How I Studied for My Step I

This is one of my most frequently asked questions via email & DMs. I thought it would be helpful to have a dedicated blog post on the topic so that people can refer to it whenever if needed! So here is an overview of how I studied for Step 1. I hope it’s helpful! (If you want general information on how I studied during first two years of medical school, it's here)

First, let's start with the overall schedule. I basically worked with my school's board exam prep office to come up with a list of all the topics for Step 1 & assigned the number of days I thought I needed for each topic. I have a video with all the resources I was using for Step I + an overview of my 6-week study schedule here. Here's an example schedule (46 days total):

Cardio- 4 days
Pulm- 2 days
Renal- 3 days
Neuro/psych- 3 days
Biochem- 2 days
Immuno- 2 days
Heme/onc- 2 days
Endo/Repro- 2 days
GI- 3 days
MSK- 2 daysPathology- 1 day
Pharmacology (principles)- 1 day
Micro- 3 days spread throughout 6 weeks

*Each system based topic was broken down into embryology, physiology, pathology, pharmacology + extra materials as needed 

NBME (practice exams)- forgot how many are available but one day dedicated to doing each NBME + going over the wrong questions. Helpful to do this with a friend so you can talk out difficult questions

Question days- At least 4-5 days dedicated to just doing UWorld Questions the week before exam day

Rest days- I took 1 full day off during 6 weeks & 1/2 day off per week to relax, go to church on Sundays, etc. Half day off often ended up becoming 3/4 towards the end of the study period and you should try to account for feeling burnt out.  

Special note about pharmacology & microbiology:
Pharm: I covered relevant pharmacology within each topic (e.g. cardio drugs during cardiology, etc) but I did take one day to cover the principles of pharmacology (pharmacokinetics, etc). I really liked Sketchy Pharm videos especially for psych drugs & antibiotics
Micro: I did a little bit of sketchy micro everyday but still had some dedicated days for micro. I made an excel spreadsheet of all the sketchy videos and checked off every time I watched a video to make sure I was covering all the videos- I tried to watch every video at least 3 times but I didn’t get to/didn’t feel the need for certain videos

How I split up my days
First half: I started each day with one 40-question block. Afterwards I went over each wrong question & made Anki cards out of wrong questions and any other questions I wasn’t 100% sure about. I found this to be extremely helpful because it guaranteed that I will at some point memorize the content that I got wrong & commit it to memory.  
Mid-day break: gym + lunch + usually a 30 min TV show (I watched Gilmore Girls because it somehow motivated me to study)
Afternoons: I did content review (should be review, not covering new stuff because you simply don’t have the time) using DIT videos, First Aid, and any of the other resources I listed below
Rest of the day: Dinner break at some point with some type of 1 hr TV show, Anki, Q bank other than UWorld, sketchy videos, etc

Here are my exact day-to-day google calendar screenshot:

How I split up UWorld Questions:
For first 3-4 weeks, I did 1 block of UWorld per day (40 questions), up to you whether you wanna do the topic you’re covering (e.g. cardiology only) or mixed questions
Week 4-5: 2 UWorld blocks per day
Last week: did nothing but 4 UWorld blocks/day + Anki cards

Resources:
I stuck to resources I have used during the school year & have liked. Including but not limited to: BRS physiology, Pathoma, Sketchy Medical, DIT video lectures, Goljan Pathology Rapid Review (thick book- only used to look up specific stuff), Goljan Audio lectures + notes (both floating around for free online), Kaplan Q bank, UWorld, First Aid (should memorize pretty much everything in this book)

Towards the end of my study period, I dedicated at least 2 hours every day to going through my Anki card deck. Probably covered over 1000 cards/day. Step 1 is a memorization heavy exam so you just have to commit everything to memory. I found Anki to be the best tool for me. You can also use the Image Occlusion add-on for Anki to make flashcards out of tables, diagrams, etc I have a short tutorial on this in one of my videos here if you’re interested.

 There are also pre-made Step 1 Anki cards made by Brosencephalon that a lot of people like. I did few decks by him but eventually wanted to tailor my learning to my weaknesses so I mostly stuck to my own cards.


Additional tips & tricks (general tips on taking BIG exams here)

  • I kept a pretty regular sleep schedule throughout my study period & was mindful of my caffeine consumption (very Type A) so that I can get restful sleep at night. 
  • I spiral bound my First Aid book (makes it easy to flip through & take notes). Some of my classmates did the same for Pathoma for the same reason. It can be done at any Staples or other office supply stores. 
  • I also got my Sketchy video screenshots printed in color & spiral bound. Very useful investment- I found myself looking through these even as I studied for Step 2 CK. If you want you can type up notes for each video “picture” & print it out as well. This comes in super handy when you want to stay away from computers (to prevent procrastinating) but you want to quickly look something up from Sketchy
  • I uploaded all the Goljan audio into an old iPod & had that be the only thing connected to my car. I did a lot of long distance driving esp on weekends bc my church was 1hr away so every time I stepped into my car, the lecture came on. I basically listened to the whole thing on repeat throughout the entire study period.
  • Anki. Can’t stress this enough. I had the Anki app on my phone, iPad, and computer. I like the iPad version bc it is the least distracting of all modalities. I know  a lot of people also use Quizlet to make their own flashcards. Pick one that works for you & stick to it
  • If you feel burnt out and tired, take couple hours off. It’s better to go outside and take a walk than to sit in front of your books feeling miserable 
  • Simulate your NBMEs as closely to your actual exam in terms of time, environment, etc. If your exam is scheduled for the morning then take your practice exams in the mornings, wear comfy clothes, only use the restroom during designated breaks, just as you would for the actual exam


Exam day:

  • Bring lots of snacks. I took a break every 2 blocks but you can decide this based on personal preference & stamina 
  • Wear layers as it might be cold/warm in the exam room
  • Read about what you can/cannot bring into the exam room. I brought soft ear plugs which were pretty helpful

Lastly, plan something relaxing and fun to do after the exam! You deserve it! 

How I studied during first two years of medical school: resources, strategies, and the big picture

Hi guys! I've been getting a lot of questions about how I studied in medical school. Studying during first two years of medical school is quite different from 3rd and 4th year so I will mainly focus on the first two years in this post. 

Starting medical school is probably one of the most exciting and daunting experiences of my life. Many people describe the learning process in medical school as trying to drink out of the fire hydrant: unrelenting and impossible. I was told that ultimately I should come to terms with the fact that I will not know everything. 

 It took a bit of adjusting but when I actually started my classes, I was pleasantly surprised to find that studying it medical school felt a lot more natural and cohesive than it did during college. At my school, the curriculum was designed in systems-based blocks (e.g. cardiology block, pulmonology block, etc) which meant that at all times we were studying different facets of the a single subject. For example, instead of having a separate class in pharmacology, histology, embryology, we had a block of cardiology where all relevant information regarding the heart was covered. This approach to learning made a lot of sense to me and it was certainly very nice that I only had to study for one exam per block. My school had a pass/fail system for the first two years of medical school so it took a lot of pressure off as well. It was freeing to shift my focus from getting a "good grade" to really understanding the material.

So with that background, here is how I approached studying in medical school in general & later on, Step 1: 

MS1: One of the most frequently asked questions is how to incorporate Step 1 studying early in medical school. I didn't really give Step 1 much thought during the first year of medical school. I focused mainly on my lectures and doing well in my in-class exams. I tried to do as much deep learning as possible but frequently incorporated fast memorization tools (e.g. Anki) right before exams. I also had a copy of First Aid but the book honestly didn't make much sense to me during MS1 because I had no idea what would be important vs. not important (turns out, everything in First Aid is important and needs to be memorized). 

  • For more physiology heavy blocks (e.g. cardiology, pulm, renal, endocrine) I tried to do as many practice questions as possible. If there weren't any readily available, I reached out to the professor, deans, previous students, etc for question resources. You can find my personal favorite physiology resources here, here, and here
  • I used Anki for memorization heavy subjects like biochemistry combined with lots of drawing out pathways and forcing the material into my head any way possible. This means something different for everyone. For me, it was simply brute memorization with frequent draw-from-scratch as my way to test myself. 
  • I did a lot of group studying/mock lab practicals for anatomy & physiology and neuroanatomy. I spent a lot of time in the lab, pointing things out and talking about the function of each structure with my classmates. I soon found out that not every structure in anatomy is equally important. Certain structures have more clinical significance. For example, brachial plexus has many related pathologies that are frequently tested (vs. one of many small muscles in the forearm that extends the fingers). Figuring out what structures have more clinical significance can take some time and practice. Review books and practice questions may come in handy in deciphering what to focus on during A&P. 
  • For microbiology, I pretty much watched Sketchy Micro over and over again until I knew all the videos inside out. I printed out screenshots of each video and made a booklet out of all the pictures and took notes in them so I can always have them with me. I referred back to them as recently as September of my 4th year when I was studying for my Step 2 CK. The videos are extremely high yield and now they have a great pharmacology section as well which will be more useful in 2nd year. 

MS2: first half of the year was pretty much the same as first year-- focusing on classes and doing well in exams. I incorporated some longer term study tools like Firecracker (you can check off the current block/topic and do short flashcard-style questions during your spare time). Firecracker can be pricey but they do hold sales every so often so I would look out for those. If you're on a budget, I recommend Anki cards made by brosencephalon and doing them throughout the year. Towards the end of my second year, I supplemented my studying with board prep questions from Kaplan (not the prep course, just the Q bank). I got through most of the questions before my dedicated Step 1 period started at which point I transitioned over to UWorld. I won't go into too much detail about what I did during my dedicated Step 1 study period (another post!) but basically my main focuses were content review (review, not learning because there isn't enough time to learn new material-- which is why it's so important to do a lot of deep learning during first and second year), UWorld questions, and content memorization (often via Anki). 


You can watch my videos on how I set up my Anki decks here. I also have an entire video describing how I took notes and used them to study in medical school here


I want to stress that none of the things I did as MS2 would have been all that helpful in MS1. I think it's easy for people to get caught up on Step 1 prep and totally miss out on the things you're actually supposed to learn as a 1st year medical student. For example, you can totally memorize all the biochem pathways written out in First Aid book but that would simply be a review or an abbreviated version of everything you were supposed to learn in lecture during 1st year. It might help you answer some questions but ultimately you will not have the complete picture. I would look to First Aid as a guideline of what is stressed or considered "important" in Step 1 exams but it definitely should not be your only resource. From what I can tell, most of my friends had almost all of First Aid memorized but the true differentiation between a great Step 1 score and an ok score is how much you learned and retained from the first two years of medical school lectures. 

Lastly, I can't emphasize how important it was for me to have a great group of study buddies who eventually became some of my best friends in and out of medical school. I was lucky enough to form a very functional study group with my friends early on in medical school, but I understand that group studying doesn't always work for everyone. Regardless of whether you are actively studying with your friends or independently studying, having a good emotional support system is incredibly important. I think I can safely attribute my academic success in medical school to having a solid support system inside and outside medical school. No amount of studying will help you if you are constantly feeling emotionally exhausted and burnt out. Find your people. They will carry you through the highs and lows of medical school.

That pretty much summarizes how I studied during the first two years of medical school. Hope you guys found this post helpful! 

Favorite Podcasts

When I was studying for my Step 1 back in May 2016, I quickly realized how valuable driving/commuting time can be if used properly. Under the pressure of the strict Step 1 study schedule, audio lecture was one of the ways I utilized what used to feel like wasted time in the car/train. I used Dr. Goljan's Pathology lectures*. I loaded it onto my iPod and set it to play automatically whenever I turned on the car. Thanks to Dr. Goljan's colorful personality and lecture style, I almost always continued to listen through my entire trip no matter how short or far the distance. I'm pretty sure I was able to repeat some of his jokes word for word at some point.
[*I do not own Dr. Goljan's audio lectures & cannot distribute the files. I suggest using Google to find out where they can be found]

 Now that I'm living my post-Step 1 life, I rarely need to listen to audio lectures during my commute to feel productive. During long trips, I still try to make the most of my time by listening to podcasts. Podcasts are great because there is a great variety of contents you can choose from depending on your mood, kind of like Netflix for ears! Much like TV, the "listen-ability" of a podcast varies not by topic but the delivery of the content via its speakers. So I think podcast is a great way to learn about topics you normally would not have looked up yourself and escape the dreaded "med school bubble." 

I still consider myself a "novice listener" so my list isn't going to unearth any hidden Podcast gems if you are already a seasoned listener. But if you are new to Podcasts and would like a few programs to get started, you may find this list helpful! 

Freakonomics

Duration: 35-45 min/episode
About: in depth discussions/conversations about all facets of life [restaurant tipping, online dating, parenting, educational system, politics, and more] from the perspectives of economists and social scientists. 
Personal note: I can't get enough of the host's [Stephen Dubner] slightly nerdy and friendly voice in this podcast. The topics sometimes sound dry, but the program rarely is. Great source of conversation starters (as I am constantly in need of those). 

RadioLab

Duration: 30-60min/episode
About:  answers questions such as "are there benefits to hunting endangered species?", "exactly how much do you want to know about your Korean celebrities?", & " how far should lawyers go to provide the best defense to the worse people?"
Personal note: I always feel smarter after listening to RadioLab. They once did a story on Henrietta Lacks (unwitting donor of famous HeLa cells still used as immortal human cell line) & I found it so interesting that after I reached my destination I sat in my car until the end of the podcast.  

Serial [season 1]

Duration: 30-50min/episode
About: a 17-year old high school student gets convicted of killing his ex-girlfriend. Did he really do it? 
Personal note: this podcast has been very popular so I'm sure many of you know about it but in case you don't--  once you start, it'll be hard to stop listening to this season. I once read that a woman ran her marathon while listening to the podcast. Prepare yourself! Undisclosed is sort of a spin-off podcast started by a family friend of Adnan Syed [the person discussed in Serial season 1]. Undisclosed season 1 discusses Adnan's case in much in depth. I'll be honest- I did get a little bored by all the nitty gritty details by about episode 10 but I thought the first half of the season was excellent. I couldn't stop thinking about it for about a month. Undisclosed now has moved on to season 2 where they investigate wrongful conviction cases. 

The Moth

Duration: usually ~20 min for the regular podcast & ~60min for Moth Radio Hour (collection of favorite stories)
About: true stories told live by storytellers. Some hilarious, some tragic-- it's basically a live version of Humans of NY but from all over the country. 
Personal note: this podcast has me literally laughing out loud or tearing up in my car depending on the story. The Moth also hosts live events throughout the country and I highly suggest it! 

Other favorites: TED Radio hour, This American Life, Reply All

 

What are some of your favorite podcasts? 

 

Morning Routine: Family Medicine Rotation Edition

Hi everyone,

First, I'd like to thank everyone for all the positive and encouraging comments on my most recent YouTube video announcing this blog/web store. There are still some kinks to be worked out [for example, I JUST figured out how to enable comments on blog posts], so I really do appreciate your patience and suggestions! 

Morning routine is one of the most requested videos on my channel. I'm still brainstorming and thinking of creative ways to portray that tiny portion of my day on video, but in the meantime I'd like to share what my typical morning routine looks like currently. Keep in mind, I'm on one of the least time-demanding rotation of 3rd year (family medicine), so this morning routine looks much different than the past few rotations. Regardless, i think it's nice for people to see that not all of medicine involves getting up at 4am to pre-round on still-sleeping patients. 

7:00am - I'll be totally honest. My actually alarm is always set about 30 minutes before my desired wake time. Clearly, I haven't figured out a way to break my multiple 9-minute snooze addiction. I've never been a morning person & it's just as difficult for me to wake up at 7am as it is at 4:15am. So far my best wake-up combination has been: adequate amount of sleep (7-8hrs) + an alarm clock that simulates sunrise. Occasionally, I also use the Sleep Cycle app, which gently wakes you up when you are at your lightest sleep within a 30 minute window. 

7:15am - when I finally manage to get myself out of bed, I make my way over to the kitchen to make my coffee. Lately, I've been using my Nespresso Pixie machine for its convenience and speed. My breakfast choices range widely from smoothies (warmer months), yogurt with fruit, oatmeal (colder months), to eggs and toast (when I have more time). I usually like to catch up on social media feeds while I eat.

7:45am - after breakfast, I brush my teeth and start to get ready for work. I try to keep my outfits minimum and hassle free. You can check out my business casual outfit video here

8:00am - before officially starting my day, I think it's really important to review my agenda for the day and make sure I have everything I need before leaving the house. This is also when I pack my lunch and mentally map out the rest of my day (e.g. are there any errands that I can take care of on the way from point A to point B?) 

8:30am - my office is only 20 minutes away door-to-door so leaving at 8:30am allows me to get to my family medicine office before patients start arriving at 9/9:30am. Let me know if you guys want me to share my Spotify playlist or a list of Podcasts I like to listen to in the car!  

That concludes my current morning routine for family medicine rotation! What is your morning routine like? Comment below!

xo,
Jamie