USMLE next Tuesday and just scored 188 on NBME 15-what to do?

[as90]

Hi,
I really appreciate all the feedback and tips you guys have shared so far. I'm just trying to figure out what I should do. I have taken 3 NBME exams so far, 2 UWSA and my results are the following:

Mid May- NBME #7 240 (3 digit score)
Early June- NBME #12 330 (3 digit)
Today June- NBME #15 350 (3 digit score)

UWSA #1- think it was around 194 (Early may)
UWSA #2- around 201 (about 2 weeks ago)

I started uworld earlier this year at 40% average it fluctuated around 50%, for the past comple of weeks I have been scoring 50-65% on my question sets of random timed (46 q's each). I have 650 questions left and I am not sure if I should use them up.

I am also 40% done with COMQUEST at a 62% average

I have almost completed DIT and the study guide that they gave us. Prior to this, I just read First Aid (70% of it) for the sake of just orienting myself only once. I also referenced it in class whenever we had a chance. However, there were times where I was more focused on just learning the big concepts and didn't want to waste time annotating the details in first aid. I also did Pathoma 50% of it during my time in Pathology.

I think since I finished school (started DIT in the third week of May), I just spent time having DIT explain things and for the most part they seemed to click. After I was done for videos for the day, I casually reviewed things in First Aid, but sometimes I felt it was better to just do questions. I also feel that maybe there were certain days when I was more focused on trying to finish the program quickly and did 20 videos in a day. For example, I spent 2 days (saturday and sunday a couple weeks ago, just doing vids for cardio b/c it was my worst subject.) no uworld questions.

Regardless, I was feeling really good about taking the assessment today and felt I learned a lot with DIT. I made a point to review at least the rapid review facts and the rapid review sheets at the end of First Aid before taking it. I feel that a lot of the times I am stuck between 2 right answer choices and I just can't remember what it is (i.e. i can remember the page in first aid but can't remember whether it was from the 3rd or 4th/6th arches) small details.

Also, I think my genetics/biochem skills (i.e. gene sequencing/lab stuff) has always been bad even in undergrad, so I don't know if I can improve much on it. I am also quite bad with Immunology.

I'm sorry for making this post excessively long, I'm just wanting to gather inputs on what I should do? My main priority is to pass of course, I am a DO student and I have to take the COMLEX (got around ~500 iirc) on the COMSAE form C. But considering the ridiculous question types I have seen people get asked I am feeling the urge to take the USMLE just in the off chance that the COMLEX may not go well for me.

I have my comlex very early in July right before I go out for rotations. I don't believe I can postpone that. I was originally planning on reading High Yield Neuroanatomy in a day, doing Pathoma for 2 days straight. Then doing specific qbank questions in tutor mode for things that troubled me (respiratory blood gas, heme/onc, immunology, cardiology) before taking the USMLE on Tuesday.

Its obvious that I do not have the knowledge base nor the time resources to acquire the ability to do exceeding great on this exam, but I must say that I got mostly B's and A's in 2nd year in Pathology and Pharm. I also did decent in Neuro last year, but its the specific genetic stuff, immunology mechanisms that always tripped me up.

I spoke to my mentor earlier who I shadowed before getting into Med school, and he suggested that maybe I should delay my USMLE after my COMLEX and take it after finishing all of uworld and reading FA once more? I will be heading right into a pediatric rotation (it will be mostly in patient but I am not sure what my schedule will be like). I was contemplating taking it 2 weeks into the rotation (perhaps each day I can do a light review of First Aid)....that way it won't be too too far from when I took my COMLEX. I am honestly not shooting for a super star score, I just want to do my best and my goal is going to be primary care. I don't mean to sound like a slacker, I am actually quite the opposite, but I think I have a weakness when it comes to preparing/performing for standardized exams.

Do you guys have any advice on what I should do or proceed? I am usually the type of person who likes to think things through so maybe I could be thinking way too much into some of the Resp/Cardiac physiology stuff. Regardless, I have always heard that the actual exam is more of a huge Pathology test overall.

The fact that there are at least 40-50% of the questions where I cannot definitively choose between 2 right answers is what irritates me the most (it means I don't know enough from the past 2 years)

BTW, I missed 26 pathology questions, 23 general disease and health q's , and 19 physiology questions (these were the majority of questions missed today).

I'm sorry for writing the huge novel, I just would appreciate any direction on what I should do.

As always, I'm very thankful for any advice you can give me.

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[Oreoomar]

Personally, i think you COULD pass, but I'm not quite sure I understand what the implications of a fail on the boards are for a student taking both the USMLE and the COMLEX. If theres one thing I can say, its that taking it weeks into your pediatric rotation is not a good idea. It will just be too stressful and you'll be forgetting material the longer you delay the exam past your dedicated study period. If you could take it after your COMLEX but before your rotations, that would be ideal. Going into it now, you'll probably get the pass, but if you haven't even been through a good thorough run-thru or two of first aid and haven't completed Uworld, you haven't given yourself a fair shot at doing the best you could.

 

[as90]

Personally, i think you COULD pass, but I'm not quite sure I understand what the implications of a fail on the boards are for a student taking both the USMLE and the COMLEX. If theres one thing I can say, its that taking it weeks into your pediatric rotation is not a good idea. It will just be too stressful and you'll be forgetting material the longer you delay the exam past your dedicated study period. If you could take it after your COMLEX but before your rotations, that would be ideal. Going into it now, you'll probably get the pass, but if you haven't even been through a good thorough run-thru or two of first aid and haven't completed Uworld, you haven't given yourself a fair shot at doing the best you could.

Thanks. I guess I won't get my money back at this point. Let's say I decide to take it and void it (i.e. the USMLE transcript will show I have an attempt but won't say a score), will this look very bad for future residencies?

I was just hoping maybe I'll get lucky and get a Pharm and GI heavy test.

 

[Anastomoses]

wait, you're the PDA person? Wow...um...good luck.

 

[g8orlife]

wait, you're the PDA person? Wow...um...good luck.

Anastomoses, OPs in a stressful position; and, your post is not helpful whatsoever.
(I hope you wouldn't choose your response in a Behavioral Science question =P )

OP, I recommend delaying your USMLE; it's not worth failing the exam.
As for the COMLEX, I think a DO student could better give you advice b/c as Oreomar mentioned, I don't know the implications of failing an exam when taking both USMLE & COMLEX.

 

[Anastomoses]

Anastomoses, OPs in a stressful position; and, your post is not helpful whatsoever.
(I hope you wouldn't choose your response in a Behavioral Science question =P )

OP, I recommend delaying your USMLE; it's not worth failing the exam.
As for the COMLEX, I think a DO student could better give you advice b/c as Oreomar mentioned, I don't know the implications of failing an exam when taking both USMLE & COMLEX.

Oh, stress. That's right. Sorry OP. I'm more worried about OP's future patients.

 

[SLC]

Oh, stress. That's right. Sorry OP. I'm more worried about OP's future patients.

Get over yourself man! Worried about future patients, give me a break...

Nobody cares for your need to assert yourself, you're throwing off some strong insecurity vibes though.

OP: I'd think long and hard about taking this exam. I'm sure it's tough knowing that you'd lose the money, but the damage done by not passing might be worse than the $600 or so you'd lose by not taking it. If you only have a COMLEX score, you can probably land a Family Medicine position in ACGME somewhere. But with a USMLE failure, those chances drop significantly.

It's my opinion that a DO student should only take USMLE if they think they can meet or exceed the average. Otherwise I think it's a waste of time and money as it likely won't open any more doors than the COMLEX alone.

In short, unless you think you can somehow manage a 225 or so, you may want to consider not taking it. All my opinion of course.

 

[Jamiu22]

Get over yourself man! Worried about future patients, give me a break...

Nobody cares for your need to assert yourself, you're throwing off some strong insecurity vibes though.

OP: I'd think long and hard about taking this exam. I'm sure it's tough knowing that you'd lose the money, but the damage done by not passing might be worse than the $600 or so you'd lose by not taking it. If you only have a COMLEX score, you can probably land a Family Medicine position in ACGME somewhere. But with a USMLE failure, those chances drop significantly.

It's my opinion that a DO student should only take USMLE if they think they can meet or exceed the average. Otherwise I think it's a waste of time and money as it likely won't open any more doors than the COMLEX alone.

In short, unless you think you can somehow manage a 225 or so, you may want to consider not taking it. All my opinion of course.

 

[Jamiu22]

Oh, stress. That's right. Sorry OP. I'm more worried about OP's future patients.

dude, I'ma be real with you... while I agree that it is important that you have a sound basic science background to benefit your eventual patients, it is also equally important to have a human aspect of medicine (empathy and compassion)... and from your posts (not just this one, but others I've seen over the past month).... you seem to be missing this latter aspect... who's patients are going to suffer? you or the OPs.... at my internet vantage point, it currently seems that OPs patients are better off than yours.

Even though, you intended to disrespect the OP.... in this and the other post, he chose to ignore your actions... this shows that OP's character is that you should strive for... I know this is the internet and anyone can say anything... but it's really quite sad that you'd chose this avenue to show your superiority complex. Most folks here are here to help - regardless of what you think of the poster (it's what we'll do as physicians - remember that before you post).

 

[as90]

Thank you all for the responses and feedback. No offense taken at all, Anastamoses. Just was trying to blast through studying so apologies for the delayed response.

I also worry about my future patients. I have always had a difficult time with cyanosis/embryological pathologies associated with heart defects. However, I'm hoping that I'll at least be in a better position come COMLEX and definitely have competency by the time I see patients.

I originally wanted to take it more so because of the fact that a lot of people had mentioned that the COMLEX was more anatomy oriented, which was one of my lower subjects. Whereas, the usmle has more of a Pathology/Pharmacology mechanisms emphasis. But, regardless, I see your point and I think I will decide not to take it.

Thanks again for the advice and I wish all of you the best.

 

[SLC]

I want to clarify my earlier post because I'm worried it might have come off as condescending. When I said that you could probably get an ACGME family med with just a COMLEX I meant with an average score, and It's not just Family Med either. IM, Psych, Peds, etc would also be possibilities.

Additionally, I don't mean to imply that Family Med is only for people with poor scores, because some of the smartest people in medicine I know are in Family Med.

My whole point (which you clearly understood) was that if you are going to try for an ACGME residency, having a USMLE failure, or a barely passing score will not do you any favors.

Focus on the COMLEX, all of us DO students have to take it so we may as well do our best there.

 

[as90]

I want to clarify my earlier post because I'm worried it might have come off as condescending. When I said that you could probably get an ACGME family med with just a COMLEX I meant with an average score, and It's not just Family Med either. IM, Psych, Peds, etc would also be possibilities.

Additionally, I don't mean to imply that Family Med is only for people with poor scores, because some of the smartest people in medicine I know are in Family Med.

My whole point (which you clearly understood) was that if you are going to try for an ACGME residency, having a USMLE failure, or a barely passing score will not do you any favors.

Focus on the COMLEX, all of us DO students have to take it so we may as well do our best there.

No worries, I didn't interpret it that way. Thanks, I agree with you, hopefully I won't have such an awful test that people are describing.

 

[Anastomoses]

dude, I'ma be real with you... while I agree that it is important that you have a sound basic science background to benefit your eventual patients, it is also equally important to have a human aspect of medicine (empathy and compassion)... and from your posts (not just this one, but others I've seen over the past month).... you seem to be missing this latter aspect... who's patients are going to suffer? you or the OPs.... at my internet vantage point, it currently seems that OPs patients are better off than yours.

Even though, you intended to disrespect the OP.... in this and the other post, he chose to ignore your actions... this shows that OP's character is that you should strive for... I know this is the internet and anyone can say anything... but it's really quite sad that you'd chose this avenue to show your superiority complex. Most folks here are here to help - regardless of what you think of the poster (it's what we'll do as physicians - remember that before you post).

And you'd be so wrong. One of my favorite stories was a close friend of mine who was starting residency...by total coincidence another good friend of mine ended up in her hospital taking a small child in after a car had hit him. Friend B had never officially been introduced to my Friend A but told me she'd run into my Doctor Friend A at the hospital and just mooned over how her bedside manner was so gentle and caring to this child, unlike the senior who was a cold dispassionate woman who barely cracked a smile.

By mere coincidence my doctor Friend A didn't realize that I knew Friend B and she starts telling me the story of this child who had come in (clearly a small community)...and she says that after the child was discharged she got reamed by her boss with 20 questions about why she hadn't run this test or hadn't checked for this type of injury. She said she could barely sleep that night with fears of him returning with internal bleeding injuries.

I'll take efficient focused doctor over sweet candy coated doctor any day of the week.

 

[Atom bum]

And you'd be so wrong. One of my favorite stories was a close friend of mine who was starting residency...by total coincidence another good friend of mine ended up in her hospital taking a small child in after a car had hit him. Friend B had never officially been introduced to my Friend A but told me she'd run into my Doctor Friend A at the hospital and just mooned over how her bedside manner was so gentle and caring to this child, unlike the senior who was a cold dispassionate woman who barely cracked a smile.

By mere coincidence my doctor Friend A didn't realize that I knew Friend B and she starts telling me the story of this child who had come in (clearly a small community)...and she says that after the child was discharged she got reamed by her boss with 20 questions about why she hadn't run this test or hadn't checked for this type of injury. She said she could barely sleep that night with fears of him returning with internal bleeding injuries.

I'll take efficient focused doctor over sweet candy coated doctor any day of the week.

Lol.


Idiot.

 

[SLC]

And you'd be so wrong. One of my favorite stories was a close friend of mine who was starting residency...by total coincidence another good friend of mine ended up in her hospital taking a small child in after a car had hit him. Friend B had never officially been introduced to my Friend A but told me she'd run into my Doctor Friend A at the hospital and just mooned over how her bedside manner was so gentle and caring to this child, unlike the senior who was a cold dispassionate woman who barely cracked a smile.

By mere coincidence my doctor Friend A didn't realize that I knew Friend B and she starts telling me the story of this child who had come in (clearly a small community)...and she says that after the child was discharged she got reamed by her boss with 20 questions about why she hadn't run this test or hadn't checked for this type of injury. She said she could barely sleep that night with fears of him returning with internal bleeding injuries.

I'll take efficient focused doctor over sweet candy coated doctor any day of the week.

There's an awedul lot of "by mere coincidence" in this story.

But what does this have to do with step1 and someone asking a question on something they dont understand as well as they'd like to again?

Your "favorite story" doesn't make your initial response in this thread any less improper. If someone makes it to residency and doesn't understand basic concepts your story might apply, but OP is an ms2, and has never even seen a patient yet; so you can spare us the superiority complex for at least the next 3 years OK?

 

[alisepeep]

take that **** and move on with ur life...being done is the best feeling in the world...at least for three weeks until the score comes haha...but at least u are guaranteed 3 weeks of happiness!!

 

[Anastomoses]

There's an awedul lot of "by mere coincidence" in this story.

But what does this have to do with step1 and someone asking a question on something they dont understand as well as they'd like to again?

Your "favorite story" doesn't make your initial response in this thread any less improper. If someone makes it to residency and doesn't understand basic concepts your story might apply, but OP is an ms2, and has never even seen a patient yet; so you can spare us the superiority complex for at least the next 3 years OK?

there's actually just one coincidence. and it relates to whether empathy is more important than competency. is your emotional response giving you difficulty with understanding the crux?

yes. I'm puzzled at how someone taking step 1 in three weeks doesn't know the bare basics of PDA. it's not superiority, it's astonishment. you don't like how i feel? don't make a post telling me how inept you will be.

 

[thawunandonly]

lol don't worry. I didn't remember **** from embryology. But I spent these past few days reviewing it and [re]learning it. Now I know it. And I knew it enough to answer OP's question in the other topic. Waddayaknow...

So...moot point. What if OP asked about Wallenburg syndrome instead? Maybe FSGS? Maybe absorption of B-12? We can ask about content here...that's one of the purposes of this board. It shouldn't matter if it was MS1 stuff or not. If OP took anything away from my post [in trying to clarify PDA], hopefully now he/she knows. I (and hopefully OP) went from not knowing something to knowing something in the span of a few minutes. Knowledge is power?

The real problem - what you or anyone of us should ACTUALLY be worrying about - is if the OP DIDN'T care about not knowing it and then didn't bother to ASK.

 

[SLC]

The real problem - what you or anyone of us should ACTUALLY be worrying about - is if the OP DIDN'T care about not knowing it and then didn't bother to ASK.

Exactly!!!

 

[g8orlife]

there's actually just one coincidence. and it relates to whether empathy is more important than competency. is your emotional response giving you difficulty with understanding the crux?

yes. I'm puzzled at how someone taking step 1 in three weeks doesn't know the bare basics of PDA. it's not superiority, it's astonishment. you don't like how i feel? don't make a post telling me how inept you will be.

Anastomoses, the only thing I'm astonished about is that you still don't recognize how smug your statements are even after all these replies to your posts.

 

[SLC]

Anastomoses, the only thing I'm astonished about is that you still don't recognize how smug your statements are even after all these replies to your posts.

What blows me away is this guy is only an MS1, he has no idea what it's like to try and recall the whole of the first two years for a single test. Anastomoses has had only 1 year of curriculum (arguably the easier of the first two years) and now wants to lecture a 2nd year on remembering something? Dude doesn't even have half the required info in his brain yet, of course it seems easy to him.

All I can say is: With the condescension that's on display here and in other threads, Anastomoses better not make a thread asking for clarification/another POV on a topic this time next year when he's studying his guts out for step1. His patients are counting on him...

Seriously, the nerve of some people!

 

[Stingarov]

Wow sounds like we have a regular House MD around here. Real class act.

To the OP: Sounds like you could pass, but it'll be touch and go. If you have no other choice (i.e. can't delay it a week or two), then I guess you could go for it. I wouldn't be comfortable at 188 however, especially on NBME15.

 

[CDI]

wait, you're the PDA person? Wow...um...good luck.

 

[CDI]

What blows me away is this guy is only an MS1, he has no idea what it's like to try and recall the whole of the first two years for a single test. Anastomoses has had only 1 year of curriculum (arguably the easier of the first two years) and now wants to lecture a 2nd year on remembering something? Dude doesn't even have half the required info in his brain yet, of course it seems easy to him.

All I can say is: With the condescension that's on display here and in other threads, Anastomoses better not make a thread asking for clarification/another POV on a topic this time next year when he's studying his guts out for step1. His patients are counting on him...

Seriously, the nerve of some people!

Isn't Anastomoses a girl?

 

[SLC]

Isn't Anastomoses a girl?

Perhaps, I don't know... Maybe I should have been more gender neutral in my post? Either way, it was a lame post...

 

[CDI]

And to OP...

I climbed out the hole you are in not too long ago.

168 - 187 - 207 - 221... 217 on the real exam. It took me about a 5-6 wks. I'm 4 years out from my preclinicals though, so I was even worse shape than you to start.

You need to dump DIT and focus on FA. Its the most efficient way to gather the most points in a short time. Anyone under 210-220...should be FA, FA, FA and UW wherever you can squeeze in some.

 

[skyblue2000]

And to OP...

I climbed out the hole you are in not too long ago.

168 - 187 - 207 - 221... 217 on the real exam. It took me about a 5-6 wks. I'm 4 years out from my preclinicals though, so I was even worse shape than you to start.

You need to dump DIT and focus on FA. Its the most efficient way to gather the most points in a short time. Anyone under 210-220...should be FA, FA, FA and UW wherever you can squeeze in some.

Correct me if I'm wrong but CDI you were around mid-50s in UW, right?

 

[CDI]

Correct me if I'm wrong but CDI you were around mid-50s in UW, right?

I think my cumulative was 53-54% by the end of it. Estimation was a 206, but with the way the exam has changed I knew that was over estimating by about 10.

I had trouble doing blocks of UW, esp seeing those low scores. I did tutor mode instead to spend as much time as I needed to learn the material.

(Big change with CK, where I'm hitting 70s in some blocks, above the average.)

 

[skyblue2000]

I think my cumulative was 53-54% by the end of it. Estimation was a 206, but with the way the exam has changed I knew that was over estimating by about 10.

I had trouble doing blocks of UW, esp seeing those low scores. I did tutor mode instead to spend as much time as I needed to learn the material.

(Big change with CK, where I'm hitting 70s in some blocks, above the average.)

But you ended up doing like 10 points better... I really hope everyone comes back saying they got their nbme average.

Nice to hear about your ck grades - heard an upward trend for step 2 CK is especially important for IMGs.

 

[Anastomoses]

What blows me away is this guy is only an MS1, he has no idea what it's like to try and recall the whole of the first two years for a single test. Anastomoses has had only 1 year of curriculum (arguably the easier of the first two years) and now wants to lecture a 2nd year on remembering something? Dude doesn't even have half the required info in his brain yet, of course it seems easy to him.

All I can say is: With the condescension that's on display here and in other threads, Anastomoses better not make a thread asking for clarification/another POV on a topic this time next year when he's studying his guts out for step1. His patients are counting on him...

Seriously, the nerve of some people!

That blows you away? Alright. It's perfectly possible that I don't understand the amount of information that leaks out of ones brain by the end of second year. I'll just have to wait and see.

Isn't Anastomoses a girl?

yeppers.