Low MCAT, high Step 1 stories

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Hi, wondering if anyone on this board was in the position where they got a low MCAT score, but a high Step 1 score - if so, mind sharing some specific, actionable tips as to how you approached the pre-clinical years / studying for Step 1, with your undergrad as a point of comparison?

Much appreciated!
 
DrK2020 said:
Took the test early May, and got my score end of May. I just finished my rotation, so I figured I'd give back to SDN because I benefited so much from reading this forum.

Final USMLE STEP 1 Score: 269

Practice tests:

First CBSE: 86 ~ 240 (10 weeks out)
NBME 13: 257 (7 weeks out)
NBME 15: 245 (6 weeks out. This was anomaly - I had to constantly stop and start because I was dealing with some research stuff at the time)
NBME 16: 255 (3 weeks out)
Second CBSE: 94 ~257
USIM 1: 275 (2.5 weeks out)
USIM 2: 264 (2 weeks out)
Third CBSE: 99 ~ 270
NBME 17: 261 (1.5 weeks out)
NBME 18: 271 (5 days out)
NBME 19: 261 (2 days out)
Final Uworld Percentage: 91% First pass

As you can tell, I was scoring very well on my practice tests, so it shouldn't come as a surprise that I scored well. However, I will say that I legit felt terrible after my exam. I counted at least 8 questions that I got wrong, and I was sure that I missed more. I had plans to go out and party that night, but I ended up not cause I was so sad about my performance on that test. I stressed out for 3 weeks after my exam, but I ended scoring well and celebrated. All in all, I will emphasize what has been stated in this forum prior: TRUST YOUR NBME's.

I was a very strong preclinical student, and scored all Honors my first year, and thoroughly read first aid, B2B, Pathoma, Golgan Audio and Sketchy. However, I am honest in saying that I did not touch one single question bank prior to my dedicated period. I didn't see the point - I think I attempted to once my first semester of med school, but I ended up feeling like it was a waste. I was missing questions not because I was inept, but because I just didn't have a strong background of the material, thus I was destined to get the question wrong. I know that there's this prevailing theme of doing questions to learn, but I don't buy it. I'll give you an example:

Patient Comes in with severe back pain, and tells you that they've been noticing blood in their stool. They tell you that they they are taking a drug to control the pain. What receptor type does this drug block that is causing these symptoms?
1. Gi
2. Gs
3. Gq
4. Non-receptor tyrosine kinase.
5. Receptor tyrosine kinase

This might be an easy question to some, but it is actually testing a number of different things. First its seeing what drug most people take for pain, then its asking you to recognize that this drug causes acute gastritis, and then its asking you to figure out what receptor type its acting on (Answer is 1 btw).

Now, if you came and saw this question, having no background understanding of the material, you are expected to learn so much from one question. Try doing this for 3000 questions, you are bound to forget stuff. However, lets say you come in already knowing some baseline knowledge like "Oh NSAIDs are used for back pain" and "NSAIDs cause acute gastritis that cause blood in stool", you only really only need to learn one fact, and that is NSAIDs affect Gi.

You can see I came into my dedicated period with a 240 baseline, which is really high - this is because I already had a strong foundation and now it was time to hone my knowledge. The only q bank that I ended up using was UWORLD during my dedicated, but I can honestly say that I mastered it after my first pass. It took me close to 4 weeks. I took an effort to truly understand the pathophysiological basis of disease. I could describe most pathological processes at the physiological and cellular level and this is what Step 1 tests. The mantra that certain things are "HY" is complete BS - if you start early enough, you can take the time to learn everything and not just the HY. I never viewed things HY or not - I just viewed them as "Testable concepts". Take the time to understand things during your preclinical class, it will surely pay off. This test is all about hardwork, which I did. Oh also, I am not this natural genius by any means -- I got a 28 on my mcat.
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This guy apparently ^^
 
The average mcat score at top schools is usually 99th percentile. The average step score for that same class is always <75th percentile. Clearly exceptionally high MCAT scores dont correlate with exceptionally high step scores. Is there a trend overall? Of course. Good test takers and commited students often stay that way.
Many things factor into this including the fact that many more students take the MCAT than step 1 and those who do well are the ones who go on to take step 1.
Step 1 can be conquered with hard work and natural ability. The MCAT is much more the latter than the former when it comes to exceptional scores.
 
Newyawk said:
Step 1 can be conquered with hard work and natural ability. The MCAT is much more the latter than the former when it comes to exceptional scores.
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Agreed. There’s also a stark difference between someone who has to work 40 hrs/week to survive while studying for the MCAT vs. those who can afford prep classes and have ample amounts of time. With step 1, everyone has access to the same amount of time and resources (mostly).
 
harkas said:
Agreed. There’s also a stark difference between someone who has to work 40 hrs/week to survive while studying for the MCAT vs. those who can afford prep classes and have ample amounts of time. With step 1, everyone has access to the same amount of time and resources (mostly).
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Some people take step after 18 months others take step after 3 years with varying amounts of dedicated time. Furthermore I know people who worked a couple of extra jobs, saved money and then took 3 months dedicated to study for mcat. Where there is a will there is a way. And working 40 hours a week doesn't necessarily mean it will impact your score, I worked more than that and did just fine.
 
libertyyne said:
Some people take step after 18 months others take step after 3 years with varying amounts of dedicated time. Furthermore I know people who worked a couple of extra jobs, saved money and then took 3 months dedicated to study for mcat. Where there is a will there is a way. And working 40 hours a week doesn't necessarily mean it will impact your score, I worked more than that and did just fine.
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Sure? I don’t know much about Step but yes, I’m sure that happens sometimes. I think there are varying experiences for everyone. Some people work 60 hours a week and get a 515, others don’t and need/needed more time. I definitely would have done better if I had more time but it worked out. That’s great that you could do that but others have lower wages, bills, childcare, family obligations, etc. and it’s just not feasible. We all do our best at the end of the day and work with what we have.
 
harkas said:
Sure? I don’t know much about Step but yes, I’m sure that happens sometimes. I think there are varying experiences for everyone. Some people work 60 hours a week and get a 515, others don’t and need/needed more time. I definitely would have done better if I had more time but it worked out. That’s great that you could do that but others have lower wages, bills, childcare, family obligations, etc. and it’s just not feasible. We all do our best at the end of the day and work with what we have.
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thanks for assuming what my situation was. I actually worked the entire time and had those obligations. It is easy to sit back in retrospect and say that things could have been different if circumstances were different, but that is not necessarily true in every case. You could give someone infinite resources and time and their score may not be different. People could study for longer amounts of time vs 3 months even with obligations. It just seems like a cop-out to blame circumstance for mcat prep time. The impact of SES on performance is more insidious and is related more to primary schooling and access at a much earlier time.
 
libertyyne said:
thanks for assuming what my situation was. I actually worked the entire time and had those obligations. It is easy to sit back in retrospect and say that things could have been different if circumstances were different, but that is not necessarily true in every case. You could give someone infinite resources and time and their score may not be different. People could study for longer amounts of time vs 3 months even with obligations. It just seems like a cop-out to blame circumstance for mcat prep time. The impact of SES on performance is more insidious and is related more to primary schooling and access at a much earlier time.
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Dude why are you coming for me? We can both be right. You had those obligations and scored AMAZING on the MCAT? Great. Not everyone does. That’s the point I’m trying to make.
 
Womb Raider said:
Yep, not 99%. Some were mid 90s though.
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I dont think it is far fetched to say that the median mcat score for t20 is around 518. Mayo is the only exception. Yes it is not 99th percentile but it is sure close to it ~96th~97th depending on the year.
 
harkas said:
Sure? I don’t know much about Step but yes, I’m sure that happens sometimes. I think there are varying experiences for everyone. Some people work 60 hours a week and get a 515, others don’t and need/needed more time. I definitely would have done better if I had more time but it worked out. That’s great that you could do that but others have lower wages, bills, childcare, family obligations, etc. and it’s just not feasible. We all do our best at the end of the day and work with what we have.
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Having been through both with kids, work, and financial strains, I would say it's harder to excel on Step 1 than the MCAT with limited resources. Not that the MCAT is easy by any means, but I personally found it easier to do well while working full-time and balancing other responsibilities than it was to balance Step studying with fewer responsibilities. I think the difference is just the sheer volume of information and detail required for Step, whereas for the MCAT, it's more about concepts and understanding what they're asking. I found Step studying far more overwhelming until I finished UWorld and things really started to come together closer to my test date, whereas for the MCAT, I felt like my progression through the material and improvement on practice test scores was more linear and predictable. The bottom line is that they are two very different tests that require similar but distinct skill sets and approaches to studying.
 
Gurby said:
Pretending to have an active MSAR subscription to win an argument 🙄
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I know the MSAR data, no school has an average 99% MCAT. He was being dramatic and using hyperbole to make a point and and wouldn't admit being wrong when he was called out. :shrug:
 
They are also different tests. A lot of people got dragged down by MCAT verbal section. Step 1 has none of that stuff. Also chem and physics are mostly understanding type of questions while step 1 is mostly memorization. The two tests test different skills
 
MedicineN'Jazz said:
I don’t mean to be a dick...but there’s a difference between median and average :shrug:
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I think in this context median is a significantly better measure. Average, especially at top schools, is going to be dragged down by special admit students with lower scores more than it will be raised by the super rare super high scorers.
 
Step 1 and MCAT measure different things. Step 1 is more a measure of conscientiousness and discipline. A matter of "downloading data and algorithms" into your brain. The MCAT is much more a thinking-on-your-feet critical thinking test that isn't so knowledge dependent. That's when it was still on a 45 scale though so it might be different now. But I'd say the amount of actual knowledge you needed to score 38+ (99% percentile) on the MCAT was probably around 25-30% of the knowledge you needed to score a 260+ on Step 1. Intelligent but lazy people can do well on the MCAT, not so for Step 1 where a hard-working disciplined person will do better the vast majority of the time .
 
WiseOne said:
Step 1 and MCAT measure different things. Step 1 is more a measure of conscientiousness and discipline. A matter of "downloading data and algorithms" into your brain. The MCAT is much more a thinking-on-your-feet critical thinking test that isn't so knowledge dependent. That's when it was still on a 45 scale though so it might be different now. But I'd say the amount of actual knowledge you needed to score 38+ (99% percentile) on the MCAT was probably around 25-30% of the knowledge you needed to score a 260+ on Step 1. Intelligent but lazy people can do well on the MCAT, not so for Step 1 where a hard-working disciplined person will do better the vast majority of the time .
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@TheIllusionist give a random person on the street a first aid book and pathoma and uworld with control F and have them take step 1 with unlimited time - do they pass?
 
Newyawk said:
@TheIllusionist give a random person on the street a first aid book and pathoma and uworld with control F and have them take step 1 with unlimited time - do they pass?
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Wait there seems to be contradicting advice regarding high Step scores both in allo and in Step forums. Some say the key to scoring high on Steps is purely by working hard but others say natural ability plays a role.

I was just thinking that good Step scores = studying hard + natural ability/good test taking skills + luck. The same thing applies for doing well on the MCAT and for any standardized exam so I'm not exactly sure what's confusing here.
 
Lawper said:
Wait there seems to be contradicting advice regarding high Step scores both in allo and in Step forums. Some say the key to scoring high on Steps is purely by working hard but others say natural ability plays a role.

I was just thinking that good Step scores = studying hard + natural ability/good test taking skills + luck. The same thing applies for doing well on the MCAT and for any standardized exam so I'm not exactly sure what's confusing here.
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I think that working hard will compensate for a lot more on Step than it did on the MCAT. The ideal is always innate ability + hard work + luck, as with success in anything in life, but I do feel that there is more (not infinite) ability to compensate for lower innate test-taking ability through sheer brute force on Step than MCAT, just because of the different styles of the tests.
 
It's important to recognize that the MCAT is passage-based, whereas the Step exams are not. By being passage based, the MCAT tested reading comprehension to a large extent. Though I took my exam a year ago, I remember many of the science section answers could be found directly in the passage or could be reasoned out from information in the passage. For one particularly difficult BB passage, I wrote out on scrap paper - something I never did on practice passages/exams - the enzyme pathway described in the passage, allowing me to more easily figure out the answers. Of course certain questions required that you know the names and properties of amino acids, and know about hormones and other facts of the human body. But it didn't require an examinee to memorize a tremendous amount of information to score a 132 on the BB section. For a large percentage of questions, the information I needed was right in the passages. But often it wasn't stated directly and you had to use reasoning and logic to arrive at the answer. In fact, many of the passages discussed biological/biochemical phenomena and/or described experiments that no pre-med student could be expected to know. But the examinee was expected to comprehend and apply information in the passage, in conjunction with undergrad knowledge they should have, to answer questions, of varying difficulty.
Though I will not take step until March 2020, it seems that it doesn't require you to comprehend and apply information from passages to the same extent as the MCAT, considering all questions are stand-alone. Where as, based on the sheer number of facts listed in FA, Step requires you to know a lot more material to score well.
 
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I can tell you from my experience, simply memorizing facts between NBME practice tests for step 1 made my score jump each time. On the MCAT, I focused on practice questions. Most of what I got wrong on NBMEs and Step 1 were purely just based on knowing a fact or not (ie. do I remember what was written at the bottom of page X next to McArdle's disease in First Aid). On the MCAT practice tests I mostly got things wrong due to not applying some principle correctly or understanding a certain concept, there were rarely any brute association questions of which there are dozens on Step 1. Anyhow not sure what the point of the comparison is.
 
Newyawk said:
@TheIllusionist give a random person on the street a first aid book and pathoma and uworld with control F and have them take step 1 with unlimited time - do they pass?
Click to expand...

Definitely think it's possible. I think the only non-memorizable topic is physiology. But if they took an undergrad human anatomy & physiology class and could take Step 1 open book I wouldn't be surprised if they passed.
 
WiseOne said:
Definitely think it's possible. I think the only non-memorizable topic is physiology. But if they took an undergrad human anatomy & physiology class and could take Step 1 open book I wouldn't be surprised if they passed.
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Yea cuz your question on mcardles im sure said "what is mcardles?"
The most memorizable topic - pharm - would still require med school education. Think about how questions are written. The easiest question on the boards that every student gets right is ACEi and angioedema. yet i have never seen that question asked where both lisinopril and angioedema are in the vignette/answer key. What they usually do is either tell you the person was on lisinopril and then describe the symptoms to you and ask what happened (med side effect), or they simply state the person had hypertension and is on meds for it, they might even ask what condition mimics this without even saying C1 factor but instead some obscure word that describes complement, etc.
Do you see how many associations you are required to make?
Sure you can argue that the person could control F the question and find it in uworld. But that is an EASY question. Now think of all of the hard ones that even I wasnt confident about after 2 years of education and almost 10000 Qs. This includes any path that isnt clear cut, ANY physio Q, even biostats can be hard to interpret sometimes, microbio bc the pics/presentation on the exam rarely are straight out of a book, immunology where they throw random crap at you that no student has ever seen before......
 
Mcat was 509 for me. I studied 2 months 1 hour a day 7 days a week, and took four practice tests. At the time I think 509 was 80th percentile.

Step 1 was 245 for me. I studied 2 months 10 hours a day 6 days a week, and took five practice tests. As of right now, I think 245 is 75th percentile.

Did I do better or worse?
 
FindersFee5 said:
I think in this context median is a significantly better measure. Average, especially at top schools, is going to be dragged down by special admit students with lower scores more than it will be raised by the super rare super high scorers.
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Yes, precisely the point. Hence it being practically impossible for any school to have a 99% average MCAT 🙂
 
Even physio needs heavy memory. I had 3 distinct questions on signaling pathway types for different phenomena. You had to first know the pathway that related to the hormone or whatever and then know what backs up. The hardest part is having the pathway memorized and its association to the process. The reasoning is knowing what backs up but even a middle schooler could intuit that, if they were given the pathway on paper.

Real intellect in medicine comes into play with weird cases, device or procedure inventions, research etc. Med school is a glorified vo tech. And honestly even someone capable of scoring a 210 could be a fine. neurosurgeon, if they took their training seriously. the licensing exams are just as artificial barriers. They are more objective than other criteria for comparing candidates which is why they are so heavily in favor.

Also no one said there is no reasoning. It's just that the reasoning is pretty gosh darn basic. That's not what separates the good from the bad or even often the good from the great. Memory and dedication do. Now the prior is a component of innate ability, so I'll give credit for that.
 
Well, I had a 508 MCAT, not really low but not high. And I would attribute most of that to innate test taking ability+critical thinking+some smarts compared to general population. Definitely not hard work, superhuman ability to memorize, and discipline. So if STEP 1 emphasizes the latter more I’m screwed.
 
I didn’t (havent taken it yet since I just finished MS1) but I have a friend who got a 28 on her first MCAT attempt and scored a 262 on Step 1. She basically didn’t exist between summer after MS1 and when she took the test though.

EDIT; 28 is 63 percentile or a 504 MCAT.
 
sunshinefl said:
Well, I had a 508 MCAT, not really low but not high. And I would attribute most of that to innate test taking ability+critical thinking+some smarts compared to general population. Definitely not hard work, superhuman ability to memorize, and discipline. So if STEP 1 emphasizes the latter more I’m screwed.
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Yeah I'm ****ed...
 
I've heard MCAT verbal was the most predictive of Step 1 score, although I don't know how close the association is or where the source was from. I heard it from one of my school deans.
 
Got a 23 MCAT, 232 step 1. Used firecracker pretty much everyday for second year. Just went through and tried to memorize most of each section. Did UW but didn't remember much from it. I don't remember things too well, but I think doing questions everyday helped with that.
 
Orka said:
30 MCAT, 265 Step 1.
Definitely possible but worked my butt off for 2 months, can't emphasize this. Baseline was 220.
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holy crap that is awesome. do you have a writeup? and arent you in dental school?
 
Raney Schauer said:
It's really not.
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True but having rich parents/access to more study resources almost certain has a drastic affect on your score. I know a lot of people who took the MCAT and did meh, their parents paid for them to take a 2-3k course and their scores all went up 8-12 points. Also if your parents can afford to pay for your living expenses and you don’t have to work on top of school and MCAT study that is a game changer. Just anecdotal but all of the people I know who killed the MCAT were in these circumstances.
 
For what it's worth, I had to retake the MCAT. First try I got a 19, second try I got a 23. I ended up with a 242 on step 1 and a 259 on step 2 CK. My school compiled MCAT vs. Step 1 scores for it's student and found no correlation between MCAT score and Step 1 score. I am proof of that. I don't know what my 19/23 is worth on the new scoring system though.
 
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