Did BAD on USMLE :(

[medInUSA]

I just got my score from Step 1 and i was shocked.

2 days before the actual exam I took an NBME (form 3) practice and got a 251

on the actual test i got 223

does anyone else have such discrepancy?? everyone told me that NBME is predictive.

I expected at least the same score, this really really really sucks, I am going drinking tonight

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[RockShox]

It was just a hypothesis, which, I realize could be very wrong. There are many reasons why a non-traditional student might score worse (or better) on a USMLE exam. All I did was propose the hypothesis that the test favors traditional students. Why some folks seem to take that question so very personally could be the subject of another paper in a psych journal....

Oh joy, I suspected that your comments were based on thoughtful scientific inquiry. I am quite intrigued at this point and would love to hear further about what you think the many reasons that non-trad's do worse (or better) on the USMLE exams. Please elaborate.

 

[PeepshowJohnny]

If nontraditionals do end up scoring lower (which I'm not convinced they would) another factor could be what specialties they go into.

In my experience (which are completely anecdotal) nontraditionals don't seem to be going for the super competitive residencies. I do know a 40 y/o who's interested in radiation oncology, but for the most part a lot of nontraditionals seem more interested in the "foundation" specialties like peds, IM, family, ob/gyn. I don't know why, if it has something to do with wanting somethin gless demanding for family reasons or more traditional views of what a doctor is or something else. Anyway, those programs tend to have less demands for board scores and so there's less reason to try and get that 265.

 

[BOHICA-FIGMO]

Oh joy, I suspected that your comments were based on thoughtful scientific inquiry. I am quite intrigued at this point and would love to hear further about what you think the many reasons that non-trad's do worse (or better) on the USMLE exams. Please elaborate.

Here are a few initial thoughts regarding USMLE exams and non-traditional students.

Possible reasons for scoring worse:
1. Many years gap in full time education between undergad or grad school and med school could result in reduced proficiency on standardized tests.
2. Older students tend to be more experiential learners who "learn by doing" rather than "learn by lecture" which is the case at many medical schools' basic science curriculum
3. Family obligations and responsibilities take time away from studying

Possible reasons for scoring better:
1. years of experience, esp. in medically related fields such as nursing or allied health, make it easier to comprehend and retain the clinical relevance of the material that is presented.
2. older students are possibly more disciplined in their study schedule/habits compared to a traditional student
3. older students are better able to discern which material is most likely to be tested and which material is less testable
4. older students are more accustomed to performing in stressful situations, and therefore suffer less test anxiety

I'm sure thoughtful inquiry could come up with many additional reasons in each category.
Anyway, I 'm not sure I have the time or the inclination to design a study and follow through with it (maybe someday). I just think it is an interesting question to consider in threads like this one.

 

[Law2Doc]

Here are a few initial thoughts regarding USMLE exams and non-traditional students.

Possible reasons for scoring worse:
1. Many years gap in full time education between undergad or grad school and med school could result in reduced proficiency on standardized tests.
2. Older students tend to be more experiential learners who "learn by doing" rather than "learn by lecture" which is the case at many medical schools' basic science curriculum
3. Family obligations and responsibilities take time away from studying

You really don't think an equally long list couldn't be made about traditional students?

Of the top three above, only the third is likely legitimate, IMHO. Nontrads more often do have an outside life. No idea if this is a weakness or a strength, though.

As for your first point above, many nontrads are coming from careers which have their own standardized tests (bar exams, series exams, LSAT, GMAT, GRE) -- trads only have the MCATs (which the nontrads also have taken). So trads on average probably have less experience than nontrads on standardized tests.

As for the second point -- I think you forget that nontrads were the same age as trads at one point, and learned the same way. I can't imagine you lose the ability to "learn by lecture" over the course of a few years (I certainly have seen no scientific data to suggest this). It's not like these are people who are coming from another planet with all life experience and no school experience -- these are people who did college, maybe a postbac or grad program on top of that, and did well in the same prereqs as everyone else in med school.

 

[Friendly]

Here are a few initial thoughts regarding USMLE exams and non-traditional students.

Possible reasons for scoring worse:
1. Many years gap in full time education between undergad or grad school and med school could result in reduced proficiency on standardized tests.
2. Older students tend to be more experiential learners who "learn by doing" rather than "learn by lecture" which is the case at many medical schools' basic science curriculum
3. Family obligations and responsibilities take time away from studying

Drop it. I agree with Law2doc - only #3 is valid. Standardized testing is one fraction of what's needed to get into medical school and stay there. Your logic that a continuous student somehow is a better standardized test taker is utter nonsense. You'll find that medical schools admit bright students, and bright students can be found anywhere - young and old.

 

[Skills of House]

Hey...I thought this thread was supposed to be about one's life being doomed as a result of getting a "mere 223" on Step 1?!

 

[SeventhSon]

I think you are deluding yourself into thinking people divide up nicely into these categories. For the most part everybody works hard for this exam -- you will more often find two groups of people. One group that "reads the syllabus 6 times, reads and takes notes...", and then actually does well, and another group that does basically the exact same approach, but it is less effective for them, and they barely pass or fail. In my experience the only people who are barely glancing over the reading are the ones who already know it all and generally do great. The people I've met who struggle in med school and on exams do not do so for lack of effort. I suspect it is the rare individual who fails this test or barely passes due to lack of time logged.

I've yet to meet anyone who didn't study because they "just wanted to pass". Lots of people will tell themselves and others that, so as not to freak, but they still study.

well of course there aren't two groups of categories of course it is a continuum... but he used an example that would be demonstrative, and I agree with it. Generally the people who do well have to put in the time, you just don't see them in the library... they are at home studying, and may be talking like they are partying. I have been very disappointed with a couple of tests in my classes even when i did above average because the time i put into studying for it was obscene. I think it's completely understandable.

 

[Law2Doc]

but he used an example that would be demonstrative, and I agree with it.

If you look at his post, he clearly suggested that the people who pass and fail are "likely different groups of people" in terms of studying efforts. I would argue that it is probably more of an issue of effectiveness than hours logged.

 

[Scaredshizzles]

If you look at his post, he clearly suggested that the people who pass and fail are "likely different groups of people" in terms of studying efforts. I would argue that it is probably more of an issue of effectiveness than hours logged.

Yea I think so too. Obviously some people are like a sponge and do fine studying very little and by any of a number of means. That being said, I think anyone who managed to make it into medical school is capable of passing given that they are able to devote a lot of study time (no, not at the expense of sleep, save that for residency) and figure out what mode of studying is best for them. In general though, I think lectures and study groups can benefit almost anyone if they aren't asleep during them. And if you're a low energy person who starts falling asleep after 20 minutes of studying (or less), then try to find a study group with some high energy level people, that stuff can be contagious. Studying with other low energy people is a formula for failure, you're gonna get distracted and not do any studying.

 

[NaturalInstinct]

Well I can't think of a better way to be voted Mr. Popular than posting this comment. I think that the flaming material coming out of the butt on your Avatar has somehow become more symbolic.

I agree.

 

[domer621]

I will ask for a recheck...

Not to ruin your hopes, but there's actually never been a score change due to a recheck in the entire history of the USMLE. I emailed the NBME.

 

[Law2Doc]

Not to ruin your hopes, but there's actually never been a score change due to a recheck in the entire history of the USMLE. I emailed the NBME.

Not surprising. Once they went to a computerized/paperless system, there really isn't much possibility for human error to creep into the system. It's a nice scam to make $50 from everyone who wasn't happy with their grade though. Nothing like kicking someone when they are down.

 

[Terpskins99]

But the OP only mentioned one NBME. And the line claiming he assumed he would get "at least the same score" as 251 is plain delusional.

If he (assuming "he", since most "she"s I know are pretty rational enough to realize that a 223 is more than just fine) only took that one NBME, then thats not necessarily the best predictor of your performance. People waver by as much as 20-30 points on different NBME exams. Sometimes you just get really lucky on that one test.

What was his Qbank and Uworld average? If he were lighting it up at around 90% or some other ridiculous number, then I suppose he had a bad day. But if he was hovering around the mid-70's... then 223 would be just right.

On the flip side, there are plenty of people that were surprised to score 250+ after projecting to around a 230 or so with the NBMEs. It works both ways.

 

[domer621]

Not surprising. Once they went to a computerized/paperless system, there really isn't much possibility for human error to creep into the system. It's a nice scam to make $50 from everyone who wasn't happy with their grade though. Nothing like kicking someone when they are down.

Yeah, it makes me sick just thinking of how much of a scam that is.

I was really surprised at the tech's honesty, though.

 

[montypython]

Not to ruin your hopes, but there's actually never been a score change due to a recheck in the entire history of the USMLE. I emailed the NBME.

I know of a person who requested a rescore after not passing and found out that the NBME F'd up royally and somehow had a computer glitch that omitted a couple blocks of the test. Long story short, this person had to retake the test because there were no recorded answers for these blocks. So although the score did not technically change upon rescore, the computer system did malfunction.

 

[Picklesali]

If he (assuming "he", since most "she"s I know are pretty rational enough to realize that a 223 is more than just fine)

humph. I'm sure there are plenty of 'shes' out there who would be disappointed with an average score if they thought they were going to do much better...