Is Uworld granular enough?

[Money Moniker]

I'm a couple weeks away from Step I and am beginning to wonder if my performance in Uworld is making me complacent. I've been scoring in the mid 80's since about the first 1/3 of the question bank, but I feel like Uworld questions rely a lot on "gestalt" for lack of a better word rather than really getting into the weeds on specifics.

For example, I have a rough idea that Ca is reabsorbed due to luminal charge in the TAL vs via active transport in the distal tubule and so far as I remember this kind of knowledge has been sufficient to answer relevant Uworld questions. On the other hand, during the renal block I remember knowing the actual individual ion channels on both apical and basolateral sides of the tubular cells across all the segments of the nephron including the ratio of ions being transported across them and so on. This kind of knowledge hasn't been required in Uworld whereas I remember it being tested heavily during actual school block exams.

I guess what I'm saying is that even though I've been acing Uworld renal questions for example, I feel like I'd barely pass the renal block if I had to take it again due to no longer remembering the nitty gritty. Same with cardio and the exact pressures across the vasculature, immuno and chain recombination, etc. I'm beginning to get worried that Uworld has been lulling me to sleep on the granularity. I feel like questions which test your ability to puzzle out the answer out of some vagueness (Uworld) play to my strengths whereas questions where the 2 answer choices you're left with after POE are A)2Na/Cl vs B)3Na/2Cl would screw me over. I haven't really seen the latter type of question on Uword but I'm afraid they might predominate on the actual test. Anybody who has already taken Step wanna comment on whether that's a valid concern?

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[siliso]

The question difficulty/level of detail is very representative IME. You don’t have to be a renal physiology expert, more to have a principle-based understanding to select a reasonable answer combined with enough high-yield minutiae in the RAM. Which doing the qs is good for installing those minutiae that are frequently tested

 

[Azete]

Real step asks minutiae, but not like that. UWorld overall is sufficient for the level of detail they expect.

An example of something you may run into that's beyond UWorld: What's the treatment for a 3 y/o with Lyme disease with a history of anaphylaxis after amoxicillin?

Still a somewhat broad concept, but probably something most people haven't thought about.

 

[Rahas]

Cefuroxime I think?

 

[Rahas]

For stage I anyway. Stage II also has the option of ceftriaxone I believe.