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UofL doc gives 'first aid' to medical student test takers; makes best-sellers list

by Anne Eldridge, HSC Office of Communications and Marketing last modified Mar 15, 2010 04:06 PM

A seven-hour exam with questions on anatomy, biochemistry, epidemiology, genetics, histology, immunology, microbiology, molecular biology, neuroscience, pathology, pharmacology, physiology, psychiatry, statistics and medical ethics - the United States Medical Licensing Examination Step 1 exam for second-year medical students is the ultimate academic emergency, the kind of exam that not only tests its victims' brain-power and stamina, but also helps determine the course of their lives.

UofL doc gives 'first aid' to medical student test takers; makes best-sellers list

Second-year medical student Raffi Kotoyan thumbs through a copy of "First Aid."

For the past 20 years, students have turned to “First Aid for the USMLE Step 1: A Student to Student Guide” for help with this critical exam. UofL assistant clinical professor Tao Le, MD, MHS, and a group of Yale School of Medicine students, compiled the book, which recently spent several weeks at #3 on’s best-sellers list, topping every category.

That’s partly because of the number of people who take the exam each year — 16,000 U.S. medical students and 17,000 foreign medical graduates. It’s a high stakes exam — the first in a three-step process toward medical licensure — so people spend months preparing for it.

“‘First Aid’ is an essential text book. You pretty much have to have it,” said UofL third year medical student Eric Yoder, who scored in the 99th percentile on the test last year. Because of his performance on the Step 1, Yoder is well positioned for a highly competitive residency in plastic surgery after medical school.

“First Aid” was started by University of California, San Francisco medical students as a database of facts culled from review books and the recollections of students who had just completed the exam. The book was self-published and distributed only to University of California students until a professor brought it to the attention of McGraw-Hill Medical, one of the top medical publishers in the world.

Now, during the board exam season, “First Aid” dominates’s best-selling text books list. In recent years, it’s started rising on the general book chart, too. Last year, it peaked at # 12 on Barnes and Noble’s best-sellers list, outperforming Barack Obama’s “The Audacity of Hope.”

“Students are so grateful. After they take their boards, many write back and share their experiences. I get 800 to 1,000 e-mails,” Le said, adding that some students send pictures of themselves with their books in exotic locations.

‘It was an insane time!’

Le became a “First Aid” student editor in the book’s fourth year, working with original student author Vikas Bhushan, MD.

“When I met Vikas, he was a radiology resident in Los Angeles. The first summer was really interesting. We would make road trips between San Francisco and Los Angeles. We’d throw a desktop computer and laser printer in the trunk and spend caffeine-fueled weekends banging out revisions,” Le said.

A Yale School of Medicine class project

When Le moved to New Haven for his residency at Yale University, he took the book with him and recruited Yale medical students to help update the study guide. Le has led the annual update since then, taking a break only during his internship year.

Today, Le is the senior editor. He still works on the book personally, setting the vision and strategy for each update and collaborating with a select team of 8 to 10 Yale student authors and editors chosen from the school’s second and third year classes. Each year, Le travels to New Haven to finalize revisions immediately after the exam is administered nationwide in June. The new edition is released in mid-December.

“This is the only book McGraw Hill does like this. The reason we do this is we want the book to be fresh and up-to-date and take advantage of the students’ experience from the board exam. That way, we get a lot of wisdom and street smarts,” he said.

Yoder attests to the value of this approach.

“It almost gives an unfair advantage over those who don’t use ‘First Aid’,” he said.

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