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Making Your Step 1 Review Effective Scott Robertson Regional Medical Programs Director January 14 th, 2015.

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Presentation on theme: "Making Your Step 1 Review Effective Scott Robertson Regional Medical Programs Director January 14 th, 2015."— Presentation transcript:

1 Making Your Step 1 Review Effective Scott Robertson Regional Medical Programs Director January 14 th, 2015

2 Source: New England Journal Of Medicine (http://www.nejm.org/doi/full/ /NEJMhpr ) “We estimate that we will see domestic production of medical school graduates functionally surpass our current number of GME postgraduate year one pipeline positions by 2015 or sooner.” Source: Dr. Thomas Nasco, CEO of the Association Council for Graduate Medical education

3 Specialty Mean US Med scores 2011 (2009) Matched Years of residency Mean hrs/ weekSchedule typeSalary range Family Medicine213 (214)352.5Uncontrollable$175k-$220k Psychiatry214 (216)448Controllable$173k-$248k ObGyn220 (219)461Uncontrollable$251k-$326k Pediatrics221 (219)354Uncontrollable$160k- $228k Emergency Medicine223 (222)346Controllable$239k-$316k Anesthesiology 226 (224 )461Controllable$331k-$423k General Surgery227 (224)560Uncontrollable$284k- $383k Neurology225 (225)455Controllable$408k (median) Internal Medicine226 (225)357Uncontrollable$184k- $231k Pathology226 (227)345Controllable$239k- $331k Transitional Yearn/a (236)1--- Orthopedics240 (238)558Uncontrollable$397k-$600k Diagnostic Radiology240 (238)458Controllable$377k-$478k Neurosurgery239 (239)6--$287k- $637k Otolaryngology243 (240) 53.5Controllable$245k (median) Dermatology244 (242)445Controllable$313k-$480k Plastic Surgery249 (245)5--$275k-$499k Program Decision Making

4 Specialty Mean US Med scores 2011 (2009) Matched Years of residency Mean hrs/ weekSchedule typeSalary range Family Medicine213 (214)352.5Uncontrollable$175k-$220k Psychiatry214 (216)448Controllable$173k-$248k ObGyn220 (219)461Uncontrollable$251k-$326k Pediatrics221 (219)354Uncontrollable$160k- $228k Emergency Medicine223 (222)346Controllable$239k-$316k Anesthesiology 226 (224 )461Controllable$331k-$423k General Surgery227 (224)560Uncontrollable$284k- $383k Neurology225 (225)455Controllable$408k (median) Internal Medicine226 (225)357Uncontrollable$184k- $231k Pathology226 (227)345Controllable$239k- $331k Transitional Yearn/a (236)1--- Orthopedics240 (238)558Uncontrollable$397k-$600k Diagnostic Radiology240 (238)458Controllable$377k-$478k Neurosurgery239 (239)6--$287k- $637k Otolaryngology243 (240) 53.5Controllable$245k (median) Dermatology244 (242)445Controllable$313k-$480k Plastic Surgery249 (245)5--$275k-$499k Program Decision Making

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6 NRMP Program Director Survey Results (2014) Percentage of Programs Citing Each Factor in Selecting Applicants to Interview Source: 2014: NRMP Program Director Survey Results (2014). National Resident Matching Program. p. 3

7 First Step: Understand what you need to know and do in order to solve USMLE questions

8 Which of the following is the drug of choice for a patient diagnosed with oral thrush? ○ A. Amphotericin B ○ B. Fluconazole ○ C. Griseofulvin ○ D. Ketoconazole ○ E. Nystatin Step 1 Evolution Single Jump, 1980’s

9 Step 1 Evolution Double Jump, 1990’s A 28-year-old HIV-positive man complains to his physician of a recurrent whitish film that seems to grow on his tongue and oral mucosa. A germ tube test is positive. Which of the following is the drug of choice for this patient? ○ A. Amphotericin B ○ B. Fluconazole ○ C. Griseofulvin ○ D. Ketoconazole ○ E. Nystatin

10 Step 1 Evolution (Triple Jump, today) Answer = B

11 Step 1 Evolution (Triple Jump, today) A 72-year-old woman is brought to her physician by her husband. He states that she is having trouble recognizing her grandchildren, and is having increasing difficulties in the planning and executing her daily activities. Furthermore, she is having a more difficult time recalling the names of common objects. He states that he often finds her wandering around the house with an “absent” look on her face. Which of the following structures is most likely affected in this patient? ○ A ○ B ○ C ○ D ○ E ○ F A 72-year-old woman is brought to her physician by her husband. He states that she is having trouble recognizing her grandchildren, and is having increasing difficulties in the planning and executing her daily activities. Furthermore, she is having a more difficult time recalling the names of common objects. He states that he often finds her wandering around the house with an “absent” look on her face. Which of the following structures is most likely affected in this patient? ○ A ○ B ○ C ○ D ○ E ○ F

12 Effective Prep Establish a S.M.A.R.T plan Spaced Repetition Active Learning Using my Kaplan Step 1 Qbank and other programs EFFECTIVELY!! Question Practice

13 Source: New England Journal Of Medicine (http://www.nejm.org/doi/full/ /NEJMhpr ) “We estimate that we will see domestic production of medical school graduates functionally surpass our current number of GME postgraduate year one pipeline positions by 2015 or sooner.” Source: Dr. Thomas Nasco, CEO of the Association Council for Graduate Medical education

14 To excel on (not simply “pass”) your exam… Set up a strategic study plan and stick to it Anticipate that questions can present the basic clinical sciences in a different format than you are typically used to seeing Review the material in ways that mimic current question demands Study actively, not passively Build in tactics to minimize forgetting key information Focus on understanding, not just memorizing Know the USMLE testing software by appropriate use of Kaplan diagnostic, Qbank, and sim exams

15 NRMP Program Director Survey Results (2014) Percentage of Programs Citing Each Factor in Selecting Applicants to Interview Source: 2014: NRMP Program Director Survey Results (2014). National Resident Matching Program. p. 3

16 Getting Started… or Planning Ahead…

17 Speak the Language: Build your test question vocabulary Glossary of Terms Frequently Used in Test Questions Term Definition Abolish To do away with, to eliminate Absolute value The distance from zero, disregarding + or - sign Abundant Plentiful, numerous Account forExplain, justify Acquire Get, obtain, gain Acrid A sharp taste or smell Adjacent Near or next to Aggravate Irritate, make worse Alter Change, modify AmenableChangeable, yielding, pliant Amplify Enlarge, make bigger Apparent Visible, evident Arrest To stop, check or hold AttenuateTo weaken or reduce in force or amount Attributable to Result from, be caused by Bear To support, hold up, endure, show or exhibit some feature Causative agent Cause Cessation Discontinue, end Cloying A too sweet smell or taste CoalesceTo grow together, combine as one thing Comprise To include or contain Concomitant To accompany or occur at the same time, along with ConcurrentSame as concomitant, but associated with time Confer To give

18 Source: New England Journal Of Medicine (http://www.nejm.org/doi/full/ /NEJMhpr ) “We estimate that we will see domestic production of medical school graduates functionally surpass our current number of GME postgraduate year one pipeline positions by 2015 or sooner.” Source: Dr. Thomas Nasco, CEO of the Association Council for Graduate Medical education

19 5 + 1 common EARLY preparation mistakes 1. PASSIVE studying – wholly focused on content review or video review or curriculum notes review… 2. Insufficient or INAPPROPRIATE practice with questions 3.MEMORIZING content, but not understanding 4.MISREADING, misinterpreting questions 5.DEVELOPING inappropriate test day strategies 6.INSUFFICIENT exam-like question practice

20 NRMP Program Director Survey Results (2014) Percentage of Programs Citing Each Factor in Selecting Applicants to Interview Source: 2014: NRMP Program Director Survey Results (2014). National Resident Matching Program. p. 3

21 The ACTIVE study cycle for all subjects… Analyze Remediate Self Test

22 Review Actively…from the start! Make summary notes of key aspects Color code to cluster and highlight similarities/exceptions Use diagrams and charts to summarize key data Do questions before and after reviewing Know “most commons” and “hot topics” Change study modes frequently to refocus your attention Use Qbank properly Work with a question partner Consider other Kaplan online resources to offer a fresh view of Step 1 topics you find difficult

23 Source: New England Journal Of Medicine (http://www.nejm.org/doi/full/ /NEJMhpr ) “We estimate that we will see domestic production of medical school graduates functionally surpass our current number of GME postgraduate year one pipeline positions by 2015 or sooner.” Source: Dr. Thomas Nasco, CEO of the Association Council for Graduate Medical education

24 Use Your Qbank Properly Begin using timed mode as soon as possible Cover answer choices initially to focus on question stem information Look at why, not just what you missed when testing Look for patterns among your errors, then adjust study to minimize these errors View questions as a guide to what content to focus on and how to store the material in memory for easier application to questions Avoid thinking of practice test scores as a judgment on your intelligence Keep mixing in items on content reviewed previously to better retain and to adjust to random nature of real exam

25 NRMP Program Director Survey Results (2014) Percentage of Programs Citing Each Factor in Selecting Applicants to Interview Source: 2014: NRMP Program Director Survey Results (2014). National Resident Matching Program. p. 3

26 Try Question Partnering An activity that can help you identify habits that are costing you points on exams A nice change of pace from solo reviewing An opportunity to learn new approaches to solving questions A chance to provide these same benefits to your partner An ACTIVE learning technique!!

27 Source: New England Journal Of Medicine (http://www.nejm.org/doi/full/ /NEJMhpr ) “We estimate that we will see domestic production of medical school graduates functionally surpass our current number of GME postgraduate year one pipeline positions by 2015 or sooner.” Source: Dr. Thomas Nasco, CEO of the Association Council for Graduate Medical education

28 How many questions is “enough?” Too many too soon wastes questions and may reinforce incorrect beliefs about the depth / difficulty of the Step 1 subject material Too few too late will not adequately prepare you for test day – cramming suppresses learning!! Sources: Kaplan Step 1 High Yield, Step 1 Qbank, Step 1 sims (2), a 2 nd Step 1 Qbank (min. 1 month)

29 NRMP Program Director Survey Results (2014) Percentage of Programs Citing Each Factor in Selecting Applicants to Interview Source: 2014: NRMP Program Director Survey Results (2014). National Resident Matching Program. p. 3

30 Create an Effective Study Plan Get organized TODAY!!!  Note important spring school dates and deadlines  Schedule review tasks around those dates Self-assess TODAY!! Hard to know where you need to go until you first know where you are starting from! Online Kaplan Diagnostic is your answer!! DO IT – NOW!! Integrate use of study resources TODAY!! Print materials like the First Aid pages Online resources like Qbank, NBME assessments Interactive resources, e.g. classmates, med advisors

31 Source: New England Journal Of Medicine (http://www.nejm.org/doi/full/ /NEJMhpr ) “We estimate that we will see domestic production of medical school graduates functionally surpass our current number of GME postgraduate year one pipeline positions by 2015 or sooner.” Source: Dr. Thomas Nasco, CEO of the Association Council for Graduate Medical education

32 Using Extra / Vacation Time Link review of 1 st year content to topics of current course lectures, such as systemic Pathology Use extra / vacation time to review 1 st year content that doesn’t easily link to current classes WHAT?!?! Begin using USMLE-style questions at exam pace ASAP Note problem topics revealed by testing for extra attention once 2 nd year classes end Where will you go for fresh questions for use in final prep period -> Kaplan Sim exams!!

33 NRMP Program Director Survey Results (2014) Percentage of Programs Citing Each Factor in Selecting Applicants to Interview Source: 2014: NRMP Program Director Survey Results (2014). National Resident Matching Program. p. 3

34 Organize Yourself After 2 nd Year Classes End

35 First 2/3 of remaining time: 1. Take first overall assessment early (Kaplan sim #1), rank order subjects by test results! 2. Complete planned review of all Step 1 subjects! 3. Final subject content review occurs in weakest to strongest order! Final 1/3 of remaining time: 1. Cycles of practice testing --- identify weak spots - review these again to refresh + clarify! 2. Refresh highest yield topics + rote during final 2 weeks! 3. Take final overall assessment (Kaplan sim #2); plan last week of review! No study the final afternoon and evening before exam day!!! Allow for final assimilation and accommodation processes!

36 Source: New England Journal Of Medicine (http://www.nejm.org/doi/full/ /NEJMhpr ) “We estimate that we will see domestic production of medical school graduates functionally surpass our current number of GME postgraduate year one pipeline positions by 2015 or sooner.” Source: Dr. Thomas Nasco, CEO of the Association Council for Graduate Medical education

37 Final Review - KEY POINTS Self-assess comprehensively (sim #1) approximately 1 month to six weeks before exam date Allocate final # days to spend per topic based on sim #1 results, as shown below Take simulated exam #2 approximately 7 to 10 days before exam date; review completely for final most challenging study review Optional: take NBME self-assessment ($50 – 4-hour exam) Assessment Scores Study Sequence# FINAL Study Days Anatomy70%72 Physiology45%15 Biochemistry60%63 Behavioral Science75%82 Pathology50%35 Microbiology60%53 Immunology45%23 Pharmacology55%45

38 NRMP Program Director Survey Results (2014) Percentage of Programs Citing Each Factor in Selecting Applicants to Interview Source: 2014: NRMP Program Director Survey Results (2014). National Resident Matching Program. p. 3

39 Plan Your CURRENT & LAST Month Carefully Content Questions T o t a l S t u d y T i m e EXAM DAY Questions* should drive you BACK to study SPECIFICS! Topical Question Review Test Simulation *Questions do not TEACH…they “TEST!” Always remember that!...

40 Questions* should drive you BACK to study MORE! *Questions do not TEACH…they “TEST!” Always remember that!...

41 “Whether you believe you can, or you can’t, you're right.” Henry Ford

42 Source: New England Journal Of Medicine (http://www.nejm.org/doi/full/ /NEJMhpr ) “We estimate that we will see domestic production of medical school graduates functionally surpass our current number of GME postgraduate year one pipeline positions by 2015 or sooner.” Source: Dr. Thomas Nasco, CEO of the Association Council for Graduate Medical education

43 NRMP Program Director Survey Results (2014) Percentage of Programs Citing Each Factor in Selecting Applicants to Interview Source: 2014: NRMP Program Director Survey Results (2014). National Resident Matching Program. p. 3

44 Thank you for your attention today! What are your questions? Scott Robertson Regional Medical Programs Manager


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