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I Failed Step I--Now what?

Discussion in 'Step I' started by 2ndyear, Jul 30, 2002.

  1. 2ndyear

    2ndyear Senior Member 10+ Year Member

    Jul 11, 2002
    New England
    Never thought that this would be me, but it looks like the ranges on Step I are larger than ever as of late and I came up on the short end. Studied hard for 4 weeks, did BRS phys and path, Ridiculously simple neuro, anatomy and micro, all 1100 Robbins Review book questions, 1st Aid once through but I used it all of 2nd year, Lippincott pharm, and flew through Kaplan at home for phys and biochem as well as High Yield Behavioral.

    I did the Kaplan CD and was scoring 50% so I put off the test for a week literally freaked out knowing that this was borderline, did more questions and still--50% on Kaplan, 55% on the USMLE CD.

    On the test it seemed like I had a million 'quote' behavioral questions and I got nearly every one wrong while practicing, this scared me before and during the test. I didn't feel that path was hit hard on my test at all. I didn't know the biochem but knew that would be my weakness.

    At my school we are starting rotations at the end of August, so now what? Obviously I can't start until at least October. My score of 166 is not good, and data shows (in 1st Aid) that I have a not so hot chance of passing the second time around. Would a full year off to study/do research help at all? Since I failed once I assume that I will be at the very bottom of the barrel come residency time, but how bad is it really? Will it be hard to find a residency period? I was looking into specialties before, that is now gone. If a family med spot will take me in Iowa, I'm there. Will a strong score the second time around help much or should I just pass? I did well my first two years, no fails, some honors, had a decent MCAT and ACT score so I assumed that the USMLE would not be that bad. Any and all advice is very appreciated at this point!
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  3. soon2bmd

    soon2bmd Junior Member 7+ Year Member

    May 27, 2002
    Look, I might not be the most qualified person to answer your question. In fact, I'm just a lowly lowly M1 that hasn't even started orientation yet.

    That might not restore much hope, but maybe this will:
    One of the finest doctors that I shadowed, got into med school on his third try. He was accepted off of the alternate list to MSU during orientation week. He ended up not passing the USMLE Step 1, and then went on to just slide by on Step 2 by the skin of his teeth. The moral of the story is that today he is called doctor.

    And oh yeah, did I mention that he's a radiologist.

    Now I'm not to the point that you are in school, but I'm hoping that this is just a minor setback. From what I can tell, USMLE is not the sole criteria for consideration in residency matching.

    I wish you well, hang in there
  4. 2ndyear

    2ndyear Senior Member 10+ Year Member

    Jul 11, 2002
    New England
    Thanks so much for the kind words! I also did not get into med school on the first time around, but I looked at what was wrong with my app and fixed it. Now I guess I need to look to where my weaknesses are and fix those for my next test date. But who would have thunk they would have been behavioral science...oh well! thanks again
  5. Crusher

    Crusher Member 7+ Year Member

    May 1, 2002
    My advice would be the following --

    From what you posted, I think you may have overloaded yourself with material. If you have done reasonably well your first two years then I would think that limiting your sources of review would be useful.

    For instance, I only read First Aid and used Qbank for questions and I did fine. I really believe if you know First Aid cold you will pass.

    If you have not done Qbank you may want to try that. The questions aren't always on target with the exam, but if nothing else you get used to doing lots of questions and get your timing down and you do learn some stuff.

    As far as the year off -- I think you may want to consider this and really bust your butt with some research. I really have no experience with this, but it is my opinion that if you were to do research for a year and get published (especially in a field you may want to enter) and then improve your Step I you will have a reasonable shot at most specialities in undesirable locations (Iowa for instance as you mentioned -- however Iowa has many EXCELLENT programs and isn't necessarily easy to get into)

    If you do nothing more than just pass the second time you will definitely get a family practice spot. In fact you are likely to be equally able to get an IM spot as well as other less competitive fields. IM would be my pick in your situation b/c you can always do more research in residency and then apply for a fellowship. There is more than one way to skin a cat.

    Good luck
  6. Crusher

    Crusher Member 7+ Year Member

    May 1, 2002
    One more thing...

    My exam was like yours with tons of BS (behavioral science or bull ****) as well. Its hard to study for, but if you think you need more help BRS Beh Sci by Fadem is an excellent read and might give you the edge
  7. Airborne

    Airborne Senior Member 7+ Year Member

    Jun 15, 2002
    East Coast

    I was under the impression that if you fail Step I and retake, the highest score they will give you is the lowest passing score...

    So if 2ndyear takes it again, and say would have gotten a 240, USMLE will only return a 178 (or whatever the lowest passing is..)

    Am I wrong?

  8. southerndoc

    southerndoc life is good Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Jun 6, 2002
    Airborne, I've never heard of USMLE only giving you a minimum passing score with any retake. I truly doubt that's the case.
  9. MustafaMond

    MustafaMond K-Diddy M.D. 7+ Year Member

    Jul 14, 2002
    Totally wrong...u can fail, and then get a 240
  10. atsai3

    atsai3 10+ Year Member

    May 15, 2002

    About the boards-- My advice to you would be: study First Aid. If you know it cold and can apply it clinically, you should be able to pass comfortably. That advice always leaves people feeling uneasy, so if you want to do more, then I would recommend Kaplan qBank. Just keep doing questions, and study the ones you got wrong.

    In any case, residency program directors consider more than just your USMLE Step 1 score. One thing you can do to redeem your poor showing on Step 1 is to study like mad for Step 2; that's partially mitigating. Ultimately, what you want to do is score well in your clerkships. For more information, you might refer to this thread:

  11. Peeshee

    Peeshee Senior Member 10+ Year Member

    Mar 16, 2000
    2nd year,

    It is ok...You got the test over at least and did not postpone it, like other people. There is always a second chance, and that does not make you any less of a dr. to be, just because of this exam. You may even become a better dr. due to the hardships you have had to overcome, and that is to be admired, so keep studying and prepare well the second time. It is your decision as to whether to take the year off. I am not sure how you feel about that, but it should be entirely up to you. Just one question-did you do QBANK at all? If so, what were you scoring on Q Bank? I am going to take step 1 soon, and I don't feel my scores are as high as they should be for me to comfortably pass. I think confidence has a lot to do with your performance on the exam. Everyone knows themselves and how much they know, and if you don't feel prepared/feel unsure, then, that probably will affect your test performance.
    Anyway, don't look this get you down. It is just ONE thing that you need to overcome, and you WILL. You will look back one day and think about this and wonder why you wasted so many hours and days worrying and getting frustrated, when really, in the big view of it all, it was just a little speck in your life. Believe me, there are many more important, be happy!
  12. Renovar

    Renovar Senior Member 7+ Year Member

    Jan 29, 2002
    First you should find out your school's policy regarding people who didn't pass step 1 and how that will affect your 3rd year. Some schools dont require the pass to progress to M3, but some does. So check out what's the deal first.

    Second, I would like to offer a word of encouragement. A member of the most recent graduating class in my medical school is heading to Yale New Haven for pediatrics. He failed his boards first time around. How did he still managed to land such a nice residency? Because he has a little phrase in his Dean's letter that says "he is the kind of doctor that I would love to take my kids to when they are sick." Oh yea, and on this second time, he studied his a$$ off and pulled a 230 on the re-take. The moral of the story: board numbers ain't even close to everything. It doesn't tell 1/2 the story about you, and your potential to become a good doc. What's important, however, is your dedication and love for medicine. You've made it this far... Is 1 test going to stop you in your track? Dont think so...

    As far as the exam go, you sound like you know your own weaknesses. It's just a matter of go back and really buckle down on those topics. As fellow MS's already mentioned, know 1st aid well. And one thing that worked for me is the High Yield behavioral science, the newest edition - it's got all the sample vignettes and standard answers to them. Those tend to be very well represented, and among the most ambiguous questions on the test - a few questions swing from incorrect to correct can easily turn the tide for you! As for biochem, I recommend knowing all the metabolic diseases down cold, as well as know your vitamins - 1st aid plus BRS should be fine.

    Best of luck to you!
  13. Bernardo_11

    Bernardo_11 I like Popeye's Chicken. Physician 10+ Year Member

    Feb 9, 2002
    Somewhere in the Pacific
    Hey there 2ndyear,

    First of all, don't sweat it. Just take it again. You will likely do fine. There are a few things already in your favor.

    1) You studied like crazy for a month studying the material. Now it's time to do nothing but practice questions. Board review series I hear is a good prep, but can be demoralizing with the difficulty of the questions. I preferred to use NMS practice tests. Great explanations. Appropriate level questions (if not a tad bit harder). I wouldn't spend a whole year off to study for step I, I would just use another month so that you can be only slightly behind on your clinical rotations.

    2) You've done the best preparation of all for any exam..... You took it once already. You know what it's like sitting in that damn Sylvan learning center, alongside people taking their 1 hour GED exams or basket weaving certifications. You are now familiar with the environment, the stress, the time constraints, and the difficulty of the questions. I would ignore the "statistics" presented to you in First Aid in regards to repeat test taking. Who really knows what makes up that group of 166 scorers? FMG's who are still trying to master the english language... who knows? It is likely that you are not in the majority profile who individuals who scored that low.

    3) Look at your score report and see where you were weakest. And don't say "everything." Look at the lowest ones I said. Review the material for those subjects only. The rest, just review by doing practice questions. Don't your scores on these tests freak you out. If you had scored high on them to begin with.. well they woulnd't be practice questions right?

    Anyhow... hope that helped. Good luck with everything.... I'm sure you'll do fine.

    Much faith in you Yoda has.
  14. 2ndyear

    2ndyear Senior Member 10+ Year Member

    Jul 11, 2002
    New England
    Thank you all so so much for the kind words, this is a really special place! I am so encouraged now after an obviously rough couple of days there and I'm going to get back to studying here really soon. One thing that is going to be hard will be 'coming out' to my classmates when I do rejoin them on rotations though. Not that they will mention it, but there will be some uncomfortable moments anyways as they will know why I missed the first 2 months. I am sure that by that time I will have come to acceptance of the fact and be more open about it with everyone though.

    For those waiting to take Step I still please don't let this worry you! I did not prepare in helpful ways, you will and you will pass!! Most people pass, heck almost all people pass. The stats are in favor of passing but you have to remember that it's a tough crowd by this point, us 7-9% who fail are still damn smart!
  15. jason952

    jason952 Member 7+ Year Member

    Apr 14, 2002
    I second the reccommendation to do MANY practive Q's. use q-bank or Board Simulator Series, then use first aid to fill in the blanks you have and don't get bogged in minutia. When will your retest date be?

  16. ckent

    ckent Banned Banned

    Jul 31, 2000
    Make sure that you have the most recent edition of high yield behavior science. I was confused when people kept talking about behavior science clinical vignettes in their high yield book, and that was because edition 1 doesn't have them but edition 2 does. You also might want to consider purchasing BRS behavioral science as well if that is your weak point.
  17. squeek

    squeek Senior Member 7+ Year Member

    Jan 21, 2002
    The BRS behavioral science is an absolute must-have. I, too, had TONS of beh sci on my test, and it was BRS that saved me. I read it less than a week before the test--complete cramming--and I was glad I did. It's very crammable, and the "high-yield" descriptor does not lie. (also, rumor has it that Barbara Fadem, the author, writes the USMLE beh sci questions).

    Good luck...hang in there. You'll make it! :)
  18. Surfer75

    Surfer75 Senior Member 7+ Year Member

    Feb 26, 2002
    Vancouver, BC
    If you get even the minimal score, you CANNOT retake the test.
  19. Eric714

    Eric714 Senior Member Physician 10+ Year Member

    Jul 21, 2000
    Southern CA
    This is kinda related to the topic.... anyone out there take the USMLE more than twice and get a decent residency?

    Basically, I'm wondering if residency programs will hold it against you if you've taken the USMLE Step 1 multiple times.
  20. fusionid

    fusionid Member 7+ Year Member

    Dec 15, 2002
    does anyone know if MCAT score correlate with USMLE score at all? I did well in the MCAT but I took it twice and studied my ass off for it.
  21. Starflyr

    Starflyr Manic Faerie 10+ Year Member

    Apr 11, 2000
    Dickinson, Tx
    I Just want to echo everybody else - First Aid is what you really need to know. At this point, forget all those other books. HOnestly, I read Micro made Ridiculously Simple and took a class called "What You Need To Know" that one of the 4th years taught, made flashcards, and did Qbank. Who knows, maybe next time around you wont get too many BS questions - I think I got maybe 2 on my exam.

  22. Winged Scapula

    Winged Scapula Cougariffic! Staff Member Administrator Physician Faculty Lifetime Donor Classifieds Approved 15+ Year Member

    Apr 9, 2000
    hSDN Member
    Moving to the USMLE Forums...
  23. doc05

    doc05 2K Member 10+ Year Member

    May 24, 2003
    hang in there. do as many practice question as you can find. qbank is really the best. also try the qbook: the questions aren't as representative in style, but they cover the content real nicely. you'll also note kaplan's way of overanalyzing the BS questions so that you can get them right on the exam.

    remember that your classmates will be rotating on different services and probably at multiple sites - and most of them won't even take notice that you're "gone" for a month. most will assume you're doing an elective or a personal vacation month.

    good luck.
  24. secretwave101

    secretwave101 Senior Member 10+ Year Member

    Dec 13, 2001
    Bruchmulbach, Germany
    Hey 2nd year,

    Bummer. I feel for you.

    I just took the test this summer and have a strong sense that I failed as well. My scores sound about like where your's were, and I also had a pretty bad test experience, for various reasons.

    I have been plotting my response to the "you suck, you idiot" letter I may get from NBME in the next few weeks, and here's some things to think about:

    -I'd suggest that you not take off 3rd year unless your school requires it. Those I know who failed have almost unequivocally stated that taking the test after 3rd year was a HUGE help. My test had LOTS of clinical questions on it that I had to guess at, but would have been no problem if I'd spent even 10 minutes on the wards.

    After spending a year learning real medicine in real-time, you're likely to find any clinically-oriented questions much easier than you did this time around. Many people wait until after their 3rd year for just this reason. Granted, you'll move that much further from 1st year, but if you're like most people, you've forgotten most of that stuff anyway.

    It would be cool if 1st Aid could separate re-test statistics into people who gained clinical experience before they re-took the exam, and people who simply studied more and then re-took it. I'll bet your 166 wouldn't look so grim.

    -BRS Behav. Sci. is really good, its what I read, and I'll recommend it along with everyone else in this thread. The ONLY question I allowed myself to check after the test was a subtle psych question, and I got it right because I remembered it directly from BRS. If you really work through that book, and do all the questions, I can't imagine the USMLE BS questions being beyond you.

    -I've thought through the "coming out" thing too. But my plan is to be as honest as possible. I'm determined to believe that tests don't define me as a person, and are poor predictors of how good I'll be as a doctor. I intend to live out that determination by being forthcoming about my test if I fail. I think more doctors - even the high-scoring ones - need to be more open about their weaknesses anyway. This will be good practice. Plus, there are lots of ways people might reach out to you to help you pass the next time. Maybe someone will give you some great notes that'll make the difference, or you'll hook up with a study partner who can make you think about the info in different ways.

    Be honest. Be real. Don't worry about residency - it's irrelevant until you pass anyway. Just focus on learning medicine.
  25. Peeshee

    Peeshee Senior Member 10+ Year Member

    Mar 16, 2000
    for those of you who have not passed step 1, what are you going to do differently this time, in order to make sure you pass? Are you going to use different books or just use the same ones and study in more detail/go over the material many more times?
    Also, how long after you did not pass the first time, are you planning to take step 1 for the 2nd time?

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