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My Best USMLE Step 1 Score Wasn’t Built in a Day (or a Month) – Part 2

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In my last post, we talked about four HUGE ways to make your medical school career more fruitful while at the same time, building the knowledge base that you need to do excellently on Step 1.

This post, we are back in action with five more ways to tailor your education so that you are well-poised for test day.

5. Maximize clinical experience

That time you shadowed a urologist and s/he prescribed tamsulosin (to everyone). The time a patient was tachycardic and got metoprolol IVs until he was back to normal. And don’t forget the first time that you actually heard a systolic murmur at the right upper sternal border of a real person! Anytime you can learn something from a clinical experience instead of from a page in a book, it will be forged into your memory like nothing else. You won’t ask that meddlesome question, “When will I ever need to know this?”

Maximizing clinical experience doesn’t merely get you close to patients and medications; it will have you rubbing elbows with residents and attendings, teachers who have a vested interest in your education. Showing a high level of proactivity will not only further your knowledge, but can help you forge relationships, find a mentor(link to mentor article?), and explore specialities to see if they are a good fit for you.

6. Get a leg up on histology

This is one that can easily slip through the cracks of our medical school education. Sure, you might see some clue cells in lecture slides, or maybe even a Reed-Sternberg cell in your virtual microscopy lab. But since histology images are so difficult to employ on pencil and paper tests throughout medical school, knowledge of histology often lies dormant until it’s time for your 2-month study period. Don’t let this happen to you!

Use the pictures in First Aid, in your textbooks, in your lecture materials, and online to bolster your histology knowledge. Place that mental picture of the spherule full of Coccidioides endospores alongside its predilection for the southwestern U.S., earthquakes, and azole/amphotericin treatment. The histology slide is equally as important as the rest of the package. In the age of google images, there is no excuse to let this one go.

7. Make pharm flash cards as you learn about each drug in class

Please (please, please) don’t cram pharmacology into 1-2 months of studying. You can start early by making pharmacology flashcards that include the drug’s indication, mechanism of action, and side effects/toxicities as you learn them. This will free up time during prep, and solidify your pharmaceutical knowledge throughout school. There are a number of pre-made sets out there, but we at MST feel strongly about the process of creating the cards yourself.

8. Extra special attention and hard work during Physiology

A firm foundation in physiology should be the bedrock of your medical knowledge. It is very heavily tested on Step 1, and the better you know it, the more sense you can make out of pathophysiology. Find a copy of Costanzo’s Physiology (both BRS and the full-size textbook), and let it be your constant companion during physiology coursework. If you are able to build a firm foundation in physiology, pathophysiology will make a lot more sense. And, as “abnormal processes” make up 55-60% of the actual test, this knowledge is paramount. Start strong with mastery of physiology so that you aren’t always playing catch-up.

9. Maintain balance (Don’t go nuts)

I want you to take all of this advice to heart, and do absolutely awesome in your medical school coursework and on Step 1. What you shouldn’t do is cram every free hour you have with thoughts of the test. The most important thing is to be excellent at everything you do in the moment; the rest will take care of itself. You can spend time with family and friends, maintain a social life, and still squeeze in a few respiratory Uworld questions while you learn about COPD. Keep a clear goal in mind, but as rapper T.I. reminds us, “Live your life.”

Usually we think of cramming as taking it easy for 2 weeks, and then going hard for the day or two before the test. We all know it doesn’t work. So don’t cram your Step 1 studying into a month or two. It literally should take years to put together the knowledge necessary for you to do well. If you put in the extra effort early on in medical school, not only will you crush Step 1, but you will be a better and smarter student. It starts now.