Accepting Applications – Askdoc’s USMLE Step 1 Prep Course

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*Enrollments for June Classes already started and will be open for the whole of May, 2009. If you are interested in enrolling please click on this link.  Thank You!

I would like to announce that I am now ready to receive applications for Askdoc’s USMLE Step 1 Prep Course which will start on January 19, 2009 and end on July 19, 2009. However, before submitting your application, please be sure you are really committed to finishing the course, since there really is limited space available.

Due to my experience with the first batch, I believe I have to describe the course in more detail including expectations and the amount of work needed so there is no misunderstanding.

  1. The course covers USMLE Step 1 which is seven subjects all in all. The course is 6 months long. Therefore telling me that you do not have enough time to finish 1 subject in 4 to 6 weeks means you won’t have time to finish the course period. Therefore please be ready to invest the time needed to do the course. Nothing less than 4 to 6 hours a day at least 5 to 6 days a week is needed. If you are unable to commit this time, then this course will not help you.
  2. The reason you would want in on this course is that it will teach you how to prep for the USMLE in the proper way. Therefore you must be prepared to follow instructions. You would be surprised at how many people insists on following their own methods of studying rather than those outlined in the course. If you will not follow the course’s review methodology, why bother enrolling?
  3. Enrolling in the course does not automatically raise your scores. YOU STILL NEED TO STUDY. I cannot magically put information in your head, only you can do that. Since this is an online course, I cannot stand behind you and monitor whether you are studying or not or force you to study. Although there are quizzes and progress reports in the online course, I cannot force you to take the quizzes or write down your progress reports. So if you are not ready to really study, then this course will not do you any good.
  4. You need to give me feedback. Per experience, the course methodology works fine for most people, however, for some people they need adjustments. Therefore, giving me regular feedbacks about how you are faring will help so that I can adjust your study methodology to suit you better. This is done by doing the quizzes. If you fail to achieve the required score then we need to review your study methodology and adjust them.
  5. You have to attend the weekly online chat. The weekly online chat is set up so you not only have an idea of how others are doing, but also to discuss any questions you have about the review process itself. Since an online course has no formal “class”. This is a good substitute.
  6. One on one chat is only available on a case-to-case basis. This is simply because of time constraint. The participant however, can pm me in case they have individual problems.

If you have read my post, you will know that there are 3 phases in the typical study plan. The “Learning” phase, the “Mastery” phase and the “Test Preparation” phase.

The learning phase is where you try to learn all the different concepts tested in USMLE Step 1. When reading, you can attempt to draw a mental picture of what you are reading to understand the concept or you can repeatedly read through the material to memorize it. In learning phase, your purpose is to understand the concept and not to memorize them.

The mastery phase, is where you concentrate on memorizing and being able to recall medical concepts in detail and at the right speed needed to be able to answer questions in 1 minute or less.

The test preparation phase is where you train yourself to answer USMLE type questions and to be able to sit through an 8 to 9 hour long exam.

There are also 3 types of activities that you use in the 3 phases. Knowledge Acquisition (KA), Knowledge Recall (KR) and Test Prep(TP).

KA includes all activities that tries to put medical knowledge into your knowledge bank (KB). This includes mostly reading and listening to lectures.

KR includes all activities that tries to improve your ability to retain and recall the information the information in your KB. This includes repeatedly reading through the course materials, using flashcards, answering questions and doing word association drills with study mates. It is rare for people to repeatedly listen to lectures when doing KR. They usually prefer to write down notes for the lectures and repeatedly read through them instead.

TP includes all activities that improves your ability to do better in USMLE type MCQ’s. This includes simulating USMLE exams, speed building, increasing stamina, etc.

Learning phase usually involves only KA activities. It is the most variable in terms of length of time needed to accomplish. It depends on how much you already know in the first place. Even fresh grads differ in the medical concepts they have retained even if they graduated together More so for people who are older grads.

People may wonder what it means to have learned something as opposed to have mastered something which is what the Mastery phase is all about. Well to have learned a concept means you understood the concept, while to say you have mastered a concept means you know it in such a depth and will be able to recall it fast when needed

To illustrate, for example the coagulation cascade. During the Learning phase, you may have read all the details of the coagulation cascade, but to consider that you have learned it, you probably need to know it this way.

1. It is a series of enzyme conversion that results in clotting
2. The final step is the conversion of Fibrinogen to Fibrin
3. This is accomplished by Thrombin
4. There is a common pathway
5. There is an intrinsic and extrinsic pathway
6. The two pathways converge on Factor X before forming the common pathway
7. The extrinsic pathway involves Factor VII and Tissue factor
8. The intrinsic pathway triggered by Factor XII triggering multiple other factors
9. Extrinsic pathway measured by Protime
10. Intrinsic pathway measured by activated Partial Thromboplastin Time

If you do not know most of the points above, you cannot consider yourself to have “learned” the concept even if you’ve read all of the above or even more details.

During the mastery phase, you should know the concept in even greater detail and be able to recall them really fast. To illustrate.

  1. You need to know the steps in greater detail. For example the intrinsic pathway includes Factor IX and factor XI. You also need to know that there are factors that act as catalyst to the reaction (Factor V and VIII) and factors that moderate or inhibit the reaction (TFPI, anti-thrombin and APC). These are just some of the additional details you need to memorize and be able to recall to consider that you have mastered the concept.
  2. You need to be able to recall facts much faster. For example, knowing that PTT measures intrinsic pathway and the factors in the intrinsic pathway will allow you to deduce the factor deficiency that causes abnormal PTT. However, it may take time for you to recall the facts if this is how you retained the information. You may need to memorize the actual factors that can cause abnormal PTT and protime directly. This is done during the mastery phase.

Of course, you need to know more than the above to truly master the concept of coagulation cascade, but the above will suffice for illustration purposes.

The Mastery Phase is composed of both KA and KR activities. Your main purpose here is to memorize, retain and recall tested medical concepts. You still do a lot of reading for KA. However the type of reading material you use will differ. It is easier to learn concepts by using narratives. Hence textbooks are more effective. But it is easier to memorize bulleted lists, tables and illustrations as well as recall information that way.

To illustrate using the coagulation cascade. It is easier to memorize and remember the concept using a combination of illustration and bulleted lists. However, trying to learn the coagulation cascade using only illustrations and bulleted lists is a challenge. It is better to use narratives that explain the whole concept first and once you’ve learned and understood the concept, use illustration and bulleted lists to memorize them for easier recall.

A reason for using tables concerns concepts that you need to differentiate from each other. It is a known fact that an important key to scoring high in the USMLE is the ability to know the key difference between diseases rather than memorizing the key features of a disease. For example, in the exam if you get a case of inflammatory bowel disease, your problem will be if you are dealing with Crohn’s disease or Ulcerative colitis. A well-constructed question will first present features common to both and just add one or two features usually buried in between the other features that distinguishes one from the other. If you had memorized the features of each diseases either reading them in text form or in bulleted lists, you will have to review in your head, the features one by one and try to sort out the features that distinguishes the two. This not only eats up a lot of time, but you could even wind up with the wrong answer. If you had memorized it as a table that differentiates the two, your ability to answer that question correctly and fast have just increased exponentially. Ditto for example a case of lung CA. A table differentiating between, Squamous Cell Ca, Small Cell Ca, Bronchioalveolar CA, etc. is a better way to retain and recall the data than just from a plain bulleted list or even a full narrative.

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