Sorry for the really late reply. Been so busy lately, even students in my course felt it. . Anyway, what you’ve been doing is OK if you want to pass this exam with average scores. But going for higher scores, 90′s, 99′s or high 99′s requires far more effort than you’ve put in. It takes about 2x as much effort to go from 90 to 95 as to go from 85 to 90. It’ll probably take 10x more effort to go from a low 99 to a high 99 (255 three-digit score) as it is to go from 85 to 90. And currently your level is at about high 80′s to low 90′s. First you cannot do without reading. If you were a fresh graduate, then depending on your native talent, it is possible to get 99′s from using q banks to learn the topics. But the q banks do not cover everything you need to learn. And therefore there will be a lot of holes in your knowledge unless you are a new graduate.

Your handling of Pathology is good as Goljan is a good source of knowledge, but not enough for someone aiming for a high 99. I suggest you go through Robbin’s Review of Pathology. Any chapter you score less than 80%, read up the corresponding chapter in Robbin’s Pathologic Basis of Disease.

For Pharma, Study thoroughly the prototype drugs. Memorize them. Make flashcards, Use flashcards. The way to learn the other drugs is to see how they are different from the prototype drugs. Use Katzung and Trevor Review of Pharmacology. There is a listing of drugs per chapter divided into prototype drugs, major variants and other drugs in the same class. Memorize the prototype drugs. Then just know how the major variants differ from the prototype. For the other drugs, just know what class drugs they are. That will be enough to do well for Pharmacology for Step 1. More detail is primarily for Step 2 CK already.

For Micro/Immuno. Most important is immunology. Master the processes. Know the components of the immune systems and how they participate in the main processes. The processes include humoral vs. cell-mediated immunity. Innate vs. acquired immunity and Active vs. Passive immunity. All components, cells, proteins, cytokines, mediators, etc. will be tested in relation to these processes. Micro is straight memorization most of the time. Use flashcards if needed to memorize the important parts. Again, differentiate between groups of bugs. eg. Staph vs. Strep. Different types of Staph vs. each other. Different types of gram negative rods vs. each other. Also memorize the main pathogenetic mechanisms of the more important bugs. Staphylococcus TSS, and endotoxin of gram negative bacteria for example.

It takes a lot of effort to achieve 99, especially high 99. Even if you manage to do all that is required to reach a 99, you may not be able to do it due to limited memory capacity and lack of enough analytical skill to tackle the tougher questions. However, if you do not study enough, even if you do have the memory capacity and analytical skill, you won’t make it.

Askdoc

I have been trying to prepare for step 1 for some time but have not made much progress, I applied but did not give my exam twice coz I knew my preparation was not good at all. I finally decided to try one last time. I have not really been into studying books cover to cover. I was an above average med student but have forgotten most of what I read then. I passed out around 3 years ago. I need your advice regarding my preparation.

This time around, I have done kaplan physio & goljan path text with his audios & notes of audio I made previously. I have also done UWorld questions -timed, subject wise, topic wise for physio, pathopysio & most of path. My current cumulative is around 64% for 35% questions done. Do you think I am on the right track? I have a greater penchant for doing and learning from questions, but I know I need to review the books too. Yet, sometimes I feel I am dragging myself while reading.

I discovered wikitestprep a few days ago, and have done physio, pathophysio & path mostly- 25% qbank covered with a 74% on it with predicted score 219. I know I am far from perfect at present, I really want a 99 with a high triple digit as I am an IMG without an impressive CV. Can you please help me improve my preparation? I know you are busy, but I just need some advice. I am not sure how to deal with pharma, micro & biochem. I am not good at memorising things.

Your help with be a boon for me. Waiting for your reply. Thanks.