Needed a ten minute break to recover… and eat a Clif Bar

This was definitely the most difficult section for me.

Section 3: 60 minutes – a couple HIV-related questions were the bane of my existence.

Section 2: 40 minutes – five minute break afterwards.

At the end of the section, I would quickly go back through and remind myself why I picked each answer and rework every calculation (sensitivity, positive predictive values, Hardy-Weinberg, etc.) This actually saved me from committing a silly mistake (0.25% is not 0.25, it’s 0.0025). My plan was to do all the questions straight through. Remaining time will automatically be added to your break time if you finish early. There are 8 hours to finish seven, 1-hour long sections. There are two timers – one for the current section and another with the overall day timing. My advice is to focus on First Aid and do thousands of questions (UWorld + NBMEs first). Between First Aid and UWorld alone, the exam was manageable however, Goljan’s high yields definitely helped me on a few questions, and some questions were very reminiscent of the NBMEs I completed. In preparation for Step 1, I used First Aid, USMLE World Question bank, NBMEs 1-7 + any questions people posted on forums, BRS Physio, chapters 1-7 of Robbins, and good ‘ol Papi Goljan. I had 5-6 questions which required headphones (heart auscultation) and less than ten questions which required calculations (mostly epidemiology). There were some epidemiological graphs which I had difficulty interpreting, but the radiographic images, gross specimens, and path slides were fair. The test had more immunology and musculoskeletal than I was expecting but less biochemistry. The rest were standard, NBME-type questions. A handful were topics I had never reviewed in detail (the specific constituents of the P450 system… like CYP3A4). USMLE Step 1 has 322 multiple choice questions – I would say about 1/3rd were “gimmies” (straight from First Aid, Goljan, and UWorld). Why my brain chose to sacrifice precious sleep the night before this exam is beyond me.

It’s like I was consciously consolidating information my heart was racing and I had a horrible headache. After midnight, my mind was racing with everything I learned over the last few weeks. The night before the exam, I slept a total of 2-3 hours.

Goljan high yield notes 100 pages