Could really use some Step 1 advice.

[deleted604914]

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Sorry if this posted a lot but I am just currently at a loss of what to do and am really freaking out! Essentially I am worried that I am not going to reach my goal on Step 1 and am wondering what I can/should do to make the most improvements from here on out. I am aiming to get a 240 but am super worried that that is unattainable at this point.

First off, I am in my dedicated study period (5 weeks period) and will be taking the exam in 3 weeks now. I have a study schedule which I have stuck to fairly well.

Throughout the year I had done UWorld + Rx for each subject area that we were studying and finished both banks once before dedicated. During the year, for each area I would watch Kaplan (Anatomy/Histo/Pharm/Phys) + Pathoma (twice) before each exam and annotated into First Aid. I averaged around ~65% on UWorld by the end. I finished DIT 1 month ago (took about 3 weeks 15-17 vids/day). The last couple weeks before dedicated I ran through First Aid + Pathoma once.

My plan has been to get through UWorld again (70% through@76% avg, should be done by next week at 4 blocks/day), then do Kaplan Q bank (4 blocks/day), then try to review my UW incorrects. I am panicking because of a couple reasons, 1) my UWorld scores haven't really changed (get around 68-80% each block, only a handful above and none below) 2) I am worried I am remembering questions and inflating my score too much or causing me to change answers because of stupid mind games.

The thing that is freaking me out the most is my track record on NBMEs. I plan to take another in 2 days.
NBME 11 (6 weeks ago): 205
NBME 12 (2.5 weeks ago): 224
UWSA 1 (2 weeks ago): 228
NBME 13 (1 week ago): 222

I just don't know if I'm spending too much time doing questions. 4 blocks + review usually takes me almost a full day, leaving not much time to just straight up review FA. Should I be cutting down on the blocks and say screw worrying about finishing Kaplan and spend more time just reviewing FA? I have been trying to make time to work on my weaknesses lately by speeding up my time reviewing UW blocks so I'm not sure if that will help. I just feel like my weaknesses have been fluctuating and the things I know I'm weak in often don't even show up (ex. I forget random stuff like neurocutaneous disorders, lysosomal storage, anatomy, histo) so I just really don't know what to do.

I am looking for any guidance on what I should do for these last weeks to try and improve because right now I am so stressed and basically losing it because I'm too scared I can't do it. Sorry for the long post!

 

[byaaaaaaah23]

Have you looked at the questions you got wrong on NBMEs? Is it stuff you're missing because you just can't remember the info or are you making testing errors like not reading the question the whole way, etc? If it's the first, then I would definitely cut back on the qbanks and just read FA until your eyes bleed. If the second, then I guess continue to do qbanks but do new questions. If you at all think you're just remembering the answers, then buy a new qbank.

I think you can raise your score but to me it seems like there might be gaps in your knowledge which is why you aren't really going up on the NBMEs so instead of spending so much time doing uworld, spend some heavy time with FA and Pathoma.

 

[deleted604914]

Have you looked at the questions you got wrong on NBMEs? Is it stuff you're missing because you just can't remember the info or are you making testing errors like not reading the question the whole way, etc? If it's the first, then I would definitely cut back on the qbanks and just read FA until your eyes bleed. If the second, then I guess continue to do qbanks but do new questions. If you at all think you're just remembering the answers, then buy a new qbank.

I think you can raise your score but to me it seems like there might be gaps in your knowledge which is why you aren't really going up on the NBMEs so instead of spending so much time doing uworld, spend some heavy time with FA and Pathoma.

Thanks for the input, really appreciate it. I have reviewed all the NBMEs.. it seems to me like its a mix of both. There are a decent amount of Qs that I'm just like, I should know that, but I just blanked. There are definitely some that I just didnt decipher what the question was asking. I own UW, Rx, and Kaplan. I do my best to try and reason through UW questions so there is some knowledge, but sometimes I'm like 'crap, I think I put this last time and got it wrong' only to find out that my original thought was right (like I said.. I play stupid mind games with myself).

How important do you think is getting through another Q bank completely vs just FA/Pathoma? I like questions a lot because I feel like I'm actually testing & solidifying my knowledge so I'm scared to just drop my schedule of getting through UW+Kaplan+UW incorrects in order to just read.

 

[byaaaaaaah23]

I would def not do any questions you've already done if you find that happening a lot. I honestly thought that UWorld wasn't that helpful because it makes you overthink everything like crazy when in my experience the real test was not like that. Can't really comment on Rx or Kaplan in that regard, sorry.

At this point, I would cut down from 4 blocks/day to 2 max since the only real benefit I saw from doing qbank was to figure out how they would ask questions. Since you've already seen so many questions, 4 blocks/day just won't help you. I don't think you should abandon questions completley but I don't know how you would you complete and review 4 blocks/day and still have time to legitimately read and retain FA. So with the time you would have spent doing more blocks, read FA over and over again. And I would make those questions that you do be from a new pool (ie any bank is fine as long as you haven't seen them before).

 

[deleted604914]

I would def not do any questions you've already done if you find that happening a lot. I honestly thought that UWorld wasn't that helpful because it makes you overthink everything like crazy when in my experience the real test was not like that. Can't really comment on Rx or Kaplan in that regard, sorry.

At this point, I would cut down from 4 blocks/day to 2 max since the only real benefit I saw from doing qbank was to figure out how they would ask questions. Since you've already seen so many questions, 4 blocks/day just won't help you. I don't think you should abandon questions completley but I don't know how you would you complete and review 4 blocks/day and still have time to legitimately read and retain FA. So with the time you would have spent doing more blocks, read FA over and over again. And I would make those questions that you do be from a new pool (ie any bank is fine as long as you haven't seen them before).

That's a good point. I will try to cut down on the blocks and pound through FA again and see how things go. I had planned to go through NBME 14-17 plus UWSA2 in the next 3 weeks. Is that too many tests? Also, is it worth doing 2 in one day to simulate a 'real' exam?

 

[byaaaaaaah23]

I don't think that's too many tests and I do think it's helpful to do 2 in one day. If you decide to cut any tests, leave out the UWSA since I've read on here (no personal experience though) that UWSAs will overpredict your scores but NBMEs are usually good predictors.

Good luck!!

 

[deleted604914]

I don't think that's too many tests and I do think it's helpful to do 2 in one day. If you decide to cut any tests, leave out the UWSA since I've read on here (no personal experience though) that UWSAs will overpredict your scores but NBMEs are usually good predictors.

Good luck!!

Hmm alright. I might try to do them (or at least 15-17 and not do 14 or something). The only reason I wanted to do UWSA is that it is new UW questions w/ explanations that I haven't seen yet so it'd be a study tool. Hopefully I can report back some improvements in the coming weeks. Thanks for all your help!

 

[deleted604914]

So I just wanted to check back in to see if anyone had any advice for how I should tackle my last 11 days before my exam. I made adjustments by trying to spent more time reading FA and going through each section and dropped it down to 2 UW blocks a day. I will finish UW tomorrow w/ an average of ~76% (2nd pass, did first pass throughout the year so probably inflated percentage).

I did NBME 15 2 days after this original post (228), and then just did UWSA2 yesterday (248) after a little more than a week of switching up my plan, so it looks like I'm at least making a little progress. Not sure if I can pull off the 240, though. Planning to do NBME 16 in the next couple days to get a better gauge for where I'm actually at but I was hoping to get some advice on what I should do based on my weaknesses.

I am a bit unsure of what to do because I feel like I often do well on certain subjects and then randomly do poorly. If someone could take a look at my breakdown that I attached and let me know what you think you would do with the last 12 days to try to improve, I'd really appreciate it!

 

[deleted604914]

Anybody have any advice?

 

[coyfish]

Not the answer you want but you really have to tailor what you do in your last week to your specific needs. Forgive the analogy but now isn't the time to be placing any new nails (learning new topics) but rather tightening up any loose ones you may still have. I personally went through flash cards and charts I had made. Then I went through topics I had stickied that I commonly forgot. Buzzwords like corkscrew eosinophilic fibers (rosenthal fibers) / etc. Easy things I knew but needed frequent refreshing. Make sure you relax the day before your test as best you can. I did not and studied most of the day. It stressed me out and did not help me at all. Remember this test is much more conceptual than the NBME's make it out to be (at least mine was). So trying to cram will only stress you out.

 

[deleted604914]

Not the answer you want but you really have to tailor what you do in your last week to your specific needs. Forgive the analogy but now isn't the time to be placing any new nails (learning new topics) but rather tightening up any loose ones you may still have. I personally went through flash cards and charts I had made. Then I went through topics I had stickied that I commonly forgot. Buzzwords like corkscrew eosinophilic fibers (rosenthal fibers) / etc. Easy things I knew but needed frequent refreshing. Make sure you relax the day before your test as best you can. I did not and studied most of the day. It stressed me out and did not help me at all. Remember this test is much more conceptual than the NBME's make it out to be (at least mine was). So trying to cram will only stress you out.

Thanks for this, any advice really helps. I totally agree with what you're saying. A lot of the mistakes I make are just little things that I forget in the heat of the moment even though they are so simple. Like on the UWSA2, there were at least 7 questions that were straight facts that I have learned that I missed (like picking CA 19-9 over CA125 for ovarian tumor marker because I panicked).

My issue is that looking at my breakdowns and the trends.. I feel like they are all over the place for certain areas. For example, I had consistently done pretty well on Cardio/Pulm but then my most recent test went down in those subjects. Do I then spend more time review that subject or do I chalk it up to a fluke on that test and focus on other things? I guess I just don't know what to make of my breakdowns and using them to triage what I should spend time on.

Except Anatomy/Embryo.. looks like I just suck at that lol. Should I just hit FA for that or is there something else I can do to get a quick comprehensive review of it? And for the rest of the weaknesses.. just read FA/notes? I'm not much of a notecard person but I have written/typed notes from studying/UW. Thoughts on doing questions (either UW incorrects or doing Kaplan Qbank on high yield)?

Thanks again for the response, really appreciate it.

 

[coyfish]

You are welcome! Well it is normal to be scattered in your breakdown at this point. If you sucked at pulm you could expect to always do poorly in pulm. The fact that it goes up and down is most likely due to the individualities of each test rather than a specific weakness. Breakdowns didn't really help me much. Once you start getting over 230 they become useless imo. I used the tests to gauge my score which they miraculously did (you will realize how crazy this is when you take the real thing). I would use your own judgement as to what you are weak at. Pretend you were going to be asked a question from one of the subjects in uworld. Which subject would you hate the most?

Embryo was pretty straightforward on the step and right from FA (for me and many of my classmates.) Anatomy is the pain. Definitely know the FA stuff. If you feel confident and don't know what more to study at this point than maybe I would recommend going though high yield clinical anatomy (not the book but the concept). Like common injuries that are not in FA. Im sure you covered a lot of that in your anatomy class. Maybe you can browse your notes. That is the type of stuff most likely to be asked along with imaging stuff. The thing about anatomy is there is just so much. I wanted to go through things so bad in my last week but i felt my time was better used elsewhere than trying to cram new stuff in and risk forgetting FA stuff. Like I mentioned I chose to hammer home any loose screws and stuff that I knew, but needed refreshed. For instance rather than reading a hole bunch of anatomy you will probably forget right now ... reread ovarian tumor markers which you have probably read so many times. It would suck to miss a question like that on the step. I also reviewed concepts I found in the NBME's not covered in FA. For example burns (1st/2nd/3rd degree), antiseptics (H2O2, OH, etc), IV lines, etc.

Questions vs FA. This is a tough one and depends on you. I personally think its a bit late to be switching q banks. It may help but it may hurt your confidence as well which is a huge thing. I am not really a "question learner." Don't get me wrong I did uworld 2x but i learn best simply by reading and rereading which is what I chose to do in my last week. If you learn best by questions maybe it will work for you. I achieved my goal and my approach towards the end was as follows. I had faith in my NBME and chose to be as confident as possible in what I knew. The inevitable crazy questions will come no matter how hard you study or how long you study...

GL and have faith in yourself!

 

[seminoma]

So I just wanted to check back in to see if anyone had any advice for how I should tackle my last 11 days before my exam. I made adjustments by trying to spent more time reading FA and going through each section and dropped it down to 2 UW blocks a day. I will finish UW tomorrow w/ an average of ~76% (2nd pass, did first pass throughout the year so probably inflated percentage).

I did NBME 15 2 days after this original post (228), and then just did UWSA2 yesterday (248) after a little more than a week of switching up my plan, so it looks like I'm at least making a little progress. Not sure if I can pull off the 240, though. Planning to do NBME 16 in the next couple days to get a better gauge for where I'm actually at but I was hoping to get some advice on what I should do based on my weaknesses.

I am a bit unsure of what to do because I feel like I often do well on certain subjects and then randomly do poorly. If someone could take a look at my breakdown that I attached and let me know what you think you would do with the last 12 days to try to improve, I'd really appreciate it!

Wow that's what a 228 looks like? Based on the bars/stars I would've guessed a much higher score than 228. Not sure where you're at, but I don't think there's a compelling reason to look outside of UFAP in the last 1-2 weeks.

 

[deleted604914]

You are welcome! Well it is normal to be scattered in your breakdown at this point. If you sucked at pulm you could expect to always do poorly in pulm. The fact that it goes up and down is most likely due to the individualities of each test rather than a specific weakness. Breakdowns didn't really help me much. Once you start getting over 230 they become useless imo. I used the tests to gauge my score which they miraculously did (you will realize how crazy this is when you take the real thing). I would use your own judgement as to what you are weak at. Pretend you were going to be asked a question from one of the subjects in uworld. Which subject would you hate the most?

Embryo was pretty straightforward on the step and right from FA (for me and many of my classmates.) Anatomy is the pain. Definitely know the FA stuff. If you feel confident and don't know what more to study at this point than maybe I would recommend going though high yield clinical anatomy (not the book but the concept). Like common injuries that are not in FA. Im sure you covered a lot of that in your anatomy class. Maybe you can browse your notes. That is the type of stuff most likely to be asked along with imaging stuff. The thing about anatomy is there is just so much. I wanted to go through things so bad in my last week but i felt my time was better used elsewhere than trying to cram new stuff in and risk forgetting FA stuff. Like I mentioned I chose to hammer home any loose screws and stuff that I knew, but needed refreshed. For instance rather than reading a hole bunch of anatomy you will probably forget right now ... reread ovarian tumor markers which you have probably read so many times. It would suck to miss a question like that on the step. I also reviewed concepts I found in the NBME's not covered in FA. For example burns (1st/2nd/3rd degree), antiseptics (H2O2, OH, etc), IV lines, etc.

Questions vs FA. This is a tough one and depends on you. I personally think its a bit late to be switching q banks. It may help but it may hurt your confidence as well which is a huge thing. I am not really a "question learner." Don't get me wrong I did uworld 2x but i learn best simply by reading and rereading which is what I chose to do in my last week. If you learn best by questions maybe it will work for you. I achieved my goal and my approach towards the end was as follows. I had faith in my NBME and chose to be as confident as possible in what I knew. The inevitable crazy questions will come no matter how hard you study or how long you study...

GL and have faith in yourself!

Thanks a lot!! I've kinda just stuck w/ FAPing at this point. Finished UW a few days ago. Basically have just watched [email protected] speed and read every word in FA for the corresponding section, trying to get through one more pass before the test mid next week. I figure at this point all I can do is hope I can retain as much of the important things as possible instead of learning anything else. Confidence is one of my biggest issues so I gotta shake myself out of being down all the time about not being where I want to be.

 

[deleted604914]

Wow that's what a 228 looks like? Based on the bars/stars I would've guessed a much higher score than 228. Not sure where you're at, but I don't think there's a compelling reason to look outside of UFAP in the last 1-2 weeks.

It's really annoying! I feel like I often do pretty well on a bunch of sections and then randomly do poorly on a section (ex. Cardio - Good> Better> Even better> bombed lol) but its a bummer bc I guess its gotta be off the charts to hit the 240 I'm reaching for. I'm not sure what else to do at this point with less than a week left except read FA and watch pathoma like I've been doing. Taking the last NBME 17 tomorrow to see if I've been on an upward trend and hopefully am peaking right before the exam but who knows. Took NBME 16 5 days ago and got a 234.. with some really dumb mistakes again.

Hope you're enjoying being done! You definitely killed it. Surprised you still check up on us mere mortals though

 

[deleted604914]

NBME 17 yesterday... I got a 251!!! Kinda regretting taking it now only a few days before the real deal because what if that was how I was gonna do on the real deal instead lol?!

But seriously.. I'm so nervous that this was a fluke. Anybody have any thoughts on NBME 17 vs the rest of the NBMEs. It seemed pretty different than most tests.. a lot of behavioral (which I feel solid at) so I hope my score is not too inflated. Just hoping for a 240.

Think I can pull it off or was this test just a fluke?

 

[greenzen]

Just curious to know if you pulled it off and how your exam experience was.

 

[deleted604914]

Thanks for the interest! I kinda fell off because I got extremely sad because of my actual score and looking at the scores on SDN really didnt help haha. I think I also started to get high expectations because of my last NBME and maybe lost focus the last few days before because of that. I want to do a competitive specialty that averages in the low 240s, and I did not reach that. Since you asked, I'd be happy to try to talk about my experience.

I'm never able to remember what was on an exam after I finish it, so I won't be able to help too much on there. I can't remember anything within 5 minutes of taking a test really, so Step wasn't very different. Though I will say that I felt like there were a lot of current events (ex... I had 3 questions relating to the Caitlyn Jenner situation).

I thought it was tough, but I couldn't gauge how well I did because the questions didn't feel as straightforward as a lot of the NBMEs. There were definitely still a bunch of gimmes and I would echo the consensus that it was a mix of UWorld/NBME style questions. I think I could have done a lot better had I started my dedicated study off better instead of waiting so long to revise my plan. My mistake was not focusing on FA/Pathoma at the beginning. There were too many details that I waited too long to memorize and instead focused too much on questions, thus wasting them because I wasn't spending enough time just learning/memorizing material in a systematic way (vs random facts from questions).

If I were to do it all again, I wish I would have used Goljan audio more systematically throughout my school year and maybe even used Rapid Review and at least read through it once during my coursework. I still think that my plan of going through each system during that module (ex. For our Cardio module- I went through Kaplan videos for histo, anatomy, physiology, pharmacology, and Pathoma for pathology in the first week before going to my class lectures and read FA concurrently though only annotating Pathoma into it). I wish I had also done Kaplan during the school year and finished it off along with Rx before my dedicated study, since I never was able to complete it. Going into dedicated, I would have focused on UFAP, making sure I systematically went through Pathoma and FA specific sections and really tried to memorize the big concepts and slowly add in details, while doing a couple UW blocks a day. I feel as though I wasted my first 2 weeks of dedicated by doing 4 blocks a day, because I was only memorizing random facts and concepts from questions that wouldn't stick, and I was struggling and rushing to try and get through that much each day, which wasn't reasonable.

I ended up with a 235 on the real deal. In the end, I realize that my score could have been a lot worse, and I really should be happy with that based on my practice test scores. But for some reason I have gotten sad about what could have been and how I've really put myself in a hole to get into the specialty I want. I'm still going to try and will keep an open mind throughout my third year and hopefully can step my game up for Step 2. Hopefully in the end I can report back that I got into the field that I love and this will all not matter! If you have any questions, I'd be happy to respond. I really do appreciate the help I got from here and am happy to help out even though I may not be the typical SDN caliber student.