Getting obliterated by uworld?

[mcloaf]

Hey all, just a quick question about using UWorld's Step 2CK bank during M3.

I'm currently pretty early in my IM rotation, which is my first of M3, with ~10 weeks to go until my shelf. My plan had been to get through the IM Essentials book + associated MKSAP Q's as well as the Uworld IM questions (minus neuro). I've been on a pretty busy subspecialty service and haven't had a whole lot of time to study but am getting my ass kicked on the few uworld sets I've done so far (60's).

I'm only a month out after step 1 and so I don't think I've forgotten too much of that material, plus I did fine there, so I'm mostly just wondering if I should be concerned yet about these scores. Considering throwing in the towel on the 500 page IM Essentials and switching over to a more condensed shelf type book like Case Files or Blueprints (I also have step up to medicine, but didn't particularly like the format).

Any insights or advice would be much appreciated, thanks.

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[Apoplexy__]

Consider quickly skimming a concise resource before UWorld if you're worried about being too overwhelmed to be learning from it (e.g. UWorld gives you a clever differential diagnosis question but you didn't know the management of those two differentials to begin with). Otherwise, UWorld is far and away the best resource, and you're fine doing pure UWorld as long as you're learning well from it. I regret most of the many hours I spent on Step Up To Medicine before UWorld.

I averaged 70% on IM UWorld in M3, and ended up with an 80 on the shelf (my second shelf). It was certainly very demoralizing to score that low on UWorld coming from Step 1 scores, as you're experiencing. Step 2 Q's are tricky in that they look and feel very similar to Step 1 questions but have a unique curve ball mixed in. You spend half of M3 figuring out that curve ball.

 

[Ismet]

Step 2 is a different animal. Yeah you have the pathophys knowledge from Step 1, but that's not what most of Step 2 questions are testing on. I felt like I learned the most from reading about my patients, especially on a general medicine service where you see a lot of GI/liver patients. Reading about patients + OnlineMedEd videos + UWorld should suffice. Step Up to Medicine or another review source if you have time/inclination to work something else in.

 

[addy]

hey man, can't give you tips but i'm in the same boat....except i'm doing closer to 50%. If you find the 'secret' to doing better, let me know, because I'm not seeing most of the pathologies on Gen Med that UWorld is asking about so just reading about patients is getting me nowhere.

 

[operaman]

I didn't see much correlation between my UWorld scores and my shelf scores. I always got obliterated by the CK questions (50-65% or so) , even after coming off step 1 where I was comfortably hitting >90% on new questions by the end of things. I always ended up crushing the shelves and did great on CK, but it was disconcerting to say the least! My guess is that this comes from:

1) The percentiles overall for World CK are derived from people who do these questions at all times during the third year; by the end your average will be a LOT higher because you'll figure out that curve ball alluded to above.

2) The 3-digit scaled scores on Step 1 and on Step 2CK are as related to each other as the MCAT and the ACT. They kinda look alike, but they are not the same. This is why everyone's score supposedly goes "up" on CK. It doesn't really; the scale is different, but nobody seems to realize it even though the NBME has made it clear.

There are NBME tests for all the clerkships, so I would strongly advise taking one of those to get a sense of where you stand for your shelf. You will probably surprise yourself!

 

[notbobtrustme]

I was in the same boat. My IM uworld scores were in the mid 60s, and felt that uworld was extremely tricky. The real deal isn't so bad.

 

[Fatalis]

Did you even read the disclaimer that uworld puts out. Uworld is meant to be a LEARNING tool not to assess! Regardless of your score 1st pass, as long as you are learning the info, who cares what your score is!

 

[mcloaf]

Thanks for the input guys, I guess I'll just keep trucking and stay optimistic.

 

[seminoma]

Kind of off-topic but did you guys all purchase 1 year of UW for 2CK? Medicine is also my first rotation, starts in a little over a month.

 

[alpinism]

The vast majority of step2 CK UW questions (~1400) are for IM.

If you have IM first I'd just go ahead and get the 1 yr subscription.

 

[alpinism]

I also went down from a mid 70s average for step 1 to a mid 60s average for step 2.

 

[seminoma]

The vast majority of step2 CK UW questions (~1400) are for IM.

If you have IM first I'd just go ahead and get the 1 yr subscription.

What do I do with it during all the other clerkships? Is there any benefit to having it between medicine shelf and 2CK study time?

 

[Psai]

I also went down from a mid 70s average for step 1 to a mid 60s average for step 2.

same

 

[Kaustikos]

What do I do with it during all the other clerkships? Is there any benefit to having it between medicine shelf and 2CK study time?

Surgery
Peds
OBGYN
Neuro
Psych
I can go on.

 

[seminoma]

Surgery
Peds
OBGYN
Neuro
Psych
I can go on.

My bad, for some reason I thought it was only for medicine, not the other clerkship.

 

[Kaustikos]

My bad, for some reason I thought it was only for medicine, not the other clerkship.

Yeah,
I mean, majority is medicine, but it's also got questions for other rotations. Not to mention the medicine questions are helpful for surgery.

 

[byaaaaaaah23]

really worth a $400/yr subscription?

 

[Psai]

really worth a $400/yr subscription?

yes

 

[serimeri]

Did you guys feel that you learned the most during 3rd year by the amount of Uworld questions you did? Or was it more so uptodate? This is geared towards those who don't have set didactics during rotations.

I should also add, when I say learn the most, I'm referring to medical knowledge.

 

[notbobtrustme]

Did you guys feel that you learned the most during 3rd year by the amount of Uworld questions you did? Or was it more so uptodate? This is geared towards those who don't have set didactics during rotations.

I should also add, when I say learn the most, I'm referring to medical knowledge.

uptodate sucks for 3rd year. Haven't touched it and probably won't. It's full of conflicting information with lots of distractions.

IMO, medscape is a much better alternative because it gets right to the point and doesn't confuse the issue with 10 different viewpoints/caveats.

All in all, the vast majority of your information should come from review books and Uworld.

 

[Elixir6]

uptodate sucks for 3rd year. Haven't touched it and probably won't. It's full of conflicting information with lots of distractions.

IMO, medscape is a much better alternative because it gets right to the point and doesn't confuse the issue with 10 different viewpoints/caveats.

All in all, the vast majority of your information should come from review books and Uworld.

? Really?

UpToDate is not a good way to go for prepping for the NBME shelf of course, but I used it constantly for my A&P for patients... for diagnosis and treatment

 

[mcloaf]

? Really?

UpToDate is not a good way to go for prepping for the NBME shelf of course, but I used it constantly for my A&P for patients... for diagnosis and treatment

Yeah I'm on UTD all the time, but it's not always super efficient. Can be annoying when you're just looking for one thing and have to sort through 5 different related articles, all lengthy, to find it.

 

[alpinism]

The main problem w/ UTD is that for some diseases its ridiculously convoluted and verbose.

Some articles drag on and on with multiple links to subtopics embedded throughout the original article.

The paragraph format also makes it a PITA to find things quickly.

As an M3 you're mainly looking for a concise and easy to read resource on how to work up and manage certain conditions.

I'd agree that Medscape or Pocket Medicine are good for looking stuff up quickly after seeing a patient.

 

[Psai]

The main problem w/ UTD is that for some diseases its ridiculously convoluted and verbose.

Some articles drag on and on with multiple links to subtopics embedded throughout the original article.

The paragraph format also makes it a PITA to find things quickly.

As an M3 you're mainly looking for a concise and easy to read resource on how to work up and manage certain conditions.

I'd agree that Medscape or Pocket Medicine are good for looking stuff up quickly after seeing a patient.

agree
older docs get upset that we use wiki for info and wiki obviously isn't the most reliable source. however, it's easy to get to and the format is pleasing to read
i use medscape a lot now to learn about the basics that we need to know

 

[seminoma]

@mcloaf have your scores gone up? I started doing questions everyday toward the end of last week and I'm getting obliterated too..

 

[mcloaf]

@mcloaf have your scores gone up? I started doing questions everyday toward the end of last week and I'm getting obliterated too..

I took the last month off and focused on just reading nms medicine and doing the IM essentials questions. Now I restarted uworld this week and it seems more manageable/scores have gone up some. I don't think I'm going to get back to where I was with the step 1 questions, but at least things seem a little less overwhelming.

 

[seminoma]

I took the last month off and focused on just reading nms medicine and doing the IM essentials questions. Now I restarted uworld this week and it seems more manageable/scores have gone up some. I don't think I'm going to get back to where I was with the step 1 questions, but at least things seem a little less overwhelming.

Any particular reason why you prefer NMS to step-up?

 

[hmockingbird]

I found that the more I did UWorld, the better I got. MKSAP helped too with just drilling the differentials of different organ system problems. (They tend to have multiple questions with very similar presenting complaints and you have to suss out the difference between them.)

 

[mcloaf]

Any particular reason why you prefer NMS to step-up?

It came recommended from a friend who killed the shelf, otherwise I'd probably have never bought it. I ended up bouncing from Step Up to IM Essentials to NMS casebook because I found it to be the most readable. The info in IME and SUTM is great but they both put me to sleep (IME is just walls of text, SUTM is death by bullet points). NMS has, at least for me, a much more easily readable style and I find the case-based format more interesting. If you can get through any one of those resources at least once in conjunction with uworld/IME q's you're probably in good shape, picking which one to use is IMO mostly just personal preference.

 

[stepone2015]

It came recommended from a friend who killed the shelf, otherwise I'd probably have never bought it. I ended up bouncing from Step Up to IM Essentials to NMS casebook because I found it to be the most readable. The info in IME and SUTM is great but they both put me to sleep (IME is just walls of text, SUTM is death by bullet points). NMS has, at least for me, a much more easily readable style and I find the case-based format more interesting. If you can get through any one of those resources at least once in conjunction with uworld/IME q's you're probably in good shape, picking which one to use is IMO mostly just personal preference.

Are you referring to this? amazon.com/Medicine-National-Medical-Series-Independent/dp/1608315819
or this? amazon.com/Medicine-Casebook-National-Medical-Independent/dp/0781784689

 

[Kaustikos]

really worth a $400/yr subscription?

Yes, most definitely. Honestly wish I had it for summer when I did my sub-i rotations.

Did you guys feel that you learned the most during 3rd year by the amount of Uworld questions you did? Or was it more so uptodate? This is geared towards those who don't have set didactics during rotations.

I should also add, when I say learn the most, I'm referring to medical knowledge.

It's 50/50. Or basically it's not clear cut. Uworld has its ups in certain areas aside from exam preparation. But rounding with an excellent team of residents and attendings goes a loooooong way. Going into third year is basically a session of humility. You have to go in expecting you have this knowledge but don't know how to use it. Being in the hospital helps you learn that.

 

[mcloaf]

Are you referring to this? amazon.com/Medicine-National-Medical-Series-Independent/dp/1608315819
or this? amazon.com/Medicine-Casebook-National-Medical-Independent/dp/0781784689

The second one.

 

[Syfte3]

I'm so frustrated with uworld right now. I just took step 1-- 2 months ago. I thought that it would be somewhat helpful to have all of that knowledge fresh but some of my best step 1 areas are my worst step 2 percentages. Everytime I see a question that says "which of the following is the most appropriate next step in management of this patient?", I know that I'm getting it wrong.

 

[Frazier]

I'm so frustrated with uworld right now. I just took step 1-- 2 months ago. I thought that it would be somewhat helpful to have all of that knowledge fresh but some of my best step 1 areas are my worst step 2 percentages. Everytime I see a question that says "which of the following is the most appropriate next step in management of this patient?", I know that I'm getting it wrong.

Why does it frustrate you? You could have been a rockstar on Step 1, but it doesn't carry over exactly to the knowledge on step 2 (as you know).

In other words, don't beat yourself up for not knowing stuff that you haven't learned yet!

 

[Psai]

I'm so frustrated with uworld right now. I just took step 1-- 2 months ago. I thought that it would be somewhat helpful to have all of that knowledge fresh but some of my best step 1 areas are my worst step 2 percentages. Everytime I see a question that says "which of the following is the most appropriate next step in management of this patient?", I know that I'm getting it wrong.

if you knew it already why would they ask you about it

 

[Kaustikos]

if you knew it already why would they ask you about it

Right?
Step 2 doesn't just rehash step 1. We aren't talking about Twilight movies.

 

[stepone2015]

Right?
Step 2 doesn't just rehash step 1. We aren't talking about Twilight movies.

You just admitted to having seen the Twilight movies. Pretty sure that line just backfired on you, buddy.

 

[seminoma]

Main gripe with Step 2 UW right now is how different score distributions are. Unless I'm remembering incorrectly, step 1 was mainly 60-70% right on any given question. Step 2 is like 80%+ on the vast majority and then randomly a question with 2 50% answers and even fewer with a random distribution. It sucks getting a question wrong and seeing that 80-90% of people got it right.

 

[Psai]

Main gripe with Step 2 UW right now is how different score distributions are. Unless I'm remembering incorrectly, step 1 was mainly 60-70% right on any given question. Step 2 is like 80%+ on the vast majority and then randomly a question with 2 50% answers and even fewer with a random distribution. It sucks getting a question wrong and seeing that 80-90% of people got it right.

lmao this happens to me all the time

 

[DocVapor]

Main gripe with Step 2 UW right now is how different score distributions are. Unless I'm remembering incorrectly, step 1 was mainly 60-70% right on any given question. Step 2 is like 80%+ on the vast majority and then randomly a question with 2 50% answers and even fewer with a random distribution. It sucks getting a question wrong and seeing that 80-90% of people got it right.

I wouldn't get to upset over the score distributions or "average" test scores. The results are all skewed by people doing questions directly after studying particular subjects (i.e. doing OB questions after studying OB all day). Obviously not everyone does it that way, but it's definitely enough to make a difference if you are like me that only did sets of 44 unused, timed, random subject.

That said, I always got more excited over nailing questions that only 20-30% got right, even after a string of wrong ones with >90% correct. Guessing right doesn't count, of course.

 

[Frazier]

Exactly there is a huge issue with the fact that people most likely do the bank multiple times. Once for shelves, once or twice for Step2.

The more random, off-the-wall question that you miss the first time the more you are likely to remember it on the retake. So when the next guy misses it for the first time, he's left wondering "how the hell did all those people know that?!"

Very likely a lot of warped percentages on there.