Jefferson Medical College Alpha Omega Alpha Guide to USMLE Step 1

The Right Resources

As you embark on your studies for the USMLE Step 1, choosing the appropriate study materials is crucial to your success. There are tons of review books and sample test question books available for your preparation but money and time are two factors you must consider. Many of these review books cost over $25 and take a significant amount of time to go through. So, here are some recommendations for books that may maximize your study success. Do not stick to one series of review books because you like the format - in every series, there are good books and bad books, and the best strategy is to use the best books from each series as appropriate.

Keep in mind, you can’t choose the "wrong" book for a subject. Pick what works for you, and don’t have second thoughts about your choices. These books are published because they are good and wouldn’t have stuck around for so long if they weren’t. When you do choose a book for a subject, stick to it.

We have broken this guide into categories: general books, book series, anatomy, behavioral science, biochemistry, physiology, microbiology/immunology, pharmacology, pathology, and practice questions.

*Essential resources.

::::GENERAL::::

*First Aid for the USMLE 1 by Le and Bushnan. Published by McGraw-Hill Medical.

We have listed only one reference in this section because this is the single best comprehensive reference for the Step 1. First Aid should be your best friend. Although in the past it was recommended for use only during your intense 4-6 week study period, a recent survey of the class of 2012 listed early use of First Aid as one of the most beneficial things you can do for yourself as a second year. Many students found it helpful to keep First Aid open to the same topic you are covering in FCM during normal studying; some even chose to take notes directly into their First Aid throughout the year.

What is so great about First Aid?
The book is separated into three sections: the guide to efficient exam preparation, database of high-yield facts, and database of basic science review books. First Aid will answer all your picky questions about the exam (# of questions, time per question, scoring, etc.). The high-yield section is very handy and is a great review of all the topics. Reading this section over for the second or third time days before the exam will definitely score you some points. While no one book works for everybody, this book consistently receives the best reviews from students who have taken the boards. Strong sections: Micro, Pharm and Behavioral Sciences. The sections pertaining to some of the lower-yield subjects (anatomy/embryo/histo) cover a huge chunk of the important and testable items that may show up on the exam, so it is certainly worth your while to know them well. As you add important facts in the margins as you study the subjects during the final few days, First Aid becomes the only thing you need to read during the final few days. Bottom line: this book should become your best friend; however, it is not recommended as a stand-alone reference.

Step-Up to the USMLE Step 1 by Mehta. Published by Lippincott Williams and Wilkins.

It does the high-yield approach by organ system, rather than the by-discipline approach of First Aid. Great organization, but has too many errors. Good as a supplement if you like the style.

::::BOOK SERIES::::

Board Review Series (BRS), published by Lippincott Williams and Wilkins:
Subjects available are Biochemistry, Pharmacology, Microbiology, Gross, Histology and Cell Biology, Embryology, Neuroanatomy, Behavioral Science, Pathology, and Physiology. All books have a similar outline format, many charts, sample USMLE-style questions with annotated answers, and a comprehensive exam. These are not textbooks; they are intended for review.

Appleton-Lange Series:
Included in this series are an excellent review book for microbiology and immunology (Levinson and Jawetz) and a pharmacology review book that is the companion to your text (Katzung and Trevor). The formats vary. Both the microbiology and pharmacology books have excellent cases and sample questions.

NMS, pubolished by Lippincott Williams and Wilkins:
Same publisher as Board Review Series, but these are textbooks, not board review books. There is much more information and detail, with a "dense" format that makes them rather formidable. The only "must have" in this series is a question book/CD called Review for USMLE Step I, 6th edition.

Ridiculously Simple:
The series has Anatomy, Neuroanatomy, Biochemistry, Pharmacology, Microbiology, and Physiology. Minimalist approach as the name suggests with silly, but helpful, mnemonics. The only "must" in the series is *Clinical Microbiology Made Ridiculously Simple.

Lippincott's Illustrated Reviews:
There are three books in this series, Biochemistry, Pharmacology, and Microbiology. Biochemistry is popular as a textbook; it is well-written and well-illustrated, but long for board review. Pharmacology also is excellent to use as a text, but long for a step 1 review book.

High Yield Series, published by Williams and Wilkins:
This series includes Gross, Neuroanatomy, Biostatistics, Embryology, Behavioral Science, Immunology, Histology, Biochemistry, Cell and Molecular Biology, and Pathology. The most popular books in the series are *High Yield Neuroanatomy, High Yield Embryology, High Yield Gross Anatomy, and High Yield Behavioral Science. These books distill the content to an irreducible minimum. No indices, no questions.

Rapid Review Series, published by Mosby:
This series includes Pathology and Biochemistry. Many students use the Pathology book as their gold standard for studying the subject. It also includes helpful images for students. The Biochemistry book is known for containing excellent diagrams that are clinically relevant. Both have very comprehensive review questions.

::::ANATOMY::::

After spending so much time studying anatomy during first year it is kind of disappointing to find out that anatomy is not really a big topic tested in Step 1. You can use this to your advantage by spending more time on other topics. Stay away from Chung and Moore. First, understand that all of anatomy is 1/7th of boards. At a minimum, you will use the anatomy sections of First Aid for the USMLE Step I. Many students contend that First Aid is sufficient by itself and additional review books are unnecessary. For those of you who would like an text, we recommend the following books by subsection of anatomy:

(1) Gross: First Aid alone or in combination with High Yield Gross Anatomy. BRS Gross is much too long for board review.

(2) Cell Biology/Histology: BRS - read the first 4 chapters on cell biology if you have time; a book to borrow or share. The practice questions will hit on most of the topics tested in this category.

(3) Neuroanatomy: First choice is *High Yield Neuroanatomy. You must have a neuroanatomy review book in addition to First Aid. BRS Neuroanatomy is much too long for board review. We strongly suggest you review your neuroanatomy before Dr. Brainard's review session: it is a great session but don't worry if it scares you--it scared all of us. There are a fair amount of neuroanatomy questions.

(4) Embryology: First Aid alone again is sufficient, and High Yield Embryology can just be used as a reference.

Bottom Line Minimum for Anatomy: Anatomy sections of First Aid for the USMLE Step 1, High Yield Neuroanatomy, and if you prefer, the first four chapters of BRS Histology and Cell Biology and, as a reference, High Yield Gross and High Yield Embryology.

::::BEHAVIORAL SCIENCES/BIOSTATS::::

BRS and High Yield are by the same author. Last chapters in either book have epidemiology and biostatistics that are essential for USMLE. Make sure you have a decent understanding of the main topics in biostats. Both books are decent, though BRS is a lot thicker. Some students have noted that the questions in BRS are helpful. Many students also read through the packet you received from Dr. Mago during FCM, finding it a great review of pertinent topics.

KNOW THE FIRST AID CHAPTER COLD.

High-Yield Behavioral Science by Fadem

*BRS Behavioral Science Review by Fadem

::::BIOCHEMISTRY::::

Biochemistry is a topic that is easily forgotten by the time the boards roll around. Going back over all the major metabolic pathways will take time. Many students solely use First Aid to study this subject because many other review books are very dense. First Aid reviews the high-yield molecular, cellular and metabolic pathways that are commonly tested on the boards. There is also a relatively comprehensive list of genetic diseases in First Aid. If you are able to review and memorize the common pathways and diseases, you probably do not need to use another review source. If you do choose to use another book, choose between Lippincott's, BRS, and Rapid Review. If you used one of these books during first-year Biochemistry, that's your ideal choice for board review. If not, then it's strictly your preference - dense outline of BRS vs. bigger pages and pictures of Lippincott's and Rapid Review. High Yield Biochemistry has a concise, no-fat approach. We recommend it only for those with a very strong background in biochemistry. The NBME (National Board of Medical Examiners) always like to ask something about several of the metabolic pathways, esp. glycolysis, citric acid cycle, oxidative phosphorylation, fatty acid oxidation, glycogenolysis, and gluconeogenesis.

*Biochemistry by BRS, by Marks

Lippincott’s Illustrated Reviews: Biochemistry by Champe
Rapid Review Biochemistry, by Pelley and Goljan

::::PHYSIOLOGY::::

BRS Physiology is a must read book for the USMLE 1. Costanzo does an excellent job summarizing a topic that is high-yield on the boards. You will do well on this subject if you review physiology with the FCM portion of your second year courses; this is essential for doing well in the courses and on USMLE. If you have a firm understanding of everything in the book you will definitely score solid points on the exam. The book is reader-friendly and has great clinical correlations that briefly go over FCM topics. By May, you should have been through a review of physiology at least once. Know this book COLD!

*Physiology by BRS, Costanzo

::::MICROBIOLOGY/IMMUNOLOGY::::

Microbiology is incredibly high yield for Step 1 so it is to your advantage to have a decent understanding of all the bugs and weapons in the body used to fight them. It is important to choose a reference that has brief and concise descriptions of all the microbes so you don't waste your valuable time. Clinical Microbiology Made Ridiculously Simple will be your major resource for board review in microbiology; it can be a long read for step 1 review, but it's well worth it. For immunology, many students said First Aid was enough if you have a strong background in the topic. For those looking for a resource, get Medical Microbiology and Immunology--Examination and Board Review (Levinson and Jawetz) or High-Yield Immunology. High-Yield Immunology is a fairly quick read and covers most of the high points for the exam. Levinson and Jawetz has a great section called "Brief Summaries of Medically Relevant Organisms" and a must-read 70-page section on immunology. Many students also opt to get micro flashcards as a quick review.

Medical Microbiology & Immunology: Examination and Board Review by Levinson

*Clinical Microbiology Made Ridiculously Simple by Gladwin

High-Yield Immunology by Johnson

::::PHARMACOLOGY::::

In recent years, most students have been moving away from Pharmacology text books and have been using First Aid alone or with pharm cards. The pharmacology on Step 1 is very straightforward and focused on drug class, MOA and the major side effects. If you want a reference book, the same said above with micro/immuno applies to pharm. You want a reference that doesn't waste your time but gets to the point as this topic is high-yield on the USMLE step 1. Tables, outlines and index cards are very helpful in studying for pharm. Lippincott’s Pharmacology has excellent illustrations and tables that are worth looking at. The book is cross-referenced to its brother, Lippincott’s Biochemistry. Johannsen’s Pharm Cards are index cards highlighting the major drug/drug classes that are very useful. The index cards have great diagrams and charts. We recommend you use the pictures and tables in Lippincott’s with Pharm Cards. If you are looking for good pharm questions, Katzung authors a board review book that has tons of them in the back. The text is good, but is too detailed and takes time to read. If you have been using the companion all year and are familiar with it, stick to it, it will be easy to go through what you've seen before. But again, most students rely heavily on First Aid and you must know the section in First Aid COLD!

*Lippincott's Illustrated Reviews Pharmacology by Harvey

Pharm Cards: A Review for Medical Students by Johannsen

Pharmacology: Examination and Board Review by Katzung

::::PATHOLOGY::::

This subject represents the foundation of your medical knowledge, and not surprisingly, the foundation of this exam. BRS Pathology and Rapid Review by Goljan are the best review books for pathology. Buy one early and use it along with every course. The BRS path book does an outstanding job of taking the vast subject matter in pathology and presenting it in an easy-to-read outline format that highlights "key points" (there are literally small keys in the margins next to important tidbits of information). It follows a very similar outline to Rubin’s pathology and includes pictures from Rubin’s Pathology that you are exposed to throughout the year during FCM. Rapid Review is a much longer review book, but students feel it is more comprehensive and contains many more useful images and review questions. We recommend that students start Rapid Review prior to Step I studying since it takes longer to complete. Do the study questions in the source you choose if you have time, otherwise you are better served saving your time for your question bank. Although it is also important to be familiar with the slides and pathology photos presented in First Aid; you will see few slides on test day. Above all, be confident that your preparation in taking FCM and Pathology this year has provided you with a good foundation for preparing for this exam.

**High Yield Add-on** Dr. Goljan (author of Rapid Review) has a lecture series available by audio that you must get your hands on. Listen to it in the car, at the gym, or running errands and he covers very high yield material and teaches in a way that sticks.

*BRS Pathology by Schneider

*Rapid Review Pathology by Goljan

::::PRACTICE QUESTIONS::::

If there is anything that really needs to be stressed in this study aid, then it should be making time for sample questions. It is imperative that you get the "feel" for exam questions. Do as many questions as you can and look at the explanations. At a minimum, complete as much of USMLE World as possible. Many students choose to use the Kaplan QBank as well. You will learn that as you do more and more questions there are certain topics that are gone over multiple times. It is your duty to pay attention to these topics during your question taking and develop a firm understanding of them. The NMS book has longer questions, but nevertheless it is a good source. Do the practice questions online that come with your Step 1 registration materials when you first begin to study, and do it again a day or two before you take Step 1 - it's not uncommon to find repeats of these questions on the actual exam! Many students find the practice NBME exams helpful as well.

* USMLEWorld Step 1
The gold standard Question Bank that most students use. Try your best to get through all the questions at least once, and repeat if you have time. Do not rush through the explanations as this is where you learn the most. Most students save this for the month right before you take the exam, but others purchase the question bank for FCM and slowly work there way through them. You can mark difficult questions and repeat them as the test date approaches. It is highly recommended!!

*Kaplan Services Q-Bank:
Another question bank that some students use in addition to USMLEWorld. Since Step I has started to include heart sounds in the exam, students find the audiovisual functions helpful.

USMLEasyLite
Over 500 sample questions in optional test formats, free on JEFFLINE as part of the AccessMedicine service.

Review for USMLE I Step 1 Examination by NMS, Lazo:
USMLE-style questions with explained answers; the vignettes are good, although the questions tend to be pickier than the actual USMLE exam, and the explanations are long. There is a CD version of this NMS question book that students did not like as much as the book.

Board Simulator Series by Gruber:
Integrated organ-system approach to questions. Board Simulators include 5 books (Systems I and II cover most of the organ systems) or a CD that has the same content as the 5 books. The Board Simulators are more challenging than the boards, although with the right attitude, they are great to learn from. Do not grade yourself (too discouraging). Overall, not recommended.

Appleton & Lange Review for the USMLE Step I by Barton

Full Length Practice Test for the USMLE by Stanley Zaslar

NBME Practice Exams:
These highly recommended half-length exams can be found on the NBME site, but you will need to pay for them. Unfortunately, the answers are not provided to you by the website.

Last updated: April 2011