HOW TO MS2

A comprehensive guide
Nicholas Trum
Sackler School of Medicine
What are we even doing here?
1. Overview of MS2 timeline
2. What to do during the year
3. Scheduling your USMLE Step 1 date
4. What to do in dedicated
5. Mental Health – Keep your head
Why should you listen to me?
1. I’m a Sackler student, just like you.
2. I made it to the other side with a competitive Step 1
score.
3. Learn from my experience, and you can avoid making
mistakes, costing time, money, effort, tears, etc.
4. There’s a whole lot of information out there, and it’s
confusing how to know who to listen to and how much.
5. You can nail MS2 by consistently following a plan.
6. This is information I wish I knew at the very beginning of
MS2.
How should I use this Powerpoint?
This is all very overwhelming.
1. Take it all in now to set expectations OR
refer to it throughout your year at key
points
2. Use it as a FAQ
3. There are useful links in orange you
should totally check out- insider info.
1/5: MS2 Timeline
Once upon a time…
◦ MS2 = organ systems.

◦ Deep dive into each system, learn them inside and

out in a short period of time ranging from 2-6 weeks.

◦ 2-4 systems per NBME, each system punctuated by a

quiz. There are 4 NBMEs.
System Time Personal Difficulty 1-10

Neurology 6 weeks Yom Kippur + Sukkot = 2 9

week break @ weeks 3-5. TRAVEL!!!
SOMEWHERE!!!
Respiratory 3 weeks 4
Cardiovascular 3 weeks 8
NBME #1
Renal 3 weeks 6
Winter Break 11 days 0
Hematology 3 weeks 7
Gastrointestinal 2 weeks 5
NBME #2
Endocrine 2 weeks 3
Reproductive 2 weeks 8
MSK/Derm 2 weeks 7
NBME #3
Psychiatry Workshop 1 week 2
Biostatistics Workshop 1 week 3
NBME #4
Dedicated 6-8 weeks TEST YOUR MIGHT
Full Sample Sackler MS2 calendar 2018-2019

https://drive.google.com/file/d/1fihQxr9LxWQv9APJDrnT49AEK_BWVpG1/view?usp=sharing

***The exact dates for any of these events may change for
your year!!! This is really just so you get a general idea of MS2/set expectations.
2/5: What to do during the year
Generally speaking:

Focus on:
1. Pathology
2. Pharmacology
3. Adding to your Physiology knowledge

You need to study at least 4 hours every day.

Remember self-care

Consistency is key
Your Resources, in order of importance
1. Stop learning in lectures. They are a complete waste of time.
2. First Aid for the USMLE Step 1. YOUR NEW BIBLE. ~$40
1. Put labeled tabs on each section for quick reference. Office Depot. Thank me later.
3. UWorld Step 1. $499.
4. Boards & Beyond. $149 for 1 year. Share a subscription with your roommates.
5. Pathoma. $100 for 1 year.
6. Anki. $Free.99
1. Means “memorization” in Japanese.
Why should I stop learning in
lectures?
◦ Passive learning. I’m sure you’ve heard it
from Dr. Sheryl Shoham before.
◦ The best way to learn is experience and
practice.
◦ At the end of the day, YOU are the one
that will have to know a subject so well
you can talk about it at length with little
reference (i.e. patient education, being
grilled by an attending, being a
gunner).
◦ Only exception: Pharmacology lectures.
What do I do with Pathoma?
◦ What is it? A high yield video series & textbook
focused on making pathology and pathophysiology
of each organ system easy to understand.

◦ Your goal is to watch all the videos and

annotate/draw/highlight your Pathoma textbook,
according to the videos, at the very start of the
system, by the end of week 1.
What do I do with First Aid + B&B?
◦ First Aid has every important fact you need to know for every NBME & Step 1. However, it is missing
certain HY details. You fill in these blanks by annotating from all your other resources. In this way,
you are actively learning from FA. Leave notebooks in college and for rotations.
◦ Boards & Beyond is essentially FA in video format with some more explanation, high yield facts,
and drawings. Annotate FA with this.

◦ 1. PUT TABS ON IT!

◦ 2. BEGINNING OF SYSTEM: Casually read through the organ system. 30-45 min.
◦ 3. THROUGHOUT: Look at your Google calendar and watch the Boards & Beyond video(s)
according to the next CBL topic. Your goal should be to complete all the B&B videos for that
organ system on topics that Pathoma DID NOT cover. Overachiever status: watch all of B&B AND
Pathoma.
◦ 4. Annotate, underline, highlight, draw into your First Aid, noticing what is repeated in
videos/UW/Pathoma and what new information there is.
◦ 5. I recommend creating and sticking to a highlighting scheme. Personally:
◦ Yellow = Key fact
◦ Blue = What is seen clinically/symptoms
◦ Orange = Connections/Associations. (i.e. Rhabdomyomas are associated with tuberous sclerosis).
What do I do Protip: Turn off the
“Add To Flash Card”

with ? function so highlight-

ing takes 1 click
instead of 2.

◦ Buy it right now. Price is high, yes, but buy it at the very start of the year. It’s totally worth it. Why? It
simulates (very closely) the actual look & feel of Step 1.
◦ This is your main active learning tool. Annotate First Aid with what you learn in UWorld.
◦ Q’s are hard at first because you may come across associations to other organ systems you haven’t
learned yet. Ex: Neurology, the first system, is strongly connected to Psychiatry, CV, and Resp.
◦ How to read a Q: 1. Read the last line (the question) to understand the goal of your investigation. 2.
Read the answers. 3. Read the entire blurb with the question in mind, searching for clues specific to the Q.
4. LAST: View the figure/lab results. 5. Eliminate answer choices. 6. The right answer is usually your gut
feeling.
◦ Your goal is to finish all the questions for each organ system before the quiz. Read the entire explanation,
and read why answers are incorrect. If you’re still having trouble understanding a Q, start by reading the
Learning Objective for the big picture.
◦ Highlight: 1. The question 2. Vital signs 3. Medications 4. Buzz words (“The pain is relieved by leaning
forward” = Automatically pericarditis) 5. Age & sex (Can change your DDx quite a bit)
Couple more
UW things.
◦ Students who complete 2000+
practice questions consistently
do better on Step 1 (Kumar et al
2015). UW is the #1 Qbank.
◦ As of July 2019, UWorld has 2,790 questions.
◦ Your goal is to complete all of these questions by the start of dedicated. You should
complete all the questions for each organ system before its respective quiz.
◦ Your second goal is to complete all of these questions again in dedicated.
◦ Timed or Tutor mode? It’s really preference. Protip: I find you can get through more
questions and simulate test conditions more accurately with timed mode.
◦ How do I know which of the above systems to pick?
◦ ENT – Do in MSK. Allergy & immunology – Do in Hem/Onc. Ophthalmology – Do in Neurology.
Infectious Diseases + General Principles + Miscellaneous – Whenever you want, sprinkle
throughout, but probably in GI or towards the end of the year. Poisoning – GI.
◦ The rest is pretty self explanatory. Do Gastrointestinal & Nutrition questions during GI.
What do I do with Anki?
◦ What is it? It’s a free flashcard program.
◦ Why should you care? Spaced repetition- Osmosis explains in 4 minutes: it’s the best
way to retain a lot of information without forgetting. Kind of important for medical students.
Also: Research consistently shows that the more Anki cards you see, the better you will do on
Step 1 (significantly correlated with score p = 0.024 Deng et al 2015).
◦ WHICH//ONE? Download Anki 2.0* (not 2.1) because there are more addons for 2.0
◦ Get the app for your phone and replace your Instagram/Facebook spot with it. At least put it
on your home screen.
◦ Go to https://www.medschoolanki.com/ and watch a couple “The AnKing” videos on
youtube for basics. I recommend the below addons to “gamify” your Anki and make it a little
more fun and visually appealing. Just search the addons, then download it by putting the
add-on code into Tools > Add-ons > Browse & Install…

***Anki 2.0 does not work w/ Mac OS Catalina (2019)

That’s great. But
where do I get
these cool cards?
◦ Go to medschoolanki.com to download well
known pre-made decks and learn more about Anki.
◦ Cards can come from two sources:
◦ Pre-made decks made by saint-like medical students.
◦ You.
◦ I personally recommend:
◦ Making your own UW Incorrects deck. I called mine “UWorld Wisdom.” This is absolutely critical in
dedicated but not during the normal school year. By doing this, you are turning your weaknesses into
strengths and climbing to the highest level of education- synthesis.
◦ How do I do this? Seems like a lot of work. You can either make a new card from scratch or search
your entire collection of pre-made cards, modify them, and move them to your incorrect deck.
◦ “Zanki Step Decks” for pathology.
◦ “Zanki Pharmacology” for pharmacology.
◦ “Lolnotacop” for microbiology ~4500 cards
◦ Dorian222’s anatomy deck for HY Step 1 relevant anatomy. ~300 cards.
◦ Brosencephalon’s Preclinical Collection. ~13,000 cards. Take cards out of here, modify, then put in your
UW Incorrect deck.
What’s a good card look like?
◦ Cloze deletions. Highlight a key fact you want to remember then press Command+Shift+C.
◦ Use chunking: It is easier to remember chunks of information rather than individual pieces.
◦ Easier to remember a phone number as 058-791-5640 (i.e., 3 separate chunks of associated
information) rather than 0-5-8-7-9-1-5-6-4-0.
◦ You can do this with the entire AIDS associated illness page (p 177 FA18) and make 1 cloze deletion
each for all the different illnesses associated with each CD4+ level.
◦ If there’s histology involved, try to Google a good example and put it in the “Extra” section.
◦ I prefer putting two or three related concepts I have trouble telling apart on the same card
to learn the key differences between them and never confuse them again. Example:
◦ You can also put in screenshots of the First Aid PDF or
UW images (On the D).

Show Answer
The same card in Edit mode:
Only put Cloze deletions
on what you have
trouble remembering.

Put little key associations

and histology in the
“Extra” section. This pops
up after you “flip the card”

If you have ANY other

questions about Anki, try to
watch a video about it. If
that didn’t satiate your
curiosity, REACH OUT to any
of your upperclassmen!!
How do I put all these resources
together? Learn top-down.
From the beginning of each organ system:
First week:
1. Review the First Aid organ system section briefly. I recommend making a list of all pathologies and
drugs for that system on a sheet of paper, just to put a name to them.
2. Do Pathoma, keeping in mind your next CBL. Finish all of it the first week of the system.
Second week and onwards:
1. Start doing 10-20 UWorld Q’s per day the second week. More if the system is short; do some math.
◦ You should be annotating First Aid when reviewing your UW results.
2. Watch Boards & Beyond to fill in any knowledge gaps. If you can, practice the knowledge right after
learning it by doing the practice Q’s for each video.
3. Superstar status: Complete Zanki. 50 new and 50 review cards a day is doable.
 3/5: Scheduling your USMLE Step
1 Date
Just like any other date, it may make you nervous and you definitely shouldn’t screw it up
 How much BS do I have to deal with?
◦ A pretty fair amount.
◦ The general process:
1. The office will email you late November with subject line “USMLE Step
1 Registration.” (Rate-limiting step)
2. Here’s the email they sent to the Class of 2021 on November 19, 2018.
3. First: Complete the ECFMG application for a USMLE/ECFMG
Identification Number.
4. Bring those forms to the office (Described in email)
5. The office will verify you as a Sackler medical student. In about a
week, ECFMG will send you 2 separate emails each (potentially hours
apart) with your USMLE/ECFMG Identification Number and password.
6. You have to sign in to OASIS, download your Form 186. You can
choose to put your own headshot in the PDF so the notary doesn’t
take a webcam picture of you.
7. This is a quick part. At notarycam.com, apply for an appointment. I
got my appointment, talked with a notary in the Midwest, and my
Form 186 notarized about an hour after I got my OASIS ID + password.
8. Now you’re officially an ECFMG certified medical student. Form 186 example
BS: Continued
1. Now that you’re ECFMG certified, you must apply
for a USMLE Step 1 Scheduling Permit. This is all
done on OASIS under “USMLE Application
Information”
2. And now, you wait. I waited from Nov 26 to Dec.
12 to receive an email titled “Your USMLE exam
application” from onlineservices@ecfmg.org. They
just say they received it.
3. And now, you wait again. This time, much shorter.
Dec. 15 they emailed me “Your USMLE Scheduling
Permit Is Available” with the PDF permit shown to
the right.
4. With the CIN provided on this PDF, you can now
FINALLY schedule your USMLE Step 1 date following
the clear instructions on the permit itself.
Selecting a Test Date
◦ Prometric only has ONE testing center in Israel. It’s at
Ramat Gan College.
◦ C/O 2021 had a 2 week window to take it, with 6
available test dates: June 3, 4, 5, or June 10, 11, 12.
◦ How do I know when to take it? Couple factors:
◦ How religious are you? Pesach was the first week of
dedicated for us. This can make a difference.
◦ There is no statistically significant benefit to preparing
more than 6 weeks (Pubmed, Reddit).
◦ Min: Taking off Pesach and taking the earliest test date
would give you exactly 5 weeks. (April 28-June 3)
◦ Max: Working through Pesach and taking the latest test
date would give you roughly 7.5 weeks. (April 18 – June
12)
◦ How do I get there? It’s a 30 minute cab ride to the
testing center. Get dropped off at Etsel Street 15,
Ramat Gan. Then it’s a 2 minute walk from the
sidewalk, through the gate, and into the test center.
4/5: What To Do In Dedicated
Where do I even start?
◦ Get inspired from my schedule. It’s a personalized,
Sackler version of the “Elite Medical Prep” schedules
modified from a previous Sackler student.
◦ I encourage you to figure out what you’re most
comfortable doing and make your own schedule.
But this worked for me.
◦ I didn’t follow that schedule 100% rigidly. I
recommend taking one day off every week/week
and a half.
This guy look familiar?
◦ Start doing 70 timed UW Q’s/day, work your way up He visits Sackler every
to 80/day by start of week 3. year as head of Elite
Medical Prep.
What resources do I use?
1. UWorld. There will be 2,790+ questions when you get to dedicated. So if
you have 43 pure study days, 2790/43 = 63 Q/day. However, you want to
finish UW a week before your test right before you take your last practice
test. This way, you can redo incorrect Q’s and/or focus more on Anki the
last week. Timed Q’s to get used to timing. 1 hour on the set, 2 hours of
review.
2. First Aid. Annotate and review as you are reviewing UW questions. Get a
searchable PDF to quickly find facts/mnemonics.
3. Anki. 150 cards a day, 2 hours a day, after you finish UW. For real. Make
cards according to your wrong answers. Some people don’t like anki and
that’s fine.
4. Practice tests: NBME, UW SIM Form, Prometric Practice Step 1, Sackler
administrated optional & mandatory Comprehensive Basic Science
Exams (CBSEs). Counting all these, I did 10 practice tests in the 10 weeks
prior. Your first one (baseline) should be relatively hard (for example,
NBME 15 or 20-23) to establish your strengths and weaknesses, identifying
where you need to focus. UW SIMs are 160 Q’s and more predictive of
your actual score than NBMEs, which are 200 Q’s and tend to
underpredict.
Practice Test at ??
Yeah for real. Do it.
Why?
◦ Familiarize yourself with the testing center surroundings, A/C
temperature, process, and travel. You don’t want to have to think
about these things on test day.
◦ Equivalent to a band doing a sound check at a new stadium
before the concert later that night.
◦ It’s $100 but totally worth it.
◦ The test they give you is AKA the “Free 120” that the NBME gives
out for free and updates every year. The interface for the Free 120
is the EXACT SAME interface you see in the actual Step 1. UW is
very close.
When do I get my score?
◦ Changes every year.
◦ For me:
◦ Test day = June 10
◦ We all received an email on July 10 at 3:22
PM Israel time.
◦ The email is from onlineservices@ecfmg.org
with subject line “Your Score Report is
Available”
◦ Log onto OASIS.
◦ Click “Score Report Information”
5/5: Mental Health
How do I keep sane?
1. You MUST exercise. I don’t care if it’s blogalates, CrossFit, or running. Probably stay
away from Iron Mans, Olympic competitions, and marathons. It must be at least 3-4
times a week.
◦ The research is clear: Exercise helps memory consolidation. Plus you will probably want to see
the outside world. It can be the one thing you do in the day that isn’t about medicine.
2. Keep your surroundings clean.
3. Switch up your study area at least once a week.
4. Simulate testing conditions as much as possible so that test day is not jarring in
environment, noise, or otherwise.
5. Sleep 7-8 hours. It also helps memory consolidation.
6. Alcohol: Moderation. DO NOT drink 2 weeks prior to your test day.
7. Food + Water: Drink 1L+ water during the day. Coffee will make you more anxious
and have deleterious effects if you are baseline anxious (because it’s dedicated).
ALWAYS have a good breakfast (ex: yogurt + granola + banana), snack throughout
the day (ex: nuts), and eat a lot after you finish studying to avoid food comas (that’s
just me). Eating healthy will keep you on track!!
8. Remember to enjoy yourself – You have a couple free hours after you finish
studying. Call a family member or loved one, watch Netflix, compose a concierto,
make memes, play a pickup game, or complain about dedicated with classmates
Take days off when you need to!!!
(But not more often than 1x/week)
!‫בהצלחה‬