USMLE Induction Booklet Published on Smashwords by: Pablo Andrés Wunderlich, M.D. Copyright 2012 by Pablo Andrés Wunderlich Disvocer the website: USMLE Fortress Smashwords Edition Hello, dear colleague. I’m pleased you’re reading this free Induction booklet, because it means that you are willing to enter the battle against the USMLE with more force than ever. It's our future and we have to fight for it. No one else will put his or her face at the front of the battle field like you would, in order to achieve your goals and dreams.   You and I share the same dream, the same goal, and the same passion. I wrote this down, because I know what you're going through, I know what you're feeling. I felt it, too. I made the decision, but never imagined it would take so long and that it would be so hard. We are, in some sort of way, brothers in arms. We battled the same 8 *or 4 if you studied in the US* long MedSchool years; we now have to fight against a greater challenge: The USMLE.   Somehow, have you noticed?, how increasingly difficult it is to become a successful Medical Doctor around the world? I know, I've suffered the same heat and that's why this USMLE Induction Booklet exists:   To tell you that YOU are not alone; that this fight should NOT be single-handedly done, but in the contrary, battled alongside camaraderie—even if we are oceans apart.   You downloaded this booklet because you chose to commit to a challenge and are willing to learn how to engage it with courage.   USMLE Fortress exists because solitude should not be your path towards your goals. USMLE Fortress exists because I was also the student who strove initially without an idea of what lay ahead of me. I only knew what I wanted; sadly, that's not enough. You also need to know who you're about to fight against.   In this USMLE Induction Booklet, I will introduce you to the world you wish to battle against; I will guide you to the basic information you should know. This book exists because we, as students, lack guidance. Of course, there are thousands of review books and videos; but no one really tells you what to do, why, how much of what to do, and what to think about what you did and are doing. I, like you, just passed my USMLE exams, so I can give you all the feedback you need to know about the USMLE. Of course, I’m not a professional, just a passionate student, like yourself, who wishes to help others out in this tiresome quest.   USMLE Induction Booklet Contents:   USMLE Basics Is it that hard? Why do I need guidance? Step 1 Step 2 Philosophizing Convalescence NEW! Practice Questions with Me! Step 2CS Videos   USMLE Basics   There's loads of information you should know about the titanic endeavor you're about to engage. Where to start when there's so much information? You start here. What does USMLE mean? United States Medical Licensing Exam. It's a series of multiple choice examinations divided in three subsequent steps. Step 1. Step 2 CK. Step 2 CS and Step 3. Sounds easy. Three steps and you're done! Nope. Sorry, it's not that easy. I'm sorry to some of us who embark on the journey to conquer the USMLE will fail during the attempt. Why? Because it's hard and it takes time, dedication, and patience.   Some of us don't have one of the above-mentioned traits. Don't worry, it means nothing. It means that you're probably best set off doing something else or becoming a multi-billionaire entrepreneur or whatever. Maybe you'd rather return home and be with your family. Whatever the reason, people drop out constantly and leave their efforts behind, resting in peace within a cave.  Anyway, back to the basics. The scores are given to you in two ways: A 3 digit score and a 2 Digit score. By far the 3 Digit score is used more often than the 2 Digit score. The 3 Digit score is more palpable than the 2 Digit score. If you say you scored a 220 versus a 250, you'd know that 250 means it's way better than 220. The scoring system of the USMLE is quite secretive, so we know little about it.    The exams are composed of only multiple choice questions.    Multiple choice questions is the way to go with the USMLE. You'd think it's easier because the answer is already given to in the list of possible choices. Oh... you're so wrong.   What if all the choices are good answers but there is ONE best answers? What if they ask you what is the most likely answer, given the circumstance? What if they give you 15 different options to choose from? What if every answer seems to be the correct one? What if you only have a minute per question!?    Oh, it's difficult. Do not assume that multiple choice questions means easy, because this is not the case.   The way I see it, the exam is built to mimic real life.   How?   Easy. In life you never have just one option. You have an assorted array of possibilities. Life is about choosing the best of the possibilities offered. Let me give you an example of how this works in real life.   You have dated Mini, Daisy, Jasmine, Cinderella and Pocahontas. You are the prince of some empire and you have to choose one of the above-mentioned ladies. Which one would you choose? You break it down.   "Mini has a great personality but her nose isn't that charming. Besides, she's a mouse and I'm not into cross pollination. Daisy is a duck and Donald is my friend, so no. Jasmine dated Aladdin--an idiot--but she's really hot. I think Jasmine is the one. But wait, Cinderella is amazing and her personality is just so compatible with mine. But she doesn't have Jasmine's eyes. Damn. Pocahontas is very hot and she has the most wonderful smile. Damn! Who should I choose!?"   You see. Your everyday choices are similar to the exam.   Now imagine that you are at a Hospital and you are moonlighting some friend at the Emergency Unit. A patient just came in and he's having a seizure. Ok doctor. What's the next step? Should you impregnate him with hydralazine? Should you vaccinate him for rabies  Should you call the attending? Should you call security and ask them to kindly tell the patient to stop moving? Should you tell the family that he's gonna die? Should you put the patient a mask with O2 and start an infusion of phenytoin? WHAT DOCTOR? WHAT SHOULD YOU DO?   Scary, huh? The exam is no different. The patient has 1 minute for you to think your stuff through and come up with a plan. Boom! Or he's dead. In the exam, you have 1 minute per question. If you can't answer a question, how the hell do you think you're going to save a patient's life? Ok. So you know the basics. Get ready and start planning on how you'll achieve your goals.   Learn How to Utterly Defeat the USMLE.   Is it Hard?   Yes. Step 1 is thought to be the world’s most difficult basic sciences exam. What!? Yes. That's exactly the expression on my face the day I found out this information. But fear not. If you're a Medical Doctor or on your way to become one, there is no reason why you should fear difficulties. Why? Because they will be with you as long as you practice your profession. So think of the USMLE as another bump in the road you have to go over to achieve your goals and dreams.   Why do I need guidance?   Because the world of the USMLE is tougher, harsher, and meaner than you think. Perhaps you don't NEED guidance, but hell, I'm sure you'd appreciate it. Ok, so you've bought 10 books to study from, you plan to buy at least 2 Q-Banks, and you plan to study 12 hours a day and then what? How will you engage, effectively, your studies? How will you enhance your performance? How will you train yourself to effectively change your behavior, so that you can achieve your goals and dreams? How? The answer is guidance. People who have taken the exam and passed it with efficiency can tell you their secret recipe, the one they used to defeat the USMLE. I share you my own and not only that, I give you Principles, Habits, Strategies, Why you should join the gym right now, why you should eat correctly, why you should sleep and respect your sleep. All this information is compounded in this book: How to Utterly Defeat the USMLE, where I share with you all the facts you should know to effectively engage your enemy: The USMLE.   Step 1   Step 1 is by far the hardest exam of the three. Take it as the filter examiners use to daunt you and haunt you at night, while you sleep. It is said that Step 1 is by far the hardest basic sciences exam in the world. It doesn't surprise me if it is. If you already took Step 1, you know what I'm talking about.   Step 1 comprises 8 distinct, hardcore, mind-bending sections:   Biochemistry and Medical Genetics Behavioral Sciences Biostatistics Pathology Pharmacology Physiology Anatomy Microbiology and Immunology   Of the above-mentioned, the one mostly asked is Pathology. Does this mean you can concentrate your endeavors only in Pathology? NO! Why? Because you'll fail, despicably.   Common Mistake: NEVER concentrate on your strengths Rather, go to your weaker sides and strengthen those. It's not about being great in one thing; it's about being well rounded across all the fields. If you boost all your fields you'll see how they help each other out. Let me explain: if you're good at physiology, pathology, and biochemistry, it'll be much, much easier for you to answer a pharmacology question because each topic boosts the other one up. Medicine is not one science but a mixture of many.   Step 1 lasts 8 hours. The exam is composed of 322 questions, divided into 7 blocks of 46 questions each. You have 1 hour per block and 45 minutes of total break time during the exam.   Scared? You should be. I'm still scared of the exam!     Step 2   Step 2 is split into two exams.   The Basics:   If Step 1 is about general sciences, Step 2 is about how you apply it into the medical setting. Step 2 is about concentrating you knowledge into the hospital setting and being able to decide what is the most likely diagnosis or what is the most appropriate next step.   Sounds easier and many students talk about how much easier Step 2 is. Avoid this thought.   Although you may find this exam being easier it actually isn't. You see, this exam is longer and the information you study is far less specific than it is in Step 1. Why? Because it's about cases, it's about the situation. You have to think the question through as it comes and each scenario is very different from others you may have studied. So avoid feeling too confident and respect Step 2.   Step 2 is divided into Clinical Knowledge and Clinical Skills. The word clinical tells you everything about the exam. As I said before, it's an exam dedicated to evaluate how well you take decisions and how polished your differential diagnosis system works.   The details:   Step 2 CK:   Internal Medicine Pediatrics Epidemiology and Ethics Surgery Obstetrics and Gynecology   Exam: 352 Questions divided in 8 blocks of 44 questions. Exam lasts 9 hours.   Although Internal Medicine is by far the broadest topic in Step 2, you should dominate all fields to get a competitive score.   Step 2 CS:   12 live patients, 1 patient per case, 15 minutes per patient. Exam lasts 8 hours.   Don't underestimate this exam. You need lots of live practice with your classmates to conquer this exam. Worry not, it can be done. If you're an IMG you should focus on your English proficiency and in your communication skills. Practice makes perfect, so go on and practice all the cases you can before going into the exam!   Philosophizing   This is your life, your career, your future. Take your time and grasp what this means to you. You've embarked on probably one of the most difficult careers known to man and now, that you've succeeded, you still have many more obstacles to go--and they get harder and harder as you advance on your quest.   You are the hero, you are the victor. You wave your sword in the air challenging the obstacles you still have to defeat. You look around you and you see yourself, reflected on a metallic wall. You touch it and it's stone-cold. You see your face and you realize that you are daunted, quivering by the fear this exam exerts on you. But fear no longer, my friend. Because you are not alone. We have all been through the pain you're about to engage. Here we are, hands open ready to brace you if you fall.   Above all, there is more to life than the USMLE. Never forget this. NEW! There are 2 new sections in the website USMLE Fortress. 1.Practice Questions with Me! 2.Step 2 CS videos These new sections were created to assist you during your quest to defeat the USMLE. Already some students use the Ask Me Anything form to submit questions from Step 1, 2CK, or any other thing you wish to know about the USMLE. You are more than welcome to join the site, and it’ll be my pleasure to help you conquer your goals and dreams. It doesn’t matter if you’re a US student or an IMG. What matters is that you have questions and I can surely assist you to answer them. I may not know everything, but hell, I surely am committed to give the best possible feedback.   Convalescence Now that you are about to finish this USMLE Induction you are ready to either start studying or continue reading about the USMLE in order to further understand this challenge. Thereafter, you have to decide whether to engage Step 1, Step 2 CK or CS. Then you must start studying with laser-like focus.   Welcome to USMLE Fortress. This website is are you disposal as it slowly grows and the community of people who share their thoughts and experiences also grows. Make yourself at home in the Fortress. As much as it's mine, it's yours, too.   Feel free to contact me whenever and for any reason. I am not and erudite in the USMLE, but I sure am a student who passed the exams and can share you my version of the story and what I have learned throughout my endeavor.   Join the Fortress. Become the Warrior.