Pre-Program Questionnaire - USMLE Step 1 Coach Pack 1 Background Info2 Exam History3 Previously Used Prep Materials4 Personal Evaluation The purpose of this form is to help us better understand your personal academic circumstances and to make sure we are able to match you with the best coach possible, and as such, we ask you to please take the time to fill out the following form as completely and accurately as possible.If at anytime you have any questions please don't hesitate to send us an email at contactus@northwesternmedicalreview.com or call us at (517) 214-1085 to speak with one of our advisors.Your name* First Last Name and location of your medical school*Have you graduated?*YesNoWhen did you graduate?* Date Format: MM slash DD slash YYYY When do you plan to graduate?* Date Format: MM slash DD slash YYYY When do you hope to take your board exam by?* Date Format: MM slash DD slash YYYY Are you flexible on this date?*YesNoMaybee.g. if your coach deems it necessary to postponeAbout how many hours per day can you devote to your preparation?*Up to 2 hours2 to 4 hours4 to 6 hoursI have no time restrictionsPlease state any other relevant time management restraints:e.g. I can only study on Mondays and Wednesdays until xx/xx/xx, my schedule is tight between xx/xx/xx and xx/xx/xx, I have clinical rotations on Tuesdays, etc. Have you taken any NBME-CBSSA exams?*YesNoFormDateScore Please upload your NBME-CBSSA score reports: Drop files here or Accepted file types: jpg, gif, png, pdf. Pictures/screenshots are acceptable. You may also email us your score reports separately.Have you taken the USMLE Step 1 exam?*YesNoDateScore When evaluating your performance on your last USMLE exam, did you notice a discipline or organ system that you felt you were extremely well-prepared for, but the exam report showed the contrary? Please explain:Did you feel that you did poorly in one area but the USMLE exam report showed the contrary? Please explain:Please upload your USMLE score reports: Drop files here or Accepted file types: jpg, gif, png, pdf. Pictures/screenshots are acceptable. You may also email us your score reports separately. Have you used any other resources before in your USMLE exam preparation?*YesNoe.g. other review courses, books, flash cards, question banks, etc.Name of serviceWas it effective for you? Do you have a current subscription to a USMLE question bank?*YesNoQuestion bank name Please indicate your academic strength with the following subjects/bodily systems (1 meaning not strong at all, and 5 meaning extremely strong):Cardiovascular*12345Hematology*12345Respiratory*12345Renal/Acid-Base*12345Endocrinology*12345Oncology*12345Neurology*12345Gastrointestinal*12345Reproductive*12345Biostatistics*12345Muscoloskeletal/Rheumatology*12345Please indicate your academic strength with the following subject areas (1 meaning not strong at all, and 5 meaning extremely strong):Physiology*12345Clinical Medicine*12345Anatomy*12345Microbiology*12345Biochemistry*12345Behavioral Sciences*12345Pathology*12345Pharmacology*12345Integrated Subjects (e.g. Physiopharmacology)*12345Please evaluate yourself on the following statements (1 meaning strongly disagree, and 5 meaning strongly agree):I am a very fast learner*12345I can read study materials for many hours without breaks and without getting tired*12345I am good at taking standardized tests*12345I am good at time management*12345Please rate the following learning styles/methods on their usefulness in your study routine (1 meaning not useful at all, and 5 meaning very useful):Big picture → to abstract details*12345Abstract details → to big picture*12345Memorizing facts*12345Multiple choice question drills*12345Word association*12345Question-pause-answer techniques*12345Visual learning*12345Repetition*12345Please share any other relevant information that will help us customize a plan for you:PhoneThis field is for validation purposes and should be left unchanged.
