Wednesday, December 30, 2009

Failed USMLE exam? Do not worry!

Anyone can fail... so do not think that world is ended the day you failed exam. Do not focus on your failure... try to think about positive things, socialize with friends and start planning for success in your next resit.

If you fail any part of the USMLE 3 times, there are 13 states in the US that will never allow you to practice medicine within their jurisdiction.

MKSAP 15, anyone

Hello guys,

Do you have MKSAP 15 - CD-ROM or Audio Companion? I am interested to get a copy of that. Please contact me at usmlestep at - and let us have a chat on how to make a swap.

Happy New Year to all of you! May 2010 bring you joy and happiness!!

Monday, December 14, 2009

Kaplan 2009 Step 2 Videos for USMLE exam

A lot of people are now talking about Step 2 Kaplan Video Lectures for USMLE - and it seems that someone have seen that Kaplan released new set of videos for 2009. I have not seen them - but would be interested to understand if anyone had a chance to get those new videos.

Any lucky USMLE takers possessing USMLE Step 2 Kaplan Videos (new edition)?

Saturday, October 31, 2009

USMLE in 2010

What are the most important changes that ECFMG Board is planning to do 2010? I am going to post them as the rumours and official announcements will be published.

Watch the space...

Friday, August 28, 2009

Do you use torrent ?

A question for my USMLE friends. Do you use torrent frequently to download USMLE materials? I know that some of you do -but I would be interested to understand how many of you are using torrent frequently.

Tuesday, August 25, 2009

How to Improve Your Memory

1. Convince yourself that you do have a good memory that will improve. Too many people get stuck here and convince themselves that their memory is bad, that they are just not good with names, that numbers just slip out of their minds for some reason. Erase those thoughts and vow to improve your memory. Commit yourself to the task and bask in your achievements -- it's hard to keep motivated if you beat yourself down every time you make a little bit of progress.
2. Exercise your brain. Regularly “exercising" the brain keeps it growing and spurs the development of new nerve connections that can help improve memory. By developing new mental skills—especially complex ones such as learning a new language or learning to play a new musical instrument—and challenging your brain with puzzles and games you can keep your brain active and improve its physiological functioning. Try some puzzle exercises everyday such as word cross, sudoku and some other games as easy to put into your mobile phone and practise it maybe once for 30 minutes per day.
3. Exercise daily. Regular aerobic exercise improves circulation and efficiency throughout the body, including in the brain, and can help ward off the memory loss that comes with aging. Exercise also makes you more alert and relaxed, and can thereby improve your memory uptake, allowing you to take better mental “pictures."
4. Reduce stress. Chronic stress, although it does not physically damage the brain, can make remembering much more difficult. After prolonged stress the brain will be damaged. Stressful situations are recognized by the hypothalamus, which in turn signals the pituitary gland. The pituitary gland secreted adrenocorticotropic hormone (ACTH)which influences the adrenal glands to secrete adrenaline and later cortisol(corticosteroids). The corticosteroids can weaken the blood-brain barrier and damage the hippocampus(the memory center). Ironically, the hippocampus controls the secretion of the hormone released by the hypothalamus through a process of negative feedback. After chronic stress it will be damaged and it will not be as efficient in regulating the degenerative corticosteroids and memory will be harmed. Neurogenesis (formation of new neurons) indeed exists in the hippocampus but stress inhibits it. To recapitulate and synthesis, chronic stress will affect your health and your memory, it will damage the brain so the best option is to learn to control stress. Stress will never be eliminated, but it definitely can be controlled. []Even temporary stresses can make it more difficult to effectively focus on concepts and observe things. Try to relax, regularly practice yoga or other stretching exercises, and see a doctor if you have severe chronic stress as soon as possible.
5. Eat well and eat right. There are a lot of herbal supplements on the market that claim to improve memory, but none have yet been shown to be effective in clinical tests (although small studies have shown some promising results for ginkgo biloba and phosphatidylserine). A healthy diet, however, contributes to a healthy brain, and foods containing antioxidants—broccoli, blueberries, spinach, and berries, for example—and Omega-3 fatty acids appear to promote healthy brain functioning. Feed your brain with such supplements as Thiamine, Vitamin E, Niacin and Vitamin B-6. Grazing, eating 5 or 6 small meals throughout the day instead of 3 large meals, also seems to improve mental functioning (including memory) by limiting dips in blood sugar, which may negatively affect the brain.
6. Take better pictures. Often we forget things not because our memory is bad, but rather because our observational skills need work. One common situation where this occurs (and which almost everyone can relate to) is meeting new people. Often we don’t really learn people’s names at first because we aren’t really concentrating on remembering them. You’ll find that if you make a conscious effort to remember such things, you’ll do much better. One way to train yourself to be more observant is to look at an unfamiliar photograph for a few seconds and then turn the photograph over and describe or write down as many details as you can about the photograph. Try closing your eyes and picturing the photo in your mind. Use a new photograph each time you try this exercise, and with regular practice you will find you’re able to remember more details with even shorter glimpses of the photos.
7. Give yourself time to form a memory. Memories are very fragile in the short-term, and distractions can make you quickly forget something as simple as a phone number. The key to avoid losing memories before you can even form them is to be able to focus on the thing to be remembered for a while without thinking about other things, so when you’re trying to remember something, avoid distractions and complicated tasks for a few minutes.
8. Create vivid, memorable images. You remember information more easily if you can visualize it. If you want to associate a child with a book, try not to visualize the child reading the book – that's too simple and forgettable. Instead, come up with something more jarring, something that sticks, like the book chasing the child, or the child eating the book. It's your mind – make the images as shocking and emotional as possible to keep the associations strong.
9. Repeat things you need to learn. The more times you hear, see, or think about something, the more surely you’ll remember it, right? It’s a no-brainer. When you want to remember something, be it your new coworker’s name or your best friend's birthday, repeat it, either out loud or silently. Try writing it down; think about it.
10. Group things you need to remember. Random lists of things (a shopping list, for example) can be especially difficult to remember. To make it easier, try categorizing the individual things from the list. If you can remember that, among other things, you wanted to buy four different kinds of vegetables, you’ll find it easier to remember all four.
11. Organize your life. Keep items that you frequently need, such as keys and eyeglasses, in the same place every time. Use an electronic organizer or daily planner to keep track of appointments, due dates for bills, and other tasks. Keep phone numbers and addresses in an address book or enter them into your computer or cell phone. Improved organization can help free up your powers of concentration so that you can remember less routine things. Even if being organized doesn’t improve your memory, you’ll receive a lot of the same benefits (i.e. you won’t have to search for your keys anymore).
12. Try meditation. Research now suggests that people who regularly practice "mindfulness" meditation are able to focus better and may have better memories. Mindfulness (also known as awareness or insight meditation) is the type commonly practiced in Western countries and is easy to learn. Studies at Massachusetts General Hospital show that regular meditation thickens the cerebral cortex in the brain by increasing the blood flow to that region. Some researchers believe this can enhance attention span, focus, and memory.
13. Sleep well. The amount of sleep we get affects the brain's ability to recall recently learned information. Getting a good night's sleep – a minimum of seven hours a night – may improve your short-term memory and long-term relational memory, according to recent studies conducted at the Harvard Medical School.
14. Build your memorization arsenal. Learn pegs, memory palaces, and the Dominic System. These techniques form the foundation for mnemonic techniques, and will visibly improve your memory.
15. Venture out and learn from your mistakes. Go ahead and take a stab at memorizing the first one hundred digits of pi, or, if you've done that already, the first one thousand. Memorize the monarchs of England through your memory palaces, or your grocery list through visualization. Through diligent effort you will eventually master the art of memorization.

How to improve your memory - Trying by Not Trying

All of us apply this method knowingly or unknowingly. Sometimes when you try to recall you may not be able to recall it at that time even if you are sure that you know it very well. You experience a blocking that prevents you from recalling it. Normally you tend to try again and again but in vain. To handle this situation you just keep away from trying to recollect it and do something else; to your pleasant surprise that information automatically pops up into your mind after some time. This is because even if you stopped trying, the mind is searching for that information and brings it to awareness when it is found. Sometimes the information was blocked when you wanted, and mind brings it forward when the blocking is removed. This is where stress plays its role in hindering recall.

If you are very anxious by nature or very stressful in nature, you may encounter this type of blockage very often. In such case, it is highly recommended that you practise some kind of relaxation technique and thus keep your anxiety and stress away. This is very important because this behavior can bring many undesirable psychological and physiological conditions. You may even consult a Clinical Psychologist in extreme cases.

How to improve your memory - bed time recital

In this technique, you do your recital or rote learning just before going to bed. The mind in the process of sleeping would then arrange the information in a systematic and effective way when you are sleeping. Psychologists have also found that if you sleep after thinking about your problems there is a better chance that you arrive at a solution the next day.

Steps for Memory Improvement

1. Be in a relaxed mood
2. Write down the things that you are supposed to remember in a piece of paper.
3. Read it aloud (if possible) once or twice and recite it two to three times.
4. Now go to sleep without worrying or thinking about anything.

You will surely retain the item longer and find it more easy to recall it when in need.

How to improve your memory - bridging


In this method, a bridge is built in between the items given to be memorized. This technique is best suited for learning material involving word pairs or material that can be reduced to word pairs. An example often cited by memory experts is the learning of the capital of Poland. The capital of Poland is Warsaw. World War II started with Germany's attack on Poland. Thus it may be arranged as Poland SAW War first.

Here, the word pair to be connected together is Poland and Warsaw. The additional information of the World War II is used as a bridge or mediator in bringing these two words together.

Again, like other techniques, the mediation technique calls for the learner's active participation in the learning process. This is because one is to bring in the mediator or the bridge from relevant items one has learned.

How to improve your memory - rhyming


This is also one of the popular and oldest methods in memorization. This technique makes use of the fact that we have a natural tendency to remember rhymes and rhythms. The following is a very popular example of application of this technique which almost all school students are familiar with.

"Thirty days haveth September

April, June and November

All the rest have thirty-one

February has twenty-eight alone

Except in leap year, then the time

When Febs days are twenty-nine."

If possible create rhymes like this and it will not only aid in improving your memory but in improving your creativity as well.

How to improve your memory - chunking


Perhaps Chunking is the oldest method used in memorization. In this method, the items to be memorized are divided into small and easily memorizable chunks or groups. This method works best when the order of the items is not important.

This method is found to be particularly well suited for memorizing multi-digit numbers (eg., ID nos., telephone nos., etc.) and for committing complicated spellings to memory.


1. The number 472627607 may be memorized easily if it is grouped as 472, 627,607 or as 47, 26, 27,607.
These chunks may then be learned by rote. Learning and retention are much facilitated if you further explore the nos. by finding some relationship among these different chunks. Finding the digital root will also be helpful. The more explorations or relations you do, the better.
2. Words like mathematics may be divided into mat +he +mat +ics, Together may be divided into to + get + her; Important may be divided into im + port + ant. This technique will make us learn much faster.
3. The list Apple, cucumber, paper, ink, cabbage, banana, grapes, beans, stapler, orange can be better learned by rearranging and applying chunking as :-
Apple, banana, grapes, orange, cucumber, cabbage, beans, paper, ink, stapler
-- 4 fruits, 3 vegitables and 3 stationary items.

If possible, organize the material as meaningfully as you can and think out relationships among each group. This not only improves learnability and retention but also aids in faster and effortless recollection.

Psychologists doing research on Human Memory have found that the capacity of Short Term Memory (STM) for humans is 7± 2 that is from the range 5 to 9 items. So you should take care to keep the chunks you create within this limit.

Saturday, August 22, 2009

Best Pathology Books for USMLE Step 1

Best Pathology Books for USMLE Step 1
1) Elsevier's Integrated Pathology

2) Robbins and Cotran Atlas of Pathology

3) Pocket Companion to Robbins Pathologic Basis of Disease

4) Robbins Basic Pathology)

5) Rapid Review Pathology

6) Robbins Review of Pathology

7) Pathology: Board Review Series

8) Kaplan Lecture Notes: Pathology

9) Essential Pathology

10) Color Atlas of Pathophysiology

Monday, August 17, 2009

Medical Books

I wonder if you have started collecting your electronic medical books collection. If not - here is your great chance to do this right now -

Medical books collection

Saturday, August 08, 2009

USMLE + twitter

You can share facts using twitter account and if you have 15-20 people in your group this might become an effective wasy of memorizing medical information

Thursday, July 16, 2009

How to interpret USMLE scores

You will get the following info in your USMLE report :
your 3-digit score
your 2-digit score
Mean and Standard Deviation for recent US/Can registrants (not IMGs) - first time test takers.

This is a common misperception to call 2-digit score percent or percentile - 2 totally different things, by the way; it's neither percent, nor percentile!

From biostatistics you should know that percentile is the percent of people from total 100% who received scores lower than yours.

By using your 3-digit score, Mean and Standard Deviation and special statistical table, you can calculate your percentile, and by using your 2-digit score, you can calculate appr. percent of correctly answered questions.

USMLE Scores and Percentiles (simple guide)

2 digit scores are standardized so that the minimum passing score is a 75 and the maximum score is a 100. This approximately correlates to each digit between 75 and 100 being 4 percentiles of those who passed. The 2 digit score is something requested/required by state medical boards for all licensing exams so they can quickly evaluate the score without figuring out each exam's scales.

Scores used to be calculated after a group of students took them and you were given a 2 digit score, a 3 digit score, and a percentile. They used to do it where a large number of students took the exam, then they were all graded and statistics were calculated based upon all the students taking it then. The percentile was where you stood among the other students who took the exam in the block from which your exam was taken and scored. Therefore, each year, the median score would get a 50th percentile, although one year this could be a 205 and the next a 210. So a 240 in 1990 might be a lower percentile than a 235 in 1991. The problem is that a 240 is doing better, but 1991 may have been a "dumber" year so you could have a higher percentile with a lower score.

Now with computerized exams, they do not score your exam relative to the others taking it when you do... it is referenced to historical performance of the test items at which time a "difficulty level" for each item was assigned. This way, a 240 is a 240 no matter when you take it. Also, you do not have to wait for thousands of students to take the exam, do all your statistics, and then calculate the scores... you can calculate the score immediately. The implication of this, however, is that it is impossible to calculate a percentile since you are being scored against an inertia-laden grading curve. Every student could get a 240 now, and every student can fail.

There are many implications of this grading policy, and understanding it (really understanding it, not just saying that 240 is good and my score report says the mean was x with a sd of y) will serve you well.

Saturday, July 11, 2009

Goljan Audio Transcript - Pathology Lectures

This is something that you shall check. Goljan Pathology lectures now are accompanied with Audio Transcript. Full content of the audio transcribed in a concise document. 300+ pages of high quality transcript...

Couple of quotes:

"I like this!!! it was difficult for me to follow Prof. Goljan listening to audio lectures. Now I can read the transcript and focus on the areas I need. I put my favourite yellow and green labels on the most inportant pages... Thank you soooo much!"

"Great stuff - I downloaded goljan package in couple of hours and already started using audio transcript. This is fabuluous!"

Tuesday, June 02, 2009

Are you preparing for Step 1 ?

Are you preparing for USMLE Step 1?
I would like to check your opinion!

What is better?

Kaplan Video Lectures
Pass Program Video
Kaplan Webprep
Gold Standard

Interesting link - medical guidemaps

That is a very useful for USMLE Step 2 CK preparation.

Here is the desceription from the owner:

I started this new website in March 2005.

Its main purpose is to host my soapbox essays. My soapbox essays are critical essays that are mainly focused on reviewing/analysing randomised controlled trials (RCTs) in order to demonstrate weaknesses/flaws in the design and interpretation of RCTs. My latest essays are at the top of the list. My oldest essays are at the the bottom of the list — some of them express opinions which I no longer hold, or opinions which reflect my limited EBM knowledge of earlier years.

I have also decided to host my medical guidemaps on this website. Please note that i) I am retired and I am no longer practicing clinical medicine and ii) I am no longer revising the guidemaps. Therefore, the guidemaps should be perceived to be outdated. I personally suspect that my neuro-ophthalmology guidemaps will remain clinically relevant, even though I am no longer updating those guidemaps.

Jeff Mann. MD.

Government Motors

I know this is not strictly related to USMLE... but I have read today that General Motors is bankrupt and people renamed it to Government motors.

The Government Motors started by selling the Hummer brand to unnamed buyer...

Do you know what will happen with General Motors after it have filed the Chapter 11


Sunday, May 10, 2009

Goljan Audio and IPOD - solution found

A Lot of people were asking how to use Goljan Audio on IPOD and there were several ways to achieve that and some of them worked and some did not.

And finally there is a full solution to the problem.
You can easily listen to Goljan Pathology Lectures on your favourite Ipod, the car, during workout, while commuting.... Please note that this method does not work for other MP3 players - only for Ipod.

Here is how to use Goljan on Ipod

Tuesday, April 14, 2009

Premier Review For Step 3

Premier Review courses are designed by the faculty of Mt. Sinai & Harvard Medical Schools and a lot of people rate Premier Review for Step 3 higher than Kaplan.

The following topics are covered in Premier Review Lectures for Step 3:
Eye and ENT
General Medicine
Hematology and Oncology
Human Development, Vaccinations & Health Maintenance
Infectious Diseases
Medical Ethics & Test Taking Strategies
Medical Genetics
Surgery, Trauma & Orthopedics

Monday, February 16, 2009

Social networking for USMLE takers

Quick questions to my regular blog readers.
Are you using any of the social networks to communicate with your USMLE peers?

Please answer in the comments to this post.
Your opinion is very important for me.

Sunday, February 15, 2009

Step 1 Notes 2009

Kaplan Step 1 Notes 2009 edition is now available for all USMLE takers. You can get them (2008/2009) if you are attending the Kaplan Live Center and paid full fee for attendance.

An alternative would be to look for Kaplan Step 1 Notes 2008/2009 edition on Ebay.
Another alternative would be to ask from your friends - some of them might have these new notes already and can share them with you.

If you are constantly on the move - then you might consider getting scanned notes instead of hardcopy notes.

Here is the link to try

Thursday, February 12, 2009

USMLE Step 2 Lectures 2008/2009 edition

Many friends asked me about USMLE Step 2 Lectures published in 2008/2009.
Unfortunately, I have not heard of these videos on the grey market. Kaplan Step 2 Videos have been released in 2002/2003. Although some people keep referring to them as 2006 or even 2007 step 2 kaplan lectures, in reality this is 2002/2003 Step 2 Lectures.

On the other side - medicine is not IT science and is not changing every 3 years.
So, stick to whatever materials you have and keep fingers crossed...
Good luck in your Exam!

Thursday, January 15, 2009

Resident salary rise in 2008

The American Association of Medical Colleges (AAMC) released survey results on what Medical residents across the US were paid for the 2008-2009 academic year and here are the mean figures:

* 1st Year (PGY1 / Intern ): $46,000

* 2nd Year (PGY2): $48,000

* 3rd Year (PGY3): $50,000

* 4th Year (PGY4): $52,000/-

* 5th Year (PGY5): $54,100/-

* 6th Year (PGY6): $56,500/-

Which roughly imply about a 3% increase over the last year.

Full salary survery report can be downlooaded from here:

Medstudy Pediatrics

2007 Medstudy Pediatrics or Pediatric Medstudy 2007 contains the following topics:

Allergy and Immunology
Emergency Toxicology
General Pediatrics
Infectious Diseases
Metabolic Diseases
MedCalc is a free medical calculator, that gives you easy access to complicated medical formulas and scores. It has been available on mobile platforms for almost a decade, so it leverages years of experience in bringing medical equations to physicians in an easy to use, yet very powerful format.


Iphone in medicine

The iPhone has huge potential as a mobile computing platform, especially for physicians.

Sure, other mobile platforms exist — the Treo, Windows Mobile devices, tablet computers — but none have the graphics capability, the memory, the computing power, the form factor, and the ease of use of the iPhone.

What follows is the result of a brief brainstorming session about potential applications of the iPhone for doctors. Some have already been announced for the iPhone, are available on other platforms, or are currently in development. Let's see how many of these applications are eventually released and sold in the App store. My guess? All of them.

* Drug database
* Anatomical atlas
* Medical calculator
* Interface for electronic health record
* Viewer of radiologic images
* Interface for laboratory results
* An expert system to help with differential diagnoses
* Messaging system for laboratory alerts and hospital pages
* Interface for medical devices (like ultrasounds and EKG machines)
* Dictation recorder
* Device for electronic prescribing
* Device for directly receiving and reading medical journals and podcasts
* Medical book reader
* Reminder system for patient visits and meetings synced remotely with the office through Mobile Me
* Display for patient education videos
* Medical simulator (ACLS, for example)
* Telemedicine device (pending the eventual release of iChat and a videoconferencing system)
* Interface for medical literature searches (Pubmed, Google Scholar)
* Word processing device for papers (I'm still waiting for a bluetooth keyboard)
* Communication device for hospital teams (Using Twitter or another system)
* Secure system for messaging/emailing patients
* CME course viewer (with text and/or video)

What other application ideas can you come up with?