194 on NBME 15, test in two weeks, ~65% of UWorld done, what now?

[2015Step1PhantomWorrier]

I've been studying for Step 1 since January. Along with classes, I did Kaplan QBank, Firecracker, watched Pathoma, and annotated First Aid until classes ended at beginning of May. I got through about 2/3 of the Kaplan QBank before switching to UWorld at the end of April. I did the UWorld Assessment #1 and got a 178. Reviewed that and started UWorld sets and took a NBME two weeks later (5 weeks out from my test) and got a 173.

I tried not to panic. I had heard from everyone how great a resource UWorld is and because of that I had been saving it for dedicated. I begin doing two sets a day in order to finish before the test and maybe have a little bit of room to go through it again. I didn't skimp on the explanations. Actually, I think I spent too much time on the explanations, making Anki cards and cross-referencing First Aid and literally working late until the night and having no time for anything else, like attending my school's review course or watching Pathoma or Sketchy again. As of today I've done about 65% of UWorld with an average of 51%. There has been a definite upswing, with my averages going from mid-40's to mid-50's. Last week I averaged high 60's on several sets but have dropped back down to mid 50's this week.

Today I took NBME 15 and got a 194. My test is Thursday, June 11.

I'm honestly not sure how to tackle the last two weeks. Pushing back the test isn't an option. When I started studying in January I had the goal of getting 230/240 but honestly (and unfortunately) now I just don't want to go into the test with a real chance of failing. I think what has been hard for me during the last three weeks is that I've only had time for UWorld and haven't incorporated any comprehensive review. That said, I've constantly heard, questions, questions, and more questions is the key to doing well.

I'm mainly wondering if my last two weeks should be spent:

1) Doing 100-120ish UWorld questions a day to finish the QBank in the next week while trying to be more efficient with my review and then using the last week to do 2-300 second pass UWorld questions per day?

2) Be okay with not getting through UWorld and prioritize going through Pathoma again while doing a set a day until the test.

3) Some other combination?

It's honestly frustrating because I feel like I have been studying like someone who wants a 260 since January and now I'm fighting to pass, it seems. Any advice would be much appreciated.

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[pd1112]

First Aid & Pathoma >>> UW 2nd pass if you're borderline passing. Those two are probably more important than finishing the first pass at this point IMO. I'd probably do 1-2 sets of Qs/day for the next week, then just put UW away & forget about finishing it in favor of FA/Pathoma. Move your test back if you can, even a day or two will help. Take another NBME 1 week out & reassess.

 

[seminoma]

I've been studying for Step 1 since January. Along with classes, I did Kaplan QBank, Firecracker, watched Pathoma, and annotated First Aid until classes ended at beginning of May. I got through about 2/3 of the Kaplan QBank before switching to UWorld at the end of April. I did the UWorld Assessment #1 and got a 178. Reviewed that and started UWorld sets and took a NBME two weeks later (5 weeks out from my test) and got a 173.

I tried not to panic. I had heard from everyone how great a resource UWorld is and because of that I had been saving it for dedicated. I begin doing two sets a day in order to finish before the test and maybe have a little bit of room to go through it again. I didn't skimp on the explanations. Actually, I think I spent too much time on the explanations, making Anki cards and cross-referencing First Aid and literally working late until the night and having no time for anything else, like attending my school's review course or watching Pathoma or Sketchy again. As of today I've done about 65% of UWorld with an average of 51%. There has been a definite upswing, with my averages going from mid-40's to mid-50's. Last week I averaged high 60's on several sets but have dropped back down to mid 50's this week.

Today I took NBME 15 and got a 194. My test is Thursday, June 11.

I'm honestly not sure how to tackle the last two weeks. Pushing back the test isn't an option. When I started studying in January I had the goal of getting 230/240 but honestly (and unfortunately) now I just don't want to go into the test with a real chance of failing. I think what has been hard for me during the last three weeks is that I've only had time for UWorld and haven't incorporated any comprehensive review. That said, I've constantly heard, questions, questions, and more questions is the key to doing well.

I'm mainly wondering if my last two weeks should be spent:

1) Doing 100-120ish UWorld questions a day to finish the QBank in the next week while trying to be more efficient with my review and then using the last week to do 2-300 second pass UWorld questions per day?

2) Be okay with not getting through UWorld and prioritize going through Pathoma again while doing a set a day until the test.

3) Some other combination?

It's honestly frustrating because I feel like I have been studying like someone who wants a 260 since January and now I'm fighting to pass, it seems. Any advice would be much appreciated.

Where are you weakest according to UW? If you're relatively strong at path then going through Pathoma wouldn't be your best use of time imo.

If I were in your position I would focus on the educational objectives only. Having a solid conceptual understanding (or ability to at least recognize them) gets you points consistently. Trying to memorize all the details sprinkled throughout the UW explanations will probably get you lots of points too, but imo those types of points are only worth spending time on when you're already scoring pretty high. For example, someone on the borderline of passing should just focus on knowing that statins are hmg-CoA reductase inhibitors and decrease mortality in CAD. Someone in the 220 or so range might also want to add the detail that statins are metabolized mainly by 3A4. Someone in the 240 range might want to know that pravastatin is the only one that isn't metabolized by 3A4 and therefore is the statin-of-choice in patients taking a macrolide, for example. Someone in the 260 range might want to add even more detail and know that simvastatin has the highest myopathy risk, that gemfibrozil combined with statins increases myopathy by increasing statin concentration, and that fenofibrate combined with statins doesn't increase the statin-myopathy risk, but instead has an independent increase in myopathy risk of its own. Not knowing those 240-260+ details won't make you fail. Not knowing the mechanism and one of the most significant clinical facts (CAD mortality) about them will.

At least that has been my approach to UW explanations... When I feel strong on a topic I take the time to learn more details. When I'm weak on a topic I keep it simple.

 

[aspiringmd1015]

how were you doing with your UW questions? were you answering them well? not that the % has a big correlation, but if you were getting decent percentages, it could be more of a test taking issue and less of a knowledge based issue

 

[2015Step1PhantomWorrier]

I thought I was doing fairly well on UWorld based on what I had heard. I had read somewhere that most students do about ~50% on the first pass and also someone posted about how they finished it with a 54% and got a 240 on the real thing.

Last week I was averaging mid-60s but this week I've had a considerable drop to about 50%. I really felt like I was learning a lot with UWorld. For example, I was really wary about pharm coming into dedicated. Literally any question I had done before that on Kaplan that was a pharm, I'd be guessing 100% of the time. Gradually through UWorld and the explanations I've been getting better and better, where on one set I got a 5/5 on pharm and from the first NBME I went from pharm being dead last to it being tight around the 'borderline performance.'

As for pathology, it was definitely a weak point on this last test and is about 33rd and 42nd percentile on UWorld. Really, all the subjects with a lot of questions on UWorld (Cardio, Neuro, Path, Pathophys, Pharm, Endocrine, Heme) I'm either a little above or below 50%. Strangely enough, on Uworld I pretty much get all the Behavioral Sciences questions right but on the two NBMEs, I did very poorly on them.

On one hand, in three weeks there's improvement. My first NBME had almost all of my subjects touching the far left lower performance bar and after this test most are around the borderline. Logically, it feels like if I just stay the course, in two weeks I'll be safely in the 200s. But my raw score from the first to the second only went up by 7%, which feels like it could just be a random fluctuation.

My recall is just bad. For example, looking through the questions now I got one wrong about the type of necrosis from an infarct in the brain. While taking the test, something was telling me, infarct in the brain is different, infarct in the brain is different, and I even thought about liquefactive, but the more sure part of my brain was saying that liquefactive is for infections. That happens to me a lot and it can go either way. For example, I can very much see a parallel question where I would have picked liquefactive and then if it was coagulative, afterwards thinking, you KNOW infarcts are coagulative, why'd you think too much into it?

That all said, after this point, I'll never forget that cerebral infarct = necrosis. I just wish I could make every single fact stick out like that in my brain.

 

[2015Step1PhantomWorrier]

I've done all the UWorld so far mixed, btw. Also, I'm 34th percentile on UWorld right now. Don't 97% of med students pass this test? Why don't those numbers add up????

*freaking out*

 

[seminoma]

I thought I was doing fairly well on UWorld based on what I had heard. I had read somewhere that most students do about ~50% on the first pass and also someone posted about how they finished it with a 54% and got a 240 on the real thing.

Last week I was averaging mid-60s but this week I've had a considerable drop to about 50%. I really felt like I was learning a lot with UWorld. For example, I was really wary about pharm coming into dedicated. Literally any question I had done before that on Kaplan that was a pharm, I'd be guessing 100% of the time. Gradually through UWorld and the explanations I've been getting better and better, where on one set I got a 5/5 on pharm and from the first NBME I went from pharm being dead last to it being tight around the 'borderline performance.'

As for pathology, it was definitely a weak point on this last test and is about 33rd and 42nd percentile on UWorld. Really, all the subjects with a lot of questions on UWorld (Cardio, Neuro, Path, Pathophys, Pharm, Endocrine, Heme) I'm either a little above or below 50%. Strangely enough, on Uworld I pretty much get all the Behavioral Sciences questions right but on the two NBMEs, I did very poorly on them.

On one hand, in three weeks there's improvement. My first NBME had almost all of my subjects touching the far left lower performance bar and after this test most are around the borderline. Logically, it feels like if I just stay the course, in two weeks I'll be safely in the 200s. But my raw score from the first to the second only went up by 7%, which feels like it could just be a random fluctuation.

My recall is just bad. For example, looking through the questions now I got one wrong about the type of necrosis from an infarct in the brain. While taking the test, something was telling me, infarct in the brain is different, infarct in the brain is different, and I even thought about liquefactive, but the more sure part of my brain was saying that liquefactive is for infections. That happens to me a lot and it can go either way. For example, I can very much see a parallel question where I would have picked liquefactive and then if it was coagulative, afterwards thinking, you KNOW infarcts are coagulative, why'd you think too much into it?

That all said, after this point, I'll never forget that cerebral infarct = necrosis. I just wish I could make every single fact stick out like that in my brain.

Have you taken any breaks? Whenever I struggle to recall simple things I know it's time for a break (half day off or something). For example a few days ago I couldn't remember if heparin was the teratogen or if it was warfarin.

 

[aspiringmd1015]

you can tell which one is the teratogen by remembering which one is lipid soluble ie heparin can be given IV, warfarin cant etc.

 

[nds86]

How many times have you completed Fa/Pathoma? I think the problem here is content related and you should be reading/memorizing more of FA and Pathoma than doing questions. I would re-do both and take another NBME.

 

[byaaaaaaah23]

Agree with above, especially if you haven't made a solid pass through Pathoma during study period. I liked watching Pathoma with First Aid in front of me and taking notes in FA instead of in the Pathoma book, just to see 2 different sources cover the material at the same time.

 

[mymembernames]

How was your performance in the first two years of med school? Just wondering if it may be related to a poor foundation in certain topics/subjects you can try to spend more time on? Just a thought.

 

[pd1112]

Based on your path percentiles, I second my original recommendation. Path/pathophys is a huge part of the test. Don't neglect the general path sections of pathoma at the beginning. He has a lot of concepts in there that can be used for almost every path question. Then the system-specific sections sprinkle in the details.

 

[QualityProcess]

Based on your path percentiles, I second my original recommendation. Path/pathophys is a huge part of the test. Don't neglect the general path sections of pathoma at the beginning. He has a lot of concepts in there that can be used for almost every path question. Then the system-specific sections sprinkle in the details.

Early pathoma chapters are key for ruling out answers. If you know absolutely nothing about a Q, having done pathoma 2x can make a 20% correct guess into a 50% educated guess.

 

[BruceWilly]

I'm in pretty much the same situation. Scored a 196 today and my exam is in two weeks. I did one pass of first aid and then 60% of Uworld on random timed. NBME said I'm below borderline performance in pathology, behavioral science, biochem, MSK, and repro.

So take a week and just redo first aid and pathoma? I feel like spending three weeks in Uworld has let me forget so many details in first aid that are high yield.

 

[2015Step1PhantomWorrier]

Been grinding it out. Just took UWorld Assessment #2. Got a 216. I know UWSA (esp #2) is supposed to inflate the scores but it's what I needed to give me fuel going into the final stretch. Going to review it for the rest of today and go over high yields tomorrow and wednesday. Wish me luck!

 

[super_mom]

Been grinding it out. Just took UWorld Assessment #2. Got a 216. I know UWSA (esp #2) is supposed to inflate the scores but it's what I needed to give me fuel going into the final stretch. Going to review it for the rest of today and go over high yields tomorrow and wednesday. Wish me luck!

Wow am happy for you that a great improvement what did you do to get this jump....pls share did u end up doing FA or you just finished ur uworld?

 

[2015Step1PhantomWorrier]

When I first posted this I was 65% completed with UWorld and now I'm 92% completed. I took the weekend for content review and then did about 120 q/day last week. The main thing I've been doing, though, is creating a ton of mnemonics. I hadn't really been doing it before because I thought it was worthless since there's so much to remember, that remembering the mnemonics themselves would be a chore. But I started making my own stories, kind of Sketchy like, to remember difficult stuff. For example, I spent half of yesterday doing it with Pharm (which is my biggest weakness) and today I got about 80% of pharm right.

For example, for macrolides:

Macrolides (crows) - Game of THROnes (has the crow on the cover) -THROmycin

Mayweather was mad at 50 Cent and kept sending a crow to steal his Whey protein, not allowing him to grow (Macrolides bind to the 50S ribosomal subunit, preventing protein synthesis). 50 cent put up a Scarecrow with Lebron Jame’s jersey (#23) on it to keep the crows away (resistance by methylation of 23S rRNA binding site)

Silly, I know, but I definitely used it to answer a pharm question today that was asking the mechanism of resistance to macrolides.

The plan for the next couple days it to sit down with First Aid, make stories out of pharm and named disorders that haven't been drilled in my brain yet, memorize stuff like cancer markers, and reinforce with doing subject sets of UWorld questions I've gotten wrong.

I'm feeling both motivated and a little frustrated because in just the first block alone, I made SEVEN dumb mistakes. There was no knowledge gap, I just read something wrong or didn't consider something I already knew/didn't look at the answer choices close enough. Motivating because 'hey, I know this stuff!' but frustrating because 'crap, I know this stuff already....'

 

[super_mom]

When I first posted this I was 65% completed with UWorld and now I'm 92% completed. I took the weekend for content review and then did about 120 q/day last week. The main thing I've been doing, though, is creating a ton of mnemonics. I hadn't really been doing it before because I thought it was worthless since there's so much to remember, that remembering the mnemonics themselves would be a chore. But I started making my own stories, kind of Sketchy like, to remember difficult stuff. For example, I spent half of yesterday doing it with Pharm (which is my biggest weakness) and today I got about 80% of pharm right.

For example, for macrolides:

Macrolides (crows) - Game of THROnes (has the crow on the cover) -THROmycin

Mayweather was mad at 50 Cent and kept sending a crow to steal his Whey protein, not allowing him to grow (Macrolides bind to the 50S ribosomal subunit, preventing protein synthesis). 50 cent put up a Scarecrow with Lebron Jame’s jersey (#23) on it to keep the crows away (resistance by methylation of 23S rRNA binding site)

Silly, I know, but I definitely used it to answer a pharm question today that was asking the mechanism of resistance to macrolides.

The plan for the next couple days it to sit down with First Aid, make stories out of pharm and named disorders that haven't been drilled in my brain yet, memorize stuff like cancer markers, and reinforce with doing subject sets of UWorld questions I've gotten wrong.

I'm feeling both motivated and a little frustrated because in just the first block alone, I made SEVEN dumb mistakes. There was no knowledge gap, I just read something wrong or didn't consider something I already knew/didn't look at the answer choices close enough. Motivating because 'hey, I know this stuff!' but frustrating because 'crap, I know this stuff already....'

wow impressive really impressive…..you are doing great i plan on taking my first UWSA june 20th 0r 21st because i plan to finish world by then….i have 55% left on world and so far my average is okay a 77% as of now but i did Rx q bank before i started UW which i think is what helped my average plus i am on my second pass of FA and dong pathos videos along with FA. but i am still not confident at all because i have always been a bad test taker…standard test freak me out alot. hopefully when i take UWSA 1 i do okay because i seriously need some confidence right now.

 

[iki4life]

im in the same boat as you man...

i haven't taken any nbme or uswa...i strictly memorizing FA, and have about 55-60% world but it is untimed and not random, with about 50% done. i watched pathoma a long time ago.

 

[super_mom]

im in the same boat as you man...

i haven't taken any nbme or uswa...i strictly memorizing FA, and have about 55-60% world but it is untimed and not random, with about 50% done. i watched pathoma a long time ago.

wow i do mine non random too but do it timed. i am glad to find someone who is doing it subject wise. i learn better that was when i focus on a subject and know it cold i plan to do my incorrect random just so i get used to random questions. when i you exam? i plan to take mine around july 10 if my assessments are okay

 

[iki4life]

wow i do mine non random too but do it timed. i am glad to find someone who is doing it subject wise. i learn better that was when i focus on a subject and know it cold i plan to do my incorrect random just so i get used to random questions. when i you exam? i plan to take mine around july 10 if my assessments are okay

do you mean subject wise or system wise?

I'm going through FA system wise...for ex- when I'm doing endo- i do only endo (anat/pharm/path/phys) ...when i finish the FA read, i select the anat/pharm/path/phys/pathophys of that same endo system and do those questions.......and then i move onto the next system like hematology or neuro or whatever it may be, and repeat the same thing.

 

[super_mom]

do you mean subject wise or system wise?

I'm going through FA system wise...for ex- when I'm doing endo- i do only endo (anat/pharm/path/phys) ...when i finish the FA read, i select the anat/pharm/path/phys/pathophys of that same endo system and do those questions.......and then i move onto the next system like hematology or neuro or whatever it may be, and repeat the same thing.

sorry i mean system wise and yea thats exactly how i do it juse like you are doing yours.

 

[LPpostbacc]

I've got a question for everyone here....I just took my second UWSA and got a 216. That's down from a 236 on the UWSA1. I've been averaging about 64-65% on my last blocks on UW, and started going through pathoma again over the last couple days, as well as pharm flashcards to reinforce things. This is after having done DIT too. I feel like my step 1 ship is taking on water...completely confused. 🙁 (especially since these UWSA's are supposed to OVERESTIMATE your scores!)

 

[super_mom]

I've got a question for everyone here....I just took my second UWSA and got a 216. That's down from a 236 on the UWSA1. I've been averaging about 64-65% on my last blocks on UW, and started going through pathoma again over the last couple days, as well as pharm flashcards to reinforce things. This is after having done DIT too. I feel like my step 1 ship is taking on water...completely confused. 🙁 (especially since these UWSA's are supposed to OVERESTIMATE your scores!)

wow omg what went wrong? how far apart did you take these two UWSA and did your change ur patten of studying between both?

 

[LPpostbacc]

I think I was burnt out. I started studying at 630am yesterday, and started the test at 1pm, after lunch. This was after putting in some very long days over the last 10 days. I gave it a brief review last night, and some of the mistakes were comical. I mean, I missed "identify which part of this brain is damaged in a patient who has rigidity, tremors, etc." Substantia Nigra? Come on. There were a few more like that. So, while I'm not thrilled with it by any means, I think a portion of it may improve with me just "hitting the brakes" a touch. 🙂

 

[2015Step1PhantomWorrier]

Hardest. Test. Of. My. Life.

I won't be surprised if I failed. I won't be surprised if I get a 220 either, since it seems feeling like you failed is a normal response. But it was exhausting and I felt like 80% of the questions were harder than anything I've seen.

The only thing that went well was how I managed my breaks. My last 5th and 7th sets I felt the best. Almost cried after the 6th.

 

[hpdoc2]

Hardest. Test. Of. My. Life.

I won't be surprised if I failed. I won't be surprised if I get a 220 either, since it seems feeling like you failed is a normal response. But it was exhausting and I felt like 80% of the questions were harder than anything I've seen.

The only thing that went well was how I managed my breaks. My last 5th and 7th sets I felt the best. Almost cried after the 6th.

Congrats!! I had similar nbme/uw scores and took the beast in May. Waiting was so rough because I was almost sure I had failed, but ended up with a good score (for myself, not by sdn standards). Enjoy your time off and try not to think about the test too much/or at all!

 

[jmc2015]

Hardest. Test. Of. My. Life.

I won't be surprised if I failed. I won't be surprised if I get a 220 either, since it seems feeling like you failed is a normal response. But it was exhausting and I felt like 80% of the questions were harder than anything I've seen.

The only thing that went well was how I managed my breaks. My last 5th and 7th sets I felt the best. Almost cried after the 6th.

Hi
I felt the same way after doing exam on Wednesday.
I am an old IMG. I did not know the importance of doing NBMEs. I was first scheduled to do the exam on May 8th. One week before I took NBME 16 and got 216 and I started to freak out a little because what if it meant real score = -10 or 20. And it was the only NBME I had done. I had only completed 50% of UW and had 70% average but most was done in tutorial mode. I postponed the exam and did it on June 10. In that time I completed UWORLD but now timed and still ended with a 70%. But i felt my knowledge base had widened. A day before exam I did the free 150 and scored 80%.

The exam was very challenging but mostly I was upset because three questions maybe more I had doubts on we're straight FA recall. I could finish qbanks in time even with few minutes to spare but in the exam especially on the first block I felt rushed in the last questions. I came out of the exam not knowing where I stood. I wanted a good score but now I just really pray to pass. I am preparing now for step 2CK .

I am just anxious and long wait for scores is driving me nuts. Why does it take so long and the test is computerized? I don't get it.

Feel free to give comments. Do most people feel this way coming out. Like there could be a possible failure. I don't know because all the posts here are reporting 260's etc.

 

[mepo12]

So..how did you guys do?!

 

[dushash]

So..how did you guys do?!

My guess is that they are in residency doing fine.

 

[Alienman52]

interested to know how OP's score as well