So the Big Day has finally come. How can you maximize your chances of doing well? Here are some basic do’s and don’ts.

1. Double-check your paperwork. Do you have your driver’s license or another signed photo ID? And do you have your orange scheduling permit? Don’t leave home without it!
2. Leave your gizmos behind. The USMLE Bulletin of Information has a long list of electronic gadgets that you can’t bring with you into the testing area. These include cell phones, calculators, pagers, PDAs, radios, recording devices, and, as of the 2008 Bulletin, watches of any kind (both digital and analog). Other items you’ll have to live without - or store in a designated locker or cubicle - include books, notes, scratch paper, and, as of the latest Bulletin, earplugs.
3. Bundle up. Although you can’t bring outerwear such as coats and jackets into the testing area, you should wear warm, comfortable clothing to accommodate variable temperatures at the test site.
4. Show up early. Try to make sure you arrive at your designated testing center about 30 minutes before your scheduled appointment. If you get there any earlier than that, you’ll run the risk of stressing out. Whatever you do, however, don’t get to the testing center late, as you will likely have to reschedule.
5. Chill out! Bearing in mind how hard you’ve worked to prepare for this test, focus on being mentally alert. Focus and avoid panic.

Wondering if the USMLERx Qmax is really worth all that time and investment?

Trying to figure out how best to incorporate your First Aid text into your board preparation?  Check out this article to find out how one USMLERx subscriber prepared for his boards and ended up scoring a 260/99 on the USMLE Step 1!

Hoon Choi is a medical student at Auckland Medical School in New Zealand. He made choices just like you did, or will do, about how to prepare for his board exam. Initially, Hoon chose to use First Aid for the USMLE Step 1 as his primary resource for Step 1 preparation, assiduously underlining the information he felt was particularly high yield. “However, [I found it] difficult to retain the information just by reading and underlining,” says Hoon. So he purchased the USMLERx Step 1 Qmax to help him retain the information he had underscored in his First Aid for the USMLE Step 1 text.

Hoon began preparing for the Step 1 exam five months before he was scheduled to take it. His preparation actually began when he first entered medical school and started to attend his classes and lectures. He studied approximately five hours each day for those five months. And with the help of his classes, lectures, First Aid text, and Step 1 Qmax, Hoon walked into the exam feeling truly prepared.

“The exam was not easy by any means,” Hoon said. “However, the questions were definitely reasonable, and the level of difficulty was not unexpected. I finished the exam feeling like I gave it all I had.”

Here are some of Hoon Choi’s words of wisdom for those of you preparing for the Step 1 exam:

“Attend your lectures, and learn the school material well. Purchase your [First Aid] book six to nine months before your set exam date, and start annotating in your book. Make it your own! Do as many questions as you can get your hands on. When you feel like you’ve done enough questions, do some more. You won’t have time to work through questions when the clock is ticking. You should be familiar with the material enough to be able to ‘react’ when the clock is ticking.”

This announcement from USMLE.org

A small number of multiple-choice items with associated audio and/or video clips will be introduced into the USMLE Step 1 Examination beginning in mid- to late May 2008. No more than 5 items with associated media clips will appear in a single examination. The 2008 USMLE Orientation Materials include a small number of multiple-choice items that contain exhibits involving audio and/or video clips. Instructions for practicing with items with associated media clips on Step 1, Step 2 CK, and Step 3 are provided in the Tutorials for each Step examination in the orientation materials.

Items with associated media were introduced into Step 2 CK in 2007, and into Step 3 in March of 2008. As of May 2008 all three multiple-choice question components of the USMLE examination will include items with associated audio and/or video.

This update from USMLE.org

Starting on or around May 15, 2008, a transitin period will begin in which the number of items in current forms of the Step 1 examination will change from 350 items to 336 items. Although the transition will occur quickly at many test centers, there may also be some locations where the changes take slightly longer to complete. The overall transition period will likely last approximately 6 weeks. The length of the examination day will remain unchanged.

The decrease in the number of items per form will be accounted for in scoring the examination results, so that scores on new and old forms will be comparable. Because of these changes in timing, as well as modifications to the test item pool and the processing load caused by a heavy volume of test takers, there will be a delay in score reporting for most Step 1 examinations administered in the second half of May and June.

The target date for reporting Step 1 scores for most examinees testing from May 15 through late June will be Wednesday, July 16, 2008.

In the past week, there have been two notable items concerning the USMLE Step 1 and Step 3. On January 4th, Usmle.org made the following announcement:

A small number of multiple-choice items with associated audio and/or video clips will be introduced into the USMLE Step 3 Examination beginning in early March 2008. No more than 5 items with associated media clips will appear in a single examination. The 2008 USMLE Orientation Materials include a small number of multiple-choice items that contain exhibits involving audio and/or video clips. Instructions for practicing with items with associated media clips on Step 1, Step 2 CK, and Step 3 are provided in the Tutorials for each Step examination in the orientation materials.

Items with associated media were introduced into Step 2 CK in 2007, and will be introduced into Step 1 later in 2008. An announcement will be posted to the USMLE website approximately 2 months before any items with associated media clips appear on Step 1 examinations. Additional information will be posted to the USMLE website as it becomes available.

On January 9th, the American Physician Scientist Association released a survey asking those in medical education (students, residents and fellows) about proposed changes to the USMLE Step 1 and 2CK. These included:

1. USMLE Steps 1 and 2 will be combined into a single exam. However, this combination would involve the creation of a new set of questions that test BOTH basic science and clinical science.

2. A combination exam will necessitate that the exam be administered earlier in training than the current Step 2 in order for its use in residency applications.

3. Pass/fail could replace the current numerical score. This is separate and may be implemented even if a combined exam is not.

You can fill out their survey (med student) (resident/fellow) or read more about it.

The NBME has recently released data showing the relationship between students’ Comprehensive Basic Science Self-Assessment (CBSSA) Performance Profile Scores and their performance on the USMLE Step 1. This data is applicable to each of the four NBME forms.

Acad Med. 2004 Oct;79(10 Suppl):S55-7 (Abstract):

Problem Statement and Background. This study examined the extent to which performance on the NBME® Comprehensive Basic Science Self-Assessment (CBSSA) and NBME Comprehensive Clinical Science Self-Assessment (CCSSA) can be used to project performance on USMLE Step 1 and Step 2 examinations, respectively.

Method. Subjects were 1,156 U.S./Canadian medical students who took either (1) the CBSSA and Step 1, or (2) the CCSSA and Step 2, between April 2003 and January 2004. Regression analyses examined the relationship between each self-assessment and corresponding USMLE Step as a function of test administration conditions.

Results. The CBSSA explained 62% of the variation in Step 1 scores, while the CCSSA explained 56% of Step 2 score variation. In both samples, Standard-Paced conditions produced better estimates of future Step performance than Self-Paced ones.

Conclusions. Results indicate that self-assessment examinations provide an accurate basis for predicting performance on the associated Step with some variation in predictive accuracy across test administration conditions.

USMLE.org has announced a change to the reporting of student scores.

Beginning in August 2007, examinees will be able to view, download and print their score reports via the Internet. [link]

During the August transition, some students will have online access while others will continue to receive their results via regular mail.  Students whose scores are available will be notified by usmle.org and will have 120 days to access their score report.  After this period, the student’s report will no longer be available online and an official transcript will be mailed.