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1Step 1 USMLE: Do it like you own it (Road to 253) – Authored by Dr. Jagjit Khosla (Jags)Step 1 USMLE: Do it like you own it (Road to 253)Source : https://iamjagjit.wordpress.com/ (My blog)BackgroundI am graduate from UCMS, Delhi, India (batch 2007).Sometimes in life you have to make a choice Either continue tolive the life of mediocrity or set sail for never ending pursuittowards masteryI made my choice and that’s how the journey began There were three phases in my preps Phase 1I started doing subjects one by one and did it like this I used to see Kaplan videos along withnotes for one subject, supplement it mostly with one extra reference book for that subject thenread first aid of that subject and add all extra important info into the first aid in empty spaces n ifrequired I added extra sheets following this I used to do subject wise Uworld questions on thatsubject (and even chapter wise for pathology) and while reading explanations I used to add allthat was missing in my first aid I did this for all 7 subjects took me about 5 -6 months to do all but at the end of that period I was done with Uworld once complete and my firs t aid containedall important info in one book I was curious where I stood but I knew it’s still premature stage so just did NBME 1 got 244 (174/200) not happy but felt confident to move on as I knew Ihaven’t revised anything yet Resources I used are mentioned later in this article Phase 2Then began phase 2 where I started revising up the Consolidated first aid and also revising upUworld random timed mode but then realized after doing 40% of Uworld that doing the sameques again wasn’t really helping me learn more because I already knew the concepts n it wasjust about memory recall so I left Uworld and never returned to it I felt doing Uworld once wellwith consolidating first aid was more than enough to learn concepts so I began doing usmle rxdaily 50-100 qs in the morning n rest of day revising up the first aid it took me over a month torevise up the first aid completely n during that time I did half of usmlerx too besides redoing 40%of Uworld ques This phase was the most difficult for me because I was learning anything new just revising stuffso got really boring also I anticipated I would be over with it in 2 -3 weeks but it stretched to 5weeks So I was freaked out literally in the mid-way I was so frustrated that one night I gaveNBME 7 got 251 (179/200) felt better because I knew it’s only going to rise up B l og : i a mja g ji t.wordpres s .c omP a g e 1 21

2Step 1 USMLE: Do it like you own it (Road to 253) – Authored by Dr. Jagjit Khosla (Jags)So after finishing up this phase I did NBME 11 n Score got better 255 (182/200) then next daydid UWSA 1 online and got 263 (770 - 83% correct) That was morale boosting I booked thedate of 4 weeks later as I felt that’s enough time I would need for phase 3 (the last phase) of mypreps Phase 3During this phase I did all NBMEs every few days and was revising up the chapters whichUWSA1 showed as weak I was also trying to do USMLERx but then I just left it after doing2/3rd because I wanted to do Kaplan qbank as many who got high scores have done it It wasabout 3 weeks from exam I was doing old nbmes but my scores had plateaued now not risingup I was frustrated coz I felt I was still not where I wanted to be esp. when I know the newerNBMEs would be much harder than this Also, I felt I was hardly able to finish up the questionson time At that moment 3 weeks from my exam I took a drastic step I bought Kaplan onlineand started doing 8 blocks daily timed random exam style mode n then used to see the wronganswers explanations in the remaining time of the day It was harder than USMLERx I got allpercentages from 70-89%. after 3-4 days I was done with 2/3 rd of it with 81% overall score(against 61% avg) Then I gave completed all old NBMEs as exam was getting close n I wantedto leave last week for one final revision scores were still in the same range but I was able tofinish blocks in 50 min so I literally trained my brain to think fast and right Also I was initiallymaking many silly mistakes due to lack of concentrations I decreased them as I moved on Soalthough the scores were still the same I knew I was improving daily by the end of that week(i.e. 10 days from exam) I was done with 2/3 rd Kaplan n all NBMEs except 12 13 15 n 16 ThenI did UWSA2 online n scored 265 (800 - 85% correct) then did NBME 12 N 13 over next twodays got good scores In the last week I tried working on my weak areas shown in UWSA2 but it was increasingly getting difficult I was reaching saturation point then 3 days from exam I decided to sit for NBME 16 online followed by NBME 15 That day I got the shock NBME 16was 251 (179/200) I was shocked to the core n furious As it was the lowest I got in all nbmes I was down thru the day so didn’t do NBME 15 but by the evening I was so furious that Idecided to be done with NBME 15 the only assessment left I finished up by 12 midnight Iremember I was so tired I was dizzy n clouded through last two blocks But still I persisted Iwas back to 262 (187/200) That was the relief I needed after that in last 3 days I was atpeace tried to revise a lot but still lot of revision was left undone My Assessment scores.B l og : i a mja g ji t.wordpres s .c omP a g e 2 21

3Step 1 USMLE: Do it like you own it (Road to 253) – Authored by Dr. Jagjit Khosla (Jags)UWORLD - 76% (First time, subject-wise)KAPLAN (finished 2/3rd) - 81% (Random, timed mode)USMLERx (finished 2/3rd) - 85% approxNBME 1 :244 (174/200) 2 month from examNBME 7 :251 (179/200) 7 weeks from examNBME 11 :255 (182/200) 4 weeks from examUWSA 1 :263 (770 - 83% correct) 4 weeks from examNBME 2 :262 (187/200) 19 days from examNBME 3 :258 (184/200) 18 days from examNBME 4 :262 (187/200) 12 days from examNBME 5 :259 (185/200) 11 days from examNBME 6 :260 (186/200) 10 days from examUWSA 2 :265 (800 - 85% correct) 9 days from examNBME 12 :258 (184/200) 7 days from examNBME 13 :256 (183/200) 6 days from examNBME 16 :251 (179/200) 4 days from examNBME 15 :262 (187/200) 3 days from examActual Exam score: 253So, in a way, NBME 16 was closest in assessing and UWSAs n other previous NBMEs over predicted. Although I still holds that above 250, it varies according to luck and it becomes a majorfactor.Night before Exam That was the worst night possible for me I had to travel over 2 hrs in morning to reach centre so I had to wake up at 4 Therefore, I decided to sleep at 8pm and get 8 hrs sleep As it happensalways in usmle journey nothing goes according to plan I couldn’t get to bed till 9 pm n eventhen I tried tried n tried but couldn’t sleep till 2am My heart was pounding and I knew I washaving panic attack and it was serious coz not getting good sleep before exam totally screwup the exam irrespective of ur knowledge coz its more about thinking So I reluctantly to ok oneLevocetrizine as I felt it will have least hangover effect next day and still may help in sleepingprocess (Although LCZ is 2 nd gen but still it has some sedation side effect not like fexofenadine)I could hardly sleep by 2am B l og : i a mja g ji t.wordpres s .c omP a g e 3 21

4Step 1 USMLE: Do it like you own it (Road to 253) – Authored by Dr. Jagjit Khosla (Jags)I woke up at 4am got ready I saw in the mirror and told myself that despite all that happened it’s all past For next 12 hrs I am going to give my best and won’t let anything affect it I realizedlife always puts you through troubles to test your inner strength and deter mination and it’s up toyou Either you can keep making excuses and blame others for ur failures, or you can stand upagainst all odds and win the day despite all resistance I had made up my mind I travelled 2 nhalf hours to reach centre It was extremely cold n foggy (those who r from Delhi know how it isearly morning in December end) I didn’t revised anything during the travel I felt it will onlymake things worse so kept my mind free remembered my god and went for it Exam experienceI started at 8 A good friend who already gave the exam told me previous day that expect theworst in the exam and u won’t panic I was also told that exam is very lengthy n u will not gettime to review marked ques even So with all these preoccupations I started my first block Itwas average not really difficult got done with all ques with about 12 -13 mins left n thenreviewed all marked n then saw all the answers just to make sure I didn’t accidently clicked thewrong option (such thing can happen) I was totally calm and no panic or tension after finishing1st block I felt I got into my zone when u r ready to face anything without tension or worry ofwhether u wil get it right or not u just have to give the best u can choose what option u feel isright there is nothing else we can do so why worry I had totally free mind n from there onthe whole exam was like that I took toilet break after each block n also rinsed my face withwater n had some glucose water by end of 4 th block I felt hungry so took a big break of 20min n had some Rajma Rice apart from that only thing I ate during exam was an apple after6th block I think just to get some energy for last push about difficult levels. As expected itincreases with each block 4 th n 5th block were really difficult 5 th was most so many weird ques but I persisted tried my best. by 6 th n 7th block I was ready for anything having already seenthe most difficult ques Overall it was great experience I was able to maintain concentration at100% thru out no dizzy episode or cloudiness My endorphins were flowing high in my brain(the same mechanism why soldiers in battlefield do not feel much pain) I completed the finalblock and was done How was exam?Pattern : Its most similar to NBME form 16 which had many weird questions only difference wasthat it had very few 2-3 liners n much larger proportion of those weird questions Difficulty: It’s doable that’s something everyone who gives exam agrees Expect the worst andyou won’t really panic but if u r going into exam expecting all things to come from book u rgoing to have shock Although about 80% of the exam is from common diseases and topicsmentioned in first aid n Uworld it’s different They will ask very simple info but will twist theB l og : i a mja g ji t.wordpres s .c omP a g e 4 21