Advice for Term 5 & Registering for Step 1 || SGU
Congrats! You’ve made it to your last term of Basic Sciences! It’s a huge accomplishment, I hope you had some time to celebrate it. Take a deep breath. The Term 1 you couldn’t do what you’re about to do. You’ve made so much progress!
General Term 5 Advice
In my opinion (and this whole blog is only my opinion) things change here. After MNI, the exams and lectures are a different style. I changed my priorities specifically when it came to how to approach learning for school module exams and how to slowly integrate prepping for Step. I realized that in the last 4 terms, I got pretty good at learning for module exams but my foundations were pretty shaky when it came to actual understanding. Even though Step 1 is coming pass/fail in 2022, the concepts don’t go away, and Step 2 really isn’t that far away.
I didn’t use lectures this term, at all. It was incredibly scary since there are people who swear off lectures. I’m certain if you have the capacity to decipher these lectures, it can make your life easier. At this point, you’re familiar with the personality with the exams and lectures will hint at what’s expected (is what I heard from some of my classmates). However, I did fairly well without living by the lectures, and trust me I’m not a naturally gifted learner. My rationale for prioritizing reviewing my outside resources and understanding is that the SGU specific exam questions will not outnumber the main concepts tested. Heart failure is heart failure, thyroid cancers, and thyroid cancers. There is only so much the school can deviate from the high yield because it wouldn’t be in their best interest for us to only be good at SGU exams.
Because that opened up my time, I had finished reviewing the rest of Boards & Beyond, Sketchy, and Pathoma by the end of Term 5. It was incredibly helpful to have finished all my resources at least once before dedicated. Even though 8 or so weeks seems like a long time, it really does fly by! I still choose to review in my dedicated and it took up a lot of time but not as much as if I had never encountered them or encountered them a long time ago. So if you plan to use outside resources in dedicated, I wouldn’t save them until then. I would also annotate First Aid now if you haven’t started. This way when you start dedicated, it’s more tweaking than installing.
That being said, I would still say active learning practices like practice questions, Anki, or Quizlet should definitely be prioritized over watching videos. I would schedule these earlier in the day to ensure they would get done.
A note on budgetting
I’m in the January class so budgeting was even more on my mind. In the January class, the loan disbursement that we received in August is to last us until our clinical rotations start in May/June. I know a fair amount of people working during their dedication. On top of that, I probably missed some financial aid meetings but I wasn’t aware of the costs for Step! Because SGU students go through ECFMG, we had to pay a certification fee of $165 + exam fee of $985. Also if you don’t have any locations near you, you might have to pay for hotel costs. In addition, if you plan on taking more than one NBME (practice exams, SGU will give you a voucher for one) each will be $60! So be smarter than me and save some money for this!
Outside resources I used
Anki
I use the premade M1M2 deck. I’ve found it super helpful because it’s tagged by SGU lecture and by resource. Here’s how I usually set my decks up. I learned most of my Anki knowledge from the Anking on YT and this SGU student’s video!
I heard if you’re not an Anki person, there are plenty of premade quizlets out there too!
Sketchy Path/Micro/Pharm
Boards & Beyond: For normal physiology and anatomy
Pathoma: For pathology
Question banks
PASTEST
We got the pastest qbank courtesy of SGU. It’s got 2300+ questions. It feels like a baby question bank. Still getting its features and little wonky. Like why can’t I highlight in tutor mode, but I can in test mode? My first question session had a content mistake. I only opted for 6 questions so it was concerning that there was already a mistake when randomly selecting 6 questions out of 2300. It’s okay and there’s app to use on your phone. So positives!
USMLE-RX
We got access to USMLE-rx in the middle of MNI and were told that assigned quizzes would start after the module. I had already purchased USMLE, but they were able to use my remaining time towards the Step 2 qbank. Of note, if you want to clear your history. You have to do it before you approve the merging of your personal and SGU USMLE-rx accounts. Both claimed they didn’t have the authority to make any changes on the account. So I guess we’re stuck with it! By the end of the term, there will be around 2000 questions assigned to you and you need to complete 50% of them (not for a grade).
KAPLAN
I think it’s better than Pastest.
AMBOSS
I love love love this qbank. I love their articles which have great concise information, perfect for making those pathology small group slides.
U-WORLD
I was so scared of this question bank. I’ve heard all about the save it for dedicated vs. do at least two passes. I ultimately decided to venture in when my tutor gave us question sets. Was it disheartening? Yeah sometimes. But so far in my total of two exam experiences, it felt fair. Amboss often felt more challenging. Pastest seems too nit-picky. But U-world seems pretty banging. There are amazing diagrams and explanations.
NBME’s
NBME’s are practice tests for Step. They are 4 blocks of 50 questions. I believe Step is 7 blocks of 4 questions. It takes about 5 hours to complete. I started integrating them into my last weeks before the end of the term. I started with old forms. The new forms (Forms 25-30 as of Jan 2022) can be purchased from the NBME website for $60 an exam. It comes with an estimated score and explanations. The school will give you 1 voucher for one exam.
Study Schedule
My schedule was based on this template for the most part. I would wake up early to exercise and take care of my dogs. I felt like when I exercised at night I had a harder time falling asleep. Also, when I did something for myself in the morning, it set the tone for the day.
Then I would prioritize active learning things like Anki and practice questions. Even if you feel you need to review more before practice questions, you really won’t have any shortage of practice questions after being given USMLE-rx and Uworld.
Then my group (Online D), had small group from 10:30 AM - 12:00 PM. Then lecture or IMCQ 11:30-1:30 PM. Only 30 minutes of break between small group and lecture!
I would finish my day off with post-reads which were watching the related videos, annotating First Aid, and adding any needed Anki. My wind-down study activity would be finishing up my Anki cards.
Disclaimer, I do usually leave some pockets of time in my schedule to catch up. I usually have practice questions or Anki cards that I couldn’t complete during their allotted time.
***For specifics about any module, try the blog posts I wrote after I completed the modules!
Productivity Thangz
Todo-ist used to have an educational discount but retired that program and that’s too bad! If you love to-do lists, this is a great app. It also integrates with my google calendar.
Pomodoro studying: I have a very limited capacity to study for long durations at a time after 5 terms. If you also struggle with attention, I would recommend looking into Pomodoro studying which is like HIIT for your brain. I do 25 minutes of work and 5 minutes of whatever I want. They have apps for this, youtube videos as well. However, I got a physical timer which has been the best for me.
Step 1 checklist/resource checklist. I made this document after grieving pushing my Step exam back haha. It is a product of a combination of a bunch of spreadsheets, I’ve come across. You can download it here! Hopefully it’s helpful to someone.
MNI
This module feels familiar. It is very much a continuation of Term 4 in terms of style. We didn’t have USMLE-Rx or Uworld at this point so I would find practice questions from other question banks. I’m in the January class so we had multiple holidays during this module and almost a week before the exam. That left a lot of time to start reviewing for FTM which starts to be included in the following exams. In addition, this module was only worth 8% of our grade so while I don’t advise letting your guard down, I would say save your stress for later. Whatever you have done in the past will likely work for this module.
Helpful reviews:
Nic for general review
CK med for micro (a surprising amount of micro in this module)
Dirty medicine for pharm or Sketchy/Physeo. Please review your pharm! There is actually a lot of relative pharm in this module
Pathoma for path of course
Taco corp for neuro
CPRH
I feel like the second module of a term is always horrible. In previous terms, the exams going forward after MNI would be BSCE’s with a more cumulative focus. This makes sense with Step on the horizon. However, for our class, the Term 5 structure was changed. These exams were now module exams with a handful of cumulative questions mainly from FTM. The lectures were also incredibly different compared to prior lectures. They were case-based with a fair amount of specific SGU-isms that were hard to find in other resources as well fairly advanced clinical information that I’d expect to find on a later Step level.
I continued to follow Grace/Firehouse Prep’s schedule. However, the schedule is structured differently. You have two options (which Grace explains in her video) based on what you primarily want to spend your time on, questions or video review. I ended up doing a mix of the pathway because I would end up getting enough wrong on questions to review almost everything in the topic. I would add the cumulative Sketchy micro/pharm (which seemed less high yield but easy points if you knew them) and FTM to review at the end of the day.
As a side note, it was super helpful to schedule my weeks for all the “BSCE”s in a way that left a couple of days for drilling questions and review. Now we have even less time for each system compared to prior terms and more systems covered for each exam. So it’s easy to forget all the hard work you put into the beginning of the module.
The weeks were structured to cover a body system each week. I would start with 1-2 days with B&B to review normal physio/anatomy and then use Pathoma for pathology.
There was a PCA here, but I spent maybe 1-2 hours and got a decent score. I wouldn’t stress this assignment too much!
Honorable Mentions:
First Step USMLE reviews: I paid the $90 for a weekend review. I think the reviews were interactive and helpful. They give you the slides to review after too. However, I felt the weekend reviews were too broad. They do have group tutoring services. They were very kind and invited me to sit on a session before committing. Though it didn’t work out, they were very kind and understanding.
Ninja Nerd EKG: Wow! Ninja Nerd has come out with pretty cool content since I started medical school. This one is particularly helpful since EKGs and imaging (not covered in this one) come back with a vengeance.
GOER
The Gastroenterology, Obstetrics, Endocrinology, and Reproductive (GOER) module was 4 weeks. This module felt more straightforward. We also had biostat DLAs and ethics included.
Notable for reviews: Dr. Damania’s reviews
DNPR
I saved all my attendance skips for the end because there were three exams to prepare for! We had our DNPR module exam on a Friday, OCEX started on Saturday for some (mine was on Sunday), and the BSFCR was on the following Friday.
There was some information from MNI, but like all the prior BSCE modules there wasn’t a lot of time to go over 4 subjects. There was also some derm and rheumatology which I believe the last time we touched that was in term 4.
We had our case presented in this module. For the case presentation, we were required to make a PowerPoint to accompany our presentation about our case study and the research question we had related to our patient. I spent about an hour making my PowerPoint and rehearsing it so I met the 10-minute mark.
BSFCR
In my opinion, this was not comparable to any NBME’s have taken. There wasn’t much information about it leading into the exam. I’m unsure if even reviewing more than I did during the term would be helpful. The correlated small groups were not related to the exam. However, by this time you have gone over every topic at least three times. If you want to see how I prepped, I did a write up in another blog post!
Clincal Stuff
OCEX
We had 3 OCEXs during Term 5. OCEX 1 was during MNI. It is an individual OCEX and we didn’t get a system on the door note like in Term 4. We covered the systems that we went over in small group. OCEX 2 is in the CPRH module and is a team-based OCEX with your small group. OCEX 3 is in the DNPR module and is an individual OCEX in which any system is fair game.
PCA
PCA’s = essays in medical school. I can’t remember the last time I wrote an essay, to be honest. We were initially required to submit a SOAP note with an evidenced-based paper and reflective essay based on a case we encountered in our hospital sessions. However since our hospital sessions change so much over the term, they opened it up for us to write our PCA’s based on the Kaplan iHuman patients. I actually thought this was easier and did both my PCAs on iHuman patients.
Hospital Sessions
Traditionally hospital sessions were exciting! Term 5 students would load onto a bus to take them to the local hospital to do “rotation”. However because of the spike in COVID cases, our hospital sessions varied over our term. Initially, our small groups were split and combined with on-site students. We had to decide on our own how we would split the workload (it proved harder than expected to be fair).
So in the first iteration, the first part of the 3-hour block we would have a simulated patient with the fancy mannequin (it blinks!). The camera angle reminded me of my remote scribes days where the physician would forget me on the bookshelf. We could see the top part of the mannequin and everyone’s shoes. Watching the on-site students get clinical training on how to properly do the things we’ve regurgitated from the rubrics was very cool! We would try to read out the instructions for the physical exams they were doing. The facilitator would try to include the online students by asking questions, but connection especially audio was often off. Then for the last part of the block, we would have a real patient who we would have to do a full interview, physical, and closure. What was different was that a lot of the chief complaints seemed to be a general check-up. It was not like Standardized Patients where you could prep before and got the door note.
Eventually, the hospital sessions were not feasible so the staff did try to have everyone online with the facilitator with the patient. However even that became too risky, so we ended up having a couple of weeks of what they called “Grand Rounds”. A physician from a specialty like Family Medicine or Surgery would do a case presentation and we would click in for attendance.
Clinical Year Intro
All in all, don’t give away too much of your attention to the clinical year information. It is important to be aware, but try not to be distracted by it during the term. There will be several mandatory clinical talks hosted by the school. We got our clinical memo/placement survey a month before the end of term and won’t find out where we will be placed until about a month before we’re required to go. The form only allows a dropdown menu for 3 states you want to be placed in, a comment box for additional things you want to mention, and a comment box for who you want to be placed with.
Registering for Step 1 & Dedicated
In the midst of everything wild in T5, you’re encouraged to get started on your STEP registration. Every step tends to take anywhere from a couple of days to a couple of weeks. Save this video for later because it’s a nice overview of what to expect, but the specifics are a little different for SGU. Also, the ECFMG has an explanation here.
If you have the capacity, I would do as much of the process as possible to avoid delay in needing to schedule Step especially if you’re in the August class. Though this process is lengthy and expensive, I wouldn’t stress out about it too much! You do have an ECFMG advisor at SGU based on your last name that you can check the status on school stuff and you can check the status of your ECFMG stuff through the OASIS tab on the ECFMG website.
You can check locations and availability of Step locations on Prometric.
DURING TERM 5
Obtain ECFMG ID number through the ECFMG website. You need this to complete the form SGU requires you to fill out shortly after Term 5. Also if you had a middle name on your identification documentation, please use it! I didn’t include it and spent another couple of days filling out an additional form to change it. (I also used this video to help me register. It walks through the application screen by screen.)
Receive ECFMG ID number, it took me about a couple of days, and I received the number via email.
OPTIONALLY DONE DURING TERM 5
Complete the ECFMG Certification application on the ECFMG website and pay the fee (fee overview here), for me in 2021 it was $165.
Form 186 will be provided and can be downloaded from the ECFMG. You will complete this form with their online service, NotaryCam. They emailed me a couple of days after I completed my certification and were able to notarize my documents the day they reached out to me. NotaryCam also sent my documents to ECFMG and SGU. You’ll get an email confirmation from ECFMG when they receive it.
Form 173 will be provided by SGU via email sometime in Term 5 and will be partially completed. You complete it after completing ECFMG certification and you will need your ECFMG ID. I completed this on Notability so I could handwrite my answers and exported it back out to email back to SGU.
OPTIONALLY OPTIONALLY DURING TERM 5?
Begin USMLE Step 1 application on the ECFMG website. You’ll need all the identification information including the ECFMG ID # and your projected graduation date (I found it in our class manual). Different admin from the school gave us different answers. Register and pay your $975.
I completed this step while in Term 5 because I had a shorter timeline, but I heard different opinions on when to complete this. Some students in the term ahead of me said SGU can’t find your ECFMG application without, some told me they didn’t need it. The worst outcome is you’re down $975 (RIP bank account) and you can see your OASIS status as “Waiting for school to verify”.
AFTER TERM 5
ECFMG sends the Step 1 application to the school. The school will approve it and send it back to ECFMG. I was in contact with my SGU ECFMG counselor and was told she receives a list of approved students from the Dean of Student. The school did not send my verification to ECFMG until 10 days after the term ended. ECFMG will send you an email once they receive verification from the school and you’ve been approved.
Wait patiently again to finally receive your scheduling permit from ECFMG, yay! It took me another 3 days after getting the approval email from ECFMG. Now you can register for Step through the link they emailed you! ECFMG also gives you a token number so you don’t pay additional fees through Prometric when you register.