Just curious.

I’m using it too. Definitely a roller coaster of scores, but I do learn from it and it does give me confidence when I answer a question and think “Hey, I just reviewed that this morning, that’s why I knew that”. I would definitely recommend for anyone preparing for Step 1. I also like the questions in Robbins Path Review Book (I bought OldManDave’s old one off of the OPM bookstore for $10…thanks Dave, it’s a real help). But the key to both is making good use of the thorough explanations in both of them.

Hey Joe,
Look for improvement in your Q-Bank scores. Don’t be to anal about the score unless you are consistantly scoring under 50%. Try to do the tests under testing conditions meaning 50 questions per test mixed up as opposed to doing just one subject at a time.
I did my tests in this manner. I would re-test myself on the questions that I missed. I would then review the area if I missed a second time. I really used the Q-Bank explanations as my main teacher and it paid off well.
Don’t get too bogged down in the Organ/Systems books unless you feel like you have major weaknesses. Be sure to look at all of the pictures in Robbin’s Pathology 6th edition. You need to be able to recognize stuff like inclusion bodies and “owls eyes” and the like. I just looked at photos from three chapters per night (just read the captions and looked at the photos). Nothing else lookes like stunned myocardium etc. BRS path is awesome. I also reviewed plently of Physio in West. West, Guyton and Ganong have great graphs which really hone the concepts.
Q-Bank is really good because the text is exactly like the real thing.
Good luck Joe. Just remember not to talk yourself out of the correct answers on the real thing. Take your time with the review. It will really be a review for you.

here’s my question… if i’m average a 49% on qbank now - can i really get it up to the magic 60% so that i can walk in feeling like i’m going to be ok? i’d almost think that i should be hitting my high right now given that i just finished my second year.
why is this always such a struggle?
thanks all…


here’s my question… if i’m average a 49% on qbank now - can i really get it up to the magic 60% so that i can walk in feeling like i’m going to be ok? i’d almost think that i should be hitting my high right now given that i just finished my second year.
why is this always such a struggle?
thanks all…

Hi Kelly,
Are you constantly improving? If so, don’t worry so much about your overall average. Just get used to answering these types of questions. Q-Bank really is much more difficult than the actual exam. If you have a good grasp of doing the kind of thought processes that USMLE Step I demands, you will be OK. Try very hard, not to focus too much on the actual numbers but on your overall progression and getting used to these types of questions. By doing lots of practice, you can’t help but review at the same time.
I wrote out my biostats formulas and pharm formulas on an index card and memorized them long enough to write them down when I got to the computer. When I found a question that needed them, I could refer to my formulas. Practice reading the questions and carefully evaluating the answers. Read all of the explanations both right and wrong answers.
Make sure you have a copy of BRS Pathology so that you can do quick reviews of any topics that are giving you trouble. Look at the photos in Robbins and read the captions. You can get good reviews by just reading the captions. BRS Physiology is also a good review book to keep around.
Other than that, set yourself a daily schedule and keep to it. Take some time to have some fun (schedule that too!) and give yourself small rewards for just finishing your daily study schedule.
I know that you are going to do fine if you keep plugging away at studying. Don’t beat up on yourself if you are not acing everything. Reward yourself for what have done and review those things that are hanging you up. Keep a list of those topics that keep giving you problems and tick off as you go through them.
You emphasis should be: Path, Pharm and Physio. Pathology is a totally open subject and should be your main emphasis. Pharm will be Autonomic, CNS and Antibiotics/Oncology Drugs. Learn the charactistics, side-effects and unique drugs of each class. Physio will be Cardiac, Respiratory or GI mainly. Be sure to know how to read graphs and diagrams.
Micro, Psych and Biochem are less well represented. You need to do a cursory review and keep going. I would be sure to review Virology and Parasitology as I got lots of parasite (worm)questions.
Gross Anatomy is not very tested at all except in the broadest sense. I did review the “blue boxes” under the extremity sections in Big Moore.
Again, let your performace on Q-Bank guide your review and keep plugging away. Get plenty of sleep the night before the test and remember to read every part of every question and each answer before you move on. There is one “Best Answer” for every question. Take plenty of breaks during the test, especially towards the end as you are getting tired of just sitting there.
Good luck and knock them dead. Resist the temptation to set your test date back because you feel that you are just not prepared. If you are having major study problems, by all means change your test date but don’t change your date unless you have strong evidence that your review is not effective. It sounds like you are on the right track now and that you are probably improving steadily.

You’re not alone. I’m sure you’ll end up doing fine, but it’s scary, you know? I spent a portion of this morning freaking out about not remembering what Horner’s syndrome was caused by. I think the hardest thing for me is realizing I’m not going to know it all, and to just keep plugging along. We will survive this!

Okay, I have a question for any of you experienced Step one passers out there.
I have gathered my books, and I have all the recommended review books (First Aid, Step Up, BRS Path and Phys, not to mention a slew of others). I have my Q-bank subscription. I have created a schedule I will try to stick too… and then my problem. How best to use this stuff?
I decided to use Step Up to guide my studying, because I like the systems approach better than the subject approach, because that was how we did it in PBL and how I think I learn best (although I’ve allocated some time with each subject to cover stuff that I missed during the systems.) But when I sit down with it and start reviewing I don’t know how much depth to go into. I know most of the stuff in Step Up (after a little review and memory refreshing), but I know that surely isn’t enough depth. So how much depth to go into? My natural tendency is to want to reread the Robbins chapter, which is obviously too time consuming to do for every system. So how did you experienced takers, or any of my fellow Step One’ers decide how much more depth to go into? I’m just afraid of getting too bogged down in detail I don’t need to know, and getting behind. (I’m already behind on the first system, but I expected it to take a little while to figure out a system, so I sort of allowed for it, but now I’m starting to worry).
Any thoughts/strategies gratefully accepted! I take the exam 5 weeks from tomorrow.

From what I have heard from many people (and what I’m doing and it seems to be working when I look at my Qbank and NBME Assessment scores) is to not go any deeper than First Aid describes. Sure, use other books to help you clarify or learn when it isn’t a review, etc. But as far as details, that’s how detailed to get. We will see…10 more days of studying for me.

Thanks for that question. I am wondering about the same issues. Hopefully, some of our more advanced members can help us out here

could someone clarify what the board questions are asking? I am told that the level of questioning is getting toward 3rd order and 4th order questioning. In other words, its not the pt presents with these signs, what is it? But He presents with these signs, what are the side-effects from the treatment you would give to him/her?

If I understand your question, it is what are third and fourth order questions. I think you’ve got it right in the example you gave. For example, the questions are not what are the side effects of Drug X, but rather give a vignette, and expect you to figure out the diagnosis, and then ask what are the side effects of the drug you would give for that condition.
But there are a mix of questions, and some are first order. Not having taken the exam yet, I can’t say for sure, but if Q-bank is representative, then that is how they ask the questions. Also, speaking only for myself, I’m not finding the way they ask the Q-bank questions to be particularly tricky (but that may be because that was how our exams were written in second year). If I have the knowledge of the subject, the answer is pretty clear. The problem is, of course, that there is so much to review, that frequently I don’t have recall of the needed knowledge yet
I hope that answers the question. Now I’m back to reviewing the cardiovascular system.

Holy crap. It’s done. Or, I hope so, anyway.

QBank is pretty representative of the style and format of questions I encountered; on the other hand, I found the USMLE questions to be generally more clear (though certainly not always easier) and also more representative of things I’d actually seen in class. That doesn’t mean I’m confident about how I did–not at all. I may be seeing that Prometrics center again soon. But I hope not. And for now, I’m just relieved to be done.

To those of you who are about to rock, I salute you.

As far as other tips: Two of my geezer-med-student buddies drove me to the testing center this morning, and accompanied me in a spirited chorus of “We are the Champions” before I went in. I recommend it, although that one line “No time for losers” does inspire the slightest bit of self-deprecating doubt when you suddenly find yourself singing it. Still, I think it’s good to have an anthem to start the morning.

I also brought plenty of food. That’s nice and reassuring to have. Luna Bars, bananas, dried mangoes, salami and cheese sandwiches, water, almonds. By the end I was a little bit stuffed, actually! But comforted also, to be sure.

Coffee and freakout brought plenty of GI peristalsis. Fortunately I had some time left over in my sections so I had plenty of time to attend to that problem without any problems.

I wore a good luck sweatshirt–my sweatshirt from the San Francisco General Emergency Department. Hopefully it brought me good fortune.

So: to summarize my helpful hints:

1. Make sure to rock out with an inspiring stadium anthem beforehand

2. Coffee is worth the GI cost

3. Wear the good luck garment

4. Food.

And finally:

5. Try to give the right answers to the questions.

(OK, so that’s the hard part, I admit.)


Congratulations Joe!
I know what you mean about food. When I took the MCAT, I brought with me a lunch that consisted of sushi, gourmet mint cookies, and expensive lemon soda. For breakfast I also had the biggest latte in the world. Everyone else at the MCAT was sitting there with their soggy looking sandwiches and boring bottled water, whereas I was living it up like I was on vacation. I don’t know how I scored yet, but I’m sure the good food didn’t hurt.
How long does it take to get USMLE scores back?
Anyway, congrats!

Congrats, Joe! I’m sure it feels wonderful, and I’ll bet you did great. Is your brain numb?
Thanks for the hints. I can handle one through four. Number five might be a bit tricky.
(11 days and counting)

Thanks for the update. I’m sure you rocked it!! Just hearing from someone else who survived helps make approaching it a little easier. Today was reproductive study day (not one of my favorite topics) but just reading your post will help me persevere
Now go and enjoy yourself!!

Tara or Kelly (or anyone else):
How are you studying for the Pharm? I’m having a mental block on it. I did fine in Pharm class, and in the Pharm section of our system classes, but I’m having trouble with the Q-bank questions–the choices are too close together! How am I supposed to choose between phenytoin and carbazemepine, or between a cephalosporin and a penicillin when they’ll both work?
Okay, deep breaths, deep breaths…
Anything in particular working for you?
MSUCHM 2006 (if I pass Step 1)

I am in the exact same boat. Pharm was one of my strengths during the year and now I feel lost when I do the Q-bank questions. One thing that has helped me are the lists at the end of the pharm section in First Aid, such as the drug interactions. I hate brute memorization, but when it comes to the nit-picky details at this point, I feel that it’s my last resort. Also, I find the tables and charts on the PharmCards helpful for just keeping the drugs organized (which drug fits where).
This probably isn’t much help, but this has become my approach. Anyone with any other hints, please toss them out here.