Making Your Step 1 Review Effective

Scott RobertsonRegional Medical Programs Directorscott.robertson@kaplan.com

January 13th, 2014

41 52.5 78

225 765 2015

Source: New England Journal Of Medicine(http://www.nejm.org/doi/full/10.1056/NEJMhpr1107519)

“We estimate that we will see domestic production of medical school graduates functionally surpass our current number of GME postgraduate year one pipeline positions by 2015 or sooner.”

Source: Dr. Thomas Nasco, CEO of the Association Council for Graduate Medical education

http://www.nejm.org/doi/full/10.1056/NEJMhpr1107519

Specialty

Mean US Med scores 2011 (2009) Matched

Years of residency

Mean hrs/ week Schedule type Salary range

Family Medicine 213 (214) 3 52.5 Uncontrollable $175k-$220kPsychiatry 214 (216) 4 48 Controllable $173k-$248k ObGyn 220 (219) 4 61 Uncontrollable $251k-$326k Pediatrics 221 (219) 3 54 Uncontrollable $160k- $228k

Emergency Medicine 223 (222) 3 46 Controllable $239k-$316k Anesthesiology 226 (224) 4 61 Controllable $331k-$423k General Surgery 227 (224) 5 60 Uncontrollable $284k- $383k Neurology 225 (225) 4 55 Controllable $408k (median) Internal Medicine 226 (225) 3 57 Uncontrollable $184k- $231k Pathology 226 (227) 3 45 Controllable $239k- $331k Transitional Year n/a (236) 1 - - - Orthopedics 240 (238) 5 58 Uncontrollable $397k-$600k Diagnostic Radiology 240 (238) 4 58 Controllable $377k-$478k Neurosurgery 239 (239) 6 - - $287k- $637k Otolaryngology 243 (240) 53.5 Controllable $245k (median) Dermatology 244 (242) 4 45 Controllable $313k-$480k Plastic Surgery 249 (245) 5 - - $275k-$499k

Program Decision Making

Specialty

Mean US Med scores 2011 (2009) Matched

Years of residency

Mean hrs/ week Schedule type Salary range

Family Medicine 213 (214) 3 52.5 Uncontrollable $175k-$220kPsychiatry 214 (216) 4 48 Controllable $173k-$248k ObGyn 220 (219) 4 61 Uncontrollable $251k-$326k Pediatrics 221 (219) 3 54 Uncontrollable $160k- $228k

Emergency Medicine 223 (222) 3 46 Controllable $239k-$316k Anesthesiology 226 (224) 4 61 Controllable $331k-$423k General Surgery 227 (224) 5 60 Uncontrollable $284k- $383k Neurology 225 (225) 4 55 Controllable $408k (median) Internal Medicine 226 (225) 3 57 Uncontrollable $184k- $231k Pathology 226 (227) 3 45 Controllable $239k- $331k Transitional Year n/a (236) 1 - - - Orthopedics 240 (238) 5 58 Uncontrollable $397k-$600k Diagnostic Radiology 240 (238) 4 58 Controllable $377k-$478k Neurosurgery 239 (239) 6 - - $287k- $637k Otolaryngology 243 (240) 53.5 Controllable $245k (median) Dermatology 244 (242) 4 45 Controllable $313k-$480k Plastic Surgery 249 (245) 5 - - $275k-$499k

Program Decision Making

First Step:

Understand what you need to know and do in order to solve USMLE questions

Which of the following is the drug of choice for a patient diagnosed with oral thrush?

○ A. Amphotericin B○ B. Fluconazole○ C. Griseofulvin○ D. Ketoconazole○ E. Nystatin

Step 1 EvolutionSingle Jump, 1980’s

Step 1 EvolutionDouble Jump, 1990’s

A 28-year-old HIV-positive man complains to his physician of a recurrent whitish film that seems to grow on his tongue and oral mucosa. A germ tube test is positive. Which of the following is the drug of choice for this patient?

○ A. Amphotericin B○ B. Fluconazole○ C. Griseofulvin○ D. Ketoconazole○ E. Nystatin

Step 1 Evolution (Triple Jump, today)

Answer = B

Step 1 Evolution (Triple Jump, today)

A 72-year-old woman is brought to her physician by her husband. He states that she is having trouble recognizing her grandchildren, and is having increasing difficulties in the planning and executing her daily activities. Furthermore, she is having a more difficult time recalling the names of common objects. He states that he often finds her wandering around the house with an “absent” look on her face. Which of the following structures is most likely affected in this patient?

○ A ○ B ○ C ○ D ○ E ○ F

A 72-year-old woman is brought to her physician by her husband. He states that she is having trouble recognizing her grandchildren, and is having increasing difficulties in the planning and executing her daily activities. Furthermore, she is having a more difficult time recalling the names of common objects. He states that he often finds her wandering around the house with an “absent” look on her face. Which of the following structures is most likely affected in this patient?

○ A ○ B ○ C ○ D ○ E ○ F

Effective Prep

Establish a S.M.A.R.T plan

Spaced Repetition

Active Learning

Using my Kaplan Step 1 Qbank and other programs Effectively!!

Question Practice

To To excelexcel on (not simply “pass”) on (not simply “pass”) youryour exam… exam…

• Set up a strategic study plan and stick to it• Anticipate that questions can present the basic

clinical sciences in a different format than you are typically used to seeing

• Review the material in ways that mimic current question demands

• Study actively, not passively• Build in tactics to minimize forgetting key information• Focus on understanding, not just memorizing• Know the USMLE testing software by appropriate

use of Kaplan diagnostic, Qbank, and sim exams

Getting Started…

or Planning Ahead…

Speak the Language: Build your test question vocabulary

Glossary of Terms Frequently Used in Test Questions

Term Definition Abolish To do away with, to eliminate Absolute value The distance from zero, disregarding + or - signAbundant Plentiful, numerousAccount for Explain, justifyAcquire Get, obtain, gainAcrid A sharp taste or smellAdjacent Near or next toAggravate Irritate, make worseAlter Change, modifyAmenable Changeable, yielding, pliantAmplify Enlarge, make biggerApparent Visible, evidentArrest To stop, check or holdAttenuate To weaken or reduce in force or amountAttributable to Result from, be caused by Bear To support, hold up, endure, show or exhibit some feature Causative agent Cause Cessation Discontinue, endCloying A too sweet smell or tasteCoalesce To grow together, combine as one thingComprise To include or containConcomitant To accompany or occur at the same time, along withConcurrent Same as concomitant, but associated with timeConfer To give

5 common EARLY preparation 5 common EARLY preparation mistakesmistakes

1. PASSIVE studying – wholly focused on content review or video review or curriculum notes review…

2. Insufficient or INAPPROPRIATE practice with questions

3. MEMORIZING content, but not understanding

4. MISREADING, misinterpreting questions

5. DEVELOPING inappropriate test day strategies

The ACTIVE study cycle for all subjects…

Analyze

Remediate

Self Test

Review Actively…from the start!Review Actively…from the start!

• Make summary notes of key aspects• Color code to cluster and highlight

similarities/exceptions• Use diagrams and charts to summarize key data• Do questions before and after reviewing• Know “most commons” and “hot topics”• Change study modes frequently to refocus your

attention• Use Qbank properly• Work with a question partner• Consider other Kaplan online resources to offer a

fresh view of Step 1 topics you find difficult

Use Your Qbank ProperlyUse Your Qbank Properly• Begin using timed mode as soon as possible• Cover answer choices initially to focus on question stem

information• Look at why, not just what you missed when testing• Look for patterns among your errors, then adjust study to

minimize these errors• View questions as a guide to what content to focus on and how to

store the material in memory for easier application to questions• Avoid thinking of practice test scores as a judgment on your

intelligence• Keep mixing in items on content reviewed previously to better

retain and to adjust to random nature of real exam

Try Question Partnering

An activity that can help you identify habits that are costing you points on exams

A nice change of pace from solo reviewing

An opportunity to learn new approaches to solving questions

A chance to provide these same benefits to your partner

An ACTIVE learning technique!!

How many questions is “enough?”

• Too many too soon wastes questions and may reinforce incorrect beliefs about the depth / difficulty of the Step 1 subject material

• Too few too late will not adequately prepare you for test day – cramming suppresses learning!!

• Sources:

Kaplan Step 1 High Yield, Step 1 Qbank, Step 1 sims (2), a 2nd Step 1 Qbank (1 month)

Create an Effective Study Plan

• Get organized TODAY!!! Note important school dates and deadlines Schedule review tasks around those dates

• Self-assess TODAY!!• Hard to know where you need to go until you first know

where you are starting from! Online Kaplan Diagnostic is your answer!!

• Integrate use of study resources TODAY!!• Print materials like the First Aid pages• Online resources like Qbank, NBME assessments• Interactive resources, e.g. classmates, med advisors

Using Extra / Vacation Time

• Link review of 1st year content to topics of current course lectures, such as systemic Pathology

• Use extra or vacation time to review 1st year content that doesn’t easily link to current classes WHAT?!?!

• Begin using USMLE-style questions at exam pace now• Note problem topics revealed by testing for extra

attention once 2nd year classes end• Reserve enough fresh questions for use in final prep

period -> Kaplan Sim exams!!

Organize Yourself After 2Organize Yourself After 2ndnd Year Classes End Year Classes End

First 2/3 of remaining time: 1. Take first overall assessment early (Kaplan sim #1), rank order subjects by test results!

2. Complete planned review of all Step 1 subjects!3. Final subject content review occurs in weakest to strongest order!

Final 1/3 of remaining time: 1. Cycles of practice testing --- identify weak spots - review these again to refresh + clarify!

2. Refresh highest yield topics + rote during final 2 weeks!3. Take final overall assessment (Kaplan sim #2); plan last week of

review!

No study the final afternoon and evening before exam day!!!

Allow for final assimilation and accommodation processes!

Final Review - KEY POINTS

• Self-assess comprehensively (sim #1) approximately 1 month to six weeks before exam date

• Allocate final # days to spend per topic based on sim #1 results, as shown below• Take simulated exam #2 approximately 7 to 10 days before exam date; review

completely for final most challenging study review • Optional: take NBME self-assessment ($50 – 4-hour exam)

Assessment Scores Study Sequence # FINAL Study Days

Anatomy 70% 7 2

Physiology 45% 1 5

Biochemistry 60% 6 3

Behavioral Science 75% 8 2

Pathology 50% 3 5

Microbiology 60% 5 3

Immunology 45% 2 3

Pharmacology 55% 4 5

Plan Your Last Month Carefully

Content

Questions

T o t a l S t u d y T i m eEXAM DAY

Questions* should drive you BACK to study SPECIFICS!

Topical Question Review

Test Simulation

*Questions do not TEACH…they “TEST!” Always remember that!...

Questions* should drive you BACK to study MORE!

*Questions do not TEACH…they

“TEST!” Always remember that!...

“Whether you believe you can, or you can’t, you're right.”

Henry Ford

Thank you for your attention today!

What are your questions?

Scott Robertson

scott.robertson@kaplan.com

Regional Medical Programs Manager