Step 1

R   December 16 2010 == Final Exam of Semester 4 at Ross University School of Medicine.
F   December 17 == Tulip
Sa December 18 == Hong Kong
Su December 19 == Home at 9p
M December 20 == Home - Passed 4th semester
T   December 21== Home
W December 22 == New TV; Dentist; Flu Shot
R   December 23 == Buy NBME test??
F   December 24 == Christmas Eve - spent time in my brother's home - Macy
Sa December 25 == Bought Glasses (32 US dollar) *** Start Studying for COMP exam.
Su December 26 == Bought USMLE Rx (79 dollar)
by Vijay
General Test Thoughts:
1. Endurance - Just think...for this type of exam, you study as much as you can, you give yourself ample time, you arm yourself with the most ammunition you possibly can, and then you just unload it all on that day. I literally had nothing left by the end of it. That test is a true test of stamina and endurance (Neel I know stamina/endurance are sensitive subjects for you buddy sorry). 7 blocks of 46 questions, each with a long-ass stem with mostly useless distractors. It's brutal just to read the questions. My eyes were bleeding by the 4th block, but what can can you do? So, my first piece of advice is...go to the gym the day before. Run. Do something. Make yourself tired. I literally did all that and laid down to sleep the night before the test and couldn't do anything cause of enormous butterflies churning in my stomach. I was fine saying goodnight to Irene, but as soon as I was left with my thoughts...I was done. So...and I know this is so pathetic...but I googled on my iphone..."how to sleep before USMLE step 1" and the first valuemd page that came up had this one post w/ some dude saying to lie down, close your eyes, and pretend you're taking a vacation. Follow all the steps from packing, to grabbing your loved one, going to the airport, everything. So, I did that, and literally I fell asleep by the time imaginary me made it to the aiport. It was awesome. That probably sounds super lame, but maybe it'll help you if you find yourself in a similar position. Make sure to pack some soda (better cold than coffee) for caffeine, pack a banana or some sugary fruit, and pack some cookies. You can crash after the test, but I loaded up on healthy brain food (eggs/toast) and some sugary snacks for the endurance test. Believe me, you're gonna need it.
2. Gambler's Ruin - Ever heard of the theory of Gambler's Ruin? The theory is simple. Say you flip a coin 100 times. You expect, by laws of probability, to get 50 heads and 50 tails, right? But, that won't happen. Also, you would never go heads-tails-heads-tails. You'd get runs of tails, and runs of heads, but in the end it'll balance out relatively, right? That's the essence of this exam. You will have runs of questions that seem easy to you. Use those to build up your confidence. Also, you'll have runs of questions that seem difficult or even impossible. This is the true evil of the way the test is written. I'm confident this is done intentionally to get under your skin, to test your mettle, and test your resolve. I remember my first two blocks were easy, and the third block was monstrous. I had 7 or 8 questions in a row I wasn't comfortable with....not clueless about...but not comfortable with either. I just told myself to breathe, I leaned back, closed my eyes, and reminded myself there are a lot of experimental questions that will not even be graded. This little momentary break actually helped me several times because it got me back in focus. Ya'll know I'm a huge sports nut, so I equate it to a great corner giving up a touchdown. You are Darrelle Revis. You have this exam on Revis Island. You give up a touchdown once in a blue moon, who cares. You still own that friggin island, and you still got that exam on lock. You gotta dare it to that to you again (and it will, lol). But, you'll be ready the next time. Hope that makes sense. Have a short term memory for the bad questions, and move on.
3. The Content - 2 years of medical school. It truly is a well-written exam in that it covers a lot of material that Ross focused on and it covers a lot of stuff that the review guides call "high yield". So, don't worry. Out of 330 questions, I saw maybe 2-3 that I had no idea wtf they were talking about. I chalked that up to an experimental question, made my best guess, and moved on. EVERYONE will have that happen to them. It's up to you to not let it phase you. Ain't nobody getting a 300 on this test anyway, so why stress over little shit like that? As for the difficulty, I'll say the real test is SIGNIFICANTLY easier than UWorld. UWorld frustrated me to no end (as you guys know if you've talked to me at all). It's amazing, but god it's frustrating. I ain't ever gonna associate dizziness w/ an enlarged liver as Wilson's Disease before considering Hepatic Encephalopathy. I would never ever ever ever make that connection. UWorld expects you to. The Step, however, does not. The step usually tells you the disease and asks you for something else about it. Case in point, something like "patient has hyperextensible joints and blue sclera...what is he at risk for?" And the choices are A. BS 2. BS 3. BS 4.BS 5. Berry Aneurysm. So, stuff like that. They have media questions that all high-definition so its easy to see what they're asking for. Usually the picture questions were hard, but I've always sucked at picture questions. I had 3 murmurs, all were a joke. Didn't need to listen to them to get it right. I had no lock-in questions (where 1 goes for 2 subsequent q's, and youre locked in after the first q), which also surprised me cause they were abundant on UWorld. The level of detail was less than minis, less than UWorld, and just about on par with the NBME's. I think I remember Dr. Sands saying something in class one time WAY back in the day...something super obscure...and it was on my test. I got that one just by dumb luck of stuff I remembered, but there are only a scattered few of that type of question.
4. The Preparation - I gave myself 5 weeks initially, and didn't consider pushing my test back. My schedule was like that UF schedule I sent you guys...it was waking up 7 am, study till 12:30, lunch break till 1pm, study till 5, eat/rest till 6:30-7:00, study till 11ish. That gives you 12-13 hrs/day of solid work. That's why your life is hell for that period. Now I'm not saying I never took little mini breaks. I always had gchat with you guys and Irene. I used to play Call of Duty for 15-20 mins at a time when I felt like murdering someone. I used to give myself half-days on Sundays because I am unhealthily obsessed with football. So, I came super close to getting my goal done in 5 weeks, but I realized I needed a bit more time cause of Reed's wedding. So, I pushed back and ended up taking a total of 6.5 weeks. The decision to push back was perfect cause I got to finish up UWorld and Goljan. As far as sources go, I used 1. First AID 2. DIT 3. Uworld 4. Goljan Audio 5. Rapid Review Path 6. BRS Physio 7. Robbins (Cell bio). Of those, the first 4 were absolutely clutch for me. Nothing to say about first aid except going through it, I made note cards for the stuff I couldn't remember. I ended up with 275+ notecards and i memorized them gradually during my studying. That was the most helpful thing I did in the whole process of studying. DIT is really good if you already have made a pass through first aid tho. I actually did the whole thing with stopping and answering all the quizzes and stuff. I printed them out twice, actually, so I basically did the program twice. It was amazing. If you are not going to do the quizzes and the whole DIT shabang, don't even bother with it cause it's worthless. Goljan Audio is absolute money. He nailed several stems from the real exam right on the head...the guy is amazing. Literally I had a question..."patient comes in with generalized lymphadenitis. What drug was he on?" LOL what the hell? Goljan mentioned that tho...and he said they would ask that...and the answer is phenytoin. It was also on UWorld. Epic. Also, a couple of questions came only from DIT....for example, what is the rx for pubic lice? Only Jenkins mentioned that Pyrethin cream was the answer and I thought to myself "CA$$$$$$$$$H". A lot of DIT I reviewed the morning of the exam came up on my test, and I got really fortunate to have seen it like 30 minutes before my exam. I also probably threw up a W in the middle of the exam center when I realized that I was that fortunate. I received several strange looks. The other sources were not as helpful simply because sources 1-4 covered them adequately. Uworld is a great tool for refining your skills and it will only become more valuable the deeper into your studies you get. They get the stems down too. There are like 8 questions on UWorld that go like this: "25 year anonymous male (call him Dinesh R. or D. Reddy, if you prefer) comes into the office with a swollen knee and history of multiple unprotected sexual partners....". After you recover from laughter of the irony of the stem involving Dinesh and getting laid, you get a tough question about treatment failures, etc etc. On the real test, it'll say knee FNA fluid reveals gram negative diplococci. Then youll get 4 gram positive bacteria as answers and Neisseria. It sometimes literally is that easy. You will see some questions that make you feel insulted that they would even ask you a question that easy. Other questions will make you go "wtffff" I never learned that before. This all boils down to your preparation, and how much you're comfortable with. You'll never get all 100% of the material covered, but you damn well are better off trying!
5. Final Thoughts - In the end, I'd say the one thing that helped me the most was having a good support system. I used to always talk to my best friend after he got off work, I'd always take a break to walk with my dad, and Irene helped keep me sane through it all. Without that system, I would have crashed and burned after 2 weeks. And believe me, I came close. It's extremely taxing, and extremely demanding. Your mood will be off, you'll want to cry, you'll be miserable, and you'll not feel like yourself. Just surround yourself with people who love you and try your best to take joy in the simple things in life, remembering that it all will be over soon and "future you" will thank you for the time you're putting in. If you have a bad day or you're getting bogged down in any subject, allow yourself to lose a few hours or even a full day getting your composure back and come back to it when you are refreshed. If you don't understand something completely, ask someone, look it up, get a general idea, and move on. This test favors the jack of all trades over the master of one. Also, remember...everyone's test is different. I heard biostats, ethics, etc were super high yield. I heard anatomy was low yield. On my test, I didn't have a single biostats question, no ethics, no confidence intervals, maybe 5 Biochem questions total (one of them said "wrinkled tissue paper cytoplasm" too, so it's not impossible, guys!), and TONS of anatomy. I also had more pharm than physio. The anatomy and pharm played into my hands, but you can't always plan for that. Just do your best to review as much variety of subjects as you can.

M December 27 == Health Assessment Form Filled but still in progress
by Neil
A general note on AICM - you dont learn anything 'new'..lectures are very much a repetition of basic sciences with some clinical points. You perform PEs - shortened versions of what we learn in ICM back there. You do learn how to write a good SOAP note which is a necessity in clinical rotations. Dont know about Miami, but here, they drill that down in your head. btw, SOAP stands for S - subjective, O - objective (i.e. Physical exams + labs), A/P - Assessment and Plan (summary of conditions + management).

--education and study-wise, I feel AICM synergy program is very relaxed (4 days off in a week - reference to my earlier email). You might have something going on weekends in Miami. Also, the big thing in Michigan is they give you the full 12 week schedule in advance (in week1) so you can plan ahead of things. In Miami, you dont know the schedule for even next week until the very end of the week. The clinical experience here is decent - will be mainly in nursing home though (will see chronic conditions - Diabetes, CHF, COPD, CVAs). Also, living here is decent and not very expensive (vs in Miami..a decent place would atleast be over 1000USD/month).

In one word, COMP was "do-able". It was on last monday (sep13 - first day of AICM, and they had 4 hrs of ethics and psychiatry after the comp :-). There were 200 questions. We got 4 hrs and 15 minutes for it (there has been an issue regarding about that extra 15 minutes from people who took the COMP for the second time on Sep10 and got only 4 hrs) And, people who took it for the second time found the questions to be harder than the ones from the earlier one (so in short, PASS it on the first attempt!..easy to say..I know) I think those extra fifteen minutes were 'life-saver' for most students from our class. This was mainly due to questions with long vignettes which was different from what we had heard from the class before us (they had short vignettes).

About the content: there was a lot of female repro - physio/path. There were some Odd behavioral questions - almost like 10 questions asking about the best response from a physician in an ethical situation (not as straightforward as questions from Dr. Sharma - open-ended questions). There was hardly any pharm on it (very high yield stuff). Same for anatomy. There were quite a bit of biochem questions (know the metabolic pathways - Amino acid, fatty acid, glucose, genetics). Not much micro. Needless to say, path was the MOST high yield thing on the COMP - KNOW IT.

T December 28 === Know my place: Our address is: 5875 Weiss apt A-3 Saginaw, MI 48603. The earliest we can move in is 10 January. The landlord's email is: marilynclrk@gmail.com but the phone number is on the website. I don't check this email often so the best way to get ahold of me is by cell phone. 248.719.2622

W December 29 === NO CAR to michigan DECIDED - try not to change it, DINNER at pheonix.
R December 30 == ????
F December 31 == sleep; new year eve
Sa Jan 1 == new year, my insurance not take care of vaccination fee $29.99.
T Jan 4 == my titres result back.. i m immune to measles (rubeola), rubella, mumps, varicella, TB negative. Hepatitis B surface AB, Quantity (immunity) is greater than 0.99 = 40.14H..<------- woo hoo.. convert with only two shots of Hep B series (one with 65 US dollar at UIC and 50 EC at Ross clinic)... best of all, done with titres and sent to Latisha Bearfield at 732-509-4820.
R Jan 6 == finish First Aid, Bill for Vaccination came in.. Set to go on Jan 14 or 15. Now time to begin RX.