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Delaying Rotations to Study for Step 1

Brorthopedic

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    Sometimes the problem is students approach this test attempting to memorize everything. Has your mindset been to just "get through everything" or have you been concentrating on understanding the material on a deeper level? The latter of the two is the way to go, no matter how time consuming it may be.

    In either case, from what I've heard, it's better to get a LOA than to fail the Step 1.
     

    TBV

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      Damn bro condolences sounds like you're going to need at least 3-4 weeks and focus on understanding concepts on UW rather than getting through passes. Make sure your learning is active and such but I'd definitely take a delay
       
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      operaman

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        Without question, delay. You're not even close to passing at this point. Few things are worse than a step failure so don't risk it. No idea on the time required or whether you will ever reach a 220.

        Do not take the test u til you're scoring at least 205 on your nbme exams. Based on their scaling, this gives you a pretty sure chance of passing when you take the real deal.

        Agree with above that your overall approach needs serious revamping. You likely have a combination of base knowledge deficits combined with poor test taking skills - a lot to fix, but doable with the right approach. I would advise seeking out as much individual one on one help as you can find. Pay for it if you have to. But don't keep doing the same things you've done already.
         
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        Instatewaiter

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          I am 9 days away from my exam and looking for advice because I scored a 166 on NBME form 15 19 days before my exam, and 173 on NBME form 17 12 days before my exam.

          I feel pretty depressed because I've had almost 7 weeks of dedicated time and don't seem to understand where to go from here.

          As far as what I've done to prepare:
          -I finished UW 1st pass 49 days before my exam and I am 276 questions away from finishing UW 1.5x
          -I re-watched 13 of 19 chapters worth of Pathoma videos
          -I have gone through 43% of USMLE RX Flash Facts (Cumulative performance, 58%)
          -I did 200 USMLE RX questions and 200 Kaplan questions
          -I re-watched sketchy micro
          -I read a few chapters of FA out loud with a classmate and discussed annotations

          So the questions are,
          (1) should I delay my exam at the expense of taking an academic leave of absence
          (2) if yes, how much time off should I take to realistically reach a 220
          (3) why have I done so many things but not had any of these preparations reflect in my score?
          (4) when should I take another diagnostic
          (5) Since I'm getting 75+ questions wrong on the NBMEs, should I be reviewing these questions
          (6) what is the best way to address knowledge gaps for weaknesses during dedicated time

          Thanks everyone!

          1) Probably. Realize if you fail step1 not only will you struggle to match but you will have to take time off anyway and will have to study during rotations which will be much more difficult.

          2) If after 7 weeks of studying you aren't even passing, you are exceptionally unlikely to make it to a 220. Shoot for passing

          3) Without actually knowing how you are studying (rather than just what you have done) it is hard to know what th e root cause is. I'd think long and hard about what the root cause is.

          4) No idea. Might make you feel better if you take one and do ok tomorrow

          5) After every question you do, you should be reviewing the answer explanations- not just the ones you get wrong. This is especially important for UW

          6) I mean you are basically asking us to answer how you study best. We don't know you. Also it is going to depend on how much time you take. First Aid was always a good resource when I took step 1 and using it as a backbone from which to flesh out deails seemed to work for people in the past.
           
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          sloop

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            This is a very easy answer: you should delay. You need to figure out what's wrong and address it. As far as how much time off, this may depend on your school. You are probably going to need to bump a core rotation into fourth year or something similar. I'd say however long a typical rotation is at your school: at least that long. A lot also depends on why you're doing so poorly. If you have absolutely no idea and can't seem to figure it out, you may need more time.
             

            mymembernames

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              Why not take a year off and study to do really well and do some research after you take it if there is time left. Easy to explain the year off and if your score is strong it shouldn't even matter from what I know.
               

              BigRedBeta

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                First you need to talk to your dean's office.

                Second, it sounds like you need to change up your study methods in some way. Whatever you're doing is not working. Whether you're trying to relearn too much detail, are too superficial, aren't paying attention to your question thought process or what not, you need to hit the reset button.

                My guess is that you're not utilizing the questions well. It's not enough to just do the question and see if you got the right answer. Nor is it enough to just read the explanations. You might try a technique that Kaplan calls "post phrasing" - you read the question, find out what the correct answer is and then without reading the "official" explanation, you come up with (and if you're like me, write out) the exact reasoning why the wrong answers are wrong. The other option is to do that process as you go through an untimed exam, and then compare all your reasoning with the explanations provided. This generates a lot more data and allows you to identify faults in your thought process, areas where you don't have a good grasp of the content, or even if you actually are thinking about a lot of the information correctly.

                Third, if you do take a LOA, I would caution against the idea that you take off a super extended period. Studying is usually subject to the law of diminishing returns. At some point you're going to plateau and depending on your level of test anxiety, may actually begin to regress. I probably wouldn't take leave longer than 8 weeks, and even then I'd say that 4 or 6 weeks makes more sense. That's also a lot more reasonable to make up third year clerkships as an M4.
                 

                nontradnyc

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                  Delay. Nothing worse than failing it. Easier to explain a LOA than a failed Step.

                  EDIT: deleted this original response. That moment when 500+ people read your thread in the course of nearly a week after posting, and not a single one of those readers can offer even a suggestion, even if to acknowledge that the answer to my question would be best answered by a dean or program director etc. I thought this site was designed to help students become doctors, when running into issues. Disappointing.
                   
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                  nontradnyc

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                    First you need to talk to your dean's office.

                    Second, it sounds like you need to change up your study methods in some way. Whatever you're doing is not working. Whether you're trying to relearn too much detail, are too superficial, aren't paying attention to your question thought process or what not, you need to hit the reset button.

                    My guess is that you're not utilizing the questions well. It's not enough to just do the question and see if you got the right answer. Nor is it enough to just read the explanations. You might try a technique that Kaplan calls "post phrasing" - you read the question, find out what the correct answer is and then without reading the "official" explanation, you come up with (and if you're like me, write out) the exact reasoning why the wrong answers are wrong. The other option is to do that process as you go through an untimed exam, and then compare all your reasoning with the explanations provided. This generates a lot more data and allows you to identify faults in your thought process, areas where you don't have a good grasp of the content, or even if you actually are thinking about a lot of the information correctly.

                    Third, if you do take a LOA, I would caution against the idea that you take off a super extended period. Studying is usually subject to the law of diminishing returns. At some point you're going to plateau and depending on your level of test anxiety, may actually begin to regress. I probably wouldn't take leave longer than 8 weeks, and even then I'd say that 4 or 6 weeks makes more sense. That's also a lot more reasonable to make up third year clerkships as an M4.
                     
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                    pre med 2014

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                      Don't take a LOA yet. Keep cramming hard throughout rotations. A 173 is less than 10 questions from the pass mark. You'll have to push back your exam but not go to LOA yet. This is the point where adding to your base is gonna give you bigger gains cause every question gets you closer to the pass mark and every question after that adds 2-3points to your 3digit score. If you were weak on neuroanatomy go over all of neuro anatomy, that's like 2-3q's better if you were weak on it (I took NBME 16 that had like 5-10 neuroanatomy q's and I hadn't gone over any of it beforehand like all the spinal lesions, etc. etc. now I know if I'd taken it now I'd have gotten at least an extra 2-3 q's correct)

                      Think of it this way, a 5hr study session on a Saturday could mean 1 more PRECIOUS question correct on the exam. Fast forward a few weeks to a couple of months and you'll at least pass.

                      Sent from my iPhone using SDN mobile app
                       
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                      Psai

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                        EDIT: deleted this original response. That moment when 500+ people read your thread in the course of nearly a week after posting, and not a single one of those readers can offer even a suggestion, even if to acknowledge that the answer to my question would be best answered by a dean or program director etc. I thought this site was designed to help students become doctors, when running into issues. Disappointing.

                        What do you want us to do? Make you smarter? Take the test for you? Tell you to redo the preclinical years? You've done all the right things with regard to the test.

                        Just look at the sections that you did poorly on and review whatever resources you have on those.
                         
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