How I Raised My USMLE Score by 45 Points (Step 1 to Step 2 CK)
This Tip of the Week is based on an interview with AUA student Omar Taha who recently matched in internal medicine at Maimonides. Omar’s score bump and volunteer work helped him secure 31 interview invitations from internal medicine and family medicine programs. If I were to summarize Omar’s approach to his clinical years, I would say that his learning was patient-centered – an approach that helped him retain important medical concepts while also elevating his sense of motivation for medicine. Do remember that each successful student has a slightly different approach to studying and attaining a match. What they have in common is taking the time to think deeply about their own obstacles, strengths, and sources of motivation.
After receiving a disappointing score on Step 1, Omar was determined to do better on Step 2. He immediately volunteered to work with an internal medicine physician he contacted through a distant family connection, an older man who was in private practice with underserved patients. Omar ended up working M-F about 7 hours each day, and he did this during the gap time before the start of his first rotation as well as during other breaks between rotations.
I was allowed to see patients alone before the doctor came in. I wrote patient notes and even did things like putting on EKG leads, with everything checked by the doctor. The doctor was old school, so if he didn’t like my patient note, he’d have me redo it from scratch. I found that I learned a lot from the experience and practice. When I saw something in the office, my curiosity was piqued and I would go home to learn everything I could about that disease. When I listened to a patient describing certain side effects of a drug, this really meant something and I would remember it. I was learning from interest, not for an exam, so I really retained the information. Later, during residency interviews, I would tell interviewers that seeing patients at the clinic meant that a disease now had a face and I would never forget it. It was now an experience, not just a fact in a book.
Most doctors love to teach, so it’s not that hard to find a volunteer experience like this. I know students who called strangers and ended up finding a volunteer spot where they got to have some great clinical experiences. My own volunteer work helped me build a strong foundation of rapport techniques and physical exam skills which helped me shine during rotations. I highly recommend this before starting your rotations if time permits. It will help open doors.
C.D.: I don’t know a lot about informal volunteering like this, but I would assume that smaller practices would be much more open and would probably be less concerned about legal restrictions.
One of my main mistakes in preparing for Step 1 is that I spread myself too thin, using too many sources and not having an organized study approach. I tried to simplify things for my clinical studies. Before the start of rotations, I used First Aid for Step 2 CK, which provided very comprehensive information. Later, during internal medicine and the subspecialty electives, I read Step up to Medicine. The book is pretty easy to read and I would carry it with me during rotations, using it to read up on patients’ diseases. I would also use Harrison’s sometimes, especially to prepare for PowerPoint presentations. During the time I was doing my core rotations, AUA did not yet have access to the Med-U cases on Blackboard, but I’ve heard they’re excellent.
Tying my learning to particular patients helped me with motivation. Still, everyone sometimes struggles to sit down and study. Sometimes to increase my motivation I would spend 5 minutes reading up on something that was from my area of interest, before switching to the work I needed to do. I would also do some self-reflection and say things like this to myself: The time served now will help my chances of matching. What’s the best way to use my time right now? It’s important to stay upbeat and study hard from Day 1! I promise the payoff will be big.
Be Wary of Advice from Well-Meaning Family & Friends
Some students do a lot of procrastinating, figuring they will wait to study for CK until the last 2 or 3 months before the exam. At times, family members will tell them that a cousin took a year off to study for Step 1 and ended up matching, so they shouldn’t worry too much. The problem is that things change and what was true in the past is no longer true. Matching is more competitive than ever before. On the other hand, family members may rush you to take an exam before you are really ready, so try to resist this as well. Be honest with yourself and do what is best for YOU. Your family will be more disappointed if you fail to match than if you take an extra month or two for study preparation.
About the Personal Statement
Don’t neglect the personal statement, but do keep it short. Try to incorporate concrete examples of desirable qualities: being a good team player, your love of the field, an outside interest that you learned from etc. Be totally honest. My interviewers read my personal statement thoroughly and asked lots of questions about it.
I wholeheartedly wish you all the best with the remaining months or years of your pre-residency education. Enjoy your rotations, be active, stay motivated, and read! When things seem tough or overwhelming, do not get discouraged. Just remember, you have made it this far and you WILL reach the goal you set for yourself the day you stepped foot off the airplane at VC Bird Airport. Keep on keeping on everyone!