1. How much do you know about Step 1? Office of Student Learning and Educational Resources UC Davis School of Medicine June 20, 2016

2. Goals Answer basic questions about the format, structure and content of Step 1 Describe common themes in the way top scoring students have prepared for the exam Describe effective ways to incorporate First Aid for Step 1 in your year 2 study Describe effective ways to incorporate Kaplan Q- bank in your year 2 study Review Step 1 services and support OSLER can provide

3. Step 1 Basics What is the passing score for Step 1? – 192 – National average: ~230 How many questions are on Step 1? How are they divided? How is the content distributed? – 280 questions total – 7 modules, each has 40 questions – Questions in each module are a random selection from all organ systems/disciplines How long does it take to complete the entire test? How much of that time is break time? – 7 hour exam administered over 8 hours – 7, 1 hour modules – 15 minute tutorial – 45 minutes of break time used at your discretion between modules

4. Step 1 Basics What is the latest date on which you can take the exam? – Friday prior to the beginning of Transition to Clerkships – Friday, April 21, 2017 What do you have to do if you want to take the exam later than this date? – Request a deferral of your first clerkship from the Committee on Student Promotions by February 11, 2017 – Deferrals granted only for health or academic reasons http://www.ucdmc.ucdavis.edu/mdprogram/medicalstudentpolici es/csp/step1policy.html http://www.ucdmc.ucdavis.edu/mdprogram/medicalstudentpolici es/csp/step1policy.html

5. What is the most “high yield” content on Step 1? Content is broadly divided between systems (e.g. cardiovascular, reproductive) and disciplines (e.g. microbiology, biochemistry) Approximately 60% of the content relates to normal/abnormal processes of organ systems Approximately 40% of the content relates to disciplines Emphasis on normal/abnormal varies by topic

6. Subjects Studied by DisciplineSubjects Studied by Organ System GENERAL PRINCIPLES OF PHARMACOLOGY (Pharmacokinetics, Pharmacodynamics, Autonomic drugs, Toxicities and Side Effects) NEUROLOGY (Embryology, Anatomy/Physiology, Pathology, Pharmacology) GENERAL PRINCIPLES OF PATHOLOGY (Inflammation, Neoplasia) CARDIOVASCULAR (Anatomy, Embryology, Physiology, Pathology, Pharmacology) MICROBIOLOGY (Bacteriology, Mycology, Parasitology, Virology, Antimicrobials) RESPIRATORY (Anatomy, Embryology, Physiology, Pathology, Pharmacology) IMMUNOLOGY (Normal immune response, abnormal processes, pharmacology) RENAL (Anatomy, Embryology, Physiology, Pathology, Pharmacology) BIOCHEMISTRY (Molecular, Cellular, Lab Techniques, Genetics, Nutrition, Metabolism) GASTROINTESTINAL (Anatomy, Embryology, Physiology, Pathology, Pharmacology) BEHAVIORAL SCIENCE (Epi/Biostats, Ethics, Development and Aging, Public Health) REPRODUCTIVE (Anatomy, Embryology, Physiology, Pathology, Pharmacology) PSYCHIATRY (Psychology, Pathology, Pharmacology) ENDOCRINE (Anatomy, Embryology, Physiology, Pathology, Pharmacology) HEMATOLOGY/ONCOLOGY (Anatomy, Embryology, Physiology, Pathology, Pharmacology) MUSCULOSKELETAL (Embryology, Anatomy and Physiology, Pathology, Pharmacology) SKIN/CONNECTIVE (Histology, Pathology) 40% 60%

7. If you want a score of 230 or above, what should you be doing now?

8. What did all of those students (230 and higher) have in common? – All had a solid knowledge base All scored >85% in all courses, not including “participation” points! – All carefully assessed strengths and weaknesses – All had thoughtful, strategic plans to address weaknesses Short term goals Long term goals – All put their plan into place while maintaining performance in courses – All evaluated their plan as they went and made appropriate adjustments when something wasn’t working If you want a score of 230 or above, what should you be doing now?

9. What is the best way to use First Aid? Identify content taught in year 1 that is relevant for year 2 courses Actively review content to ensure strong foundational knowledge Quiz/summarize year 2 content at the end of courses to ensure it is “Step 1 ready”

10. What is the best way to use First Aid? Identify content taught in year 1 that is relevant for year 2 courses Year 2 CourseYear 1 Content (2016 First Aid page #) Neuroanatomy Neurons (453) Astrocytes (453) Microglia (453) Myelin (453) Schwann cells (453) Oligodendroglia (454) Sensory receptors (454) Peripheral nerve (454) Landmark dermatomes (476) Brainstem – ventral view (477) Cranial nerve and vessel pathways (478) Cranial nerves (479) Cranial Nerve reflexes (479) Common cranial nerve lesions (480) Mastication muscles (480) Auditory physiology (481) Ocular motility (488)

11. What is the best way to use First Aid? Use the headings as a quiz Explain, teach, diagram Check Mark/annotate what you DIDN’T know

12. What is the best way to use First Aid? NerveNameTypeFunctionResult of Lesion I II III IV V VI VII VIII IX X XI XII Cranial Nerves

13. How should you be using your Kaplan Q-bank? Assess the quality of your review of year 1 content – Review cardiovascular physiology – Complete a test of cardiovascular physiology questions Assess the quality of year 2 content as it relates to Step 1 – End of Brain and Behavior complete the questions related to neuroanatomy, neurophysiology and neuropathology. – What is strong? What needs additional review?

14. What can OSLER do to help you prepare for Step 1? On-going Workshops (watch for announcements!) – End of each block/course – how to plan a review of year 1 content relevant to the next course/block – How to register for Step 1 (October) – Planning a review for Winter Break Wednesday morning review sessions Pharm Club Individual study plans for March/April study (November-February) Step 1 Review class (March/April 2017) Moral support

15. Important Dates and Deadlines December 7, 2016 – BSE – Step 1 practice test REQUIRED for all students!! February 11, 2017 – deadline to apply for clerkship deferral/extended study time April 21, 2017 – deadline to take Step 1

16. Step 1 Timeline July August September October November December January February March April Intensive Study Step 1 Deadline: April 21, 2017 Block 3: Brain & Behavior Block 4: Musculoskeletal, Derm, Heme, Pulm, Cardio Create study plan for Block 3 Create study plan for Block 4 Begin registration process Apply for testing accommodations Select test date and schedule Step 1 Create schedule for “intensive study” in March/April BSE: Monday, December 7, 2016 Nephrology, GI Create study plan for winter break

17. A word about testing accommodations… If you plan to apply for testing accommodations for a physical or other disability… – Process starts in August/September OSLER will contact students about decision to apply Assemble necessary documentation Have paperwork ready to submit in October/November with registration – Information related to testing accommodations for USMLE http://www.usmle.org/test-accommodations/