Level1FACTS:

400questionsin8hoursdividedintotwosessionsconsistingoffoursections. 72secondsperquestion. 4hourspersessionusetimeasyouwishbetweensectionsinasession. Optional10minutebreaksbetweensections2&3andsections6&7. Optional40minutebreakbetweensections4&5(inotherwords,sessions1&2). Mostquestionsaresinglevignettewithasinglequestionandasinglebestanswer.There aresomematchingsetquestionsandsomevignettesthatarefollowedbymultiple questions. 99th percentile~725
Mean score 500 Passing score 400 Pass rate 87.6% for first-time test takers in 2010-2011

Atrackrecordofsuccessonstandardizedtests(e.g.inMCAT)doesnotguaranteeahighscore. Hardworkandsolidplanningwillmaximizeyourpotential. Allquestionsaresinglebestanswermultiplechoiceandmatching.Youllhavetoexclude apparentlygoodoptions. Mostlyclinicalvignettes,someresearchscenariosreasoningandpatternrecognitionrather thanstraightrecallisrequiredtosolvequestions.

RESIDENCYFACTS:
Theaverageprogramreceives716applications. ResidencyprogramsrelyonStep1scorestoscreenoutapplications. Percentageofresidencydirectorscitingfactorswhenconsideringacandidate: o 73%citeStep1/Level1scores. o 71%citelettersofrecommendationinthedesiredspecialty. o 68%citepersonalstatement. o 62%citegradesinclerkships. o 61%citeStep2/Level2scores. o 59%citeclassranking/quartile. ManystudentsdontdiscovertheirrealpassionuntiltheyareinclerkshipsaftertakingLevel1.

Specialty FamilyMedicine Psychiatry Ob/Gyn Pediatrics EmergencyMedicine Anesthesiology GeneralSurgery Neurology InternalMedicine Pathology Orthopaedics DiagnosticRadiology Dermatology PlasticSurgery

MeanUSMed scores2012 Yearsof (Matched) Residency 213 214 220 221 223 226 227 225 226 226 240 240 244 249 3 4 4 3 3 4 5 4 3 3 5 4 4 5

Meanhrs/ week 52.5 48 61 54 46 61 60 55 57 45 58 58 45

Scheduletype Uncontrollable Controllable Uncontrollable Uncontrollable Controllable Controllable Uncontrollable Controllable Uncontrollable Controllable Uncontrollable Controllable Controllable

Salaryrange $175k$220k $173k$248k $251k$326k $160k$228k $239k$316k $331k$423k $284k$383k $408k(median) $184k$231k $239k$331k $397k$600k $377k$478k $313k$480k $275k$499k

PREPARATIONPRINCIPLES
Studyregularlyforshortperiodsoverthelongterm.Theamountofinformationyouretainwill plateauifyoutrytostudyintensivelyoverashortperiod. Putabigpictureframeworkinplaceearlyonbymakingafirstpassthroughthematerial.This allowsyoutoassociatenewmaterialtoexistingmaterialandretainmore. Buildspacedrepetitionofresourcesintoyourplan.Thisiskeytoimprovingretention. Repeatweakareasmoreoftenbutmakesureyourepeatallareas.Otherwise,youmayturn strengthsintoweaknesses.USmedicalstudentswesurveyedratedBehavioralMedicineasthe fourthhardestdisciplineontestdayharderthanpathology. DoingwellinMedicalSchoolisagreatfoundationforStep1andimportanttoResidency Directors.Studymaterialthatalignswithyourmedicalschoolcurriculumandyoulldowellin both. 2

Makesureyouhaveeverythingyouplantomasterorganizedinoneplacebeforeyoustart studyingintensively. Familiarizeyourselfwithanyresourcesthatyouplantousewellbeforeyouplantousethem. Dontwaituntilthelastmomenttofindoutthatsomethingdoesntworkforyou. Properplanningminimizesstressandmaximizesscores.Putaplaninplacethatyouare comfortablewithbeforeyoustartstudyingintensively. Askanupperclassmanyoutrusttoreviewyourplan.Becautiousofanyonewhosaysthetest iseasywiththebenefitofhindsight. Createadailyscheduleforeachphaseofstudy.Trythescheduleoutbeforeyouentereach phasetocheckthatitworksforyou.Ataminimuminclude3quick,healthymeals,a30 minutewalk,2hoursofnonstudy,and8hoursofsleep. Takeonedayoffstudyingeachweek.Inanemergency,thesecanactascatchupdays however,relaxationtimeiskeytomakingitthroughyourStep1preparationtime. Onceyouhaveaplanthatworkssticktoit. Makesureyouunderstandthematerialduringyourfirstpassputtingitintoyourownwordsif necessarysoyouarenottryingtofigureoutwhatitmeansforthefirsttimeduringyourfinal review. Understandingthelogicbehindmaterialwillmeanlessrotememorizationitwillalsohelp youreasonthroughnovelscenariostothebestanswerontestday. Studywithpurpose.Activelyaimtoretainmaterialateachpassratherthanpassivelyviewing orreading.Forinstance,coverselectedstudymaterialandimmediatelytrytoputwhatyou learnedinyourownwords. Seeinginformationinmultiplewaysaidsretention.Makesureyourstudiesaremultimodal: o Useexamlikequestionslimituseofrecallquestions. Testingoninformationjuststudiedhelpsyoutoretainit. Becauseansweringquestionsisactiveithelpsyoumaintainattention. Examlikequestionshelpyouunderstandthewayyouwillapplyknowledge. Examlikequestiondemandintegratedknowledgewhichhelpsyouintegrate. Immediatetestingofmaterialhelpsyouretainit. Spacedretrievalmakesknowledgeeasiertoretrievelater(TheTestingEffect). ChooseaplanthatgetsyouthroughtwoQbanks.WhenwesurveyUSmedical studentstherewasaclearrelationshipbetweennumberofQbankscompleted andscoringhigher:

=1 Qbank

o Readmaterial. Readingisafasterwayofcoveringalltestingpointsthanquestions. Youshouldmakereadingactivebytakingnotesandimmediatelytesting yourselfinQbank. EngageinadialoguewithtextWhatdoesthismean?WhatelsedoIknow aboutthiscondition?Whatprocessisthislike? OnLineLectures. Lecturerscanexplainhowtheymasteredmaterialmorevividlythanintext. Lecturerscanintegratemoreelegantlythancrossreferencesinreviewbooks. Lecturesprovideforwardmomentumwhenyourenergyislowforinstance whenyouarestilldirectingyourenergytoyourmedicalschoolcurriculum. Lecturesprovidepushtohelpyoucovertopicsyoudislike. Illustrationsandanimationshelpyouvisualizeconcepts.

SUGGESTEDSTUDYPLAN:
EachLectureendswith~5questions,sothatyoucanactivelyapplyknowledge. 4

1LecturebasedReviewSession=Four30minutelectures+20questions=3hoursofstudy. 1Qbankblock=50COMLEXstylequestions=2.5hoursofstudy.

PREPREPARATION|>6monthstogo:OccasionalLectures|Qbank:15Qs/week|Preptime: negligible CHECKUP1|6monthstogo Kaplan'sStep1Diagnostic INCURRICULUMPREPARATION|626weekstogo Lectures:1Session/week|Qbank:15Qs/day|Preptime:~1hours/day CHECKUP2|6weekstogo COMSAEFormA REMEDIATION|46 weekstogo Lectures:RepeatweakSessions| Qbank:Incorrect/MyQuestions |Preptime:variable CHECKUP3|4weekstogo KaplanSim 1 FINALMONTH|14weekstogo Lectures:1Session/day| Qbank:2blocks/day|Preptime:810hours/day CHECKUP4|4weekstogo COMSAEFormB FINALWEEK|27daystogo Lectures:Reviewweakesttopics|Qbank:2blocks/day|Preptime:810hours/day FINALDAY Reviewsheet|Relax

Acceleratedplans. Werecommendusingthisplaninfull.Ifyoudoneedafasterplan,herearesomerecommendations. 14weeks ShortenPhase2to10weeksbystudying~2hoursaday.CutoutPhase3. 6weeks StartwithPhase4.After3weeks,repeattopicsinwhichyouareweak.MoveonwithPhase5.

CHECKUPs:
TaketheStep1Diagnosticbeforestudyinginearnest.Expecttodobadly.Seeingthatyou needtoraiseyourscorelendsurgencytoyourstudy.Seeingprogressfromabaselinekeeps youmotivated. Onbalance,moststudentsfindtheCOMSAEFormstobefairlyreflectiveofthetestanda reasonablepredictorofperformance.However,useallscoreestimatestoreducestressand notasareasontostopstudying. WedontrecommendfocusingonCOMSAEformsasthetestapproaches.Theydontinclude explanationsandarenotanefficientlearningtool. Youshouldcompleteatleastonefulllengthsimulatedexampriortothetest.Youcannot expecttohavethestaminaforan8hourtestunlessyoudofulllengthsimulations. Ontestday,studentssittingother,shortertestscomeandgothroughouttheday.Consider takingyourpracticetestsinalibraryenvironmentsoyoucanpracticeshuttingoutdistractions. Wedontrecommendtakingasimulatedexamlessthan2weeksfromtestday.Apoor performancecouldunsettleyouanddamageyourperformance.

PHASE1:PREPREPARATION
General Ifyourmedicalschoolcurriculumisntalreadyinacalendarapplicationworkasaclasstoadd it.Includealltests,breaks,andyourschoolsmusttestdate.Addyourstudyplantothat calendarbasedontherecommendationsprovidedhereandwhatworksforyou. Ifyourgoalisagreatscore,youneedtostudymorethanjustthehighestyieldmaterial.Create aHighYield/WeakestTopicsFolderandcondensematerialfromotherresourcesintoit. o PurchaseFirstAid,takeittoaprintshopandhavethebindingremovedsoitcanbe addedtoyourHighYieldFolder.UseFirstAidtokeepmaterialyouaddorganized. o InMarch,addtheHighYieldslidepacktothefolder(FirstAidPagerefsincluded).Your slidepackwillbeavailableonyourKaplanstudenthomepage. o Watchoutforhighyield,helpfulhandoutsfromclassandadd. o Usesingletopicreviewbooksduringyourcurriculum,extractingkeyinformationtoadd toyourfolder.IfyoudonothaveaccesstoKaplanlecturenotes,werecommend PathologyGoljanRapidReview BiochemistryGoljanRapidReview MicrobiologyMicroMadeRidiculouslySimple GrossAnatomyBRSAnatomy BehavioralMedicineBRSBehavioralScience NeuroanatomyHighYieldNeuroanatomy PharmacologyBRSPharmacology PhysiologyBRSPhysiology 6

Step1OnlineLectures Viewlecturesthatalignwithyourmedicalschoolcurriculum.Aswellashelpingwithyour coursework,thiswillensurethatyouarecomfortablewiththecourse. Qbank Startdoing~15questionsperweekthatalignwithyourcoursework.Understandingtheway theNBOMEtestsmaterialwillhelpyouidentifythetestrelevantmaterialthatyoushouldbe addingtoyourHighYieldFolderduringyourcurriculum.AddkeyinformationfromQbankto yourHighYieldFolder.

PHASE2:INCURRICULUMPREPARATION.
General ContinuemigratinginformationtoyourHighYieldFolder.BytheendofPhase2,youhavea singlefoldercontainingallthematerialyouplantomasterforCOMLEX.Otherreviewbooks maynowbeusedforreferenceonly. IfyouplantocreateflashcardforPharmandMicro,createthembeforeyouareinaperiodof intensestudy. Attheendofeachweek,setasidetimetoquicklyreviewyournotesfromthepreviousweek. OnlineLectures CoveroneLectureSessionperweek(~3hours).Followtheorderrecommendedinthe syllabus,unlessyouhaveamedicalschooltest,inwhichcaseyoushouldplantocoverthe relevantmaterialfromOnlineLecturesthatweek. FollowalonginyourHighYieldFoldertakingnotesputacheckmarknexttoeachFirstAid headingyoureviewandunderstand.PlaceanXnexttoanyheadingyoufindchallenging. ImmediatelyapplyyourknowledgeusingtheinteractiveCOMLEXstylequestionsattheendof eachOnlineLectureSession. Qbank Do15Qbankquestionsperdaycoveringmaterialstudiedthepreviousweek(spacedretrieval). Bytheendofphase2,youwillhavecompletedafirstpassofQbank.Continuetoaddkey informationfromQbanktoyourHighYieldFolder. Eachweek,dooneblockthatmixesalltopicsstudiedtodate.

PHASE3:REMEDIATION
General Thehoursyoustudyperdaywillvarydependingonwhetheryouarestillinclass. Ifyourecoveryourweaktopicsearly,startphase4anddomorequestionsperday. Scheduleanactivityyouenjoyimmediatelyafterthetesttorewardyourhardwork. ChecktheCOMLEXwebsiteforlatebreakingannouncements. 7

 RepeatviewingOnlineLecturesfocusedontheweaknessesidentifiedintheCheckUp, reviewingtherelevantsectionsofyourHighYieldFolder. ReviewallFirstAidheadingsthatyoumarkedwithanXduringPhase2.Seekhelpwith anythingyoustillfindchallengingandaddanexplanationinyourownwordsinFirstAid.Your goalinthisphaseistobeabletoputacheckmarknexttoeveryheading.

Qbank CreatemixedtopictestsoutofincorrectquestionsandquestionsfromyourQbank MyQuestionspool. Ifyouhavetime,repeatquestionsyouansweredcorrectlyinareaswhereyouareweak.

PHASE4:FINALMONTH General
Knowyourroutetothetestingcenter. Ifyouchangeyourtestdatewithin30daysofthetestyoumayincurafee.Westrongly recommendthatyouavoidchangingyourtestifyouhavefollowaplanlikethisoneyouwill begreatshapeanddelayingwillbecounterproductive. Attheendofeachweek,setasidetimetoreviewyournotesfromthepreviousweek. OnlineLectures CompleteoneLectureSessionperdayfollowingalonginyourHighYieldFolder.Regularly pausethevideotoreadallnotesthatrelatetothelecture. Usex1.5speedtocompressyourreviewtimebutbehonestwithyourself.Ifyouarenot absorbinginformationatthefasterspeeduseregularx1speed. Answeringthequestionsattheendofeachsectionasecondtimeishelpfulbutoptional. Qbank Ifneeded,considerpurchasinganadditional,1monthQbank.Doingtwoblocksadaywillhelp youcompleteit.

PHASE5:FINALWEEK
Dontstudyanynewmaterialinthelastweek. GooveryourHighYieldFoldercoveringevenportionseachday. 8

Createaseparatecheatsheetbywritingoutanythingyouhaventmastered. Studyimmunology,microbiology,andpharmacologylast,astheyarethehardesttoretain. Continuedoingtwo50itemmixedtopicblocks. Planouthowyouwanttousebreaktimeontestday.

PHASE6:FINALDAY
Yourgoaltodayistoensurethatyouarewellrestedandrelaxedontestday. Somestudentstakethedayoff.Somestudentsfindadayoffmorestressfulthanstudying. Limityourselfto5hoursandfocusonreviewingyourcheatsheet.Absolutelynostudyofnew material. Keepthesamesleepschedule/mealscheduleyouhavebeenusingupuntilthispoint. Avoidtalkingtootherswhohavetakentheexamaboutthetest.Itwilljuststressyouout. Makepreparationsfortestday.Buysnacks,drinks,andmakeyourselflunch.

TESTDAY:
Wedontrecommendyoudoanyreviewonthemorningofthetest. Bringsnacks,water,andsimplelunch. Wearlayerssoyoucanadjustfortemperature. YoucantbringanythingintotheexamroomexceptyourID.Nowatchesorhats. Manystudentsreportseeingstringsofrelatedquestionsdontbedistractedbyperceived patternsoroversampling.

QUESTIONPRACTICE:
Youarenotgoingtoknoweveryquestionontestday.Practicepickingthemostplausible choice,markingthequestion,andreturningiftimeallows. Questionsthatyouperceiveasunfair/obscurecanthrowyourperformanceonsubsequent questions.Practicecalmlymovingon. Thetestincludesafewexperimentalquestionsthatdonotcounttowardsyourscore,however assumethateventhemostbizarrequestioncounts. Dontexpectanytestwisecluesonthetest(i.e.correctanswersmorepreciselydefinedthan distracters).Buzzwordsstillappearoccasionallybutdontcountonthem. Youhave72secondsperquestion.Youshouldstartusingthetimedtutormodeasearlyasa possible.UsetheTestmodeinthefinalfewweeks. Moststudentstakemorecareandgoslowerintheactualtest.Aimtofinishpracticeblocks withatleast23minutestospareinordertocompensateforthis. Bearinmindthatyouwillanswerreusedquestionsmorequicklyandscorehigherinthem. 9

Treatanycorrectanswerthatyouwerentcertainofasincorrectandaddittoyour MyQuestionspoolsoyoucanrepeatit. Forincorrectitems,reviewfullexplanationsandthenreKaps.Forcorrectitemsitisbetterto readexplanationsbutyoumayfindthatthereKapsareenough. Ifyourecognizeawiderweaknessonyourfirstpass,viewthehighyieldoverviewtablesfrom medEssentials. Donotwastetimecheckingthetimer.Checkyourtimeratthehalfwaypointandthenwith10 questionstogotoensureyouhaveachancetoanswerallquestions. Youwillbeprovidedwithawhiteboardfornotetakingkeepscrappaperhandywhenusing Qbanktodeterminehowyouwillwanttousethisresourceontestday. Qbankandthetestsoftwarebothprovideaccesstolabvalues.Manyquestionsincludepanels oflabvalues.Beingabletoquicklyrecognizeabnormalvalueswillsaveyoutime.Thelab valuesinthetestwillnotbegreylearningtorecognizekeyvalueswillsaveyoutime. Qbankprovidesinformationonwhetherchangingyouranswerchoicepositivelyornegatively impactsyourscore.Usethisinformationtodecidewhethertohavethecourageofyour convictionorsecondguessyourself. Experimenttoseewhetherreadingtheanswerchoicesfirstwhenyouhitalongvignetteallows youanswermorequickly. AgoodQbankshouldbeexamlike: o Nostraightrecallquestions o o o o o o o

Realisticclinicalvignettes NBOMEstylephrasing Nopickyortrickyquestions Nonegativelywordedquestions Nobuzzwordsorcluesforthetestwise Sufficientbutnotoverwhelmingevidence Alldistractersplausible

AgoodQbankshouldalsofocuson: o Multiplevignettesonimportantdiseases o o o o o o

Oversamplingofthehighyieldconcepts Noquestionsonuntestedtopics Oversamplingofhardquestionsorunfamiliarquestiontypes Noquestionseasierthanthetest Oversamplingofmultistepquestions Oversamplingofintegratedquestions

10