I am here today to talk about my USMLE Step 1 journey. I am a registered doctor in India and came to the USA after marriage like a lot of other girls. It took time for me to adjust in a different environment and then started thinking what to do next regarding my career. I had few of my university friends who were already doing residency of their choice in great hospitals. I thought of talking to them and make a plan on how to study for step 1, then dive into it and finish it as early as possible.
I was advised by many just to focus on First aid for step 1 and do online Uworld question bank. They told me to know both of these resources by heart and to know every word in the book (FA). I did not take it seriously, I thought how on earth is it possible to remember every word on a given book (FA is more than 600 pages I guess). I started reading FA and soon understood that this is not going to work because I was overwhelmed by the load of information in that book. Moreover, I am an old graduate, so I forgot the basic sciences completely. Then I started listening to Kaplan videos along with FA (I didn’t do Kaplan notes). This helped me to understand the concepts given in First aid, so I finished reading FA and Kaplan together which took me around 4-5 months. I also started doing UW one block per day taking notes. Then I took an NBME and I failed poorly. I was broken, I did not know what else to do. I cried and thought to quit, but then for me quitting is hard, and trying once again is easier.
I started to look for a Study partner over skype. I started revising FA with the partner and study UW on my own. By this time I did UW once, but my memorization strategy was always very weak, so when I took my NBME, I failed again with almost the same score. I was devastated. I felt this is it. Maybe this is not my cup of tea. I had to cancel my exam and had plans to go to India beforehand, so I stayed in India for around 3 months with the negligible amount of studying.
I came back to the US and realized that I have forgotten a lot of material. FA and UW were so new to me again. Never take a break in between preparation guys! I did not quit! I started doing offline UW and reading FA again. I was suggested by some friends to do Pathoma for pathology. I then started doing Pathoma videos (I am more of an audiovisual learner). I then realized I did not know so many concepts. I took one more SP and kept revising FA. I decided to take one more NBME. No surprise, I failed again. This was the third time! I was getting frustrated, losing patience, and felt like a complete dumb of not being able to pass even after studying. I realized my mistake that I was not doing UW enough. This time I bought online UW again and found that I did not know 50% of the material, so how was I expected to pass? I read the FA very less. I took one more NBME, I failed but near pass. I was like what the hell…what am I supposed to do this time… Kill me? Lol. I was so damn low. I did not know what to do with my career. I always dreamt about saving lives! I spent so many countless days crying, angry, and depressed during my preparation.
I am a mediocre student, I always had to struggle to pass (70%) in my university. My husband supported me a lot during these times. Though he is not a medico, he helped me a lot during my preparation by encouraging me and reminding me that I am already a registered doctor in India and to never lose hope and keep fighting hard. We sat together to analyze my NBME score report. I understood that since I was weak in Musculo, reproductive, and endocrine and I worked more on these and did not revise other systems, my performance dropped in other systems except Musculo, reproductive and endocrine. I then realized I have to keep revising my strengths to maintain it as my strength. I took study partner again to revise FA and did UW on my own. I took one more NBME and this time I passed. Though I was relieved I knew just passing is not going to help me. I started working more and more. I went through all NBME questions and the online NBME which I did before. I took NBME 18 and got 211. By this time, I was so low that I would be very happy if I would just pass in the real exam. It was going to be around 1 and a half year of my preparation, I was exhausted. I decided to book my triad and go for it. I kept revising FA and UW for one more month and then I took the exam.
Before the exam day, I relaxed, watched TV, did a chit chat with my husband, and just went over some high yield tables (Tanner staging, clinical trial phases, etc.) and went to sleep. I slept very nicely thinking about what is the worst that could happen “I will fail” but life will not stop and I will find other ways to excel. This relieved me from all tension and I slept really well.
On the exam day, I was surprisingly very happy because my misery was coming to an end… lol. When I saw the first question, I smiled and thought that this the exam I was preparing for so long and who cares if I fail but I will fail with no regrets and care a damn about this exam later. So I was very calm and cool during the exam. One thing I would like to say this exam not only tests your knowledge but your stamina, patience, and how do you deal with 8-hour stress. I got the first two easy blocks in which I got only very few doubts, but the third and fourth block was very tough with a lot of pharma graphs, mice experiment-based questions, etc. The rest of the blocks were medium tough. Since I had already accepted my fail score of 191 (I used to get cute little panic attacks thinking I would get 191 and fail), I was at ease. I was talking to the tough questions “BRING IT ON”. Let me see how tough can you be? If I fail, I will fail like a fighter who did not give up until the end. I was never drowsy throughout my exam because I slept well but I was feeling exhausted from the inside. When I was done with the 6th block, I was literally talking to myself in my mind that “You did good, just one more block to go and you can do it”. Towards the end of the exam, questions were more lengthy (or maybe my battery was low…lol). I literally had to read the big question twice to find out what they were asking. I did not have time shortage till block 6 but the 7th block was over just on time. I was so happy that I was done with the exam, that I also answered a 5 min USMLE and Prometric survey, hilarious isn’t it?
So to sum up regarding the exam I would say build your concepts doing UW and hammer FA again and again. Analyze your weakness with NBME and keep working on it. If you are just a beginner and is an old graduate just like me, there is no harm in doing Kaplan videos. I started doing Kaplan Q bank but did not like it. So I just solved UW and read FA and did all the NBMEs starting from NBME 1. I know I did a lot and ended up with a below-average score, but when I look back I don’t see what else I could have done. Maybe this is my maximum, so I am happy. I always dreamt of my writing my USMLE step1 journey since a long time. Give your best guys! I know scores are very important but accept what you have and move on. No need to sit and cry. I know it feels bad but what is done is done, move to the next level. I have decided I will never let a score decide how caring, loving, and hardworking doctor I would be one day in the US. This is me and I know I will take care of my patient not as just a human body with the disease but with love and empathy and always greet them with a smile on my face no matter what.
Guys, we all know what material we have to study, everything is all over the internet. I thought of writing it differently because very few people talk about the struggle, hopelessness, and low confidence phase during this preparation when you feel you are a nobody. Life is bigger than everything, we get only one life and I want us to live it well.
That’s it, this is me and this is my story. I am sorry if it hurts anybody’s feelings.
May GOD bless us all!
Dr. Moumita Chakraborty