USMLE Not where I need to be

[stuckrut2016]

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Hi,

MS2 here just finishing up 5.5 weeks of dedicated studying. Before dedicated I took NBME 15 and got a step 1 score of 166, then two weeks into dedicated I took NBME 17 and got a 175, then two weeks later I took NBME 13 and got a 198, then today I took NBME 16 and got a 202.

I'm actually scheduled to take my test next Friday, but talked with the dean just now and we agreed that I should delay it in order to reach my goal of 230 for the specialties I'm interested in. I go to a mid tier MD school. Passed all of my blocks, usually around average and maybe a little bit above. Basically I now have this next full week, I then have two weeks of clinical orientation which lasts from 8am-5pm, and then four weeks of additional dedicated studying.

My school's curriculum does not go off of first aid, and I would say a good 1/3 of the material in FA I hadn't seen before. That isn't a good excuse for where I am, because although many of my classmates are struggling with studying, they have definitely been doing better than I am. It just seems like I have forgotten SO MUCH STUFF of what I knew at one point. Some of it came back quickly, other stuff didn't come back as quickly.

My study schedule has revolved around reading first aid and doing Uworld questions. I started doing block specific questions in uworld, but for the past two weeks I have been doing mixed blocks. I have 31% unused questions left. My average is 59% correct, and I am in the 57th percentile. I don't understand how I can be in the 57th percentile on uworld, but be >1 standard deviation from the mean on the nbme's... but that is just a ranting question of mine. I annotate major concepts into FA that aren't already there, and I keep a document of each question I'm getting wrong with the correct answer to it (for instance:
a. Scabies generally occurs at the stratum corneum whereby there is a rapidly spreading and pruritic rash with erythematous papules and excoriations on the extremities that suggest scabies. This spreads person to person and is seen in the daycare setting often. The rash is worse at night and is a type 4 hypersensitivity reaction. Generally on the hands, may be on feet.). It's up to 39 pages now.

Could anyone please give me some advice on other things that I can be doing to improve my score? Is it just reading and re-reading first aid? I've gone through pathoma through MS1 and MS2, and used it a little bit while step studying (mainly for getting down the nephrotic/nephritic syndromes and the different GU tumors), but other than that it just seems to be a restatement of FA.

I think a lot of my problem is stress related, which then compounds itself to make me more stressed. The worse I do, the more stressed I get, which makes me do worse.

My schedule is waking up at 5:45am, starting to study at 6:15, take a break from 10-10:30 for "lunch", take a break from 3-3:30 for "dinner", and then stop at 9:30pm for the night to watch half an hour of TV or something. In between, I probably take a 5 or 10 minute break every 90-120 minutes. I really don't know how I can do another month of this kind of schedule and it has me studying so much more than I'm used to.

If anyone has some tips or tricks that might make some kind of difference, that would be really helpful.

 

[Entadus]

Of course it is frustrating to not be hitting your goals, and to see your progress is slower than you want. But I don't think you're "in a rut", and you're definitely not stuck. From what I can tell you have not plateau'd (your scores are still improving!!) so do whatever it takes to find the motivation to continue onward. Take some time to think about your goals and ideal outcome, formulate a plan of attack, and then go after it RELENTLESSLY. Good luck and keep us updated!

 

[Please_Stand_By]

Keep chugging through questions. Questions questions and more questions. Those who total well over 4k/5k/6k etc Qbank questions statistically score better, plus it's more active. Writing out notes on each question is a great idea too. I would finish up uWorld. Find each topic in First Aid and write notes on the margins as well. Since you mentioned stuff in FA was unfamiliar, probably sub to usmleRX as well.

 

[dirty630]

Your scores are improving, which is probably the best thing you can hope for right now. It shows that you're still learning the material and that there's still room for improvement. So that shows that what you're doing now is working. You still have a lot of UWorld left, and your score will continue to increase as you finish it. From there, a lot of people do it a second time, or at least redo the questions they got incorrect. Personally, I like pathoma more than just reading FA because I like watching the videos and hearing someone teach me the material. I like to follow along in FA as he goes and write down some of the things he says but aren't in the book.

Stress can make dedicated tough. Have you been working out and eating well? You can only study X many hours in a day. Sacrificing 30 minutes to run or lift weights can be good. If you're stressed right now, go ahead and order some takeout. You don't have to cook anything and you can away from where ever you're studying for a little bit and get some food from your favorite restaurant.

Keep on improving and good luck!

 

[MudPhud20XX]

I think you are doing the right thing delaying the exam date. It's just a matter of time I think in your case. So take the time to study more to see how much improvement you get in the next several weeks.

Don't be too obsessed with your nbme scores, for some folks they really don't represent what you will get in the real one.

Also, whatever specialty you are aiming to get in, there is really no score that will prevent you from entering. Check out the charting the outcome and you will see what I mean by this.

Just do what you need to do to keep your sanity and you know when you are ready.