Man, it was soooooooo crazy... I've been studying a LONG time and I'll just say a few things about the exam. Where to begin... All the subjects were blended in such an odd way. For example, you get classic descriptions of personality disorders yet your asked about GFR, or serum K! You get pictures of Gaucher cells and get asked what the PCO2 is!!! There were so many tripped out questions like that. Man, edema edema edema edema, infiltrates were all over that thing. My test wanted to know everything about edema. There are so many questions with classic presentations however they would ask you for information that goes above and beyond what you find in Kaplan/Goljian... PHARM PHARM PHARM. I love pharm by the way its my best subject. All over this thing. All presented with graphs and numbers and charts and diagrams. Drug X mixed with drug Y titrated with drug Z would yield which of the following?? uhhhhh... your mother! Path... hardly any.. I know you dont believe me but I don't care. Most of it was what people call Pathophysiology, or what I would call "Pharmopathology" if that could ever exist. Not a lot of straight path, it was truly just integrated into PHYSIO questions. Yep that's right. You get descriptions of infamous stuff like Pneumonia but then asked about Afterload or TPR. Uhhhhh... WHAT?? I feel like there were so many questions like that. Also, the biggest thing the test likes to do is HIDE EASY QUESTIONS. Yup, the question is easy so what they do is throw tons of lab measurements, data, graphs, numbers at you and then they hide what they really want to know in different WORDING. Yup, all of the processes were disguised in odd language twists... the answer usually pops into your head after you disect all of this sludge... DO NOT NEGLECT PHYSIOLOGY. You will not get a high score if you don't have a good grasp of this subject its all over the place.. EVERYWHERE! YOU'll see! GFRs, filtered loads, Flow, tpr, MAP, CO, percentage occlusions of major vessels and their effect on all sorts of different physiologic processes! THE THREE P's BABY! BEHAVIORAL: HUGE HUGE HUGE HUGE part of my exam. SOme easy questions, some super hard ones that I feel only a good clinical experience can actually prepare you for that. Stuff like what kind of specialties would normally get referrels from primary care physicians. WAACK! HUge twisted integrations like hematological effects of Sleep Terror Disorder and Restless Leg Syndrome. Molecular: I dont know what the fuss is, most of the stuff is in the Kaplan biochem book, hopefully you have it, but i doubt its worth buying HY. Not too much on my exam. Path: like I said... i hate to say it, Im a huge Goljan fan, but I have a feeling the question writers have copies of his notes and start writing stuff that they know is not in there. BUT MAYBE IM PARANOID. USMLEWORLD.. seriously.. honestly.. i got 11-15 word for word questions. I wonder if they are breaking any copywright laws but I got an odd x-ray that I ONLY saw in USMLEWORLD. I hate to promote a product, I should get paid for that... but let me tell you.. even though I got 11-15 exact repeated questions, I got pretty much 40-50 repeated concepts that they emphasize. If I could go back I would do USMLEWORLD 3 more times, slowly!!!! Q bank... I wish I never bought it. Nothing like my exam. Biostats.. thank goodness mostly 'give me' points! There were 3 per block. Freebies/Give me questions... I assume everyone gets these right, and there are give me questions but I feel the only reason they are on the exam is to keep you from throwing in the towel. After 5 back to back Acidosis questions I wanted to just go home, but then they tossed me an easy G6PD question, so I stuck with it. Okay look.. the concepts from Goljian notes are there.. but the way its presented is going to be most students downfall.. It's all hidden.. the average student is going to go "WTF???" after each question but the above average student thinks hard, thinks hard, thinks hard, and BAM.. OH YA.. THATS IT.. I SEEE THROUGH THE ILLUSION!!!!!! Many questions were also just flat out impossible. Hopefully experimental but I could just see the questions writers stairing right back at me through that computer screen saying "We know you don't know this.. THAT's WHY WE'RE ASKING IT..MUHAHAHAHAH!" First Aid... uhh.. as of today I'm not a huge fan. HA. NBME... helpful as everyone says. Graphs/charts are presented the same way. Questions on the real exam are way more surreal and integrated. Anatomy... dont neglect it! Many LUMBAR PLEXUS questions asking specific nerve roots. Neuro, FA is not enough for sure. Embryo... HUGE. HUGE. Not stuff in FA, like what pouch is this or what arch gives you that. Theoretical embryological malformations that you get presented with. Also one liners like patient comes in with X, what was the defect. Tons of questions on infants with malformed brains, or even weird stuff like, 1/4 of this region was malformed embryologically, what happens. Genetics...one word...HUGE. weird Pedigrees left and right...stuff you never see but you know they made up just to mess with you. Strange incestuous matings between cousins and uncles All right, I'm a little exhausted right now after having a huge conversation with my father about how much life will be better when I'm actually a doctor doing clinical stuff rather then sitting in a dank hole 20 hours a day stairing at Kaplan books and First AID. ITS NAP TIME!! If anyone has any questions, JUST ASK! Conclusion: All in all I feel, really the only way to do well is to have kicked ass 1st and second year. The test felt more like an IQ test meant to separate the intellectually elite from the average student. Know concepts and how to apply them to very weird unimaginable situations and graphs....and then be able to think 2 steps beyond that. And again I HATE to promote stuff, I feel like Im making some greedy corporation RICH.... but I would get Usmleworld, the questions are at the same difficulty, but mostly harder. SOme were "word for word" exact replicas. I wonder how they got away with that.