My case in public. Please help

[stronghold]

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Dear SDNers and all those great people I PMed many times and were very helpful. I am really confused and depressed. I just did NBME 15 and got 240 (29 mistakes), did NBME 13 two days ago and got 240 (25 mistakes). I really don't know what to do since my target is 260 and unfortunately, this is much below my target.

As of my background:
- Started with review books like BRS phy and path, Kaplans, Microcards, HY...for about 8 months.
- FA X2 (first one was before starting questions banks-3 months ago, and the second pass was completed 4 days ago)
- Did about 1000 of Rx after the FA first pass and realized that my FA memorization was not great
- Did selective 500 questions of Kaplan Qbank after those 1000 of Rx
- Then Did UW, random and timed, took me about 6-7 weeks. My cumulative was 75%
- Tried NBME 6 as the first NBME experience when I was 30% of UW, and got 212 (6-7 weeks ago), then did NBME 11 after 5 days and got 235, was much better then 6, but still away than my target.

That's my story. I really think to postpone the exam for additional 3-4 months. But really don't know what I need to study more! I tried to listen to Goljan, but only could do few lectures. Tried to watch pathoma, but oculd not do all of it because I preferred to start the FA 2nd pass, so just watched CV and Hem/Onc systems.

What do you thing guys? What I need to work on to get me close to my target? I tried firecracker for CV and found it useful but takes much time, so I could not even complete the CV system!

Everybody says that you need to know your weaknesses. I guess my problem is in that point since I could not identify where it is. Even NBMEs weak areas are very variable! sometimes neuro, sometimes respiratory, sometimes immune/micro! For example, GI was borderline 2 days ago on NBME 13, but it is strong with only one mistake in NBME 15 today! Biochem is always solid- even in UW was 89%. I always have 3-4 mistakes in Behavioral science and about 8-10 in what is called General health and disease principles!

I really can not identify where is the problem. When I see a strange, long questions of NBME like those on mice and experiments, I say WTF and can not focus on it.


Here is my NBME 15, 240 (today)

Here is my NBME 13, 242 ( 2 days ago)

 

[witzelsucht]

Jeeez buddy, you're complaining about "only" getting 240s?? 240 v 260 is not going to make or break an application for neurosurg, or pretty much any other field.

I guess you should probably try to hit up more Pathoma, especially for GI and respiratory if you don't want to do it all. Did you take notes on your UWorld wrong answers? Maybe review only things you initially got wrong and make sure you understand why.

Otherwise what else can you do besides more questions? Go back to USMLERx perhaps?

 

[webgenius]

why did you get "the questions you got wrong" wrong?
Is it a memorization problem or concept problem?

If it's a memorization problem then I suggest going over FA once again word by word, read and analyze every word of FA.
DON'T READ SENTENCES! READ WORDS. EVERY WORD IS A POTENTIAL QUESTION.

If it's concepts problem then I suggest reading Goljan Rapid Review the 4th edition and watching the whole pathoma videos + re-reading FA when you're done.

Also finish usmlerx and kaplan Qbank, every Q helps.

On a side note, you do realize that FA is a short term memory book right? You can't really score higher than 240 if your last read was more than two weeks.
So if this is your case just read FA again then take another NBME.

Good luck.

 

[stronghold]

Jeeez buddy, you're complaining about "only" getting 240s?? 240 v 260 is not going to make or break an application for neurosurg, or pretty much any other field.

I guess you should probably try to hit up more Pathoma, especially for GI and respiratory if you don't want to do it all. Did you take notes on your UWorld wrong answers? Maybe review only things you initially got wrong and make sure you understand why.

Otherwise what else can you do besides more questions? Go back to USMLERx perhaps?

First, thanks for willing to help. Yes, man. Many things have changed recently in terms of neurosurgery match. Competitive applicants have + 260 in both steps (if not even 270s) and MS or PhD! That's why my target is crucial. If my NBMEs were in 250s range, I would be happy, but they are in low 240s. Do think Pathoma teach well things outside pure pathology? I don't think the problem is pure pathology. I don't think it's FA problem, either. I noticed that most mistakes are not mentioned directly in FA. So probably thought process problem? Concepts? When I get a strange question, I just feel lost between choices in a way I pick randomly between them, or don't know why I picked it

why did you get "the questions you got wrong" wrong?
Is it a memorization problem or concept problem?

If it's a memorization problem then I suggest going over FA once again word by word, read and analyze every word of FA.
DON'T READ SENTENCES! READ WORDS. EVERY WORD IS A POTENTIAL QUESTION.

If it's concepts problem then I suggest reading Goljan Rapid Review the 4th edition and watching the whole pathoma videos + re-reading FA when you're done.

Also finish usmlerx and kaplan Qbank, every Q helps.

On a side note, you do realize that FA is a short term memory book right? You can't really score higher than 240 if your last read was more than two weeks.
So if this is your case just read FA again then take another NBME.

Good luck.

Thanks for willing to help dude. I don't think it's FA problem. After I did NBME 15 today, I noticed that most mistakes are not mentioned directly in FA. So probably thought process problem? Concepts? When I get a strange question, I just feel lost between choices in a way I pick randomly between them, or don't know why I picked it.
Do you think Pathoma help in areas outside pure pathology? like concepts and thought process?

 

[webgenius]

First, thanks for willing to help. Yes, man. Many things have changed recently in terms of neurosurgery match. Competitive applicants have + 260 in both steps (if not even 270s) and MS or PhD! That's why my target is crucial. If my NBMEs were in 250s range, I would be happy, but they are in low 240s. Do think Pathoma teach well things outside pure pathology? I don't think the problem is pure pathology. I don't think it's FA problem, either. I noticed that most mistakes are not mentioned directly in FA. So probably thought process problem? Concepts? When I get a strange question, I just feel lost between choices in a way I pick randomly between them, or don't know why I picked it



Thanks for willing to help dude. I don't think it's FA problem. After I did NBME 15 today, I noticed that most mistakes are not mentioned directly in FA. So probably thought process problem? Concepts? When I get a strange question, I just feel lost between choices in a way I pick randomly between them, or don't know why I picked it.
Do you think Pathoma help in areas outside pure pathology? like concepts and thought process?

Yes. It forces you to think more and search for the reason behind everything in medicine.
But question banks help more.
Finish usmlerx and kaplan and you'll be fine.

Picking random question no mentioned directly in FA is a comprehension/recognition problem.
I'm sure you know the concept but couldn't recognize it.
Polyurea polydypsia lethargy, what is the dz process?
The answer can be simply DKA or can be more challenging "autoimmune dz"
add a couple of more confusing answer choices and you will get totally lost.
So do more questions to recognize more weird ways of asking questions or weird answer choices.

Keep your mind opened, if you're aiming >260 you can't simply memorize facts or concepts ... Be aware of them.

 

[Phloston]

Your 260+ or die mentality is healthy. In fact, it's essential as an IMG seeking a competitive specialty. AMGs don't need scores of the same caliber for the same residency spots. So keep up what you're doing and push through.

Based on the match data from 2011, the relatively lesser number of IMGs matching into competitive specialties reflects the fact that IMGs score lower overall. However, if you're an IMG breaking 260, you're pretty much just as competitive as an AMG at programs with a history of accepting IMGs.

For instance, I've seen people talk about how integrated plastics is generally impossible to get into as an IMG, but if you look at the match data, zero IMGs in 2011 applying into plastics had actually scored >260, so of course they didn't match.

In terms of your situation, I would make sure you've finished USMLE Rx, UWorld and all of the NBMEs. USMLE Rx + FA, as a combo, is of such strong utility; I cannot stress that anymore. I've said this before and I'll say it again: your best bet is to really analyze WHY you're getting NBME questions wrong. If they're stupid mistakes, then you need to go with your gut and avoid overthinking things. If they're content-based, then you need to review material in relation to the particular question (e.g. if you get a neuroanatomy question wrong on the spine, review that material).

 

[stronghold]

Thank you Webgenius and Phloston. Thank you all. I really appreciate it.