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re: Calling MD's/Med Students

Posted on 7/21/16 at 5:00 pm to
Posted by Hopeful Doc
Member since Sep 2010
15053 posts
Posted on 7/21/16 at 5:00 pm to
quote:

Tell her to just keep on taking the exam. I know several lawyers that took the bar 3-4 times before they passed.


You can't get a license in Louisiana if you fail any part of the step exam 3 times or more.
Posted by Patron Saint
Member since Jul 2013
4195 posts
Posted on 7/21/16 at 5:01 pm to
She needs to seriously evaluate her study methods. First, she needs to be dedicating the time to studying for Step 1. If she isn't studying at least 8 hours a day for 6 weeks (probably longer since she failed twice), then she's not spending enough time studying. The USMLE Step 1 exam contains a massive amount of information that can't be learned/reviewed in a short period of time. There are no shortcuts.

Second, did she do well in her pre-clinical courses (first two years of medical school)? If she didn't learn the information well the first time, then it will be nearly impossible to do well on Step 1 because you need a good foundation of knowledge.

Third, she needs to make sure she is using the right study materials. Different people prefer different study materials, but you have to narrow your focus and use only 2-3 different sources and learn those sources forwards and backwards. The current Holy Trinity for Step 1 studying is First Aid (a review book), UWorld (a question bank), and Pathoma (vidoes plus workbook).

Everyone uses UWorld because it's over 2300 questions that are similar to the real exam. If it doesn't take a minimum of two hours to go through a block of 45ish questions, then she's doing it wrong. She needs to read over the explanation to every single question whether she got it right or wrong, probably while annotating in her First Aid book.

She should also be doing the NBME practice exams. Most people do these and it gives you a good idea of where you stand before taking the actual Step 1 exam.

This is a long post and doing all of these things will take a long time and a ton of work, but Step 1 is a brutal test that most people spend weeks/months preparing for.

Also, as others have said, she needs to absolutely kill her rotations and do well on Steps 2 and 3, and even then will likely need to apply very broadly for non-competitive residencies/preliminary positions.
Posted by Patron Saint
Member since Jul 2013
4195 posts
Posted on 7/21/16 at 5:03 pm to
quote:

Doing some reading on the USMLE. Holy shite that sounds brutal.



It is probably the hardest test in American education. Eight hours of pure misery and you have to basically speed read the entire test to have a chance of finishing each section on time. That's not to mention the ridiculous amount of time and stress spent studying for it. And then the test itself costs over $600 plus probably another at least $300 on study materials.
Posted by KarlMalonesFlipPhone
Member since Sep 2015
3848 posts
Posted on 7/21/16 at 5:04 pm to
quote:

She should also be doing the NBME practice exams. Most people do these and it gives you a good idea of where you stand before taking the actual Step 1 exam.


This, and it's something so many people neglect. I did every single one available for step 1 and step 2 and both times, my average score from all the tests was the exact score I got on the real deal.
Posted by Lokistale
Member since Aug 2013
1200 posts
Posted on 7/21/16 at 5:06 pm to
quote:

My girlfriend just failed the 1st step exam


OK... the step exams must have changed since I took them about 20 years ago. I thought that the Step 1 exam was given between 2nd and 3rd year in med school. In my program, you were not allow to progress to 3rd year without passing to exam.

So you must be talking about her 3rd year rotations and not her residency after she graduates from med school (she'll have to pass Step 2 to qualify for most US residency programs).

Well, the answer is simple... she need to pass the Step 1 exam first before any scenarios about 3rd year rotations can even be discussed.

I think for a med student from a Caribbean school... only certain US medical schools will allow them to do rotations in their programs because she is still basically a student and can only go to a teaching hospital...
This post was edited on 7/21/16 at 5:08 pm
Posted by Hopeful Doc
Member since Sep 2010
15053 posts
Posted on 7/21/16 at 5:11 pm to
quote:

But, I agree with the rest of your post. I don't have much memory of preparing for Step 2 or 3, but I have vivid memories of how I studied 12 hours a day for Step 1.

Step 1- I studied 12-16h/d for 4.5 weeks. I took 4 separate 4 hour practice exams.
Step 2CK- I read 1/2 of "Step 2 Secrets," did about 30% of qbank. Total time spent was the hours leaving the park at Disney World until I fell asleep for a week plus about another 3 days total.
Step 2 CS- I studied for however long the car ride from New Orleans to Houston is.
Step 3- I just took. I did 600 questions and about 12 of the cases. Grand total of about 8 days of really studying.
Posted by Patron Saint
Member since Jul 2013
4195 posts
Posted on 7/21/16 at 5:11 pm to
quote:

I did every single one available for step 1 and step 2 and both times, my average score from all the tests was the exact score I got on the real deal.


I can't remember how I did on the NBME for Step 2, but for Step 1 I took the last NBME a week before the real thing and got the exact same score on the real Step 1.

Also, she needs to review every question she misses on the NBME. You can usually find people discussing the question you miss by just googling the exact question.

The NBME is not only valuable because it provides an additional review of knowledge, but because it uses the exact same software as the real test (so you are familiar with the testing software on test day, which is very important for you sense of comfort and for speed). It's also good for working on your timing as far as finishing sections of the test.
Posted by Patron Saint
Member since Jul 2013
4195 posts
Posted on 7/21/16 at 5:13 pm to
Do you know how you did on Step 3? I'm currently preparing for it also and wondering how exactly to prepare. Harder to find info about good test prep compared to Step 1.
Posted by CrimsonTideMD
Member since Dec 2010
6925 posts
Posted on 7/21/16 at 5:28 pm to
quote:

The current Holy Trinity for Step 1 studying is First Aid (a review book), UWorld (a question bank), and Pathoma (vidoes plus workbook).



This right here.

Earlier I mentioned "Crush Step 1"; my mistake. It's been a few years for me.

Crush was ok, but First Aid is by and far the best review book.

My advice remains the same: she needs to memorize that book.

Posted by Yellerhammer5
Member since Oct 2012
10854 posts
Posted on 7/21/16 at 5:43 pm to
For step 3, uworld is probably enough. First aid for step 3 is fine if you need something extra. I studied about 2 weeks for it and passed easily.

The important thing for step 3 now is to understand how the CCS case software works. Uworld works for this and there are some sample cases through the USMLE c
This post was edited on 7/21/16 at 5:46 pm
Posted by LSU alum wannabe
Katy, TX
Member since Jan 2004
27053 posts
Posted on 7/21/16 at 5:53 pm to
So as a nurse I gather from this thread that IM and Psych are the shite programs and fields to be in?

I assumed IM as those guys here in Houston always seem to look 26 years old and just in a 5th year of residency. Also, always seem to be in large groups?

Worked like a dog by a hospital or the guy over the practice?

Psych just seems to suck to me because it is psych?


What are the impossible residencies to get into? I assume plastics? CT Surgery? But it's only an assumption. Then ER and rad for the flexibility of leaving the job at the hospital.
Posted by Yellerhammer5
Member since Oct 2012
10854 posts
Posted on 7/21/16 at 5:58 pm to
quote:

So as a nurse I gather from this thread that IM and Psych are the shite programs and fields to be in?



IM isn't a bad field and a ton of doctors go into it. Psych actually has one of the best $/hr ratios in medicine, but it doesn't appeal to most people. These fields are mostly less competitive because there are tons of spots, not because the job sucks.

EM is a cool field right now, but the competitiveness of fields varies over time. fields like cv and neuro surgery are always competitive.
This post was edited on 7/21/16 at 6:00 pm
Posted by Breauxsif
Member since May 2012
22290 posts
Posted on 7/21/16 at 5:58 pm to
False. NY, CT and Mass was the hardest bar exams in the US.
Posted by Patron Saint
Member since Jul 2013
4195 posts
Posted on 7/21/16 at 6:00 pm to
quote:

So as a nurse I gather from this thread that IM and Psych are the shite programs and fields to be in?


It's an over generalization but primary care fields have more spots nationally so a shitty program is easier to get into. There are still good programs, and some incredibly smart people go into IM (same for psych).

quote:

seem to look 26 years old and just in a 5th year of residency. Also, always seem to be in large groups?


26 is pretty much the minimum age for graduating medical school. They're in large groups because that group probably includes medical students, intern, resident, and attending.


quote:

What are the impossible residencies to get into?

The most competitive ones tend to be orthopedics, plastics, dermatology, and ophthalmology.
Posted by Cosmo
glassman's guest house
Member since Oct 2003
120679 posts
Posted on 7/21/16 at 6:05 pm to
I guess Im the only one that didnt find the usmle bad.

If you are a good test taker you will do fine. Some people are just shitty test takers.
Posted by CrimsonTideMD
Member since Dec 2010
6925 posts
Posted on 7/21/16 at 6:07 pm to
quote:

The most competitive ones tend to be orthopedics, plastics, dermatology, and ophthalmology.




Add RadOnc and that's a solid list
Posted by LSU alum wannabe
Katy, TX
Member since Jan 2004
27053 posts
Posted on 7/21/16 at 6:10 pm to
quote:

ophthalmology.



LASIK baby.

Orthopedic I forgot, but yes. A few of those established orthopod make major cash. Cranking out hips and knees like a cabinet factory.

Still have one in west Houston area that is old school. Abusive to staff. Throws trays!?

He'd get one tray past me. The next would be returned with velocity and I'd aim for that frickers hands or eyes.
Posted by Jizzy08
Member since Aug 2008
11266 posts
Posted on 7/21/16 at 6:13 pm to
Don't judge IM too harshly. To be a cardiologist or gastroenterologist, you have to do IM residency first. Plenty of extremely smart people choose to go into IM because of the fellowships alone.
Posted by MrSpock
Member since Sep 2015
4378 posts
Posted on 7/21/16 at 6:14 pm to
quote:

So as a nurse I gather from this thread that IM and Psych are the shite programs and fields to be in?


While this is generally true IM is a necessary step for Cardiology, Gastroenterology, Hem/Onc and IM is full of people who could have gone into anything they wanted.

quote:

What are the impossible residencies to get into? I assume plastics? CT Surgery? But it's only an assumption. Then ER and rad for the flexibility of leaving the job at the hospital.



Integrated Plastics and Integrated Vascular are probably the most impossible because there are so few spots. But, matching IM at a top ten program is just as difficult as either of those specialties.
This post was edited on 7/21/16 at 6:17 pm
Posted by MrSpock
Member since Sep 2015
4378 posts
Posted on 7/21/16 at 6:16 pm to
quote:

Don't judge IM too harshly. To be a cardiologist or gastroenterologist, you have to do IM residency first. Plenty of extremely smart people choose to go into IM because of the fellowships alone.


Correct. IM has the most people who were AOA and 250+ on Step 1 among its ranks.
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