Tag Archive: Step 1

Picmonic: A Cursory Review

When I heard about Picmonic, I actually let out a little yelp of excitement and anger. Excitement because I wish I had such a tool while I was in the first and second year of medical school; anger because I thought about building just such a company about a hundred times but never went through with it. Picmonic was developed too late for my first years of medical school, but I keep hearing great things about it from our medical students. Because of all the buzz, I recently downloaded their trial software to test it out and I am impressed. The idea behind Picmonic is to develop absurd images in order to help memorize difficult to understand concepts. Each Picmonic image contains a number of important pearls that should be memorized. Picmonic walks the learner through the image to highlight each pictoral 'mnemonic'. The staff at Picmonic were kind enough to send us their image for clindamycin [shown below]. In this way, any time a student is placed in a situation (in the hospital or on an exam) where he/she must remember these important concepts, the absurd image will pop right into their head, increasing memory recall.


Increased memory retention using absurd images is actually a well-known phenomenon in teaching organizations. In fact, the best memorizers in the world often use abstract and absurd imagery to memorize lists of random words and numbers. The developers at Picmonic openly state that their software increases memory retention by "300%" and may increase scores on exams by "50%". These numbers seem a bit outrageous, but they recently published their results in a peer reviewed journal (pub med link) and they seem to have some evidence to support their claims. Thousands of medical students are using their software and I have never heard anyone unhappy with the purchase. Some use it far more than others, but everyone who purchases the resource appears to be quite happy. Of course, the utility of this type of device is likely more useful to those students who are more visual, but its effect on memory retention is likely to be universal.

If you haven't tried it out, go to their website, www.picmonic.com, and download their free trial. This is a great resource.

Top Ten Books for the USMLE Step 1

This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3.

Before I plunge into the Top 10 books for Step 1 let me first explain that books were only the second best resource for me while studying for Step 1.  I found question banks to be the most efficient means of studying for Step 1. In order to do well on an 8 hour test, you need to be accustomed to doing hundreds of questions in a day.  Doing well on Step 1 is not just a question of learning the info in the books I list below, but also a question of developing the stamina to say focused on the 349th question of the day….it is like preparing for a marathon. USMLEworld and the Kaplan Q-bank in my opinion are the best resources for preparing for Step 1, but you can not do questions for 1 month straight, you need to spend some time in books. Now for the books…

  • Updated April 2015

1. First Aid for the USMLE Step 1:

I don't know how they do it, but the First Aid people have an unbelievable ability to know exactly what is important to the people who write board questions.  First Aid is reprinted each year. I suggest buying one copy early in med school and study from it while you study for your other classes. Then, purchase the new copy when you are studying for Step 1.  First Aid is not sufficient for Step 1, but it should be required reading for all students as it highlights the stuff that you absolutely must know. Some students also recommend Kaplan's MedEssentials for the USMLE Step 1

2. BRS Pathology:

Another required book for Step 1 is a pathology review book. The two most commonly used books are BRS Pathology and Goljan's Rapid Review Pathology (#3). I prefer the BRS book because it is a no-nonsense text with a few pictures and tables but mostly focused on simple and clear text.  You should browse through both books before deciding which one you will use.

3. Rapid Review Pathology:

The other famous pathology review text for Step 1. This book is written by Dr. Goljan of "Goljan Lectures" fame. (If you do not have these lectures, see my article and links about the subject because they are fantastic). The content is similar to the BRS Pathology text but the delivery is quite different. This text is more visually appealing with colors, images, and many tables. Pick your poison.

4. BRS Physiology:

A broad physiology text is another book that most students use when studying for USMLE Step 1. It is unlikely that you will learn anything new when ready a physiology text. However, a physiology text will help you cement concepts in your mind. A great understanding of physiology will help answer the difficult Step 1 questions. I found that reading the physiology text for one organ system, then the pathology text and First Aid for the same was great preparation for questions on that subject.

5. High Yield Biostatistics:

You can not forget the small categories that are tested on Step 1. Biostat/epidemiology is one of these areas. I am sure I had 10-15 questions on these topics. The High Yield book is quick and easy; you can get through it in just a few hours. Don't go into the test without knowing all forms of bias and all calculations of a two-by-two table.

6. BRS Behavioral Science:

The behavioral sciences will also take up at least 5-10 of your Step 1 questions. These are hard to study for but you must find a way to do it. There are a few books options in this category, the great asset of the BRS book are about 15-20 questions at the end of each chapter. Many students swear by High-Yield Behavioral Science. This book is also very good, more concise, and easy to read. It does not have questions.

7. MicroCards:

Flashcards will give you a nice break from question banks and books. MicroCards have a ton of information. It may seem like some of the information is superfluous, but after taking the exam you will realize that many Step 1 questions ask very specific questions about bacterial anatomy and antibiotic targets.  I will never forget that on my Step 1 they wanted me to know the treatment for sporothrix schenckii.  So, yea, get some microcards.

8. PharmCards:

This is another set of flashcards that you can use in the bus, at night on the bed, during lunch, etc. Like MicroCards, these cards have a ton of information. However, you will be asked some very specific questions. One example I still remember is being asked the mechanism of action of ethosuximide.  Even though it is "Step 1" they will still ask pharm quesions.

9. First Aid Cases for USMLE Step 1:

You will find a common theme here: find something to break up the books and question banks. Though questions and the first 4 books will be your main ammunition to study for Step 1, you can not do that for a whole month. Flash cards and cases will help break things up while still learning and picking up some questions. The First Aid case book is very good and highly recommended by all. I used case books when my mind was tired of memorizing, and I think they helped me pick up a few questions. Most of you are also familiar with Kaplan's USMLE Step 1 QBook in print format, which is another great distraction of texts and computer questions.

10. USMLE Step 1 Secrets:

I did not use this book. I had heard good things during medical school, but it never made it into my bag. Since I wrote this post I have had numerous students write to me and explain that book became a foundation for them. As the book states in its Preface, it is not a stand-alone resource. The book aims to add clinical context to the data you will glean from texts and First Aid. I place it tenth on my list only because I do not know its true power. After reading through the book after-the-fact, I am convinced that I would have used it quite frequently during my study time.


Top Ten Books for First Year Medical Students

This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3. 

  • Updated April 2015

In this list I will review books used in the basic science courses in medical school.  If you are interested in microbiology, pharmacology, and systems based books check out my list of the Top Ten Books for Second Year Medical Students.

1. Netter's Atlas of Human Anatomy:

You can not live without an atlas while you are studying gross anatomy. There are a number of atlases to choose from and choosing 'the best atlas' for med school depends on how you learn. Netter's atlas is brightly colored with finely demarcated images.  There is very little text and the atlas focuses solely on great drawings.  This is my favorite. If you are not a fan of Netter's, there are plenty of other options. Grant's Atlas of Anatomyis widely used by many medical students; it contains more detailed images and text that highlights some important clinical relationships. Check out these other Amazon links if you want to learn more about the other options available. Gray's Anatomy Clemente's Anatomy Rohen's Color Atlas of Anatomy Fellow bloggers over at medstudentbooks.com have written a concise, well organized review of the differences between each atlas.  I recommend you read their comments on the subject. (link)

2. Med School Confidential: 

This book is like having a life coach next to you as you start medical school. It describes every part of medical school and is a great guide through the process of applying, starting med school, boards, wards, and applying for residency. It is a great read, and as you can see from the reviews on Amazon, everyone loves it.

3. Netter's Anatomy Flash Cards:

Just like an anatomy atlas, there are many options to choose from in this category. I found flash cards even more helpful than the anatomy textbook.  I rode the bus to school most mornings and could go through 10 or so flash cards a day.  It is a great way to study while on the move and it gives you some time away from books.  I used Netter's, because they were so pretty! Many students also rave about Kaplan Anatomy Flashcards .

4. Clinically Oriented Anatomy:

In addition to an anatomy atlas and anatomy flash cards, an anatomy textbook is a must have.  You will be tested on anatomy identification in the anatomy lab. However, most of your test questions will come from clinical relationships in anatomy. A good anatomy text is crucial to understanding these relationships. This was my favorite.

5. Grant's Dissector:

Most medical students are required to purchase a dissector during gross anatomy.  My advice?  Get a second copy that never gets soaked in formaldehyde.  Skim over the text before anatomy tests and make sure you know ALL the bold terms.

6. High Yield Embryology:

The High Yield series is very good, but this is their best product. (High Yield Series, Amazon Link) Embryology can be terribly difficult to understand, but this book made it much more clear while I was studying.  If you like what you read, you should also check out High-Yield Gross Anatomy and High-Yield Biochemistry. .

7. Lippincott's Illustrated Review of Biochemistry:

We all have to take a biochem test in medical school, and we all hate it.  There is no relaxing or enjoyable way to memorize the Kreb's Cycle, but this book is the most efficient and high yield resource that I have found.

8. First Aid for the Basic Sciences, General Principles:

The First Aid series is one of the jewels of medical school. You will certainly learn this as you are studying for Step 1. However, their texts for first and second year medical school coursework are also very good. First Aid books are never sufficient, but they are great tools to help you learn the most important points and should be used in conjunction with other texts and tools.  The Basic Sciences book is a great companion throughout most of your first year courses. (It's companion, First Aid for the Basic Sciences: Organ Systems, is a similarly great tool for the second year). You can get a $40 discount if you buy both the Organ System books together on Amazon. Click Here: First Aid Basic Sciences (VALUE PACK)

9. First Aid for the USMLE Step 1:

There is no reason to wait.  Buy this book the first day of medical school and make it your best friend.  The people over there at First Aid have an uncanny knack for knowing what will be asked on the boards (trust me, I've used their books for Step 1, Step 2 CS, Step2 CK and Step 3! They have been SPOT ON each time!).  It is important to learn the nitty gritty of each course you take so you can do well on your exams, but it is also important to know what you actually need to take away from those courses.  This is where First Aid comes in. Use it as a brief review of the most important topics for each course.

10. Kaplan's USMLE Step 1 Lecture Notes:

Yes, this is expensive. Yes, it is just a summary of everything you are already learning. However, Kaplan is a good product. No, they are not paying me to say this. I just think they are a very concise product and I have had a lot of success with them. These notes are only recently available. They are more in depth than First Aid for Step 1. They would make a great study partner


Histology Websites

Image from "Ed's Histology Review"

Histology is an extremely important topic during medical school, both in the pre-clinical years as you study anatomy and pathology, and during the clinical years when you are diagnosing patients. Many questions during school, including all three parts of the USMLE or COMLEX test will include histologic slides and ask for diagnosis or interpretation.  It is imperative that all medical students get a solid foundation in histology.  Years ago, most student would purchase histology textbooks.  However, recently, a number of medical schools have created free and easy-to-use websites for studying histology.  If you are still a book person, let me suggest Histology: A Text and Atlas which has great slides and explanations.  Otherwise, if you are like me and would like to save the money, let me outline some of the best histology review sites on the internet.

If you don’t want to spend the money and don’t mind using websites to study, let me recommend two fantastic  histology websites

If you know of other great websites, please let me know.


Goljan Audio Lectures and High Yield Notes

As you begin to prepare for USMLE Step 1 you will likely something about the Goljan lecture series and the Goljan pathology review book.  Dr. Edward Goljan is a pathologist at Oklahoma State University Medical School (you can read more about him at his university website or on Wikipedia.) In my opinion, there is no one in the country who knows more about what student need to learn for Step 1 than Dr. Goljan.  There are currently a number of board prep materials available to medical students thanks to Dr. Goljan, let me discuss a few of them.

1. Audio Lectures: Years ago Dr. Goljan taught a prep course for both parts of the boards, both Step 1 and Step 2. Somehow, these lectures were recorded and are now shared between medical students across the country and across the globe.  While I do not endorse illegal file transfers, these files are available for download on the internet and there is no other possible way to obtain them.  From everything I have read and after countless requests of my own, I do not believe it is even possible to purchase the audio files. I will provide a couple of links, but they will, inevitably, not always work.  

Your best bet is to google "Goljan Audio" or ask students in your school if you can use their copies.  As you know, it is always risky to download data from websites you don't know. Link 1: This is a skydrive directory that seems to have all the lectures available for download individually Link 2: I used this website, filstube.com.  It looks a bit shady but it worked well for me. Again, the best method would be to find some on a friend's computer. I wanted to mention what makes these lectures most useful.  I do not believe that listening to them early in your first or second year of med school is helpful.  They are not a great review for your school tests because they are only an overview.  Also, when you begin to make your study plan for Step 1 you are not going to have 40 hours to sit and listen to lectures.  Frankly, you will fall asleep and get nothing out of it.  I found that listening when I exercised every day was a fantastic way to use them.  That way I didn't feel guilty about taking an hour to exercise (which, by the way, is the best thing you can do when you are studying 10 hours every day) and I surely learned more from Goljan than I would have from Eminem and Coldplay.  In fact, I know that just listening in the car and while running picked me up a good number of questions on Step 1.  I still remember, word for word, one question that I absolutely would not have known if not for Goljan's lectures. I have heard that there are 'new' Goljan audio lectures since I took Step 1.  I can not verify this, and I search using my usual websites only found the same audio files that I used 3 years ago.  If anyone knows more about this, please leave a comment.

2.  Dr. Goljan's Book, Rapid Review Pathology: There is ongoing debate about what is the best pathology review book for USMLE Step 1.  The debate usually comes down to Dr. Goljan's Rapid Review of Pathology, and BRS Pathology.  Dr. Goljan's book tends to have more images, a more modern layout, and does not rely solely on text to teach pathology while the BRS book is a no-nonsense text book which attempts to teach the most important points of pathology quickly.  So, the choice depends on how you learn. While the issues at the heart of that debate will have to wait for a different post, we can all agree that BOTH books are very good.  Links to the newest additions of both books on amazon.com are shown below.  I used primarily the BRS Pathology book, but I have only ever heard great things about Goljan's book. In fact, some students believe it added double digit points to their board score.  Link to Amazon.com and the newest editions of both the Goljan's Rapid Review, and the BRS book are shown below.

Dr. Goljan's Book 

Dr. Goljan's Competition

3. High Yield Notes: Less known are the Goljan High Yield Pathology Notes.  The format that is available on the internet is not ideal, but I do think that these notes can be very useful.  The document is a very rapid review of the pathology associations that are most common and most important to Steps 1 and 2.  It is long (30-40 pages) and very dense (no pictures, small font size, all pages are full of text) but it highlights very efficiently the high points of pathology for the USMLE. Again, you can search the internet for "Goljan High Yield" and you will be inundated with places to download the file.  Alternatively, I will attempt to keep my copy on my website until someone tells me that it is illegal, which I do not believe it can be as this, too, is not available for purchase anywhere else. Click the link below to download the pdf. Goljan High Yield Pathology Notes  

Am I a competitive residency applicant?

This question starts to plague your mind the day you don the short white coat, and it never leaves until match day during your 4th year.  Although you don’t have to decide what you want to go into until the summer of your 4th year, it is a good idea to know what you would have to do to be competitive in a difficult specialty.  There are two great ways to obtain this information.

  1. For 3rd and 4th year students, speaking to a student-friendly advisor is a great idea. HOWEVER, beware of the nice guy.  Find an attending who won’t be afraid to break your heart.  Better to have it broken now, than spend thousands getting your hopes up when you really had no chance anyway.
  2. For first and second year students, the best resource in the world is the Outcomes of the Match materials provided by the NRMP.  The document is fantastic, but it is a lot to chew.  The link below is the most recent report, which summarizes the results from the 2009 match.


Periodically, I will be breaking down all the information provided by this document.  For the time being, look it over and study the graphs.  Everything you want to know about competitiveness of each specialty (not ophthalmology!) is in this document…here are a few to whet your appetite

Average Step 1 scores
Average Step 2 Scores
Average # matched applicants who were AOA
Average # or research projects
Percent of matched applicants with Ph.Ds