Heres some advice and the (in)famous Penn Method (!

!) to help guide you as you prepare for Step 1. The following is NOT a strict plan; some of the suggestions may or may not jive with your study habits, so dont feel as though you need to stick to everything that we advise. It is really about figuring out what works for you. First, decide when you want to take the boards and then make a study schedule leading up to that point. Its best to write down exactly what you plan to accomplish each day to keep you on task. People generally study for anywhere from 4.56 weeks (though some take the test in as little as 3.5 weeks; others in > 8 weeks). Youll start to get antsy around weeks 45, so in our experience its probably best not to prolong the inevitable. Many people found it helpful to schedule 5 (or 6 days, max) per week for studying, utilizing the remainder of the week for catchup, review, questions, or for fun. Yes, fun! A lot of people, at least for the first couple of weeks, worked from sunup to sundown, and then used the remainder of the night to go out, let loose, relax. Overall, there are two main ways to structure your study time each day. Some decide the number of hours they plan to study each day and then stop when the clock strikes whenever. Others decide how many pages of a particular subject they want to cover that day and stop after reaching their goal. If you get behind (which will inevitably happen), you can make up the pages another day. So fret not. The following cannot be stressed enough: give yourself time to enjoy your life. Brief, short breaks throughout the day (lunch, workingout, etc.) and some chill time each evening can make your study time much more pleasant and productive. You should also schedule in break days. Yes, days devoted to NOTHING. Complete vegetation. Also remember that there will be times when you will feel overwhelmed and frustrated this is NORMAL. Give yourself the freedom to have bad days and to take a break during the tough moments. (But, honestly, it aint all bad.)

Without any further ado, we present The Method: Suggested Books: A caveat: Remember, these are just suggestions. You may find it helpful to look at the recommendations in the back of First Aid for the Boards, find the highest rated books for each particular subject area, and flip through the books in a bookstore to see which best fit for your learning style. Book sources: We suggest getting used copies of most of the below b/c costs accumulate quickly; online book depots usually have great, cheap finds, as do your upper classmen. Dolbys, of course, has everything...for a price. If you are going to buy your books from a retail store, it might be worth your while to check out Jeffersons Bookstore as medical students get a 10% discount on books purchased there.

First-Aid for the Boards - USMLE part 1: the bible for most. If you memorize (or really know) this book, you will do VERY well on the Boards. This cannot be stressed enough. At the end of the day, the other books are SUPPLEMENTAL this book is MANDATORY. Most people use this as their primary book and annotate it with information from the supplemental books and

question sources as they study. It represents the USMLE's scope and breadth very well, and keeps your eye on the big picture. Supplemental Books: Most people choose to purchase all, or at least most, of these. They give you more detail than FirstAid and most are thin enough that they can be read in a day or two.

Lippincotts Biochemistry* or BRS Biochemistry or High Yield Biochemistry Lippincotts Pharmacology* or Lange: Pharmacology** Microbiology Made Ridiculously Simple High Yield Immunology or Microbiology and Immunology (by Lange orange and dark grey book, Immunology Section only) BRS Pathology BRS Physiology High Yield Anatomy High Yield Embryology or BRS Embryology High Yield Neuroanatomy or Clinical Neuroanatomy Made Ridiculously Simple High Yield Behavioral Sciences High Yield Histology or High Yield Histopathology * If you choose to read Lippincotts Biochemistry or Pharmacology, you will have to skim some sections, as these books are very long. Dont worry about not reading every sentence carefully, but focus on the big picture! If you are the type of person who has to read every word, then you might want to choose a different book. The clinical correlations in these books are excellent, but again, you will not have time to read every word. ** Some people choose to study only using Pharm Cards. These are less detailed, but people say that they contain all the info needed for Pharm on the Boards. Question Sources: Unfortunately, except for the actual Step 1 examination, question sources can be the most expensive part of the process. Some people share resources, but questions are an obvious musthave and integral to your studying experience. It's best to google the options below, look at their websites, what services they include figure out how much you're willing to spend and go for one question database at a time. As the test date draws nearer, it's not uncommon to sign up for another question source (for additional practice or peace of mind). Primary Question Sources, all with online memberships: Kaplan Q-Bank: For many years was the database of choice. While you get a lot of questions, sometimes people felt they were too minutiadriven and not actually representative of the actual examination. Still, if you know the minutia, the basic concepts will be a breeze. NBME examinations: There are 45 examinations that can be purchased for 45$ each at https://apps.nbme.org/nsasweb/servlet/mesa_main. They mimic the actual online format of the examination, and are supposed to give you a good representation of how you would score on the actual test day. Unfortunately, these examinations don't come with answer keys, but they usually make you feel pretty good about yourself after you see how (comparatively) easy the question types are compared to Kaplan, USMLE World, etc.

USMLE Rx: A newer question database, this service has grown in popularity in the last couple of years. Questions are written by medical students (including Penn Med students) who have been through the USMLE, and write to the test.

USMLE World: Has grown in popularity in the last few years. Many students use this question source now. Most feel the level of difficulty and actual format is the best representation of the actual USMLE examination. A lot of Penn students recommend it either instead of, or in addition to, Kaplan. Backup Question Sources: There are tons of perfectly legitimate book options, including Appleton & Lange's USMLE Step 1 (1200 questions + answers, including 2 fulllength examinations). But, most people enjoy the freedom of the online question banks b/c you can google something you don't understand, don't get bogged down by books, etc. Study Schedule: Most schedule the below within 2634 days, depending on how many days you spend on each subject. These days are meant to get your familiar with the material for you to see all the material once and to distill out the most testable points for further study (see "Review" section below). Again, these are just suggestions. If you were a biochem major and know it well, you might only want to spend 2 days studying that subject. It's up to you. Don't get caught up with trying to memorize every detail. These days should be approximately 810 hours of studying/day, and you can study the subjects in any order you see fit. Subject Study Schedule (suggested): 34 days: FirstAid for the Boards 45 days: Biochemistry + 50 biochem questions per night Note: BASIC concepts, & scenarios in First-Aid, are emphasized on the Boards. 34 days: Microbiology (Micro Made Ridic Simple) + 50 microbio questions/night 12 days: Immunology (Lange's book) + 50 imuno questions 1 day: Embryology + 50 embryology questions 1-2 days: Anatomy + 50 anatomy questions This topic can seem somewhat overwhelming; but it should NOT be a review of your 3-month anatomy course. Most questions relate to a clinical scenario, which is helpful. 1 day: Neuroanatomy + 50 neuroanatomy questions 3 days: Physiology + 50 physiology questions/night 46 days: Pharmacology + 50 pharmacology questions/night 34 days: Pathology + 50 pathology questions/night 1 day: Histology + 50 histology questions 1 day: Behavioral Sciences + 50 behavioral sciences questions

Breaking down the overall schedule: Typically, students start with a cursory read of FirstAid for the Boards (which usually takes 34 days). Some people, however, find FirstAid to be vague and difficult to read without background material/details, so they skip this initial read. People then tackle the individual subject areas, taking notes in the margins of FirstAid. This notetaking is important it helps to remind you of concepts, connects the dots in FirstAid and keeps you actively engaged in the studying process. This means that during the background reading portion of your studying, you will likely read FirstAid twice. For the individual subject areas, some students start with their favorite subjects in order to start with a positive attitude, while others start with their worst subjects in order to get them over with and have more time to process the material. Of note, Pathology/Pathophys is basically what youve been doing during your year of clinics so most people leave these subjects until the end b/c theyre mostly review. THERE IS NO RIGHT/WRONG

WAY TO DO THIS! Most importantly, make sure you sleep, eat, and exercise during this time. Breaking down the daily schedule: After you finish your reading for the day, try to DO at least 50 PRACTICE QUESTIONS on the topic (i.e Biochemistry) that you read about that day and read ALL the explanations for each question on the Kaplan Website or at the back of the Book. Some students choose to take notes on the questions that they get wrong in order to process/remember this material. Given the amount of questions in your purchased "bank" you might want to do more or less, keeping in mind that it's best to leave some questions for the Review Period. Most importantly, try and relax for AT LEAST 12 hours per night (i.e hang with significant other, watch movies, leave the library). Your brain needs time to chill and process the massive amount of info that you are putting in there! The Review (Last 5-10 days): The last 5-10 days are the most important study days. The goal is to go over the bulk of the material you have studied by REVIEWING YOUR NOWANNOTATED COPY OF FIRSTAID. At the end of each day, DO AS MANY QUESTIONS AS YOU CAN (50150 if possible) pertaining to the topics you reviewed. Some people found it helpful to review FirstAid and their notes twice during this time, while others found it helpful to review the entire book and their notes once, marking pages that were particularly unfamiliar or particularly high yield and reviewing only their marked pages a second time. These days are approximately 12 hours of studying/day, except for the day before the boards (this should be a much lighter day). You should still take a bit of time each day to relax; it is important to maintain your composure and constantly remind yourself that you are doing the best you can (and to also remind yourself that Penn students rock this exam).

The Day before: We have all taken a billion standardized exams; you know what works for you. For most, the day before the Boards is a time to (briefly) review all of the marked 'highyield' or 'unfamiliar' pages in First Aid. You can also catch up on any reviewing that you did not get to. Some people recommend not doing any questions the day before so that you do not psyche yourself out but others found it helpful to do some questions the day before the exam. Regardless, it is generally advised that you do NOT study for 1214 hours the day before the Boards. The USMLE is tests information, but it also tests stamina it's long so just make sure you get a good night's sleep and are ready to rumble.

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General tips:

Its really important to do questions everyday so that you dont wind up having to do 300+ questions per day in the week leading up to the exam. Dont worry about getting all of the Qbank questions right. If youre getting 65 75% correct BY THE END of YOUR STUDY TIME, you will probably get an excellent score on Step 1. Schedule your test early so you get your preferred location. Philadelphia's test site is on Walnut Street, generally comfortable and a pretty lowstress experience.

Alternatives / Complements to the Penn Method: While many people find The Penn Method to be a helpful guide, many others utilize Kaplan materials instead of the Penn Method or in conjunction with the Penn Method. This is a very viable option. If you are interested, here is some advice that members of the Class of 2007 had to pass along: Using Kaplan Materials INSTEAD OF the Penn Method:

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56 weeks tended to be the recommended amount of time to get through the material. 2. Most people decided on their number of study days and divided the series into sections based on number of pages or on the number of study days recommended by the Penn Method for that particular topic 3. As people read, they took notes either in the Kaplan books or in FirstAid. 4. They also did questions on a daily basis (Q bank was the question source of choice) 5. Then, for the last 510 days, they reviewed their notes and did more questions. Using Kaplan Materials IN CONJUNCTION WITH the Penn Method: 1. Some students followed the timeline of the Method, but compared the Kaplan materials to the Penn Method materials for individual sections and chose one or the other for each section (and some used the leftover resource for additional reference if needed). 2. The notetaking / question answering / reviewing recommendations listed above were also followed. We hope these options help you as you prepare for Step 1. Just remember, THERE IS NO CORRECT WAY TO PREPARE. YOU HAVE TO FIND A SCHEDULE AND RESOURCES THAT WORK FOR YOU. No particular set of materials will guarantee you a certain score, so dont constantly compare yourself to your classmates (and dont let them stress you out). You are Penn. We are Medicine. You will do great! (Honestly!) Best of luck! - Class of 2009