STEP 1

The USMLE Step 1 exam focuses on testing the ability to apply the knowledge of basic sciences to clinically oriented problems. Its curriculum roughly corresponds to what a medical student would learn in his first two to three years of medical school.  However, as an International Medical Graduate (IMG) you become eligible to take the exam in your fourth year of medical college.

The first important decision that you must make regarding the Step1 exam is when to take it! While you are eligible starting your fourth year, it is important that you only take it when you feel you have adequately prepared for the test. A failing score will stay on your test record permanently and a poor passing score cannot be improved by taking the exam again. Therefore, the aim should be to take it only once and do well in that very attempt. Find out application process in our General Page

The other important issue is off course what to study, where from, and how. The basic subjects included in the exam include Anatomy, Biochemistry, Physiology, Pharmacology, Microbiology, Pathology, Genetics, Behavioral sciences, and Statistics among others. The aim is test your understanding of basic sciences and clinical topics through series of clinically oriented questions. There are many textbooks and guides that are more suitable for studying for the USMLE and even among them, certain section more important than others. 

To learn more about the Step 1, choose the appropriate section:

   What to Study

   Text resources

   Online resources

   Practical tips

 

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Studying for the Step 1 – Text References

There are a variety of books and resources available for the step 1 examination. All these books can be classified into three major groups

1.     Standard textbooks

2.     Review books

3.     MCQ books.

 

Standard textbooks you all studied at your medical school. We don’t recommend you to read all your standard textbooks once again. What we recommend for you is to go through the review books, and if you feel that a particular topic was dealt with better in one of the standard texts you may go back to read it again.

A MCQ resource would be definitely required for your preparation.

We at doctorscybernetics would be giving you course content guidelines. However these should in no way be a substitute for your standard texts. We would aim to streamline your USMLE preparation for a better result.

We have tried to put together a list of books that we feel is comprehensive, yet useful in that it provides sufficient focus so as to stay manageable for the student. A student would still have to pick the one or two within each section that he or she is most comfortable with.

General Review

Anatomy

Physiology

Biochemistry

Pathology

Microbiology

Pharmacology

Behavioral Sciences

Genetics

 

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General Review

The following texts are across all the different sections and provide a good overview of the content in addition to offering a number of tips and areas of focus that are useful.

a.     First Aid for the USMLE Step 1 2000: A Student to Student Guide
by Vikas Bhushan, Tao Le,Anthony Chu, Chirag Amin, Esther Choo, Vipal Soni  Appleton and Lange
This book has been written by medical students and is meant for medical students taking the exam. It provides you with high-yield study topics and extensive mnemonics. An overall very helpful text.

 

 

b.     Appleton & Lange Review for the USMLE Step 1
by Thomas K., MD Barton: Appleton and Lange.
Large number of well written multiple-choice questions. One chapter per subject plus a test. Questions tend to be slightly more difficult than the real exam.

c.     Review for USMLE: United States Medical Licensing Examination, Step 1 -by John S. Lazo, Bruce R. Pitt, Joseph C. Glorios National Medical Series (NMS)
This book contains four simulated USMLE Step 1 exams which give a very good sense of what you will face during the actual exam.

d.     Exam Master CD

Since the actual exam is a computer-based test, you must practice the actual test simulations. Exam Master offers you the best such simulation and results. See Online Resources for more details.  http://www.exammaster.com 

Anatomy

You will need to consult various textual resources in anatomy, as there are many different subunits that need to be covered. Core regional anatomy forms a small percentage of the anatomy one has to master and a significant portion is dedicated towards cellular and molecular anatomy and neuroanatomy. The books we recommend for different sections include:

1.     Cell Biology and Histology  

a.  Cell Biology and Histology by Leslie P. Gartner, James L. Hiatt, Judy M. Strum   National Medical Series textbook A must for cell biology text. A small but very useful book. Must see the electron micrographs.

b.     Defoire Atlas of Histology This is an atlas of histology, you must have referred in your medical school. Excellent pictures.

c.     High-Yield Gross Anatomy
by Ronald W. Dudek  Williams & Wilkins This book would tell you more in detail what topics you must lay emphasis on.

Lay more stress on molecular mechanisms in cell biology and ultra-structural cell biology. Read the Compass Notes or First Aid to USMLE Step 1 for more detail on important topics to be covered in these sections.

2.     Neuroanatomy

a.     Neuroanatomy (Board Review)
by James D., Ph.D. Fix - Williams & Wilkins

b.     NMS Neuroanatomy (National Medical Series for Independent Study)
by William Neuroanatomy Demyer

c.     High-Yield Neuroanatomy
by James Fix Williams & Wilkins

NMS text is a detailed but an excellent source however you may be stressed a lot as the information is overwhelming. You may not need all the information for step 1. Board review series would keep you more focused. A special emphasis is needed for cross-sectional neuroanatomy. You must be apt in reading Ct and MRI scans, at least the normal structures.  Please see Online Resources for different sites about Cross-sectional and Radiological Anatomy.

3.     Embryology

a.     Lang man’s Medical Embryology
by T. W. Sadler, Jan Lang man:  Williams and wilkins

b.     High-Yield Embryology
by Ronald W. Dudek  : Williams and Wilkins

Both these are excellent books. You may use the one you are more familiar with. You should stress on diagrams and applied aspects of developmental anatomy.

4.     Regional Anatomy

a.     NMS Anatomy – National Medical Series

b.     High-Yield Gross Anatomy
by Ronald W. Dudek  Williams & Wilkins

This large chunk of anatomy has to be done bearing in mind only the applied aspects. For example no one will ask you the course of Median nerve. What you need to know is what happens when Median nerve is injured, which muscles are affected at what levels of injury, and how can we test for individual muscles. Radiological Anatomy is however is must.

Physiology

a.     Physiology
by Linda S. Costanzo- National Medical Series

b.     Review of Medical Physiology
by William F. Ganong  McGraw hill.

 

The NMS is a standard review used by many students preparing for Step 1 and is quite good for physiology. The Ganon’s Review is also a concise textbook, about the same size as the NMS, but is more widely used among medical students. If you have already referred it in your medical college, then it is best to revise it. It is recommended to especially go through various diagrams, pictures and graphs that are worth reviewing for the exam.

Biochemistry

a.     Lippincott’s Illustrated Reviews: Biochemistry
by Pamela C. Champe, Richard A., Ph.D. Harvey- Lippincott

This is the best and most concise biochemistry text. It is so well done that most students do not refer to anything else. Te genetics section is a must and very important.

Pathology

a.     Pathology
by Arthur S. Schneider, Philip A. Szanto Board Review Series - Williams & Wilkins

b.     NMS Pathology – National Medical Series 

c.      Curran’s Atlas of Histopathology
by Robert Curran, J. Crocker Oxford University

The BRS Pathology is undoubtedly the best pathology review. It contains only the most relevant topics for the USMLE and there is very little that you can skip in this book. The NMS, on the other hand, is a more detailed text and good for as a reference for specific topics. However, both the texts have very few pictures, which are important for the exam. The Curran’s is a good atlas to refer to for diagrams and pictures.  In addition to these texts, it is a good idea to review gross pathology specimens and hematology slides, sources for which can be found under the Online Resources section.

Microbiology

a.     Medical Microbiology & Immunology: Examination & Board Review
by Warren E. Levinson, Ernest Jawetz  Williams and wilkins

This is a highly recommended book for USMLE and contains all the relevant sections with regard to microbiology for the Step1 exam.

Pharmacology

a.     Lippincott’s Illustrated Reviews : Pharmacology : Special Millennium Update
by Mary Julia Mycek, Richard A. Harvey, Pamela C. Champe – Lippincott

b.     Pharmacology: Examination & Board Review
by Bertram G. Katzung  Williams and wilkins

 

Another Lippincot book and like the one for Biochemistry this is another essential text. You can comfortably use this as the only pharmacology text you read. You would need to study all the portions in this book. There is practically nothing you can afford to leave. 

Behavioral sciences

a.     Behavioral Science (Board Review Series)
by Barbara Fadem Williams & Wilkins

b.     NMS Behavioral Sciences – National Medical Series 

c.     High-Yield Behavioral Science
by Barbara Fadem Williams and wilkins

The Board Review Series text is an excellent and concise text. Given that behavioral sciences is a complicated subject and no single book is actually sufficient, this one is the best. NMS text has excellent sections on Medical ethics, Interviewing skills and Developmental behavior

Genetics

a.      Genetics: Pretest Self-Assessment and Review (Pretest, Basic Science Series)
by Golder Wilson (Editor), R. Henry Capps (Editor), Yu-Wayne Chu (Editor) McGraw Hill

 

Molecular genetics has become an important topic on the USMLE. A large part of the subject is covered as part of the Biochemistry texts, but it is important to do a lot of practice questions. This is one area where you can answer the questions quickly and with relative ease if the material has been reviewed thoroughly. Do not neglect this high yield area!

 

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Online Resources for Step 1

There are a number of online resources that are helpful in preparing for the Step 1 exam. Especially for more visually oriented questions, these sites have a good collection of images, slides, and radiographs etc., which are good to review. In addition, there are a number of general preparation sites that provide sample exams and helpful study tips.

General Preparation Sites

   The ALERT Site (http://www.healthworks.co.uk/hw/partner/CDFrame/HWOCDCat/college.html#ALERT) - ALERT preparation CD-rom from Appleton and Lange

   Exam Master (http://www.exammaster.com/) - Exammaster Review Courses, CD-Roms.

   Boards preparation Interactive http://boardsprep.com/usmle/step1/. This site contains interactive preparation information for step1.

   University of California http://www.uic.edu/~dlanier/bds1web.htm List of study material for step1 referred at University of California.

 

 

Radiological Anatomy

   Radiological Anatomy Browser http://rad.usuhs.mil/rad/iong/homepage.html

   Radiological Anatomy of the extremities.www.scar.rad.washington.edu/RadAnatomy.html 

   Human Cross-sectional Anatomy www.npac.syr.edu/projects/vishuman/VisibleHuman.html 

 

 

   Whole Brain Atlas. www.med.harvard.edu/AANLIB/home.html 

 

Pathology Images

   Pathtest  http://www.pathtest.com/ a very good site also evaluates your knowledge in various topics in pathology.

   Web path www.medlib.med.utah.edu/WebPath/weppath.html 

   Urbana Atlas of Pathology www.med.uiuc.edu/PATHALASf/titlepage.html 

   Pathology Simplified http://erl.pathology.iupui.edu.

 

Microbiology Images

   http://www.asmusa.org/test/division/c/library.htm Microbiology Image Library.

 

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Practical tips for step 1

No USMLE guide would be complete without offering a few tips on what to study and what not to study. To that end, the following set of tips was put together by a set of students who have taken the exam in the recent past, to help you in study efforts.

   Step 1 is a logic-based exam rather than knowledge based one. It is much more important to understand the concepts rather than simply memorize the facts. 

   Pay special attention to all the photographic material during the examination.

   Have a strong understanding of graphs and graphical interpretations. You should be able to tackle questions where key information is presented in a graphical format. 

   Electron micrographs and molecular concepts in cell biology are very important and should be reviewed thoroughly.

   Biochemistry and physiology graphs should be reviewed carefully, especially those regarding enzymes and respiration.

   Drugs of choice against microbes must be thoroughly done.

   Study hematology slides, including bone marrow films.

   Common Genetic conditions such as Duchenne and Cystic fibrosis should be studied in detail, including their exact genetic defects.

   There is no need to remember drug dosages in pharmacology, but knowing drug interactions is essential.

 

You are encouraged to use our USMLE contents section for more comprehensive tips on all the topics and subtopics for this examination. This experience would go a long way in developing the right skills required to ace the examination.

We wish you all the best in your USMLE preparation and hope that you would get an excellent score. Bon Voyage!!

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