How to Prepare for the USMLE: Setting a Schedule

January 9, 2007

How do you set a schedule? Well, how much time do you have?

For the US medical student, I think 5-7 weeks is the standard break from last class to next, and it’s in this time that they have to prepare. Of course, knowing this heading in means you can start reviewing material during your regular classes, but I think most just put it off. In the Caribbean (with SGU at least) it’s a little different.

As a January student, I’m off from Dec 17th (end of 6th term) till the beginning of my clinical rotations (end of May). For those counting at home, that’s 5 months. This should sound like 3 months too long for even the most dedicated, and it is. If you’re in the position where you need to cram information for the Boards (which describes most of us) then whatever you crammed weeks ago has fallen out well before that week when you need it.

The courses that are set up to prepare you seem to know this already. Kaplan’s program takes place over 6 weeks and they recommend taking one week off between the end of the course and the USMLE to conduct a “rapid review” of the most high-yield material (whatever that is at the end of two years). Talk to the people that have gotten antsy and delayed the test for an extra two weeks after the course and most of them will tell you that it was a mistake. So let’s believe them and not repeat it.

My plan was to relocate to Cincinnati where I knew no one, stay with my medical school roommate, and live in a library from Jan 4th until test day, March 14th. That comes to one day shy of 10 weeks, or 70 days (compare against 48 days for the average US student). To keep our sanity, we’re taking one full day off each week, bringing us down to 60 days. To build confidence, we’re finishing all material one week before the test to leave one week of “rapid review.” So with roughly 54 actual days of covering material, we had to figure how to divide it.

As always, I decided to fall on the First Aid for the USMLE. In the 2007 edition, everything has been rearranged. The second half of the book takes a systems-based approach, incorporating anatomy, physiology, pathology and relevant pharmacology into each. This is a completely alien way of learning for me as SGU is subject-based, and I decided to try something knew if only to make old information new again. The first half of the book contains the fundamental concepts like biochemistry, biostatistics, pharmacokinetics, and other things that didn’t fit neatly into a system. After some back and forth, we decided to weight each subject according to the First Aid, down to the last page.

I counted every page in each section (omitting title pages, vignettes, etc) to get to the meat. I took the total number of pages (329) and divided them by my total number of days (54) to find that 6 pages each day was a good pace. In certain places I added or subtracted a day to reflect how weak/strong I felt in a subject, but for the most part I stuck to it. You can do the same calculation with however many days you have. These were my page counts per section with days allotted in parentheses:

First Half – 146 pages (26days)

  • Behavioral/Biostatistics – 13 (2/1)
  • Biochemistry/Molecular – 41 (5/2)
  • Embryology – 8 (2)
  • Microbiology – 47 (8)
  • Immunology – 14 (2)
  • Pathology (neoplasia and inflammation) – 7 (1)
  • Pharm (kinetics and dynamics) – 16 (3)

Second Half – 183 pages (33 days)

  • Cardiovascular – 27 (5)
  • Endocrine – 14 (2)
  • Gastrointestinal – 24 (4)
  • HemeOnc – 18 (3)
  • Musculoskeletal – 16 (3)
  • Neurology – 31 (6)
  • Psychiatry – 13 (3)
  • Renal – 16 (3)
  • Reproduction – 13 (2)
  • Respiratory – 11 (2)

We ended up going over our allowance and eating into some of our days off. If we stay on our original pace, we will earn those days back as reward, and I would rather earn a day off then lose a day to falling behind (perspective is so important). My schedule is available on Google Calendars (for those that are curious) as “USMLE Step 1 (topher).”

For those still couting at home, that leaves 9 weeks off between the Boards and clinicals in New York. What should you do with this time? You could always piss it away, or you could take the money you saved by not taking a Kaplan course and travel Asia/Africa/Europe/S.America for 6 weeks. Your choice.

Return to USMLE Step 1 page.

Welcome to Grenada, A Student’s Guide for Students

December 4, 2006

I have been silent in this space for a little while now but I have not been lazy. The end of my first two years is 10 days away and I will soon leave the Caribbean for a permanent place back home in the US. I have taken a comprehensive diagnostic test of my skills clinically and academically (both in-house) and I just returned from a trip to Grenada to finish work on a two-year project of mine. These are exciting times.

I’m incredibly proud of the work that’s now over. Coming in at 11,000 words, it’s about as long as an Atul Gawande article with about 1/11,000 of the readership.

Welcome to Grenada, A Student’s Guide for Students” began in April of 2005 as a seven-page introduction to your new life on the island. It has since swelled to include information and advice for the first two years of island living. With our fingers crossed, we hope it eventually has information for the clinical years, interviewing for residency, and a guide to the match (with specifics for FMGs).

The editors believe in the power of honesty. If I told you that everything was perfect, would you believe anything I said? With that in mind, we hope you find our honest take on attending Saint George’s University to be helpful and that by showing you the rust you will appreciate the shine. For more on why we wrote this and our general mission statement, please read the Letter From the Editors.

And with that, I am exhausted. A lot has happened and the telling will all have to wait until I’m sipping egg nog, wearing a ridiculous sweater, and enjoying being the tannest man in the room.

Happy Holidays, topher.