百歌医学#USMLE考经#，小编注：根据最新《USMLE Step1 考经可信度分级标准》http://bug-online.org/usmle-exp/step-1/11006/，这篇考经rating为：4/5星考经。

评分细节：

根据BUG，SUG，GZUG，CUG，SZUG，JUG，CSUG，SYUG，HUG，ZUG，TUG等全国知名讨论组考经的一贯统一风格，分为出分前考经和出分后考经。李兴哲的考经只有出分后考经。

编者按：作者李兴哲，2003入读北京大学医学部基础医学，本科毕业后在NIH继续研究，完成研究课题后转入辛辛那提公共卫生学院就读MPH，毕业后考入美国肯塔基大学医学院，目前是医学院第3年医学生。

本考经的文本部分是由李兴哲首发于Student Doctor Network （所以是英文版），经作者允许，转载于百歌医学。

李兴哲同学的成绩超群，而且同样是中国医学院学生，其考试经验中有很多，是从中国医学生或者中国人角度，去讲如何用英语理解医学知识在美国备考的诀窍秘籍，百歌医学在2015年8月9日，由李嘉华对李兴哲进行了接近2小时的公开采访（webinar gotomeeting）《Step1 272麦地非典型学霸Nollid分享Step1考试经验（汉语~）》，并将其录音制作成了百歌医学电台（荔枝FM1409256）的节目，供大家无限制地随时收听：

☞《学神 & 学霸の往事：Step1 272非典型学霸分享考经》

Background: Non-traditional student (did research for a while, got a master’s degree, worked a bit before starting medical school), mid-tier state medical school, pre-clinical class ranking ~top 2%

Impression of exam

Overall, I’d say it felt like an upgraded version of the most recent NBMEs, with significantly more questions that have longer stems. There were more questions involving complicated experiments requiring very solid understanding of physiology and molecular biology, uncommon pathologies requiring very broad knowledge base, rare side effects/ uncommon application of common drugs that you may never heard of and of course the odd anatomy and behavioral science questions which you cannot really prepare for (or just learn anatomy really well during M1 and think like a normal person). One major theme across the board is integration of knowledge, combining imaging, lab techniques, genetics, anatomy, etc in a clinically relevant way.

I usually finished NBMEs with 25 mins left to check my answers but on the real deal I was constantly left with only 15 minutes to check my answers. Itwas due to both the increased difficulty in ~1/3 of the questions and me being more careful on picking answers. I usually mark about 8-12 questions per block on NBMEs, out of which I usually end up being not a 100% sure about 2-4 per block. On the real deal, I was marking between 12-18 questions per block before second pass and in the end was not a 100% sure about 4-6 per block in the end.

I was feeling pretty good about the first 5 blocks as I took a break between each block to drink water, eat bananas/yogurt/granola bars, go to the bathroom, stretch and even go out to get some sunshine. I finished the last two blocks without a break in between and found the last block to be considerably more difficult than the first 5 or 6 blocks. However, after going through my 18 marked questions, I was able to reduce the number down to 6. Therefore I think fatigue could be a main contributing factor when you feel a certain block is much harder.

Walking out of the prometric center, I knew I probably killed it coz I know the curve is more lenient than NBME and I was well conditioned and more concentrated than usual. Coming home although tired I jogged down about 25 questions that I marked and remembered in the end and started looking for answers. I ended up being correct about 50%, missed about 40% and still not
sure until today about 10% of the 25 or so questions. Therefore I think to answer the often seen questions on this forum, you probably need to have no more than 2 incorrect questions per block to safely land above 270.

Advice for preparation:

• General advice: My dean gave us a piece of advice in the beginning of second year for Step1 preparation: doing good in M2 courses is the best preparation for Step1. I would extend that suggestion to all pre-clinical coursework. Seriously don’t study too practically for boards or only focus on the so-called ‘high-yield’ facts, sometimes please study for the sake of curiosity. Google whatever that come across as unknown to you and try to learn a little bit about new stuff every day, from news, facebook or even Netflix. Just as an example, if you don’t know most of the exciting discoveries that won the Nobel Prize in Physiology or Medicine, maybe take an hour or so to browse the list and I guarantee you if they test you on molecular biology, the main concept will be from the list.

• Timing: Don’t start too early when you know nothing, you’ll get frustrated and waste your time and resources. A good time to start is usually the beginning of second year. You’ll have almost a year to explore what resources fit you the best and make a plan before dedicated study time comes.I have no recommendation for the length of dedicated study time as it really varies based on knowledge foundation, goal and endurance. I would recommend, however, pushing your limit a little bit, learning a little bit more as you’ll need most of these stuff to survive the pimping on third year rotations and of course to become a competent doctor.

• Material: UFAP: Yup, no secret here. Of these three, FA is the king. Buy the latest version, the new things are not added randomly. Actually, pay extra attention to the new stuff. UWorld is good for learning, but kind of bad for training your test taking skills as it makes you overthink too much. Pathoma is great for path foundations and some integrations but I personally think Goljan had more integrations and his teaching style reaches you better.

  • Rx Qbank: good to use with courses to build a solid foundation. Suggest starting early on this one but don’t need to use during dedicated time.

  • Kaplan Qbank: also pretty solid and actually after recent updates, having better pictures and explanations. Suggest using together with Rx if you have the time or choose one of the two along M2 courses. (I personally would choose Rx since it’s based on FA). Don’t use during dedicated time except for the hard questions to pick up some zebras (those are really hard: average pct was 40% or so).

  • Red Robbins (the pathology Qbook): super long question stems and covers almost all common and quite a few uncommon pathologies from the big Robbins. It’s actually better to use along coursework but I decided to do it during dedicated study time and I think it trained me well for long stems with lots of labs and really helped me on differentials within single organ system.

  • BRS Physiology: Worth going over it at least twice. The best book for physiology review. Physiology can get really tricky on Step1 and a good foundation here is key to success.

  • Other BRS series: don’t use them in dedicated time except for browsing some of the questions. Generally not great questions that simulate step1 but can help fill some gaps.

  • Goljan audio and Rapid Review Path: the audios are great to listen to while jogging, working out or driving. However the RRP book is kind of too dense to review and I would recommend using it along coursework instead of during dedicated study time.

  • USMLE Step1 Secrets: A great book that use cases to integrate concepts. A perfect companion for FA. I usually read a chapter in Secrets before I go over the corresponding chapter in FA. Dense to read but worth it in my mind even during dedicated time.

  • Microcards: a must have if you don’t use picmonic or sketchy micro I guess. Constantly referring to these cards during my dedicated study time and they are a great expansion of FA micro chapter.

  • Katzung and Trevor Pharm: a great book with very nice concept figures and tables. Actually a few NBME questions and quite a few UW questions are derived directly from the figures in this book.

  • For Biochem, Genetics, Nutrition, Cell and Molecular Biology, Immunology, FA is enough. However they do find new ways, especially integrating lab techniques with other concepts with very long stems to test you. Be careful.

  
  

Advice for Exam Day:

Arrive early and dress comfortably. Bring enough food and water as you’ll need it. Take breaks often as time permits: I highly recommend taking a break after each block to clear your mind and give yourself a morale boost looking into the mirror in the restroom! Keep yourself hydrated and motivated. Your neurons work much better in a good mood!

Final Words:

Bath yourself in questions. I did probably over 10, 000 question combining all the Qbanks, NBMEs, Sim Exams, Question books and Questions from review books. The whole idea is to see as many as possible to expand your knowledge base and to also employ the active retrieval method of memory consolidation。In the end I don’t think any specific resource is a must have except for FirstAid as I don’t really remember any specific question that I wouldn’t know if I didn’t use certain resources (again except for FA), which means they all cover things pretty good. Finally, understand stuff, don’t just memorize them, as has been iterated so many times by the previous high scorers.

Main Prep Resources:

• Aug 2014-April 2015---- USMLE-Rx Qbank First pass, organ system specific
  along M2 courses: 90% correct

• Aug 2014-April 2015---- Kaplan Qbank First pass, random mixed/organ system
  specific along M2 courses: 80% correct

• Jan-April 2015---- UWorld First pass, random mixed/ organ system specific
  along M2 courses: 83% correct, 94th percentile

• BRS Physiology, Pathoma, Goljan audio---- finished along M2 courses.

• Lippincott’s Microcards----used during M1 micro block.

• FirstAid 2014----organ systems briefly reviewed along M2 courses.

Partially Used:

• FA Organ Systems (selective chapters for clarification)

• Lange Pharm flashcard (selective chapters along M2 courses)

• Rapid Review Pathology (selective chapters along M2 courses)

• Kaplan Physiology Review Book and Physiology Qbank (mainly Cardiovascular,
  Pulmonary and Renal)

Barely touched (but frequently mentioned on this forum):

• Firecracker (wasted $350+…only used about 1%)

• Anki (collected quite a few decks but didn’t use any)

Dedicated Study Time: Mid May-Late June 2015, 6.5 weeks

• UWorld second pass: mixed random timed, 94%, 99th percentile

• UWorld marked/missed final pass (during last 5 days)

• USMLE-Rx Hard level about 250 Qs and Kaplan Hard level about 200 Qs (during
  last 5 days)

• FirstAid 2014/15 First time serious pass (highlighting and annotating)

• FirstAid 2014/15 Second pass (reviewed mainly highlighted parts and
  annotations-during last week)

• FirstAid 2014/15 Final quick pass (only highlighted parts-the day before
  exam)

• USMLE Step1 Secret x1

• Pathoma x1.5 (second pass: highlights only during last week)

• Robbins and Cotran Review of Pathology (all questions)

• Katzung and Trevor’s Pharmacology Examination and Board Review (Chapter
  questions + Comprehensive exam + Texts from selective chapters)

• Lange Review of Medical Microbiology and Immunology (Comprehensive exam only)

• BRS Behavioral Sciences, Neuroanatomy, Pathology, Physiology, Embryology,
  Cell Biology & Histology, Biochem/Molecular Biology and Micro/Immunology (End of Book Comprehensive Exams only, except for BRS Physioloy)

• Rapid Review Pathology (only blue texts, selective chapters)

Practice Exams:

In School:

• April 2015 Offline NBME Form 5 missed 16, Form 7 missed 16

• April 2015 Free 132: 93%

• End of April UWSA1 265 (87%)

• May 1 2015 Offline Form 11 missed 15

• May 10 2015 Form 15 missed 13, 262 (Baseline)

Dedicated Study Time:

• May 17 2015 Form 12 missed 6, 273

• May 24 2015 Form 13 missed 10, 266

• May 31 2015 UWSA2 265 (93.8%)

• June 4 2015 Kaplan Sim 1 (7 blocks), 85%

• June 5 2015 Kaplan Sim 2 (7 blocks), 87%

• June 17 2015 Form 16 missed 7, 271

• June 24 2015 Form 17 missed 7, 269

#USMLE考经#考生更详细信息：

• 复习模式：兼职（详见：《考USMLE，全职准备好还是兼职准备好？》）

• 参照的路标系统版本：第二版和第三版交界期间

• 【课考区间】 = N/A（详见：《考出USMLE Step1 需要多少时间？》）

• 考试题目数：44x7=308（详见：《最新USMLE Step1考试改革影响分析》）

• 考试地点：美国本土考场

• MD学位学校：美国肯塔基大学医学院

• 星座：天秤座

• 姓名：李兴哲

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