Preparation for step 1 thus far...why am i not breaking a 250?

[router1]

My preparation for step 1 thus far, started in november

Kaplan videos x1 (except path)
DIT x2
Goljan rapid review cover to cover x2
Goljan biochem book x1
pathoma cover to cover plus videos x3
immune section of review of micro and immuno x1
Uworld qbank x1
Kaplan qbank x1
First aid x4 or some sections x5

nbme cbssa: 220
Nbme 12: 228
uworld self assesment: 224

Coursework
Mostly As first two years with a few Bs

Why am i not breaking a 250 after doing all of this work? so discouraged

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[lrkoehle]

My preparation for step 1 thus far, started in november

Kaplan videos x1 (except path)
DIT x2
Goljan rapid review cover to cover x2
Goljan biochem book x1
pathoma cover to cover plus videos x3
immune section of review of micro and immuno x1
Uworld qbank x1
Kaplan qbank x1
First aid x4 or some sections x5

nbme cbssa: 220
Nbme 12: 228
uworld self assesment: 224

Coursework
Mostly As first two years with a few Bs

Why am i not breaking a 250 after doing all of this work? so discouraged

With all that work, it seems like your knowledge base should be sufficient to be hitting the 250's. Are you having trouble deciphering exactly what the questions are asking? Making too many silly mistakes? Mental Fatigue mid-way through the practice exams?

How were your scores on UW and Kaplan?

 

[ijn]

When you say First Aid x4 or Pathoma x3, what does that mean? You've simply read it or can you actually recall and integrate that knowledge without looking at the page?

 

[router1]

Read it and made an effort to recall information from the page without looking at it. Also uworld and kaplan scores...started in the late 40s and early 50s. was hitting 70s towards the last few blocks of uworld and kaplan i.e 72 or 73

 

[router1]

I guess the only explanation that I can think of is that I am a f**king ******ed mule.

 

[Blue Saphire]

I guess the only explanation that I can think of is that I am a f**king ******ed mule.

If it makes you feel better, I am in a similar boat. Have been working very hard, but didnt see that translate in UWSA 1 and 2. Have done some random NBME questions offline but no full NBME exam yet. Its very demoralizing I know

 

[lrkoehle]

I guess the only explanation that I can think of is that I am a f**king ******ed mule.

I definitely don't think that's it...a mule getting into medical school surely would've made national news and I would've heard about it.

It is kind of difficult for us to truly assess the source of your problem. As I said above, with all that reviewing, it seems like your knowledge base SHOULD be good enough. However, maybe you're lacking on the details necessary for putting you into that 250+ range? I am just now making my first pass through FA 4 days out from my exam, and I can say it definitely lack the details required to push into the 250+ range without some serious annotating. Still, your other sources should help you in that regard, and the practice tests should point out any glaring weaknesses you may have in certain areas (which if there are some, make sure to address those obviously).

The more likely problem for you may well be your approach to answering the questions, and, again, you're going to have to identify what's going wrong. Are you not reading the questions carefully, are you not able to translate from NBME-speak to English to figure out what they're trying to ask, not reading the answer choices carefully, are you feeling rushed to answer the questions quickly, or is it something else?

I wish I had a more specific answer, like do this and your problems will all be solved, but you're going to have to analyze what's going wrong and then work on it. If you have a more specific idea of what is going wrong, I'm sure people on here who have gone through the same thing can help. Like if you're feeling the pressure to answer the questions quickly so you don run out of time, maybe do some questions in untimed, tutor mode and see if there is improvement. Or you could do shorter blocks and build up to maintaining your speed and accuracy throughout a full 46 question block.

Good luck.

 

[san2]

You need to look at Kaplan MedEssentials and use alongside First Aid (in addition to Pathoma) if you wanna crack 250.

Also complete Uworld and Kaplan Qbank

 

[RedSoxSuck]

I definitely don't think that's it...a mule getting into medical school surely would've made national news and I would've heard about it.

It is kind of difficult for us to truly assess the source of your problem. As I said above, with all that reviewing, it seems like your knowledge base SHOULD be good enough. However, maybe you're lacking on the details necessary for putting you into that 250+ range? I am just now making my first pass through FA 4 days out from my exam, and I can say it definitely lack the details required to push into the 250+ range without some serious annotating. Still, your other sources should help you in that regard, and the practice tests should point out any glaring weaknesses you may have in certain areas (which if there are some, make sure to address those obviously).

The more likely problem for you may well be your approach to answering the questions, and, again, you're going to have to identify what's going wrong. Are you not reading the questions carefully, are you not able to translate from NBME-speak to English to figure out what they're trying to ask, not reading the answer choices carefully, are you feeling rushed to answer the questions quickly, or is it something else?

I wish I had a more specific answer, like do this and your problems will all be solved, but you're going to have to analyze what's going wrong and then work on it. If you have a more specific idea of what is going wrong, I'm sure people on here who have gone through the same thing can help. Like if you're feeling the pressure to answer the questions quickly so you don run out of time, maybe do some questions in untimed, tutor mode and see if there is improvement. Or you could do shorter blocks and build up to maintaining your speed and accuracy throughout a full 46 question block.

Good luck.

I have a similar problem but i have not used as many resources as OP. For example. in UWSA 2, question about a person with subcutaneous nodules on hand and leg. Parents have a history of Diabetes and MI. And which of the following are decreased in the patient? HDL particles, LDL receptors, TAG, LPL or homocyst....For some reason i did not connect that subcutaneous nodules is a xanthoma. Would you that this is due to lack of knowledge or just was not able to interpret the language. BTW, it was the 1st question on the 1st block.

 

[Aclamity]

I have a similar problem but i have not used as many resources as OP. For example. in UWSA 2, question about a person with subcutaneous nodules on hand and leg. Parents have a history of Diabetes and MI. And which of the following are decreased in the patient? HDL particles, LDL receptors, TAG, LPL or homocyst....For some reason i did not connect that subcutaneous nodules is a xanthoma. Would you that this is due to lack of knowledge or just was not able to interpret the language. BTW, it was the 1st question on the 1st block.

Assuming these are the kinds of questions that are getting at you, it sounds like you just need exposure to more questions. In other words, it doesn't seem like you have a lack of knowledge, just need to see more vignettes and get a better idea of how the questions are asked. IMHO each question is just a code of symptoms that you need to decipher, and once you do, you can apply your knowledge to answer the question. Learning the "code" is really just a matter of doing a bunch of questions

 

[RedSoxSuck]

Assuming these are the kinds of questions that are getting at you, it sounds like you just need exposure to more questions. In other words, it doesn't seem like you have a lack of knowledge, just need to see more vignettes and get a better idea of how the questions are asked. IMHO each question is just a code of symptoms that you need to decipher, and once you do, you can apply your knowledge to answer the question. Learning the "code" is really just a matter of doing a bunch of questions

Right!! and also sometimes on difficult questions, i just fail to link the material together.

I mean i normally read the question and come up with a diagnosis based on the presentations. If i can't then i try to work backwards by looking at the answer choices and trying to remember their presentations. If they match to the ones presented in the stem then its probably the answer. If they don't then its not. If i still can't figure it out then make an educated guess, mark it and move on.

 

[router1]

I think so. I fail to link material together. Like the last question on one of the blocks of uwsa 1. The question was about hereditary spherocystosis and I couldn't decipher based on the experimental data they provided that it was an osmotic fragility test. I have a week left so I am going to try to redo all of the questions I missed in Uworld. I feel like the questions in Kaplan were a joke because they almost always provide you with enough clues to decipher the answer and there was not a whole of secondary or tertiary reasoning. I was hitting 78% towards the end on those. But uworld the most i got was a 72% and that was only on the last 4 or 5 blocks

 

[RedSoxSuck]

I think so. I fail to link material together. Like the last question on one of the blocks of uwsa 1. The question was about hereditary spherocystosis and I couldn't decipher based on the experimental data they provided that it was an osmotic fragility test. I have a week left so I am going to try to redo all of the questions I missed in Uworld. I feel like the questions in Kaplan were a joke because they almost always provide you with enough clues to decipher the answer and there was not a whole of secondary or tertiary reasoning. I was hitting 78% towards the end on those. But uworld the most i got was a 72% and that was only on the last 4 or 5 blocks

It just mentioned that osmotic fragility test as salt solution which i was like wth is that and i dont remember reading it.

 

[peace zealot]

I am in a similar boat, working hard for long but could not reach a 240. I am 17 days away from the big day and my last NBME 13 score was a mere 224. Most of the questions I got wrong were not due to lack of knowledge. Sometimes, I am very much convinced with the right choice but then end up with the wrong one, and I really feel like hitting my head somewhere

Also please give me some advise how can I maximize my score in the 2 weeks that I am left with. I have seen lots of people here improve by 15 to 20 points in the last few days (obviously not those who are scoring 260s a month away).

 

[3dee]

Are you passively reading through first aid or making sure you memorize and know the concepts as you go through?

 

[peace zealot]

Previously, I was stressing on concepts in FA and didn't memorize much facts but now I am making sure along with concepts I know all the little facts, like previously I would make sure I know the mechanism of action of a drug and major side effects and clinical uses that I can derive from its action, but now I make sure I memorize them all.

 

[katarina90]

Feel the same way. Been through FA 2011 x 3, FA 2012 I'm finishing my second pass (though I read slow, I'm doing it very thoroughly). Already done over 5000 practice questions (Kaplan Q Bank, R and C Review of Path, etc. and almost done with UW). Kaplan vids x 1, read entire Robbins over school year, etc. Almost done with my 3rd pass of Goljan's RR Path, and have watched all the Pathoma videos as well as done most of the Goljan lectures.

So far: UWSA I got a 234, NBME 7 224, Kaplan Q bank predicted 232, got a 210 on the basic science shelf (that was a month or so back).

Anyways not trying to hijack your thread or anything, I guess I'm in the same boat as well. Not shooting for a 250 but I'd like at least a 230.

Are you running out of stamina at the end of your practice tests? Sometimes I think that's my problem. Also changing answers and second guessing seems to hurt me a lot. My Uworld percentage is in the mid-60s, though most of it is due to little factoids I never learned in first two years (by never learned I mean never exposed to--I'm a DO student so we got less molecular/biochem).

My scores have gone up a little since I started making myself come up with a rationale for each question. I always only use up about 30 minutes of a 60 minute timed block so I have the time for it, it helps me organize my thoughts and sometimes I realize something is wrong when I type it out and then change gears to the right answer. Anyways good luck! I hope you do well--rooting for you, you really deserve it with all the work you've done.

 

[hotchik]

Feel the same way. Been through FA 2011 x 3, FA 2012 I'm finishing my second pass (though I read slow, I'm doing it very thoroughly). Already done over 5000 practice questions (Kaplan Q Bank, R and C Review of Path, etc. and almost done with UW). Kaplan vids x 1, read entire Robbins over school year, etc. Almost done with my 3rd pass of Goljan's RR Path, and have watched all the Pathoma videos as well as done most of the Goljan lectures.

So far: UWSA I got a 234, NBME 7 224, Kaplan Q bank predicted 232, got a 210 on the basic science shelf (that was a month or so back).

Anyways not trying to hijack your thread or anything, I guess I'm in the same boat as well. Not shooting for a 250 but I'd like at least a 230.

Are you running out of stamina at the end of your practice tests? Sometimes I think that's my problem. Also changing answers and second guessing seems to hurt me a lot. My Uworld percentage is in the mid-60s, though most of it is due to little factoids I never learned in first two years (by never learned I mean never exposed to--I'm a DO student so we got less molecular/biochem).

My scores have gone up a little since I started making myself come up with a rationale for each question. I always only use up about 30 minutes of a 60 minute timed block so I have the time for it, it helps me organize my thoughts and sometimes I realize something is wrong when I type it out and then change gears to the right answer. Anyways good luck! I hope you do well--rooting for you, you really deserve it with all the work you've done.

I think the key is NOT memorizing (i.e. how many passes of FA you do) but rather understanding the concepts and know the WHY (just like goljan says)...this will help actually help with memorizing the little factoids if you understand the why...for example, general concept in drugs toxicity is usually excess of what you are trying to achieve with that certain drug (i.e. glyburide toxicity is hypoglycemia...why? glyburide is trying to increase insulin release...what happens when you have excess insulin? --> hypoglycemia)...this strategy you can apply to all other concepts

As for questions...doesn't matter how many questions you do... you must take your time to understand each one and the different angles that the same concept may be tested...

the reason i say # of passes of FA doesn't matter too much is from my own experience:
1) Did a full pass of FA...didn't see a huge increase in practice scores
2) After taking a few NBME's i came to the conclusion that you can pass if you memorize details, but you can't get a good score if you can't reason thru answers that you haven't memorized (which unfortunately are the questions that are designed to separate the A students from the B students)

Anyways, hope this helped...bottom line...know the WHY not the WHAT!!!

 

[HelpPleaseMD]

I think the key is NOT memorizing (i.e. how many passes of FA you do) but rather understanding the concepts and know the WHY (just like goljan says)...this will help actually help with memorizing the little factoids if you understand the why...for example, general concept in drugs toxicity is usually excess of what you are trying to achieve with that certain drug (i.e. glyburide toxicity is hypoglycemia...why? glyburide is trying to increase insulin release...what happens when you have excess insulin? --> hypoglycemia)...this strategy you can apply to all other concepts

As for questions...doesn't matter how many questions you do... you must take your time to understand each one and the different angles that the same concept may be tested...

the reason i say # of passes of FA doesn't matter too much is from my own experience:
1) Did a full pass of FA...didn't see a huge increase in practice scores
2) After taking a few NBME's i came to the conclusion that you can pass if you memorize details, but you can't get a good score if you can't reason thru answers that you haven't memorized (which unfortunately are the questions that are designed to separate the A students from the B students)

Anyways, hope this helped...bottom line...know the WHY not the WHAT!!!

I totally agree. I did only 1 pass of FA, listened to Pathoma maybe 3 times throughout the school year, and did UWORLD. I have been averaging 75% on uWORLD and had a 250 on my last NBME test. This test is a lot more conceptual if anything.

 

[router1]

I just did uwsa 2 and scored a 244. So a little bit happier than yesterday.

Thanks for all of the support guys!!

Just gotta keep busting a** for the next week and hopefully I can get over the finish line.

 

[router1]

Just took nbme 12. Got a 233. I know its a decent score but for the amount of time and Money I put into this preparation I feel like a utter and complete failure. I feel like slitting my wrists. anybody got any advice? exam is this saturday...should I postpone it? I have a mandatory class next week that runs from 9-5 M-F in preparation for rotations...do you think its wise wise for me to study 5-12 and just take it the following week after the class? I know I am not going to break a 250 but can I still break a 240?

 

[amakhosidlo]

Delete

 

[ijn]

Dude you're about to start third year. Give yourself at least a week of breather. Being exhausted before you even start rotations isn't a recipe for success.

 

[hotchik]

Just took nbme 12. Got a 233. I know its a decent score but for the amount of time and Money I put into this preparation I feel like a utter and complete failure. I feel like slitting my wrists. anybody got any advice? exam is this saturday...should I postpone it? I have a mandatory class next week that runs from 9-5 M-F in preparation for rotations...do you think its wise wise for me to study 5-12 and just take it the following week after the class? I know I am not going to break a 250 but can I still break a 240?

You have a good chance of breaking a 240 if things go your way on test day. Always prepare for +/- 10 pts at least...don't feel like a failure...imagine where'd you be if you DIDN'T put all this amount of time and money into your preparation? would you even pass if you didn't do all of this? Just be confident on test day and do your best...as long as you do that, then you'll have no regrets

Good luck with everything!

 

[Chaoticsheath]

since today is the last day, just write down all your micro mnemonics and draw all your biochem pathways

 

[startoverat40]

consider your test strategy. from Kaplan MCAT prep I learned that after you read the question stem, stop, think, predict, then look for the answer choice that matches your prediction. don't try to figure out the answer by reading all the choices. if you don't know the answer right away, eliminate the choices that are clearly wrong, then try to pick the right answer from the remaining ones.

when you review your wrong answers in practice tests, focus on why you got them wrong. I would guess that the test authors use the same "wrong answer pathologies" as authors of the MCAT use. so look for Opposites, Out of Scope, Faulty Use of Detail, etc.

you probably have all the raw knowledge. you just need to integrate, and also improve your testing strategy. good luck.


Step 1 strategy
USMLE Wrong answer distractors

 

[Valadi]

consider your test strategy. from Kaplan MCAT prep I learned that after you read the question stem, stop, think, predict, then look for the answer choice that matches your prediction. don't try to figure out the answer by reading all the choices. if you don't know the answer right away, eliminate the choices that are clearly wrong, then try to pick the right answer from the remaining ones.

when you review your wrong answers in practice tests, focus on why you got them wrong. I would guess that the test authors use the same "wrong answer pathologies" as authors of the MCAT use. so look for Opposites, Out of Scope, Faulty Use of Detail, etc.

you probably have all the raw knowledge. you just need to integrate, and also improve your testing strategy. good luck.


Step 1 strategy
USMLE Wrong answer distractors

I was about to post something similar. Test taking ability is likely your limiting factor.

Spend a whole day doing UNtimed questions and critically analysing them to get to the correct answer choice. Your deductive reasoning is being tested in addition to your core knowledge.