The United States Medical Licensing Examination (USMLE) is a 3-day test crafted by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).  An M.D. must pass this exam before they’re allowed to apply for a license and practice medicine in the United States.  The fees for taking this exam vary, depending on whether you went to medical school in the U.S. and Canada or abroad.  The PASS Program offers a 4-week or 8-week preparation course for this important exam.

The USMLE assesses a doctor’s abilities to apply their knowledge, concepts, and principles, and to show important patient-centered skills, that are vital to medical treatment and are the foundation of effective care.  Each individual step of the USMLE complements the others and no one section may stand by itself in the evaluation of preparedness for medical licensure. 

The Three Steps

• Step 1
  Assesses whether medical school students or graduates understand and can apply important concepts of the basic sciences to the practice of medicine.  It covers a range of topics, both systemic and procedural, in subjects such as anatomy, biochemistry, physiology, pathology, behavioral sciences, and more.  This is an 8-hour exam.
• Step 2 
  Broken out into two sections and is meant to address whether a recent graduate of medical school can apply the knowledge and skills they have acquired to understanding clinical science and patient care through simulated patient interactions (Step 2-CS) and a written multiple choice test (Step 2-CK).  This takes approximately 9 hours.
• Step 3 
  Traditionally taken at the end of the first year of residency for U.S. students or for foreign medical graduates, before starting a U.S. residency.  This step is a 16-hour examination spread out over two days, which includes a multiple choice written test and clinical case simulations.

The PASS Program Edge

93% of PASS Program students succeed on their licensing exams.  Our unique approach works in reverse of traditional teaching and begins with high concepts as opposed to starting with the hundreds of relatable facts that leads up to it.  Having a fuller understanding of top-down clinical science is more beneficial than rote memorization of myriad symptoms because it changes the way you think about a specific problem. Our students are trained to first focus on the normal physiological processes of the body and the biochemistry involved in those processes.  The more aware you become of that, the more patterns start to emerge.  Check out our four and eight week courses and see if the PASS Program is right for you.

Learn More About The USMLE

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According to this article on Medical News Today, a study conducted in the UK revealed that new physicians feel inadequately prepared to care for acutely ill patients. Over the next few weeks, we will be discussing some key acute and critical conditions that future (and current!) physicians should be especially aware of.

One of the most common disorders and most potentially deadly that we see in the Medical ICU is sepsis. Sepsis can occur quickly and, if not recognized and treated swiftly, can kill a patient in a matter of hours. Remember this: A systemic inflammatory response + infection = sepsis. A systemic inflammatory response (SIRS) can occur when there is an insult to the body that causes a cellular reaction that initiates “a number of mediator-induced inflammatory and immune responses” (Gabbard, 2012).

Two or more of the following symptoms indicates a systemic inflammatory response:

In essence, sepsis is basically SIRS caused by an infection or infections – usually gram negative and usually originating in the urinary or respiratory systems. Familiarizing yourself with the pathophysiology of sepsis is of fundamental importance.  It is believed to start with activation of the clotting cascade and RBC abnormality that leads to endothelial injury, mitochondrial dysfunction, vasodilation, and fluid redistribution (Gabbard, 2012). When a patient starts to become agitated and restless, as well as tachypnic, tachycardic and hypotensive, these are classic warning signs of sepsis. If left untreated, this process will progress to severe sepsis and ultimately septic shock, which brings with it a rather grim prognosis.

Proactively speaking, the best way to prevent sepsis from even occurring is by treating the underlying infection which causes the response. However, oftentimes sepsis will worsen regardless. The latest critical care guidelines recommend treatment of septic shock with a “Six hour resuscitation bundle” of broad-spectrum antibiotics, aggressive fluid replacement with normal saline, dobutamine and/or blood transfusions to achieve adequate ScvO2 (which measures the oxygen saturation in venous blood returning to the heart and reflect the balance between oxygen delivery and oxygen consumption), and vasopressors to maintain a mean arterial pressure (MAP) of >65 mm Hg (Gabbard, 2012).

References:

Gabbard, E. (2012). Multisystem. CCRN certification exam review. MedEd. www.MedEdSeminars.net

Rattue, P. (2011).  Newly qualified doctors feel unprepared to look after acutely ill patients, Medical News Today Retrieved from http://www.medicalnewstoday.com/articles/239309.php

2012 is bringing with it changes to the USMLE examination format and content areas, and, whether or not you have already taken a Step (or 2), you may want to familiarize yourself with these changes. A sample of the modification . . .

Six-time limit to pass any USMLE Step (including incomplete attempts).

Effective:

Follow the PASS Program concepts, and you shouldn’t have to take any USMLE Step more than once, much less six times!

Also, according to usmle.org, effective June 17, 2012, the Communication and Interpersonal Skills (CIS) portion of the USMLE Step 2 CS exam has been expanded to assess a wider range of competency (i.e. It will be more extensive) and will focus on five sections:

For more info about the examination changes, and the USMLE, in general, please become familiar with the USMLE Bulletin at ww.usmle.org/bulletin/

By looking at our students’ rate of achievement, one has to ask: Why are the PASS Program teaching methods so successful?  The answer seems complex, yet its origins are rooted in simplicity – we are retraining your brain how to think.  Instead of learning from the bottom-up, you’re learning from the top-down and the results are speaking for themselves. 

The PASS Program has completely revolutionized the conventional way that students learn.  It has quickly become the most effective way to improve skills in knowledge organization, knowledge integration, and short/long term memory, which translates to increased accuracy and higher test scores.  In preparing for a career in medicine, too many students spent hours memorizing endless pathological situations and processes of the body.  This is a less effective and less accurate technique, but it’s the way many people learned to educate themselves.  But the days of flash cards are over, or at least they should be.  We train our students to first focus on completely understanding the normal physiological processes of the body and the biochemistry involved in those processes.  The more aware you become of that, the more patterns start to emerge.  

This method of learning actually goes back to the earliest form of learning that the brain utilizes. Children begin learning language by merely repeating the words that they hear. Quickly, they begin to speak phrases and then sentences that no actual person had spoken to them before.  Fundamentally, they pick up the patterns in formulating sentences consistent with the language that they have been exposed to thus far. This is why a child can easily learn and master multiple languages during this stage of life.  This recognition of patterns is how we approach higher education.  You will begin to do more than just understand the medical information.  The mind will integrate it, reason with it, and extrapolate from it.

Imagine understanding how to figure out the signs and the symptoms for any disease, the infections that are likely as part of the disease, the complications of the disease, the causes of death for that disease, the drugs of choice for treating that disease, as well as how to manage the disease in the short and long term.  We are empowering our students with these skills.

Our top-down technique to teaching begins with the final concept at the top of the pyramid, instead of starting with the myriad relatable facts and components that lead to that concept.  Traditional education falters by spending too much time at the bottom of the pyramid and the students never reach a full understanding of what the true concept is.  Effectively, we have turned the pyramid upside down. By understanding the concept first, the brain is able to connect an incredible amount of facts that are simply related to the main concept. In fact, the brain can create relationship patterns that allow it to integrate copious amounts of information to a specific problem.

Over 93% of our students succeed on their licensing examinations, with more than 80% receiving a score of 200 or better. 

The distinction between “bad fats” and “good fats” has received a lot of attention in the public and medical arenas. Generally, we think of saturated fats, trans fats, and Omega-6 fats as “bad” fats, while monounsaturated and Omega-3 fats are considered “good” fats. However, in some instances the distinction is more difficult to make.

One example is Arachidonic acid, an Omega-6 fatty acid present in foods such as red meat, organ meats, and egg yolks. According to an article by Dr. Barry Sears, Understanding (AA) Arachidonic Acid – (Omega 6- Pro Inflammatory Fat), mice injected with pure arachidonic acid die within three minutes.  However, arachidoinic acid, from a clinician’s point of view, is also an essential ingredient in several key bodily functions including healthy skin, blood clotting, and leukotriene and protaglandin synthesis.

Arachidonic acid is an integral part of the pathway to production of lipoxygenase  ultimately leading to production of leukotrienes C4, D4, and E4, which are responsible for bronchoconstriction. However, this pathway also results in the production of leukotriene B4 which is a key component in the inflammatory process that attracts leukocytes to the site of injury.

Arachidonic acid also figures into the cyclooxygenase pathway (COX-1 and COX -2) that produces endopyroxides, prostacyclin and prostaglandin. Endopyroxides are directly related to the production of Thromboxane A2, which serves a primary role in blood clotting. Prostacyclin (PGI2) is pertinent to vasodilation and in decreasing platelet aggregation. Prostaglandins, depending on their type, are responsible for uterine contractions and gastric mucosal protection (E2), or vasoconstriction (F2a). 

So, while you may not want to gulp down Arachidonic acid supplements, or inject yourself with an arachidonic acid serum, this is one Omega-6 acid that your body can’t do without.

Daphne Scott-Henderson, RN, BSN
FNP candidate 2013, Georgetown University

Sears, B., Understanding (AA) Arachidonic Acid-(Omega 6- Pro Inflammatory Fat.  http://www.cbn.com/health/naturalhealth/drsears_arachidonicacid.aspx

My name is Ryan Cannon-Scott. I am Director of Marketing for the PASS Program. Over the past six years, I have worked to help to promote the PASS Program to medical students looking for help in passing their medical boards. I received my B.S. in Psychology and my M.A. in Human Service Administration, from Bradley University. I have worked around medicine most of my life. I first began working as a receptionist in high school at Dr. Francis’ pediatrics clinic in Peoria, IL! Nearly fifteen years later, I still run into patients of Dr. Francis who are just as crazy about him now as they were back then. From there I spent time working in child welfare and drug and alcohol counseling.

As a case manager at an AIDS service organization, I worked with HIV+ individuals and their families to advocate for services they needed. I switched to the prevention side and became Coordinator of the Education and Outreach Program, offering counseling, testing and a myriad of other prevention services. I continue to volunteer my time to help prevent the spread of HIV and to help young people make the best choices for their future. My program, AZIZZI Girls, helps to educate young women of color about their bodies, their choices, and seeks to help them reach their full potential in life while avoiding many of the pitfalls that are all too common amongst our youth.

One of the best parts of my job with PASS Program is all of the community service projects we are involved in. I help to manage our corporate giving program, and in the last year alone we have provided 70 families with Thanksgiving meals, 40 kids with new coats and shoes for the school year, and have supported local after-school programs. There is nothing like seeing a young child’s face light up when they see someone with no “obligation” doing something kind for them. It is our mission at PASS Program to serve our community, but to also inspire the many doctors who pass through our doors to do the same. We are the village.

Another great part of my job is traveling all over the country and beyond to speak to medical students and educate them about our program. Almost everywhere I go, I run into former PASS students who came to us in despair, but who now have incredible stories of success, confidence, and triumph to share.It makes my job that much easier to have such great advocates for our program. I encourage you, if you are a former student, to share your stories with us on Facebook, sending a video or an email to info@passprogram.net.

It is so exciting to be around so many passionate people who are helping students achieve their goals, sometimes, against all odds. I feel very privileged to be a part of the PASS Program family and I wish everyone could have the experience of being inside these walls. You will walk away changed in some way, for the better. You will be challenged in new ways, you will find a new confidence, or you will meet incredible people with incredible stories to share, and hopefully all of the above. 2012 is going to be a great year for PASS program and we are working hard to bring you even better services. Next up, we’ll post a great article with advice from Dr. Francis himself.

The PASS Program staff would like to welcome you to our revamped website. We think it's pretty snazzy, if we must say so ourselves. The new site has been a long time in the making, and our hope is that you will be better able to find all the information you might need to make your decision to attend the program. Of course, we are always available by phone and email to answer any of your questions. Please feel free to use our feedback form under "Contact Us" to share any suggestions you have to help improve our site.

This is the first in a series of blogs introducing you to our new website, our services, and our staff. In the coming weeks, we will "Spotlight" a PASS Program team member in order to give some insight into what makes PASS so special. Because you spend do much time working one-on-one with our tutors and instructors, you will soon become of the family. As new staff members join our team, we will keep you updated. We will also be sharing some 2012 "early-bird" promotions and prizes. Check our blog frequently for up-to-date news on the USMLE and COMLEX exams, and what is going on in the world of medical students. Finally, as the year closes, we will be sharing video testimonials from our former students, so you can hear first hand how the PASS Program has impacted the lives of so many students.

Thank you for visiting our site. We hope to see you again soon!

Best Wishes,
Ryan Cannon-Scott
Director of Marketing