The Haversian Canal

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September 22, 2006

Get First Aid for USMLE Step 1

I recently got an e-mail that included this: "some students are questioning if and what is being addressed and how".

This is an issue of schema, and I empathize, to a point. The students with this concern want to know how this stuff should fit in the framework of knowledge, even as they are trying to build their own framework for the knowledge, their own schema. I recommend every first year medical student go get First Aid for USMLE Step 1 and start annotating their own copy with anything that isn't covered in class. Second year students who don't have this are likely behind the curve, or fall into the enviable group of people who don't have to study.

With an N of 1, a sample size of 1, the variance is infinite. You never get more variance reduction than when you go to N = 2. So maybe others had better think a bit about the audience, at least in some regards." - Edward Tufte, Technical Communication Quarterly, 13(4), 447–462

First Aid is written and edited by students and former students who have taken the test. So it's kind of like Wikipedia, in that it is a constantly improving resource, indeed, the kind of resource it is is a schema, which is improved by community feedback. A new edition is published every year, and I can attest to the fact that the current edition has new content every year. It the best possible ready-made schema simply because so many minds over so many years have worked on it. Perhaps you can develop a better schema all on your own, but First Aid has 400,000 customers, so the odds are against any given individual doing better. Peer-review from some subset of 400,000 recent test-takers, or one PhD, who never took the test. What do you think? A professor can certainly be relied on to get the solution right to the first approximation, and that's a big first step, huge, but First Aid has gone through new iterations of peer review every year and it is sensitized *to the test*, not to what one person or one school's department may have learned over the last year. It's not sensitized to what I think. First Aid is sensitized to the test.

Another interesting point about First Aid is who is investing their effort into it: all of the contributing authors for this year are from Yale. What, I thought the authors were from California? Well, Yale doesn't require their students to take tests, let alone go to class. You want to talk about some people who *need* to find their own schema, it's the Yale kids. Schema, schema, schema. See my blog's archives of medical education for copious detail on schema.

If you're a second year medical student, you've probably heard of Katzung's pharmacology books, but did you know he is one of First Aid's five faculty reviewers? Perhaps the most appropriate thing to do would be for medical school classes to buy their course coordinators their own personal copies of First Aid. At least then the maximum number of people would be singing from the same sheet of music.

Posted by Niels Olson at September 22, 2006 3:43 PM

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