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Canadian USMLE Step 1 writers from 3 Year schools (or 4 year schools): Tips!

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3 hours ago, DermJuly2018PGY1 said:

what you score?

Doesn't matter. This advice

4 hours ago, Edict said:

1. Use UWorld + First Aid. 

2. Use either Pathoma or Goljan's as well

3. In subject areas you are weak, buy a book that advertises itself as USMLE friendly

 

is solid. If you read any other forum it will essentially be the same. How well you score depends on how much you study. If you want to aim for 250+ you basically need to just know FA (with uworld annotations) cold. 

EDIT: Also, cannot stress how valuable pathoma is. If you had to choose between that and Goljan, absolutely do pathoma. 

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18 hours ago, skyuppercutt said:

Doesn't matter. This advice

is solid. If you read any other forum it will essentially be the same. How well you score depends on how much you study. If you want to aim for 250+ you basically need to just know FA (with uworld annotations) cold. 

EDIT: Also, cannot stress how valuable pathoma is. If you had to choose between that and Goljan, absolutely do pathoma. 

I would agree, Pathoma was a gold-mine. The book + videos side by side, covered everything far more succinctly and clearly than my preclin courses did. And to much broader breadth.

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I scored very highly. i took it after medical school so my vantage point was slightly different but i think were i to do it in medical school i would have followed the same plan.

1. get the most recent edition of first aid and go through each of the chapters, making your own notes as you go along using three ring binders and lined paper. paraphrasing things helps you remember them and understand them. if you dont understand something, find a source like goljan, costanzo, etc and clarify it. FA is an outline of what you should know. it does not have the detail you need.

2. get pathoma and annotate the appropriate FA chapters with pathoma lecture information. although it comes with a book i didnt use it, but as a student the pathology images contained in it may prove valuable. 

 

NOTE: pathoma is good enough to recommend to every medical student even if they dont plan on sitting for the usmles. it really is that good. Praise Sattar.

3. finally do uworld in timed random, NOT TUTOR and NOT UNTIMED, eight-to-ten blocks one day, with three days of annotation following. REMEMBER TO ANNOTATE! The explanations in uworld are the best you can find anywhere. with this pattern you can get through uworld in one month. i think its valuable to do uworld last, after FA and pathoma, because you can use it to test your knowledge and MCQ strategies as you will be simulating testing conditions. if you go into it at the start, it is useless for assessment purposes.

4. do the uwsas and the two most recent nbmes throughout your uworld studies, with the last ones at the end.

overall you can do it in four to six months. usmle is no joke and requires intense study and dedication, and the score is very important, doubly so as a canadian as trumps regime is cracking down heavily on h1b visas.

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2 hours ago, GrouchoMarx said:

I scored very highly. i took it after medical school so my vantage point was slightly different but i think were i to do it in medical school i would have followed the same plan.

1. get the most recent edition of first aid and go through each of the chapters, making your own notes as you go along using three ring binders and lined paper. paraphrasing things helps you remember them and understand them. if you dont understand something, find a source like goljan, costanzo, etc and clarify it.

2. get pathoma and annotate the appropriate FA chapters with pathoma lecture information. although it comes with a book i didnt use it, but as a student the pathology images contained in it may prove valuable. 

 

NOTE: pathoma is good enough to recommend to every medical student even if they dont plan on sitting for the usmles. it really is that good. Praise Sattar.

3. finally do uworld in timed random, eight-to-ten blocks one day, with three days of annotation following. with this pattern you can get through uworld in one month. i think its valuable to do uworld last, after FA and pathoma, because you can use it to test your knowledge and MCQ strategies. if you go into it at the start, it is useless for assessment purposes.

overall you can do it in four to six months. usmle is no joke and requires intense study and dedication, and the score is very important, doubly so as a canadian as trumps regime is cracking down heavily on h1b visas.

The best resources are definitely UWorld, First Aid, and Pathoma (it really is just as good as everyone says it is). Depending on your learning style, I would advise starting UWorld as early as possible. Yeah you will get a lot of questions wrong at first which will feel like shit, but it is a more practical way to learn the material. The only thing shown to correlate with a high score is the number of practice questions a person can cram into their head. It is in your best interest to do as many questions as humanly possible. UWorld is a learning tool, not an assessment tool. If you want a proper assessment, take one of the NBME self-assessment exams (which are actually fairly predictive). How you use UWorld (or other qbanks) is also really important. Make sure you take the time to go over each question thoroughly so you understand what the question is trying to ask and why the other options are incorrect. Also try to annotate FA while you go through UWorld as the explanations are better than what you'll find in most textbooks.

I never completed a full read-through of FA while studying for Step 1 but still managed to score very well. I did, however, complete an embarrassing number of practice questions. A lot of the exam is pattern recognition which just takes practice. If you can put yourself in the shoes of the question writers and understand why they are asking certain questions, or how they could change the wording slightly to get a different answer, you'll be in good shape. Also if FA puts you to sleep, DIT basically reads FA to you so that is another option for getting through the material.

At the end of the day, it's important to figure out which resources work best for you. Don't be afraid to switch things up if something isn't working just because someone read FA 10 times and got a 250. Another resource I found helpful was SketchyMicro, but I am more of a visual learner. Goljan is kind of like the precursor to Pathoma but is more of a slog to try and read through. There is an audio recording of Goljan's Step 1 lecture series online somewhere which can be good to listen to while on the go or working out.

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On 4/12/2018 at 8:04 PM, thatiswhat said:

The best resources are definitely UWorld, First Aid, and Pathoma (it really is just as good as everyone says it is). Depending on your learning style, I would advise starting UWorld as early as possible. Yeah you will get a lot of questions wrong at first which will feel like shit, but it is a more practical way to learn the material. The only thing shown to correlate with a high score is the number of practice questions a person can cram into their head. It is in your best interest to do as many questions as humanly possible. UWorld is a learning tool, not an assessment tool. If you want a proper assessment, take one of the NBME self-assessment exams (which are actually fairly predictive). How you use UWorld (or other qbanks) is also really important. Make sure you take the time to go over each question thoroughly so you understand what the question is trying to ask and why the other options are incorrect. Also try to annotate FA while you go through UWorld as the explanations are better than what you'll find in most textbooks.

I never completed a full read-through of FA while studying for Step 1 but still managed to score very well. I did, however, complete an embarrassing number of practice questions. A lot of the exam is pattern recognition which just takes practice. If you can put yourself in the shoes of the question writers and understand why they are asking certain questions, or how they could change the wording slightly to get a different answer, you'll be in good shape. Also if FA puts you to sleep, DIT basically reads FA to you so that is another option for getting through the material.

At the end of the day, it's important to figure out which resources work best for you. Don't be afraid to switch things up if something isn't working just because someone read FA 10 times and got a 250. Another resource I found helpful was SketchyMicro, but I am more of a visual learner. Goljan is kind of like the precursor to Pathoma but is more of a slog to try and read through. There is an audio recording of Goljan's Step 1 lecture series online somewhere which can be good to listen to while on the go or working out.

goljan is great for listening to during commutes but outside of that i wouldnt concentrate on it. i also wouldnt use his book as a primary source but as a reference to fill in gaps that are present in FA (which are a lot)

i dont know about sketchy but a lot of people like to use it.

DIT is a HUGE waste of money. DONT use it. considering that pathoma is a fraction of the price, and actually useful, i am not impressed with DITs price gouging of neurotic medical students and IMGs for what basically amounts to someone reading FA to you like a bedtime story.

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that means you need a high score potentially - most people would write it between clerkship and clerkship and ideally be studying all along a bit from the start (ha which is so hard to do). In a third year program is a bit more compressed obviously and I would think yeah after 1st year with adequate prep seems reasonable (others may have other opinions on that). 

In my case I don't need to do well at all actually - I just have to pass it. I don't want to do super badly on it though of course - don't want to fail it and don't want to ha take an ego hit either I guess but I 100% know parts of it aren't particularly important to me except for general interest. Actually it is good just to remind me that I like science for science sake. 

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On 9/12/2018 at 3:11 PM, End Poverty said:

When is the best time to write the USMLE in 3 year medical school program?  After 1st year ?

I would say during MF5 i.e. after first year. Basically, right before clerkship. 

If you are serious about going to the US, i'd do an enrichment year, make your degree a 4 year degree. The reason is, you want more elective time to go to the US to do them, you also need more time to study for your USMLE Step 2 CK. 

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3 hours ago, Edict said:

I would say during MF5 i.e. after first year. Basically, right before clerkship. 

If you are serious about going to the US, i'd do an enrichment year, make your degree a 4 year degree. The reason is, you want more elective time to go to the US to do them, you also need more time to study for your USMLE Step 2 CK. 

Thank you for your reply, Edict.  

I go to U of C and I don't think we can get an enrichment year :(.  

I was wondering if  we have to do electives in the US if we would like to match there? I'm honestly mainly writing the USMLE in case I want to do a dermatology residency ( it is in my top 3 list of residencies that I'm currently  interested in),  but I'm concerned that I may not have enough time to build my resume for CARMS because I am still not 100% sure if dermatology is my top choice residency. I'm usually really good with standardized exams and I feel that if all I need to get dermatology residency in US is scoring extremely well on USMLEs, then I can definitely do that :).   I feel that writing the USMLE would allow me to keep my options open.  I also think that writing the exam while the material is fresh in my mind is easier than writing it later and possible having to re-study the material  that I might have forgotten.  It's a good way to review everything before clerckship.

My dilemma is that I am currently interested in Derm,  internal medicine, OB/GYN and I have not decided yet which option is what I really would like to pursue for the rest of my life, and I'm writing the USMLE to keep my options open.

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10 hours ago, End Poverty said:

Thank you for your reply, Edict.  

I go to U of C and I don't think we can get an enrichment year :(.  

I was wondering if  we have to do electives in the US if we would like to match there? I'm honestly mainly writing the USMLE in case I want to do a dermatology residency ( it is in my top 3 list of residencies that I'm currently  interested in),  but I'm concerned that I may not have enough time to build my resume for CARMS because I am still not 100% sure if dermatology is my top choice residency. I'm usually really good with standardized exams and I feel that if all I need to get dermatology residency in US is scoring extremely well on USMLEs, then I can definitely do that :).   I feel that writing the USMLE would allow me to keep my options open.  I also think that writing the exam while the material is fresh in my mind is easier than writing it later and possible having to re-study the material  that I might have forgotten.  It's a good way to review everything before clerckship.

My dilemma is that I am currently interested in Derm,  internal medicine, OB/GYN and I have not decided yet which option is what I really would like to pursue for the rest of my life, and I'm writing the USMLE to keep my options open.

I've heard UofC also doesn't have much pre-carms elective time, something on the order of 10 weeks, of which much of it is early in clerkship? I'd write the USMLE Step 1 after first year, but i'd be careful about stretching yourself too thin. a 3 year school is a huge challenge in and of itself, trying to match to derm and apply to both Canada and the US at the same time? That is really taking the cake if you manage it. 

I would study and write the Step 1 right now, but take things in small bits, try to figure out your specialty choice, and look into options for maybe doing a masters or somehow extending your time to 4 years especially if you can get more electives and you become serious about the US.

I would look at every derm program in the US that you are interested in's website, and go contact them to see if they accept Canadian electives and ref letters, some may, some may not. Don't forget that matching derm in Canada is tough already and you realistically need to limit your specialty choices down to two as soon as you can. 

 

 

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7 hours ago, Edict said:

I've heard UofC also doesn't have much pre-carms elective time, something on the order of 10 weeks, of which much of it is early in clerkship? I'd write the USMLE Step 1 after first year, but i'd be careful about stretching yourself too thin. a 3 year school is a huge challenge in and of itself, trying to match to derm and apply to both Canada and the US at the same time? That is really taking the cake if you manage it. 

I would study and write the Step 1 right now, but take things in small bits, try to figure out your specialty choice, and look into options for maybe doing a masters or somehow extending your time to 4 years especially if you can get more electives and you become serious about the US.

I would look at every derm program in the US that you are interested in's website, and go contact them to see if they accept Canadian electives and ref letters, some may, some may not. Don't forget that matching derm in Canada is tough already and you realistically need to limit your specialty choices down to two as soon as you can. 

 

 

Thank you so much for taking the time to write the detailed response, Edict :). I really appreciate it :)

I am actually studying for the USMLE as I am studying for my school exams, so it is not too bad. I  will definitely shadow more to try to figure out what I really want and I will be doing more research about the different options for pursuing Derm in Canada and US ( If I am still interested in it and I can't see myself doing anything else).

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21 hours ago, End Poverty said:

Thank you for your reply, Edict.  

I go to U of C and I don't think we can get an enrichment year :(.  

I was wondering if  we have to do electives in the US if we would like to match there? I'm honestly mainly writing the USMLE in case I want to do a dermatology residency ( it is in my top 3 list of residencies that I'm currently  interested in),  but I'm concerned that I may not have enough time to build my resume for CARMS because I am still not 100% sure if dermatology is my top choice residency. I'm usually really good with standardized exams and I feel that if all I need to get dermatology residency in US is scoring extremely well on USMLEs, then I can definitely do that :).   I feel that writing the USMLE would allow me to keep my options open.  I also think that writing the exam while the material is fresh in my mind is easier than writing it later and possible having to re-study the material  that I might have forgotten.  It's a good way to review everything before clerckship.

My dilemma is that I am currently interested in Derm,  internal medicine, OB/GYN and I have not decided yet which option is what I really would like to pursue for the rest of my life, and I'm writing the USMLE to keep my options open.

If you want to do a derm residency in the US potentially, then yes you defintiely need some US derm electives.  If you are seriously considering the US, then you need to add extra time onto your degree or risk going all-in on the US and not Canada etc. Heavily disadvantaged for elective time compared to 4 year programs from the perspective of dual applying Canada/US. Not saying its impossible without adding extra time, but very difficult.
 

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On 9/14/2018 at 9:58 PM, End Poverty said:

Thank you for your reply, Edict.  

I go to U of C and I don't think we can get an enrichment year :(.  

I was wondering if  we have to do electives in the US if we would like to match there? I'm honestly mainly writing the USMLE in case I want to do a dermatology residency ( it is in my top 3 list of residencies that I'm currently  interested in),  but I'm concerned that I may not have enough time to build my resume for CARMS because I am still not 100% sure if dermatology is my top choice residency. I'm usually really good with standardized exams and I feel that if all I need to get dermatology residency in US is scoring extremely well on USMLEs, then I can definitely do that :).   I feel that writing the USMLE would allow me to keep my options open.  I also think that writing the exam while the material is fresh in my mind is easier than writing it later and possible having to re-study the material  that I might have forgotten.  It's a good way to review everything before clerckship.

My dilemma is that I am currently interested in Derm,  internal medicine, OB/GYN and I have not decided yet which option is what I really would like to pursue for the rest of my life, and I'm writing the USMLE to keep my options open.

Excuse my bluntness, but writing USMLEs for the possibility of “keeping options open” to a US residency does not seem like a good idea, when you have 3 very different specialties of interest currently. I think you are better off putting time towards figuring out which of those 3 you want to do, then go for it in Canada - that is where your best chance of matching will be. FYI, unlike IM and obgyn, Derm is even more competitive in the US so regardless of your USMLE score (it’s just one of many factors), this would not be a backup option and more like a primary option if you feel you are competitive enough. 

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55 minutes ago, ZBL said:

Excuse my bluntness, but writing USMLEs for the possibility of “keeping options open” to a US residency does not seem like a good idea, when you have 3 very different specialties of interest currently. I think you are better off putting time towards figuring out which of those 3 you want to do, then go for it in Canada - that is where your best chance of matching will be. FYI, unlike IM and obgyn, Derm is even more competitive in the US so regardless of your USMLE score (it’s just one of many factors), this would not be a backup option and more like a primary option if you feel you are competitive enough. 

Thank you for your advice, ZBL I really appreciate it because I am NOT familiar at all with the US system. I'm working on figuring out what I want, but it is difficult because I have not done a lot of the course content in school yet and I don't want to make a pre-mature decission.   Hopefully, by the time, I do Course 2, I'll  be more decisive. When I talked to my academic counsellor, she was telling me to still keep my options open at this point, and she was saying that even if I want Derm then I can still make it even if I make my decision to pursue it late in my first year. So, I definitely agree with you that my best chances is to do it in Canada. 

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On 9/13/2018 at 4:56 PM, rmorelan said:

that means you need a high score potentially - most people would write it between clerkship and clerkship and ideally be studying all along a bit from the start (ha which is so hard to do). In a third year program is a bit more compressed obviously and I would think yeah after 1st year with adequate prep seems reasonable (others may have other opinions on that). 

In my case I don't need to do well at all actually - I just have to pass it. I don't want to do super badly on it though of course - don't want to fail it and don't want to ha take an ego hit either I guess but I 100% know parts of it aren't particularly important to me except for general interest. Actually it is good just to remind me that I like science for science sake. 

Why do you not need a high score?

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5 hours ago, jfdes said:

Why do you not need a high score?

My understanding is that if you are writing the USMLE for later doing a fellowship (MOST fellowships, not all) or working in the US after a Canadian residency, a passing score is good enough to do that, whereas for residency, since it's used as a primary metric for ranking, you need a competitive score to match.

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54 minutes ago, Monkey D. Luffy said:

My understanding is that if you are writing the USMLE for later doing a fellowship (MOST fellowships, not all) or working in the US after a Canadian residency, a passing score is good enough to do that, whereas for residency, since it's used as a primary metric for ranking, you need a competitive score to match.

exactly - if you already have your fellowships - which I do I suppose - then the USMLE only serves as a means to get actually fully licensed. most places in my field allow you to do a fellowship without the USMLE. If you want to moonlight then you do need a full license and you MAY need it - actually I still don't for the state of MA as the LMCC counts for them as well but I still would need it for a H1B visa. Interestingly if I get that visa I have to pay their equivalent of a EI and CPP on my taxes it seems - which is 500US a month. So unless you plan on moonlighting enough to actually earn 6K after takes moonlighting doesn't seem to be a logical ( I mean you can earn that, but it is interesting there is a disincentive to doing only a small amount). 

 

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