Discussion in 'General Residency Issues' started by Call Me Dr., Nov 23, 2014
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Discussion in 'Step I' started by amavir281, 02.15.12.
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Thanks bfg. Hope to pick up pace.
Agreed. I doubt they will do that, and from subsequent responses it seems like just heart sounds is what's shown up on the real deal so far.
For those wondering, the Kaplan questions with video have been pretty obvious so far, for example the Babinski reflex shown.
took the beast. i'll post more when i get my score back.
overall though, it felt like a little tougher version of the NBME's. just a few WTF questions. a few questions that were veryyyy picky on detail. most of the difficulty was the fact they ask questions in the most ass hat backwards way. even if i studied for another year or had my book in front of me, it would not have helped. its annoying that they do this and i really feel the only reason they do it is to generate a curve. otherwise most of us would get 80-90% of the questions right.
there was also a question on pharmacokinetics that had no correct answer which shocked me. i can guarantee every answer choice was wrong. i was pretty sure i knew what answer they were looking for, but it wasn't scientifically correct! anyone know if there is a way to contact them about a particular question?
and i wouldnt worry too much about the moveable heart sounds. i was able to answer the heart sound questions without even listening (obv i did anyway).
anatomy is one area where FA/Uworld is probably not enough. I used gunnertraining and some class notes to supplement, so I can't speak to BRS. Some resource is probably necessary though.
there were some weird anatomy questions. its tough to prepare for those. you really have to hope they ask you stuff you happen to remember. i think your best chance with anatomy is learning it really well the first time around
Jason E and DoctwoB,
Any thoughts on CT scans, or weird brain cross sections for neuro. It seems like most of the neuro questions are asked via CT, MRI, Cross sectional images or via drugs. Any particular advice regarding those?
I have checked out couple of med school links that were posted here on SDN but it seems way too many scans. Perhaps just focus on the ones in U world?
they didnt ask anything too fancy, IMO, if there was an image on the test, it wasnt anything picky. i think kaplan neuroanatomy did a great job
and i also think the test was pretty balanced. i know people post about how their test had a ton of anatomy or biochem or whatever, but it seemed even to me. just like the nbme's
Took el nino (step 1) about a week ago. I have no idea how it went honestly, lots of gimmes but several that I could only narrow down to two decent sounding answers. I can only remember a handful of WTF questions. I plan on doing a full write up when I get my score back. any questions are welcomed
Thanks.. Also i think, when people post about having too much anatomy etc its probably because those were the questions they struggled with on the test. Or perhaps got 2 or 3 in a row or even in a block that they did not know. So perhaps thats why it seems overwhelming. And negative / unpleasant experience is always magnified.
Good advice. Thanks.
Considering the NBMEs played a significant role in your prep, would you recommend buying them in untimed-mode (in order to review actual questions later on) or timed-mode? Same with UWorld; I noticed you did timed-mode for that. Would you recommend that over tutor-mode?
I find posts like this entertaining for some reason. It's kind of like if one of our friends gets ketchup on his white suit, we laugh, but in actuality we're all scared s***less of this happening to us as well.
I'm sure those were probably experimental questions. Or at least I hope so.
For the NBMEs, I never took one untimed so it is hard for me to say. I did consider it, exactly for the reason you mention. You could try one untimed and see what you think. Obviously, it detracts from their ability to predict your score. What I did was, as I was taking the exam timed, I'd jot down a few notes about questions I wasn't sure about. Since I took the exams with expanded feedback, I knew which one's I got wrong. Anything that I had jotted down that wasn't in my missed questions, I knew I had gotten right. I thought this worked well. For Uworld, I can't speak to tutor mode. I chose to random timed unused, because timing was an issue for me and I wanted to simulate the real thing. Also, most studies show that variable practice is better than blocked practice. I will say that a drawback to random/timed/unused, is that you don't feel like you are learning things as well, even though you actually are. I found this affected my confidence somewhat.
Try out a screenshot program. Or try poking around some of the IMG websites for offline copies.
My experience of the test:
NBMES & UW, UWSA were GOLD! Questions jumping out straight. Nbme 6 7 11 12 13
Revise UW- worth the time
Marked Nbme questions make a quick note to go thru again since they are not given in the incorrect list. You want to be sure what you did.
Anatomy- Images CT MRIs -identification of the questioned part directly(had abdomen 2-3)
Media radiological image with a clue in stem , gross specimen
Rest you could guess with stem- limbs - nerves , muscle actions
Neuro Anat- CTs MRIs - UW was helpful, can add a source for images
Molecular biology- FA inadequate . There were obvious experimental questions I took guesses presuming they were not counted -instinct based! Brush up from a source you already did.
Biostats. - Straight forward - half - Types of studies,formulae -FA fine
Applied- half the questions
Know your definitions at spinal level.It will save time and divert it to required ones
I was by default bad at Biostats. Your score can improve with these"extra" qns.
Beha sci and Ethics- were pretty straight forward- know - defense mechs, behavioral
patterns, basic addictive drugs signs
Immunology- Immuno path FA good enough. All systems immunology based questions were
there which you would have covered anyway.For basics follow your source.
Everything to do with MHC 1 & 2 read.
Genetics- were dealable with pedigree qns and modes of inheritance, molecular based some
Media based- Heart sounds normal & abnorm with good clues in stem , Chest X-rays
Graphs- patho phys, pharmac mostly. Applied questions- based on FA & UW - glance thru
Gen path & Gen pharmac sections of FA - HY
Rest FA was ok. I used Kaplan for foundation tho long back.
HY of HY to review last
Malignancies of all organs incl molecular facts,gross,histo,genetics
Phacamatoses, Multiple sclerosis,cystic fibrosis,turners,Congenital MR,
Chest X-ray/ CT of lung diseases
Immuno deficiency diseases
Biostat types of studies,formulae
Neuro UW/ other CT images ,Neuro embryology
Limb -nerves, muscle actions
UW all images , graphs
Abusive drugs signs and withdrawal
Everything of alcohol incl biochem enz CTs behavior.........a few to name
My outcome might have nothing to with my experience, this is just to contribute! I don't want to think about the result yet.
Are experimental questions even real? Or are they just med student folklore?
If any questions were experimental, I would think they'd be more based on question-style rather than actual content.
My guess would be that the "experimental" ones are those where they incorporate either a novel method of asking the question (e.g. video, multi-location heart sounds, etc.) or 2CK material (to see how much we've learned clinically, earlier than expected, perhaps in an effort to conflate future testing material somehow).
Hey, everyone who's taken the exam or is currently doing Uworld Qs. Is pathoma + DIT suficient to know everything you NTK for the exam or do I need to add RR pathology to the mix?
I've come across several flavors of these so far:
The most notorious type are the hardcore genetics questions entailing experiments on mice. These require a thorough knowledge of gene modification, cloning, etc. Answering them requires either an intimate familiarity with genetics, or studying pages 85-86 in FA 2012, the last two chapters in Kaplan Biochem lectures (whatever # they may be), knowing how to apply that information, and a bit of luck.
Another type of experimental question is something obscure - say, a random gene. Remember the FOXO3? Best way to answer these would be to troll this and the 2011 official experience threads.
A third type is the super-specific question, in any subject. These may or may not be experimental, but they are certainly ridiculous enough not to count wrong. Two examples on my test were a question about the specific organic chemistry reaction behind a drug splitting into its metabolite, and a question about the specific chemistry behind a drug interacting with a receptor. You could probably reason some of these out to a degree, but either knowing the subjects down to the trivia (akin to what you were doing on your respiratory epithelium thread) or lucky guesses would be the key here.
Yeah, but why would any of that make the questions "experimental?"
There are obviously going to be minutiae questions in genetics, biochemistry or whatever subject, but that merely makes them curve-defining, not experimental.
Unless any of us were actual test-writers, I'm not sure we could post definitively as to what the exp. ones actually are.
Experimental here is used interchangably with "unreasonably difficult for step I." Even First Aid, in the Difficult Questions section of its first chapter, states that between 10 to 20% of questions have been marked "experimental" on past exams and did not count towards the final score. I haven't seen or heard of questions being asked in the novel ways you describe, nor of clear-cut step 2 material tested. I definitely have seen questions testing extreme minutiae and questions of such obscurity I couldn't find the answer even after extensive searching online.
just to chime in, ive looked up some of the questions i got and some of them did not have a clear answer. total BS
This is indeed BS. I wonder if there is any way to dispute an answer. Probably not though.
Question: Is there a urine or a drug test before the test? Or just finger prints like the MCAT. Thanks!
They actually do a punch biopsy on the site using generalized anesthesia and then a follow up with a confirmatory bone marrow biopsy using crack cocaine as an anesthetic. After which they do a hair based drug test (which will definitely be positive from all the crack cocaine).
On my exam, the difficult questions were the extremely obscure questions that AndyRSC is talking about. Stuff that is pure trivia. Like obscure autoantibodies and their targets, very specific genes or gene products, stuff like that. The answer choices were all absurdly specific, making it impossible to reason through a good guess if you didn't know the answer.
I can't see how these questions would be "curve-defining", because let's be honest -- we all use fairly similar core materials with a finite set of content. The obscure questions on my exam were light-years away from that content. I looked up one, and had a hard time finding any information on it outside of pubmed (and this is a specific protein we're talking about).
Those questions are experimental, or the test-writers were writing completely unreasonable questions.
Bear in mind, these questions were in the extreme minority on my exam (3-4 tops thinking off the top of my head).
Ha, yeah, it always reminds me of those UWorld questions where there are five answer choices and only 18-19% of people answered it correctly. I'm always super-proud of myself when I get those right, but honestly, I probably don't have any better than 20-25% success on them.
Yeah, so I took the exam yesterday. It was hard as hell. I had talked to a few friends before the test and they had warned me that on their tests certain blocks were super hard and others were easier. My first 3 blocks were ridiculously hard. Ridiculous. I would say 25% of the questions were things you could have learned from First Aid. I kid you not - 25%. So many experiments and random facts and molecular bio and 3 step reasoning questions. Literally like 5-10 actual 1-2 step reasoning questions on each of those blocks of out 46. Not stuff you could have studied for, no way a ton more studying on my part would have helped more than a little bit on those sections. I am hoping this was all experimental (haha maybe that is just me being delusional). I have no idea what resource you could use to prepare to these types of questions.
The last 4 blocks were much more what I had expected in terms of content. Lots of 1-2 step reasoning questions, although still lots of questions you had to think hard about and definitely still a lot of stuff not in FA. I had a 5 or 6 very hard anatomy questions, 1 that I knew for sure because it had been in first aid. The other questions were so obscure that if I would have put in another day studying anatomy hard I think I would have known the answer to 1 or 2 maybe.
I had timing issues throughout the whole exam because a lot of the question stems were very long, as others have mentioned. I also had a Ton of graphs, and definitely not things you could have picked up from first aid. If you are weak at reading graphs you better brush up before this exam cause they love them.
I had 1 question straight out of UWorld. I didn't read back over my q bank because I ran out of time and I do regret that.
They are very good at presenting things in ways that are not obvious, that they know you haven't seen before, really seeing if you can make educated guesses based on what you know. I don't know what the best way is to prepare for those types of questions. My test was Very heavy in biochem (a bunch of these were in first aid and I just missed them because I hate/suck at biochem). I know that everyone's test is different, I studied so many things that didn't show up, I definitely felt like I couldn't show how much I know.
I also think I understand better now why people fail if they are just going off of memorizing FA - a lot of what they are doing is really trying to tease out your actually understanding of things. Goljan audio was helpful for this. Or they would pick these tiny details that only a super gunner would know - I don't know what would be helpful for learning these little obscure facts, like others have said I guess starting studying in first year and just going for volume of information.
My advice to people who have a decent amount of time left would be to really focus on the q banks, and make sure you understand the 'why'. And to those taking it soon, just be prepared for them to ask you a million things you don't know and don't panic because lots of people have had similar experiences.
Thank f*ing god this is over, I'll post when I get my score. Cheers!
What resources did u use? and can you post your practice exam scores?
I used FA mainly, I watched all the DIT videos and listed to about 2/3 of the Goljan videos. I made it through 60% of UWorld qbank throughout the school year (only doing organ systems stuff as we did it in school) and then reset it and made it through 60% again, trying to hit up most of the questions I hadn't done over the school year. I had aimed to do all of Uworld (and Kaplan haha) but I ran out of time. DIT was pretty good to drag my ass through first aid the first time through but I found a lot of it pretty frustrating because he would literally just read FA out loud (and fast!) and that is not helpful at all imho, it would take me 6 hours to get through one 1.5 hour lecture sometimes because I would stop and try to actually review the subject. I had 5 weeks off to study which was definitely not enough time, I really wish I would have started really studying earlier. Starting out I was decently strong in 2nd year systems subjects (we had NBME exams for almost all of our classes this year and my percent corrects ranged from 80-94 with most being upper 80s on those exams) but very weak in Micro/Biochem/Heme/Immuno/Pharm/Embyo, (all the first year stuff - I wasn't a science major and I felt a pretty steep learning curve starting first year) - those are big guns not to know going in, I think that hurt me for sure. About 2 months before my 5 weeks off I started trying to go over the subjects I was super weak in but I didn't get that far with all my normal school stuff to think about. I only did 2 practice tests because I felt so short for time (technically 3 if you count the school sponsored CBSE I took back in February before I had started studying - on that one I got the equivalent of 190, just passed).
On UWorld Self Assessment 1 I got 236 - that was about 3 weeks pre-test
NBME form 11 I got a 238 - 2 weeks pre-test
I had wanted to do another form but yeah, ran out of time (notice the theme!).
Thanks for the response, a lot of people feel the way you did after the exam, i'm sure you did fine...a few more questions lol...did u use rapid review, brs, or any other books besides First Aid?
And did you use any other videos, like pathoma, usmlerx, kaplan hy?
What were you averaging on the uworld toward your test day?
I did watch some Kaplan videos - parts of Micro/Biochem/Immuno- maybe 25% of Biochem/Micro and 60% Immuno, but that's it. No other resources.
You're making me feel bad... lols.
On UW my average now says 67% correct but I skipped/omitted a bunch of questions (I would start blocks and not finish them - not sure if that is factored in) and also was trying to move fast at the end and so I would read the question click randomly and then read the answer so that probably brought the average down. Sometimes I would do really well on blocks, sometimes I would do bad, usually if I did a big block of pharm I was still only averaging like 50% at the end but on others I would get in the 90s. I also didn't go back over almost any of the subjects that I am actually good at, I'm sure the average would have been higher if I went back over the organ systems.
I also Hate studying, I'm super ADD - like Super - I can't sit for more than 5 minutes without being horribly board and feeling extremely distracted so this whole process was a bit of a struggle.
lol didn't mean to make you feel bad, was just wondering because i'm pretty much using First Aid and uworld only, haven't really watched any videos or used any other sources
No worries, I was just kidding I think if you can understand what's in FA without extra sources it's enough, I just needed a little boost on certain subjects because I had holes in my understanding. I'm just not a gunner, never will be, although I admire people who can study all the time without a gun to their head
it sounds like you'll do fine. I'd imagine you did similar to your practice tests and your last NBME is good.
As for feeling you had a holes in your understanding on certain things...it seems like that may have been the case due to your study plan? It seems like you used many different resources but didn't complete any of them. If you do that, of course you'll have random holes in your knowledge. Everyone tells me to pick a few good resources and finish them to completion or else you'll have holes like you're saying.
But what do I know? I'm starting my 5-week hardcore studying tomorrow! I'm sure you did great!
Thanks! The holes for me were from what I missed in first year, not so much not finishing study materials. I did go over first aid 3 times total but after 2 times certain things - amenias for example, were still just a big ????? until I listed to Goljan's heme lectures (which I Highly recommend). First Aid really is a skeleton and if you don't understand a concept you aren't gonna understand the cliff's notes version of it. Although I definitely agree that sticking with one study method, if it is complete, is a much better way to go than jumping around. I bought a whole mess of books and flashcards and didn't use almost any of it and all it did was give me anxiety about how I should look at the stuff. The issue with the available prep materials that I've seen is that everybody does different things well. DIT's cardio lectures were really good actually, better than Goljan (different, but better in my opinion), but DIT's Heme was Horrendous. I'm sure there is a method out there that covers all subjects well, maybe it's Kaplan - their videos seemed very thorough from what I could tell, but I think if you added up the lectures hours for Kaplan I think it would be a couple hundred or something? I just didn't have time to get through it all, I realized that early on so I just tried to use them for subjects I really didn't get the basics of and switched to DIT which moved at a faster pace and used FA which I knew I would have to go over anyway. I would say to definitely make Qbank a priority, I'm sure you've heard that a million times now. They really help you get a sense of what you understand and what you don't. Good luck! I don't envy you!!
Everybody talks about annotating UW into FA. I was wondering when you annotate, did you write down everything that was not included in FA? Just what you did not know? Or did you just write down the key concepts/key teaching points? I'm not sure what is too much as far as annotating from UW. Do people just throw tons of additional pages into their FA? Thanks for your help. Congrats on the amazing score.
Doing questions is huge.
Annotate into FA: 1) anything you don't understand entirely (which means all of us should be annotating A LOT) or 2) any detail you pick up in a question that you know is not in FA (because you should absolutely do a cover-to-cover pass of it before even starting questions, so you should be aware of what is unique to the QBank vs already in FA), no matter how minuscule.
I find the "minuscule" info contains a lot of the "whys?" The annotations and answer explanations, following each question, are as important as each question itself.
As holyhekshler has pointed out, knowing FA is just not enough. After you've done lots of questions, you realize that most things, conceptually, ultimately converge back onto FA, but the core concepts and details aren't in the book. You need to do thousands and thousands of practice questions.
I used multiple colors...one for World, one for Kaplan qbank, one for Goljan (if I found some facts in there I wanted in my FA; I did not comb through Goljan though), one for random stuff. I would write in facts that weren't in FA, and would highlight facts that were in FA that I got wrong. Worked great for me. Helped me systematically memorize most of FA simply because when I'd re-read it, the stuff I got wrong or was heavily tested in World popped out at me.
Does 2090 count as thousands and thousands?
Don't you think it's best to let those who have taken the test give advice?
i've done 13000 questions and I agree with Jack. Where the 260 rain makers at? Let me know the dets
Thousands and thousands requires a minimum of 4000. You have done a little over 2000, I believe that counts as thousand and thousand of questions...another example is someone who has done 3000 questions, they have done thousands and thousand of questions...You have done thousands of questions though, two thousands to be exact. Wow, did I really just type all that? I've been studying too long today. Well, now that I've typed it I may as well post it...
Took step last Thursday. My prep consisted of FA, World (twice), kaplan qbank (75% complete) Kaplan videos for biochem, behavioral science, molecular bio, immuno, and some pharm (cardio, neuro, psych, and muscarinic/adrenergic), pathoma and Goljan audio. Over Christmas break, I listened to all of pathoma and all of Goljan audio then had about 7 weeks to study after classes ended.
Finished World at 73% the first time
USWA 1 (7 wks out): 216
NMBE 11 (6 wks out): 228
NMBE 7 (5 wks out): 228
NMBE 6 (4 wks out): 238
NMBE 12 (3 wks out): 238
NMBE 12 (2 wks out): 252
USWA 2 (1 wk out): 263
The actual test -- it seemed pretty straightforward. I feel like 60-70% was really, really easy, roughly 20% made me work but I felt "good" about them, and then 10% were 50-50s for me. I think World tests pharm and micro significantly different from actual step. I do think FA was really good for micro and the kaplan qbank seemed more in tune with the way they wanted to conceptually test micro. I thought the kaplan videos were really solid for pharm and taught you how you would be tested on step 1. I felt like there was an emphasis on things like antibiotics (esp HIV), cardio drugs...very straightforward like patient presents with blah blah blah what should you give them or some adverse reaction after they had begun treatment. Overall, I'd just say have a plan, trust your plan, and try to keep as calm as possible. I think Goljan's HY (like 36 pgs) stole me 10 or so question on really random stuff I didn't know. I thought I was wasting my time the day before the test but it ended up paying off. Best of luck everyone. It is a tough process and am very thankful to be finished with it.
Thanks for sharing your experience. Can you please give some idea about how many UWorld Qs and how much First Aid you were doing on daily basis in the last 5 to 6 weeks of your preparation or whatever your daily study plan was.
Duke, this is exactly how I feel right now. Took it today (well technically, yesterday, I guess, since its 4 am and Im still awake obsessing about it...haha).
Left it feeling pretty good, like "hey that seemed pretty damn easy compared to what I expected and compared to some UW Qs" etc, but then thinking back I remembered saying to myself during the test - damn I definitely KNEW this at one point and SHOULD know it, and OTHER people probably know it, but Im guessing here... and knowing that I got some of those easy ones wrong and worrying about the "easy curve" (if that is indeed an actual phenomenon) is killing me. You would think coming out of an exam feeling like it wasnt super hard would be a good thing!!... haha. Ugh.
Really interested to know how things turn out when one "feels it was too easy, and yet also knows they got things wrong," as I am in the same boat.
So even if you choose not to post your results, would love to hear what happens via PM if you are comfortable sharing. Would relieve some anxiety hopefully! And happy to return the favor of course.
Well, I should be able to help you out in a week or two when I get my scores back. I studied like mad for this exam. I've never really applied myself to the best of my abilities before like I did on this test. Average MCAT, average undergrad GPA, average med school grades, but I feel like I have never really tried. I studied my ass off for Step 1 so hopefully it will pay off (at this point I'm gunning for an incredibly competitive specialty).
I don't really remember too many specifics from the test (took it almost 2 weeks ago on Thursday), but I do remember thinking "wow, this *$&% seems way too easy." And that worries me for some reason. There might have been 1 or 2 questions total where I literally had no idea and had to blindly guess. So not too many WTF questions on mine.
I took about 3 months to study, basically following the TAUS method exactly. FA and UWorld were my main study sources, along with Goljan RR. I also listened to all of the Goljan audio, some of them twice. A few of the other books I found helpful were CMMRS, Biochem RR, Lange Review of Micro and Immuno (only for the immuno portion), and I glanced through HY Anatomy.
For qbanks, obviously UW (almost made it through the questions twice - final % of 71, I think). I would normally do 2 blocks every morning, timed tutor mode. I added USMLERx late in the game with about 3-4 weeks to go and I would say it was moderately helpful, more of just a change of pace from UW. I only completed about 25% of USMLERx - all of the questions I did on "hard" mode.
As far as practice exams:
The one we took through our school (>2 months out - no real heavy studying before): 185
NBME 6 (4 weeks away): 226
NBME 11 (3 weeks away): 235
NBME 12 (10 days away): 254
So my scores were kind of all over the board, and I was afraid to take another one closer to my exam after scoring that 254 - because anything less would have just freaked me out. So hopefully the trend continues upwards! (doubt it though, I'd be happy with a 240+).
So, in summary:
I'll report back with my scores shortly
My advice isn't blind. I don't need to have already sat the exam to know what's going to work.
You've probably already seen this post, but it's all right here:
Very interesting. I have that PDF on my computer and hadn't really thought about looking at it, but that sounds like a great idea for the day before! Awesome that it paid off for you.
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