Hey guys,
I wanted to write this up to see if I could provide some guidance from my experience with Step 1 and possibly help the next wave of examinees. I benefitted from this site a lot and wanted to pay it forward. I'm an IMG from Pakistan who graduated last year. Got my score back a few days ago and scored 229. Needless to say, I was disappointed. Not that I had scored super high on practice tests, but I felt like I was peaking around the right time and had room to grow. My overall experience was disjointed as I spent about a year studying and employed a wide variety of resources, which was quite inefficient and didn't do me any favors. I also had a strange experience with the predictive value of various NBMEs as my fatigue near the end affected my performance on these exams and gave widely variable results. Combine all of that with the fact that I didn't get more than 30 minutes of sleep the night before the exam due to nerves, and you have a pretty clear insight into the reason behind my performance. Maybe in hindsight, a 229 is something to be thankful for tbh.
Here's what I used: DIT 2015, FA 2017, UW (3 times), 2014 Kaplan lectures (about 3 times like some kind of idiot), Qmax, Kaplan Qbank, High yield neuroanatomy, Sketchy micro for some bugs, Pathoma, Goljan audio, some Pastest questions. The last 6 weeks were focused on purely FA and UW Pathology questions.
I took a baseline NBME 12 in January 2017 and got a 165. Not ideal, but plenty of room to improve. In the early stages, I annotated all of UW into FA. That took me about 3 months. I then took NBME 13 and got a 186. Still not awesome, but improvement. Then I watched Kaplan lectures multiple times, which took me 3-4 months. I'm not even talking about just covering them. I'm talking about going into such excruciating detail that it's not even funny. AMGs might not know, but Kaplan lecture notes are DENSE. They go way overboard. But I wanted to do well, so I decided to just grit my teeth and tried to learn it all. This was problematic for 2 reasons. 1) It was totally unnecessary, even if you wanted to do well. 2) It sapped a lot of time and energy, both of which I desperately needed to save for more useful resources. Thinking about my stupidity even now makes me want to punch myself.
I then took NBME 15 in October and got a 186 again. It was brutal because after roughly 9 months of studying, I still hadn't passed. Even worse, I hadn't improved a single point in months. If there was a rock bottom in this studying marathon from hell, this was it.
I decided to use the anger and just attack BCQs from then onwards. Do all the BCQs everywhere. I finished Qmax in a month and took UWSA 2 and got a 228. 42 point jump. They overpredict, sure, but at this point honestly idgaf. I then spent another month doing Kaplan qbank and then took UWSA 1 and got a 220. Not the direction I was looking for, but hey, at least I'm passing and I still have time to improve. This is where my preparation became a little bit aimless. I was sometimes doing UW, sometimes covering FA, sometimes going into pathoma. It was inefficient and a poor use of time. I took NBME 16 in February and got a 215. I felt like the recent 2 exams were not a good indicator of my knowledge as I had made some silly mistakes, and I was fading. I was also running out of time as I was hoping to apply for the 2019 cycle. So I made a pact with myself and decided to take it 6 weeks from that point, on March 15th 2018. I started doing an NBME every week. I took NBME 17 and got a 223. Then 2 weeks before my exam, I took NBME 19 and got a 230. That's right, NBME 19 which, as conventional wisdom dictates, is known to underpredict by 10-25 points was scoring me at a 230 with 25 mistakes 2 weeks before my exam. I was elated. Then a week later it came crashing down when I took NBME 18 and scored 217. Pure fatigue is the only way I can describe it. I was misreading questions left and right. Made 47 mistakes, about 18 of which were due to simply misunderstanding the question. I wasn't going to delay however. The reason was that if I were to delay it a few weeks, my anxiety would only grow and there would be no meaningful improvement to my knowledge or score. And if I were to delay by a few months, then the fatigue factor would really worsen and my score might actually decrease. There were no ideal options so I went with the best one.
I took the exam as planned and thought it was super hard. I didn't feel the fatigue and lack of sleep as much, but I knew that there was still a chance that I'd make those same mistakes (I didn't have a feeling of fatigue as I was taking NBME 18 either, and that result speaks for itself). But the content was difficult at times, and some things (heart sounds grrrr) that I wasn't great at came up. Overall I thought I at least passed. I was hoping to get into the 230s at least. My goal score was 240, but I thought 230s was solid and attainable, especially considering my NBME 19 result. But alas, the dice did not roll that way.
I only found out a few days ago but I honestly feel legitimately down. I had really high aspirations to match into a good university program. I love IM, and I'm intrigued by EM enough to want to do a few rotations after CK, but I feel like this really hurt my chances to do well with either. I'm fortunate though. As an IMG, I've seen this exam hurt a lot of people. It's put strain on marriages and messed with people's mental health and ended some medical careers altogether. So I'm just trying to be thankful and not bellyache about an average score because it could honestly be so much worse.
Overall advice if you're an IMG: Just because you can use as much time as you want to take this exam doesn't mean you should. Fatigue and burnout are real. The longer your study marathon goes, the less efficient it becomes. I learned this the hard way. Make your first 3-4 months of studying SUPER efficient. Learn as much as you possibly can early on. I came from an almost nonexistent basic sciences background, so I know what you may be going through covering the resources. Use only a few resources and master them all, don't go through a million things.
Sorry for the rant that accompanied the stats, as well as this being somewhat chaotically formatted. This was a source of catharsis for me as well as a way to help those who might benefit even a little. I have my CS coming up in 4 days so hopefully that goes well. I wish you all the best of luck with future exams. Love you guys. Lmk if I can answer any questions.
I wanted to write this up to see if I could provide some guidance from my experience with Step 1 and possibly help the next wave of examinees. I benefitted from this site a lot and wanted to pay it forward. I'm an IMG from Pakistan who graduated last year. Got my score back a few days ago and scored 229. Needless to say, I was disappointed. Not that I had scored super high on practice tests, but I felt like I was peaking around the right time and had room to grow. My overall experience was disjointed as I spent about a year studying and employed a wide variety of resources, which was quite inefficient and didn't do me any favors. I also had a strange experience with the predictive value of various NBMEs as my fatigue near the end affected my performance on these exams and gave widely variable results. Combine all of that with the fact that I didn't get more than 30 minutes of sleep the night before the exam due to nerves, and you have a pretty clear insight into the reason behind my performance. Maybe in hindsight, a 229 is something to be thankful for tbh.
Here's what I used: DIT 2015, FA 2017, UW (3 times), 2014 Kaplan lectures (about 3 times like some kind of idiot), Qmax, Kaplan Qbank, High yield neuroanatomy, Sketchy micro for some bugs, Pathoma, Goljan audio, some Pastest questions. The last 6 weeks were focused on purely FA and UW Pathology questions.
I took a baseline NBME 12 in January 2017 and got a 165. Not ideal, but plenty of room to improve. In the early stages, I annotated all of UW into FA. That took me about 3 months. I then took NBME 13 and got a 186. Still not awesome, but improvement. Then I watched Kaplan lectures multiple times, which took me 3-4 months. I'm not even talking about just covering them. I'm talking about going into such excruciating detail that it's not even funny. AMGs might not know, but Kaplan lecture notes are DENSE. They go way overboard. But I wanted to do well, so I decided to just grit my teeth and tried to learn it all. This was problematic for 2 reasons. 1) It was totally unnecessary, even if you wanted to do well. 2) It sapped a lot of time and energy, both of which I desperately needed to save for more useful resources. Thinking about my stupidity even now makes me want to punch myself.
I then took NBME 15 in October and got a 186 again. It was brutal because after roughly 9 months of studying, I still hadn't passed. Even worse, I hadn't improved a single point in months. If there was a rock bottom in this studying marathon from hell, this was it.
I decided to use the anger and just attack BCQs from then onwards. Do all the BCQs everywhere. I finished Qmax in a month and took UWSA 2 and got a 228. 42 point jump. They overpredict, sure, but at this point honestly idgaf. I then spent another month doing Kaplan qbank and then took UWSA 1 and got a 220. Not the direction I was looking for, but hey, at least I'm passing and I still have time to improve. This is where my preparation became a little bit aimless. I was sometimes doing UW, sometimes covering FA, sometimes going into pathoma. It was inefficient and a poor use of time. I took NBME 16 in February and got a 215. I felt like the recent 2 exams were not a good indicator of my knowledge as I had made some silly mistakes, and I was fading. I was also running out of time as I was hoping to apply for the 2019 cycle. So I made a pact with myself and decided to take it 6 weeks from that point, on March 15th 2018. I started doing an NBME every week. I took NBME 17 and got a 223. Then 2 weeks before my exam, I took NBME 19 and got a 230. That's right, NBME 19 which, as conventional wisdom dictates, is known to underpredict by 10-25 points was scoring me at a 230 with 25 mistakes 2 weeks before my exam. I was elated. Then a week later it came crashing down when I took NBME 18 and scored 217. Pure fatigue is the only way I can describe it. I was misreading questions left and right. Made 47 mistakes, about 18 of which were due to simply misunderstanding the question. I wasn't going to delay however. The reason was that if I were to delay it a few weeks, my anxiety would only grow and there would be no meaningful improvement to my knowledge or score. And if I were to delay by a few months, then the fatigue factor would really worsen and my score might actually decrease. There were no ideal options so I went with the best one.
I took the exam as planned and thought it was super hard. I didn't feel the fatigue and lack of sleep as much, but I knew that there was still a chance that I'd make those same mistakes (I didn't have a feeling of fatigue as I was taking NBME 18 either, and that result speaks for itself). But the content was difficult at times, and some things (heart sounds grrrr) that I wasn't great at came up. Overall I thought I at least passed. I was hoping to get into the 230s at least. My goal score was 240, but I thought 230s was solid and attainable, especially considering my NBME 19 result. But alas, the dice did not roll that way.
I only found out a few days ago but I honestly feel legitimately down. I had really high aspirations to match into a good university program. I love IM, and I'm intrigued by EM enough to want to do a few rotations after CK, but I feel like this really hurt my chances to do well with either. I'm fortunate though. As an IMG, I've seen this exam hurt a lot of people. It's put strain on marriages and messed with people's mental health and ended some medical careers altogether. So I'm just trying to be thankful and not bellyache about an average score because it could honestly be so much worse.
Overall advice if you're an IMG: Just because you can use as much time as you want to take this exam doesn't mean you should. Fatigue and burnout are real. The longer your study marathon goes, the less efficient it becomes. I learned this the hard way. Make your first 3-4 months of studying SUPER efficient. Learn as much as you possibly can early on. I came from an almost nonexistent basic sciences background, so I know what you may be going through covering the resources. Use only a few resources and master them all, don't go through a million things.
Sorry for the rant that accompanied the stats, as well as this being somewhat chaotically formatted. This was a source of catharsis for me as well as a way to help those who might benefit even a little. I have my CS coming up in 4 days so hopefully that goes well. I wish you all the best of luck with future exams. Love you guys. Lmk if I can answer any questions.
