how to score 245+

[jackets5]

talking to a guy at school who scored 248 on step he was telling the big difference he found is that most people who score in the 220's know the big subjects well, path, phys, pharm etc. He said what he found that pushed his score up as high as it was that Behavioral (especially biostats), biochem (maybe for a greater molecular understanding?) so called lower yield subjects pushed his score so high. Does anyone agree?

---

Members don't see this ad.

 

[TexasPhysician]

I guess everyone has theories. I thought I did so well because of my path, phys, and pathophys knowledge. Its been awhile now, but I swear those 3 topics were about 90% of my test.

 

[Pinkertinkle]

248? To get SDN high know everything.

 

[GMDMD]

talking to a guy at school who scored 248 on step he was telling the big difference he found is that most people who score in the 220's know the big subjects well, path, phys, pharm etc. He said what he found that pushed his score up as high as it was that Behavioral (especially biostats), biochem (maybe for a greater molecular understanding?) so called lower yield subjects pushed his score so high. Does anyone agree?

I'd say in general people who score in the 220's don't know the big subjects as well as they might think.

He is right in a sense, however. The whole point of the test is to have ZERO weaknesses. It is better to be strong overall than to be excellent in any given subject. If you neglect bull**** subjects like behavioral science and biostats it can easily come back to bite you in the ass. It is probably easier to learn 80% of that material than it is to master an additional 15% of the "tougher" subjects.

People need to realize that even if there are 30 equal subjects with 1000 questions each in their question bank, you shouldn't expect to get 10 questions from each subject on your exam. The nature of random selection almost guarantees you will see an unequal distribution across subjects. Any one subject can sink you.

When people claim they had "soooo much of X subject" subject on their exam, take it with a huge grain of salt. People tend to remember stuff they suck at because it's harder and more stressful. And you can't expect to get the same distribution they did.

 

[78222]

There is no Grand Unifying Theory of scoring high. The best advice I would give is to study every subject as though it was the only one on the exam.

 

[Terpskins99]

I'd say in general people who score in the 220's don't know the big subjects as well as they might think.

What??? That doesn't make any sense.

If you don't know the big subjects "as well as you think" you're flunking the test, not scoring "220s".

The difference between a 220 and a 245+ is knowing the minutiae, not the "big subjects".

 

[diosa428]

What??? That doesn't make any sense.

If you don't know the big subjects "as well as you think" you're flunking the test, not scoring "220s".

The difference between a 220 and a 245+ is knowing the minutiae, not the "big subjects".

No, if you don't know the big subjects at all you're flunking the test. People who have a decent understanding of all the big topics will probably score around a 220 (which somewhere around the national average). However, a decent understanding is not the same as an excellent understanding, which will help with points a lot.

 

[blz]

248 is child's play around these parts...

 

[Tiger26]

talking to a guy at school who scored 248 on step he was telling the big difference he found is that most people who score in the 220's know the big subjects well, path, phys, pharm etc. He said what he found that pushed his score up as high as it was that Behavioral (especially biostats), biochem (maybe for a greater molecular understanding?) so called lower yield subjects pushed his score so high. Does anyone agree?

I got a 247 and a star in behavioral, biochem, and cell bio/histo for what it's worth.

As has been said, minutae is key but you also really have to understand the material inside and out goljan-style

 

[GMDMD]

What??? That doesn't make any sense.

If you don't know the big subjects "as well as you think" you're flunking the test, not scoring "220s".

The difference between a 220 and a 245+ is knowing the minutiae, not the "big subjects".

220 is an average score. Nothing wrong with it. Nothing really to write home about either. I disagree that a 25-30 point difference in score boils down to minutiae. I know several people who knew as much or more minutiae than I did and ended up with 220-range because they did not understand the material well enough to apply the blindly memorized knowledge.

At least in my experience during test preparation, there is a world of a difference between the 220 kid and the 250 scoring student. When querying the former for explanations on concepts you more frequently get "i dont knows" or "I just memorized that" vs the latter students who can usually better explain the pathophysiology.

My friend who scored in the 260's and outscored me didn't know more details than me. We knew about the same amount of minutiae, I think. He was just smarter than me and we both knew it.

I'd say the difference between a 235 and a 245 is minutiae. The difference between a 245 and a 265 is about 50% hard work and 50% brilliance.

 

[Terpskins99]

I'd say the difference between a 235 and a 245 is minutiae. The difference between a 245 and a 265 is about 50% hard work and 50% brilliance.

At that point, what differentiates people here is 1% hard work, 9% brilliance and 90% luck.

 

[Stark]

The secret to scoring in the top 1-5% is repetition. This is how I scored above 250 on Steps 1 and 2 (and a 235 on Step 3 - a little lazy).

Don't just focus on the minutia. Don't just focus on the big stuff. Don't get stuck at the beginning trying to memorize anything.

Make it through all the material - I mean everything as fast as you can three times. For Step 1 I used First Aid and Step Up and BRS Path with a few other books. I went through each of them as fast and as hard as I could. The first time through, retention is low - 15%, the second time it's better - 40%, the third time through it's really high - 80% to 90%. I used audio because it was easier for me to get through everything fast.

Then, and only then, after you have made it through everything three times - THEN you sit down and memorize stuff that has to be memorized. You have to make it through every bit of the minutia and the big stuff before memorization.

I call it FAMILIARIZATION FIRST, MEMORIZATION LAST. And it was a great formula for success for me.

Memorization is a temptation that must be resisted until you have really gone through everything. Then it's time to memorize.

Best of Luck,

Stark
www.ApolloAudiobooks.com

 

[xanthomondo]

How much material comes from first year versus second year of med school?

 

[Instatewaiter]

How much material comes from first year versus second year of med school?

2nd year >>> First year

The vast majority of 1st year stuff that is tested will be re-covered during your second year courses.

All that anatomy/histo minutia does not show up strong on the boards. Physiology however does. That said, if you dont have a good base in physio you are going to struggle second year so it gets ingrained in your head.

 

[GMDMD]

At that point, what differentiates people here is 1% hard work, 9% brilliance and 90% luck.

Which score jump are you referring to? 235-245 or 245-265.

I don't have a strong opinion on the former but I believe your statement is absolutely not true for the latter. I believe people who score 265 will almost always score above 255. It's not luck. Look at the score reports on the preparation threads.. the dwyanewades and others repeatedly dominate the NBMEs and then they do the same on the real thing.

The people in my class who score 260+ were the exact people I would have predicted to score 260+ prior to studying. The same people who consistently score 80%+ on UWorld towards the end of their studying. It's really not luck.

 

[Stark]

I agree, Luck is the least contributor to high scores.

For the 1% of students who are brilliant - hard work doesn't matter that much, they can score 250's without too much time or effort.

For the other 99%, me included. At least 90% of success is hard work, time, effort, and dedication. For me, hard work meant repetition. Going through the material over and over.

I have always felt that most college students could do pretty well in medical school. The difference is whether they would put in the time and effort to do really well.

Stark,
www.ApolloAudiobooks.com


btw - I am not saying pure hours and effort will insure a 250+. You have to put in the time and effort and repetition in a study medium that works for you. Some people are flash card people, some are photographic memory people, some are study group people, some are visual, some are audio, some are lecture, whatever. Find what works, then put in the hours.

I went through the first couple of months of med school with below average results because I was using a study method that didn't match my learning style. When I changed to what worked for me, I had a lot of success. So find what works for you - then put in the hours, effort, and repetition.

 

[Terpskins99]

Which score jump are you referring to? 235-245 or 245-265.

I don't have a strong opinion on the former but I believe your statement is absolutely not true for the latter. I believe people who score 265 will almost always score above 255. It's not luck. Look at the score reports on the preparation threads.. the dwyanewades and others repeatedly dominate the NBMEs and then they do the same on the real thing.

The people in my class who score 260+ were the exact people I would have predicted to score 260+ prior to studying. The same people who consistently score 80%+ on UWorld towards the end of their studying. It's really not luck.

The 90% luck I was referring to was the jump between 245-265.
I think 90% hard work is the difference between 235-245.

Its just a reflection of the statistics and observations I've made of others who post their progress on the USMLE Experiences threads. People who score at the high end of the spectrum usually vary quite a bit with their NBME scores, but the people scoring at the lower end usually have NBME scores that stay quite tight to each other as well as the actual score on the real USMLE.

Based on that, I just figured that the number of additional correct answers you need to get from 235 to 245 (which may vary by several dozen) is more than the number of questions that differentiate you from 245-265 (which may be just a handful).

 

[gluon999]

Steps to scoring 245+

1) Go through everything 3 times.
2) Don't ignore the useless crap like behavioral sciences and cell bio. Treat it with respect.
3) Know your pathophysiology of the core subjects like cardio, pulmo, GI, nephro really well. Know it like a Goljanoid!
4) Do >3000 questions. Uworld > Kaplan Qbank. Spend a day going through 7 blocks of questions back to back so you can build stamina.
5) Work super hard. Have no regrets when you get your score back.

 

[InertQuail]

248 is child's play around these parts...

SDN is the only place where I can come to feel bad about scoring >255 (but <260) on step 1. Thanks SDN, for keeping me humble.

 

[Atomic1000]

Steps to scoring 245+

1) Go through everything 3 times.
2) Don't ignore the useless crap like behavioral sciences and cell bio. Treat it with respect.
3) Know your pathophysiology of the core subjects like cardio, pulmo, GI, nephro really well. Know it like a Goljanoid!
4) Do >3000 questions. Uworld > Kaplan Qbank. Spend a day going through 7 blocks of questions back to back so you can build stamina.
5) Work super hard. Have no regrets when you get your score back.

When you say, "Do >3000 questions", do you include questions that come bundled with review books (such as those online for RR Path/Biochemistry) or do you exclude those, but assume that they would be done anyway?

Thanks.

 

[gluon999]

When you say, "Do >3000 questions", do you include questions that come bundled with review books (such as those online for RR Path/Biochemistry) or do you exclude those, but assume that they would be done anyway?

Thanks.

I didn't really care for much of those questions in review books. I guess you could do them but many of them aren't "USMLE style" questions, i.e. they are too short or too simple.

I meant do lots of board style questions like U.world, kaplan qbank, etc. I'd say 95% of U.world questions are realistic in that they represent the material on the actual exam whereas maybe 60-70% of Kaplan questions are worth your time.

 

[Atomic1000]

I didn't really care for much of those questions in review books. I guess you could do them but many of them aren't "USMLE style" questions, i.e. they are too short or too simple.

I meant do lots of board style questions like U.world, kaplan qbank, etc. I'd say 95% of U.world questions are realistic in that they represent the material on the actual exam whereas maybe 60-70% of Kaplan questions are worth your time.

thanks.

 

[JeffLebowski]

SDN is the only place where I can come to feel bad about scoring >255 (but <260) on step 1. Thanks SDN, for keeping me humble.

Yeah, no kidding. Except I feel even worse as a >250 but <255 individual. You can imagine my humiliation.

When you say, "Do >3000 questions", do you include questions that come bundled with review books (such as those online for RR Path/Biochemistry) or do you exclude those, but assume that they would be done anyway?

Thanks.

Yeah...I don't know. That's just what rough range you should shoot for. If you go through all the UW questions, that's 2000. Personally, I think that's enough as far as questions go to do extremely well, but if you can, do more. A good rule of thumb is to get through UW for sure, then as many more questions as you can. But getting through your UW bank is a big milestone (assuming you were going through the answers & taking notes, etc.). All those random little question sections in BRS, etc. are kind of icing on the cake, I mean do them and do as many as you can, but it's not like you need to hit 3000 to get a 240 and 4000 to get a 250 and 5000 to get a 260. Do UW, do as many additional questions as you can.

For the record, I think I did around 3500-4000 questions, including the 2000 Q UW bank, BRS sections, NBME exams, etc. ...but then, we did have ~4-5 shelf exams for classes M2 year, so I guess that doesn't count those. Maybe 4000 all together.

 

[78222]

SDN is the only place where I can come to feel bad about scoring >255 (but <260) on step 1. Thanks SDN, for keeping me humble.

lol, I scored a 248 and sdn makes me feel like a dummy. I think no matter how high you score, you end up wishing you'd scored just a little higher. Personally I just wish I'd busted 250 although the difference between a 248 and 250 is trivial.

 

[GMDMD]

Its just a reflection of the statistics and observations I've made of others who post their progress on the USMLE Experiences threads. People who score at the high end of the spectrum usually vary quite a bit with their NBME scores, but the people scoring at the lower end usually have NBME scores that stay quite tight to each other as well as the actual score on the real USMLE.

It certainly would make sense to see a larger score change per missed question as you get to the higher end of the spectrum. It wouldn't surprise me however if the difference between a 245 and a 265 was at least 20 questions, which would be about 7% of the total questions (assuming they throw out 1 block of experimental questions).

It would be nice if they were more transparent regarding the scoring system. It'd be nice to know the approximate % of questions for a pass vs the average (222). It probably gets quite complicated however and harder questions may be weighted more heavily, so the path to a 260 might lie more in the number of hard questions answered correctly rather than the raw % score.

One explanation for the variation you see in the experiences thread might be due to the fact that people who end up with midrange scores tend to plateau rather early, whereas those with higher ceilings will see much higher jumps as they approach their test date. There are also only 200 questions on the NBME so you would expect a greater variance in scores at tail ends of the bell curve.

 

[Blesbok]

My theory for getting >250.

Study your ass off second year and work with the mindset that your effort is going to affect the rest of your life

Setup a good schedule and the books that you want to use before you start reviewing.

Use the study habits and methods that worked for you during the first two years to study your ass off during review time.

 

[Blesbok]

lol, I scored a 248 and sdn makes me feel like a dummy. I think no matter how high you score, you end up wishing you'd scored just a little higher. Personally I just wish I'd busted 250 although the difference between a 248 and 250 is trivial.

:werd:

Everyone is going to wish they did a little better no matter what. It may be trivial, but you didn't get into med school because you were content with just being. You got into med school because no matter how hard you work, you always want just a little more.

 

[Stark]

I always had a problem with those questions that had 4 paragraph explanations to them. This is too much information. You need to know what you know and don't know and review the stuff you don't know.

there used to be a software program call "Board Simulator" that had thousands of questions with short, but useful explanations. If you can get your hands on a copy (and are still running XP) this could be a useful questions tool.

I used Kaplan some, but the explanations were too long and exhaustive. Unfortunately, I don't know if you can buy the "Board Simulator" questions any longer. I would stick to the online Q-Banks with the shortest explanations possible.

Stark
www.ApolloAudiobooks.com

 

[Blesbok]

SDN is the only place where I can come to feel bad about scoring >255 (but <260) on step 1. Thanks SDN, for keeping me humble.

You fail at life. Get out of here.

 

[InertQuail]

You fail at life. Get out of here.

wha?

It was meant to be a joke. relax.

 

[Blesbok]

wha?

It was meant to be a joke. relax.

This board is for 265+ only, seriously, get out of here.

 

[InertQuail]

This board is for 265+ only, seriously, get out of here.

Christ, I didn't realize I had stepped into a 265+ room. I feel like a fool. I'll be going now. Just to be forthright, I may've knocked over your fish tank on accident, and i ate something resembling old pizza from the fridge. also, i wouldn't go in the bathroom for a coupla weeks. may you all continue to prosper. if you need your socks darned or feet rubbed, i'll be hanging out on the sub-260 island of sadness, just a few clicks to the east, as the bird flies.

 

[DwyaneWade]

220 is an average score. Nothing wrong with it. Nothing really to write home about either. I disagree that a 25-30 point difference in score boils down to minutiae. I know several people who knew as much or more minutiae than I did and ended up with 220-range because they did not understand the material well enough to apply the blindly memorized knowledge.

At least in my experience during test preparation, there is a world of a difference between the 220 kid and the 250 scoring student. When querying the former for explanations on concepts you more frequently get "i dont knows" or "I just memorized that" vs the latter students who can usually better explain the pathophysiology.

My friend who scored in the 260's and outscored me didn't know more details than me. We knew about the same amount of minutiae, I think. He was just smarter than me and we both knew it.

I'd say the difference between a 235 and a 245 is minutiae. The difference between a 245 and a 265 is about 50% hard work and 50% brilliance.

I agree.

I'm surprised to see "score-discrimination" among some of our older posters, clearly maturity is not a strong suit in medicine

 

[Pinkertinkle]

I agree.

I'm surprised to see "score-discrimination" among some of our older posters, clearly maturity is not a strong suit in medicine

I think it was the OP's first post that described his friend with a 248 who described his own score as "high as it was" and "so high" which seemed kinda douchey and didn't sit well with some of us.

 

[laxman310]

Doing UWorld, I've noticed that questions with increasing difficulty have more paragraphs explaining the answer, broken down like this:

1st paragraph-basic nomenclature, identifying the disease, basic recall

2nd paragraph-pathology, pathophysiology of the disease.

3rd paragraph-remote facts, 3rd/4th step reasoning.

Questions with only 1 paragraph explanation typically 60%+ of takers get it right. I imagine if you know the information in the first paragraph, that is a passing score. (<200)

Questions with 2 pargraph explanations typically have 40-60% get right. I imagine if you know this info, you are in the 200-230 range.

Questions with 3 pargraph explanations typically have <40% get right. I imagine if you know this info, you are in the 230+ range. If you consistently can do 3-4 step reasoning, and recall obscure facts, more likely 245+.

 

[wagonwheel]

So after reviewing this board, everybody keeps mentioning Goljan but then claims to use BRS path to review. Does anybody use the Goljan text?

 

[laxman310]

So after reviewing this board, everybody keeps mentioning Goljan but then claims to use BRS path to review. Does anybody use the Goljan text?

Pretty sure >75% of the 245+ high scorers use Goljan. Some people do like BRS path, but Goljan is def the gold standard.

 

[gluon999]

So after reviewing this board, everybody keeps mentioning Goljan but then claims to use BRS path to review. Does anybody use the Goljan text?

BRS path is good, but Goljan is much better. I'd say pick one and stick with, although I jumped back between the two and did well anyway.

 

[DwyaneWade]

I think it was the OP's first post that described his friend with a 248 who described his own score as "high as it was" and "so high" which seemed kinda douchey and didn't sit well with some of us.

It is a high score. Why shouldn't he be proud of it? Expectations are relative, remember.

 

[Pinkertinkle]

It is a high score. Why shouldn't he be proud of it? Expectations are relative, remember.

People with 260+ here don't describe their scores with such generous words, its a matter of modesty.

 

[DwyaneWade]

People with 260+ here don't describe their scores with such generous words, its a matter of modesty.

Modesty? All I see is people saying "248 is nothing around these parts" and (joking but not really) "You need to be above 260+ to post around here".

Just because other people lack humility does not mean we have an excuse to be pricks.

Anyways it is no big deal. Re: the OP, if you understand concepts you can get above 240+. It is all about how well you understand them.

EDIT: This is my last post on SDN for a good while guys, maybe for good. One of my new year's resolutions is to get off SDN . It's been a fun ride all of you who I studied for Step 1 with and good luck to all of you. If anyone ever wants to contact me my AIM and email are in my profile.

 

[wagonwheel]

People with 260+ here don't describe their scores with such generous words, its a matter of modesty.

enough with the bickering. step 1 is stressful enough without it.

 

[scrubnotes]

Honestly, the score itself does not matter so much unless you consider the context, or rather your specific goals. If you must have a number cutoff, in the U.S., the most competitive specialties have an average USMLE Step 1 score for matched applicants around 240 or so, which basically means, if you score above a 240, you can match into any specialty in theory. Of course, within any specialty, you're going to have to do more to match into the most competitive programs within that specialty, but I think this is the only relevant yardstick. If you're not going into something uber-competitive, don't sweat all this Step 1 stuff. Just study the best you can, do your best, and then work on doing well on your rotations which can count as much as your Step score in some cases. Hope that calms some of you down!

-Scrub

 

[DrKuroneko]

So after reviewing this board, everybody keeps mentioning Goljan but then claims to use BRS path to review. Does anybody use the Goljan text?

I'm currently using both! I mean Goljan is great for integrating many areas of the exam and his lectures are great! BRS is a very fast read once you've done the same chapter in RR. I find with reading both that it sticks very well and it doesn't take as much time as you think.

 

[Darkshooter326]

Does anyone know about how many questions/percent you need to get correct (out of 336 or whatever) to get a 240 or 250 on Step 1?

I think FA says 60% is pass?!?!

 

[gluon999]

Does anyone know about how many questions/percent you need to get correct (out of 336 or whatever) to get a 240 or 250 on Step 1?

I think FA says 60% is pass?!?!

This data is not published to my knowledge. But I do think that if you are scoring in the 70% range on UW or Kaplan, then you should be able to get a 240+, all other things being equal. I for one was in the mid 60s on UW by last week of test prep and still got 245+ on the real thing.

 

[scube]

Honestly, the score itself does not matter so much unless you consider the context, or rather your specific goals. If you must have a number cutoff, in the U.S., the most competitive specialties have an average USMLE Step 1 score for matched applicants around 240 or so, which basically means, if you score above a 240, you can match into any specialty in theory. Of course, within any specialty, you're going to have to do more to match into the most competitive programs within that specialty, but I think this is the only relevant yardstick. If you're not going into something uber-competitive, don't sweat all this Step 1 stuff. Just study the best you can, do your best, and then work on doing well on your rotations which can count as much as your Step score in some cases. Hope that calms some of you down!

-Scrub

if you check charting the outcomes there are ppl with 220s matching in competetive not a large percentage but it does happen. There was also one soul with a 250 who didn't get a spot in FM. more goes into matching than a three digit number. there are in fact SOME programs not specialties that have a cutoff number.

 

[AllUpOnYoMama]

The secret to scoring in the top 1-5% is repetition. This is how I scored above 250 on Steps 1 and 2 (and a 235 on Step 3 - a little lazy).

Don't just focus on the minutia. Don't just focus on the big stuff. Don't get stuck at the beginning trying to memorize anything.

Make it through all the material - I mean everything as fast as you can three times. For Step 1 I used First Aid and Step Up and BRS Path with a few other books. I went through each of them as fast and as hard as I could. The first time through, retention is low - 15%, the second time it's better - 40%, the third time through it's really high - 80% to 90%. I used audio because it was easier for me to get through everything fast.

Then, and only then, after you have made it through everything three times - THEN you sit down and memorize stuff that has to be memorized. You have to make it through every bit of the minutia and the big stuff before memorization.

I call it FAMILIARIZATION FIRST, MEMORIZATION LAST. And it was a great formula for success for me.

Memorization is a temptation that must be resisted until you have really gone through everything. Then it's time to memorize.

Best of Luck,

Stark
www.ApolloAudiobooks.com

Great advice. I agree 100%.