I'm TERRIFIED of failing Step1 again. Any advice/reassurances?

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whitetopaz

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Disclaimer: not trying to scare anyone. Clearly, my situation was a fluke. Trust your practice test scores, friends.

Long story short: I failed Step1 back in August. NBME's were 230-240 in the last month, UWSA2 was a 247 ~2 weeks out, 97% on the free120 a few days out. Got a 185 on the real deal.

What happened? No idea. Please don't speculate; it took me a LONG time to recover emotionally/mentally, and I don't have the energy/time to dive down that rabbit hole again.

I ended up taking a break for health reasons and started studying in December for my retake. Kept up with Anki for biochem only during my break.

Current numbers (All practice tests were retakes. Tests were taken for the first time in June-July):

NBME 26 (6 weeks out): 230
NBME 30 (5 weeks out): 224
NBME 27 (4 weeks out): 243
UWSA1 (3 weeks out): 271
UWorld (Reset for a clean slate): initial blocks were ~60%; averages increased to 80-90%, with a few blocks of 100%

Holding off on UWSA2 and Free120, but I'm not even sure they're worth doing at this point since my original scores clearly weren't predictive.

I scheduled to take it in ~2 weeks because I wanted a numbered score before reporting becomes pass/fail, but I'm SOOO scared that I'm going to fail again. I don't know if my scores are predictive at all since they're retakes. And even if they're predictive, who's to say I won't fail again? If it happened once, it might happen again, right?

And then there's the question of whether I should just take it pass/fail. What if I end up passing, but it's a low score? Should I just push it back so I can take it pass/fail and focus on doing well on Step2 instead?

Any advice/feedback would be appreciated. Thanks in advance.
 
I would say your best bet is to take it scored when considering the scenarios. I'm going to make up scores for the sake of the example.

Scenario 1: Pass/Fail
First Step 1 attempt: 185
Second Step 1 attempt: Pass
Step 2: 260

Scenario 2: Scored, don't do well
First Step 1 attempt: 185
Second Step 1 attempt: 200
Step 2: 260

Scenario 3: Scored, do well
First Step 1 attempt: 185
Second Step 1 attempt: 240
Step 2: 260

To me, there is little difference between scenarios 1 and 2. There is a significant advantage to scenario 3. The risk of getting scenario 2, given that it is not very different from scenario 1, is worth the chance of getting scenario 3.
 
What are the downsides of taking it scored in your case? People who see fail -> pass will assume that you just passed. Even if you score a 200 on the real deal (low probability given your practice tests and that its your second shot), I don’t think that’s much different than just having Pass. Seems like it’s all upside to having those numbers. It’s also going to feel good as hell when you get a 260!
 
Disclaimer: not trying to scare anyone. Clearly, my situation was a fluke. Trust your practice test scores, friends.

Long story short: I failed Step1 back in August. NBME's were 230-240 in the last month, UWSA2 was a 247 ~2 weeks out, 97% on the free120 a few days out. Got a 185 on the real deal.

What happened? No idea. Please don't speculate; it took me a LONG time to recover emotionally/mentally, and I don't have the energy/time to dive down that rabbit hole again.

I ended up taking a break for health reasons and started studying in December for my retake. Kept up with Anki for biochem only during my break.

Current numbers (All practice tests were retakes. Tests were taken for the first time in June-July):

NBME 26 (6 weeks out): 230
NBME 30 (5 weeks out): 224
NBME 27 (4 weeks out): 243
UWSA1 (3 weeks out): 271
UWorld (Reset for a clean slate): initial blocks were ~60%; averages increased to 80-90%, with a few blocks of 100%

Holding off on UWSA2 and Free120, but I'm not even sure they're worth doing at this point since my original scores clearly weren't predictive.

I scheduled to take it in ~2 weeks because I wanted a numbered score before reporting becomes pass/fail, but I'm SOOO scared that I'm going to fail again. I don't know if my scores are predictive at all since they're retakes. And even if they're predictive, who's to say I won't fail again? If it happened once, it might happen again, right?

And then there's the question of whether I should just take it pass/fail. What if I end up passing, but it's a low score? Should I just push it back so I can take it pass/fail and focus on doing well on Step2 instead?

Any advice/feedback would be appreciated. Thanks in advance.
Have you had difficulties with standardized tests before? The MCAT?

It’s one thing to score high on a practice test at home. Performance on test day is another. Clearly you have the foundation to score well. However if you have a history of test taking issues you might be better off taking the p/f version. X2 if taking a scored exam will add to your stress and performance anxiety
 
What are the downsides of taking it scored in your case? People who see fail -> pass will assume that you just passed. Even if you score a 200 on the real deal (low probability given your practice tests and that its your second shot), I don’t think that’s much different than just having Pass. Seems like it’s all upside to having those numbers. It’s also going to feel good as hell when you get a 260!
I don’t want to be a downer but i’m not sure why we’re assuming OP will get a 260. The comparison should be whether to take it P/F vs a 230 or so, which is a difficult decision. I don’t know what happened with OP’s first attempt but as long as OP can figure out what to do to avoid the repeat of that on test day, they can decide to take it scored. Otherwise, going for P/F may be a better idea
 
Have you had difficulties with standardized tests before? The MCAT?

It’s one thing to score high on a practice test at home. Performance on test day is another. Clearly you have the foundation to score well. However if you have a history of test taking issues you might be better off taking the p/f version. X2 if taking a scored exam will add to your stress and performance anxiety

I never knock standardized testing out of the park, but I've always scored high enough for college/med school applications.

2200/2400 SAT, 33/36 ACT, 510 MCAT. All first attempts.
 
I dropped pretty precipitously on Step. NBMEs under testing conditions in 250s, real deal 220s. It happens. We're in a system that helps pick ourselves up and move forward.

With your prior history of doing well and having a huge drop - I would personally take it P/F late January then shift my efforts to focus on step 2.

If you need assurances, go onto charting outcomes. For example: Internal med had a 85% chance matching with step below 200.
 
I never knock standardized testing out of the park, but I've always scored high enough for college/med school applications.

2200/2400 SAT, 33/36 ACT, 510 MCAT. All first attempts.
Yea these are solid numbers. I’m still 50/50 about scored or p/f because of the additional stress that comes with a scored test. Your focus now is to pass the test, and convince yourself during the test that you’re definitely meeting your goal of putting this test behind you. Last thing you need is one difficult block stressing you out about getting a high score that you have a rough rest of the exam.
 
Yea these are solid numbers. I’m still 50/50 about scored or p/f because of the additional stress that comes with a scored test. Your focus now is to pass the test, and convince yourself during the test that you’re definitely meeting your goal of putting this test behind you. Last thing you need is one difficult block stressing you out about getting a high score that you have a rough rest of the exam.

Definitely agree with you. It's probably expected/obvious, but I always do better on second attempts of an exam (2370/2400 SAT, 35 ACT, didn't bother retaking the MCAT), so objectively speaking, I should be able to pass. I'm just not sure if I should take it with a scored result because that adds extra stress. And I've never been in this kind of situation where I'm so stressed over a retake to begin with.
 
OP, I know this is water under the bridge at this point, but did you ever ask for a re-score? The huge drop from your practice exams plus your previous good results with standardized testing really makes me wonder if there might have been some sort of legit scoring error in your case,
 
OP, I know this is water under the bridge at this point, but did you ever ask for a re-score? The huge drop from your practice exams plus your previous good results with standardized testing really makes me wonder if there might have been some sort of legit scoring error in your case,

I did pay for a re-score, but nothing changed. Waste of $80, but at least I got some closure. Otherwise, I would have always wondered if that was the reason.
 
Disclaimer: not trying to scare anyone. Clearly, my situation was a fluke. Trust your practice test scores, friends.

Long story short: I failed Step1 back in August. NBME's were 230-240 in the last month, UWSA2 was a 247 ~2 weeks out, 97% on the free120 a few days out. Got a 185 on the real deal.

What happened? No idea. Please don't speculate; it took me a LONG time to recover emotionally/mentally, and I don't have the energy/time to dive down that rabbit hole again.

I ended up taking a break for health reasons and started studying in December for my retake. Kept up with Anki for biochem only during my break.

Current numbers (All practice tests were retakes. Tests were taken for the first time in June-July):

NBME 26 (6 weeks out): 230
NBME 30 (5 weeks out): 224
NBME 27 (4 weeks out): 243
UWSA1 (3 weeks out): 271
UWorld (Reset for a clean slate): initial blocks were ~60%; averages increased to 80-90%, with a few blocks of 100%

Holding off on UWSA2 and Free120, but I'm not even sure they're worth doing at this point since my original scores clearly weren't predictive.

I scheduled to take it in ~2 weeks because I wanted a numbered score before reporting becomes pass/fail, but I'm SOOO scared that I'm going to fail again. I don't know if my scores are predictive at all since they're retakes. And even if they're predictive, who's to say I won't fail again? If it happened once, it might happen again, right?

And then there's the question of whether I should just take it pass/fail. What if I end up passing, but it's a low score? Should I just push it back so I can take it pass/fail and focus on doing well on Step2 instead?

Any advice/feedback would be appreciated. Thanks in advance.
Did you do well in any specific systems/disciplines?

What was your preclinical GPA?
 
Did you do well in any specific systems/disciplines?

On Step1? No. According to the score report, I didn't have any strengths, which was shocking because I was above average in several systems/disciplines (renal, behavioral sciences, physiology, microbiology, etc.) on all of my NBME's and got perfect scores in those sections near the end of dedicated leading up to my first attempt.

What was your preclinical GPA?

My school has a P/F curriculum for preclinicals, so no official GPA, but I easily passed every class.
 
On Step1? No. According to the score report, I didn't have any strengths, which was shocking because I was above average in several systems/disciplines (renal, behavioral sciences, physiology, microbiology, etc.) on all of my NBME's and got perfect scores in those sections near the end of dedicated leading up to my first attempt.



My school has a P/F curriculum for preclinicals, so no official GPA, but I easily passed every class.
Anything going on in your life that's distracting you???
 
Unless you were looking things up while taking those NBMEs (people do that) which would make your score artificially high, it sounds like you either had crazy test anxiety or something else was going on in your life that came to a head around that time (but you didn’t mention anything).

And I agree with @Lawpy. Everyone always gives advice like “if you get a 250 on the retake, that’ll be way better than a pass.” But—and I don’t mean this to be harsh—you failed the first attempt. Why would you assume you’ll be able to get a 250+ on the second attempt? To me that’s a huge gamble with not great odds.

Unless you can identify something that was going on that you can resolve or can identify some test anxiety and have a great way to control it, I feel like taking it scored again when you have the option of a pass is risky.
 
And I agree with @Lawpy. Everyone always gives advice like “if you get a 250 on the retake, that’ll be way better than a pass.” But—and I don’t mean this to be harsh—you failed the first attempt. Why would you assume you’ll be able to get a 250+ on the second attempt? To me that’s a huge gamble with not great odds.

I guess my question would be, if you already have a failed attempt, does a low pass really look that much worse than a "pass"? Even a 220 after a fail I think looks better than only a pass. Or at the very least, doesn't look worse. In this situation, I don't see how a pass benefits them even over a low score given the fact that they already will have a failed attempt.

I 100% agree with taking it pass/fail if they were going to get a low score on a first attempt. But at this point, I guess I don't see what score is feared enough that a pass looks better.
 
I guess my question would be, if you already have a failed attempt, does a low pass really look that much worse than a "pass"? Even a 220 after a fail I think looks better than only a pass. Or at the very least, doesn't look worse. In this situation, I don't see how a pass benefits them even over a low score given the fact that they already will have a failed attempt.

I 100% agree with taking it pass/fail if they were going to get a low score on a first attempt. But at this point, I guess I don't see what score is feared enough that a pass looks better.
There is no clear comparison between a pass and a score. I think one way to do it is to look at Step 1 medians (national and specialty) of successful applicants and set that as a pass

I think OP’s top priority should be to just pass Step 1 in any capacity so taking it P/F would be better
 
I guess my question would be, if you already have a failed attempt, does a low pass really look that much worse than a "pass"? Even a 220 after a fail I think looks better than only a pass. Or at the very least, doesn't look worse. In this situation, I don't see how a pass benefits them even over a low score given the fact that they already will have a failed attempt.

I 100% agree with taking it pass/fail if they were going to get a low score on a first attempt. But at this point, I guess I don't see what score is feared enough that a pass looks better.
Yeah I don’t think we can really say. I guess we could try to find some data from next years match since it will be one of the few where people have mixed scored and pass/fail steps. It’d only be one person, but maybe @NotAProgDirector could let us know what he’d prefer to see?
 
I guess my question would be, if you already have a failed attempt, does a low pass really look that much worse than a "pass"? Even a 220 after a fail I think looks better than only a pass. Or at the very least, doesn't look worse. In this situation, I don't see how a pass benefits them even over a low score given the fact that they already will have a failed attempt.

I 100% agree with taking it pass/fail if they were going to get a low score on a first attempt. But at this point, I guess I don't see what score is feared enough that a pass looks better.
Isn’t the test going to be pure p/f soon? ie, for all residency ADCOMS will assume OP didn’t have a scored choice. They can’t really hold that against him. They’ll have to treat his pass the same as anyone who failed then passed in this new era of scoreless step 1.
 
Isn’t the test going to be pure p/f soon? ie, for all residency ADCOMS will assume OP didn’t have a scored choice. They can’t really hold that against him. They’ll have to treat his pass the same as anyone who failed then passed in this new era of scoreless step 1.
Yeah but it’s very clear that the date is Jan 26 and that op could have taken it for a score.
 
There is no clear comparison between a pass and a score. I think one way to do it is to look at Step 1 medians (national and specialty) of successful applicants and set that as a pass

I think OP’s top priority should be to just pass Step 1 in any capacity so taking it P/F would be better
I agree with this. There’s no guarantee of a high score. Why risk it? Also, this experience has probably been difficult enough as is - IMO, best to take some pressure off, pass Step 1, and then focus on Step 2. Given your practice scores, a high Step 2 score shouldn’t be out of reach for you. I’m really sorry this happened to you!
 
I agree with this. There’s no guarantee of a high score. Why risk it? Also, this experience has probably been difficult enough as is - IMO, best to take some pressure off, pass Step 1, and then focus on Step 2. Given your practice scores, a high Step 2 score shouldn’t be out of reach for you. I’m really sorry this happened to you!

With this logic OP should take a scored Step 1. I agree with earlier posts regarding the scenario where you follow-up a Step 1 Failure with a >230 or whatever is superior to a simple P (and basing future success off practice scores can be done for both the Step 1 retake as well as Step 2)

Scenario 1: F Step 1 first attempt, 2nd attempt Step 1 > 230, Step 2 > 240
Scenario 2: F Step 1 first attempt, 2nd attempt Step 1 Pass, Step 2 > 240
 
With this logic OP should take a scored Step 1. I agree with earlier posts regarding the scenario where you follow-up a Step 1 Failure with a >230 or whatever is superior to a simple P (and basing future success off practice scores can be done for both the Step 1 retake as well as Step 2)

Scenario 1: F Step 1 first attempt, 2nd attempt Step 1 > 230, Step 2 > 240
Scenario 2: F Step 1 first attempt, 2nd attempt Step 1 Pass, Step 2 > 240
Scenario 3: F first attempt, second attempt 205. Imo that looks worse than F -> P.
 
Anything going on in your life that's distracting you???

I had surgery a few weeks before and a family member passed away from a terminal illness shortly afterwards, but my practice test scores (247 on UWSA2 and 97% on Free120) indicated that I should still pass so I went ahead and took it.
 
Scenario 3: F first attempt, second attempt 205. Imo that looks worse than F -> P.
I don't think it's out of the realm of possibility that most PDs may simply view a P the 2nd time as the lowest possible P given the 1st time failure tho. .

Scenario 4: F first attempt, P second attempt, Step 2 first attempt 210
Scenario 5: F first attempt, 205 second attempt, Step 2 210

I don't think there is much of a difference in those. So essentially if the OP trusts their practice scores and can come out with a respectable improvement (220+) that seems better to me, and would also seemingly prove to OP that they can do similar on Step 2


I will say idk of there is a true and hard way to go about this. But thats my opinion
 
I had surgery a few weeks before and a family member passed away from a terminal illness shortly afterwards, but my practice test scores (247 on UWSA2 and 97% on Free120) indicated that I should still pass so I went ahead and took it.
Take it scored. You took it under terrible life stress which should nearly guarantee a lack of typical focus on test day
 
Unless you were looking things up while taking those NBMEs (people do that) which would make your score artificially high, it sounds like you either had crazy test anxiety or something else was going on in your life that came to a head around that time (but you didn’t mention anything).

I responded to @Goro's question already, but to reiterate, I had surgery a few weeks before and then a family member passed away from a terminal illness. I took UWSA2 and Free120 a few days before my test date, and decided to trust my scores and go for it.

And there's no way in hell I would look things up. Those tests are $60 a pop and I'm not pouring that kind of money down the drain to transiently stroke my ego.
 
I responded to @Goro's question already, but to reiterate, I had surgery a few weeks before and then a family member passed away from a terminal illness. I took UWSA2 and Free120 a few days before my test date, and decided to trust my scores and go for it.

And there's no way in hell I would look things up. Those tests are $60 a pop and I'm not pouring that kind of money down the drain to transiently stroke my ego.
Are there any NBMEs available that you didn’t already take when studying for first time?
 
I don't think it's out of the realm of possibility that most PDs may simply view a P the 2nd time as the lowest possible P given the 1st time failure tho. .

Scenario 4: F first attempt, P second attempt, Step 2 first attempt 210
Scenario 5: F first attempt, 205 second attempt, Step 2 210

I don't think there is much of a difference in those. So essentially if the OP trusts their practice scores and can come out with a respectable improvement (220+) that seems better to me, and would also seemingly prove to OP that they can do similar on Step 2


I will say idk of there is a true and hard way to go about this. But thats my opinion
The Step 1 failure is already a red flag in the first place whether OP takes it scored and gets a 260 or takes it P/F and gets a P. It’s just needlessly risky and stress inducing to take it scored again when P/F is an option
 
The Step 1 failure is already a red flag in the first place whether OP takes it scored and gets a 260 or takes it P/F and gets a P. It’s just needlessly risky and stress inducing to take it scored again when P/F is an option
Disagree, OP had real life circumstances that can be explained for why they failed, ESPECIALLY if they get a baller score like that
 
Are there any NBMEs available that you didn’t already take when studying for first time?

Unfortunately, no. I took all the NBME's (25-30) because I wanted to expose myself to as many questions as possible. In any case, the NBME's weren't reflective of my Step1 form in my opinion. NBME questions all felt very straightforward for me and didn't require the level of critical thinking/reasoning that UWorld and Step1 did.
 
Unfortunately, no. I took all the NBME's (25-30) because I wanted to expose myself to as many questions as possible. In any case, the NBME's weren't reflective of my Step1 form in my opinion. NBME questions all felt very straightforward for me and didn't require the level of critical thinking/reasoning that UWorld and Step1 did.
Did you do any Amboss questions? If those are new you can just make your own randomized test and see what percentile you're answering in (if you're searching for new questions, Amboss has a tree trial too)
 
Disagree, OP had real life circumstances that can be explained for why they failed, ESPECIALLY if they get a baller score like that

I really appreciate your optimism that I'll do well, but I know a 260 isn't in the cards for me. I have a track record of scoring dead average and/or the bare minimum to clear a certain requirement (note my 2200 SAT and 510 MCAT). I had assumed a ~230 was an achievable goal during my first attempt, but at this point, the only thing I can confidently say about my retake score is that I think it will start with a 2.
 
Did you do any Amboss questions? If those are new you can just make your own randomized test and see what percentile you're answering in (if you're searching for new questions, Amboss has a tree trial too)

I used Amboss and USMLE-Rx throughout M1/M2 year, so none of those questions are new for me. Also, Amboss was all around soul-crushingly difficult IMO, and I don't want to relive the pain when I'm only a few weeks out.
 
I really appreciate your optimism that I'll do well, but I know a 260 isn't in the cards for me. I have a track record of scoring dead average and/or the bare minimum to clear a certain requirement (note my 2200 SAT and 510 MCAT). I had assumed a ~230 was an achievable goal during my first attempt, but at this point, the only thing I can confidently say about my retake score is that I think it will start with a 2.
Yeah 260 is not gonna happen but 240 could be well within reason (60th percentile or so)

And dead average on the MCAT doesn't mean anything. Don't put yourself down. Mcat is in the past and it really doesn't ha e to mean you're not capable of X score. I got a 512 myself and scored a 249 Step 1. A buddy of mine scored a low 500s and got a 250. Another buddy scored 515 or something and scored low 240s
 
It’s still a red flag that has to be explained either way
Right, so "I had a personal surgery and then a suddenly unexpected death in the family, but I retook and scored a 230 which is much more in line with my Step 2 of 235 on first attempt" is better than only a pass IMO. Again idk if there's a right or wrong answer.



@OP if you're out of practice questions entirely then I'm not sure what would be best. I'd say probably Amboss if those were harder and you took them longer ago. Only do the 2-4 hammer questions
 
Right, so "I had a personal surgery and then a suddenly unexpected death in the family, but I retook and scored a 230 which is much more in line with my Step 2 of 235 on first attempt" is better than only a pass IMO. Again idk if there's a right or wrong answer.



@OP if you're out of practice questions entirely then I'm not sure what would be best. I'd say probably Amboss if those were harder and you took them longer ago. Only do the 2-4 hammer questions
The thing is a pass can be viewed similarly to the median Step score, which can be 230 in at least some specialties.
 
The thing is a pass can be viewed similarly to the median Step score, which can be 230 in at least some specialties.
I could agree with that for someone taking Step 1 the first time around. But thats not even a guarantee. Let alone someone with a F on their first attempt. If OP was talking about taking their first jab at Step 1 and aren't too confident because of personal health and family issues + not trying for competitive field I'd say sure just take Step 1 P/F
 
I had surgery a few weeks before and a family member passed away from a terminal illness shortly afterwards, but my practice test scores (247 on UWSA2 and 97% on Free120) indicated that I should still pass so I went ahead and took it.
Well that answers that. I think you have a decent chance of getting what you should have gotten the first time as long as you’ve been able to somewhat process these things enough to compartmentalize.
 
Well that answers that. I think you have a decent chance of getting what you should have gotten the first time as long as you’ve been able to somewhat process these things enough to compartmentalize.

You'd think so, but I took the SAT while I had bronchitis, and took the MCAT while also studying for final exams in college. So I've had practice compartmentalizing/suppressing distractions and powering through exams. But it didn't work for Step1 and I just feel like I'm drowning in fear and stress over failing a second time.
 
You'd think so, but I took the SAT while I had bronchitis, and took the MCAT while also studying for final exams in college. So I've had practice compartmentalizing/suppressing distractions and powering through exams. But it didn't work for Step1 and I just feel like I'm drowning in fear and stress over failing a second time.
Bronchitis and multiple exams isn’t the same as surgery and a family member dying.
 
From the debate in this thread and your responses, OP, it seems like P/F is the right move. No one knows what PDs will say and there’s great arguments both ways but it’s just a thought experiment (and a very unique one). What’s most important is how you’re going to feel. If you really wanted to prove it to yourself or whatever and wanted to get a good 3 digit score that would be one thing. If you’re feeling very anxious a few weeks out, just push it, take it pass fail. Study hard, rest assured, and move forward
 
There's no "right" answer. A great score is better than a plain pass. A plain pass is probably better than a 203. Some programs will decline to interview based upon the prior fail regardless. Other programs will care less, and focus on a S2 score. It probably doesn't matter all that much either way.

All things being otherwise equal, there's probably some benefit to taking it scored. If there's a benefit to the OP in taking it later than the change, I wouldn't worry about it. Any benefit to a scored result is small.
 
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