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THE FINAL USMLE PREPARATION STRATEGY YOU WILL EVER NEED
Copyright © USMLE Success Academy You may print and distribute this document to friends and colleagues as long as it is kept in its original format.
PREFACE
We were not going to write this guidebook, simply because the contents within it are the result of years of trial, error, testing, and tweaking. We thought the results of our years of effort should be restricted to our students, to those who decided to join us at The Academy for their USMLE Step 1 preparation. However, as we move forward and continue to grow by leaps and bounds on a weekly basis, we know that the right thing to do is to help as many students as possible, by answering the question we literally are asked several times per day: How do I study for the Step 1 exam. We get emails coming in every single day, with that exact question! I cannot stress enough just how many hours and years of hard work have gone into testing our USMLE preparation strategy – 1000’s of hours. If you troll the USMLE forums these days, you will see a generic response to this ever-‐so-‐important question asked mainly by foreign students from India and the Caribbean, mainly telling students to use Kaplan and some question bank. Personally, when I was in medical in the Caribbean earlier this century, I received absolutely terrible advice from my school’s administration on how to prepare for the hardest exam of my life. How do I know it was terrible advice? Because when I took an NBME (for the first time) just days before my attempt at the Step 1 exam, the results were absolutely horrifying. The advice I received (from a non-‐MD), was to ‘Do as many questions as you possibly can… Up to 10,000 questions should be done before writing your exam). I thought “OK, I’ll do that and get a 260”, but this simply does not work. Doing question after question without a plan does absolutely nothing to help you achieve that illustrious 99 on the exam. Sure, questions are an integral part of your preparation, but only when approached strategically and with a proper plan-‐of-‐action. I was ashamed to have to postpone my Step 1 exam… Not only was it personally embarrassing, but I already had an illustrious Psych rotation set up in Chapel Hill, North Carolina, that was the opportunity given only to those who were deemed ‘exceptional students’ by the faculty
and administration. Not only did I let myself down, I let my clinical co-‐ordinator down… But here’s the thing… She was the one who gave me the very vague and non-‐directional advice that put me into this position in the first place. I realized, after delaying my exam, that this was NOT about them, it was about ME… Why was I being rushed into clinicals when I clearly wasn’t prepared?? Why squander away any chance I have at attaining a Residency position when I wasn’t ready? So equipped with this epiphany, I decided to start my Step 1 preparation from scratch… I did well in the Basic Science classes. I was known as one of the hardest working students in class. And I don’t share this with you to brag, not in the least. In fact, if you knew me, you would know that I am not one to boast, I prefer being the strong silent type. But I tell you this so you realize that simply being a good student, with solid basic science grades, and a strong work ethic will not automatically translate into a great Step 1 score. Once we start preparing for the USMLE Step 1 exam, we are all starting with a clean slate, and how well you do is not necessarily based on your current knowledge, but rather based on how you approach this exam. I compare the Step 1 exam to a marathon. You may be in good shape, you may hit the gym regularly, you may even be a casual jogger, but unless you are implementing a specific training regimen for that marathon, you are likely to come up short. The Step 1 exam is a marathon, both in preparing for it and actually writing it! It is tough, exhausting, and the process is downright cruel. But, we all have to do it, and it is a right of passage for each medical student. Great pride comes with getting over the hurdle, just like great pride comes to those who are able to withstand the cruel and punishing training for a marathon. So, when I realized I was going to fail based on my NBME exam (which by the way, my school never taught me about), I joined a popular preparation program in the Mid-‐west, an investment that I paid over $5500 for. I figured if anything could help me, this would be it. So I hopped on a plane and headed to the program. I quickly realized that this program was NOT for me… I value my time more than anything else in this life, and I really did not appreciate wasting a couple hours of
every full day of lecture listening to our teacher’s life stories, anecdotes on life, and musings. Not to say the program itself wasn’t useful, it had its moments, but what took us 8 hours to get through everyday could have been taken care of in only a couple of hours per day, leaving me with real time to prepare and study. So I left, locked myself in my hotel room for several weeks, and started reaching out to the best of the best students on the UMSLE Forums. I searched night and day for success stories from students like myself, I compared and contrasted preparation ideologies, and eventually put together what I believed to be the best series of steps that needed to be taken in order to achieve a score putting me into the elite level of test-‐takers. The only way to actually test out this strategy was to put it into action – and that’s what I did! Fast-‐forward a couple of years… I met Dr. Stavros in our 4th year of Clinical rotations in a South Side Chicago hospital. We were immediate friends, and soon began small Step 1 tutoring sessions with students who had yet to take the exam. We prepared high-‐yield lectures, and we taught them our strategy for success. This became quite popular and it soon consumed lots of our time, and we simply couldn’t keep up with the demand. Eventually students started offering to pay us to continue with our tutoring, and although we were in medicine to help the patients, we soon realized the value we could offer to other students who were following in our footsteps. As students came and went, we started to see amazing scores! This was immensely rewarding for us, and with that The Academy was born. As we continued to help students, we tweaked the original strategy that I developed on my own while locked in that hotel room in Illinois back in 2007. We combined a lecture series comprised of approximately 100 hours with our detailed, step-‐by-‐step strategy for achieving enormous success. Since we officially launched The USMLE Success Academy in 2009, we made minor tweaks and changes to our preparation strategy in order to boost scores even more. At this point in time, the strategy is perfected!
Students who follow our lectures and our success strategy are achieving amazing scores, every single time, no matter how weak of a student they were in the past, no matter which Caribbean school they came from, no matter how many failures on the Step 1 they come to us with – they always score well with our strategy. Now, because we are being asked several times per day about the ‘Best way to prepare for the Step 1 exam’, we are going to lay it all out for you here today. Now, let get started. Keep in mind, what you are about to read is not just a recommendation that you should try, it is not something to pick and choose ideas from… It is our tested and proven formula for a great score on your USMLE Step 1 exam. Let’s get started! To your success, Dr. Paul & Dr. Stavros
TOOLS NEEDED FOR THE USMLE PREPARATION STRATEGY In order to best prepare yourself, you need the right tools at your disposal. Below I’ve outlined a few things you should have before even starting your preparation, so that as we move through the plan, you have everything right at your disposal. What you’ll need: 1. Excellent review notes Excellent review notes come from one of two sources. They are either created by you through carefully moving through your basic science notes and combining all of the high-‐yield information into a neat document, or they come from following a review program that tackles the high-‐yield information in great detail. Please realize that ‘study guides’ such as the First Aid or even our USMLE Step 1 BIBLE are not comprehensive review notes, they are only review guides that tell you what is considered to be high-‐yield. You should be able to look at the First Aid and be able to discuss any topic inside in great detail – simply memorizing the information in any study guide will leave you falling well short of the knowledge base you need to succeed. 2. USMLE World Question Bank Through the years, I’ve tried all of the more popular question banks out there, and I can say with complete confidence that USMLE World is the superior product on the market. A 1-‐2 month subscription to USMLE World is all you will need. 3. NBME Examinations In order to get the most accurate feedback of your progress as you move through our success strategy, you are going to need to use NBME examinations. Many students don’t like the fact that they have to spend some money for these exams, but keep in mind that these exams are made of real USMLE questions that are being used today. What this
means is that the level of difficulty that this exam presents to you will give you both an accurate assessment of where you stand and it will give you a great look at the level of difficulty that you can expect on the real USMLE exam. Each NBME is $45, which is a very small price to pay for the valuable information and feedback that you will take away from each one you take. Please, embrace these exams and be prepared to take anywhere from 2-‐5 of them throughout your preparation, as it will help you boost your score by dozens of points! As far as tools go, that’s what you need! Now, let us get into the details of the strategy.
THE BASIC STEPS INVOLVED
Below I am going to outline the general overview of the success strategy. After the outline, I will go into detail about how to approach each step, and how to maneuver your way through the entire strategy from Day 1 of your studies, all the way until the moment you are ready to write the exam! Let’s go… 1st step – Take an NBME exam 2nd step – Develop a study schedule based on your timeframe (+ schedule your USMLE Step 1 exam) 3rd step – Begin studying by moving through each discipline 4th step – Once through your initial review, start doing 3-‐4 blocks of UW questions per day 5th step – Perform the 2nd run through Qbank 6th step – Take NBME 7th step – Improve weak areas based on NBME feedback 8th step – Take NBME (repeat step 6, 7, & 8 until no identifiable weaknesses) 9th step – Take your USMLE Step 1 confidently
At first glance, it looks as though a good chunk of your time is spent taking NBME exams, but this isn’t the case. In fact, the NBME exams are only going to take up a couple hours of your time here and there. But, the layout/schedule of your NBME exam attempts are very carefully placed, and should be followed exactly as prescribed. So now that you get what the overall picture looks like, let us take a much closer, more detailed look at exactly what to do in order to go from where you are right now, to a place where you are equipped to score in the top 1% of all USMLE test-‐takers. Before we start… As I mentioned earlier in this guidebook, your USMLE scores are yours and yours only! They are not for your school, they are not for anyone else but you. So don’t think for a minute that you MUST take the test in 1 month, or 2 months, or even 6 months if you aren’t ready. The clinical rotations will always be there, you only have one shot at this exam – so take your time, but don’t fall into the trap of taking too much time. For example, there is absolutely no plausible reason for taking 1yr to prepare for this exam. If you are a student who is fresh out of the basic sciences, we should have you ready quickly (1-‐3 months). For those of you who are out of school for 5+ years and who truly and honestly believe they are starting from scratch, you should be working hard and efficiently, but may need 6-‐9 months to prepare. In general though, you are likely a relatively recent graduate who can manage to get ready in 90 days or less. 1ST STEP – TAKE AN NBME I’ve dealt with students fresh out of the basic sciences and I’ve dealt with students 20 years out of medical school, and no matter what your case may be, taking an NBME will give you an idea of where you stand.
It will let you know how strong or weak you are overall, and it will pinpoint your strengths, your weaknesses, and your average areas. So get an NBME and take it. Since we are just getting started with our preparation, ultimately we need to identify our weaknesses, but we are still going to do thorough and detailed studying of all the principles tested on the USMLE Step 1 exam. At this point take note of your strengths and weaknesses based on the NBME, but we are still going to attack all of the material. 2ND STEP – DEVELOP A STUDY SCHEDULE BASED ON YOUR TIMEFRAME GOALS This is trickier and different for everyone, but as a general guideline, a student who is above average in their basic science classes should aim to write their exam within 6-‐8 weeks. My suggestion is to be honest with yourself as far as how much time you need; did you fail a few classes in med school? If you did, you’ll need more time. If you did well, then schedule your exam for a couple months away. The most important thing is that you do in fact schedule your exam. Nothing is worse than starting your preparation without having a defined date and goal in place, because what are you working towards if you don’t set a date and goal? You can always change your test date. You also need to identify a target score. If your goal is to become a Family Physician, which is known to be a favorite amongst IMG’s, don’t for a second think that just ‘passing’ the exam will get you in these days, because it absolutely will not! When I hear a student tell me their goal is to ‘just pass’, I will immediately warn them about thinking too small. Even if you want to get into one of the easier specialties, you should still be shooting for a top score. Never limit yourself based on your own falsely set limitations… Just because you are an IMG doesn’t mean you can’t get into Dermatology, or Plastic Surgery. Sure, it is highly unlikely and extremely challenging, but never limit yourself based on what you hear from others. And so with that said, what is your goal? Do you want to try for a challenging specialty? If you do, then you want to score at least a 235,
especially these days with the high number of competitors. If you want an easier specialty such as Pediatrics, you still want to aim for a score that is above the national average, which is around 222-‐225 (this is changing on a yearly basis, but usually hovers around this marker). So, define your ultimate career goals. Define your goal score. Set a date for your exam. How do you plan a study schedule? This is done based on a few factors, namely whether or not you are dedicating 100% of your day to your Step 1 preparation. And if I may say, this is one exam you will want to focus 100% of your time and effort towards. A rock-‐solid approach is to dedicate 6-‐8 hours of each day to Step 1 preparation. In The Academy’s Step 1 Preparation Program, we ask students about the amount of time they can dedicate to their studies, and based on this recommend 4, 8, or 12 weeks of preparation time. For a student who has only the Step 1 to focus on, 4 very intense weeks should be enough time to get through the basic sciences, while also implementing daily questions into their strategy and also keeping an hour or so for review. For those with part-‐time jobs, children, or other responsibilities that use up part of their day, aiming to dedicate 2-‐4 hours of highly focused, interruption-‐free studying/preparation is ideal. Now, based on the amount of time you can dedicate, create a plan that maps out how you will divide your time. Did your NBME tell you that you are weak in a few areas? If it did, give yourself some extra time to go over those topics. Now keep in mind, the major topics you must master for the USMLE Step 1 exam include: -‐ Genetics -‐ Cell & Membrane Behavior -‐ Behavioral medicine -‐ Biochemistry -‐ Neurology -‐ GI Systems (GI, Renal, etc)
-‐ Dermatology -‐ Pathology/Pathophysiology -‐ Pharmacology -‐ Physiology
To name the big ones…. Now, where and/or how you get the information for this material is up to you. Ideally you took excellent notes during your basic sciences and have actively been preparing high-‐yield USMLE notes based on the ‘testable’ material as set out by the USMLE.org website, or you could join our preparation program to get everything you need. But, one thing I absolutely, positively must warn you about, again, is that using a review book such as the First Aid, Step-‐Up series, USMLE BIBLE, alone are not sufficient for in-‐depth review and analysis of the important information. They are ‘guides’, not comprehensive sources. So once you’ve got your plan in order, it is time to really dig into the hardcore studying. 3RD STEP – BEGIN STUDYING How you study is ultimately up to you, but a couple things I can recommend that will go a long way in helping you master a lot of complex material is to: 1. Draw when possible and 2. Create lists About Drawing: Drawing is one of the best ways of taking complex material and turning it into easy-‐to-‐understand and remember material. Take the Brachial Plexus for example; how on earth could you possibly master that anatomical structure without drawing it out over and over again? Sure, you may remember the names of the nerves, which muscles that supply, and what kinds of pathologies occur when they are damaged, but it sure makes it easier when you can visualize that image of the plexus and its major nerves travelling throughout the arm.
This is effective for anatomy, and equally effective for Physiology, as we can really simplify complex physiological processes by turning them into illustrations. Take the tubules of the kidneys as an example; we know that we can turn a lot of complex physiology into very easy-‐to-‐understand processes with a single picture, as I have drawn in below.
Look at what this simple illustration can explain to us… not only how the PCT physiology works, but how Pharmacology effects it’s ability to function. A picture, as they say, is worth a thousand words. And turning your medical information into illustrations will allow you to learn an astoundingly greater amount of information than simply trying to memorize a bunch of books. For this reason, we use hundreds of illustrations for our students throughout our own Step 1 program, not because we like to draw, but because it works!
This is an effective strategy throughout every topic you will study, so making use of drawings, both anatomical and physiological, will help you boost your score. And of course can help you with your Pharmacology as well. Take the following image as an example:
This is a drawing of the pro-‐insulin and insulin molecules, which I can guarantee you will be on your exam! Sure, this isn’t a complicated example, but just looking at this simple drawing, which took me 20s to make, can tell us a world of information relating to not only the structures of the molecules, but it directly links to several pathologies (Insulinoma vs. insulin administrated hypoglycemia for example). By just looking at this image, I can talk to you about Physiology, Pharmacology, Pathology, Pathophysiology, Histology, and Anatomy. I can even link it to Neurological information. The point is, start drawing! It will truly make a difference in your overall education and this type of stuff will stick with you for the rest of your career, while others are constantly reading to remember, you will never forget!
About making Lists: Lists are an effective way to organize information. Pharmacology and Microbiology are two areas that can best be supplemented with well-‐organized lists. Take it a step further, and do yourself a HUGE favor by implementing mnemonics anywhere and everywhere that you can. The best way to make use of mnemonics??? Make up your own! I remember back in my Pharm class during basic sciences, I decided that for the anti-‐hypertensives lecture, I would create all of my own mnemonics, and forego anything that I was to read or be told about. And to this very day, I can rattle off every single anti-‐hypertensive drug, even though I go months without thinking about it. The point is, there is massive power in creating your own memory aides, so don’t be afraid to make up something unique to you, something that only you will remember, as there is a great deal of benefit to be had from doing it. Another great addition to lists is the addition of COLOR. Using colors to separate classes of drugs can be exceptionally helpful. Using a color system to separate gram negative lactose fermenters from the non-‐lactose fermenters can impact your score in the long run, simply because we tend to remember colors very well, and if we combine colors with categories and sub-‐categories of information, we can help out our own cause. Once you have finished a thorough review of your basic sciences material, dive into USMLE World questions! Perform 3-‐4 Blocks Of USMLE World Questions Per Day: In addition to daily review, you should perform 3-‐4 blocks of 46-‐48 questions per day. The reason why I say 3-‐4 blocks is because it is just enough to help you get through the entire question bank in just 14-‐21 days, and it is not so much that you can’t absorb everything on a daily basis. You should mix your USMLE world questions, as this will create the environment that you will experience on the real exam.
Below I have outlined the necessary steps that you should follow while doing QBank questions: First... keep in mind that you don't want to use your UW % as the predictor of your knowledge, you want to use it to build your knowledge. Use the NBME's for assessment purposes... that is important to remember! So here's my suggestion: 1. Go through questions in a TIMED format, doing a full block of questions at a time (46-‐48q) (Reason: you need to train for the USMLE exam like you would train for a physical event like a marathon, and the best way to build your stamina is to perform a full block of questions in the same timeframe that you will do so on the real exam. If you do this from the start, you will build excellent stamina, you will learn to work faster yet still efficiently, and it will go a long way on the real exam). 2. Once finishing each block of questions, now is the time to go back over all of the answers. Open up your basic science notes (the ones you took or the ones you have from a review course) and take insert notes anywhere appropriate. This will help round-‐out your notes and will also force you to review everything. Keep track of your strengths and your weaknesses as you move through these question/answers. This takes time, but the more detailed you can be with your explanations about each question, the more you will learn and the better you will be in the long-‐run. Continue this until you finish the entire question bank. With each passing day, look over the notes you've made in your notebook, talk aloud in explaining certain concepts or pieces of information you are struggling with, and be sure to consistently review review review. If you have someone who can quiz you (friend, family member), create your own short questions and have them drill you with them on a daily basis… as this will serve to help drive important facts into your long-‐term memory. You should continue to study your notes and/or follow your prep program and doing questions in the format explained above until you are through everything. For the qbank, it should take around 14-‐21
days. 4TH STEP – TAKE ANOTHER NBME At this point, you have finished going through your notes, you have finished taking notes, and you have finished your first run through the USMLE World question bank. You have come a very long way since beginning your preparation, and now you should take another NBME exam in order to determine where you are weak, average, or strong. The image below is the image attained at the end of an NBME exam, and as you notice there is a ‘borderline’ marker near the middle of the chart. Everything to the left of this marker is indicative of a weakness, everything to the right is indicative of a relative strength. It is important to realize that any subject that crosses over the borderline marker at any point should be assumed ‘weak’.
The ultimate goal is to get all subjects in the ‘Strong’ side of the chart. Based on this NBME, this student should spend time working on Mental Disorders, Gynecologic Disorders, and Psychiatry above all else. Those topics deserve 1 full week of intense study each, totaling 3 weeks. The
subjects that hover over the ‘Borderline’ area should also be studied further, although a couple days for each of these ‘average’ areas may be sufficient to bring them over into the ‘Strong’ area. While spending more time specifically on your weaker and average areas, you will also do a 2nd run through of your USMLE World question bank, however, you are going to do it in a completely unique way that will help propel your knowledge above and beyond its current level (this strategy is outlined below). 5TH STEP – PERFORM A 2ND RUN THROUGH YOUR QBANK Before doing this step, spend extra time on each one of your weaknesses in order to bring them up to par with the rest of your knowledge. The 2nd run through of your QBank is performed as follows: Now, the mistake I see a lot of students making at this point is to simply re-‐do the entire question bank. When you simply re-‐do the qbank, you may see an improvement in your %, but you have to realize that this is most likely due to memorization of some answers. Instead, as you move through each day, you should be truly MASTERING the information within your notes. So by the time you are done with the 1st round of the qbank, your depth and breadth of knowledge should be much greater. Once you have thoroughly studied your notes (in addition to your straightforward studying from your basic science notes or review course if you choose to do one), then it is time to go through your UW Qbank a 2nd time, but the key to truly using it to maximize your knowledge isn't to simply go through the questions again in a Multiple choice format -‐ NO! Instead, what you should do is the following: Note: this time you don't have to perform the questions in a timed mode and you should perform them in ‘random’ mode. 1st -‐ Read the question as you normally would (note: be sure to always read the last line of the question first, as sometimes reading the entire stem isn't even necessary to answer the question -‐ and if you have 2-‐3 of
these per block, you can save yourself a few minutes of precious time). Back to the main point... read the question as you normally would, but instead of simply choosing the correct answer (which should be easy based on your having properly gone through the 1st time), you want to identify the proper answer from the answer choices, but instead of just answering it and moving to the next question, explain to yourself, aloud, why the question you believe to be correct is in fact correct. If you can explain why an answer is right, then you have a much better overall comprehension of the material. In addition, take a look at the answers you find to be incorrect, and discuss with yourself why each incorrect answer is in fact 'incorrect'. You see, if you only master the information for each correct answer, you overlook the learning opportunity for all 4-‐5 of the other answer options, because even though they're incorrect for this particular answer, they are still pieces of information that you should know/learn/understand. Simply move through the qbank this way until you get through the entire thing. So this means your 2nd time through is more about being able to explain information, instead of simply being able to remember correct and/or incorrect answers. This is just like teaching someone the information… When you can discuss something out loud, then you can be certain that you truly know the information. This takes time, I won't lie to you, it takes lots of time and patience... BUT, you will learn so much medical information that when it comes time for you to sit for the real exam, all of the hard work that you put in will make things much easier for you. No matter how the questions are thrown at you on your actual Step 1 exam, your knowledge should be so strong that whichever direction the questions are coming from, you won’t be tricked. 6TH STEP – TAKE ANOTHER NBME By now, you have properly studied your basic science material, and you have performed the QBank two times. You should be extremely close to ready, if you are not already ready to write your exam. But before you do so, we need to be sure that you will pass with 100% certainty. There are a couple of important criteria you absolutely MUST meet if you want to ensure you are completely prepared to write your exam; which
includes a WELL-‐DISTRIBUTED exam result and a minimum score of 500. Let me explain first what I mean by ‘well-‐distributed’… It means that when you see your results, you want all of the subjects to be fairly equally distributed across the entire spectrum. Take the two NBME results below, where each yields a score of 500, but the one on the left is not well-‐distributed (ie. All of the bars are not approximately in the same area on the chart). The one of the right, while all topics are not on the far right (higher performance) side of the chart, is well-‐distributed and means that you have a very well overall knowledge of the information. The reason why a poorly distributed result is risky is because lets say the real USMLE exam is heavier in those topics you are a bit weaker in… If you don’t take the time to bring up those weaknesses, you may have a false sense of security because of a decent NBME score, but you still risk failing. On the other hand, if all of your subjects are at least on the right side of the ‘borderline’ performance, at least no matter which topics may be heavier on the real exam, you at least know that your knowledge is well-‐distributed and that you know enough to safely pass your exam with a good score.
Poorly Distributed Well Distributed And finally, you want to achieve a score of at least 500 because this correlates with the approximate USMLE Score of 220, which is at the marker for the National Average for all test-‐takers. Scoring in this range will give you a good chance of being invited for Residency interviews.
7TH STEP – IMPROVE WEAK AREAS BASED ON NBME FEEDBACK If you’ve taken an NBME and achieved a score of at least 500 and the results were well-‐distributed, you are ready to take the exam. If, on the other hand, there are still weaknesses (ie. Bars to the left of the ‘borderline’ marker), then you should dedicate 1 week to each of your weaknesses, and then repeat an NBME (note: Don’t do the same NBME twice). 8TH STEP – TAKE AN NBME From here, you will repeat steps 6, 7, and 8 until you reach a point where you have achieved a MINIMUM score of 500 and all subject bars are to the right of the ‘Borderline’ marker, as you see below:
If you’ve achieved this important point, I highly suggest taking another two NBME exams, as a way of solidifying your confidence in your ability to pass. I have a very important motto that I use with my students inside The Academy:
Once is a Fluke, Twice is a Coincidence, Three times is a pattern
What this means, simply, is that it is possible that you got lucky and scored well on the exam, so by taking another exam and scoring in the same ballpark, it demonstrates that you may be onto something, but twice is still a possible coincidence. But, once you’ve achieved the same result three times in a row, it demonstrates that you are in a pattern of success, and you are absolutely, 100% ready and prepared to do well on your USMLE Step 1 exam. And now, you should be confident in your ability to pass! 9TH STEP – TAKE YOUR USMLE STEP 1 EXAM WITH CONFIDENCE I think this one speaks for itself. At this point, you’ve put in the blood, sweat, and tears, and you have come a long way in your entire preparatory process. By following the steps that have been outlined for you here today, you can be confident that you will pass your exam. You see, inside The Academy, students often ask us why we offer them a passing score money-‐back guarantee. And the reason why we do this is to demonstrate that we have the utmost confidence in our program and in our entire preparation strategy, which gives our students the confidence to push hard and follow the plan exactly as it is laid out. The thing that most students don’t realize is that with the awesome high-‐yield lecture series we’ve created, in combination with the steps that they must take in order to prepare for the exam, we can be 100% certain that each student will pass. When a student demonstrates that they have scored over 500 on three consecutive NBME exams, along with a well-‐distributed knowledge base that is based on the hard facts of the NBME results, it is simply unlikely that you will fail. The hard data tells us whether or not our students have taken the appropriate steps and mastered the information; there is no risk involved with our preparation program, which is why our students consistently score above the national average. When we took the last four years to create this perfect preparation strategy, and started to implement it within our Academy, the results were the same every time – a passing score.
Thanks for taking the time to read and absorb The Academy’s Success Strategy Manual. If you made it this far, you are serious about scoring exceptionally well on your Step 1 exam.. To your USMLE Success! Dr. Paul & Dr. Stavros