当前在线人数14274
首页 - 博客首页 - 美国医学教育博客 - 文章阅读 [博客首页] [首页]
chihpengc: Step 1 成績出爐: 276/99
作者:USMedEdu
发表时间:2009-01-21
更新时间:2009-01-21
浏览:2370次
评论:0篇
地址:10.
::: 栏目 :::
现代医学vs“中医”
社会、艺术与医学
住院/FELLOW单位
中外医学网站精选
国内外医学交流信息
生物医学人物
力刀美加医学教育专
临床见习/实习/义工
医学生理学诺贝尔奖
医生助理(PA)职业
医学书籍照片及图谱
社会与医学瞬间定格
医学典故/医史杂谈
USMLE复习和考试
申请和面试住院医生
住院医生生活和工作
FELLOWSHIP
医生就业、工作及生
医学科普及问题解答
美加医学院申请/MCA
中美医学临床教育比
医学新进展及新闻
社会医学伦理

发信人: chihpengc (Pollux), 信区: MedicalCareer
标 题: Step 1 成績出爐: 276/99
发信站: BBS 未名空间站 (Wed Jan 21 15:07:37 2009)

USMLE Step 1 score: 276/99

考前目标: 250+
准备时间: 约一千个小时

目前就读於澳洲昆士兰大学的医学系,刚升上四年级。
以下是我NBME模拟考试的分数。NBME1 和 NBME2 是下载版,其馀是付费上线做的。
NBME 1: 258 (考前九个月)
NBME 2: 261 (考前两个月)
NBME 6: 262 (考前二十五天)
UW 1: 265+ (考前十五天)
NBME 3: 265+ (考前八天)
NBME 4: 265+ (考前六天)
UW 2: 265+ (考前四天)
NBME 5: 265+ (考前二天)
USMLE CD: 96% (考前一天)

深觉得题海战术还是很重要的,我做了超过一万题的练习题。
USMLERx: 94%
Kaplan Qbank: 91%
First Aid Q&A step 1: 93%
UW: 88% (Random, unused, first time through)
Plus NBME + UW exams + USMLE CD + RR Goljan...

准备材料:
首推 FA,说它是应考圣经真是一点也不为过。我从头到尾读了大概有三丶四次,但我
在看其他书时常常也会对照 FA 里的解说。上课上到相关知识点时,我也会拿它出来翻
阅对照,往往已经熟到不用查书尾索引都可以找到东西的地步了。而在作练习题的时候
,我也会把重要的资讯写在 FA 上面。我建议在平常阅读时要特别注意书里的 diagram
/table/metabolic pathway ,最好是能熟悉到不用看书就能默写下来的程度。FA里面
的 mnemonics 也是建议尽量多背下来。
Anatomy: Kaplan notes & Kaplan webprep, USMLE Road Map Anatomy, HY
Neuroanatomy.
Behavioural science: Kaplan notes & Kaplan webprep.
Biochemistry: Kaplan notes & Kaplan webprep.
Cell biology: HY Cell and molecular biology.
Microbiology: Kaplan notes & Kaplan webprep, Micro Made Ridiculously Simple,
MicroCards.
Immunology: Kaplan notes & FA.
Pharmacology: Kaplan notes & Kaplan webprep, HY Pharm, Pharmacology Flash
Cards (Brenner).
Physiology: Kaplan notes, BRS Physiology.
Pathology: BRS Pathology, Goljan audio, Goljan notes.

准备过程:
原来计画像美国的学生,在升第三年的暑假就把第一阶段考完的,无奈只有一个月的时
间,自觉得准备得不够充裕,所以延後一年再考。当初还痴心妄想可以一边做
clinical rotation 一边准备考试,等到第三年开始时,发现时间精力光是应付学校的
课业都不够用,更别谈准备考版了。除了在轮转乡村医学科和精神科时闲暇时间稍微多
些,才勉强能排出来准备考试,但顶多也就是放学回家时花一两个小时做些练习题而已
,只有在周末的时候才能专心的学习。一直到十一月底第三年的课程结束,我才有时间
全职应付考版。

在医学院第二年时,我的目标就是把 BRS Pathology 背得滚瓜烂熟。我别的不会,就
是会背。一方面我很喜欢病理学,所以不以为苦;另一方面,我跟我的室友喜欢从 BRS
出题互考对方,以刁钻题目考倒对方为乐,久而久之整本书就这麽背下来了。这本书
也为我後来听 Goljan 课程打下了良好的基础。Goljan 我也是翻来倒去的一听再听,
足足听到他老人家讲的笑话我都会背了,不过我还是极力推崇他上课的内容,每次听都
有新的体悟。

2007 年十二月 - 我花了一个月的时间把 Kaplan notes 全部读完,同时也读完了
Goljan notes for general pathology and systemic pathology。每天大约是花八到
十个小时读书。

2008 年一月到十一月期间 - 因为学校课程的关系,我并没有太多的时间来准备考试。
三月时心血来潮,想评估一下自己准备的状况,所以做了 NBME1,没想到跌破眼镜拿了
个 258(720),心里还挺得意的,觉得十二月那一整个月的辛苦是值得的。但接下来水
深火热的日子并没有很多时间让我好好继续加强,只有其中四个月的时间比较有空,周
末时能够拨出时间学习,平均一周大概读两十五个小时。在这四个月之内,我读了一些
复习用的书,像是 High-Yield 和 Road Map 之类的,深觉得这些书还是在後期使用的
效果比较好,尤其是读完 Kaplan Notes 之後,很多之前觉得困难的知识点已经变得耳
熟能详,这时再看 High-Yield 和 FA 才是事半功倍。我在上下学搭公交车时特爱拿
Kaplan Webprep 出来听,觉得这教材真是好,一科才讲八小时,没有废话,字字珠矶
。尤其是生化和药理,听完有如打通任督二脉,再搭配上 FA 里的图解一同理解记忆效
果更佳。同时我开始着手作题,每天至少作一百题,从未间断。

2008 年十二月 - 最後冲刺阶段,作了其馀的 NBMEs 以及 UW assessment exams。又
把 UW question bank 拿来做了一遍。最後一周,早上作题,晚上背 FA 宝典,下午精
神不济时就去健身房跑个步,回家洗个澡重新开始。这段时间应该是最辛苦的阶段,但
是现在回想起来一切都是值得的。

2008/12/26 考试:

考试前天晚上其实并没有睡得很好,一方面心理压力大,另一方面是好死不死有蚊子骚
扰。大概迷迷糊糊睡了五个小时,心想其实也不错了,想当年考 MCAT 的前夜连三个小
时都没睡到呢。

八点半进考场,四点钟考完,休息时间尚有二十分钟。我勉励自己,经历过一万题模拟
试题的无情磨练,区区三百三十六题实在不算什麽。我每个 block 平均花四十分钟作
题,五分钟检查有做记号的题目。多出来的十五分钟则全数被我拿来当休息时间,所以
我每个 block 作完都可以休息个二十分钟,吃点面包丶喝半瓶茶丶跑个厕所丶洗把脸
清醒清醒好继续挑战下个 block。我觉得做题时因为休息足够,所以并没有出现恍神或
者倦怠感,得以发挥平常的实力,这是我运气不错的地方。

考完试其实就觉得考得不错,知道没有意外估计应该是有 260,运气好的话上 270 也
是有可能。但毕竟 NBME 预测最高只有到 265+,所以我对 270 的困难度其实是没有什
麽概念的。昨天一整天上课完全心不在焉,只想着赶快下课查成绩,没想到 USMLE 还
真的是时间不到就不放榜,一直是到我这边半夜时成绩才出来。这下可好,我看到成绩
後还想睡得着吗,门儿都没有。现在是清晨六点了你看我还在做啥就知道了。

最後要衷心的谢谢医学职业版上诸位版友,我一直拿大家辉煌的成绩作为学习效法的对
象,很幸运这条路上有你们先走过,留下了宝贵的经验,不管你们是直接帮过我或间接
帮过我,我都很感谢。最後如果大家有任何疑问,随时欢迎你们 PM 给我或 email me
at [email protected],我会尽快答覆。之前承蒙大家不吝帮忙,希望我现在也能
够帮助到一些人。 :)
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 203.214.]





买美元?买欧元?网上体会货币买卖其中乐趣
09年元旦--情人节(2月14日),每天一束免费鲜花
南京航空航天大学诚聘海外杰出人才
西南交通大学期待海外优秀人才加盟


chihpengc

进入未名形象秀
我的博客
[回复文章] [回信给作者] [本篇全文] [进入讨论区] [返回顶部] [修改文章] [删除文章] [转寄] [转贴] [ 2 ]

发信人: chihpengc (Pollux), 信区: MedicalCareer
标 题: Re: Step 1 成績出爐: 276/99
发信站: BBS 未名空间站 (Wed Jan 21 15:09:07 2009)

再贴上之前写的考试经验供大家对照。


整体来讲,难度大概介于NBME和UWorld之间。考前也作了UWorld Simulated Exam,觉
得这个题库难度大概是跟真正考试最接近的。还是老话一句,First Aid一定得读熟,
大概七成左右的知识点可以在FA里面找得到。有时候FA内容里面冷僻的知识点当初读的
时候觉得不重要,到头来竟然一个一个在考试上出现了。FA读透了再把UWorld作完且解
释仔细的看过一次,大概考试内容九成左右就可以掌握到了。

接下来分科解说一下:

病理:不意外的比重是所有科里最多的。起码七成的题目都是病理题或是需要
Pathology integration,例如把患者症状描述出来再问一些其它相关的知识点。基本
上这一类的题目UWorld cover得很好,所以没有什么出乎意料的题目出现。需要看
Gross pathology specimen的题目也没有想象中的多,大概有五题左右。

解剖:大概二十题左右,以MRI/CT为主,没有什么太冷僻的题目。光是膝盖附近的靱带
结构就考了两题,Brain CT以及Angiogram也各出了几题。Neuroanatomy占了很大比例。

行为医学:二十题左右,一半是Biostats,另一半则是给你一个状况要你答出 Which
one of the following is the best response/course of action。这个部份我觉得只
念FA并不是相当的够;UWorld里面类似的题目其实不错,只不过太少了些。FA的
Psychiatry section几乎是没有考出来,除了几题 Psychotropic medications以及
defense mechanism的题目。

生化:比重相当重,至少有五十题以上。尤其以Molecular Biology为最,算是占了刁
钻题目的大宗,光是Regulation of gene expression就出了很多题。偏题不少,例如
the effect of acetylation of histone on DNA transcription,就让我碰见了两题
。我在考前一个礼拜特别翻过High Yield Molecular Biology (1999),想起来起码多
赚了五题。Lysosomal storage disease里考了Hurler’s disease,另外连 I-cell 
disease也考了出来。Metabolism方面要特别注意 Insulin and glucagon’s effect
on metabolic pathways and their respective intracellular signaling pathways
(Insulin – tyrosine kinase; dephosphorylate enzymes. Glucagon – Gs and
CAMP; phosphorylates enzymes)。我觉得平常学习时看到Receptor and
intracellular pathways就得特别注意,像是G-protein coupled receptor非常的重要
,不过其它的也是fair game,像说 Cytokine receptor – JAK pathway也是考了出来。

药理:大概二十五题。还是以常见的药为主,没有什么太偏的题目,读完FA应该就绰绰
有余了。值得注意的是Pharmacodynamics,出了不少Competitive/noncompetitive
enzyme inhibitor及Receptor agonist/competitive antagonist/noncompetitive
antagonist/partial agonist的题目,需要把FA Pharmacology section的前面三页彻
底弄懂才行。Autonomic pharmacology题目也不少,典型的有the effect of various
sympathomimetics on BP and heart rate。

微免:算是我最有自信的一科,但是只有考出三十题左右。需要弄清楚various
exotoxins and their mechanisms of action,因为这种题还真的不少。TB/HIV的重要
性自然不在话下,也各出了不少题。我觉得比较偏的题,大概非West Nile莫属,还好
作NBME 6有看到这个病毒,所以还稍微查了一下相关信息,不然这题铁定爆掉。

生理:也考了三十题左右,主要还是那种上上下下的箭头题和Graph interpretation,
内分泌的题也考出来了不少。
--




因为最近很少以中文写作了,我不三不四的中文程度还请大家不要贻笑大方。同时附上
英文版,请大家自己挑个比较顺眼的版本看。


Step 1 score: 276/99

Initial goal: 250+
Total prep time: 1000 hours.

IMG at an Australian medical school (UQ); MCAT=38
NBME 1: 258 (9 months out)
NBME 2: 261 (2 months out)
NBME 6: 262 (25 days out)
UW 1: 265+ (15 days out)
NBME 3: 265+ (8 days out)
NBME 4: 265+ (6 days out)
UW 2: 265+ (4 days out)
NBME 5: 265+ (2 days out)
USMLE CD: 96% (1 day out)

I did over 10000 USMLE-style practice exam questions in the following order:
USMLERx: 94%
Kaplan Qbank: 91%
First Aid Q&A step 1: 93%
UW: 88% (Random, unused, first time through)
Plus NBME + UW exams + USMLE CD + RR Goljan...

Prep material:
FA of course!! I read it cover-to-cover 3 times. However, I tend to cross-
reference it when I read other books and I frequently consulted it during
second year during PBL. I also annotated notes in FA when I did UW, so I was
very familar with the content of this book. For every diagram/table/
metabolic pathway in FA, I made sure that they were familiar to the point
that I was able to to reproduce them from memory.
Anatomy: Kaplan notes & Kaplan webprep, USMLE Road Map Anatomy, HY
Neuroanatomy.
Behavioural science: Kaplan notes & Kaplan webprep.
Biochemistry: Kaplan notes & Kaplan webprep.
Cell biology: HY Cell and molecular biology.
Microbiology: Kaplan notes & Kaplan webprep, Micro Made Ridiculously Simple,
MicroCards.
Immunology: Kaplan notes & FA.
Pharmacology: Kaplan notes & Kaplan webprep, HY Pharm, Pharmacology Flash
Cards (Brenner).
Physiology: Kaplan notes, BRS Physiology.
Pathology: BRS Pathology, Goljan audio, Goljan notes.

Preparation timeline:
Probably quite atypical compared to most US medical students. I initially
intended to sit the exam at the beginning of third year, so I spent a month
studying after second year was over. At the end of the month, I didn't feel
quite ready and decided to postpone my exam till the end of third year,
thinking that I would have plenty of time to study during the clinical
rotations. Wrong. I only had some time during my rural rotation and
psychiatry rotation to study for USMLE, but could only manage to do 1-2hr/
day on weekdays and up to 8hr/day on weekends. At the end of third year, I
spent a month studying hardcore again, and finally took the exam on the 26th
of December. The Australian school year runs from January to November, by
the way.

During second year - Read BRS Pathology and pretty much memorized the book.
I love pathology so it wasn't really a daunting task for me. I also started
listening to Goljan audios in first year and I was really glad that I
started early. I finished Goljan audios at least three times, but I always
felt that I learned something new each time.

December 2007 - Finished reading Kaplan notes (all subjects except Path) and
Goljan notes for Path. 8-10hr/day. (300hr)

Jan - Nov 2008 - On and off. I did NBME1 in March and got 258(720) and was
pretty happy that reading Kaplan notes paid off. However, I had only about 4
months during this time (rural and psych) where I could fit USMLE studying
into my schedule, but could only manage to study about 25 hours a week.
During this time, I read the supplementary material (HY, Road Map, flash
cards), listened to Kaplan webprep while commuting, and did the majority of
the practice questions. (400hr)

December 2008 - Did most of the NBMEs and UW assessment exams in this month.
Completed UW question bank for the second time. Spent the last week just
memorizing FA and doing practice questions. 8-10hr/day. (300hr)

Exam on 2008/12/26:

I started the exam at 8:30 and finished at 4:00 with 20 minutes of break
time to spare. On average, I spent 45 minutes in each block and took a 20-
minute break after each block (except the first block). During each break, I
would drink 300mL of oolong tea or green tea to keep me awake, eat half a
sandwich, go to the washroom, and wash my face so I felt refreshed and ready
to tackle the next block. I thought the strategy worked quite well for me.

I thought the exam was quite a bit harder than NBME but easier than UW. It
was probably comparable to UW self-assessment exams in terms of difficulty.
I marked 6-7 questions each block. I thought 85% of the questions was
straight-forward, 10% was tricky, and 5% was difficult.

Pathology: Not surprisingly the bulk of the exam. Around 70% of the
questions were patholgy questions or required pathology integration. I
thought UW covered these sorts of questions really well, so there weren't
really any surprises for me. I only had around 5 questions that came with
pictures of gross pathology specimens.

Anatomy/neuroanatomy: 15 questions. Most of them involved intepretation of X
-rays/CT/MRIs, nothing too obscure. I even had brain CT and angiograms for
structure identification. Make sure you know the brain stem and cranial
nerves well.

Behavioral science: 20 questions. Half were biostatistics, and the other
half were the typical "what would be the best action/response in this
scenario" type of questions. I thought just reading FA or Kaplan notes was
not really sufficient to answer these sorts of questions. I had almost no
questions that came out of the psychiatry section in FA, except a few
psychotropic medications and a question on defense mechanisms.

Biochemistry/Cell bio/Molecular bio: Geez, I noticed the trend of increasing
proportions of cell biology questions in the NBME, but I never expected
this many on my exam. I probably had 50 questions that fell into this
category (Biochem/Cell bio). I was glad that I flipped through HY Cell and
Molecular biology just a few days before the exam, because it probably
helped me answer 5 questions correctly. The different kinds of receptors and
intracellular signalling pathways are extremely high-yield. For metabolism,
know the key regulatory enzymes and global control of metabolic processes (
i.e. insulin vs glucagon's effects).

Pharmacology: Around 25 questions. Piece of cake compared to UW. I thought
FA covers pharmacology in sufficient details. As usual, emphasis was placed
on autonomic pharmacology and cardiovascular medications. I had quite a few
questions on pharmacodynamics too.

Microbiology: 30 questions. Make sure you know the various bacterial
exotoxins and their mechanisms of action. Quite a few questions involved TB
and HIV. Even West Nile virus appeared on my exam.

Physiology: 30 questions. Most involved the up/down arrows and graph
interpretation. Endocrine questions are high-yield too.

I walked out of the testing centre feeling quite confident I did pretty well
. I was certain I broke 260, but wasn't too sure if I was able to get 270+.
Got the score today, 276/99! I didn't even know it was possible! Needless to
say, I was ecstatic!!

--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 203.214.]

[上一篇] [下一篇] [发表评论] [写信问候] [收藏] [举报] 
 
暂无评论
 
用户名: 密码:
发表评论
评论:
[返回顶部] [刷新]  [给USMedEdu写信]  [美国医学教育博客首页] [博客首页] [BBS 未名空间站]
 
Site Map - Contact Us - Terms and Conditions - Privacy Policy

版权所有BBS 未名空间站(mitbbs.com) since 1996