USMLE STEP 1 SURVIVAL GUIDE

1. USMLE STEP 1 SURVIVAL GUIDE

2. Overview • Licensing Exams • USMLE Step 1 • Content • Application and Scheduling • Strategies for Success • Special Issues

3. Licensing Exams

4. To become licensed to practice medicine in the United States, one must: • Earn a medical degree • Pass several licensing examinations • Complete one or more years of residency training • Apply for licensure from a state medical licensing authority

5. The National Board of Medical Examiners (NBME) www.nbme.org • The NBME is an independent, not-for-profit organization that provides examinations for the health professions.

6. The United States Medical Licensing Examination™ (USMLE™) www.usmle.org • The USMLE, co-sponsored and co-owned by the NBME and the Federation of State Medical Boards, is a three-step examination for medical licensure in the United States. • Step 1 • Step 2, Clinical Knowledge (CK) • Step 2, Clinical Skills (CS) • Step 3

7. The United States Medical Licensing Examination™ (USMLE™) • The USMLE assesses one’s ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care.

8. The United States Medical Licensing Examination™ (USMLE™) • Results of the USMLE are reported to medical licensing authorities in the United States for their use in granting the initial license to practice medicine.

9. USMLE Step 1 • Computer based examination • Assesses whether medical students can understand and apply important concepts of the sciences basic to the practice of medicine. • Step 1 is usually taken at the end of the second year of medical school.

10. USMLE Step 2 • A two step examination that assesses whether students can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention.

11. USMLE Step 2 Clinical Knowledge • A computer based exam consisting of multiple-choice questions that focus on the principles of clinical science that are deemed important for the practice of medicine under supervision in postgraduate training.

12. USMLE Step 2 Clinical Skills • Uses standardized patients to test one’s ability to gather information from patients, perform physical examinations, and communicate findings to patients and colleagues. • Usually taken during the fourth year • Five test centers in the United States

13. USMLE Step 3 • A computer based exam that assesses whether medical school graduates can apply the medical knowledge and understanding of biomedical and clinical science considered essential for the unsupervised practice of medicine. • Step 3 is usually taken during or after the first year of postgraduate residency training.

14. UMMSM Requirements • Students must pass Step 1 for promotion to the third year • Students must take Step 2 CS and CK as a condition for graduation • Passing Step 2 CS and CK is not a requirement for graduation

15. USMLE Step 1

16. Important Websites • USMLE • www.usmle.org • NBME • www.nbme.org • Prometric Test Centers • www.prometric.com

17. 2009 USMLE Bulletin http://www.usmle.org/General_Information/bulletin/2009.html

18. Step 1: Content • Anatomy • Behavioral sciences • Biochemistry • Microbiology • Pathology • Pharmacology • Physiology • Interdisciplinary topics, such as nutrition, genetics, and aging.

19. Step 1: Content • Classifies test items along two dimensions, system and process • System • 40%–50% General principles • 50%–60% Individual organ systems • Process • 30%–50% Normal structure and function • 30%–50% Abnormal processes • 15%–25% Principles of therapeutics • 10%–20% Psychosocial, cultural, occupational and environmental considerations

20. Step 1: Format • Step 1 has approximately 350 multiple-choice test items, divided into seven 60-minute blocks, administered in one eight-hour testing session. • Step 1 consists of multiple-choice questions designed to measure basic science knowledge.

21. Step 1: Format • Some questions test the examinee's fund of knowledge • The majority of questions require the examinee to: • interpret graphic and tabular material • to identify gross and microscopic pathologic and normal specimens, • to solve problems through application of basic science principles

22. Step 1: Format • Step 1 includes only single one best answer test questions. • Items consist of a statement or question followed by three to eleven response options arranged in alphabetical or logical order. • Some questions involve interpretation of graphic or pictorial materials. • Examinees are required to select the best answer to the question. • Other options may be partially correct, but there is only ONE BEST answer.

23. Step 1: Reporting • The number of test items you answer correctly is converted to two equivalent scores. • The three-digit score • The minimum passing score is 185. • The mean score for first-time examinees from accredited U.S medical schools is in the range of 200 to 220 (SD +/- 20) • The two-digit score • Is derived from the three-digit score and is not a percentage score. • Is used in score reporting because some medical licensing authorities require a "passing score of 75." • A score of 75 always corresponds to the minimum passing score.

24. Application Process • Review the 2009 USMLE Bulletin http://www.usmle.org/General_Information/bulletin/2009.html • Complete your application materials and submit them online at www.nbme.org • Request a 3 month eligibility period • Receive a Scheduling Permit verifying your eligibility and authorizing you to schedule the examination

25. Application Process • Follow the instructions on your Scheduling Permit to schedule your test date at a Prometric Test Center at www.prometric.com • On the scheduled test date and at the scheduled time, bring to the test center your Scheduling Permit and the required identification. • Take the test

27. Strategies for Success

28. Strategies for SuccessGame Plan • Time Management • Resource Management • Study Strategy • Test-Taking Skills

29. Strategies for SuccessGame Plan: Recommendations • Read all info on the USMLE website • Familiarize yourself with content of exam • Once you develop a schedule and study strategy… stick to it! • Don’t procrastinate • Most of all…

30. Strategies for SuccessGame Plan: Recommendations • Don’t distress … De-stress!!!

31. Strategies for SuccessTime Management • Prolonged study ≠ better retention • Develop daily schedule • Keep reasonable study periods • Set aside time to “decompress” • Don’t forget fundamentals of maintaining health and wellness

32. Strategies for SuccessResource Management • You can’t review it all – so stick with what has worked for you! • Class notes • Videos • Textbooks • Board Review Books • On-line materials • Tutors

33. Strategies for SuccessResource Management • USMLE Prep Courses • Kaplan • Princeton Review • Falcon Review • USMLE World • UMKC: Institute for Professional Preparation

34. Strategies for SuccessResource Management • USMLE Study Guides • First Aid USMLE Step 1 • USMLE Step 1 Secrets • High-Yield Comprehensive USMLE Step 1 Review • Underground Clinical Vignettes USMLE Step 1 • BSS: Body Systems Review I • USMLE Step 1 Recall: Buzzwords for Boards • Rypins' Basic Sciences Review • Kaplan USMLE Step 1 Home Study Program • Rapid Review Series: USMLE Step 1 • Deja Review: USMLE Step 1 Essentials • Cracking the Boards: USMLE Step 1 • Board Simulator: Normal and Abnormal Processes • Laughing Your Way to Passing the USMLE • Step-Up • BSS: General Principles in the Basic Sciences • Rypins' Q&A for Basic Sciences Review • Blueprints Q&A USMLE Step 1 • PreTest: Clinical Vignettes USMLE Step 1 • USMLE Step 1 Made Ridiculously Simple • PreTest Self-Assessment and Review • Rapid Preparation for the USMLE Step 1 • Lange Practice Tests for the USMLE Step 1 • Research & Education Assn: USMLE Step 1 • Lange Q&A: USMLE Step 1 • Appleton & Lange Outline Review for USMLE Step 1 Laughing Your Way to Passing the USMLE

35. Strategies for SuccessStudy Strategy: Study Smart, Not Hard • You can’t know everything! • Ask yourself, at this point in your career: • What is vital information? • What is recall information? • What is “forget it” information?

36. Strategies for Success Study Strategy: Study Smart, Not Hard • Be an active learner • Use visual elements where possible • Pick out relevant information • Look for overlaps between subject areas • Write questions rather than notes • Use study groups… wisely! • Assess – study – reassess

37. Strategies for SuccessTest-Taking Skills:Practice Exams • NBME Comprehensive Basic Science Exams (free) – this spring, before and after the Transition Block

38. Strategies for SuccessTest-Taking Skills:Practice Exams • USMLE Step 1 Orientation and Practice Materials • http://www.usmle.org/Orientation/2009/menu.html • The software has over 100 practice test items and a software tutorial • Cost = Free

39. Strategies for SuccessTest-Taking Skills:Practice Exams • USMLE – Computer Based Testing (CBT) practice session at the Prometric Test Center • https://apps.nbme.org/CBTPSRegistrationWeb/jsp/usmle_CBTPS_registration.jsp • The Practice Session is a maximum of 3.5 hours and is divided into three 1-hour blocks of 50 multiple-choice test items each. • When you complete the session, you will receive a printed percent correct score • Cost = $42

40. Strategies for SuccessTest-Taking Skills:Practice Exams • University of Missouri - Kansas City (UMKC) Computer Based Tests • http://www.umkc.edu/ipp/cbt.asp • Diagnostic Exams (2) = $45 each • The output from this test will assist in pinpointing weaknesses and strengths as you prepare for the exam • Mock Board Cost = $45 • Seven blocks, 50 questions per block, timed exam • Provides a realistic day of testing. The test, once begun, requires up to eight hours for completion, just like the USMLE • A comprehensive diagnostic report is produced to help the student focus his or her study time for maximum effectiveness

41. Strategies for SuccessTest-Taking Skills: Practice Exams • NBME - Comprehensive Basic Science Self-Assessment http://www.nbme.org/programs-services/medical-students/sas/index.html • Standard-Paced: four sections, 50 items each, up to one hour to complete each section • Self-Paced: four sections, 50 items each, up to four hours to complete each section • Immediate feedback, profiles indicate relative strengths and weaknesses • Profiles similar to those Step 1 candidates receive • Score interpretation guide provides approximate Step 1 corresponding total score to assessment score • Cost = $45

42. Strategies for SuccessHandling “One best answer” questions • Read each question carefully and understand what is being asked. • Try to answer the question first, then look at the option list. • alternatively, read each option carefully and eliminate those that are clearly incorrect. • of the remaining options, select the one that is most correct. • If unsure about an answer… guess!!! • unanswered questions are automatically counted as wrong answers.

43. Strategies for SuccessHandling “One best answer” questions • DON’T SKIP questions. If you don’t know it when you see it, you’re probably not going to get it later. • DON’T spend too much time on an individual question. • NEVER CHANGE your answer. • SCAN for trigger phrases or words. • GUESS consistently.

44. Strategies for SuccessPreparing for the Day of the Test • Decompress a few days before the exam • Check out the test center / confirm your test date • Get all of your papers in order • Get a good night’s rest

45. Risks for Failure • Consistently marginal / poor academic performance during the first two years of medical school • Prior history of problems with board type exams (MCAT, SAT). • Performing poorly on mock exams • Thinking you can’t fail • Thinking you can’t pass • Not putting in the time / effort to prepare.

46. Special Issues • The Seven Year rule • Testing accommodations • http://www.usmle.org/Test_Accommodations/test_accommodations.html • Irregular behavior • When things go wrong

47. Summary: Strategies for Success • Game Plan • Manage Time Wisely • Study smart, not hard! • Manage resources • Practice, practice, practice • Take care of yourself

48. USMLE Step 1 Mean Scores: 2004 - 2008

49. USMLE Step 1 Pass Rates 2004 - 2008

50. YOU CAN DO IT!