2007 USMLE Step I Experiences

[missmod]

I think I'll start the thread, since I just finished Step I today! Boy does it feel good to have it over with. In case you guys are wondering, my med school is on a different schedule, so we do basic sciences in 1.5 years, do one year of clerkships, and then take the boards.

So I started a 6 week study schedule (started after new years). The first five weeks, I studied for about 9-10 hours with a lot of breaks and took weekends off to either have fun or catch up/review. The last week I saved just for review and as many questions as I could fit into my 10 hour day. I have to say, this last week was the worst. Not in the no-sleep-cram-for-a-test kind of way, but in the huge-weight-on-your-shoulders kind of way.

Now for a breakdown of the subjects...

Biochem: There was not a lot of biochem on my exam. A few key enzyme deficiency ones (Lesch Nyhan, Maple Syrup Disease) but all of the questions were very obvious and did not require you to put much thought into it. Don't blow off porphyria and lead poisoning-- for some reason I got so many questions on that!

Molecular Bio: This was a big one! I think the NBME is moving away from the biochem towards questions on molecular bio. Many questions about DNA regulation, transcription, translation, bacterial plasmids, etc. Sometimes these questions look very scary -- they are always so long and use long names for molecules or restriction enzymes that you have never heard of. You need to get used to the question style and realize that what they are asking is very simple. The NBME forms have questions very similar to the molecular bio ones I saw on the exam.

Pharm: Another one I thought would be difficult but not. Big drugs you should know a lot about (like antihypertensives, drugs for hyperlipidemias, cardic drugs, etc.) However, I wouldn't worry too much about the side effects for every tiny drug -- especially the chemo and immunosupressant drugs that kept on tripping me up so much.

Micro/Immuno: I had not a single question on parasites! That huge chart of worms and helminths in First Aid had me worried for a while, but it was not a big part of my exam. If anything, just know the key phrases because if they do test you on it, it would be a really obvious scenario. Mostly bacterial processes and what you would use to treat them... or what was their mechanism of disease (i.e. endotoxn, exotoxin, etc.) Know immunology and cytokines well, as well as the functions of all the cells. Different immune deficiencies were all asked on my exam (there is one page in First Aid that sums them up very well).

Anatomy/Neuroanatomy: Always combined with a pathology question or an imagine. I had a few branchial plexus/lumbar plexus questions. Many questions would give you a clinical scenario, then ask you to identiy the artery/nerve/organ on a CT scan/MRI/angiogram/brain cross section. Again, I think Qbank does not help you much at all because there aren't that many images. All i can say is look through some atlases quickly as you are studying anatomy -- not Netters bc that won't help much, but books that will give you real radiographic images.

Physio: This was almost always combined with Pathology--they would ask the physiology behind some path process. I had so many questions where the question asked "what would be the levels of x, y, and z enzymes/hormones?", answer choices being "increased, decreased, etc"

Pathology: Not as detailed orientated as Kaplan. Very little histology related pathology -- most of the questions though, required you to make a diagnosis and then know something about the pathophys of the disease or the treatment of the disease. There were also a lot of images -- MANY more than Qbank's representation.

All in all, I think the test more manageable than Kaplan's Qbank. Don't let Qbank discourage you -- ! Doing the questions help you to learn, so if you were getting them all right then the questions are too easy and not really helping you much. I do remember many questions that I knew only because I got the question wrong on Kaplan's Qbank. Also, the NBME tests are VERY good and very representative of the real thing. They also help you get used to the wording of the Q's, which can be a LITTLE different from what Qbank is like. I did forms 2, 3, and 4 and I thought 2 and 3 were the best. A few images on those practice exams were repeated on my actual exam.

Goljan's book and lectures were great. He pointed out lots of things that wound up being on the exam and presents them in a way that really sticks. Also, his images are a great resource.

I've been lurking for a while and haven't really posted since applying to med school, but I have to say you guys have really helped me out during my boards studying. Good luck to everyone else getting ready to take this monster.

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[Luc]

Is HY Behavioral Sci's biostats section enough to answer all the biostats questions that come up on the test, or is it worth getting the HY Biostats book?

 

[DocMizzle]

Is HY Behavioral Sci's biostats section enough to answer all the biostats questions that come up on the test, or is it worth getting the HY Biostats book?

I looked at FA, HY Behavioral science, and did some UW questions. Took maybe a few hours, and this was plenty for biostats.

 

[discreet44]

Thanks to everyone who have posted their experiences. Reading these was helpful in my preparation for the exam, and hopefully I can help out others by posting my own experience, since I just took the exam a few days ago.

It was a reasonably difficult test with a mixture of 1st and 2nd order questions. Roughly 20-30% of the test was very straightforward recall (ie. Which vitamin contributes to normal bone strength? [Vitamin D]). The rest of the test consisted of 2 step thinking that required you to know the diagnosis plus something about it (ie. An alcoholic man falls down the stairs, briefly loses consciousness, has 'lucid interval' in the ER, and then becomes unresponsive. Which vessel is likely implicated? [Epidural hematoma - Middle meningeal artery]). Many questions were in the this "USMLE WORLD style." Overall, this exam was probably slightly less difficult than 350 random UWORLD questions and I think it's fair to say it was comparable to or slightly more difficult than NBME 3. If you're like me you will leave the test feeling, "Wow, there was a lot of stuff I didn't know". This test covers pretty much everything you have ever studied and probably a lot of stuff that you didn't study, so don't worry about it b/c everyone is in the same boat.

As far as the composition of the test...

PATHOLOGY - This subject is KING. This is definitely the most important subject and really interrelates with almost all the other subjects. This subject was the most heavily tested on the exam. Within this discipline, every organ system was covered pretty thoroughly. My test seemed to have quite a bit on the reproductive system with lots of questions about pregnancy, prenatal care, breast cancer, etc. I also had a couple questions related to the eye, a subject that I don't think is well covered in FA or BRS (although maybe I just don't remember reading about it!). As Goljan promised, there was also a good amount of physical diagnosis clues in the question stems ("Systolic murmur in left sternal border, increasing in intensity on inspiration, which valve is affected?" [Tricuspid]).

PHARM - As promised by First Aid, this part of the exam was relatively straightforward. MECHANISMS!!! Almost all of my pharm questions required an understanding of the mechanism and that's it. For some reason I didn't have a whole lot of questions about side effects, but obviously this is important to know. The most heavily tested topic on my exam were autonomics. A smattering of everything else was there as well, including some questions about pharmacodynamics and competitive/noncompetitive inhibitors. I think FA is particulary useful for this discipline.

MICRO / IMMUNO - There was some micro on my exam, but less than I expected. Know the mechanisms of the bugs, especially the bacteria. With immuno, know the mechanisms in relation to pathology (ie. Patient has hypopigmented, anesthetic areas on the face and limbs, acid fast stain shows scant bacilli, which cytokines are most important? [Tuberculoid leprosy - IL-2, INF-gamma] (I think?!))

BIOCHEM / CELL BIO / GENETICS - I don't remember much from this part, just that it was tested in a seemingly reasonable amount, maybe 20% of the exam. Metabolic pathways and their rate limiting steps were tested extensively. Some recall of details necessary at times, but generally it was stuff covered in FA.

ANATOMY - Seemed to be relatively more questions in this area than I had expected. Most high yield areas for my exam were CLINICAL CORRELATIONS and upper and lower extremity anatomy. Be comfortable looking at MRI's (knee), x-rays, and CT's - these were well integrated into the pathology questions. Several neuroanatomy cross sections, I would know those and the lesions that are caused at various locations.

EMBRYO - Very few direct "where does this structure come from" questions. Most were clinical correlations. Know the mechanisms of the various malformations, etc. (ie. Vitelline duct remnant in Meckel diverticulum)

BEHAVIORAL SCIENCE - This part of my exam was surprisingly difficult. I had many "What would you say?" and 'ethics' questions that I really couldn't answer definitively. These were definitely comparable in difficulty to the behavioral science questions from UWORLD. The biostats found in FA and HY Behavioral Science is sufficient.

PHYSIO - Not a whole lot of direct physio questions that I can recall, but it underlies pathology so it is an important subject to know well. Most of these were integrated with pathology questions.

I probably left some stuff out because this test really does cover EVERYTHING. If you studied during your 1st 2 years and take a month to review you will be fine. Here's my profile stats:

MCAT: 32

6 weeks of questions done with coursework (Robbins Qbook, Elsevier Qbank - 50 per day)

Elsevier Qbank - 68% average. This was an excellent resource, cheaper than Kaplan and questions were similar in style and difficulty to many of the questions on the actual exam. Definitely glad I purchased this.

NBME #2 :224 (4 weeks before exam) - Just used this as a diagnostic to get a general idea of where I was at.

1 month of board studying (UWORLD - 100 per day) - BRS - Path and Phys, HY - Neuroanatomy, Embryo, Biochem, FA - Micro and pharm, pharm cards. Throughout, supplemented with Robbins and Lehninger Biochem text. GOLJAN AUDIO (everything this man says is high yield)!

UWORLD - 72% average. This was an excellent resource as well. Many exam questions were in this style. I showed only modest improvement throughout, maybe 5% points on average from beginning to end. My range was 60%-90%. They always seem to come up with questions I don't know! Extremely glad I used this resource.

Robbins Qbook - Great source of pathology questions of comparable or greater difficulty level to the actual exam. I did many of these with coursework and a bunch toward the end of my studying. Worth the money.

NBME #3: 242 (1 week before exam) - Used to check my progress.

Relative strengths: Path, phys
Relative weaknesss: Pharm, anatomy/embryo

As far as the practice Q's go, I really couldn't say that one of them is superior to the others because I found them all useful. I guess if I had to pick one I would go with UWORLD because I'd rather take harder Q's and have the test feel "easier" (chances are the real exam will feel tough regardless). However, I think it is advantageous to use both UWORLD and Elsevier because they are different and the questions resemble both sources.

I'm expecting to score lower than my last NBME because I felt that my percentage on the real exam will be lower, but who knows how the scoring works. My goal is to break 230.

Hope this information will be helpful to someone, good luck to all!

 

[surfgirl2]

Well, after reading this for a while I decided it is my turn to contribute...

I honestly think that the test really was not that bad. I might be getting into trouble by saying this but it was very much like NBME #3 and USMLE World. I think that path and physio were VERY highly represented and pharm was only really out of first aid. Anatomy and embryo made up about 2-3 questions per block total and were VERY straightforward- gotta know the brachial plexus, hernias, common nerve injuries, etc. Only a few MRI's and CT's which I was happy about There were maybe 2 WTF questions and as people say, molecular biology is highly represented. Know DNA, transcription, translation, receptors, etc. Behavior was also 3-4 questions per block and not as much stats as I had expected, more what would you do type questions.

I didn't particularly think one block was harder than the other and time wasn't much of an issue. I marked between 5-12 questions per block that I felt I had to guess on so we shall see about those.

As for my stats... I was hoping for 230+ and I think/hope that happened. Overall world 90% complete. I started in the 50-60's and ended in the high-mid 70's. I got a 232 on NBME form 2 about 3 weeks out and 238 on form 3 about 1 week out. 85% on the 150 released questions.

I will let you know when I get my scores... Good luck to all! Hopefully this was helpful.

 

[WhoisJohnGalt]

I am very excited that it is finally my turn to post on this thread!

First off, as most people have said, it was definitely a FAIR exam. It was really pretty much what I expected, no more and no less. I felt that my exam was a pretty good mix; biochem was definitely tested more than I would have liked, but in exchange, the anatomy was REALLY easy (except for a few tendon attachment questions that I wasn't expecting)-- no crazy MRI's or anything like that, and the embryo was essentially non-existent. I had tons of path, which is one of my strong suits (thanks to RR Path), and lots of phys as well, which I was also quite prepared for.

If there was one thing that I have to say I worried about way too much, it was definitely pharm. There was ONE drug that wasn't in FA, and as a previous poster said, if you knew the other ones, you could figure it out by elimination. IMO, it is a waste of your time to look outside of FA for pharm-- your time is much better spent knowing FA pharm cold. And really, even that is excessive. I can only speak for my exam, but in my case I needed to know very basic questions-- how the drugs work, and the REALLY infamous side effects (Obviously I can't cite the specific examples from my exam, but to get an idea, I'm talking about things like gray baby syndrome for chloramphenicol or agranulocytosis for clozapine-- REALLY knee-jerk stuff).

Maybe I just got a weird exam, but I really don't agree with some previous posters that have talked about how the exam requires 3 and 4 step reasoning. There were more 1 step questions on my exam than 3+ steps... although most were probably 2. The big difference for me between the NBME/USMLE Rx/UW questions and the real deal was length of question stem. Despite the many warnings about this in this very thread, I was still surprised when I had ~5 minutes left at the end of every block as compared to ~20 minutes left at the end of UW blocks. It really only took me a block to get used to reading the last sentence first though; in the end, it wasn't a big deal.

Okay, I've really been rambling on way too long. Here's the gist of my post: FA + RR Path + UW is really all you need. If I had known these cold, I would have scored VERY well on my exam. As it is, I'll be very happy with a 220, though certainly satisfied with 200+. I would not put 230 outside of the realm of possibility, though I would probably pass out if I got much higher than that. My stats:

MCAT: 34
NBME 2 (3 days in): 211
NBME 4 (10 days in): 216
NBME 1 (4 days before the exam): 228
150 q's: 84/247

I expect that the last NBME will probably be closest to my real score, but I could eat those words

Good luck to those that remain!!

 

[AggieJohn]

Now that you are all done with/in the midst of Step 1, if you guys could go back 2 years to the beginning, what would you do differently?

I'm starting in the fall and would like to hear your combined wisdom

 

[Jay Jay]

Now that you are all done with/in the midst of Step 1, if you guys could go back 2 years to the beginning, what would you do differently?

I'm starting in the fall and would like to hear your combined wisdom

Not the right thread to do this. This is for stressed out M2s who are hours/days/weeks from the most important test of their lives. Nothing like a "should have done this two years ago" to make you feel like sh#$. I am a huge College Station fan, though, so I'll let it go

 

[Luc]

I looked at FA, HY Behavioral science, and did some UW questions. Took maybe a few hours, and this was plenty for biostats.

Cool thanks for that!

 

[AggieJohn]

Not the right thread to do this. This is for stressed out M2s who are hours/days/weeks from the most important test of their lives. Nothing like a "should have done this two years ago" to make you feel like sh#$. I am a huge College Station fan, though, so I'll let it go

Okay, okay. I gotcha. Sorry for the intrusion.

 

[WhoisJohnGalt]

A few more things I thought of.

I forgot to post my UW average. By the time I took the exam, I was averaging about 65% on random UW blocks, and completed about 90% of the qbank (no repeats).

Also, I wanted to mention the "what would you do next?" questions. As always, there's the possibility that my exam was an anomaly.

That said, in my case, there were four of those q's per block and they were easy freebie gimme points. All but ONE (so I'm seriously talking about something like 27 easy cheesy points) were incredibly straightforward, there-can't-possibly-be-any-other-viable-option questions. They just tested the most basic ethics principles; be nice, respect patient autonomy, ask open-ended questions, blah blah blah. NOTHING remotely tricky. I was definitely dreading those going into the exam since there were so many horror stories about them on this thread, but very quickly I started looking forward to them.

In any case, there's not really much you can do to prepare for them, but just wanted to let everyone know that you might not necessarily have to dread those q's

 

[lucutis]

A few more things I thought of.

I forgot to post my UW average. By the time I took the exam, I was averaging about 65% on random UW blocks, and completed about 90% of the qbank (no repeats).

Also, I wanted to mention the "what would you do next?" questions. As always, there's the possibility that my exam was an anomaly.

That said, in my case, there were four of those q's per block and they were easy freebie gimme points. All but ONE (so I'm seriously talking about something like 27 easy cheesy points) were incredibly straightforward, there-can't-possibly-be-any-other-viable-option questions. They just tested the most basic ethics principles; be nice, respect patient autonomy, ask open-ended questions, blah blah blah. NOTHING remotely tricky. I was definitely dreading those going into the exam since there were so many horror stories about them on this thread, but very quickly I started looking forward to them.

In any case, there's not really much you can do to prepare for them, but just wanted to let everyone know that you might not necessarily have to dread those q's

Thanks for the info, and well done on being done! How long before you start wards?

 

[WhoisJohnGalt]

Thanks for the info, and well done on being done! How long before you start wards?

2 weeks today

 

[insistence]

Happy that I can finally add my name to this thread! Everyone’s write up’s have been so helpful over the past 1-2 years, so I’m glad I can finally write my own.

I felt that the exam was a solid mix of virtually everything I had learned my 1st two years. Of course, everyone gets a different “kind” of test but I really don’t feel that one subject was overly tested. However, if I had to recall the subjects that initially seemed more represented than I expected, I would say: 1)immuno – usually mixed in with path; 2) neuroanatomy lots of MRI’s; 3) ethical/”what would you say?” ; 4) HIV/AIDS - path, treatment, mech of infection, ect. I finished the test thinking that it was a pretty fair test and felt decent about it (220-230 hopefully). The feel of the questions was pretty much 1st and 2nd order questions of the “UW feel” but they provided MUCH more info in the question stem and the answer choices were different enough to clearly understand what they were looking for.

Now for the subjects:

Pharm: Again, to supplement what most people seem to be saying…KNOW FA. UNDERSTAND MECHANIMS. Half the time they would set up the question so it was sooooo obvious what drug they were talking about. Then they would ask about mechanism or which bug would be ideal to treat it with.

I’m not sure what else to add here. I used a supplemental pharm book to understand mechanisms of toxicities a little bit better but I’m not sure it really helped me that much (Deja Review Pharm). I was REALLY worried about pharm, especially with anti epileptic and HIV drug toxicities (I just couldn’t keep them completely straight!). Of course, getting a slightly more heavy AIDS, HIV focus on my exam, I got a good amount of pharm related to it. There was one question where I had to differentiate between the toxiticies of similarly classed HIV drugs. If I remember correctly, it’s covered in FA.

Physiology: Again, almost always presented with a graph or arrow table with 10 different choices. You just had to know it. I seemed to be tested on lots of respiratory and renal mechanisms. Often mixed in with pathology. I used BRS physiology and felt reasonably prepared.

Pathology: Now that I think about it, my exam seemed to have a lot of hematology, which was good since I felt pretty comfortable with it but they picked a few topics to test repeatedly. A lot of immunology was integrated into these questions. All path was well represented. There were more than a few path questions that simply had a pic with a VERY BRIEF description of the problem and you had to identify the mechanism or make a diagnosis. For those questions I had to rely on basic histo to figure it out, especially with those skin lesions.

I used Goljan (audio and book) and thought he was amazing for understanding mechanism for anything path or path-related. His book was a bit of overkill but the clinical integration really helped everything stick. The numerous tables, pictures, HY’s, and clinical integration of path, immuno, biochem, physiology, and micro were the reason to use this book over BRS. I actually switched from BRS to Goljan right before boards studying. There were 5-7 questions that were not in his book though..kinda surprising. Fortunately I remembered something from class!!

Microbiology/Immunology: Lots of it, mostly bacteriology. Not much with viruses but if so, usually in an AIDS/HIV patient – really straightforward. No crazy +/- strand, “eveloped or not” kind of questions thankfully. 1-2 questions on helminths AND treatment. Like I mentioned before, immunology was much heavier than I expected but nothing off the wall. Usually was associated with path.

I used Micro Made Ridiculously Simple to help with mnemonics and funny pics then moved to FA. FA’s micro section is quite solid – no questions outside of it. However, for immunology, I don’t think FA is enough. I read Lange’s 90pg immuno section which was waaaay more than you really need for the exam. If you can understand the basic concepts from each chapter and salient details plus FA immunology you should be more than prepared.

Biochemistry: Not heavily as tested as micro or pharm but they were looking for basic ideas here. FA’s biochem section is quite strong and should help answer 80% of these questions off the bat. The other 20% seemed to be about big picture concepts which you can lose in FA if you don’t understand how all the pathways are integrated and how major hormones and regulators affect multiple pathways. Surprisingly, virtually no nutrition but lots about signaling systems. Again, mechanisms of disease are what they want you to know.

Behavioral: Tons of “what would you do next or what is the appropriate response” type of questions. I actually began to look forward to these questions because 85% of the time it was so obvious. 1-2 were pretty tricky in that both answers seemed correct. Decent amount of biostats and identifying study types. FA’s behavioral section is gold for these questions.

Molecular/Genetics: Genetics and I do not get along but I felt these questions were reasonable. Lots of pedigrees. Not really sure how best to prepare outside of FA to be honest. It seems to have the minimal info you need.

Molecular bio I turned into a strength in the last few days before the exam thanks to 1st edition HY Cell/Molecular (HIGHLY RECOMMENDED). Not many questions but they tended to be a bit detailed. Fortunately, they were testing a very fundamental concept so don’t get worried by those insane question stems.

Anatomy: lots of MRI’s and exactly 1 arteriogram (VERY straightforward). I was worried about this section and unfortunately got a ton of neuro anatomy. I would say learn FA’s neuro section well and add concepts from HY Neuro if you're missing details. Unfortunately, HY has too much info but I used it to supplement if I wasn’t understanding certain spatial relationships. In terms of what to expect with MRI's, I would say watch for clear landmarks (gastric air bubble, ribs, etc) to know what level you’re at. You can usually reason from there..really not anything terrible.

Embryology: basically owned me and I went through FA’s section twice. There was 1 picture that I’m certain I saw while breezing through HY Embryo. Probably not high enough yield but I got about 4-5 questions. Just stick with FA for basics.

Hopefully this is kinda helpful to someone! Good luck to everyone still studying.

 

[Luc]

Happy that I can finally add my name to this thread! Everyone’s write up’s have been so helpful over the past 1-2 years, so I’m glad I can finally write my own.

I felt that the exam was a solid mix of virtually everything I had learned my 1st two years. Of course, everyone gets a different “kind” of test but I really don’t feel that one subject was overly tested. However, if I had to recall the subjects that initially seemed more represented than I expected, I would say: 1)immuno – usually mixed in with path; 2) neuroanatomy lots of MRI’s; 3) ethical/”what would you say?” ; 4) HIV/AIDS - path, treatment, mech of infection, ect. I finished the test thinking that it was a pretty fair test and felt decent about it (220-230 hopefully). The feel of the questions was pretty much 1st and 2nd order questions of the “UW feel” but they provided MUCH more info in the question stem and the answer choices were different enough to clearly understand what they were looking for.

Now for the subjects:

Pharm: Again, to supplement what most people seem to be saying…KNOW FA. UNDERSTAND MECHANIMS. Half the time they would set up the question so it was sooooo obvious what drug they were talking about. Then they would ask about mechanism or which bug would be ideal to treat it with.

I’m not sure what else to add here. I used a supplemental pharm book to understand mechanisms of toxicities a little bit better but I’m not sure it really helped me that much (Deja Review Pharm). I was REALLY worried about pharm, especially with anti epileptic and HIV drug toxicities (I just couldn’t keep them completely straight!). Of course, getting a slightly more heavy AIDS, HIV focus on my exam, I got a good amount of pharm related to it. There was one question where I had to differentiate between the toxiticies of similarly classed HIV drugs. If I remember correctly, it’s covered in FA.

Physiology: Again, almost always presented with a graph or arrow table with 10 different choices. You just had to know it. I seemed to be tested on lots of respiratory and renal mechanisms. Often mixed in with pathology. I used BRS physiology and felt reasonably prepared.

Pathology: Now that I think about it, my exam seemed to have a lot of hematology, which was good since I felt pretty comfortable with it but they picked a few topics to test repeatedly. A lot of immunology was integrated into these questions. All path was well represented. There were more than a few path questions that simply had a pic with a VERY BRIEF description of the problem and you had to identify the mechanism or make a diagnosis. For those questions I had to rely on basic histo to figure it out, especially with those skin lesions.

I used Goljan (audio and book) and thought he was amazing for understanding mechanism for anything path or path-related. His book was a bit of overkill but the clinical integration really helped everything stick. The numerous tables, pictures, HY’s, and clinical integration of path, immuno, biochem, physiology, and micro were the reason to use this book over BRS. I actually switched from BRS to Goljan right before boards studying. There were 5-7 questions that were not in his book though..kinda surprising. Fortunately I remembered something from class!!

Microbiology/Immunology: Lots of it, mostly bacteriology. Not much with viruses but if so, usually in an AIDS/HIV patient – really straightforward. No crazy +/- strand, “eveloped or not” kind of questions thankfully. 1-2 questions on helminths AND treatment. Like I mentioned before, immunology was much heavier than I expected but nothing off the wall. Usually was associated with path.

I used Micro Made Ridiculously Simple to help with mnemonics and funny pics then moved to FA. FA’s micro section is quite solid – no questions outside of it. However, for immunology, I don’t think FA is enough. I read Lange’s 90pg immuno section which was waaaay more than you really need for the exam. If you can understand the basic concepts from each chapter and salient details plus FA immunology you should be more than prepared.

Biochemistry: Not heavily as tested as micro or pharm but they were looking for basic ideas here. FA’s biochem section is quite strong and should help answer 80% of these questions off the bat. The other 20% seemed to be about big picture concepts which you can lose in FA if you don’t understand how all the pathways are integrated and how major hormones and regulators affect multiple pathways. Surprisingly, virtually no nutrition but lots about signaling systems. Again, mechanisms of disease are what they want you to know.

Behavioral: Tons of “what would you do next or what is the appropriate response” type of questions. I actually began to look forward to these questions because 85% of the time it was so obvious. 1-2 were pretty tricky in that both answers seemed correct. Decent amount of biostats and identifying study types. FA’s behavioral section is gold for these questions.

Molecular/Genetics: Genetics and I do not get along but I felt these questions were reasonable. Lots of pedigrees. Not really sure how best to prepare outside of FA to be honest. It seems to have the minimal info you need.

Molecular bio I turned into a strength in the last few days before the exam thanks to 1st edition HY Cell/Molecular (HIGHLY RECOMMENDED). Not many questions but they tended to be a bit detailed. Fortunately, they were testing a very fundamental concept so don’t get worried by those insane question stems.

Anatomy: lots of MRI’s and exactly 1 arteriogram (VERY straightforward). I was worried about this section and unfortunately got a ton of neuro anatomy. I would say learn FA’s neuro section well and add concepts from HY Neuro if you're missing details. Unfortunately, HY has too much info but I used it to supplement if I wasn’t understanding certain spatial relationships. In terms of what to expect with MRI's, I would say watch for clear landmarks (gastric air bubble, ribs, etc) to know what level you’re at. You can usually reason from there..really not anything terrible.

Embryology: basically owned me and I went through FA’s section twice. There was 1 picture that I’m certain I saw while breezing through HY Embryo. Probably not high enough yield but I got about 4-5 questions. Just stick with FA for basics.

Hopefully this is kinda helpful to someone! Good luck to everyone still studying.

Thanks for the post, if you don't mind me asking, what score are you aiming for?

 

[insistence]

Thanks for the post, if you don't mind me asking, what score are you aiming for?

Aiming for 220 but I'd be ok with 215 and quite happy with anything in 220-230 range.

 

[kate0834tkjn]

Took the exam a few days ago and have recovered enough to post........

General advice: bring your own earplugs (my center let me use them but they had to check them first), advil and some eye drops. reading the screen is tough on the eyes....also consider taking breaks between each section. I think it helped me.

Anatomy: killed me. tons of q's about vasculature, identifying structures on ct/mri, and NO brachial plexus/lumbar plexus. Not a single one. This really took me by surprise.....I was definitely underprepared for this section. I also had a ton of neuro....at least 10-15 brain images (both gross specimens and ct/mri) and probably 3 spinal cord pics. Wish I'd spent more time.....

Micro: again very heavily tested.....pretty straightforward, mainly bacteria but more parasites than I would have liked. No viruses. prob 10 per block. I used made ridiculously simple and FA and it was perfect.

Pharm: very heavily tested on my test which seems to be the exception...I prob had 5-10 per block. FA was enough for most but I had probably 4-5 drugs that weren't in FA at all and some random toxicities I got out of Kaplan/qbank.

Embryo: one question. literally, one question. i read hy embryo and thought it was great but didn't get many q's.

Path: unfortunately not much strict path. a few pictures but only once or twice was the picture absolutely necessary to figure it out. Unfortunately I don't think goljan, etc, really helped that much since I had so few q's.

Pathophys/phys: a fair amount....lots of up down arrows although not nearly as much pathophys as I would have liked. Basic phys was big and kind of got me....like gi hormones, cardiovascular etc. I wish I'd spent more time w/ brs phys. Know ADH/osm relationships, calcium/vit d/pth, etc.

Biochem/molecular: missed some easy stuff b/c I forgot it...frustrating ones to miss. Got a q on hox genes and got it right only b/c I read hy molecular. Probably experimental though, so probably didn't even count! Other than that, pretty basic stuff. Biochem q's could all be answered from FA if you don't forget things like I did. hy molecular was helpful for a few q's. know receptor mechanisms.

Biostats/behavioral: TOUGH! I had lots of calculations more complicated than spec/sensitivity....statistical analysis, 95% CI, # needed to treat. Ethics q's were a mixed bag...I think that brs helped a little but there were 3-4 where I had no idea and more than one answer seemed ok....then again some were really really obvious. Not sure what I could have done differently, so I am trying to forget about it--again brs was somewhat helpful and I also read hy biostats but forgot most of it before my test.

Immuno: a few questions but probably not more than 4-5 on the whole test. Very basic.

I didn't have any exact q's from the free 150 but ones that were very close so I would recommend doing them.

I liked UW- as has been said by others, the software very closely approximates the software on the real thing so it does feel like doing UW again. In addition to UW I did NBME 2 (740/260) and NBME 3 (770/263). UW started off about 60% and finished low to mid 80s but didn't do that many questions the last week (just tried to cram FA). Would love to do as well on the actual test as my practice tests but I doubt it's going to happen...

Good luck to those who have yet to take it!

 

[notsittinpretty]

Well I just took it yesterday, and I'm still recovering.............from my hangover! Hollah!

Seriously though, let me start off by saying that the test was definitely more difficult than I thought/expected it to be. I didn't take any of the NBME practice tests; i relied exclusively on Kaplan Q Bank for questions. I did this because most people i've spoken to told me that Q-bank was harder than the actual questioins, so I thought i'd be pleasantly surprised come Test Day. Well, I can say that the questions were about on par with Q-bank, and maybe even a little more difficult. Also, while people will post what was on their specific test, PLEASE realize that the selection of questions they give you is TOTALLY RANDOM. Some of the questions i had were way out of left field, and the distribution of questions I had was completely ridiculous. Example: I probably had 12-15 Biostats quetions....and about 2 on the total renal system combined. Not even a single acid-base problem. I don't quite understand the point of this; perhaps i'm just pissed off that i spent about two minutes on biostats and about 2 days reviewing the renal system. Anyway, the point is, just be prepared for anything. AND DON'T NEGLECT BIOSTATS! With that said:

1) Pharm: I'll Echo pretty much what everyone else said. I just studied the drugs in first aid and i was fine. Mostly mechanisms....a few adverse reactions question. They also liked to ask questions about antitodes....for red man's syndrome, tylenol overdose, etc. I think there is a pretty good page in First AID for this.

2) Behavioral Science: Ethics questions were cake. You will learn to love these as you go through your test day. Some personality disorder questions, mood disorder questions. The answers were pretty obvious though. Like I said, tons of Biostats. And not just, "calculate the mean." I was calculating odds ratios, relative risks etc....so be prepared. I really hated this about my test.

3) Micro: Pretty straightforward stuff. I didn't get a single virus question, but did actually get a fair amount of parasites. The parasites were your garden variety ones....nothing crazy - giardia, river blindness, entamoeba, etc. Definitely concentrate on your bacteria and know your antibiotic mechanisms.

4) Physiology: Hardly any straight physiology. Like i said no acid base questions, did get a few compliance curves and resistance problems.

5) Pathology: You need to know this stuff. I don't care what anybody else says. This is the most emphasized subject on the test. Mostly in the form of pathophys. though.

6) Neurology (special shout out): HOLY CRAP. This was ALL OVER my exam. I couldn't believe it. I'm talking tracts, MRI's, brain cross sections, stroke questions, arterial distribution questions. Organ system wise, CNS/PNS questions dominated.

7) Embryo: I think i had a cleft palate question and a brachial arch derivative question....that's about it.

8) Anatomy: Hardly anything. I had a few brachial plexus questions but they were pretty basic. Also had some really basic hernia questions. Anatomy is probably my weakest subject, so i was pleasantly surprised by this section.

9) Biochem: Ummm yeah, definitely study it. The NBME likes their enzyme deficiencies. And yeah, that huge list of lysosomal storage disorders....that's important. As is the list of glycogen storage disorders.

10) Immunology: This probably required the most thought during the exam. Nothing here was really straightforward. You really had to know how the immune system works to answer the majority of these questions.

Don't even ask me how i did, because i have no clue. I was getting about a 75% on my q bank....i would be happy with whatever that translates to on the actual test. Good luck everyone.

 

[kamal2toys]

Hello fellow step1 takers, I just took my exam today and i want to share my experience with everyone.

First of all i will like to start by saying " to who much is given, much is expected." this site and everyone`s post has definitely helped me and i feel indebted to everyone still preparing for the exam.

First of all i will like to start by saying that there is no one way on doing well on this exam but certain things are guaranteed to help pass the exam. Question are definitely keys and while there has been alot of debate about which qbank is the best, i think both kaplans and uw are the 2 most widely used and most tested and i higly recommend both.

As for the exam content, there is no easy way of saying this, test takers have to know their stuff. I dont think there is a short cut to this but the focus of studying should be understanding and not memorization. I know there are those little details that has to me memorized but the scope of the exam is much bigger that pure memorization. A solid understanding and some analytical thinking is what is needed to do well on the exam.

Personally i feel that the exam is a fair test. there is gonna be stuff the test taker knows, stuff the test taker should have known and some Wtf question. The goal is to get the most point for what the test taker know and what the test taker should have known.

A break down of the exam is as follow.
No 2 exam will be the same but just about everything imaginable is tested on the exam. Heads up for "what will the physician say in this situation" as i had a ton of those on my exam. I really dont like those but i got close to 20 questions.

Path was straight forward and not as twisted as UW.

Biochem is very straight forward and easy if well studied. I had a question from college general chemistry and i was like wtf. the question basicly gave a redox reaction and ask for the free energy of the equation. I figured this is one of those questions the 269er get right.

There as been alot of cry about the amount of molecular/genetic question on the exam and level of difficulty but i think they only test the most basic and simple things in the wierdest way. with a basic understanding, these are the easiest questions on the exam.

Anatomy is one of those subject thats is very tricky. i had the traditional brachial plexus and ct and mri questions but i think the anatomy in most qbanks will sufficiently cover the most tested basic concepts. same applies to embryology.

Pharm has lots of the foolish "what is drug x and drug y questions." i think again with a basic understanding, must of the graphs and drug x and drug y questions can be figured out.

Physiology has the traditonal arrow questions tied to the pathology so again, basic understanding is key.

For the actual exam, definitely fatigue and other unforseen factor will play into the test takers performance. the only advise is that each individual has to know their test taking abilities and prepare according to their capabilities. Breaks are very important and timing is key on the exam. if a test taker can finish uw within the aloted time, they should be fine for the exam.

I know i might not have said much when comparing this post to other post exam experiences but the honest truth that i will like to share with everybody is that this exam is doable and is not out of the realm of what a 2nd yr med student should know. Understanding is key and why is the name of the game not what. doing lost of questions and learning from those questions is key and anyone doing this can never go wrong.
Believe in yourself and most importantly do your homework and it will all be well.

 

[ayanjoe]

well, guys i found the test either testing general medical knowledge or PhD stuff !
and i felt that it was measuring my I.Q and reading speed ?
did anyone feel the same way ?

 

[PeepshowJohnny]

Just wanted to put up my impressions.

Biochem --- Relatively straight forward and about the amount I expected. I was surprised how distributed my test was, I had like one question each on glycolysis/neogenesis, fatty acids, protein synthesis, urea cycle, storage disorders, nucleotide synthesis, even a porphyria question! However, the questions were very straightforward and wer emore about "do you have a familiarity with this material?" then detail. This was how I'd studied for biochem in my last little runthrough the week before so I felt okay

Micro --- Again, pretty much exactly what I espected based on FA. In fact, the little breakdown they give about how much bacteria, virus, and immuno in their little introductoin was probably right on the money. For bacteria: not a lot of classification based on gram stain or lab tests, more about epidemiology and what toxins do. Even had an anthrax question, but it was something I'd remembered studying. Viruses were basically the classification stuff, segmented, rna, etc. which I'd pounded into my head. Immuno was pretty much just normal FA questions.

Pharm --- My friend had had a very pharm heavy difficult test the week before but I got off relatively scott free. I remember one difficult question about HAART side effects that I had no clue one, but it was mostly picking out the only representative of a class of drugs that made sense (which of the following diuretics will raise K+ type stuff) I'd pounded cancer drugs with a friend earlier in the week. He walked out with none, I walked out with two questions on methotrexate alone.

Molecular --- Scared my crapless going in, but wasn't used much. Basic questions about "what does (organelle) do". No dreaded EM pictures of gap junctions or anything like that.

Behavioral --- I felt I was a lot more confident with my selections for ethics type questions on Qbank vs. here. Qbanks were very long and detailed with many response options. USMLE were very short with only a few options showing a major ethical principle. I felt like I wanted more information on Step 1 but c'est la vie. I had ONE development question but it was a doozy, asking about which of several responses were appropriate in a certain kid.

Neuro --- I was a bit disappointed in neuro. I felt I did fine with the standard cranial nerves and nerve injury type questions, but there were some ones I just didn't feel confidence on which I should have. My major "WTF" question of the test was a section of a brain (extreme close up) where they wanted me to find a certain nuclei. I had no idea and moved on quickly.

Biostats --- Pretty straightforward, a bit of computation, a bit of "do you know what specificity, sensitivity, pos/neg predicative value actually mean?" and a bit of which study is this?

Path --- Lots of questions, but the majority were spelled out nicely. BRS Path and my memory of basic pathology were more than sufficient for this, so this wasn't Goljan level by an means. Basically it was "you know what disease I'm talking about here, right?"

Phys --- This was the majority of my test. I felt FA and BRS phys prepared me well but these questions wore me out to the point where I was really slowing down in the last sessions. I can't give any advice but know the charts, become a master of "what goes up, what goes down", and just know a lot of disea

Anatomy --- Somewhat scary. Lots of images, the CT's which I had feared turned out okay, but they kinda scared me by flashing up an MRI of a shoulder for a rotator cuff question. I probably overstudied for this subject.

Genetics --- Smooth saling, mostly. A bit of describe a disease and ask of it's inheretance pattern, a bit of "what kind of inheritance?" from a pedigree, and a bit of "what are the odds?" type questions, only one of which caused me a bit of consternation, but was nowhere near some of the crazier ones on Qbank. I don't even think I got asked what chromosome a single gene was on.

 

[TopSeed]

Well I just took Step 1 today. My initial impression was that there is no way to assess my two years of medical knowledge with 350 questions.....But I can honestly say that my exam touched on just about everything. The MCB sticks out, simply because it was like reading Chinese (and I'm not Chinese).
If I had the opportunity to do it all again, all I would use would be 1)USMLE WORLD 2)First Aid 3) Goljan.
Know these three well and the test will be much easier.

Best of luck to those left in the battle!
-TopSeed

 

[Haybrant]

thanks for the inflos!

 

[viostorm]

General advice: bring your own earplugs (my center let me use them but they had to check them first), advil and some eye drops. reading the screen is tough on the eyes....also consider taking breaks between each section. I think it helped me.

I agree 100%, especially on ear plugs and on taking breaks between every section. I blasted through sections 2 and 3 without taking a break and I think it hurt me.

 

[PugnaciousF]

Exam Overview

Bring your own earplugs. My center had these giant ones you could put over your ear, unfortunately after 10 minutes they started hurting my neck. The center women were nice enough to wedge me into the back corner so I had very few distractions. I thought about screwing with the other med student during the lunch break by saying things like "damn this exam is SO easy, too bad you go to X med school etc", but all my evil premed piss and vinegar has crumbled due to memorization overload and indifference.

to review..

1) Pharm - hooray for mechanisms. Very basic, very fair. All in FA. There was one drug I did not recognize and at worst I narrowed it down to a 50/50. These questions were very quickly done and I tried to "snap" through them so I'd have more time for 2nd and 3rd order questions. Lots of "Drug X" questions that turned out to miror atropine, or some other drug.

2) Physio - very few direct physio questions, I had some questions about cardiomyocytes, LES tone with a bolus, kidney, etc. I had a huge amount of endocrine (not sure where to include this). Endocrine is 1 of the 3 subjects I nearly made honors in and due to its mechanistic nature I adore).

3) Path - USMLEWorld how I love you so. I had multiple quotations and paraphrased questions from USMLEWorld on here. Even a wicked tuberous sclerosis question that < 20% UW users got right was on my USMLE. It made me laugh. Again tons of endocrine disorders - hepatitis, wilson's, alcoholism path on every part of the body, thyroid disorders out the wazoo, a few cancer questions.. 2 pics (one was either a direct port from Goljan's or UW). Most of the path was fair, though sometimes it'd ask for a very specific pathway I couldn't come up with. Definitely a fair amount of nephro/cardio/resp ( i missed a gimme fibrosis question), but all of the questions are fair and obvious. I had some nasty eye questions (retinal detachment etc), My mom is a secretary in a doc's office and she gave me a free eye pathology calendar that subsequently allowed me to answer a pretty tough eye path question. LOL, random I know!

4) Anatomy - This pissed me off. I had not one, but TWO, TWO damn questions on mouth anatomy. Specifically anatomy that a FILTHY DENTAL STUDENT WOULD KNOW, but things we don't emphasize, ie - where a duct is in relation to a tooth, or if you have surgery on this bone/muscle, what nerve is damaged. 1 cervical plexus question, 1 question about SITS muscles. Not bad stuff honestly, the more I look up my answers, the easier it seems... but I was panicking during the test b/c this was supposed to be my "strength" (I can usually just visualize any vessel/nerve/muscle etc) and I did not review anatomy b/c it was always a high score on UW. I had tons of CT/MRI images, some were not easy. Some you simply had to know what you were looking at to answer the path question. I'm glad I showed up to all my schools pointless radiology sessions, they don't seem so pointless now.

5) Neuroanatomy - Huge part of my exam. My school dropped the ball on neuro, so I read FA neuro 2x + HY neuro +1 and took notes. Pounded it. My neuro had virtually everything on it, syringomelia, multiple infarction questions, path disorders, alcoholism disorders, nutritional disorders, tract disorders with diagrams. Which Cranial nerve innervated the eye muscle that moved in X direction etc. It was fun.

6) Immuno - I regret not reading Kaplan Immuno and taking an afternoon off. I had tons of Immuno ~ 30 questions. Some were easy, most were not. You definitely have to know every damn IL, TNF, and CD out there and just how everything interacts. I had lots of immuno path too. My school teaches immuno in its first year. HEAR ME WELL MED STUDENTS, FIRST AID DID NOT CUT IT FOR IMMUNO! I definitely pulled some answers out of my butt, but I think I survived.

7) Embryo - I had very little embryo. First aid had some parts of it, not all, didn't matter. Not high yield. Usually the embryo was mixed with path (ie DiGeorge syndrome etc) or something obvious PDA.

8) Micro - ah micro, how I love and hate you. I had at least 5 mycosis questions, some of them easy, some not so much. UW rocked me on these so I felt ready. Standard questions really, not a lot of surprises, but you have to be ready for subtleties in descriptions, bird poo + "Midwest" etc. In general I had a lot of HIV and <blank> questions with micro/immuno. I like those questions. One or two mechanisms for bacteria, fairly benign. I had a few virus questions, the evil ones... from the charts... ie a patient presents with these 9 symptoms ... you get excited b/c you know EXACTLY what it is... "which of the following is causing the dz - ss+ RNA, ss- RNA, etc). I pulled both random viruses from that chart out of my butt as well. I forgot to review the virus chart recently, but it turned out to work in my favor. Lots of malaria and helminth/parasite questions. My friend and I just looked up a question on helminths that we STILL cannot solve wit hthe help of google. Hopefully it was experimental b/c that was straight garbage.

9) Heme/Onc.. Heme onc can be scary. This was not... I did have trouble with one cancer drug mechanism - not in FA. But the cancer questions were directly from 1st aid and UW. The heme questions were also very fair. Howell jolly bodies, sickle cell, ITP, DIC, etc.

10) Behavioral/Epi - stupid Epi, I can statistically prove that you suck. All of the epi was fair. Toughest question I had was to calculate an odds ratio. Kap - behav science was great for my exam. Independent probability calculations etc. Tons of ethics questions and "what would you do" as a doctor questions Kaplan Behavioral Sci has this one chapter that reviews "appropriate doctor responses". It helped me big time. IE never ever refer. Psych was cake, know every form of schizophrenia and personality clusters. I had a lot of questions on psych drugs. I don't like psych drugs + SE (some I have never seen) b/c I know nobody uses half of the ones we are pushed to study.

11 ) biochem - roughly 10 biochem questions... all easy..
roughly 20 med genetics questions... very specific, basic... but so specific - ie this organelle does this, this modification occurs where. I panicked a little. Then I got some nastier questions about RFLPs, Linkage, Lac operon crap, etc. I'm glad I took genetics b4 med school. a large portion of the med genetics is NOT in FA, but it is in kaplan biochem/genetics.

 

[Tastebuds]

Thanks guys for all the replies......did the NMBEs help at all in your course of studying for Step 1

 

[viostorm]

Thanks guys for all the replies......did the NMBEs help at all in your course of studying for Step 1

Minimally if at all.

 

[Roy7]

Minimally if at all.

You didnt study the NBME's enough or had a reallly reallly strange test.

My class as a whole studied the NBME's thoroughly - and not a single person who took the exam (all 100 of us) had less then 5 repeated questions verbatim from NBME's.

People that say "they didnt help" most likely took the NBME's under timed constrainted and never went over their answers.

Either get a bootleg version of the NBME's, make your own, or take 4 hrs for them - the questions repeat. My exam had 12 I can remember (I re-reviewed the NBME's the day before my test). I'll post more after I get my score.

 

[blz]

You didnt study the NBME's enough or had a reallly reallly strange test.

My class as a whole studied the NBME's thoroughly - and not a single person who took the exam (all 100 of us) had less then 5 repeated questions verbatim from NBME's.

People that say "they didnt help" most likely took the NBME's under timed constrainted and never went over their answers.

Either get a bootleg version of the NBME's, make your own, or take 4 hrs for them - the questions repeat. My exam had 12 I can remember (I re-reviewed the NBME's the day before my test). I'll post more after I get my score.

I still dont buy that they are that useful. 12 repeat questions? probably 12 easy questions you were gonna get anyways. i also used a source that got me about -320- questions on my boards - it's called FA. it's a four day investment to get those NBMEs done and reviewed. it's up to you, but dont stress if you can't fit them in. these tests are just to guage how well you're doing and nothing more. you can search for bootleg versions with answers but that would be breaking the law and also wasting your time.

 

[viostorm]

You didnt study the NBME's enough or had a reallly reallly strange test.

I did study about 100 out of the 800 total NBME questions, mostly the ones that I had difficulty with. None of the hard ones from the NBME's were repeated on my USMLE.

I think it is "higher yield" to go through 200 Qbank then NBME because you aren't wasting time looking up answers and many of those will be repeated in concept on the USMLE.

The only reason to do a NBME in my opinion is to get a feeling of where you stand.

I really didn't think the questions on the USMLE were even the same style as the NBME. They felt like they were written by different people.

 

[Scottish Chap]

I did study about 100 out of the 800 total NBME questions, mostly the ones that I had difficulty with. None of the hard ones from the NBME's were repeated on my USMLE.

I think it is "higher yield" to go through 200 Qbank then NBME because you aren't wasting time looking up answers and many of those will be repeated in concept on the USMLE.

The only reason to do a NBME in my opinion is to get a feeling of where you stand.

I really didn't think the questions on the USMLE were even the same style as the NBME. They felt like they were written by different people.

I agree with you. I did a couple of NMBE exams in timed mode. The point was to see which areas I was weak and strong in two weeks before the exam. In my humble opinion, it's a total waste of time to spend that money on NBME exams only to do them in extended mode for the sake of hoping to see a couple of questions repeat themselves on Step 1. I recognize questions I have seen before very easily and, on my Step 1 a few weeks ago, I personally didn't see any NBME questions repeat themselves. I did, however, see a very similar MRI and a very similar statistical chart on commercial questions banks that I used (I used two banks from different companies) - but that's just because they are very common concepts that a second-year medical student should know rather than anything 'cloak-and-dagger' going on. That's just two questions out of >4500 questions. Hopefully that will put it into perspective. Hard slog in MSII, First Aid and review books, and understanding concepts from commercial banks helped me in preparation; they are far more important....but that's just my own opinion.

 

[Roy7]

I did study about 100 out of the 800 total NBME questions, mostly the ones that I had difficulty with. None of the hard ones from the NBME's were repeated on my USMLE.

I think it is "higher yield" to go through 200 Qbank then NBME because you aren't wasting time looking up answers and many of those will be repeated in concept on the USMLE.

The only reason to do a NBME in my opinion is to get a feeling of where you stand.

I really didn't think the questions on the USMLE were even the same style as the NBME. They felt like they were written by different people.

If you're doing the NBME questions anyway - which most people are, go through them so you're at least getting the most for your time (2 extra hours to go through the right answers isnt much). And while yes I probably would have gotten those questions right anyway - I cant say that was the case for all of them - as some I just missed something or read the problem wrong.

I dont know what happened with your test, you must have had a strange exam or horrendously bad luck - I'd finished both Qbank and World (world 2x) and really though that Qbank was off World was great and the NBME's were closest (not any one, mine was a pretty even mix). I guess the exam is really that different from person to person, but man, you got screwed. Well, probably not, I'm sure they'll level it all out with a fair scale.

In response to a 4 day investment of doing the NBME's versus just reading - okay fine I'll agree w/you that it's not a life-or-death issue as you'll learn way more from reading than doing an NBME. But, if you're going to do the NBME's to "find out where you stand" - go over the answers.

 

[joe6102]

You didnt study the NBME's enough or had a reallly reallly strange test.

My class as a whole studied the NBME's thoroughly - and not a single person who took the exam (all 100 of us) had less then 5 repeated questions verbatim from NBME's.

People that say "they didnt help" most likely took the NBME's under timed constrainted and never went over their answers.

Either get a bootleg version of the NBME's, make your own, or take 4 hrs for them - the questions repeat. My exam had 12 I can remember (I re-reviewed the NBME's the day before my test). I'll post more after I get my score.

I agree. They were very helpful, probably got me 5 questions right that I wouldn't have otherwise. You tend to remember the difficult questions from the NBME's that you had to look up. I think these 800 questions are more valuable than any qbank out there. There are no official answers available, but the vast majority are relatively straightforward, and you can look up these answers quickly with your books/google/wikipedia. Even without the answers they are a MUCH better use of time/money than kaplan qbank.

 

[viostorm]

If
I dont know what happened with your test, you must have had a strange exam or horrendously bad luck - I'd finished both Qbank and World (world 2x) and really though that Qbank was off World was great and the NBME's were closest (not any one, mine was a pretty even mix). I guess the exam is really that different from person to person, but man, you got screwed. Well, probably not, I'm sure they'll level it all out with a fair scale.

Yeah, I took it June 20, and I can't help to think that they really changed the test up recently hence the whole waiting for scores thing. My wife and I took it same day at same test center and didn't have any of the same questions ... so yes, I think people really get different tests.

Overall I felt pretty good but Goljan/FA/question banks really preps you for Form 2 and my test was certainly not form 2 ... unfortunately. There doesn't seem to be anything that really preps you well for the molecular mechanisms they are going after.

I bet Goljan was the bomb back in the day when his stuff matched exactly what was on the test.

 

[Tastebuds]

Thanks guys for all your input......as this will definitely help me in the upcoming test (in 3 weeks)

Good luck to those who have not recieved their scores yet!

 

[Direct Laryngoscopy]

Took the test last week tues. and I have to say it was not that bad.

I had 2 blocks that had harder questions, but not out of this world. Maybe about 3 or 4 questions that I did not know at all what was going on. Reproductive (which I'm not particularly fond of and didn't want to see many of) and hepatobiliary were the flavor of the day for me. These 2 subjects were heavy on the 1st 3 blocks and spread throughout the other blocks.

The other organ systems were represented pretty balanced. Embryo was pretty nonexistent (first aid was enough for my exam). Anatomy was asked in the context of organ systems (CT/MRI, pathology). Neuroanatomy was also in CT/MRI but very simple (know origins that are ipsilateral vs contralateral). Not too many biochem questions but those that were asked were pretty straigh forward. For molecular, if you can get your hands on HY Molecular/Cell Bio (old edition) you'll get a few questions. Know the last chapter on receptor types (MAP kinase. Jak/Stat etc.).

Micro was also well represented on my exam also. Some question were not straight forward (ie experiment, 2nd and 3rd order questions). One parasite question and straight forward (South america....yada yada yada). A few viruses questions but very straight forward (more like first aid).

Behavioral/epidemiology questions were not that bad. Some of the what would you say next.. were always down to 2 choices but made an educated guess. Epidemiology overall was pretty straight forward.

For pharm 1st aid and no more.

My advice to those out there is to questions. USMLEworld is whats up thats all you need as a question bank. Don't even waste your money on CRAPLAN like I did. USMLEworld has great 2nd and 3rd order question so that you won't be intimidated by the real deal and can reason out accordingly. There were about 12 or so questions word for word that I did as a practice questions (I did maybe about 3000 questions) that was on the real deal.

My stats aren't great like you superstars out there (I call myself the anti AOA). My goal was 250 but wanted anything over 230.
NBME 1: 195
NBME 2: 204
NBME 3: 209 1 week prior
Free 150: 79%~237 - 2 days prior
We'll see what happens. I woke the other morning to a dream which my score was 216. Thanks to all the advice out there.

 

[Old_Mil]

Well, my turn...Like most people so far, I'd say that two blocks out of the seven were harder than the rest. Time wasn't an issue on any of them.

Embryology was nonexistent - maybe one or two questions tops. Neuroanantomy was in a clinical context, maybe a dozen questions. There were about a dozen biostats questions, all significantly easier than USMLEWorld. Same thing for behavioral med - I didn't review it and the questions posed no problem at all.

The bottom line was that the test I drew was an intracelllular test. I'd say that 35%-40% of the questions focused solely on intracellular mechanisms, enzymes, and so on. The system, or subject didn't seem to matter either. I was absolutely shocked at the amount of cell and molecular biology on the thing. Everyone knows its on there, but if you added up the Cell/Molecular and Biochemistry questions, they were probably equal in number to the total of Path, Phys, Micro, and Pharm.

To tell you the truth, I could have handled the Path, Phys, Micro, and Pharm on the test without a single day of review. I would've done better had I spent all my review time on Rapid Review Biochem and HY Cell/Molecular Bio...and found a Pharm resource that dealt with the mechanisms of actions in greater detail than Pharmacology Recall did.

Here's hoping for that 185. (My Stats... MCAT (33), USMLEWorld Avg (52nd percentile), Qbank % Right ~ 70%, didn't do any NBMEs)...

What I thought about the various review materials out there:

Step Up - Good
Step Up to the Bedside (Cases) - Good
RR Path - Excellent, but not emphasized much...I think they're testing around it. The "high yields" didn't seem to be.
RR Biochem - Excellent, heavily emphasized
HY Cell/Molecular - Excellent...basically, memorize the whole book
Clinically Oriented Micro - Excellent
USMLEWorld - Excellent

In my opinion, Pharm Recall and First Aid both fell in the category of "utter crap". Compared to the real thing, First Aid is like "See Spot Run...Run Spot Run..." Same thing for Pharm Recall - get a source that deals with drug MOAs in more detail...maybe BRS Pharm. Qbank - completely unrepresentative of the actual difficulty of the exam.

 

[cpb80]

Well, my turn...Like most people so far, I'd say that two blocks out of the seven were harder than the rest. Time wasn't an issue on any of them.

Embryology was nonexistent - maybe one or two questions tops. Neuroanantomy was in a clinical context, maybe a dozen questions. There were about a dozen biostats questions, all significantly easier than USMLEWorld. Same thing for behavioral med - I didn't review it and the questions posed no problem at all.

The bottom line was that the test I drew was an intracelllular test. I'd say that 35%-40% of the questions focused solely on intracellular mechanisms, enzymes, and so on. The system, or subject didn't seem to matter either. I was absolutely shocked at the amount of cell and molecular biology on the thing. Everyone knows its on there, but if you added up the Cell/Molecular and Biochemistry questions, they were probably equal in number to the total of Path, Phys, Micro, and Pharm.

To tell you the truth, I could have handled the Path, Phys, Micro, and Pharm on the test without a single day of review. I would've done better had I spent all my review time on Rapid Review Biochem and HY Cell/Molecular Bio...and found a Pharm resource that dealt with the mechanisms of actions in greater detail than Pharmacology Recall did.

Here's hoping for that 185. (My Stats... MCAT (33), USMLEWorld Avg (52nd percentile), Qbank % Right ~ 70%, didn't do any NBMEs)...

What I thought about the various review materials out there:

Step Up - Good
Step Up to the Bedside (Cases) - Good
RR Path - Excellent, but not emphasized much...I think they're testing around it. The "high yields" didn't seem to be.
RR Biochem - Excellent, heavily emphasized
HY Cell/Molecular - Excellent...basically, memorize the whole book
Clinically Oriented Micro - Excellent
USMLEWorld - Excellent

In my opinion, Pharm Recall and First Aid both fell in the category of "utter crap". Compared to the real thing, First Aid is like "See Spot Run...Run Spot Run..." Same thing for Pharm Recall - get a source that deals with drug MOAs in more detail...maybe BRS Pharm. Qbank - completely unrepresentative of the actual difficulty of the exam.

holy shnikes ... all of that cell bio sounds frightening?!? I'm surprised noone is pro-Kaplan with regard to it's Medical Genetics section as it covers prokaryotes as well as the eukaryotes (ex replication and enzymes), whereas HY only focuses on the eukaryotes. I guess that's not even an issue??
Just to make sure we're all talking the same jive- it's the High Yield Cell and Molecular Biology by Dudek (1999 no ed.)?? Yikes, looks like I need to read this before my test this Tues I apologize for hijacking, but any suggestions are much appreciated.

 

[Roy7]

holy shnikes ... all of that cell bio sounds frightening?!? I'm surprised noone is pro-Kaplan with regard to it's Medical Genetics section as it covers prokaryotes as well as the eukaryotes (ex replication and enzymes), whereas HY only focuses on the eukaryotes. I guess that's not even an issue??
Just to make sure we're all talking the same jive- it's the High Yield Cell and Molecular Biology by Dudek (1999 no ed.)?? Yikes, looks like I need to read this before my test this Tues I apologize for hijacking, but any suggestions are much appreciated.

The kaplan biochem/genetics section is good - but from what I'm hearing - everyone that had a molecular/genetics heavy test kaplan was no where near enough for the questions people are getting.

That being said, my test had little or no molecular and all the genetics questions I had were more than covered by kaplan.

 

[Taus]

The amt of Q's on Biochem, Molec and Genetics seems to be luck of the draw....I put a lot of time into studying that crap and I only ended up getting maybe 20 q's total on them....not complaining about that...just providing an example

That being said, the combination of the FA Biochem chapter + the old (1999) edition of HY Cell & Molec seemed perfect for everything I encountered in NBME exams and UWorld

 

[Tastebuds]

I have 3 weeks before my exam.....Should I buy the HY cell and molecular bio book. I have all the kaplan books...but if its not enough...I rather start reading HY. Also, was USMLE world enough for cell bio? It scares me that there was that much cell and molec bio on your exam!!!! Any advice on what I should do at this point would be very helpful.

Thanks

 

[Roy7]

I have 3 weeks before my exam.....Should I buy the HY cell and molecular bio book. I have all the kaplan books...but if its not enough...I rather start reading HY. Also, was USMLE world enough for cell bio? It scares me that there was that much cell and molec bio on your exam!!!! Any advice on what I should do at this point would be very helpful.

Thanks

Everyone says good things about the old edition. I found only the first chapter of the new edition and the section on cancer to be really useful. I'd suggest reading the first chapter of a friends - it's like 20 pages, but got me like 15 q's on my exam.

 

[Bubchik]

I have 3 weeks before my exam.....Should I buy the HY cell and molecular bio book. I have all the kaplan books...but if its not enough...I rather start reading HY. Also, was USMLE world enough for cell bio? It scares me that there was that much cell and molec bio on your exam!!!! Any advice on what I should do at this point would be very helpful.

Thanks

Just took mine yesterday. I did Kaplan books and FA just because I did not have enough time and Kaplan's Histo and molecular bio were more than enough, actually overkill: I had a coupe of very straight forward questions on DNA and RNA structure and NO questions on actual histology.
But I got so many neuro questions with speciments and CT/MRIs that I would rather have histo instead.

Good luck.

 

[Tastebuds]

What kaplan book has the molecular bio in it......biochem? I was thinking of purchasing the new edition of HY molecular bio.....but if kaplan is enough...i rather stick with it. Kind of confused on the matter...as I am not good in molec. bio. Advice?

 

[smalley]

What kaplan book has the molecular bio in it......biochem? I was thinking of purchasing the new edition of HY molecular bio.....but if kaplan is enough...i rather stick with it. Kind of confused on the matter...as I am not good in molec. bio. Advice?

yes kaplan biochem has the molecular biology an the genetics section also..
i think they explain it quite well...
am supplementing hy with kaplan though

 

[Trooth]

Like everyone said...never did i imagine that a 350Q test could cover everything but it really did - but some more than others.
Heavy on :
Anatomy (i know WTH!)
Biochem
Path of Rashes
XRays
Beh. Science - VERY much so - I would focus on knowing how to actually do the calculations, i knew the stuff cold but spent a good 10 mins doing a HW question because the #s were tough for me to set up...maybe I am just weak in math

Weak on:
Embryo
CTs
Genetics


i studied Golgan path reading (not audio)
and went through FA 2x - 1st time very slowly took a week
and the 2nd time the week pre test again to make sure it was all sunk into my Hard Drive

Took all 4 NBMES
did not waste time/money on Qbank
No usmle world bc I learned about it the week pre test - sadness..i know.
My school gave me 2 NBMES - I failed both and was annoyed because I did not even study at all and they still subjected me to that depressing humiliation which I think I would have liked as vouchers to do the NBME later or on a computer atleast.

 

[Tastebuds]

How did you do on the other 2 NMBEs....fair or good? Just wondering whether I should take NMBE 2 since i didnt do well on the first one. Also, how did you find the real exam? I have 3 weeks before my exam...just wondering how I should spend those 3 weeks.

Thanks

 

[LADoc84]

-

 

[Trooth]

How did you do on the other 2 NMBEs....fair or good? Just wondering whether I should take NMBE 2 since i didnt do well on the first one. Also, how did you find the real exam? I have 3 weeks before my exam...just wondering how I should spend those 3 weeks.

Thanks

not sure if this Q is for me but just incase..

i took a total of 6 NBMES

2 paper by my school
4 paid online

I failed the 1st 2 (60 & 58)

then I read Goljan and took NBME form 3 - and passed it

I think form 3 was the most like my test because it had a lot of guessing Qs - Qs that you can eliminate 3/5 choices or just deduct out the answer..but everyone has a opinion on which form was closest to the test so pay me no mind.

I passed the last 4 computer NBMES. I think they were easily well worth the money, I did not think about Kaplan till about 3 weeks before my test and I did not want to shell out $300 or w/e it is to depress myself. The NBME tests were good for me, they also let me see a upward trend, I need that personally as a motivator so I was pleased.

Also the graph after the test gave a me a good idea of what I sucked at - but in a last ditch tactic i focused on excelling at stuff I liked and knew already than brining upto great the stuff I just could not grasp. I think it was a effective way..but we will see in a few weeks.

I would have paid 10x over for FA and 5x over per NBME...I did buy the Kaplan book set but found it weird and basic and then nitty gritty. I have a strong kaplan opinion from using them before.

 

[Tastebuds]

not sure if this Q is for me but just incase..

i took a total of 6 NBMES

2 paper by my school
4 paid online

I failed the 1st 2 (60 & 58)

then I read Goljan and took NBME form 3 - and passed it

I think form 3 was the most like my test because it had a lot of guessing Qs - Qs that you can eliminate 3/5 choices or just deduct out the answer..but everyone has a opinion on which form was closest to the test so pay me no mind.

I passed the last 4 computer NBMES. I think they were easily well worth the money, I did not think about Kaplan till about 3 weeks before my test and I did not want to shell out $300 or w/e it is to depress myself. The NBME tests were good for me, they also let me see a upward trend, I need that personally as a motivator so I was pleased.

Also the graph after the test gave a me a good idea of what I sucked at - but in a last ditch tactic i focused on excelling at stuff I liked and knew already than brining upto great the stuff I just could not grasp. I think it was a effective way..but we will see in a few weeks.

I would have paid 10x over for FA and 5x over per NBME...I did buy the Kaplan book set but found it weird and basic and then nitty gritty. I have a strong kaplan opinion from using them before.

Thanks for your reply......I didnt do well on my first NMBE either...took before studying...and our school made us take a mock 8 hour exam before leaving to study for the exam...which I did good. I am debating whether to take NMBE 2 tomorrow....a month after studying...but like you...if I dont pass...I will not be motivated to study. So I guess I really dont know what to do. Any advice from you would help...on if the NMBEs were helpful for the real exam etc. Also, I have 3 weeks before my exam.....how would you recommend spending this time?

Thanks

 

[SoCuteMD]

Thanks for your reply......I didnt do well on my first NMBE either...took before studying...and our school made us take a mock 8 hour exam before leaving to study for the exam...which I did good. I am debating whether to take NMBE 2 tomorrow....a month after studying...but like you...if I dont pass...I will not be motivated to study. So I guess I really dont know what to do. Any advice from you would help...on if the NMBEs were helpful for the real exam etc. Also, I have 3 weeks before my exam.....how would you recommend spending this time?

Thanks

If you have 3 weeks I'd take another NBME soon, then target your studying to the weaknesses it finds.