Note: This was initially published in 6 parts and was then consolidated into a downloadable ebook.
Why create a study plan?
This is probably the question foremost in the mind of anyone who ever thought of tackling the USMLE. I remember when I was starting out, how this pre-occupied me a lot. Although studying for the USMLE is a big endeavor, studying how to study for the USMLE is no mean feat either. Just like an architect or engineer needs to plan out how to build a building before actually building it, we need to plan out how to prepare for the USMLE before we even begin studying.
Now some people can just jump right into reviewing and 3 to 5 months later take the exam and come out with a 99. I’m not one of those and so are I believe majority of those taking the USMLE. Some will start by applying and scheduling an exam 5 months later, only to find out that they’re not ready. So they extend their period of eligibility and still they’re not ready. Some will take the exam and fail or score so low that it amounts to the same thing. Some will forfeit the application fees and reapply later. Of those who do, some wind up getting good scores because they’ve learned their lesson and did better preparation this time, while for others the results are going to be poor because they did not change anything they’ve done before. Proper planning is crucial for proper preparation
Steps to creating a study plan.
Often, in forums, I’ve heard people refer to taking the USMLE in military terms. Going to War against the USMLE, they call it. Military generals never go to war without a thorough battle plan, that is if they expect to win and neither should you. We’ll be tackling this topic head on.
The Steps to creating a study plan are:
- Determine your objective
- Know thy enemy
- Know the learning process
- Know the components of a good study plan
- Know the factors that can affect your study plan
- Scheduling
- Importance of sleep, rest and recreation
- Putting it all together
Determine your objective.
Just like all battle plans, you start out with what is your main objective.
- Is it to pass the exam?
- Get an average score?
- Beat the mean?
- Ace it?
High scores isn’t everything in the match. But it can make up for other deficiencies in your resume, like less than stellar grades in medical school, older grad, lack of USCE, etc. Often you see people in forums posting their study plans and asking if it is enough, but enough for what. Determining your objective is the first step in assessing whether your study plan is adequate or not.
So how high a score should you aim for? Well, it is a universal truth that most people do not achieve what they aim for so it is a good maxim to aim high. In the Greatest Salesman in the World, Og Mandino stated that
“It is better to aim for the moon and hit an eagle then to aim for the eagle and hit a rock.”
If you aim for a 75 and fail to reach it, you are in trouble. If you really want a 99 aim for a high 99 so you have points to spare in case not everything went as planned.
One word about setting objectives is to never set it in stone. As you finish your study plan and even as you begin your studies, you may find that your objective may change. Either you’ve underestimated yourself and have found out that you could do better, or your situation’s change, (e.g. your wife gets pregnant or you got pregnant, lost your job, got promoted, etc.) Do not be afraid to reset your objective, just be aware how it will impact your over-all chance in the match.
We’ve often heard about how people downgrade their objectives when they are unable to follow through on their plans. But how often have you heard of people who failed to upgrade their objectives when presented with the opportunity.
In 1863, on the first day of the Battle of Gettysburg, when Gen. Robert E. Lee’s Confederate Army defeated the Union Soldiers defending the three ridges south of Gettysburg, Lt. Gen. Robert Ewell refused to take Cemetery Hill, which wasn’t part of the original Battle Plan, even though it was lightly defended at that time. On days 2 and 3 after Cemetery Hill was reinforced by Union troops, the Confederates made numerous charges to take Cemetery Hill to no avail. This led to the famous Pickett’s charge by 12,500 Confederate troops on the 3rd day of battle which was repulsed by union rifle and artillery fire at great loss to the Confederates. By refusing to upgrade his objective, Gen. Ewell missed an opportunity that could have changed the outcome of the war and the destiny of the United States.
Know thy enemy.
Now like all good Generals, we have decided on our main objective for the USMLE. The next step is to study the nature of the enemy, only then can we know how to defeat it.
Now someone might say, why don’t you just post a study plan and like good soldiers we will follow them. Well that would be easier for me, but I doubt it will work or be effective for a lot of you. You see, a plan presumes that there is an objective, takes into account where you are coming from, your skills and particular strengths and weaknesses and your particular condition. A one-size fits all plan presumes you have the same objective, the same skill sets, the same background and the same prevailing environment which is just not true.
Now normally when somebody asks you how to go to Times Square, you presume he is somewhere in NY. But in the internet, the person may be in San Francisco, Baltimore, London, Karachi or even Manila. And the answer would be different in each case.
So too must your study plan be different depending on your particular circumstances. Just as a doctor tailor makes his treatment plans depending on your circumstances (child, adult, geriatrics or healthy, immuno-compromised, debilitated) we must tailor make our study plans accordingly. But just as doctors have treatment guidelines to guide them in formulating a good treatment plan, so too does this book attempt to provide you with guidelines on how to study to help you formulate a good study plan.
Now a thorough analysis of the USMLE even just Step 1 is impossible in a short article such as this due to its complexity. For those who want more details, refer to my post here and here.
January 24th, 2009 at 10:53 am
Hi,
Thank you for sharing this and for all the valuable information here. I just bumped into your blog last night and have read a few posts. A lot of great insight here and inspiration.
I am an IMG and in this long and arduous journey. Reading others’ experiences and perhaps if we’re lucky, a good advice like this, helps a lot!
Thanks!
All the best to you!
January 28th, 2009 at 1:44 am
hey,
thanks a lot, for posting all of this information… i certainly know now and i am absolutely overwhelmed by the sheer intensity of the struggle that lies ahead if indeed, i muster all my courage to attempt takin this exam !!! i’m scared shits bout even thinkin bout it ! i have a lotta questions which i wish i could ask u without sounding like a clod but i guess i’d rather reserve them for my seniors who have completed this already !! adios amigo !!
god bless u !
January 28th, 2009 at 5:21 am
Hi sikha,
USMLE is hard but not impossible. What is needed is proper prep. I, too was terrified when I started contemplating on taking it. But knowledge is power. By knowing all there is to know about the exam, how you are tested, how you are graded, what is tested and the mechanics of the exam itself, it was easier to design a program that will ensure success. Prep right and you will succeed. Most people fail because of improper prep rather than any other reason.
Askdoc
January 29th, 2009 at 12:24 am
what happened to the ebook? I click on the link and it doesn’t go anywhere
January 29th, 2009 at 5:41 am
Hi yoojin,
Sorry, I made some fix-ups on the blog software which unfortunately have the side effect of making the download page unreachable. I’ve already fixed it. Thank you for informing me.
Askdoc
June 1st, 2009 at 11:42 am
Thanks alot for such valued information ..
I am a newly grad from Saudi Arabia .. this blog turned to be my favorite USMLE guide !
as an international medical student I know few things about USMLE; the plan described above helped me alot, now i am more enthusiastic to start studying for the exam.
June 16th, 2009 at 12:03 pm
Hi! Thanks for this guide, it is really helpful!
I had a question regarding the study plan. I’ve taken a whole semester off from medical school to dedicate myself exclusively to study for the exam and hopefuly ace it. I made a plan which dedicates a whole month for Pharma, another for Pathology, and then the crammable subjects towards the final months. The last 3 months I plan on taking a CenterPrep self study course, which hopefuly will help reinforce what I studied during the first 2-3 months. I want to start with Pharmacology, because in my school we didn;t finish covering all the coursework and I can’t recall some things. Nevertheless, is it more practical a systems-based approach to my study or to study the different subjects separately?
Many thanks!
June 20th, 2009 at 8:26 am
Hi Francisco,
Depends on whether we are talking about the learning phase or the mastery phase. In learning phase, systems-based is good. But in mastery phase you should cover them by subject. If you are only dedicating 1 month to Pathology, then you need to read all the articles in my blog and forum, because it means you haven’t.
Askdoc
June 27th, 2009 at 7:43 pm
Hi, doc, thanks for your reply, I was wondering if you knew of a good q bank or questions book by subject that I could use to accompany Lippincott’s illustrated review of Pharmacology. I’m finding the book very helpful, but could use questions to assess my learning of each chapter. Im trying to find one that preferably covers each of the different pharmacology subjects. Would kaplan Q book be useful!
Many thanks! and thanks for the blog, it’s really helpful to prepare my study plan!.
July 9th, 2009 at 12:19 am
Hi Francisco,
You are welcome. For Pathology I recommend Robbin’s Review of Pathology question book. For micro/immuno, I recommend Levinson and Jawetz Microbiology and Immunology book by Lange. The questions in the back are good chapter by chapter quiz. For Pharmacology, Katzung and Trevors Pharmacology Review book (not the textbook) have very good chapter by chapter quiz at the end of each chapter. For the rest of the subjects, Kaplan q book would be fine.
Askdoc
September 3rd, 2009 at 1:23 pm
Hello !
I can see that the problem with me is in the knowledge acquisition phase.
Could you please go into a little detail on how to tackle “that” situation ?
Thanks !
September 3rd, 2009 at 1:41 pm
I forgot to go into a little detail in my previous comment.
I’ll be frank. I was not that great a student. And hence many of my basic medical concepts are weak.
But being an IMG, its important for me to not only pass the USMLE but also get a good score. So, how should I go about the KA phase that you mention.
Kaplan Notes vs. The BIG books ??
Coz what I feel is, there’s not enough time left for me to review all the heavy material in a time period of 6 months or so.
What would you advise ?
September 7th, 2009 at 12:57 pm
Hi Dr. Mehta,
If you are weak on concepts, no choice but to hit the big books. If you know the concepts but find it hard to learn the details, then Kaplan notes may suffice. However, Kaplan notes are not organized for efficient recall. In fact in my prep course, I am forced to write my own notes to cover this deficiency. Initially I just wrote notes for Pathology, but most of my students want me to write notes for all the rest of the other subjects rather than use Kaplan notes. Again, you need to read up on the 3 phases of preparation, learning phase, mastery phase and test preparation phase. It’s posted in somewhere in my blog. You need to do all 3 right if you want to get a good score.
Askdoc.
September 8th, 2009 at 7:31 am
Thank you askdoc,i read your posts at pre4usmle site as well long ago but didnt know if you had blog as well,glad to find it
.
I read in one reply of yours to one comment here(in blog) where you talking about learning phase and mastery phase.but where actually did you discuss these two i couldn’t find in your blog.kindly direct me to your that blog post.
Regards,
September 8th, 2009 at 9:03 am
Hi rm,
It’s in the posts about my prep courses. http://blogs.askdoc-usmle.com/june-class-accepting-applications-for-askdoc’s-usmle-step-1-prep-course/
It’s in the middle of the above post.
Askdoc
September 9th, 2009 at 8:33 pm
Hi doc.
I’m having a little trouble on how to proceed with my study plan. As I mentioned in some other post, Im a mexican student who just completed the basic sciences courses. Since my school doesn;t allot time to dedicate to boards prep (unless you wait until you get your degree, 5 1/2 to 6 years), I took the semester off to prepare myself, made my own study plan, and have been following it almost very faithfully (some colleages from school have done similar stuff like that).
I did however also buy a centerprep kaplan course for 3 months starting this month to complement my study prep (as this was the only way I could take a semester off, taking it as if it where an ‘exchange’ program with Kaplan, but I’m at a loss as to if I should start focusing more on the type of prep Kaplan offers, with its personal learning system, or just follow my original study plan, with some review books I already have. So far I’ve covered all Pharmacology and most of Pathology with my own plan (lippincott, katzung, BRS, with robbins review and goljan to complement), and I’m starting on the other subjects remaining.
I took the diagnostic test kaplan offers for the PLS, and came out with a scary total score of 57%. I know I never had the behavioral sciences courses in my mexican curriculum, nor some aspects of anatomy, so some of my weak areas came there. It was only a 3 block, 3 hour exam of 150 qs, so I’m sure it’s not a very accurate diagnosis of my present status, because in the Practice Test offered by Prometric (I know, I blew my confirmatory test to assess my readiness for usmle before I ended my review; it was only later I found out when reading your post) I got a 65%.
So, though I’m worried about having enough time to study the lecture notes on my own AFTER reading them together with the DVDs, should I stick to my original plan with other review books or focus from now on on Kaplan?
Many Thanks!
September 19th, 2009 at 8:20 am
Hi Francisco,
Sorry for the late reply. Been really busy with preparing my online live lectures for my prep course. 6 live online lectures on Study Methods and Test taking strategy for my September class. Anyway, I have started writing a reply for your question, but it’s become really long and I might expand it to a full post later with full explanation. Anyway the short reply is this. When you use Kaplan, you are actually relying on Kaplan to tell you what you need to study. If you use your own study plan, you are relying on your own judgment on what you need to study. The question you have to ask yourself is how confident are you about your ability to judge what you need to know in order to do well in the exam. When you enroll in a course like Kaplan or in my course, you are using substituted judgment, or substituting Kaplan or my judgment on what to study, how much to study and how to study rather than using your own judgment. Kaplan actually just gives you what to study, not how much to study and how to study unlike in my course.
Anyway, the materials you use will determine what you will study and if that is not enough to get the score you want, then you won’t get it. For example, First Aid is very good study material, but First Aid’s goal is to help you pass, not get a high score. So if you study everything in FA, you will probably pass. but if you just read FA a couple of times, you won’t even learn enough to pass. Kaplan provides enough material for you to get 90’s, probably even 99. But you need to study everything very well and high 99 is probably out of the question. I will go into more detail about this in a full post as this will be a very long discussion. Actually this is the topic of the first of my 6 live online lecture in my prep course. The first topic discusses what to study, how to study and how much to study in order to master Step 1. The other 5 live lectures deals with studying specific subjects, planning your whole prep schedule from the start until you sit for the exam including when to do qbanks, when to do NBME and when to actually schedule the exam and lastly, test preparation strategy including speed building, analyzing test questions to catch tricks, drills to eliminate bad habits exploited by test makers, etc.
As to getting a 57% in the Kaplan diagnostic exam. Well in 2005, I also did the diagnostic exam and I got a measly 45%. But 8 months later, I got a 99 / 256. I also did the Practice test given in the USMLE CD and got somewhere in the 50’s. But was scoring in the 90’s with only 1 to 2 items wrong per block around 3 weeks before the exam. So you see, my statistics was even worse. So it’s not where you are starting from, but what you actually reach that counts. And what you do during the journey makes a lot of difference on where you wind up in the end.
Finally, no you did not blow your confirmatory test. The confirmatory test is NBME assessment test which has six forms for Step 1 and not the prometric exam. The prometric exam is very, very easy compared to the actual exam.
Askdoc
October 3rd, 2009 at 3:19 am
Hi Askdoc,
I am a fresh IMG who graduated last year. I started to prepare for Pathology as my first subject in my step 1 study plan. I have some gaps in knowledge so according your advise i will start by the KA phase.
I chose the following notes: Kaplan lecture Note Pathology (Study note), Goljan’s Rapid review Pathology & BRS Pathology (Outline notes).
my questions:
1. do you think those resources are enough? I am an an average student, a hard worker and committed, and i aim to ace the usmle.
2. shall i start firstly by reading Kaplan thoroughly till i finish it, then go through the outline notes afterwards?
3. when shall i use the Q’s books; side by side with study notes or by the end of each chapter? which Q books you advise me at this stage; Kaplan Qbook or Qbank? or UW?
Thank you very much for all your efforts, I really appreciate you.
October 3rd, 2009 at 2:10 pm
Another thing,
I took a general view at the Pathology demo you provided in your prep course. I really liked your study notes as i found them more comprehensive than the Kaplan’s lecture note -at least in Patho-.
As i wrote above i just started my USMLE journey and i am still in the KA phase.
My question: is there a chance i can get the full Pathology 25 chapters online even i am not enrolled in your course? is it free or i need to pay for this, if yes how much is the price?
Thanks again
October 6th, 2009 at 12:52 pm
Dear Askdoc,
sorry to bother again and again.
well, after reading almost everything you wrote wither in blog, forum, and the prep course methodology, i believe you will be my best advisor to prepare for the USMLE step 1 as I liked your systemic approach which really fits my studying way.
I tried to join the November 2009 batch but after submitting my information and before payment I noticed there are only 2 options to choose: either September 09 or October 09 !
there was no November Batch and i am afraid to miss the chance to join this class, i would really like to finish by May 2010.
I tried to email you in private but actually i don’t know how to do that. I would appreciate it if you inform me how to join your course as a student in the November 2009 batch.
Many Thanks.
Dahlia
October 8th, 2009 at 10:25 am
Hi Dahlia,
I had not been able to update the enrollment site due to pressing work. You are the third person to point that out to me, so I have fixed the enrollment system today. Please read as there are new information about the course beginning with November batch. For example 6 live online lecture are now included with the course. Plus there is a downloadable pdf file for the Suggested Prep Schedule for the course. Plus access to online resources will now be 9 months, although the group chat and lecture sessions will only be for 3 months. You will still have support via pm from month 4 to month 9.
There will be available starting March, an option to enroll in the course only for the notes and online quizzes without lectures or the chat sessions. It will be called guided self-prep course. This was what you were asking about in the earlier post.
Askdoc