Swanson's is actually a pretty reasonable approximation of the questions i was getting. my blocks were predominately comprised of outpatient medicine, and almost all the topics in swanson are in that style. the surgery, OB, peds, etc are all either follow-up visits or early symptoms requiring diagnosis prior to referral, etc.
i had 5 blocks of outpatient scenario, one ED, one inpatient block. the ED scenario was by far the worst, because some of the options were just vague... as someone else said in a different thread you can be staring at options A-E thinking.. well i'd do F - the correct answer - if it were listed.
i hope tomorrow is even easier than today, because when the smoke settled, today was easier than Step 2, in my opinion. Not quite "bring a #2 pencil" like the old adage proclaims, but not a real migraine-inducing "here are some obscure diseases from every discipline... go!" scene like Step 2.
my advice - review the Epidemiology section in Swanson if only to memorize the sensitivity/specificity equations (easy gimmes on any of these exams). review the IM sections, maybe the peds/OB too.
second day was more of the same, although i felt there were more "wtf are they getting at??" questions on day 2. this could be entirely due to me being tired from day 1. i definitely had a hard time staying awake through the 4 shorter blocks on day 2. auditory hypnagogic hallucinations galore.
the cases were simple and straightforward. i think i completely blew one that in retrospect was likely sarcoidosis (after 11 million times seeing classic sarcoidosis on practice questions, i miss it on a case!). some others were just cake - normal pregnancy, child abuse, etc.
after all is said and done, i can say with certainty that i definitely either passed or failed it.