Over the past 10 years, student stress associated with USMLE Step exams has definitely increased! This post covers recommendations for Step 1. It is a little longer than usual, but please take the time to read through it, especially if you are in Years 1 and 2. For students in Years 3 and 4, this is a great place to make comments and suggestions to benefit your classmates. A future post is coming about Step 2.

There are several resources to consider when preparing for Step 1:

USMLE World Question Bank:  This nearly 2000-question bank has been recognized by TTUHSC students as the most useful resource while preparing for Step 1.  The SOM has provided the UWorld QBank to students for approximately 8 years, increasing the length of the subscription from 9 to 12 months in 2013. Based on results of student surveys, those who perform the strongest on Step 1 have completed the question bank at least twice before taking the exam.

Scheduling Apps: It is critical that students successfully balance completing the Year 2 curriculum with preparing for USMLE Step 1.
Scheduling apps are available (e.g., USMLExcellence or Cram Fighter)
that provide guidelines on appropriate numbers of questions to complete during times when classes are in session and then in the 4-6 weeks recommended for focused preparation for the exam.

Pathoma™: Pathoma™ covers fundamentals of clinical pathology.  Students in the Class of 2015 identified Pathoma™ as a vital supplement to preparing for Step 1, and the school decided to provide all Year 2 students with complimentary access beginning in 2013. Block Directors are given subscriptions and are currently developing methods for fully incorporating the content of the Pathoma™ review course into the curriculum.

Practice Exams: Step 1 practice exams can make a big difference in a student’s outcomes. The Comprehensive Basic Science Examination helps prepare students and gives an accurate picture of how ready one is to take the exam.The CBSE is currently offered four times during the MS2 year.

• CBSE0 – Offered in October at the end of the first block of the year. This allows students to complete the exam and gain experience by reading and answering the complex (and sometimes long) questions characteristic of Step 1.
• CBSE1 – Offered in March at the end of the third block of the year.  The EPC has determined that a score on the CBSE that corresponds to a passing score on Step 1 (+ the standard error of measurement of the exam) should be sufficient for approval to take Step 1.  Currently that score is 70. About 30% of the class has achieved this goal on CBSE1 over the past three years.
• CBSE 2 and 3 – Offered in May and June respectively with the vast majority of students achieving the requisite score on one of these attempts.  Over the past several years, greater than 98% of students who achieved the requisite score successfully passed Step 1 at the first attempt.
• Students who fail to achieve the requisite score after CBSE3 receive individualized advising on appropriate methods to proceed, which may include the use of commercial prep courses (such as Doctors in Training) and/or a delay to starting Year 3.

Personal Tutors: The Office of Student Affairs offers a tutoring program working with upper level students to help identify needed improvement areas. Tutors are paid a stipend by the school in acknowledgement of their support of the educational mission of the school. Any student who would like to either obtain a tutor or serve as a tutor should contact Allison Perrin in the Office of Student Affairs at allison.perrin@ttuhsc.edu.

Additional Resources: The school does not currently have specific recommendations for the use of commercial preparatory courses (such as Doctors in Training or Falcon Review) as part of a general approach to Step 1 preparation.  These types of programs were used by approximately 40% of the most recent class prior to taking Step 1, and students rated these prep courses as fourth place in terms of their value in studying for Step 1 (after UWorld, First Aid, and Pathoma™).  In addition, students have used many other resources, including Picmonic and Firecracker to name just two, in preparing for Step 1.  The utility of these resources is likely to depend on personal preferences, and students are advised to carefully screen their available resources and attempt to keep the number of unique resources to a minimum.