What to Study for the USMLE – Part II

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We begin part 2 of our series on “What to Study for the USMLE”. For those just joining us, please refer to previous post here. Before we discuss the various criteria for selecting study materials for review, we need to clarify some concepts and discuss some limitations.

First, there is no real guarantee that if you study certain materials you will get a particular score. All you can be sure of is that you have a high probability of getting that score. The reason for this is varied and not all of them under your control. For example, since different exam sets are given to different examinees, the exam set you wind up with in the actual exam has a big impact on your final scores. It’s a universal fact that nobody can know every concept tested in the USMLE, therefore the more the exam set covers what you have studied and remembered, the higher your score will be. If it happens to cover a lot of materials you never read or do not remember then you are out of luck.

Second, two persons can study the same material, but what they remember, how much they remember, let alone how much and how complete their understanding of the material they’ve studied will vary. It seems everybody is studying the same material and doing the same Q Banks and yet the results vary from failing the examination to getting double high 99’s. Therefore, it is not enough to know that you have read Kaplan notes or First Aid, etc. You must know how much of what you have read, you understood and can recall.

Remember, for the purpose of the USMLE, what you cannot recall, usually in a minute or less, you do not know. In fact, the USMLE does not care whether you’ve read the concepts or understand it. You’ve to have read it, understood it and can recall it instantly in the examination. That is a stiff requirement. Therefore, it is not enough to have read the materials, you need to be able to understand and recall them. You need to read, understand and be able to recall at least 75 to 80% of Kaplan Notes to be able to pass the exam and yet most people just read them numerous times, hoping that that would be enough to pass the exam. You probably need to be able to recall 95 to 100% of Kaplan notes to score in the 90’s and depending on how much you were able to absorb from the qBanks have a small to average chance of getting 99’s.

Third, as I stated in my ebook “How to Create a Study Plan for the USMLE”. It is a universal truth that people usually miss their target therefore it always make good sense to over study a little bit. If you just want to pass, aim for an 80 so that you have enough allowance in case not everything go as planned. Therefore our recommendations will take that into consideration

If you haven’t read my other posts on high yield concepts, Mastery, know and familiar and information recall, please read them first. Then come back and join us in the discussion.

Dr. Goljan emphasized in his lectures that the more you read and know the higher your score will be in the USMLE. I will add something to that. The more you read, understand and can recall in the actual examination, the higher your score will be in the USMLE.

If you are aiming just to pass the examination, then you don’t have to read, understand and remember as much as someone who is aiming for a 99. However, it is still good policy to aim for an 80 or so, just to make sure you will pass, as too many variables not under your control can affect your final scores and the higher the score you actually aim for the lower the chance that you will fail.

There are 2 ways to achieve a passing score. One is to study only high yield stuff, ignoring lower yield ones. It requires mastery of high yield concepts, that is knowing enough details about high yield concepts that you will be able to answer the tough questions that is inevitably the form most high yield concepts will appear in the exam. This is because you will invariably miss a lot of low yield easier questions as you did not study them.

Two, is to study both high yield and low yield stuff. This way, you do not really need a high level of mastery of the high yield stuff as you can pick up points answering the lower yield stuff. The question now is how much detail you go into the high yield stuff and how much low yield concepts you need to know. Again this is a judgment call and not everyone is skilled in making this judgment on their own.

You also need to do q Banks even if you are just aiming to pass. This is mainly to familiarize yourself with CBT type of examination. Struggling with the computer software during the actual exam can lower your score significantly. However, using q Banks as a study tool is only advised if you are using the second strategy of studying both high and low yield stuff.

If you are aiming to score average to above average (85 and above) again it is advisable to aim for 90’s. You must study the high yield stuff and master the proper amount of detail. But it is also imperative that you cover lower yield stuff. You can use q Bank, especially UW to cover the lower yield stuff, but you must take notes and reread those notes at least a couple of times. Goljan’s Pathology lectures can help you achieve the right level of mastery at least in pathology to help you score above average. Goljan also covers the other subject albeit not as comprehensively in his notes. Kaplan notes have the required level of detail to score average to above average scores but you must be able to recall at least 95% of the details in the notes to do so.

Aiming for 99’s is much, much more difficult. You need to cover not only the high yield stuff and master them, you need to cover a lot of low yield stuff, plus you cannot have a weak subject. Since you need to make sure you score high in all sections of the examination, having a weak point in a subject can cause you points you need to reach 99 or high 99. In fact the higher the 99 you are aiming for, the more you cannot afford any weak point. Whereas, you can afford to cover major subjects only if you are aiming for above average scores, eg. mastering only Pathology, Microbiology and Pharmacology in Step 1 or Internal Medicine in Step 2 CK and Step 3 while just skimming through the rest. You have to master almost all subjects if you are going for 99’s. Kaplan notes is not enough for 99’s in Step 1 even with UW q Bank or Kaplan q Bank, your chance for a 99 is low to average. You need at least Goljan or Robbin’s Basic Pathology for Pathology, Jawetz and Levinson’s Microbiology and Immunolgy as supplement to increase your chances of a 99. For Step 2CK, Kaplan notes, mastered at 95 to 100% + UW q Bank at 80 to 90% is minimum if you want a good chance of getting a 99. In Step 3, doing well in the MCQ section is not enough, you need to do well in CCS section too as it is 25% of your score.

Remember, you can study less than what I have stated and still get the score you desired, however your chance of doing so is much lower and your chance of failing to reach them is much higher. In sports, records are considered broken only if it is achieved during competition and not during practice. Therefore athletes aiming to break world records, break those records numerous times during practice to insure that they have a high chance of doing so during actual competition. Otherwise, they can break records only through pure luck. The same goes with the USMLE. You must consistently score high during practice and review to insure that you will get the score you desire and not depend on luck.

We will stop here and continue our discussion next time. We will give more detailed discussion of the various resources you need to use for each of the above scenario for Step 1, Step 2 CK and Step 3. We will then continue on to discuss individual resource and their pros and cons in achieving your objective in the USMLE.

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