Official 2010 USMLE Step 1 Experiences and Scores Thread

[FMD212]

Good luck all. I have my exam end of March and hope to be the 1st one to post here for 2010.

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[radiodoc99]

Alrighty then...seems weird to be posting here, but here is my experience:

PREPARATION
Going into medical school, I knew that I was one of those people that had to see stuff over and over and over again for it to stick. I am not one of those people that has a reliable long-term memory. I posted in the NBME thread that I forgot the direction of DNA replication!
So when I came upon Gunner Training (GT), I knew I had found at least somewhat of a cure for my ills. I think people on here are at least familiar with the program so I won't go into all that, but I started doing GT in June of last year, slowly adding in material from first year. I kept up with it every day and added in material as we covered it in 2nd year. This was by the far the most important part of my studying, especially given my proclivity to forget the simplest, most rudimentary basic science facts.
Another thing, GT is essentially First Aid in flash card/spaced learning format, and one of the "pillars" to my studying for Step 1 was to be as familiar with this book as possible. Hence my use of USMLERx and DIT throughout the 2nd half of my 2nd year, to keep First Aid as fresh as possible.
And of course, I went into 2nd year with the approach of being as hardcore as possible about classwork, because I knew how high yield this stuff was. So I studied my caucasian derriere off. I would head up to school at about 7 every morning and study in the learning resources unit/library until about 5. I started off every day by doing my assigned GT and doing so as quickly as possible, because I didn't think that lingering over things I got wrong in GT served its purpose well. I wanted multiple succinct reviews, and that's what I got. I also made it a point to become as familiar with medium Robbins as possible, and I made it a goal to nail pathology in every block, as I knew this was the core of what would be on Step 1 (and you know all that third year crap too ) I made time almost every day to work out, if at least for 20 minutes. Once I came home, I was done and I spent time with my wife, read, watched TV, whatever. I can't stress enough how important I think it is to find balance throughout this whole process. I also took every Sunday off from studying, because I may be a weakling, but I can't keep up 10 hour days 7 days a week.

TIMELINE
-June before 2nd year: started GT, this was the only studying I did. Maybe took me 30 minutes a day.
-2nd year: kept up with GT, tried to own pathology, and listened to Goljan lectures as many times as possible with the according system. I would maybe use FA as a quick review before our exams, but that's it. Also I used Robbins Review questions, because they were much harder than necessary, and I wanted to "over train," as it were.
-January of 2nd year: started doing USMLERx to again solidify what was in FA, and to get used to doing boards-style questions. I started doing 48 random, timed questions on tutor mode. Towards the end of February, I started doing 96 questions every morning just to get through them quickly, as I was anxious to move on to UW.
-March-May of 2nd year: Still stayed dedicated to class stuff, but I was doing 48 blocks of UW on random, timed mode and would annotate in as necessary. This was a crucial part of my learning. UW is so tough but I wanted again to "over train" for the exam by using materials that were typically more difficult than the real thing, so that when I took the exam it actually felt easier. I also trained myself to start flying through questions, which I'm usually a pretty fast test taker, but I wanted to get through a block of 48 with at least 15 minutes left, because I knew on test day some people were a lot slower.
-May (dedicated prep time): I started doing DIT the day after our neuro final. Every AM I did my GT, then would watch DIT lectures from 8-2, and afterwards I tried to do UW and study that days material in FA. If you do DIT I really recommend being pretty comfortable with FA, or else it'll get frustrating and anxiety-producing because he constantly drills you over stuff that, at least I wouldn't have been able to recall had I not been doing GT and RX to familiarize myself with FA.
On weekends I took practice exams. I heard that NBME 4 and the UWSA's were tough, so I did those. I did NBME 5 in the middle because I wanted a bit of a confidence boost, I know that's weird and kinda goes against my whole "harder than the real thing" philosophy, but whateva, whateva, I do what I want! Here is my breakdown:

CBSE (school-mandated, given in April): 240
NBME 4 (3 weeks out): 244
NBME 5 (2 weeks out): 255 - It was at this point I decided to move up my test another week. I was already in "I'd crap myself if I scored this" goal range and still had another 2 weeks, even after moving up my test.
UWSA 2 (1 week out): 258
Free 150 (1 week out, taken after UWSA 2 so as to simulate a full-length exam): 255

USMLERx: 72% with 100% completed
UW: 75% with 100% completed, last few blocks were 100%, 89%, 85%, 85%, 83%

TEST DAY
Had a great night's sleep the night before, stayed in a hotel as the testing center was 45 minutes from where I live, but I didn't want to take any chances. The place I checked in was quiet and since I had already done my finger printing for the MCAT in 2007, I didn't need to go through that again. The proctors were laid back and didn't waste my time every time I checked out, I just had to sign in on a piece of paper every time. It was fine. And for some reason, I really wasn't that nervous. I usually get bad test-day anxiety (I did for the MCAT and it really cost me), but I didn't on Monday. Strange.
So, I sat down and flew through the tutorial, only checking to make sure the headphones worked (they did, but only in one ear, but I wasn't going to waste time trying to get it fixed).
I started and FLEW through the first block, I was finished in 30 minutes. I knew I had a propensity to go too fast and make dumb mistakes, so I went back and rechecked everything, especially the ones I marked. Didn't find any dumb mistakes, so I went on and still banked like 15 minutes of break time. I finished the 2nd block with about 12 minutes left, so I took a break afterwards. I ate a protein bar and chugged a sugar-free red bull and went back in after 10 minutes. I powered through the next 2 blocks and then took a 20 minute lunch. I ate a chicken sandwich with some fruit, not wanting to stuff myself and crash 30 minutes later. The proctors let me go outside and get some fresh air, which was nice. After the 5th and 6th block, I also took 20 minute breaks just so I could splash some water on my face, grab a red bull, and rest my mind. This was crucial as I didn't feel exhausted on any block, not even the 7th. I finished the exam with almost an hour of break time remaining. I know that some people would say I'm going too fast, but it worked for me on UW, and I didn't want to hem and haw over questions I was unsure of, because I usually ended up over thinking and changing my answer to an incorrect one.

EXAM BREAKDOWN
Overall, this was a very fair and balanced (Fox News ) kind of test. Very well-written questions. Though one thing they like to do is ask you straight-forward concepts in the most jacked-up of ways. You have to filter through the bull crap, but if you can, those kinds of questions become simple. I think this is where doing a crap ton of questions helped me, because I could read the stem and usually understand exactly what they wanted from me.

PATH: Very balanced, and very straightforward for the most part. There were quite a few 2nd order questions, but most weren't as challenging as UW questions. It seems like there was a lot of Derm on there, but I'm just having some selective recall, I think. I don't really remember a lot of out of the blue questions here. Oh, and EVERY OTHER PT was preggers. I swear! It was ridiculous. Know your repro path, COLD.

PHARM: Cake compared to UWorld. I don't recall having ANY autonomic pharm. I had some anti-virals and abx questions, as well as some CV pharm, but overall I don't remember anything too weird, except for one asking for the MOA of an alcohol-abuse drug, and there were 2 right answers! Fortunately I picked one of them, but still. Yikes! Also I had 2 questions on competitive inhibition, one of which was a lineweaver-burke plot. Overall, pretty straightforward. Most of the questions had to do with MOA rather than random side effects.

PHYS: Renal seemed heavy, with some cardiac and endo stuff. UNDERSTAND the whole afferent/efferent arteriole business with renal, they love to ask you questions on that.

IMMUNO: Had lots of immuno questions. They love to ask what cell is responsible for what kind of reaction, so that's important (e.g. which cell is responsible for type 4 HS rxn?) Also know the immunodeficiencies (I had one on Job syndrome and Wiskott-Aldrich). I had no immunosuppressant questions.
Out of the blue: MOA of papain on immunoglobulin? I looked it up and I guessed right, but yikes.

MICRO: Pretty good mix. I have but one piece of advice here: READ THE DESCRIPTION OF THE BUG. I have a tendency to, when I see buzzwords, click on the appropriate answer choice and not even read the frickin question. They used the word "honey-crusted lesions" in one stem, and I wanted to pick S. pyogenes, but the description of the bug was "gram positive in groups and clusters." As well, pt has a fever and indwelling venous catheter, I wanted to pick Staph epidermidis, but no, the bug described was "gram positive in chains and pairs." They're onto us and our Jedi mind tricks, so read the stem carefully!
Random stuff I had: mecA gene, tx for scabes, aeromonas hydrophila

BIOCHEM: Overall, not as bad as it could have been, given that this is my weakness. Basically they just asked about enzymes gone wrong in diseases. G6PD, NADPH oxidase, Hurler's syndrome, and a glycolysis questions (got that one wrong, I think). I definitely had a random throwback to first year biochem, I don't know how I remembered, but understand how your body buffers pH and when certain things do their buffering.

BEHAVIORAL: Lots of "what would you say next" questions, probably 1 or 2 per block. I laughed when I saw one, because it was a repeat from NBME 7! (You mistake a male pt for a girl, what do you do?). Another random one had to do with a pt who quit smoking for a month before an operation, what complications would most likely be decreased? One psych personality d/o question, and I think that was it. Overall, not too bad. UW prepares you well for these.

ANATOMY: Definitely the most random crap on here. No way I would have known some of this stuff if I had studied another week. They love the brachial plexus and stuff taht can be damaged during surgery (PDA repair, thyroid surgery, just as examples). Also, know what artery/nerve can be injured when a certain bone is broken, and don't forget the lower extremity! And don't forget the blood supply to the genitals (middle cerebral wasn't an answer).

NEURO: Not too bad, had one brain stem slice that I probably got wrong (I'm terrible at those) and a REALLY simple spinal cord lesion that had the same answer on it at least twice. I would recommend being comfortable with correlating clinical sx with MRIs of the brain and being able to point out where the lesion should be. Standard stuff, nothing too crazy.

MEDIA: Had 3, all were heart sounds. 2 were the same thing, and 1 was just a variant of normal. You could have figured 2 of them out from the stem (the two that were the same thing), probably, but the heart sound really helped.

Overall, I walked out feeling kinda good about the exam, but I don't want to get my hopes up. Thanks to everyone who posts on here for your insight and contribution. Any time I was feeling a lack of motivation, I just read Pollux's post from last year, or imagined myself on match day opening up the letter and being disappointed. Sounds lame I know, but whatever works!

PM me if you have more questions.

Thank you for the explanation. How did you use DIT, GT and USMLERx? Just review the tests you took daily? Or take notes? What is your learning method?

 

[fluffhead]

Took it yesterday. I studied for 6 weeks, mostly FA and UW, read BRS Physio once through, and did some Goljan RR.

My practice tests were UWSA1 244, NBME7 247. UW final was 68%, but had been doing random blocks every day of studying. The last 2 weeks of UW was consistently in the 70s-80s.

I feel the same was as Domenech, above. There were so many questions about topics I had never heard of before, anywhere. My musculoskeletal and anatomy questions were completely off the wall. Also, it was very immunology heavy-- I thought immuno was one of my strengths, b/c my school's immuno course was great and I knew FA cold. Alas, the immuno questions were bonkers... I've never been so perplexed by the functions of a macrophage in my life. I really just felt like I was getting hit by a train over and over and over again. I marked ~10 per block, which were ones I was neither 100% certain of nor 100% uncertain of. There were probably at least 5 more per section that I didn't even know how to begin to answer, so I just clicked an answer and moved on.

All in all, I was really discouraged. I know it's normal to feel pessimistic after you take this thing, but I just can't see how I could possibly have done well on this test. I am glad other people had similar experiences but got respectable scores. I'll keep my fingers crossed. I just felt really, really good going into the exam and wasn't prepared to see question after question about things I had never heard of.

Oh-- last comment about the exam. I've heard many different things from my friends who have taken it in the last few days, but the questions I asked seemed to be substantially longer than those in UW. I ran out of time on every block, even though time has never been an issue for me before. Questions commonly gave a long paragraph vignette, followed by every lab value under the sun, and then a follow up paragraph with a question. It was brutal.

 

[golfman]

Took it yesterday. I studied for 6 weeks, mostly FA and UW, read BRS Physio once through, and did some Goljan RR.

My practice tests were UWSA1 244, NBME7 247. UW final was 68%, but had been doing random blocks every day of studying. The last 2 weeks of UW was consistently in the 70s-80s.

I feel the same was as Domenech, above. There were so many questions about topics I had never heard of before, anywhere. My musculoskeletal and anatomy questions were completely off the wall. Also, it was very immunology heavy-- I thought immuno was one of my strengths, b/c my school's immuno course was great and I knew FA cold. Alas, the immuno questions were bonkers... I've never been so perplexed by the functions of a macrophage in my life. I really just felt like I was getting hit by a train over and over and over again. I marked ~10 per block, which were ones I was neither 100% certain of nor 100% uncertain of. There were probably at least 5 more per section that I didn't even know how to begin to answer, so I just clicked an answer and moved on.

All in all, I was really discouraged. I know it's normal to feel pessimistic after you take this thing, but I just can't see how I could possibly have done well on this test. I am glad other people had similar experiences but got respectable scores. I'll keep my fingers crossed. I just felt really, really good going into the exam and wasn't prepared to see question after question about things I had never heard of.

Oh-- last comment about the exam. I've heard many different things from my friends who have taken it in the last few days, but the questions I asked seemed to be substantially longer than those in UW. I ran out of time on every block, even though time has never been an issue for me before. Questions commonly gave a long paragraph vignette, followed by every lab value under the sun, and then a follow up paragraph with a question. It was brutal.

Do remember any of the obscure anatomy ones? I'm just curious to see how obscure they are. I'm worried about that section. Maybe I need to buy BRS Anatomy or something.

 

[fluffhead]

From talking to many friends, it seems like most people just get your standard nerve/joint injury questions (fracture at midshaft of humerus = radial nerve injury, etc). Mine were much more picky about *very* specific, more atypical locations of injuries and what nerve or muscle/tendon was affected. BRS Anatomy is massive... even after going through what I did I am not sure I'd bother with it; I think your study time can be better spent elsewhere, especially since most people seem to get the more straightforward questions. And even though I'm complaining about it, I think there were only 3 questions on my exam like that, so it's not like it's the end of the world.

 

[Dirt]

Dirt, would you mind sharing your practice scores ? UWSA 1/2 and NBME scores? UWorld % correct? etc.l (and any input on how they compared to the actual exam)

I was gonna hold off until I got the actual score back but...

CBSE - 247 (Before studying)

UWSA 1 - 252 (After going over 2nd year stuff once, 2 weeks in)

UWSA 2 - 265 (3 days before the exam)

Free 150 - 93% (Also 3 days before the exam)

UWorld - 81%

I mentioned above how the actual exam compared to Uworld, we will see about the score.

BTW, the truly best prep was doing well in all my classes years 1 and 2.

 

[AggieSean]

Thank you for the explanation. How did you use DIT, GT and USMLERx? Just review the tests you took daily? Or take notes? What is your learning method?

For GT: I did my scheduled review every day (no note-taking) and went through the questions as quickly as possible, my purpose being to get multiple, quick reviews, instead of lingering on the cards I couldn't remember. Did this from June after 1st year 'till 1 week before the test.

Rx: I did random, timed blocks of 48 during January and February, increasing to 2 blocks in the AM. I did them on all subjects. I very rarely took
notes, and when I did, it was when I was repeatedly missing questions on a certain concept and I would then annotate that concept into FA (I had a specific ink color system so I could prioritize studying on my final pass of FA).

DIT - essentially I studied his notes and drilled on the details on which I was weak. I annotated his tidbits that weren't already in FA or that I hadn't annotated from GT or UW, again using my color-coding system.

Hope that helps!

 

[PistolPete]

Well, took it today, and needless to say, I left fairly discouraged. It was quite hard. In terms of breakdown:

Anatomy: a number of questions (probably 10), the majority of which I did not know. And not just your easy, "what nerve is injured?" type of questions, but more like they described a certain pathology, and asked "where does the tendon attach?" type of thing, or "does it flex, extend, etc. etc?". UGH.

Embryo: almost none to speak of.

Biochem: also almost none to speak of. I spent so much time on this I kind of wished there was more.

Microbio: decently well represented. Not too difficult. Know common etiologies of pneumonia/STD's.

Physiology: all systems well-represented, not too bad though. A lot of arrow questions.

Path: I got a lot of pulmonary, which is my weak point, so this kind of discouraged me. Otherwise well represented between all the systems.

Immuno: You gotta know those CD markers, as well as Fas/Fas-L. Definitely know that chart in First Aid with Bruton's, SCID, etc.

Neuro: same crossection showed up twice. Didn't know it. Darn. Otherwise, a decent amount of neuro.

Repro: some tricky questions, decently well represented. Know pre-eclampsia vs eclampsia vs placenta accreta etc.

Pharm: THANK GOD FOR PHARM. Never thought I would say this. 90% of my q's were just "how does this drug work?", only a few SE. Got like 5 questions on HIV drugs. Know those. All in all, I think pharm saved me.

Renal/Cardio: not too many.

Biostats: 2-3 questions. Anything else I forgot, it was probably just a smattering of q's here and there.

Overall, a lot of pulmonary, weird immuno, microbio, pharm and phys. I thought 40% of the questions were easy, and the rest were just ridiculous. I'd say the test definitely felt harder than the NBME's. If I had to estimate, I would say 30% like NBME, 70% UWorld. UGH. This is gonna be a long 5 weeks. Here's to hoping for a decent curve.

Oh yeah, I had the 46 q version. Time was NOT an issue. The short questions you either knew or you didn't, and the longer vignettes, well, those were usually pretty tough, but maybe I'm just stupid.

Time to get a drink. Any questions, just post.

 

[LoveGI]

Also in the club that took my exam yesterday. I'll try to give a general outline of the day below, and when I get my score I can post my study prep and all the good details (expecting an average score, hoping for a slightly above average!!).

General: Lots of renal, lots of cardio, TONS of musculoskeletal. Specifically, renal physio and cardio pathology/treatment. Of course, these are my two weakest subjects...oh well. I had more than plenty of time, which is the usual for me- thank god for being a speed reader! I usually finished the first pass through a block with ~20 min left, so I could review any I marked (usually 10-15, which were any I wasn't completely sure of, but that also weren't a blind guess on something I had never heard of) and also one more read through the ones I thought I for sure knew. I actually caught 2 where I had misread the question, so got to fix to the correct answer for what they were actually asking! Only took 2 bathroom breaks, no lunch, so was done in a good amount of time.

Didn't feel fatigued at the end, since the last 3 days before I had worked up the number of USMLEWorld I did per day, basically saving the qbank for the last 2 weeks of my study. This was SUCH a good idea, since at least 15-20 weird questions were duplicated on my exam that I doubt I would have gotten right if they were more distant in my memory. I also broke the rule about not studying the day before- I did a pass through First Aid, complete, in the two days before. This also got me another handful of questions I would have likely missed otherwise, the small details that slip your mind if you haven't seen them in 2 weeks.

Pathology: Pretty broad number of topics, maybe 1/3 of my total questions were pathology. Cardiology was overly-represented, but only had 2 audio questions (both heart sounds, only one you could answer without listening, the other was essentially "listen and name this murmur!"). Otherwise had some favorite topics with 2-4 questions on them (multiple sclerosis, rheumatoid arthritis, ALS). Most were OK, and you could study for, but some I honestly had no idea how I would know what they were asking! Also, some topics that I was SURE I would see never made an appearance: Hep serologies, barely any neuro path (I mean nothing, no Huntingtons, no dementias, only 1 stroke question, no neuro drugs AT ALL), maybe 1 vasculitis, one glomerulonephritis type deal.

Physiology: virtually every question was renal physio, changing a parameter and asking what the overall effect would be, or doing a "drug X does this, a decrease in which of the following would mimic that" sort of thing. Half were do-able, half were super tough. I feel like this is where I lost the majority of my points If it wasn't renal physio, it was cardio physio- and I love me some GI and pulm, but sadly got less than 5 questions on those topics. It's like they know what you like and what you hate!!

Pharmacology: I got the same ANS question in three separate blocks- got it wrong in the first two, looked it up at a break so I salvaged another question. Lots of graphs with multiple drugs on them, asking about how one effects the other- yikes! And not simple ones like in First Aid, but the tough ones from USMLEWorld. Most of the pharm questions were straightforward- asking what drug you would use to treat X, the mechanism of X, or giving a mechanism and asking what drug was like it, etc. Only had 2 drugs that I had never heard of, and made 2 stupid pharm mistakes I know of...I had multiple questions asking about side effects, and not all of them were the obvious ones you know to study for. Didn't have any one pharm topic stressed, had a good mix of cardio/NSAID/musculo/ANS/chemo, and the random things they threw in. I did not have a single neuro/repro/endo/pulm drug question!

Biochemistry: know the enzymes deficient/products built up/clinical presentation of every single disease in this section!!! I had probably 10 questions on enzyme deficiencies, and they were usually 2 or 3 step questions- they would give a very vague clinical presentation, and then a vague idea of what might be wrong (ie they are excreting increased amounts of a reducing agent, instead of the 'buzz words'). Most of these were answerable, they just took some time, which is obviously a precious thing in this test! At least for me, they wanted details, not just which enzyme was off. Other than those questions, I had maybe 3 that wanted to know a straight biochem answer- what enzyme catalyzes this reaction. I did not know, since I had limited study time and frankly think those questions are whack. So I picked C and moved on. But there were literally maybe 3 total, so the topic was definitely low yield for me.

Micro: I had a lot of micro, probably upwards of 40 or so that related to a bug of some kind. I'm cool with that, since I like it. In my opinion, First Aid would NOT have been enough to answer half of my questions. I used CMMRS, and there were still maybe 3 that wanted detail over what was in THAT book. They didn't want to know what was single stranded or whatever, but they did want you to know the details of how the bug or virus works, how you treat some common infections, and WHY you used that particular regimen for treatment. Some of these last ones bordered on not really being what I would consider Step 1 material, but maybe they were experimental...

Embryology: I had one, and it was a super toughy.

Anatomy: I had a good number of anatomy questions, maybe 25 total. A few MRIs, which were tough because they were asking a really random question most of the time. 3 angiograms, which were maybe my favorite anatomy questions because they were interesting, but still answerable! Couple of questions about anastamosing of arteries that don't really matter (so of course I didn't know the answer), couple of questions about blood flow that does matter...3-4 xrays, both things I didn't see in my dedicated study but somehow remembered from seeing it in clinic or from anatomy first year. One brainstem, that in my spinning head I somehow mixed up anterior from posterior and therefore got the answer wrong- that one is embarassing to admit to!

This topic would have been almost impossible to study for- I did spend a good chunk of time on it, and knew a decent number of the random questions they asked, but still had a good number I just wasn't sure on. I did not get any basic questions I was expecting (radial nerve injury, foot drop, etc). This was a tough topic, since it is so broad and they can tap into so much! Just spend a few extra hours on it, and hope for the best. You could study a week just for anatomy and still likely miss 1/3 of the questions they ask you!

Genetics: had 3-4 where I had to calculate the odds of their kid having this or that, also 3-4 pedigree based questions. The genetics wasn't too tough, but you needed to understand a concept rather than just have memorized what gene is deleted in this disease (had only one of those, and an easy one).

In summary: I know ~15 that I missed for sure, and I was marking that many in every block so I'm sure I missed waaaaay more than that, I just don't remember what they were so I can't reference em up- if I was a betting man, I would say I missed ~60 or so as a fair estimate. I'm with everyone else that posted about yesterday- that sucker was tough, easily as tough as doing blocks of USMLEWorld. Hopefully, I am having selective memory and am worrying about all those experimental questions (which only maybe 5 stuck out as no way this is a real question)...I guess only time will tell! As long as I passed, I promise I will not cry either way!

I don't want to break down the individual organ systems, since some would be super long and some would have one line. Basically, I'm a pessimist and figured I would pull the things I'm bad at so over-studied those...and lo and behold, that's exactly what happened!! So right now I'm kind of bummed, because I do think my score will be lower than my true potential, but feel like I knew enough of them that I should have passed...now I have to wait a long 5 weeks to find out if I did or not! Now packing to leave for a week long vacation to the beach!

Good luck guys, you'll rock it!

 

[Ju46]

Thanks for the informative post, GI! Would you mind sharing your stats from things you used to prepare (UW %, NBMEs, etc.)

 

[LoveGI]

Thanks for the informative post, GI! Would you mind sharing your stats from things you used to prepare (UW %, NBMEs, etc.)

Sure, no problem putting that stuff up, but understand that I don't have a real score yet so take it for what its worth!

School's CBSE in March: 170 (ouch, I know!)

NBME 7, 4 weeks out: 212

NBME 6, 10 days out: 220

I stopped 'assessing' myself 10 days out so I wouldn't freak myself out, but continued to study hardcore, hoping that I could bump myself above the average by the time of the real deal.

USMLEWorld 91% complete, random, tutor mostly so I could learn what I got wrong so it would stick: 62%, with a severly heavy upward trend- Started in low 40s, was consistently 70-80% in the last 2 weeks

Really hoping to be average or close to it on either side, since I want to try and match into medicine!

 

[utdoc05]

Well took it yesterday, it was the 46q version. Timing wasnt an issue at all really. There were plenty of very short and normal length vignettes, with some of the mixed in long vignettes. Some of the longer ones you didnt need the whole thing to answer but maybe 75% of them you did (example. patient with a history of 5 different cancers and what is the cause of his current metastasis). The test i would say was overall a little easier than world, but there were a few questions each block that just have you scratching your head.

Anatomy: Prob the most annoying part of the test cause they arent really hard but I just hadnt seen some of the material in a while. You can get them down to 2 or so answers and kinda give your best stab. You can maybe run through brs anatomy, i didnt and not sure if it would help.

Embryo: Had multiple "chicken embryo was exposed to this/or this was removed from development --> what is the result" Maybe 4 on the test total.

Biochem: Luckily for me not too many, and the few they had instead of saying aldolase B they said fructose 16 bisphosphate aldolase which made me second guess myself. Overall FA is enough for biochem.

Microbio: Prob 15 questions, def know gram - coccobacilli type descriptions and those charts in FA that have all those spelled out.

Physiology: Lots of the cause effect arrow charts that are all over world. BRS phys is a good choice along with FA.

Path: All over the test, RR path and FA are all you will really need.

Immuno: 5 to 10 questions, pretty straightforward, FA is all you need. CD markers, what immune cell responds and is seen in tissue, things like that.

Neuro: Lots of identify the location of the lesion, had 1 spinal cord section, medial medullary syndrome and a few stroke questions

Repro: A decent amount of clinical scenarios involving pregnant women, had one weird placenta previa with partial placenta accreta question. Besides that nothing too screwy.

Pharm: Not nearly as much as I was expecting and a decent amount of drugs I had never seen before. But its hard to prepare for those really

Renal/Cardio: 10+ questions, media questions, glomeruli stains, images and path questions. Be very familiar with these inside and out

Biostats and Epi: A lot of "what should you say to initiate the conversation" and a lot of the biostats calculations questions (50% easy 50% a little bit more involved) - FA is enough really just know ALL the equations.

75% Usmleworld 100% complete timed and random
75% UsmleRX over 80% complete

cbse in march 208
nbme2 in april 218
DIT started wk 2 of may
After 1 wk DIT - nbme6 234
After 2 wk DIT - uwsa1 244
After 3 wk DIT - uwsa2 256
weekend before test - nbme7 251

Hard to tell how I did, my first 5 blocks felt like every other practice test but my last 2 blocks were tough, hoping I was able to reason through those tough questions. best of luck to everyone

 

[tideleonheart]

very nicely and honestly written...any score you post i would believe
it unlike some of these 250 260 278 lol......my guess is you got somewhere between 200-215

I doubt it... my bet is close to 230.

 

[golfman]

I doubt it... my bet is close to 230.

I would guess 230 as well. 220 ten days out, and studying hard those last 10 days should bump you up a bit. Don't listen to the person who said 200.

 

[pittnative]

Took it yesterday. Immediately after and during the exam I felt pretty good... then of course while cleaning up my piles of notes/books that had taken over my apt I flipped through first aid a bit, and I definitely missed some gimmie questions.

Anyways, as for my general thoughts:
My first 2 sections were fairly easy, and I was getting finished with about 10 minutes to spare so had plenty of time to go back over questions I had marked which was anywhere from 15-20 (I like to mark everything that I may be questioning, including ones that I feel are really easy and I just answer with skimming the question and reading the last line cause I already know what they wanted, so if I had time I would go back and read the whole question just to double check, which actually cost me on one question---see above)

Then they threw the kitchen sink at me... I swear in my 3rd section I had no idea on like 20 questions. It got a little ridiculous and I was thrown off, I spent like 5 minutes on question 7 before I realized what was happening. I made up the time on a few easy ones, but I only had like a minute at the end. And this section had a handful of questions that just took time to map out and think about - someone posted above about difficult immuno questions, well yeah, I had about 5 of those back-to-back. I just guessed a random answer and didn't have time to go back and double-check those...oh well.

I took a break after that section, and it got a little better after that, it could not have possibly gotten worse. I think it was like my 6th section that went extremely well, like I knew everything cold, so hopefully that will balance out my score a little.

As a whole I thought the test was not bad at all, there were maybe 10 that I had never even seen or heard of (like I wouldn't have gotten with my notes/wikipedia even in front of me), and about 10 others that I had known at one point but yesterday had no idea because they were very minute details. And a good mix of questions I was a little unsure about, but had pretty much narrowed it down.

As for each section:
Biochem/Cell Bio: Was essentially non-existent on my test. I had maybe 5 biochem questions, which was a shame cause I knew it so well, and the questions I did have were very random. Cell bio stuff was straight forward, very similar to what I saw on UWorld.

Microbio: Someone above said thank god for Pharm, well I say thank god for Microbio. I mean they were giving away the answers.

Pharm: Like Micro these were very straightforward questions.

Anatomy: I only had a couple of questions, but they were very straightforward.

Everything else was pretty mixed, nothing too crazy stood out.

My practice tests were:

School administered written test: 190 (I didn't take this very seriously and knew I didn't know anything cause I hadn't started studying at all)

NBME 6:236 (3 weeks out)
UWSA2: 236 (2 weeks out)
UWSA1: 247 (1 week out)
Uworld Avg. 70% --> I started out around like 50%, and towards the last week I was doing pretty well with avg. in high 70s low 80s, I had a couple blocks over 90%, and a couple around 70%

I definitely came a long way with my studying, and felt pretty good with the end result. I started off studying pretty slow, and didn't go over everything as many times as I would've liked in the end. I kinda did a condensed Taus method... Here is how I broke it down over the 5 weeks, I had gone through First Aid once in its entirety in about 2 weeks during my last class block:

Week 1: Listened to all the Goljan lectures w/ the RR book + UWorld Random 24 Q blocks
Week 2 - 3: 2nd time through FA, just reading to try to memorize a little bit, and I outlined all of the FA Drugs at the end of each section, which was helpful (and more than enough for the test along with UWorld). I also did 48 Q blocks in UWorld by each organ module after I finished studying it (i.e Neuro, or Cardio). For me, doing random Q's that I had no idea what they were asking was a waste of time, and I was transcribing everything from the UWorld Q's into my FA book, like even the incorrect Answer choices. It took about 3 hours to go through a 48 Q block. This probably helped me the most because I thought the actual test was very comparable to the UWorld Q's in terms of Question set up, etc.

Week 3: Took NBME 6. Outlined FA Microbiology and Biochemistry and Immuno sections. I wanted a good base in the basic sciences because I expected these questions would be very straightforward if I knew the basics, and for the most part I was right, because I felt the Q's I had in these sections were probably the easiest.

Week 4:Took UWSA #2, which I agree with others that this was scored pretty generously, I thought I did not do very well (I missed Q's that I had definitely studied in FA, but just couldn't remember) and got a 236, which I consider a decent score. I started doing everything according to Organ system (Review FA, medications, and listen to Goljan a 2nd time by each section). I was doing Random 48 Q blocks in UWorld.

Week 5: I wanted to review everything from FA one last time. I started with Micro and Biochem, which I think was a mistake. I made it through Repro, Endocrine, Renal, Respiratory, Cardio, and Neuro and Psych in about 3 days, but ran out of time at the end to go over GI, Musculoskeletal, which I don't think hurt too much.

Last day: I'm not the type to just relax and wait for a test, I never have been. So I went over Embryo, Micro, and Biochem and one last time through all of the drugs. I wish I would've payed closer attention to the drugs cause I think I missed a couple easy questions by just getting myself mixed up.

I thought my preparation consisting of First Aid (3 times), Goljan Audio (2 times --> should have used the Goljan High yield notes to listen to the lectures with, if you can get them they are great, I thought the book was too much and didn't have enough time to review it more than once), and all of UWorld just once, but paying close attention to the answer explanations covered everything that was on the test.

My best advice would be not to get too caught up in a bunch of extra sources and not focus on the basics because with a firm understanding of the basics (All of First Aid) you can pretty much reason your way through most of the questions. Like I said there were maybe 10 questions I had never heard of, but unless you want a 265+ your points are going to come from getting ALL the questions that are straightforward, and not making any little mistakes.

 

[TheFranchise]

very nicely and honestly written...any score you post i would believe
it unlike some of these 250 260 278 lol......my guess is you got somewhere between 200-215

So you'll believe a lower score over a higher one because it was "nicely and honestly written" haha. That's good, but remember you're on SDN, and 250+ isn't going to be a rare occurrence.

 

[BenCarson]

yes man, don't listen to what that person said. How does he/she know how you did? Given that NBME 6 underestimates and you studied hard for 10 days there is high probability that you will get 230. Excellent job man.

 

[Ju46]

Though I'd go ahead and post my exam experience, which was two days ago.

I'm always amazed by how much people remember about their exams, question-wise. As soon as I hit the door on the way out, I had forgotten most everything that was on the exam, except for those questions that were really getting under my skin during the exam.

I'll echo the sentiments of those before me who said that the new 46-question blocks didn't play much of a role on the exam. Had no one told me that the exam was different, I wouldn't have blinked an eye at the questions (although a few of the questions were stupid-long).

All in all, I thought the exam was fair and not as terrible as I thought it was going to be. I'd say there were 10 questions or so that were a shot in the dark, and then a large handful of questions (30ish) that were difficult and required solid reasoning to get to the right answer (which I hope I did!) I marked maybe 2-8 answers/block, and felt decent about the others.

As far as my prep stats go, for those interested:
UW: 100% complete, timed/random - 72%
Qbank: 75% (100% complete)
NBMEs: between 234 (beginning) to 255-260 (end of studying)
UWSA: 260

That being said, no idea how I did on the real deal. I'm confused as h*** about how these things are scored and how many you can miss total/per block to get a 240+ type score. Just hope I didn't blow it without realizing it!

 

[LoveGI]

yes man, don't listen to what that person said. How does he/she know how you did? Given that NBME 6 underestimates and you studied hard for 10 days there is high probability that you will get 230. Excellent job man.

Huge thanks to ya, man, and everyone else who is thinking I may have actually beaten the average! I came into this completely honestly (I am in the middle of my class at a really good state school), so I never set myself up saying "Oh, I want a 250+" cuz I knew that wasn't realistic. I just always wanted to beat the average, even by 2 points, and my dream 'realistic' goal was a 230!



I'll try and recopy my post once my score comes in...but honestly, I might not remember since I'll be solidly into surgery by then!

 

[MoscowAbe]

For those who posted their experience, big thanks

I'm curious to know what role did UW play in your prep, and did you find that UW covered a major portion of the exam? Or better do you think UW + FA + RR = Above average Pass

 

[NoWayOut]

For those who posted their experience, big thanks

I'm curious to know what role did UW play in your prep, and did you find that UW covered a major portion of the exam? Or better do you think UW + FA + RR = Above average Pass

Moscow..you're asking exactly what's on my mind... i hope someone answers soon!

 

[Real Name]

I just took it today. Don't get freaked out and review a lot of sources. U world and FA. Goljan is good, but he can make you paranoid. Focus on the common things and know them well! Don't go chasing too many zebras. Also, about timing, I would finish my Uworld sets with about 20 min left to go, but today I was struggling to finish. It wasn't just because the passages were longer either. You are just going to a testing center to take 7 sets of uworld. That's exactly what it was like.

 

[jmayer]

I just took it today. Don't get freaked out and review a lot of sources. U world and FA. Goljan is good, but he can make you paranoid. Focus on the common things and know them well! Don't go chasing too many zebras. Also, about timing, I would finish my Uworld sets with about 20 min left to go, but today I was struggling to finish. It wasn't just because the passages were longer either. You are just going to a testing center to take 7 sets of uworld. That's exactly what it was like.

congrats on being done!

did it take longer because it was more difficult or because u were purposely going slower (since its the real thing vs uworld)?

any other thoughts on the exam overall, particularly anatomy?

 

[Real Name]

I definitely think I went slower because it counted more. As far as anatomy goes, 9/10 questions were in FA. The one outlier was able to be reasoned out. I would not go outside of FA for anatomy. With the exception of looking at brainstem sections and CTs, especially of the brain. Don't freak yourself out.

 

[Phenytoin]

I just took it today. Don't get freaked out and review a lot of sources. U world and FA. Goljan is good, but he can make you paranoid. Focus on the common things and know them well! Don't go chasing too many zebras. Also, about timing, I would finish my Uworld sets with about 20 min left to go, but today I was struggling to finish. It wasn't just because the passages were longer either. You are just going to a testing center to take 7 sets of uworld. That's exactly what it was like.

Thanks for sharing your experience. How was biochem/cell bio? With 9 days left, would you recommend Goljan audio or RR or neither (i've already read it in a first pass but i've recently been focusing only on FA and World)?.

Thanks again.

 

[cushie]

.

 

[MoscowAbe]

Congrats to all you guys who gave the exam already.

Best wishes.

 

[woodhorse22]

Toook my exam today. It was a doozie. I thought it was much tougher than any of the NBMEs i took. The questions were long. The first block was ridiculously tough which really shook my confidence. There were so many I didn't know at all, just guessed. I hope I did well although I dont feel too hot about it. Well atleast I put my best work in it. Hoping for a big curve. ...I am shooting for a 230... lets see i get there...Good luck

 

[ATLNEWDOC]

Despite my status as a longtime lurker, this forum has given me a considerable amount of insight during my board preparation. As such, I would like to add to the litany of experiences.

Method to madness:
• 5 weeks of study post 2nd year
• Performed reasonably well (top 5% of class) throughout first two years
• Standard utilization of FA, UW, Goljan Audio, Kaplan Q Bank (secondary)
• Supplemented resources consisting of Deja Review Neuro (incredible), BRS Anatomy, Klatt’s Review of Pathology, WebPath

Progress:
• CBSE: 220 (8 weeks before end of 2nd year, before Endocrinology or review)
• NBME 7: 247/610 (1.5 weeks of board study)
• UWSA 1: 252/670 (3 weeks)
• NBME 6: 253/540 (4 weeks)
• Free 150: 93% (4 weeks)
• UWSA 2: 258/720 (4.5 weeks)
• NBME 5: 253/640 (5 Weeks)
• UW: 74% Throughout 2nd Year; 88% during study
• Kaplan Q Bank: 76%

The BEAST:
Summarily, I left the testing center feeling humbled, beaten, and dejected. I marked about 30% of my exam (i.e. I lacked 90% confidence, had no idea, or needed to check calculations). While this was certainly more than usual, I consistently received over 50% of marked questions back on practice exams (UWSA and NBME expanded feedback). As many of us speak in relative terms, I feel that it was a majority NBME style questions (50-60%), with the remainder of UW mental jumping jacks (30%) and a healthy bolus of punch in the face.

I won’t spend needless time rehashing breakdowns of my exam since we all know the content varies. While my exam was seemingly all neuroscience and pharmacology, with every other patient either exhibiting a neurologic lesion or pregnancy, yours will most likely differ. Instead I wanted to point out some general observations I made that might provide helpful insight.

Regarding strategy, my major concern was a lack of adequate time for review in most blocks, especially blocks 3 and 4, which was never a problem during practice forms. I actually recall at least two questions in those blocks that I don’t even remember how I answered! While some of this was certainly attributable to the underlying stress of the real deal, there were some other issues at play I can share.

I noticed multiple questions that were seemingly designed to catch “high efficiency” examinees that might be inclined to read the last sentence or two only and draw a conclusion. All of these were initially “answerable” with just the last line, but buried in the vignette was some key element that made the most probable answer, impossible. While I wish I could provide specifics, suffice it to say that if it looks like a duck, walks like a duck, talks like a duck, lays eggs...make sure they didn’t mention you were in Australia. Wow! Every one of these gave me the “oh God, if I hadn’t noticed that phrase moment.”

The other time bandit during my experience arose from my own neuroticism mixed with test writer savvy. Several straightforward questions were written with an ellipsis of trigger words and/or traditional signs and symptoms. While this should never come as a surprise, be aware that in the stressed environment of the real exam, this can cause you to second guess even a solid understanding of core pathologies. I made at least 3-5 errors in this trap.

Additionally, be aware that it seems they take advantage of several deficiencies regarding FA details. For instance, many musculoskeletal and dermatological conditions in FA generalize pathologic etiologies which leave the examiner an opening to inquire on deeper, differential details. Any detailed look at the lower limb chart or dermatologic pathology section should elucidate my point. Likewise, there were several anatomy questions (3-5) simply not located within the pages of FA. Certainly not worth committing the BRS or CAMRS to heart, just be aware.

Hope any of this helps.

As for me, I have confidence in 70% of my exam, the remaining 30% includes both flagged questions and the tallied list of about 15 that I looked up and found incorrect. Yes, I can hear the collective eye roll regarding my neglect of the cardinal SDN rule, “though shall not look up answers post examination...and self flagellate.” My issue is that if I remember those 15, how many did I miss with blissful ignorance? Selective recall sucks.

Cannot believe how irritated I am with myself. Right now it seems like such a waste of two long, hard years that I might have blown it here at the end. I’m struggling to resist the urge to camp in front of my computer (sans shower, of course) until the NBME elite decide to descend from the mount on or about the 15 of July. All I want is my 250. Ugh.

Self loathing aside, I want to express my deepest appreciation to this board and all the SDN posters without whom this journey would have certainly been reinventing the wheel. While “we ourselves must walk the path,” it is so much easier with trailblazers like you.

 

[mq123]

Despite my status as a longtime lurker, this forum has given me a considerable amount of insight during my board preparation. As such, I would like to add to the litany of experiences.

Method to madness:
• 5 weeks of study post 2nd year
• Performed reasonably well (top 5% of class) throughout first two years
• Standard utilization of FA, UW, Goljan Audio, Kaplan Q Bank (secondary)
• Supplemented resources consisting of Deja Review Neuro (incredible), BRS Anatomy, Klatt’s Review of Pathology, WebPath

Progress:
• CBSE: 220 (8 weeks before end of 2nd year, before Endocrinology or review)
• NBME 7: 247/610 (1.5 weeks of board study)
• UWSA 1: 252/670 (3 weeks)
• NBME 6: 253/540 (4 weeks)
• Free 150: 93% (4 weeks)
• UWSA 2: 258/720 (4.5 weeks)
• NBME 5: 253/640 (5 Weeks)
• UW: 74% Throughout 2nd Year; 88% during study
• Kaplan Q Bank: 76%

The BEAST:
Summarily, I left the testing center feeling humbled, beaten, and dejected. I marked about 30% of my exam (i.e. I lacked 90% confidence, had no idea, or needed to check calculations). While this was certainly more than usual, I consistently received over 50% of marked questions back on practice exams (UWSA and NBME expanded feedback). As many of us speak in relative terms, I feel that it was a majority NBME style questions (50-60%), with the remainder of UW mental jumping jacks (30%) and a healthy bolus of punch in the face.

I won’t spend needless time rehashing breakdowns of my exam since we all know the content varies. While my exam was seemingly all neuroscience and pharmacology, with every other patient either exhibiting a neurologic lesion or pregnancy, yours will most likely differ. Instead I wanted to point out some general observations I made that might provide helpful insight.

Regarding strategy, my major concern was a lack of adequate time for review in most blocks, especially blocks 3 and 4, which was never a problem during practice forms. I actually recall at least two questions in those blocks that I don’t even remember how I answered! While some of this was certainly attributable to the underlying stress of the real deal, there were some other issues at play I can share.

I noticed multiple questions that were seemingly designed to catch “high efficiency” examinees that might be inclined to read the last sentence or two only and draw a conclusion. All of these were initially “answerable” with just the last line, but buried in the vignette was some key element that made the most probable answer, impossible. While I wish I could provide specifics, suffice it to say that if it looks like a duck, walks like a duck, talks like a duck, lays eggs...make sure they didn’t mention you were in Australia. Wow! Every one of these gave me the “oh God, if I hadn’t noticed that phrase moment.”

The other time bandit during my experience arose from my own neuroticism mixed with test writer savvy. Several straightforward questions were written with an ellipsis of trigger words and/or traditional signs and symptoms. While this should never come as a surprise, be aware that in the stressed environment of the real exam, this can cause you to second guess even a solid understanding of core pathologies. I made at least 3-5 errors in this trap.

Additionally, be aware that it seems they take advantage of several deficiencies regarding FA details. For instance, many musculoskeletal and dermatological conditions in FA generalize pathologic etiologies which leave the examiner an opening to inquire on deeper, differential details. Any detailed look at the lower limb chart or dermatologic pathology section should elucidate my point. Likewise, there were several anatomy questions (3-5) simply not located within the pages of FA. Certainly not worth committing the BRS or CAMRS to heart, just be aware.

Hope any of this helps.

As for me, I have confidence in 70% of my exam, the remaining 30% includes both flagged questions and the tallied list of about 15 that I looked up and found incorrect. Yes, I can hear the collective eye roll regarding my neglect of the cardinal SDN rule, “though shall not look up answers post examination...and self flagellate.” My issue is that if I remember those 15, how many did I miss with blissful ignorance? Selective recall sucks.

Cannot believe how irritated I am with myself. Right now it seems like such a waste of two long, hard years that I might have blown it here at the end. I’m struggling to resist the urge to camp in front of my computer (sans shower, of course) until the NBME elite decide to descend from the mount on or about the 15 of July. All I want is my 250. Ugh.

Self loathing aside, I want to express my deepest appreciation to this board and all the SDN posters without whom this journey would have certainly been reinventing the wheel. While “we ourselves must walk the path,” it is so much easier with trailblazers like you.

Thanks for posting! I think you've reiterated a few points that other test-takers have made regarding the content of the test (like getting a lot of pregnancy related Qs, FA lacking in MSK, etc). MSK is one thing that I think FA should be enough to cover the the majority of the Qs, ant the rest I'll never learn as well as I did in year 1 anatomy.....

However, thanks also for mentioning the thing about examiners taking advantage of the FA deficiencies. I got lulled into a false sense of calm with the 2 pages of Skin in FA, since the Skin chapter in Goljan is a nightmare for me, but if I only read FA, I'll be focusing on the 'what' and missing out on all the 'why/how' that Goljan is so useful for.... So I agree -- it's very unfair that we get tested on obscure material, but they probably read FA cover-to-cover also and test us outside of that

 

[Domenech]

Despite my status as a longtime lurker, this forum has given me a considerable amount of insight during my board preparation. As such, I would like to add to the litany of experiences.

Method to madness:
• 5 weeks of study post 2nd year
• Performed reasonably well (top 5% of class) throughout first two years
• Standard utilization of FA, UW, Goljan Audio, Kaplan Q Bank (secondary)
• Supplemented resources consisting of Deja Review Neuro (incredible), BRS Anatomy, Klatt’s Review of Pathology, WebPath

Progress:
• CBSE: 220 (8 weeks before end of 2nd year, before Endocrinology or review)
• NBME 7: 247/610 (1.5 weeks of board study)
• UWSA 1: 252/670 (3 weeks)
• NBME 6: 253/540 (4 weeks)
• Free 150: 93% (4 weeks)
• UWSA 2: 258/720 (4.5 weeks)
• NBME 5: 253/640 (5 Weeks)
• UW: 74% Throughout 2nd Year; 88% during study
• Kaplan Q Bank: 76%

The BEAST:
Summarily, I left the testing center feeling humbled, beaten, and dejected. I marked about 30% of my exam (i.e. I lacked 90% confidence, had no idea, or needed to check calculations). While this was certainly more than usual, I consistently received over 50% of marked questions back on practice exams (UWSA and NBME expanded feedback). As many of us speak in relative terms, I feel that it was a majority NBME style questions (50-60%), with the remainder of UW mental jumping jacks (30%) and a healthy bolus of punch in the face.

I won’t spend needless time rehashing breakdowns of my exam since we all know the content varies. While my exam was seemingly all neuroscience and pharmacology, with every other patient either exhibiting a neurologic lesion or pregnancy, yours will most likely differ. Instead I wanted to point out some general observations I made that might provide helpful insight.

Regarding strategy, my major concern was a lack of adequate time for review in most blocks, especially blocks 3 and 4, which was never a problem during practice forms. I actually recall at least two questions in those blocks that I don’t even remember how I answered! While some of this was certainly attributable to the underlying stress of the real deal, there were some other issues at play I can share.

I noticed multiple questions that were seemingly designed to catch “high efficiency” examinees that might be inclined to read the last sentence or two only and draw a conclusion. All of these were initially “answerable” with just the last line, but buried in the vignette was some key element that made the most probable answer, impossible. While I wish I could provide specifics, suffice it to say that if it looks like a duck, walks like a duck, talks like a duck, lays eggs...make sure they didn’t mention you were in Australia. Wow! Every one of these gave me the “oh God, if I hadn’t noticed that phrase moment.”

The other time bandit during my experience arose from my own neuroticism mixed with test writer savvy. Several straightforward questions were written with an ellipsis of trigger words and/or traditional signs and symptoms. While this should never come as a surprise, be aware that in the stressed environment of the real exam, this can cause you to second guess even a solid understanding of core pathologies. I made at least 3-5 errors in this trap.

Additionally, be aware that it seems they take advantage of several deficiencies regarding FA details. For instance, many musculoskeletal and dermatological conditions in FA generalize pathologic etiologies which leave the examiner an opening to inquire on deeper, differential details. Any detailed look at the lower limb chart or dermatologic pathology section should elucidate my point. Likewise, there were several anatomy questions (3-5) simply not located within the pages of FA. Certainly not worth committing the BRS or CAMRS to heart, just be aware.

Hope any of this helps.

As for me, I have confidence in 70% of my exam, the remaining 30% includes both flagged questions and the tallied list of about 15 that I looked up and found incorrect. Yes, I can hear the collective eye roll regarding my neglect of the cardinal SDN rule, “though shall not look up answers post examination...and self flagellate.” My issue is that if I remember those 15, how many did I miss with blissful ignorance? Selective recall sucks.

Cannot believe how irritated I am with myself. Right now it seems like such a waste of two long, hard years that I might have blown it here at the end. I’m struggling to resist the urge to camp in front of my computer (sans shower, of course) until the NBME elite decide to descend from the mount on or about the 15 of July. All I want is my 250. Ugh.

Self loathing aside, I want to express my deepest appreciation to this board and all the SDN posters without whom this journey would have certainly been reinventing the wheel. While “we ourselves must walk the path,” it is so much easier with trailblazers like you.

Your practice scores aren't too dissimilar from mine, and it appears you just spoke my dejected mind. You and I are afloat the same boat. Good luck comrade. Hopefully we'd both sail through it!

 

[proud]

I am finally free! Took the exam yesterday, now it's time to relax

My first block was ridiculously hard. I'm pretty sure they piled all my experimental Q's in there. I had to take a break after it because I was almost in tears, praying that the rest of the exam wasn't going to be like that. Seriously, the first two questions I not only didn't study the material, but I had absolutely no idea what they could possibly be going for.

!!

can you please give at least one example of the experimental Q or Q that you have not heard of????????????????

 

[orthosurgeon]

I am orthopaedic surgeon from India. 2001 IMG. Planning for fellowship/residency in USA.
My step1 score – expecting a 250+
(exam date-June10th 2010; report date- Waiting for the result)
Pre-Exam scores:
•Total preparation time 5months15days; practicing orthopaedics(trauma and joints) 8 hours a day; reading 6-8 hours a day
•Aim- 278/99 because nothing less would even give me at least a distant shot to ortho residency/ fellowship
•Initial 5000 questions, started answering after one reading of all subjects, randomly one question from each file (UW offline 2007, Kaplan Q bank 2007, USMLE Rx 2008, wikiprep, USMLE consult pathology etc) - 78%
•Last 5000 questions, after second reading of all subjects , randomly one question from each file (UW offline 2007, Kaplan Q bank 2007, USMLE Rx 2008,wikiprep, Usmle consult etc) - 84%
•NBME 1-6 offline, started 70days before exam, one test a day, searched for each and every answer myself (considered all my answers wrong for which there is no available proof in print) – Average 92%( NBME 1 to 6- 187, 181, 182, 184,190,182)
•NBME form 7 online, 50 days before exam, in exam mode i.e., one hour3min per block, could manage to write down all the questions in that time, searched for answers in print, got 92% correct , official score by NBME is 620/249
•FRED free 143, 2010 version, 40days before exam - 92%
•UWSA exam1, online, 15 days before exam – 261/750 (82% correct)
•UWSA exam2, online, 14 days before exam – 265/800 (86% correct)
•NBME free 144, 2009 pdf version, 11 days before exam – 142/144 (98% correct)
•NBME free 150, 2006 pdf version( go to google and search; its not in official web site), 10 days before exam – 143/150 (95% correct)
Materials and methods
1.Kaplan 2004 version – read (all except pathology) head to toe 4 times
2.Pathology-
•Got Goljan latest, dint like it. It is actually notes written by him to lecture to students, not to be read by us. Figure are good, but you can see them all free of cost in google, plus may more varieties. Even in real exam, I felt those who read Goljan and nothing else for patho cant do good.
•My preference is Robbins, review version, which is now not available in India, so I could not read.
•Goljan audios are pure gold. He really tells you many things, which you cant catch in any other way. I listened to them 3 times over(33 hours appx) when I go for 1 hr daily walk, every day for 3 months.
•This is the my most well kept secret. CECIL’S ESSENTIALS OF MEDICINE 7TH EDITION. I read it top to bottom twice except for things like arrhythmias, men’s health, woman’s health etc.
•To summarise, best combination is Robbins review + Cecil’s essentials of medicine+ google search for images of all important topics.
3.Genetics/cell biology
•Toughest part of my test was genetics. There were not less than 30 questions. Pedigree charts alone were 10. Not a single RFLP analysis!
•I suggest the serious guys to search and catch hold of a good concise human genetics book and **** it thoroughly and teach these NBME examiners a lesson that you are not afraid of their genetic carpet bombing. Premutations, isodisomy, heterodisomy, gene probabilities, preventive strategies in genetics, inheritance patterns, AR disorders with complete penetrance…. You name it, they had it on test. Days of learning just pleotropy, anticipation, mosaics are not going to get you through260+. If some one is aiming for 260+, genetics is the key.
•Cell biology esp. structural proteins, organelles and their malfunction is stressed.
4.Epidemiology , Biostatistics
•I am research oriented and hence took time to read Katz. Excellent book, but you should have interest and time. It will help you through all the steps( I answered all biostat questions of UW upto step3 with nearly 95%+ score after reading it) and more than that teaches you how to think.
How is the real exam compared to UW/Kaplan ?
•These NBME question writers really know the art (its beyond science now) of framing concept-based questions. I found one question out of 322 which I felt could have been better framed as I could not make head or tail of it, mostly it is correctly framed and I am dumb enough not to grasp it. They wont ask most things directly. Even a simple SSRI mech. of action was complicated by saying transporter polymorphisms bla bla bla.. They are not going to give away the stem directly. Just like a lady’s love, you need to earn it. I read somewhere that they frame questions such that an expert (say for example me when it comes to ortho questions) should be able to answer it without looking at choices. This is the carry home message, ANSWER LIES REALLY IN GETTING THE STEM OF THE QUESTION NOT THE CHOICES. YOU SHOULD BE ABLE TO GET AN IDEA ABOUT THE POSSIBLE CORRECT ANSWER TO THE QUESTION SAY AT LEAST 75% OF THE TIMES EVEN BEFORE YOU LOOK AT THE CHOICES! If you did, NBME examiners will salute you.

•UW is nearly as above when it comes to stem of the question, but occasionally they get carried away taking the stem in to too much of vague nonsense. Because several times you don’t get the answer in the stem! The real difference from real exam is UW makes the choices also equally tough, and not uncommonly two choice are very much possible. Some times I feel certain themes are lifted from NBME. After all we all want to think like NBME examiners, don’t we?

•Kaplan questions are mostly okay, occasionally brilliant, some times very stupid.
•Do every question only in random mode, only after a good reading of ALL subjects once( NOT JUST THAT SUBJECT, QUESTIONS THEN MAY LOOK SIMPLE BECAUSE OF EASY RECALL), annote the essence of it in a text which you can revise in last 20 days. Any thing that you cant revise in last 20days is just a waste of time as far as exam is concerned.
•I don’t want to talk about usmle consult, at least patho part which is pure nonsense, more often than not.
Exam experience
I am used to long hours of operating. Took a 5 min break after the 5th block to empty my bladder, had a slice of bread and lemon tea, came back and finished the last 2 blocks. My advice to all is this- If the current block is really engaging and you are doing good, don’t take a break.

 

[turtles89]

Despite my status as a longtime lurker, this forum has given me a considerable amount of insight during my board preparation. As such, I would like to add to the litany of experiences.

Method to madness:
• 5 weeks of study post 2nd year
• Performed reasonably well (top 5% of class) throughout first two years
• Standard utilization of FA, UW, Goljan Audio, Kaplan Q Bank (secondary)
• Supplemented resources consisting of Deja Review Neuro (incredible), BRS Anatomy, Klatt’s Review of Pathology, WebPath

Progress:
• CBSE: 220 (8 weeks before end of 2nd year, before Endocrinology or review)
• NBME 7: 247/610 (1.5 weeks of board study)
• UWSA 1: 252/670 (3 weeks)
• NBME 6: 253/540 (4 weeks)
• Free 150: 93% (4 weeks)
• UWSA 2: 258/720 (4.5 weeks)
• NBME 5: 253/640 (5 Weeks)
• UW: 74% Throughout 2nd Year; 88% during study
• Kaplan Q Bank: 76%

The BEAST:
Summarily, I left the testing center feeling humbled, beaten, and dejected. I marked about 30% of my exam (i.e. I lacked 90% confidence, had no idea, or needed to check calculations). While this was certainly more than usual, I consistently received over 50% of marked questions back on practice exams (UWSA and NBME expanded feedback). As many of us speak in relative terms, I feel that it was a majority NBME style questions (50-60%), with the remainder of UW mental jumping jacks (30%) and a healthy bolus of punch in the face.

I won’t spend needless time rehashing breakdowns of my exam since we all know the content varies. While my exam was seemingly all neuroscience and pharmacology, with every other patient either exhibiting a neurologic lesion or pregnancy, yours will most likely differ. Instead I wanted to point out some general observations I made that might provide helpful insight.

Regarding strategy, my major concern was a lack of adequate time for review in most blocks, especially blocks 3 and 4, which was never a problem during practice forms. I actually recall at least two questions in those blocks that I don’t even remember how I answered! While some of this was certainly attributable to the underlying stress of the real deal, there were some other issues at play I can share.

I noticed multiple questions that were seemingly designed to catch “high efficiency” examinees that might be inclined to read the last sentence or two only and draw a conclusion. All of these were initially “answerable” with just the last line, but buried in the vignette was some key element that made the most probable answer, impossible. While I wish I could provide specifics, suffice it to say that if it looks like a duck, walks like a duck, talks like a duck, lays eggs...make sure they didn’t mention you were in Australia. Wow! Every one of these gave me the “oh God, if I hadn’t noticed that phrase moment.”

The other time bandit during my experience arose from my own neuroticism mixed with test writer savvy. Several straightforward questions were written with an ellipsis of trigger words and/or traditional signs and symptoms. While this should never come as a surprise, be aware that in the stressed environment of the real exam, this can cause you to second guess even a solid understanding of core pathologies. I made at least 3-5 errors in this trap.

Additionally, be aware that it seems they take advantage of several deficiencies regarding FA details. For instance, many musculoskeletal and dermatological conditions in FA generalize pathologic etiologies which leave the examiner an opening to inquire on deeper, differential details. Any detailed look at the lower limb chart or dermatologic pathology section should elucidate my point. Likewise, there were several anatomy questions (3-5) simply not located within the pages of FA. Certainly not worth committing the BRS or CAMRS to heart, just be aware.

Hope any of this helps.

As for me, I have confidence in 70% of my exam, the remaining 30% includes both flagged questions and the tallied list of about 15 that I looked up and found incorrect. Yes, I can hear the collective eye roll regarding my neglect of the cardinal SDN rule, “though shall not look up answers post examination...and self flagellate.” My issue is that if I remember those 15, how many did I miss with blissful ignorance? Selective recall sucks.

Cannot believe how irritated I am with myself. Right now it seems like such a waste of two long, hard years that I might have blown it here at the end. I’m struggling to resist the urge to camp in front of my computer (sans shower, of course) until the NBME elite decide to descend from the mount on or about the 15 of July. All I want is my 250. Ugh.

Self loathing aside, I want to express my deepest appreciation to this board and all the SDN posters without whom this journey would have certainly been reinventing the wheel. While “we ourselves must walk the path,” it is so much easier with trailblazers like you.

UW AVG 78%
Q bank AVG (40% complete) 78%
NBME 1-7 AVG ~262

You just said everything I feel ATLNEWDOC. I am new to SDN and this is my first post. I took the exam got the new format. It was much much different then I expected.

UW and FA are still the gold standard. BUT, only about 70% of the questions could be answered from those two sources alone. The other 30% of the questions were complete curveball obscure material that I had never seen before or thought it was untestable. Studying for a few more weeks wouldn't have helped because there is just no way to prepare for those types of questions. My best advice is lock down on FA and UW and go with your instincts on the curveballs.

I usually marked about 8 questions on every NBME section. On the real deal, I marked on avg 15 questions per section. Thats a grand total of a 105 questions. So as you can imagine, I am not even confident that I broke 230 at this point. As soon as I came home I looked up around 20 questions and got 15 of those wrong so that was another blow. This is the worst feeling in the world...especially when the answer was in FA.

As far as timing goes, it wasn't a big issue but I could've used more minutes to look back over the 15+ questions I marked in every single section. Just to put things in perspective, I usually finished a NBME or UW section in about 35-40 minutes. But on the real deal, I only had on avg about 12 minutes to remaining to review marked questions.

Wish all of the SDNers best of luck in their studies and I pray that in the end, it works out for all of us. PM or post any questions

 

[coldweatherblue]

^ respect for an immense amount of preparation.

My advice to all is this- If the current block is really engaging and you are doing good, don’t take a break.

this was my experience too.. I did three blocks straight then took a 5 min break, did two more blocks, 5 min break, then finished the last two. I felt like it was a little hard getting back into "exam mode" after the breaks, even though I know I needed the time off. I'd planned on using more break-time but kept hitting "start next block" cause I was feeling good.

 

[Phenytoin]

Thanks for everyone's experience. Of those who have taken the test recently and talk about curveballs that could not be studied for, could you give an example of such a question if you can remember. What subject did these questions mostly test?
Thanks again!

 

[turtles89]

Thanks for everyone's experience. Of those who have taken the test recently and talk about curveballs that could not be studied for, could you give an example of such a question if you can remember. What subject did these questions mostly test?
Thanks again!

A lot of the questions that I had very little to go off of were the anatomy questions. This is probably because it's been 2 years since I took anatomy and I didn't devote much time to studying it. I wouldn't say the anatomy questions were curveballs but just that I just hadn't looked at the material since 1st yr of med school. If you wish to go above and beyond then I guess you can give BRS anatomy a quick read but I would strongly advise against it. Your time is better spent reviewing the pathology, pharm and physiology.

Other types of questions that I thought were difficult were the behavioral science questions. There were atleast 10 questions which gave you a scenario and asked what would you do next or say next. From what I've heard, these are supposed to be easy questions but behavioral science questions were never intuitive for me. I could always get it down to two and usually end up picking the wrong one.

A classic curveball question that I remember right off the top of my head was a pharm question which required to you know the definitions and characteristics of the different drug schedule classes. Now I don't about you'll but this information was not covered in our curriculum. I thought this was more of a step 2ish type question.

 

[coldweatherblue]

x2 on anatomy. I had a couple questions describing a very vague injury, then giving a clinical test (eponym) that'd I'd never even heard of and asking to ID the defect. The anatomy was all clinical.. best way to study for that would maybe be to read an ortho pocketbook? but who has time for that..

 

[pntgrd]

I took my test last week and also had some curve balls. Many though are probably experimental, at least I hope. Perhaps some step 2 type questions are there to ascertain the difference in knowledge between 2nd year and 4th year medical students.

On the other hand, I have never actually seen evidence that 48 of the questions are experimental as some people claim. Does the NBME actually say there are this many experimentals?

 

[Phenytoin]

A lot of the questions that I had very little to go off of were the anatomy questions. This is probably because it's been 2 years since I took anatomy and I didn't devote much time to studying it. I wouldn't say the anatomy questions were curveballs but just that I just hadn't looked at the material since 1st yr of med school. If you wish to go above and beyond then I guess you can give BRS anatomy a quick read but I would strongly advise against it. Your time is better spent reviewing the pathology, pharm and physiology.

Other types of questions that I thought were difficult were the behavioral science questions. There were atleast 10 questions which gave you a scenario and asked what would you do next or say next. From what I've heard, these are supposed to be easy questions but behavioral science questions were never intuitive for me. I could always get it down to two and usually end up picking the wrong one.

A classic curveball question that I remember right off the top of my head was a pharm question which required to you know the definitions and characteristics of the different drug schedule classes. Now I don't about you'll but this information was not covered in our curriculum. I thought this was more of a step 2ish type question.

Thanks for clarifying! I guess there is no way to prepare for those and it's just the luck of the draw.

 

[free_radical]

UWSIM1: 248
UWSIM2: 253
Real Deal: 247/99

Modified Taus. Most focus on just reading and rereading FA.

Scoring in the 80%'s on UW.

Gave myself 4 weeks to study.

Looking to go into radiology; hoping this'll do it.

G'luck to y'all.

 

[badasshairday]

UWSIM1: 248
UWSIM2: 253
Real Deal: 247/99

Modified Taus. Most focus on just reading and rereading FA.

Scoring in the 80%'s on UW.

Gave myself 4 weeks to study.

Looking to go into radiology; hoping this'll do it.

G'luck to y'all.

Thanks. When you say you were hitting 80s, that was that the last several blocks? Also did you redo wrong questions? How long after finishing UW did you take the exam? Did you read Goljan as Taus recommends the last two weeks?

Sorry, that was like a rapid fire question sequence. lol.

 

[hartbot]

This orthosurgeon just scared the crap out of me. Somebody please reassure me that I dont have to read 2000 pages of an internal med book, or even Robbins to do well on this test

 

[1nycdoc8]

A classic curveball question that I remember right off the top of my head was a pharm question which required to you know the definitions and characteristics of the different drug schedule classes. Now I don't about you'll but this information was not covered in our curriculum. I thought this was more of a step 2ish type question.

yeah we unfortunately had to know this, not like any of us remember it though. Congrats on being done!

 

[Starshope]

This orthosurgeon just scared the crap out of me. Somebody please reassure me that I dont have to read 2000 pages of an internal med book, or even Robbins to do well on this test

He wants a 280...so yea...I suppose if your goal is a 280 you can do that. As for the rest of us I dont think that is all that advisable.

 

[_T_]

for those that recently took the test and noticed the extra anatomy.. do you think the moore blue boxes would be sufficient?

 

[DRJJ1]

This orthosurgeon just scared the crap out of me. Somebody please reassure me that I dont have to read 2000 pages of an internal med book, or even Robbins to do well on this test

the guy hasn t been studying for 9 yrs and scaring people
with 280 test target,,does it seem unreasonable? sure does,,why? cause if he was so on top of things don t you think he would have sat for the steps earlier? be cautious of claims being made

many mean well but many are overzealous in their predictions

 

[vicinihil]

This orthosurgeon just scared the crap out of me. Somebody please reassure me that I dont have to read 2000 pages of an internal med book, or even Robbins to do well on this test

Read it and let us know how it goes.

 

[tachyon34]

i just took the test.... i thought i got ROCKED hard. There were so many questions that I just had no idea what was going on.

several drugs I have never heard of.

I also got a LOT of neuro (at least 8-9 questions on seizures) although it was doable and very little biochem.
I got some crazy anatomy questions, but those you cant really prepare for.
A lot of random questions though that I have never seen anywhere (goljan, UW, FA, School, etc)

I had a 253 on practice tests and 76% on UW going in, but now i don't know. It feels like I prepped as much as i could but in the end all the questions were ones that I had to guess on or were really simple

one piece of advice... even though there are 46 questions now, the test takes SIGNIFICANTLY longer to get through almost every question is now a large paragraph type. (i used to finish world with 10 minutes to spare to review answers) whereas on this test I barely had time to finish at all, so be aware that they took out the One-liner questions and replaced them mostly with long vignettes

 

[TheLesPaul]

I took it today -- overall, a good experience, and I thought the test was very fair. Know your equations! Well!

I also accidentally locked the key to my locker inside the locker, and had to get the proctor lady to get a bolt cutter and cut it open -- apart from that snafu, excellent day. Good luck all .

 

[badasshairday]

I took it today -- overall, a good experience, and I thought the test was very fair. Know your equations! Well!

I also accidentally locked the key to my locker inside the locker, and had to get the proctor lady to get a bolt cutter and cut it open -- apart from that snafu, excellent day. Good luck all .

Which equations did you have in particular? The general biostats stuff? Or are you talking about repitory/renal physio?

Also would you mind sharing how you felt it was like compared to UWORLD? NBME's etc. Your scores on those. Thanks.