Grey strands of time

 Grey strands of time; 

3:00 am; 

I wake up with a burning stomach, already regretting last night's dinner. I try to sleep back for some time, but sleeping now seems like an arduous task, a fight that I already fought and won only a few hours ago and don't have the will to fight again. Fajar time is near so I decide to pray tahajjud. My long lasting comrade (and sometimes rival) is still sleeping. Still beautiful as ever. Carefully I find my way to wazu. Everything aches. This is how a rusted piece of metal must feel like if It had feelings. I pray tahajjud and recite some Quran and Lo! Its fajar time. Time to go to masjid and meet my only friends these days. White bearded fellows with hearts as young as ever. Time to discuss politics, pull some legs, worry about youth and the future of this country. How exciting! 

12pm; 

I feel hungry. Anyone would if they had a breakfast like mine. I sigh and wonder, Why does age bring so many restrictions? Can't take sugar for risk of diabetes, can't talk salt, can't even have a paratha for fear of hypertension! Eat greens they say, am I a cow or something? Why haven't they discovered a cure yet for all these ailments. The anger that has filled me with all these thoughts, vanishes as I see my son, my world, come out his room for breakfast. I thought this whole thing with Quarantine and not being able to go outside would mean more time with my sons and daughters, but man was I wrong. It appears they've become owls. 

I call this young man to my room, ask him for a glass of water. Little does he know I just want to see him, talk to him, for moments like these when He's out of his room are very rare. He brings me a glass and is about to run off, when I ask him how's He. 'okay, dad' He says. I ask him about his studies for lack of another topic. His response is rushed and subtle. This generation is always in a rush. Little does He know that I wait all morning for him to wake up. For Him to spend some time with me. How happy I was those last years of my job, thinking of how now I'll be able to spend time with my family, How wrong I was.

7pm; 

The sun is setting down, letting out its last bit of light for the day. It reminds me of my own condition. I wonder if time has slowed down for the sun too in these last moments. I wonder if it is too, giving up all its strength for this dim light. I wonder if it misses its glory days too, when it shone on top of the world with all its brilliance. But ofcourse No, the sun never cared about the future. It probably didn't spend its peak hours preserving its light for a rainy day. It did not make all the plans in the world for tomorrow. No, it just enjoyed the moment while it could. I wonder if that makes it happier in these last moments, unlike me, who spent my whole life worrying about tomorrow. Making career, making a family, making money, all the while forgetting that my strength is leaving me. The grains of time are falling, taking me with it, piece by piece.

Step 2 Ck (270)

 STEP2 CK 270 writeup.

Total duration : 8 months (dedicated: 2 months)

Resources used: 

UWORLD: 

Needless to say Uworld is the best and most important resource for step2ck. I did 2 complete passes of uworld. I made my own notes in a notebook of the important points from uworld and went through these notes during my second pass. Writing stuff keeps me from dozing off while solving qs and helps me retain better. But everyone have their own way. Find what works for you. 

During first pass I did 2 blocks/day in tutor timed mode. 1 in morning and 1 in evening/night. It took me around 4 hours to go through a block. It is very important to do first pass as thoroughly as possible, reading all the incorrect options as well as the explanations because during second pass you don’t have the same energy while going through the content, 2nd pass should be more about test taking strategy, improving timing and revising small details. 

I did 100 qs/day during second pass. I made 2 decks in uworld flashcards section, one titled “algorithms” and the other “high yield” which contained tables/points I thought were important. In the weeks before my exam I went through these flashcards (just once, without reviewing) for a quick revision, and it helped in revision. 

AMBOSS: 

I actually started my prep with amboss, before buying uworld. However I wouldn’t recommend doing amboss first, as uworld does a better job in explaining concepts since u have to dig deep into amboss to learn. After my first pass of uworld, I did amboss again to test what I had learned in uworld, and to get a break between 2 passes of uworld so that I don’t solve uworld from memory. This time I did around 80q/day and only 3-5 hammer ones. 

Amboss has its perks. First, it complements uworld and have somewhat similar concepts but different presentations. Secondly the more questions you do the better. Step2 is all about critical thinking that takes practice to develop. Real deal had many questions that I hadn’t seen in any qbank but you can solve them if you have the feel for the question and know what they are asking. Amboss also has those History of presenting illness (HPI) type questions that you do not find in uworld much. Step2 exam also has these. 

DIVINE intervention:

Divine intervention’s podcasts were GOLD. I listened to his rapid review series (around 100 podcasts 30-40 minutes long) on my morning run. He presents the concepts in a scenario like manner which kept me engaged to get the answer before he told me. Most of the High yield concepts are covered in these and its another source of info into your head apart from uworld. Highly recommended. There are also some very high yield podcasts that people do a few days before their test. I would link them below. You can download his podcasts free from https://divineinterventionpodcasts.com/category/rapid-review-usmle-step-2/. Also fav the ones you find most info in, so you can listen them later too. 

Also there are Divine’s shelf review videos on youtube, they are about 3-4 hours long for each shelf, do these about a week before your test. He goes through many many concepts in these, truly some of the highest yield videos out there. Do check the comment section however as some of the info is updated since he posted these to make sure u don’t miss anything. Following are some of the High yield episodes. 

CMS Forms:

These are the clinical mastery series from NBME. Each form contain 50 qs. I only did the latest 4 ones for each subject. They are nbmes styled questions and you’ll find some new concepts in here, but they do not represent the real test at all. Do them to get exposure to more questions. 

AMBOSS ARTICLES :

(copied from reddit); these are the High yield articles that I recommend going through detail and then solving the associated questions. I recommend going through these and amboss biostats close to your exam. You’ll find these useful inshaAllah. 

Health care system -https://next.amboss.com/us/article/Np0-pS

 ===> 7 QUESTIONS

infection prevention and control https://next.amboss.com/us/article/WQ0PEf

 ====> 11 QUESTIONS

patient communication and counseling https://next.amboss.com/us/article/3K0STS

 =====> 13 QUESTIONS

overview of palliative medicine https://next.amboss.com/us/article/3n0SGg

 =====> 7 QUESTIONS

quality and safety https://next.amboss.com/us/article/mp0VJ

 ======> 29 QUESTIONS

ethics https://next.amboss.com/us/article/DO01uT ======> 73 QUESTIONS

palliative medicine (very important) https://next.amboss.com/us/article/3n0SGg

 ======> 7 QUESTIONS

Death (very important) https://next.amboss.com/us/article/vP0AgT

 ======> 5 QUESTIONS

SCREENINGS/IMMUNIZATIONS 

I did screenings from the USPSTF website (only do A and B recommendations) and immunizations from CDC website. Also listen to divine’s podcast on screenings (episode 325) and vaccines (episode 350). 

Note that the cdc website has a lot of details on vaccinations like catchup, intervals between doses etc. you do not need to learn these. Just learn the routine immunization, special situations and contraindications of each vaccine. Also amboss has a table for travel vaccines. Do that for completeness sake. 

SELF ASSESSMENTS:

I did Uwsa1 after first pass of uworld. Uwsa1 and nbme9 are the hardest self assessments. Don’t be discouraged by them! I did nbmes offline during the last month. I wish I had spread them out over 2 months during my 2nd pass of uworld to actually see some improvement. I don’t recommend doing them back2back. Go through nbmes thoroughly as some of these concepts are repeated. UWSA2 was most predictive for me. I scored one point higher than it. Real deal was most similar to free120 in terms of question lengths are vagueness. 

VIDEO RESOURCES :

At the beginning of my prep I tried various video resources like bnb or onlinemedEd. These are not needed. if you have a strong foundation from step1 you should jump directly into uworld. Most of the video resources teach you concept from scratch with some step2 related stuff mixed in. you don’t need that because you learn those things in step1. Make uworld your study tool. You can watch a video or two for a topic you find specially hard, but that’s all. 

TEST DAY EXPERIENCE: 

The test is long (duh). You will get tired by the end of it. Make sure you get a good night’s sleep the day before. Unfortunately I could only sleep 3 hours and Allah knows how I went through that test (redbull, snickers and whole lot of prayers). During my second pass I had left 320 questions for myself at the end and did them in one day, simulating test day and taking breaks as I would on real deal.  It gave me the confidence that yes I can sit through those 8 hours because I had done it before. 

Also go through heart sounds and Ecgs a day or two before test. Dirty medicine ecg video is a nice one . for heart sounds check out medzcool heart sounds on youtube. 

Take breaks after every block. Wash your face. Eat something. instead of thinking about the whole test, think of each block as a separate test and an opportunity to get your dream score. 

Final remarks: 

Believe in yourself and the work you put in. Allah swt will reward you if your intentions are clear. Steps journey is a long one. Take care of your mental health. Have friends you can talk to. I would like to mention a few people here who were there for me throughout the year, always believed in me and had Faithful prayers for me,my wardmates and ofcourse, my family ❤️. They deserve more credit than can be put into words.Make dua for yourself and watch miracles happen. Make sure to help others whenever you can because it’ll come back to you in wonderful ways. Reach out to me if you need help with anything. Please remember me in your prayers if you find this writeup helpful. Now Go crush that exam!! 

Best wishes.

Faraz waheed. 

USMLE STEP 1 (267) Writeup

Total prep: 8 months (4th year) 

Dedicated: 8 weeks. 

Resources used: 

 

BNB: 

I started out with watching bnb videos, followed by reading FA of the same system, I added any HY point or something that wasn't in FA from bnb to FA. However I have to warn not to make ur FA too messy as in the end it'll be harder to revise. Keep it clean n simple. I think bnb is the best resource to complement FA as it provides explanations for FA and it sticks. Also I believe bnb writers have gone through uworld and amboss lol bcz I encountered everything from bnb in these qbanks. Thats why I say not to write everything down from bnb. Understand it, nd write the things that makes FA easier for u. 

FA: 

We all know FA is essential for step1. Every page of it has many different concepts and any one can be tested. I started out hating FA for its compressed writing, but with time I came to love it. FA isn't to learn stuff, its where u come to see what u don't know. Everytime I read it, I found something new to learn. But u have to search for the explanations in other resources. In the last phases of preparation FA becomes ur best friend as u can easily revise lots of concepts in a few pages. I did FA 3 times. Everytime it took me 2 months to do so. I don't know how people are able to go through it in a week or two. At my best I could do a system in 3,4 days. But I guess doing it better and slow is far beneficial than just revising and reading the stuff u already know. 

Uworld; 

The Gold standard for Step1 prep as we all know. From what I experienced I think the first pass of UW is the most important, no matter how much u want to finish it asap. In first pass I only did one block per day in tutor mode. I read all the explanations, the correct and incorrect ones. Made notes and added stuff to FA that wasn't there. A thorough first pass will make ur life so much easier believe me. In the second pass, I only did it to develop test taking strategy, to recognize patterns, exclude options and improve timing. I only read the edu objectives in second pass. 

Amboss; 

Amboss is highly underrated imo. Throughout all my journey I don't think I enjoyed any other resource more than amboss. The UI is beautiful, the explanations are shorter than UW, the library is perfect for explanations and reading up on difficult topics. I did amboss after my first pass of UW. I wanted it to serve as a break between my first and second pass, bcz I didn't want to remember all of UW answers in my second pass of UW. 

I got 3 months of amboss scholarship, however I did amboss in 1.5 months, doing 2 blocks daily. I only did 2-5 hammer questions. 

What I liked about amboss is that it touches on parts of FA that uworld tends to skip. UW hits on the major concepts mainly, while amboss tends to get nitpicky with their questions. I found it helpful for me as it made me read FA in a different light, recognizing n seeing things that I didn't with uworld. 

Anki; 

I found out about anki very late in my prep. So I couldn't use it for its full potential. I only used it for Biochem (zanki deck) and 100 concepts deck and immuno (from anking decks)  It made biochem my strongest subject in uworld. No matter what System I was doing I would set aside one hour to do like 200 cards daily, it kept me in touch with biochem throughout my prep. Superb resource all in all. 

Practice tests; 

Nbme 25 > 4 months out > 246 

Uwsa1> 2 months out > 279 

Nbme 26 > 5 Nov > 265 

Nbme 27> 10 Nov > 260 

Nbme 28 > 15 Nov > 258 

Nbme 29 > 20 Nov > 266 

Nbme 30 > 25 Nov > 260 

Uwsa2 > 29 Nov > 271 

Free120 > 95% > 3 dec 

Real deal > 267 > 8 dec  

I also did other nbmes from 15-24 in the preceding months, they were in 240-250 range. The new nbmes has many repeats from these old ones but I guess if you learn from ur mistakes thats a good thing anyways.

Some Last minutes tips: 

>100 concepts anatomy: 

Must do these as questions come directly from this book. Between 100 concepts, FA and UW I think anatomy shouldn't be a problem for you. 

>Nbme pictures: 

Do revise these, both old and new, as these do get repeated. 

>Pathoma 1-3 : 

Easy points on exam directly from these. 

>Vitamins and substances of abuse

Again easy points, do them before the test. 

>Biostats; 

I think there has been a shift in the test where they don't ask about much calculations in biostats, rather the concepts. These are present in new nbmes. Learn the ROC curve guys. Learn the meaning of P-value and alpha etc. Intention to treat analysis, biases etc. 

> Pharma graphs : 

Both autonomic and general pharma graphs are HY. 

> Heart sounds

Medzschool youtube playlist before the test. 

That's all that comes to mind..Feel free to ask anything I'll try to answer if I could. 

Best of luck to everyone for your coming exams. May U all achieve ur goal scores. 

Remember me in ur prayers.

Life in an alternate universe:

I lay in bed scrolling casually in my phone before I ultimately fall asleep. A friend has updated his profile pic. I think to myself, wow this person has no sense of style whatsoever. And why is he showing off so much?? Anyways,"Nice pic, you look fashionable" i comment. I keep my phone down and go to sleep. 

[ ] My room is filled with glimmering light as if it were morning already. I open my eyes and what I see next totally confuses me. I am not in my room. I look around, everything is new to me. I freak out. I run out of the room and see that Its a strange house. I rush down a flight of stairs to see a man sitting at a breakfast table. He's much older than me, yet not too old. He has a pleasant smile on his face. He's wearing white clothes and a white cap, his long black beard is neat and well groomed like that of the kind hearted devoted muslims who never forget to give me some candies whenever i meet them in college. Immediately I feel at ease. I ask him, what is this place? "You look scared, come, sit here" He said as he pointed to the chair infront of him. I comply. "You're in a different universe young man, don't ask how you got here, even I don't know that. All i know is that you're here for one day, and that I have to be with you in all this time, as your guide and protector. I saw this in a dream and I've been waiting for you ever since.My name is afaaq. Like the sky. Now, there, its settled. have some tea now, Its still hot, no need to be scared". I look around, everything is normal, the sun is shining outside, the birds are chirping. Cars are passing in the street in front, and this man looks nothing like an alien or an interdimensional specie. I think to myself, "I have to get out of here". But he laughed and said No you don't. I was shocked.He then explained to me how this universe is different than the one I came from.

 
[ ] We went out for a walk, everything is same as it is on earth. He told me that the special thing about this universe is that we can read each other's thoughts. We can feel each other's true feelings and know whats in the heart. I ask him, "wow, life must be pretty chaotic here then, always knowing what the other person really thinks?". He said not at all. We are born with this ability, so we never learned to have contradictions between our words and our thoughts and feelings. We are honest with each other. Not being able to hide something makes us not having something to hide. We have no secrets, yes, but then, we have no SECRETS. We are not bothered by the burden of our lies, we don't have to pretend. While he was saying this, another man who seemed to know him, and who surprisingly also had the same pleasant aura about him, came to cross our path, and with all the pleasantness and kindness in the world, met afaaq. I had never seen such purity, such love in two people meeting each other. After spending a moment or two with this fellow, we continued our walk. He further told me that because of this special character of our universe, there is no crime here, since all crime results from need, from trauma, from pain. and we can't hide these from each other, so we help each other, with kind words, with hope, with compassion. Also, there is no hatred, since hate in the heart can't be hidden, so we learned to conquer hate with love, rather than keeping it within us and allowing it to consume all the good we have in our heart. Hearing this, I remembered my own world, where the heart is filled with jealousy, with hate and envy, but our words are carefully picked to deceive. How, no matter how much our hearts are broken, how sad and depressed we may be, yet our faces are masked by the facade of happiness. I thought to myself, how easy life must be in this universe. How pure. How light must the heart feel. Having no secrets. No ugly truths to cover. No one to deceive. I now understood, why my companion seemed so relaxed, so at peace. Why his smile was full of joy. Why his words had such an impact. Why his greeting was so lovely. It was pure. It was at one with his heart. What I initially considered this universe's flaw, I now saw as its power. I imagined, how beautiful life would be, if on my earth, the heart was not so hidden! 

[ ] My eyes open to the sound of my phone's ring. After 3 missed alarms my phone finally had woken me up. It was just a dream. I close my eyes thinking back at this strange dream. My phone beeps. Its the daily ayah from my muslim pro app;

إِنَّه ُُ عَلِيم ٌ بِذَاتِ الصُّدُورِ

He knows what is in every heart.