USMLE Step 1 : 276
Pollux is the screen-name / pseudonym of a Queensland IMG from Australia. He was a student
from a top university in Australia and prepared for USMLE for a protracted amount of time. This
article describes his USMLE Step 1 experience on how he prepared for the exam and aced it with a
While he had an initial goal of 250+, he far exceeded his own aim by more than 25 points and
scored 276 on his USMLE Step 1 Exam. This is a very inspirational post for anyone preparing for
their USMLE as it demonstrates which books to pick for which subject, which books to choose for
over all review of the entire material. Which qbanks to use and how each qbank helps develop
one’s analytic ability. It also includes which resources he thought were not helpful in his prep.
These should also be kept in as wasting one’s time on low yield resources is just as harmful as not
adequately using high yield resources.
He also explains how he used NBME forms to help improve his score. The NBME form numbers
along with the respective scores have been explained here.
Pollux AKA Jason Chang is currently a pathology physician in NY. He did his med school from
Queensland and then went on to do a residency in the US and is currently practicing Pathology in
NY. Following is Dr. Jason Chang’s 276 experience:
Welcome to USMLE Experience Post:
USMLE step 1 Score is one of the major Determinant of residency Match. It has been said till date
If you cross 250 in step 1 then you have got the safe score . this means chances of getting match
increases exponentially even if you are average in other aspects like LOR , thesis, average step 2
Getting 250 + is not an easy cake for USMLE aspirants these days . It needs a lot of determination,
hard work in studies, nicely time framed schedule and good resources.
Today we are going to post an Experience who scored Sky-high 276 score in Step 1 . and this
intelligent fellow is from Australia Who basically an IMG for US residency. His name is POLLUX .
IMG – POLLUX – USMLE Step 1 Experience: 276
Initial goal: 250+
Total prep time: 1000 hours.
IMG at an Australian medical school (UQ); MCAT=38
NBME 1: 258 (9 months out)
NBME 2: 261 (2 months out)
NBME 6: 262 (25 days out)
UW 1: 265+ (15 days out)
NBME 3: 265+ (8 days out)
NBME 4: 265+ (6 days out)
UW 2: 265+ (4 days out)
NBME 5: 265+ (2 days out)
USMLE CD: 96% (1 day out)
I did over 10000 USMLE-style practice exam questions in the following order:
Kaplan Qbank: 91%
First Aid Q&A step 1: 93%
UW: 88% (Random, unused, first time through)
Plus NBME + UW exams + USMLE CD + RR Goljan…
FA of course!! I read it cover-to-cover 3 times. However, I tend to cross-reference it when I read
other books and I frequently consulted it during second year during PBL. I also annotated notes in
FA when I did UW, so I was very familar with the content of this book. For every
diagram/table/metabolic pathway in FA, I made sure that they were familiar to the point that I was
able to to reproduce them from memory.
Anatomy: Kaplan notes & Kaplan webprep, USMLE Road Map Anatomy, HY Neuroanatomy.
Behavioral science: Kaplan notes & Kaplan webprep.
Biochemistry: Kaplan notes & Kaplan webprep.
Cell biology: HY Cell and molecular biology.
Microbiology: Kaplan notes & Kaplan webprep, Micro Made Ridiculously Simple, MicroCards.
Immunology: Kaplan notes & FA.
Pharmacology: Kaplan notes & Kaplan webprep, HY Pharm, Pharmacology Flash Cards (Brenner).
Physiology: Kaplan notes, BRS Physiology.
Pathology: BRS Pathology, Goljan audio, Goljan notes.
Probably quite atypical compared to most US medical students. I initially intended to sit the exam
at the beginning of third year, so I spent a month studying after second year was over. At the end
of the month, I didn’t feel quite ready and decided to postpone my exam till the end of third year,
thinking that I would have plenty of time to study during the clinical rotations. Wrong. I only had
some time during my rural rotation and psychiatry rotation to study for USMLE, but could only
manage to do 1-2hr/day on weekdays and up to 8hr/day on weekends. At the end of third year, I
spent a month studying hardcore again, and finally took the exam on the 26th of December. The
Australian school year runs from January to November, by the way.
During second year – Read BRS Pathology and pretty much memorized the book. I love pathology
so it wasn’t really a daunting task for me. I also started listening to Goljan audios in first year and I
was really glad that I started early. I finished Goljan audios at least three times, but I always felt
that I learned something new each time.
December – Finished reading Kaplan notes (all subjects except Path) and Goljan notes for Path. 8-
Jan – Nov – On and off. I did NBME1 in March and got 258(720) and was pretty happy that reading
Kaplan notes paid off. However, I had only about 4 months during this time (rural and psych)
where I could fit USMLE studying into my schedule, but could only manage to study about 25
hours a week. During this time, I read the supplementary material (HY, Road Map, flash cards),
listened to Kaplan webprep while commuting, and did the majority of the practice questions.
December – Did most of the NBMEs and UW assessment exams in this month. Completed UW
question bank for the second time. Spent the last week just memorizing FA and doing practice
questions. 8-10hr/day. (300hr)
Exam on December 26:
I started the exam at 8:30 and finished at 4:00 with 20 minutes of break time to spare. On
average, I spent 45 minutes in each block and took a 20-minute break after each block (except the
first block). During each break, I would drink 300mL of oolong tea or green tea to keep me awake,
eat half a sandwich, go to the washroom, and wash my face so I felt refreshed and ready to tackle
the next block. I thought the strategy worked quite well for me.
I thought the exam was quite a bit harder than NBME but easier than UW. It was probably
comparable to UW self-assessment exams in terms of difficulty. I marked 6-7 questions each
block. I thought 85% of the questions was straight-forward, 10% was tricky, and 5% was difficult.
Pathology: Not surprisingly the bulk of the exam. Around 70% of the questions were patholgy
questions or required pathology integration. I thought UW covered these sorts of questions really
well, so there weren’t really any surprises for me. I only had around 5 questions that came with
pictures of gross pathology specimens.
Anatomy/neuroanatomy: 15 questions. Most of them involved intepretation of X-rays/CT/MRIs,
nothing too obscure. I even had brain CT and angiograms for structure identification. Make sure
you know the brain stem and cranial nerves well.
Behavioral science: 20 questions. Half were biostatistics, and the other half were the typical “what
would be the best action/response in this scenario” type of questions. I thought just reading FA or
Kaplan notes was not really sufficient to answer these sorts of questions. I had almost no
questions that came out of the psychiatry section in FA, except a few psychotropic medications
and a question on defense mechanisms.
Biochemistry/Cell bio/Molecular bio: Geez, I noticed the trend of increasing proportions of cell
biology questions in the NBME, but I never expected this many on my exam. I probably had 50
questions that fell into this category (Biochem/Cell bio). I was glad that I flipped through HY Cell
and Molecular biology just a few days before the exam, because it probably helped me answer 5
questions correctly. The different kinds of receptors and intracellular signalling pathways are
extremely high-yield. For metabolism, know the key regulatory enzymes and global control of
metabolic processes (i.e. insulin vs glucagon’s effects).
Pharmacology: Around 25 questions. Piece of cake compared to UW. I thought FA covers
pharmacology in sufficient details. As usual, emphasis was placed on autonomic pharmacology
and cardiovascular medications. I had quite a few questions on pharmacodynamics too.
Microbiology: 30 questions. Make sure you know the various bacterial exotoxins and their
mechanisms of action. Quite a few questions involved TB and HIV. Even West Nile virus appeared
on my exam.
Physiology: 30 questions. Most involved the up/down arrows and graph interpretation. Endocrine
questions are high-yield too.
I walked out of the testing center feeling quite confident I did pretty well. I was certain I broke 260,
but wasn’t too sure if I was able to get 270+. Got the score today, 276/99! I didn’t even know it was
possible! Needless to say, I was ecstatic!
While Pathology is a highly competitive and lucrative branch in the united states, Dr. Chang has
managed to secure a highly prestigious residency in a top notch university hospital after scoring
276 on USMLE Step 1… He also scored 270+ on his USMLE Step 2 CK exam. I recommend you
check out all the resources listed above which he used as a major part of preparing for USMLE is
to know which resources cumulatively give the knowledge that is needed to get all of the
information tested on the USMLE. Many people do only the major resources which are used by
everyone like UW, FA and Pathoma… This does not help get the score we desire… since everyone
uses these books, USMLE tests are not prepared from only these books… There are many other
books, banks, flashcards, video series which help in preparing for USMLE Step 1 and Pollux aka Dr.
Jason Chang has used all of them to get a score of 276 which is a dream for many.