Paul Ciurysek MD
@usmleguys
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Founder of The USMLE Guys | I give away 15+ years of USMLE prep knowledge, tips, & tricks in my USMLE Times Newsletter.
Detroit, MI
Joined July 2019
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USMLE QUESTIONS...
Can be tricky as hell...
They'll misdirect, confuse, and sow doubt!
Recognizing & avoiding these antics is vital to exam success.
Here's how to beat the question writers at their own game ⬇️
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🧵USMLE STEP 1 STUDY CHECKLIST OF THE TOP 200 HIGH-YIELD USMLE STEP 1 EXAM DAY CONCEPTS…
REFINE YOUR USMLE STEP 1 EXAM PREP BY PRIORITIZING THESE TOP 200 HIGH-YIELD CONCEPTS THAT ARE HIGHLY LIKELY TO APPEAR ON EXAM DAY 👇
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Hey Med Students… Hands Up If You HATE Doing Calculations 🤲🏼🤲🏽🤲🏾🤲🏼🤲🏽🤲🏾 (Us Too!!)
Let’s simplify this for you…
Here’s 35 of the HIGHEST-YIELD, MUST-KNOW equations for the USMLE Step 1 exam with samples questions… 👇
Bookmark for future reference
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💊 HIGHLY TESTED USMLE DRUG ANTIDOTES 💊
MED STUDENTS... Here's a handy list of commonly tested medications/poisons and their ANTIDOTES 👇
SAVE LIST FOR RAPID REVIEW ✅
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🧵If you're like many of the students we work with, biostats is at the bottom of your USMLE 'to do' list. Here's a quick run-down of 48 biostats topics that are likely to show up on exam day ⬇️
This tutorial will cover essential biostatistics topics for the USMLE Step 1 exam.
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Be a failure.
Tackle your UW or Amboss practice Q's & get destroyed.
Find weaknesses, fix them, try again.
Fail early, fail often, improve, & pass.
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Med Students... Capture EASY Biochemistry Points On Your USMLE Step 1 Exam With This Rapid Recall Checklist of Rate-Limiting Enzymes & Their Vital Clinical Connections 👇
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55 "Must-Know" USMLE Step 1 BUZZWORDS...
They won't be the answers, but they will help you recognize the question's topic to help you more accurately answer.
Bookmark this thread to review these 55 key associations that will most likely be on your exam 👇
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A USMLE Step 1 “Cheat Code” For Medical Students: How to go from where you’re at today to exam-ready with as little friction as possible - enjoy!
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The USMLE Step 1 won't test the superficial, high-yield facts ❌
It will test those facts 2-5 levels deeper ✅
Knowing the details of a high-yield fact will make you bulletproof on exam day.
Here's how to do it ⬇️
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USMLE Step 1 Pass/Fail "Green-light" criteria...
Here's our in-house criteria for Step 1...
1. 70-72% on an unused online NBME OR 75% on the Free 120
2. 95% chance of passing if taken within 1 week
If you suffer from test anxiety... Aim for 75%+ on the NBME.
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USMLE PREP 101:
In the past 15 years, I've worked with all types of med students.
Ivy League, Caribbean, & everything in between.
Schools teach medicine, not USMLE prep (but I do).
Here's the 5-step process anyone can use to simplify the USMLE exam preparation process 👇🧵
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7 Rules for USMLE Step 1 Success:
1. Don't repeat questions
2. First Aid is a supplement
3. UW & FA isn't all you need
4. Reddit isn't USMLE gospel
5. NBMEs are for assessing only
6. Aim for 72-75% on NBME b/f exam day
7. Invest in your prep if necessary
You've got this 💪
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3 Tips To Bust Through USMLE Step 1 Study Plateaus...
If your Step 1 prep has hit a wall, here are 3 proven strategies (based on trial & error with 1000's of students over 10+ years) that are highly effective & can help you reach new heights quickly! 👇👇👇
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5 Tips To Achieve Laser Focus For An Effective USMLE Step 1 Study Sessions ⬇️
1) Embrace the Pomodoro Technique: Divide your study sessions into focused, 25-minute intervals with 5-minute breaks in between. This method prevents burnout and improves retention.
2) Create a
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The new USMLE Step 1 epidemic - months of studying, limited progress.
Shiny new resources hit the market each week🤦♂️
Resources don't matter... Strategy does!
Want to WIN no matter which resources you use?
Here's my TOP 5 KEYS to WIN👇
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USMLE QBank Scores Not Improving?
Don't sweat it - it's more common than you think.
It's fixable... You just need to know WHY you're stuck and HOW to adjust!
Here are THREE common causes & their FIXES 👇
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A Quick Reminder For IMG Med Students...
In 2022...
18 IMG's matched into Neurosurgery...
19 IMG's matched into Orthopedic surgery...
11 IMG's matched into Plastic surgery...
It's not going to be easy, but it is possible...
You CAN Get Into Your Dream Specialty!
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TOO MANY USMLE resources...
It's getting out of hand...
Skip the overwhelm... Just get yourself👇
• 1 resource to learn (Video courses are great)
• 1 resource to challenge your knowledge (Qbank)
• 1 resource to assess your readiness (NBMEs)
Simple and effective 👍
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USMLE Questions Reminder 🧠
Eliminating answer choices is a last-resort strategy.
Use it when you're stumped - not as a default.
Can't answer without eliminating?🤷
You've got too many knowledge gaps - fix them ASAP.
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Hard pill to swallow...
The USMLE Step 1 isn't hard.
It's not overly complicated.
The truth is...
Your study method sucks.
Your actions move you in the wrong direction.
You follow the advice of 'orangecat352' on Reddit.
Get organized, follow our 'learn, apply, assess'
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1/26🔬 50 HY USMLE STEP 1 HISTOLOGY FINDINGS! 🩺 Quick Reference Guide To Master Histo For Step 1! 💯
#USMLE
#MedTwitter
#MedStudent
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5 New Truths For Actual USMLE Step 1 Prep Progress:
1. First Aid is a supplement
2. Repeating Q's is useless
3. UW + FA is NOT all you need
4. Reddit is not your personal mentor
5. NBMEs are for assessing, not memorizing
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MED STUDENTS…
Not sure where to put your attention to easily master the Step 1 info?
Remember this:
Normal = Physiology
Alter physiology = Pharm
Break Physiology = Path
Therefore… master physiology first because it is FOUNDATIONAL 🫡
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7 Rules for USMLE Step 1 Success:
1. Don't repeat questions
2. First Aid is a supplement
3. UW & FA isn't all you need
4. Reddit isn't USMLE gospel
5. NBMEs are for assessing only
6. Aim for 72-75% on NBME b/f exam day
7. Invest in your prep if necessary
You've got this 💪
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Effective USMLE Step 1 prep can be summarized with one word: SIMPLICITY.
THE CORE: 95% of your prep
✔️Learn & review (Video course or class notes)
✔️Apply knowledge (Amboss & UW)
✔️Assess yourself (NBME)
Add topic-specific resource(s) when trying to fix a specific weakness.
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MED STUDENTS...
USMLE Qbank scores stopped improving & you can't figure out why?
No problem!
Here's FIVE common reasons & how to fix them 👇
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An avoidable trap med students doing USMLE prep get caught in:
Doing the same Q's over & over.
Instead, try focusing on:
• Making & documenting weaknesses
• Improving weaknesses by reading
• Challenging yourself with fresh Q's
Repeating Q's = false confidence.
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💊 30 High-Yield USMLE Step 1 Meds With Unique Side Effects 💊
⬇️
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A BIG USMLE Struggle:
Forgetting what you've studied.
The solution?
Treat your study notes like a book...
A book you'll read over and over again...
Set a 30-min timer... When it goes off, bookmark your spot.
Pickup from that spot tomorrow...
Repeat until exam day.
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USMLE Arrow-Based Questions...
You know 'em...
You hate 'em...
But there's a simple trick that makes them super-easy!
Here's how it works 👇
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Reading the First Aid but keep forgetting?
Try this....
Get a friend... Pick 10 pages... You each read those 10 pages in 1hr...
Then, quiz each other hard for 30 minutes straight!
Will this suck? YUP
Will it help you learn? 100%
Unorthodox strategies create amazing results!
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Here's the step-by-step framework we use with our Step 1 students to take them from lost/stuck to Step 1 exam-ready in 4-6 weeks:
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USMLE Questions...
Such a pain in the ass!
But... If we use a detective's mindset, they become infinitely easier!
Here's how to decode USMLE vignettes like Sherlock Holmes ⬇️
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MED STUDENTS...
Let's talk about USMLE distractors...
The hidden poison of a USMLE question.
They'll destroy your scores if you let them.
And they'll show up in one of two ways...
Here's how to avoid falling victim👇🧵
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5 tips that can help you score 250+ on Step 2 CK 👇
1. Start your prep on day 1 of 3rd year
2. Dedicate 2hr/day to study/review
3. Focus on 'Next best steps' early
4. Master foundations, then details
5. Build study notes from shelf prep
The details of each ⬇️
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Does doing USMLE World questions seem like a chore?
Re-frame your approach...
Read a vignette as though you're seeing a patient.
Give them a name, a face, a physical appearance...
A family by their bedside.
Remember why you're doing this...
It's all for the patients.
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A Quick Reminder For IMG Med Students...
In 2022...
18 IMG's matched into Neurosurgery...
19 IMG's matched into Orthopedic surgery...
11 IMG's matched into Plastic surgery...
It's not going to be easy, but it is possible...
You CAN Get Into Your Dream Specialty!
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Typical Step 1 prep strategy:
- Begin without a clear, comprehensive plan or strategy
- Do randomized Q's many times w/o direction
- Passively skim FA several times
- Engage in activities deemed 'essential' by others
- Underperform on NBME exams
- Repeat the cycle, neglecting
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USMLE Struggles Are:
• Rarely about the resources...
• Often about how they're used.
Emphasize strategy over resources...
Discipline over motivation...
And mastery over weaknesses.
Do these things & you'll be unstoppable on exam day!
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Don't let people invade your Step 1 study time...
Time is our most valuable resource...
Guard it with your life... Set boundaries...
Turn off your phone...
Maximize your results by maximizing your time.
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MED STUDENTS...
How hard is it to match into your dream residency?
Easier than you think...
And a simple roadmap will pave the way...
Follow it to arrive safely at your chosen destination ⬇️🧵
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Simplify USMLE Questions By Following A 3-Step Formula 👇
Ask yourself 3 things as you go through each practice question.
#1
. “What am I actually looking for?”
✅The last holds the key. Read it first so you know what the question wants from you. Keep the question in mind as
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1/ 6 🎯 Attention med students! Struggling to maintain focus during endless study sessions? We've got your back! Here’s 5 unconventional, yet powerful tips to supercharge your concentration and dominate those exams! Time to unleash your inner study ninja! 🥷⬇️⬇️
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Study not because you've got a USMLE exam in the future.
Study to save lives & positively impact your future patients.
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Med students...
You're overcomplicating your USMLE Step 1 prep.
Try this mental model instead 👇
Think of your prep in 3 phases:
Phase 1. The "Learning" Phase
Phase 2:. The "Application" Phase
Phase 3: The "Assessment" Phase
Each phase has its own goals:
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Med Students...
If You're Struggling With ONE SPECIFIC USMLE Topic...
I use a simple 5-step process to help my students turn weaknesses into strengths—fast!
Here's how it works 👇
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If I was forced to prep for the USMLE Step 1 after my 15yrs in the exam prep industry, knowing what I know now, here's exactly what I'd do:
1st. Watch OME Front-to-Back
👉 To expose myself to all of the highest-yield information in a well-organized manner. OME = online med ed.
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USMLE Step 3...
The final med school challenge.
How could it impact your residency application?
After 15+ years of trial & error...
Here's my definitive Step 3 recommendations ⬇️
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As you go through your USMLE practice questions, keep this in mind 👇
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Stuck on a USMLE Step 1 weakness that you can’t seem to improve?
If you’re trying to boost it with the First Aid…. STOP ✋🏻
It’s a killer of progress…
FA = amazing review resource ✅
FA =not great for fixing weaknesses ❌
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What does it take for medical students to get interviews and match into their dream residency specialty/program?
Here's how ANYONE, even IMGs, can get interviews in their dream residency program or specialty ⬇️
// THREAD //
#medtwitter
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Med students... It's GLYCOLYSIS TIME! 🤗🏥
Here are 30 super HY basic & clinical facts you need to know for your USMLE Step 1 & Step 2 CK exams 👇
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How to level-up your USMLE test-taking skills 👇🏽
🛑 STOP focusing on WHAT to think
✅ START focusing on HOW to think
Instead of… Which receptor should I block to manage stable angina?
Try… How can I alter the heart’s physiology to improve oxygenation?
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Want the secret to easily passing the USMLE Step 1 on your first attempt?
Shh 🤫- here’s the secret 👇🏼
Don’t share this with your competition ❌
Adjust your frame of mind to thinking in terms of “phases”
Phase 1: This is your “learning phase”… classes, text books, video
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Like, Share, & Save 👉 100 Commonly Tested USMLE Step 1 Medications & Their Common/Unique/Worrisome Adverse Effect(s)... This might not be comprehensive, but this list will likely get you a handful of points on your exam! (Save & share) ⬇️
Acetaminophen - Hepatotoxicity
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MED STUDENTS...
Why think of an answer before looking at the options?
• True test of knowledge—USMLE Qs can be answered without the options.
• Avoid confusion—answers are designed to confuse.
• Maintain control—you control your thoughts, not the test writers.
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3 Priceless Pieces of USMLE Step 1 Prep Advice I Wish I Knew Before My Exam 🧵
1) Practice Q's... There's a right way & a wrong way to use them.
2) The First Aid is an amazing tool, but there's a right & wrong way to use it.
3) NBMEs are the gold-standard.
More details ⬇️
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Not sure how to structure your USMLE Step 1 study plan?
Here's a simple strategy using the First Aid 👇
1) Start at the 1st topic
2) Move from topic-to-topic
3) Expand when necessary
Here's the nitty-gritty of this strategy ⬇️
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I Failed Step 1, Now What?
Failing Step 1 sucks & it hurts...
But it's not the end of your journey!
Here are FOUR STEPS to bounce back from Step 1 failure & pass on your next attempt 👇
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2) START VERBALIZING...
This one works wonders! Find someone studying for the exam and commit to a daily 'verbal review' with that partner for 1hr/day. Speaking the info strengthens neural connections & works wonders when you've hit a plateau.
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Most Students SUCK at USMLE Step 1 Prep...
"I've done UW 3 times"
"I read the FA 10 times"
"I've memorized every single NBME question"
These actions stem from bad advice passed down from generation to generation.
Times have changed...
Here's 7 New Rules for Step 1 success 👇
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1) RE-FRAME YOUR THOUGHT PROCESS WHILE REVIEWING MATERIAL...
One of my faves... Instead of just 'reviewing' the material, imagine clinical scenarios based on what you're studying. This can connect dry/stale info to real-life situations, making the info it easier to master.
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USMLE QUESTION OF THE DAY:
A 29-year-old female presents with a 6-month history of widespread pain and fatigue. She reports tenderness to palpation at multiple sites, including the neck, shoulders, back, hips, and knees. She also reports morning stiffness and chronic fatigue.
Amitriptyline
353
Meperidine
82
Paroxetine
150
Fluvoxamine
73
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Med Students...
USMLE practice question mistakes don't matter...
It's what you do with those mistakes...
It's turning weaknesses into strengths...
That ultimately decides USMLE exam success.
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5 New Truths For Actual USMLE Step 1 Prep Progress:
1. First Aid is a supplement
2. Repeating Q's is useless
3. UW + FA is NOT all you need
4. Reddit is not your personal mentor
5. NBMEs are for assessing, not memorizing
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Struggling With Biochem Pathways?
Try this 3-step process ⬇️
1st - Focus on the entirety of biochem (big-picture)...
2nd - Focus on understanding the relationship between each cycle...
3rd - Get granular with each specific cycle (ie. The details)...
Start big, then narrow.
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Our TOP PERFORMING STUDENTS all focus on these things 👇
1) Religiously following a detailed daily plan
2) Daily execution
3) Consistency
4) Focus on 1 BIG thing per day
5) Proper REST
6) Discipline > motivation
7) Long term goal, short term execution
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Struggling to master USMLE content?
This is the FASTEST way to make progress 👇
Select: Your weakest subject.
Choose: One topic within that subject.
Focus: On mastering that 1 topic before moving on.
Repeat... Accumulate mastery... Win the race!
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Reading the First Aid but keep forgetting?
Try this....
Get a friend... Pick 10 pages... You each read those 10 pages in 1hr...
Then, quiz each other hard for 30 minutes straight!
Will this suck? YUP
Will it help you learn? 100%
Unorthodox strategies create amazing results!
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Our USMLE Step 1 "Green-light" criteria...
We put this in place to ensure Step 1 exam success...
They are:
1. 70-72% on an unused online NBME OR 75% on the Free 120
2. 95% chance of passing if taken within 1 week
If you suffer from test-anxiety... Aim for 75%+ on the NBME.
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Med Students... Do You Keep Getting Stuck On TWO Answer Choices When Doing Practice Questions?
Here's the strategy I use with my students to help them overcome & prevent this from happening as they continue moving through more & more USMLE practice questions ⬇️
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Struggling with your USMLE Step 1 exam prep?
The "BIG 4" will help you get & stay on track...
Clarity + Focus + Leverage + Systems 👇
💡 Clarity: Crystal clear goals & a detailed plan are a must for achieving success.
➡️ Action step: Come up with your exam goals & create a
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3 Tips To Secure A USMLE Step 1 Pass ⬇️
Tip 1. Build The Foundation
👉 No amount of HY review can replace a solid foundation.
Tip 2. Be Intentional
👉 Everything should be done for a specific purpose.
Tip 3. Don't Wait
👉 When an NBME says '99% chance of passing' - take it.
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HELPFUL? HERE'S WHAT'S NEXT...
I'm going to send you a free high-yield USMLE practice question every day for the next 100 days?
Just use the link on the image below to get started!
Don't forget to bookmark this, repost it, and like it if you found it helpful!
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MED STUDENTS... Failing Step 1 Is A Red Flag 🚩
THE FACTS...
• It's pass/fail but still difficult
• It can't be underestimated
• Most students overcomplicate their prep
Complexity ≠ better... So, let's simplify!
Here's a simple 3-step model to secure a Step 1 "Pass" ⬇️
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💊 ACETAMINOPHEN
ANTIDOTE: N-acetylcysteine
GOAL: Replenishes glutathione stores, detoxifying NAPQI, the toxic metabolite of acetaminophen.
💊 SALICYLATES (Aspirin)
ANTIDOTE: Sodium bicarbonate
GOAL: Alkalinizes urine to enhance salicylate excretion.
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A Residency Application Too Good To Be Ignored...
Most medical students don't think about Residency applications until late into 4th year... It gets thrown together last minute, and they pray someone will give them a chance.
Top students—those positioned to match—skillfully
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3 Tips To Get USMLE Step 1 Ready If You’re Short On Time 👇🏼
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MED STUDENTS...
Doing USMLE practice questions in mixed mode can ruin your Step 1 & Step 2 CK exam results.
If you're doing Qs in mixed mode—or plan to—and aren't getting the desired results...
Keep reading for the solution 👇
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Want an instant 10-20% boost in your Qbank & NBME scores?
Try this 👇
1) Always read the last 1-2 lines of the vignette first:
▶️ This will help you better understand exactly what you need to look for in the vignette.
2) Always highlight the important info:
▶️ This will save
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BECOME A TOP PERFORMER ON STEP 1 👇
1) Build & follow a detailed study plan
2) Execute your plan daily
3) Adjust your plan based on your progress
4) Focus on 1 BIG thing per day
5) ID & fix all weaknesses as you go
6) Assess with online NBMEs only
7) Get an NBME to 70%+
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Why the 3 Ps are the BIG point of LEVERAGE for Step 1 exam prep 👇🏽
Physiology forms the foundation…
Pharmacology alters physiology…
Pathology is broken physiology…
The 3 Ps are intertwined, affect each other, and form the foundation of your basic sciences understanding.
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There's only ONE WAY to do an NBME exam for your USMLE Step 1...
It should be:
1) Timed
2) Unused
3) Online (new version)
4) Done in exam-like settings
Accurate feedback requires exam-like settings 🤯
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🩸🧬 Understanding lipid profiles is crucial for USMLE Step 1 & Step 2 CK prep. Here's 9 nuggets breaking down important aspects of lipid testing, management, and treatment for various conditions. 💓👇
1/ 🩺 A full lipid profile is preferred for patients with suspected
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20 things every medical student should know to:
• Survive & thrive in the basic sciences
• Cruise through Step 1 & Crush Step 2CK
• Be a top student in Clinicals
• Match into their desired Residency program
Let's dive in:
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RESIDENCY INTERVIEW REMINDER...
If you're in the room, you've qualified for the program.
You don't have to prove that you belong...
You have to prove that you'll be a tolerable colleague for the next few years.
So relax, be yourself, and let the chemistry happen.
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If you found this to be helpful, do me a favor and tap the heart ❤️ & retweet it to your compadres.
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There are THREE things you need to master for success on your USMLE exams...
1. Content
2. Test-taking skills
3. Endurance
If you're missing one, you're flirting with disaster.
Here's how to make sure you master all 3 👇
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Some Tips Guaranteed To Boost Your USMLE Test-Taking Skills 👇
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It’s hard to beat a person who never gives up. ~ Babe Ruth
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Do you label yourself as a PROCRASTINATOR?
Here's some tough love...
Procrastination is a decision...
And you can decide to STOP ⛔
You're not a procrastinator... You choose to be one.
Choose wisely.
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