A lot has transpired these past few weeks.
I've studied very hard for and I have taken the USMLE Step 1. Contrary to popular belief, it really wasn't that difficult. When compared to the difficult subject matter and questions asked in question banks offered by Kaplan and USMLE World, the USMLE was a cake walk. Sure, there were some obscure things that I didn't know, but I figure that's always the case and I don't beat myself up over it. The real trick in the pursuing the answers in the sample question banks is finding the patterns. Learning WHAT is important -- recognizing it, predicting the answers and selecting the right one and then -- immediately moving on.
One of my classmates was thrilled about finally getting to the good stuff. "This is what the entire first two years of medical school should be like! None of this 'PBL' BS" he exclaimed to me (on multiple, multiple occasions!) By that, he meant something along the lines of: insane study schedules, insular learning (people rarely met in study groups except to 'pimp' each other on random facts, do question after question after question after question....
Yikes! I sometimes felt as though I were half-assing it. I didn't study as hard as some of my dedicated colleagues, as I would wake up around 9am, eat a leisurely breakfast and googleread my blogs, have lunch and stroll into school around 1pm and do questions until I maxed out on my daily learning (my daily max was around 150.) I spent extra time reviewing ALL of my answers, trying to decipher why each answer was selected by the writers and a possibility. Sometimes this schedule would take me to 2am. Sometimes just 7pm and I'd go have dinner with a friend. Regardless, it was a relatively "easy" life of studying, after the rigor of Unit 4 (where I routinely studied until 2am EVERY DAY for four months straight.)
There's two basic methods in approaching the Step 1.
1) Study very hard to memorize facts and vocabulary to the point of reflexive recall between two seemingingly nonsense words i.e. cough=captopril, pigeons=cryptococcus, odds ratio=case control.
2) Love medicine and learn it.
I took the second approach for the most part. Over the past two years, I've spent a lot of my free time acquiring links to different blogs and websites that inform me about medicine. I've shared my silliest mnemonics with my study groups and I've taken extra time to truly learn the learning issues from our paper cases. For a while, I studied for the boards just by reading the old cases and thinking about them. It was a helpful exercise, especially on the physiology heavy subjects like cardiology, pulmonology and nephrology.
I found that I didn't have to learn very much new material during my studying for the boards. Most of it I had already learned along the way in our Problem-Based Learning curriculum.
There's a lot more that I'd like to say, but I would prefer to show examples along the way in an upcoming series of entries. If you want to just get a high-yield version of my message, it's this: make everything relevant to your learning. Engage yourself. Most importantly, learn about learning. The more you understand heuristics, algorithms and cognitive processes, the more powerful your pattern recognition and fact recall will be.