USMLE Failed UWSAs, study strategies/tips for exam in one month

[mandym00]

I took UWSA2 last Friday and did horrible. I was scheduled to take my USMLE on this upcoming Saturday but pushed it back a month due to the score I got on the simulation test. I am a DO student and just took my COMLEX on Monday. I am wondering what I should do next. I did dedicated studying (board studying all day everyday basically) for 7 weeks prior to taking my COMLEX. I came to the realization I was horrible at standardized testing/tests in general a few months ago when doing practice questions during the semester. I used to change answers (from right to wrong answers) a lot, I've stopped for the most part. Also my scores on practice blocks fluctuate a lot from like 70% to 50% on back to back blocks. I am also confused as to why I did much worse on my UWSAs compared to my UWorld average. Is there anything I can do to improve my test taking skills?

Here are the resources I used:

FA: read the entire book & marked it up while going through lectures, notes, when reviewing practice question answers, etc.​

Pathoma: watched the lectures that I hadn't done during the semester and reviewed the rest of the chapters I had already watched​

Sketchy Micro​

Sketchy Pharm​

UW: completed 1600 questions with 59%. I still have 1189 questions.​

My practice exam scores:

Prior to dedicated my school did gave us an NBME I got a 57 (Step 1 equivalent 165-170)​

UWSA1 181 (51.8%) at 4 weeks into dedicated​

UWSA2 175 (53.8%) at 7 weeks into dedicated​

Besides finishing UWorld what else should I do? I feel hopeless because I did what I thought was the right thing. I have been studying my ass off and now I'm here questioning whether I will even be able to pass STEP 1.

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[eagle311]

How do you think you did on COMLEX?

 

[mandym00]

How do you think you did on COMLEX?

Feeling uncertain about COMLEX. I used TrueLearn COMBANK a little bit but not enough and did the OMT review book. The test was very weird. Nothing like I would have expected. I feel like I studied so many things that were no where to be found on the exam which was puzzling. I think I did okay, enough to pass I hope.

 

[eagle311]

I was in the same boat. I recommend doing professional online tutoring through MedBoard Tutors or anything similar if you haven't already. It should help with test taking skills, target weaknesses, etc. Also, try to go through UWORLD more times than one!

 

[Medic741]

I took UWSA2 last Friday and did horrible. I was scheduled to take my USMLE on this upcoming Saturday but pushed it back a month due to the score I got on the simulation test. I am a DO student and just took my COMLEX on Monday. I am wondering what I should do next. I did dedicated studying (board studying all day everyday basically) for 7 weeks prior to taking my COMLEX. I came to the realization I was horrible at standardized testing/tests in general a few months ago when doing practice questions during the semester. I used to change answers (from right to wrong answers) a lot, I've stopped for the most part. Also my scores on practice blocks fluctuate a lot from like 70% to 50% on back to back blocks. I am also confused as to why I did much worse on my UWSAs compared to my UWorld average. Is there anything I can do to improve my test taking skills?

Here are the resources I used:

FA: read the entire book & marked it up while going through lectures, notes, when reviewing practice question answers, etc.​

Pathoma: watched the lectures that I hadn't done during the semester and reviewed the rest of the chapters I had already watched​

Sketchy Micro​

Sketchy Pharm​

UW: completed 1600 questions with 59%. I still have 1189 questions.​

My practice exam scores:

Prior to dedicated my school did gave us an NBME I got a 57 (Step 1 equivalent 165-170)​

UWSA1 181 (51.8%) at 4 weeks into dedicated​

UWSA2 175 (53.8%) at 7 weeks into dedicated​

Besides finishing UWorld what else should I do? I feel hopeless because I did what I thought was the right thing. I have been studying my ass off and now I'm here questioning whether I will even be able to pass STEP 1.

If you’re scoring that low you have major topic weaknesses. Identify them and fix, I’d strongly consider pushing step into early 3rd year if I were in your shoes.

What were your COMSAE scores??

 

[mandym00]

If you’re scoring that low you have major topic weaknesses. Identify them and fix, I’d strongly consider pushing step into early 3rd year if I were in your shoes.

What were your COMSAE scores??

Yes, I know. I struggled a lot both first and second year to keep up with the amount of material. It doesn't help that I was only recently diagnosed with a learning disorder so I'm playing catch up at this point.
With my USMLE currently scheduled in late July, I will already be in my third year and have started rotations. I have my elective first and its fairly low-key so I can get lots of studying in. Since you say early third year, when would you suggest I take it?

The only COMSAE I took was proctored by my school and taken at the end of last semester. I got a 387. This was before dedicated started and all I had really reviewed during the semester was Neurology and other random topics here and there.

 

[mandym00]

I was in the same boat. I recommend doing professional online tutoring through MedBoard Tutors or anything similar if you haven't already. It should help with test taking skills, target weaknesses, etc. Also, try to go through UWORLD more times than one!

Thank you for the advice. I plan on doing uWorld once and then repeating my missed/marked questions. Unfortunately I don't have the money for professional tutoring.

 

[eagle311]

Sure. Some schools, if you give them a quote will extend your financial aid amount to cover the costs.

 

[DNC127]

I would not take usmle if I were you. At this point, the risk of failing is too high. I would just wait for comlex to come back and roll with that.

 

[FindersFee5]

I have some advice about test taking strategy and mindset in the guide in my signature.

Tell us more about your thought process as you answer questions! That might help us figure out what more specific advice to give you.

 

[mandym00]

I would not take usmle if I were you. At this point, the risk of failing is too high. I would just wait for comlex to come back and roll with that.

I've considered this but I would like to go into pathology. From my understanding pathology programs have all historically been ACGME programs. The reason for taking USMLE was because I thought if I did not, it would decreased my chances of matching into pathology.

 

[DNC127]

I've considered this but I would like to go into pathology. From my understanding pathology programs have all historically been ACGME programs. The reason for taking USMLE was because I thought if I did not, it would decreased my chances of matching into pathology.

Pathology is not competitive at all. You will be fine without usmle. You could probably SOAP pathology if you wanted.

 

[mandym00]

I have some advice about test taking strategy and mindset in the guide in my signature.

Tell us more about your thought process as you answer questions! That might help us figure out what more specific advice to give you.

I have read your post previously, it was extremely helpful. So thank you very much for sharing what you have experienced.
My approach to questions is similar to yours, so I don't think that is the issue.
Honestly I believe the biggest issue is knowledge gaps and memory failure. I feel like Anki is something that could fix that issue for me but I clearly don't have the time to go through any full pre-made decks like Zanki. Should I just made my own cards for topics missed on UWorld questions? Or possibly pick out relevant Zanki cards from my missed topics? I feel like the latter may be a more efficient use of my time since making cards can be cumbersome at times. I feel as if my brain has reached max capacity. As soon as I learn something new, I seem to end up forgetting something I previously learned.

 

[kb1900]

I have read your post previously, it was extremely helpful. So thank you very much for sharing what you have experienced.
My approach to questions is similar to yours, so I don't think that is the issue.
Honestly I believe the biggest issue is knowledge gaps and memory failure. I feel like Anki is something that could fix that issue for me but I clearly don't have the time to go through any full pre-made decks like Zanki. Should I just made my own cards for topics missed on UWorld questions? Or possibly pick out relevant Zanki cards from my missed topics? I feel like the latter may be a more efficient use of my time since making cards can be cumbersome at times. I feel as if my brain has reached max capacity. As soon as I learn something new, I seem to end up forgetting something I previously learned.

Absolutely make your own cards on incorrects. This actually should have been standard practice from the beginning and I’m surprised that not all medical students know to do this.


You can also download zanki, suspend all of it, and pull in relevant cards as warranted for your weak areas/areas you consistently miss.


Whatever you do don’t get discouraged!

 

[FindersFee5]

I have read your post previously, it was extremely helpful. So thank you very much for sharing what you have experienced.
My approach to questions is similar to yours, so I don't think that is the issue.
Honestly I believe the biggest issue is knowledge gaps and memory failure. I feel like Anki is something that could fix that issue for me but I clearly don't have the time to go through any full pre-made decks like Zanki. Should I just made my own cards for topics missed on UWorld questions? Or possibly pick out relevant Zanki cards from my missed topics? I feel like the latter may be a more efficient use of my time since making cards can be cumbersome at times. I feel as if my brain has reached max capacity. As soon as I learn something new, I seem to end up forgetting something I previously learned.

Agreed with the above that you should definitely be making cards for your incorrects. I wouldn't use a premade deck for this - making your own cards forces you to reflect on questions you get wrong and really figure out what key pieces of information you're missing. When you do make cards though, make sure only a single fact is being tested at a time on each card.

 

[mandym00]

Thanks to both of you @kb1900 and @FindersFee5 . I will start making cards today and pulling some cards from Zanki for my weak topics. Will definitely come back with an update to let you know how my progress is going. Thank you for the encouragement! I appreciate the positive vibes.

 

[ASGD1983]

I would not take step1 until you get your comlex scores back. Just study until then. If you passed (I'm hoping you did pass as 387 on new comsae is not too bad and plus you had dedicated weeks to improve) then you can plan to take step1, but without risking to fail it. So I would not attempt to pass it until you see 200+ on your NBME. Comlex will get you into pathology, but comlex + failed step1 will create barriers. Just my opinion.
So I would check the schedule with your school and postpone it maximally but without falling a year back. If it's not possible to postpone - I would consider skipping step1 and focusing on taking step2 later in addition to a mandatory comlex level 2. I'm not sure if step2 will help with pathology, but it for sure won't hurt. Imho for specialty you want to go - letters and interview is more important than step1 score. I'm saying it from experience (my brother got into pathology and he is an IMG with low step1 score). Deciding factor was an interview he conducted. No one cared about step1 score.

 

[mandym00]

I would not take step1 until you get your comlex scores back. Just study until then. If you passed (I'm hoping you did pass as 387 on new comsae is not too bad and plus you had dedicated weeks to improve) then you can plan to take step1, but without risking to fail it. So I would not attempt to pass it until you see 200+ on your NBME. Comlex will get you into pathology, but comlex + failed step1 will create barriers. Just my opinion.
So I would check the schedule with your school and postpone it maximally but without falling a year back. If it's not possible to postpone - I would consider skipping step1 and focusing on taking step2 later in addition to a mandatory comlex level 2. I'm not sure if step2 will help with pathology, but it for sure won't hurt. Imho for specialty you want to go - letters and interview is more important than step1 score. I'm saying it from experience (my brother got into pathology and he is an IMG with low step1 score). Deciding factor was an interview he conducted. No one cared about step1 score.

Thank you for your advice! I have considered this. If my situation was simpler I would have already done what you advised. Given that my eligibility ends July (I know I can pay to extend) but also that I will begin my second rotation in August (Psych ER/inpatient which will be more time intensive), I think taking the exam on the date I have scheduled, July 28, is the best decision. If for some reason I fail COMLEX (score release date is July 24-25 per NBOME website and my exam date), then I will pay what I need to to reschedule/cancel the exam for a later date. I know if I wait until then the fees will be a lot more but I'm confident enough in myself to believe that I have passed COMLEX and will be ready to take STEP on July 28.

 

[mandym00]

*UPDATE* (since I promised I would)
I took STEP 1 on Sunday. Here's what happened in the meantime:

I finished UWorld and made Anki cards for topics I would get incorrect. Thank you to those who suggested Anki, @FindersFee5 @kb1900
Anki helped so much! I wish I had incorporated it earlier in my studies, at least during dedicated on topics/facts/concepts I would get incorrect while doing UWorld. Also regretting that I hadn't tried to incorporate Zanki into my studies for class in first and second year and I found it to really help with those random facts/details or simple memorization that I would always forget. I'm more of a concept person and don't do well with memorizing facts without context or knowing its importance in the big picture therefore Anki really helped with that.

I got my COMLEX Level 1 score back on Thursday but didn't look at it until Sunday night after my STEP just in case. I passed but didn't do well at all, 437. With the new exam and everything I don't know where that stands nor what the mean on the exam was, I'll attach a photo to show you what I see on my score report. Looks like I'm ~2 SD out of the norm with an average ~520-540 but whatever I passed and that's what I was hoping for.

Now about STEP. The week prior to the exam I took the Free120 and got a 73% so I was feeling pretty good about the exam. My friends had already told me they felt that UWorld sometimes asked questions that were more difficult/not as straight forward as the actual exam and that the Free120 felt more like the actual exam than UWorld. I would agree with that. The answers were usually more straight forward than uWorld but not always as easy as the Free120. Just my two cents. I felt 10X better after STEP compared to how I felt after LEVEL 1. I'm sure some of it had to do with how poorly written COMLEX is but I also think I was a lot more confident in my answers due to knowing more details thanks to Anki. I won't have my score back for a couple weeks but I do feel like I did much better on STEP than I did with the COMLEX

Glad to be done with board studying (for now). Onto starting my second rotation on Monday!

 

[mandym00]

Last and final update. Got my STEP 1 score back today, 218. Mean score 231 with SD of 20.
I am happy with that. My gut was right about feeling like I did better on STEP than LEVEL 1.
In case anyone stumbles upon this post in the future and needs some motivation:
You can pass the board exam. You will pass if you put 100% into it and self-reflect on what is/is not working for you. Don't be afraid to ask for help or advice. Don't compare your progress to others. I pushed back my test date a whole month because I knew I could perform better. Don't be ashamed of yourself for not being ready.
In the end you are much more than a test score, even if you don't do as well as you wanted to it's okay. Move on and focus on other aspects that you can use to prove yourself to residency programs. Willingness to learn and work hard, and ability to incorporate changes based on feedback from attendings, residents, and other providers will serve you well.

 

[OverlyRomantic]

Congratulations! Now go party

 

[JustOnePing]

Last and final update. Got my STEP 1 score back today, 218. Mean score 231 with SD of 20.
I am happy with that. My gut was right about feeling like I did better on STEP than LEVEL 1.
In case anyone stumbles upon this post in the future and needs some motivation:
You can pass the board exam. You will pass if you put 100% into it and self-reflect on what is/is not working for you. Don't be afraid to ask for help or advice. Don't compare your progress to others. I pushed back my test date a whole month because I knew I could perform better. Don't be ashamed of yourself for not being ready.
In the end you are much more than a test score, even if you don't do as well as you wanted to it's okay. Move on and focus on other aspects that you can use to prove yourself to residency programs. Willingness to learn and work hard, and ability to incorporate changes based on feedback from attendings, residents, and other providers will serve you well.

Just wanted to say what an amazing update! Super inspiring post. Thank you for updating us, @mandym00

 

[DNC127]

Last and final update. Got my STEP 1 score back today, 218. Mean score 231 with SD of 20.
I am happy with that. My gut was right about feeling like I did better on STEP than LEVEL 1.
In case anyone stumbles upon this post in the future and needs some motivation:
You can pass the board exam. You will pass if you put 100% into it and self-reflect on what is/is not working for you. Don't be afraid to ask for help or advice. Don't compare your progress to others. I pushed back my test date a whole month because I knew I could perform better. Don't be ashamed of yourself for not being ready.
In the end you are much more than a test score, even if you don't do as well as you wanted to it's okay. Move on and focus on other aspects that you can use to prove yourself to residency programs. Willingness to learn and work hard, and ability to incorporate changes based on feedback from attendings, residents, and other providers will serve you well.

Love it. Proud of you for proving me and others wrong. Congrats!!!