Official 2008 Usmle Step 1 Experiences and Scores Thread

[lion]

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Greetings my brothers and sisters ,

I am new member here and will be taking my boards in another few months .
I thought I would start a thread devoted to a compilation of 2008 usmle experiences . I don't have anything to report as yet since my test is in a few month but anyone who has taken the test in 2008 please share with us your experience and feedback so we can keep the SDN tradition alive !

Good Luck

"Never , never , never , never Give up ! "

 

[BlazerMed]

I took it today. It seemed like I had 2-4 biostats/behavior questions per block, which I'd think is high. Thankfully, the antibiotics and pharm questions were fairly rare. I feel pretty good, so I hope I'm not jinxing myself.

 

[TonyDaTigrUprct]

Just got done taking it today (6/17/08)... thank you to everyone that posted their advice/experience, so I shall return the favor.

My grades in medical school are average, I had exactly 5 weeks to prepare.
After having gone through the test, the main things I've taken away from this whole experience is that...

1) USMLE World is the bomb-diggity (always do timed,random,unused)
2) First Aid is a must (got through this ~3x)
3) The review books that were most helpful to me were Rapid Review Path, Rapid Review Micro/Immuno, and Katzung Pharmacology Review (I used these throughout 2nd year)
4) Review with ONE friend/classmate

Other books I used were BRS phys, Kaplan Qbank to study embryo/anatomy, and USMLE Roadmap Neuroscience. After having taken the exam, none of these resources helped me out.

Test breakdown:
For my specific test - of course Path is the most represented, after that came Pharmacology, Immunology, and Neuroscience.

My advice for those taking it:
First Aid, RR Path, and U World are a MUST. Also, make sure you know disease PATHOGENESIS, not just the random facts. For example, sickle cell is a mutation in the B-globin of Glu for Val, we all know that, but the USMLE doesn't test that, they want to know that the RBC's sickle because the hemoglobin S will polymerize and aggregate during hypoxic states.. **** like that. Needless to say, I did a lot of googling and wikipedia, and I feel like that gave me a slight edge.

The last bit of advice I have is, for the last week, STUDY WITH ONE FRIEND (it's tough to do it with more than one classmate). Set a schedule when you will meet and what you will review. The last week I was studying sections of First Aid during the day and reviewed with my friend at night. I feel like that helps retain it better and it keeps you going and motivated cuz that last week is TOUGH to get through, and your friend fills in gaps that you are weak on and vice-versa. I seriously think that this probably bumped up my score at least 10-15 points.

As for the actual test, my first block really rattled me. It had so many tough questions that I was unsure about. I was flagging almost half the questions in the block. But DO NOT GET RATTLED.. I just calmed myself down, took a break, and it got MUCH better after that. So don't let one block's performance affect your whole test taking experience.

As for studying phys and pharm, don't just memorize the stuff but be able to interpret alot of graphs and also charts that have up and down arrows, I rarely got a flat out phys or pharm question, it was usually in some type of graph form, and KNOW your immuno, what the cytokines do, what cell type is predominant in diseases (ie CD4 helper Tcells and macrophages in tuberculosis).

Good luck!

MCAT 29
150 Sample Q's at Prometric - 67% (2 months out)
NBME 3 - 214 (2 weeks out)
NBME 4 - 228 (1 week out)
UWorld avg - 66% (75% for last 15 tests), 100% complete
Step 1: 239

 

[DwyaneWade]

kasha, the information I put up there was right from the usmle website, confirmed by Kaplan.
From the usmle website (cut and pasted):

As if I would ever be so mean as to make it up and freak y'all out more. 😡

Wow that sucks.

 

[lipofuscin232]

So...I just took mine today. I studied for 6 weeks using Kaplan books, RR path, First Aid, and USMLEworld. I didn't use BRS path or any other books and found the ones above to be sufficient. However, I did get a couple questions on developmental genes that I had no idea about...so definitely study the hox genes, pax genes, etc. My overall opinion was that the test really isn't all that bad...I actually even had some questions asked more than once but in a different way (like the kidney's role in the vit D pathway). I swear I also had the same picture twice but in seperate sections (hemorrhagic necrosis of mamillary bodies). I actually saw some of the exact same questions from usmleworld on my test also so it's a great resource. Had one audio/video question and I couldn't even hear the heart sound but oh well. Overall I though the test was completely fair, and a lot of the answers could have been chosen just by a process of elimination b/c a lot of the options didn't even make any sense. Some of the answers even seemed too obvious at times. One big recommendation I have is that after you finish a section, make sure to review your answers! There were several that I looked over a second time and caught on to the trick behind the question. Just have faith in yourselves guys, there wasn't much on there that you haven't seen before. Good luck!!

 

[DrFraud]

So...I just took mine today. I studied for 6 weeks using Kaplan books, RR path, First Aid, and USMLEworld. I didn't use BRS path or any other books and found the ones above to be sufficient. However, I did get a couple questions on developmental genes that I had no idea about...so definitely study the hox genes, pax genes, etc. My overall opinion was that the test really isn't all that bad...I actually even had some questions asked more than once but in a different way (like the kidney's role in the vit D pathway). I swear I also had the same picture twice but in seperate sections (hemorrhagic necrosis of mamillary bodies). I actually saw some of the exact same questions from usmleworld on my test also so it's a great resource. Had one audio/video question and I couldn't even hear the heart sound but oh well. Overall I though the test was completely fair, and a lot of the answers could have been chosen just by a process of elimination b/c a lot of the options didn't even make any sense. Some of the answers even seemed too obvious at times. One big recommendation I have is that after you finish a section, make sure to review your answers! There were several that I looked over a second time and caught on to the trick behind the question. Just have faith in yourselves guys, there wasn't much on there that you haven't seen before. Good luck!!

Make sure that you and anyone else who has had a similar problem contact the nbme at [email protected], The more people that write in, the quicker they will fix this problem.

 

[GynGuy1983]

Take note that you can see the thorax moving on inspiration and expiration, so be aware that they may ask you to place the stethoscope in different places to determine if the murmur increases on inspiration or expiration based on location.

I just saw this on the free USMLE practice test.

 

[kkc620]

I've been hearing that the questions now have really long stems. How do you approach these questions? Do you read the last statement first?

 

[DwyaneWade]

I've been hearing that the questions now have really long stems. How do you approach these questions? Do you read the last statement first?

that worked for me personally, but a couple of times when reviewing I would catch mistakes because I had missed something important

 

[obiwan]

Take note that you can see the thorax moving on inspiration and expiration, so be aware that they may ask you to place the stethoscope in different places to determine if the murmur increases on inspiration or expiration based on location.

I just saw this on the free USMLE practice test.

where did you find this test?

 

[DrFraud]

where did you find this test?

I believe you have to download either the step 1 or 2 fred program...

http://www.usmle.org/Orientation/2008/menu.html

 

[BrisketAttack]

Took step 1 today. am wasted as all hell. will write a formal review at a later date. if I had to sum up the test in a single phrase:

"painfully long question stems"

 

[rb10]

Took step 1 today. am wasted as all hell. will write a formal review at a later date. if I had to sum up the test in a single phrase:

"painfully long question stems"

nice! i hope to be in that state soon... 👍 🙂

Question: To recent test takers -- what do you think the value in really memorizing FA is?

Seems it at least helps take care of fact based questions (50%). Then Goljan RR should take care of the understanding for the other (40%) - then the last 10% you cant really study for... or do you think many of those tough concept questions could have been boiled down to some obscure fact in FA?

thoughts?

 

[45408]

Okay, it's over. I made it through 75% of UW with a 62% average, and I would say that Step 1 questions felt easier than World questions. Most questions required 1-2 steps, but there were still a few really complicated ones. I also had some near exact duplicates of UW questions on the real deal. Those guys at UW know how to write 'em.


I was surprised at the number of things on there that our professors had taught us that I told myself "WTF? We're NEVER gonna need to know that." And there it was on Step 1. Like Schistosoma haemotobium and bladder cancer, and some others. I'm also glad that I studied as long as I did - there were at least 5 questions that I covered in the past week that I didn't know beforehand.

My test had a LOT of biochemistry (the enzyme deficiency diseases were well represented), a LOT of microbiology (especially bacteria), and plenty of pharmacology. Fortunately, my school's pharm class is a monster, and the pharm questions seemed pretty easy. Decent amount of path, a good bit of neuro, a good bit of immunology, a fair amount of biostats and behavioral science questions, but not much anatomy or embryology. I had two A/V questions - I already forgot one of them, but the other was a heart sounds question. I'm not that good with actually recognizing the murmurs aurally, so I'm not sure I got it.

Thankfully, they saved the hardest block for last (or I was just getting dumber/more tired). A few of the first blocks felt pretty easy compared to what I was used to with UW. Definitely encouraging. Difficulty was about on par with NBME 5.

I used up almost all of my time on every section. I finished all the questions as quickly as possible so that I'd at least get through it all, but on review, I got down to the 2 minute warning at least three times. Break time was adequate - I used all but 9 minutes. My test center was pretty quiet. Temperature was comfortable, only one person was typing anything, and that was only for like half an hour. LCD monitors.


I looked up a few questions afterwards - got a few wrong, got a few right. After the second or third block, I thought I should go look up CA 125 and CEA, just to be sure what they do. I didn't. Sure enough, I got a question on CEA, and I thought it was in germ cell tumors rather than colon cancer, so I got it wrong. 😛

 

[beponychick]

Okay, it's over. I made it through 75% of UW with a 62% average, and I would say that Step 1 questions felt easier than World questions. Most questions required 1-2 steps, but there were still a few really complicated ones. I also had some near exact duplicates of UW questions on the real deal. Those guys at UW know how to write 'em.


I was surprised at the number of things on there that our professors had taught us that I told myself "WTF? We're NEVER gonna need to know that." And there it was on Step 1. Like Schistosoma haemotobium and bladder cancer, and some others. I'm also glad that I studied as long as I did - there were at least 5 questions that I covered in the past week that I didn't know beforehand.

My test had a LOT of biochemistry (the enzyme deficiency diseases were well represented), a LOT of microbiology (especially bacteria), and plenty of pharmacology. Fortunately, my school's pharm class is a monster, and the pharm questions seemed pretty easy. Decent amount of path, a good bit of neuro, a good bit of immunology, a fair amount of biostats and behavioral science questions, but not much anatomy or embryology. I had two A/V questions - I already forgot one of them, but the other was a heart sounds question. I'm not that good with actually recognizing the murmurs aurally, so I'm not sure I got it.

Thankfully, they saved the hardest block for last (or I was just getting dumber/more tired). A few of the first blocks felt pretty easy compared to what I was used to with UW. Definitely encouraging. Difficulty was about on par with NBME 5.

I used up almost all of my time on every section. I finished all the questions as quickly as possible so that I'd at least get through it all, but on review, I got down to the 2 minute warning at least three times. Break time was adequate - I used all but 9 minutes. My test center was pretty quiet. Temperature was comfortable, only one person was typing anything, and that was only for like half an hour. LCD monitors.


I looked up a few questions afterwards - got a few wrong, got a few right. After the second or third block, I thought I should go look up CA 125 and CEA, just to be sure what they do. I didn't. Sure enough, I got a question on CEA, and I thought it was in germ cell tumors rather than colon cancer, so I got it wrong. 😛

Hey! Congrats on finishing!! Did you find that your question stems were longer than UW?

 

[VPDcurt]

Where's Brisket?

 

[DrFraud]

Okay, it's over. I made it through 75% of UW with a 62% average, and I would say that Step 1 questions felt easier than World questions. Most questions required 1-2 steps, but there were still a few really complicated ones. I also had some near exact duplicates of UW questions on the real deal. Those guys at UW know how to write 'em.

Congrats. You worked hard. Now it's time to relax, and celebrate!!!.

 

[DwyaneWade]

Where's Brisket?

Celebrating I hope...

I guess there are no new scores tonight, which means that July 16 really is D-Day...

 

[45408]

Hey! Congrats on finishing!! Did you find that your question stems were longer than UW?

Yes.


The questions that really annoy me are when they describe someone with hypertrophic cardiomyopathy and a murmur, and they ask what the cause of the murmur is. 😡 Is the hypertrophic cardiomyopathy the CAUSE of the murmur? Or is the mitral regurgitation the cause of the murmur?

 

[BrisketAttack]

Where's Brisket?

Hey VPD, what's up? I went and had some din din with the wife and got a little wasted (much needed).

oh, for what it's worth, there was only 1 av question on my exam. young preggars chick with heart problem. no ****ing clue what she had, and the av didn't help. 100% sure I got it wrong.

my exam was physiology heavy. very heavy. like every other f-ing question. also, let's see...there's 336 question total on the exam, right? well my test had 335 questions with lung complaints. g-damn lungs!! resp is my weakest subject. our resp phys teacher was borderline ******ed. no, that's giving too much credit, he was hanging out around an IQ of 65. son of a b.

 

[Its_MurDAH]

Just took the test today.

Half my test was ridiculously weird/hard path and pathophys - and those were supposed to be my strongest subjects according to the path shelf and my year-long path course. Each goddamn question had pretty much EVERYTHING that could possibly describe a patient - labs, bmi, history etc etc. And you only needed to focus on one small aspect of the history to answer the question. It was so difficult to just single one thing out cuz your brain is pretty much programmed at this point to process every fact that you see on a question stem. So I would be reading the stem and I would think "okay he has metabolic acidosis", then two seconds later they would describe that he has bipolar disorder so I'm thinking "Lithium, NDI", then the next sentence is about how he has vague muscle pains and then they talked about his liver enzymes for like an hour. All of this is after I had trained myself to glance at the answer choices before actually reading the question...that sh1t didn't help at all. The answer choices were all vague, and there were atleast a handful of questions where I couldn't narrow the choices down AT ALL. That was the scariest part.

On a better note, I only had like 3 embryo questions. The biochem was pretty simple for the most part (definitely had some crazy malic enzyme question) and FA was good for that, Pharm was pretty well covered especially in the last block where I had like 5 pharm in a row. Definitely had to remember some small detail I learned in class and nowhere else to answer a couple of the questions. Immuno was very integrated with path and micro. I had ZERO CD markers, no interleukin questions. I had a TON of biostats. I counted atleast 30-32 and all of them were unnecessarily long with the answer choices being "conclusions that you can draw from the study". I always tend to get these types of questions wrong. I was hoping for more micro but those questions were also very integrative. Almost no questions on anti-microbials, which i was pissed about. No HLA questions at ALL. None of the minutiae in first aid showed up, a lot of the test was really general (read:vague).

I honestly think that this test is best approached by having a strong overall foundation. Crammers and last-minute studiers like myself don't really have a strong chance of scoring well because it isn't a detail-oriented test. A lot of the questions require you to have some basic/general concepts implanted firmly in your head and no matter how much stuff you memorize, if you don't understand a certain mechanism you are screwed. I approached this test the way I approached all my tests in class. It doesn't work well that way because for class there is a finite amount of info you need to know but for this test they will pull stuff out of histo from first year that you didn't even know mattered. I had so many questions about desmoglien and desmoplakins, connexons, shear stresses, transcellular transport systems, and whatnot that I just wanted to shoot myself. That kinda stuff isn't even something you can prepare for, you know?

Oh well, it's done and I am glad. Although I always knew that it was gonna be checking my score that was going to be more painful than taking the actual test itself. I really wanted to do well but after today I am not so sure. If I think of more questions or whatever I will post them a bit later. If you have any other questions feel free to ask. Good luck to all that are still studying for this thing.

 

[synapse lapse]

Oh well, it's done and I am glad. Although I always knew that it was gonna be checking my score that was going to be more painful than taking the actual test itself. I really wanted to do well but after today I am not so sure. If I think of more questions or whatever I will post them a bit later. If you have any other questions feel free to ask. Good luck to all that are still studying for this thing.

Thanks for your writeup, and for prowlers too. Man, these tests seem insanely hard. It is incredibly unfair to give you only 1.5 minutes to read a long as stem with a bunch of labs and disparate findings and then figure out what's going from vague answers! Everyone always described the boards as being classical presentations, but it seems like most people are saying that isn't the case, and that they are trying to trip you up. Questions on malic enzyme, connexons, etc., who cares? I don't see how that is at all relevant to the practice of medicine (but I guess that is a lot of what we learned these 2 years, hence the name basic science). Anyhow, I hope you did ok! Sounds like you had a good foundation...I can't imagine how nervewracking it would be to have a number of questions you couldn't narrow down at all. I have had a few on UW that I thought were ridiculous, but I didn't expect that on he real deal.

 

[Vizsla]

Just took the test today.

Half my test was ridiculously weird/hard path and pathophys - and those were supposed to be my strongest subjects according to the path shelf and my year-long path course. Each goddamn question had pretty much EVERYTHING that could possibly describe a patient - labs, bmi, history etc etc. And you only needed to focus on one small aspect of the history to answer the question. It was so difficult to just single one thing out cuz your brain is pretty much programmed at this point to process every fact that you see on a question stem. So I would be reading the stem and I would think "okay he has metabolic acidosis", then two seconds later they would describe that he has bipolar disorder so I'm thinking "Lithium, NDI", then the next sentence is about how he has vague muscle pains and then they talked about his liver enzymes for like an hour. All of this is after I had trained myself to glance at the answer choices before actually reading the question...that sh1t didn't help at all. The answer choices were all vague, and there were atleast a handful of questions where I couldn't narrow the choices down AT ALL. That was the scariest part.

On a better note, I only had like 3 embryo questions. The biochem was pretty simple for the most part (definitely had some crazy malic enzyme question) and FA was good for that, Pharm was pretty well covered especially in the last block where I had like 5 pharm in a row. Definitely had to remember some small detail I learned in class and nowhere else to answer a couple of the questions. Immuno was very integrated with path and micro. I had ZERO CD markers, no interleukin questions. I had a TON of biostats. I counted atleast 30-32 and all of them were unnecessarily long with the answer choices being "conclusions that you can draw from the study". I always tend to get these types of questions wrong. I was hoping for more micro but those questions were also very integrative. Almost no questions on anti-microbials, which i was pissed about. No HLA questions at ALL. None of the minutiae in first aid showed up, a lot of the test was really general (read:vague).

I honestly think that this test is best approached by having a strong overall foundation. Crammers and last-minute studiers like myself don't really have a strong chance of scoring well because it isn't a detail-oriented test. A lot of the questions require you to have some basic/general concepts implanted firmly in your head and no matter how much stuff you memorize, if you don't understand a certain mechanism you are screwed. I approached this test the way I approached all my tests in class. It doesn't work well that way because for class there is a finite amount of info you need to know but for this test they will pull stuff out of histo from first year that you didn't even know mattered. I had so many questions about desmoglien and desmoplakins, connexons, shear stresses, transcellular transport systems, and whatnot that I just wanted to shoot myself. That kinda stuff isn't even something you can prepare for, you know?

Oh well, it's done and I am glad. Although I always knew that it was gonna be checking my score that was going to be more painful than taking the actual test itself. I really wanted to do well but after today I am not so sure. If I think of more questions or whatever I will post them a bit later. If you have any other questions feel free to ask. Good luck to all that are still studying for this thing.

😕 posts like this make me wonder if the nbme practice exams are representative of the real exam at all...I felt that the majority of the practice exam questions were relatively straight forward and described classical presentations of the disease.

 

[kkc620]

did you all (who have taken the test) notice a lot of pictures associated with questions? are they difficult as well?

 

[2cr8tive]

😕 posts like this make me wonder if the nbme practice exams are representative of the real exam at all...I felt that the majority of the practice exam questions were relatively straight forward and described classical presentations of the disease.

im with u on this ... kinda scares me...

 

[Its_MurDAH]

😕 posts like this make me wonder if the nbme practice exams are representative of the real exam at all...I felt that the majority of the practice exam questions were relatively straight forward and described classical presentations of the disease.

Hey guys,
The purpose of my post wasn't to freak anyone out. I think most of the earlier part of my post was mere frustration from just having taken the thing and finding it tougher than I had hoped. What you feel after taking the test is definitely a measure of your preparedness and I didn't feel like I was well prepared. Also, most people tend to have severe recall bias about the test especially if particular questions or subjects are exceptionally stress-inducing. I may have fallen victim to that myself. Overall, the test is very do-able and the questions are a bit longer and tougher than the 150 free NBME questions. If you have studied hard for 4-5 weeks, I feel there really isn't any reason anyone should get below a 220.

 

[2cr8tive]

Hey guys,
The purpose of my post wasn't to freak anyone out. I think most of the earlier part of my post was mere frustration from just having taken the thing and finding it tougher than I had hoped. What you feel after taking the test is definitely a measure of your preparedness and I didn't feel like I was well prepared. Also, most people tend to have severe recall bias about the test especially if particular questions or subjects are exceptionally stress-inducing. I may have fallen victim to that myself. Overall, the test is very do-able and the questions are a bit longer and tougher than the 150 free NBME questions. If you have studied hard for 4-5 weeks, I feel there really isn't any reason anyone should get below a 220.

LOL now i can go sleep. thanks for all ur input ... im sure u know how freaked out we are right now 🙂 relax and take it easy for now, im sure u so deserve it 🙂

 

[BrisketAttack]

Just took the test today.

Half my test was ridiculously weird/hard path and pathophys - and those were supposed to be my strongest subjects according to the path shelf and my year-long path course. Each goddamn question had pretty much EVERYTHING that could possibly describe a patient - labs, bmi, history etc etc. And you only needed to focus on one small aspect of the history to answer the question. It was so difficult to just single one thing out cuz your brain is pretty much programmed at this point to process every fact that you see on a question stem. So I would be reading the stem and I would think "okay he has metabolic acidosis", then two seconds later they would describe that he has bipolar disorder so I'm thinking "Lithium, NDI", then the next sentence is about how he has vague muscle pains and then they talked about his liver enzymes for like an hour. All of this is after I had trained myself to glance at the answer choices before actually reading the question...that sh1t didn't help at all. The answer choices were all vague, and there were atleast a handful of questions where I couldn't narrow the choices down AT ALL. That was the scariest part.

On a better note, I only had like 3 embryo questions. The biochem was pretty simple for the most part (definitely had some crazy malic enzyme question) and FA was good for that, Pharm was pretty well covered especially in the last block where I had like 5 pharm in a row. Definitely had to remember some small detail I learned in class and nowhere else to answer a couple of the questions. Immuno was very integrated with path and micro. I had ZERO CD markers, no interleukin questions. I had a TON of biostats. I counted atleast 30-32 and all of them were unnecessarily long with the answer choices being "conclusions that you can draw from the study". I always tend to get these types of questions wrong. I was hoping for more micro but those questions were also very integrative. Almost no questions on anti-microbials, which i was pissed about. No HLA questions at ALL. None of the minutiae in first aid showed up, a lot of the test was really general (read:vague).

I honestly think that this test is best approached by having a strong overall foundation. Crammers and last-minute studiers like myself don't really have a strong chance of scoring well because it isn't a detail-oriented test. A lot of the questions require you to have some basic/general concepts implanted firmly in your head and no matter how much stuff you memorize, if you don't understand a certain mechanism you are screwed. I approached this test the way I approached all my tests in class. It doesn't work well that way because for class there is a finite amount of info you need to know but for this test they will pull stuff out of histo from first year that you didn't even know mattered. I had so many questions about desmoglien and desmoplakins, connexons, shear stresses, transcellular transport systems, and whatnot that I just wanted to shoot myself. That kinda stuff isn't even something you can prepare for, you know?

Oh well, it's done and I am glad. Although I always knew that it was gonna be checking my score that was going to be more painful than taking the actual test itself. I really wanted to do well but after today I am not so sure. If I think of more questions or whatever I will post them a bit later. If you have any other questions feel free to ask. Good luck to all that are still studying for this thing.

well, you just described my test. to a T. I guess now i don't need to embellish at all on my experience. i think we may have gotten the exact same set of questions. everything you described was on my test. the thing that stuck out most in my mind was your description of the question stem with 20+ distractors, and then 5-6 vague answer choices. so difficult.

 

[45408]

I didn't feel like my test stems were as full of distractors as yours, but maybe that's just because I got distracted by them. 😛 I definitely noticed a good 10% of questions had a clinical scenario that gave two seemingly different complaints, and you had to figure out which one was the root of the other.

I had ZERO CD markers, no interleukin questions.

Yeah, I had several of each.

Almost no questions on anti-microbials, which i was pissed about. No HLA questions at ALL.

I had a few antibiotics questions that were fairly specific (you have to know what vancomycin's mechanisms, gentamicin's toxicity, piperacillin's uses, etc.), but also, no HLA questions.

I had so many questions about desmoglien and desmoplakins, connexons, shear stresses, transcellular transport systems, and whatnot that I just wanted to shoot myself. That kinda stuff isn't even something you can prepare for, you know?

I had a handful of those, but I had a lot of questions that asked "What intracellular cascade does the hormone that triggers glucose uptake use?" I'm glad I spent a while looking at the chart in BRS Phys and HY Cell & Molecular that tell you things like endothelial growth factors that use receptor tyrosine kinases. Yes, that specific.

 

[boardssuck]

Took the damn thing yesterday. It was tough, but hey we are used to that kinda thing by now. Honestly, I would say that three weeks is plenty of time, and all you need is First Aid. I agree with whoever said above that the important thing is just paying attention the first two years because no matter how hard you study in the end the test makes you think about stuff more than memorize. The people who said all they did was memorize First Aid, I think probably already had a good understanding of concepts. Study hard, don't flip out and you guys will all be fine!

 

[45408]

Took the damn thing yesterday. It was tough, but hey we are used to that kinda thing by now. Honestly, I would say that three weeks is plenty of time, and all you need is First Aid. I agree with whoever said above that the important thing is just paying attention the first two years because no matter how hard you study in the end the test makes you think about stuff more than memorize. The people who said all they did was memorize First Aid, I think probably already had a good understanding of concepts. Study hard, don't flip out and you guys will all be fine!

The reason that I didn't just use FA - and couldn't just use FA - is that I need a variety of things. When I'm looking at the same page in FA for the fifth time, I just look at the things I know and go "Oh, yeah, I know that" without looking at the things I don't know. For me, having a book for each subject - say, BRS Phys - and knowing that I only have three days to get through the whole thing really put a fire under me to take it seriously. If I'd taken FA and said "Okay, I have four weeks to get through this," it would've been awful.

 

[indo]

plus, some times FA uses lingo that I don't know about. "amiodarone: causes Pico de Gallo thigh syndrome". wha?

 

[BusterDO]

plus, some times FA uses lingo that I don't know about. "amiodarone: causes Pico de Gallo thigh syndrome". wha?

That's why i personally believe FA is not enough, BUT FA and wikipedia is more than enough 😉.

 

[indo]

I've been using the Wiki School of Medicine's pathology department quite a bit.

 

[DwyaneWade]

plus, some times FA uses lingo that I don't know about. "amiodarone: causes Pico de Gallo thigh syndrome". wha?

You know what's sad?I actually googled this

 

[SaoTo]

Had 5 weeks to study-started out a ton of books, plus U World. Study progression was not going as I wanted it because I was getting tired of reading the same material in 5 different places (FA, RR Path, UW, BRS physio, BRS physio and other books). Came to the realization that FA is tried and trusted and has lots of info- stopped using UW and RR path 3 weeks ago and started hitting FA hard (about 1 subject a day thoroughly, or 2 for stuff like Neuro and Micro). Did an ungraded NBME 3 before I finished studying and scored 80% (whatever that translates to).

The exam was straight-forward, and I'll have to say that you could use FA to answer over 95% of the material. My exam was heavy on Molecular Bio and Immunology (I counted 20 questions directly related to these two in the first 2 blocks alone- FA could answer every single one except one that pertained to CD57) and I thought that FA prepared me excellently for this. If I had to do it all over again I would only use only FA and UW (I ended up doing only 25% of it, but saw ~5 questions that were almost identical, and a few more that had the same theme).

Overall, I think the exam was A lot easier than I thought it would be.

 

[45408]

You know what's sad?I actually googled this

did it send you to Qdoba's website?

 

[doctorFred]

Qdoba

 

[cyclohexanol]

Took it today. Not much to report, I had a good representation of just about everything. I was pleasantly surprised to find that the question stems weren't as long as I had been hearing lately and was easily able to finish each section. I had a few random questions but nothing too out of left-field. My only gripe was the audio question volume was too low. Fortunately, I didn't even need to hear it to answer. But if I had one that required listening to diagnose, I would have been pissed. Glad its over, time to relax!

 

[OneTree]

Before I start, I want to say that I don't even know why I am reading this thread because it is very depressing for some "Average Joe's/Jane's" like me. I will add my 2 cents anyways. This is for the other average (or maybe less than average) students like myself.

I am holding ~82% avg for the 1st 2yrs of med school
1st NBME (b/f I started studying)= 169
2nd NBME (2wks into studying and 10 days b/f the real thing)= 198
Kaplan Qbank avg after doing 100% of the questions= 60%
Main study sources: FA and Qbank; studied ~10-12hrs everyday
Goal for the real thing= 220 (is it possible to go up 22pts after 10 extra days of studying???? I really hope so!)

I took the test today and to be completely honest, it was NOT a good experience. I felt like I had to guess for at least half the questions for all the blocks and I always felt rushed towards the end. I didn't have enough time to go back and check the questions that I marked. I honestly don't know if I passed, but I am PRAYING that I did and was able to get my goal score.

 

[DrBorisCA]

Off topic... But haven't been back to SDN since med school apps, after a two year hiatus! And here we are at third year! Back to Heme-Onc now...

Nice to see all the old cronies from back in the day!

😍

 

[Cards21aceking]

Well, I suppose it's my turn to step up to the plate and contribute to this forum that's given so much over the past few years. Took the beast today, and overall...it's just a serene feeling to be done with it. Talked with a few friends of mine and we all agree that we have no idea where the hell we'll land on the proverbial bell curve of life.

That being said here goes:

Test date: 6/19

Background
MCAT: 30Q
Med school GPA: ~ 87-88ish. Lower during first year, little higher during second.
Free NBME 150 (May 12) - 70ish.
NBME 3: 224 (6/1, Took the pdf version and input answers online to see how I was doing)
UW: 62-63% (scoring a little higher as test date approached, broke 70 a few times)
Qbank: 60% (stopped about 2 weeks away from test date)
Prep time: ~39 days, with some half days put in between
Goal: 220+ (Consider myself an average student who works hard, so anything above average is gravy)


Overall
Fair mix of everything. For some reason, I felt like I had a very random test that wasn't heavy on any one particular topic. The weirdest questions I got were from:

Repro (way the f* out of left field)
Pharm (not really sure what some of these researchers actually do aside from coming up with convoluted ways of asking stuff)
Molecular (figured this would happen)​

Test day
Got to the center around 7, flipped through the Abx section of FA one last time (could never remember some of this stuff for some reason), started around 7:30. My test center allowed you to use ear plugs, so I was pleased to find that out when I called a few days prior. For anyone who is used to wearing ear plugs, call the place before. They're usually very nice and were quiet honest with their response.

If you're taking the test in the test in the same city that you live in, I would also recommend driving by and walking around the test center one or two days before the test.

I took a short break between all of my sections, and I was glad that I did. I realized that I was anxious enough during the test that I needed to use the break time just to calm my nerves between sections. Couldn't sleep the night before, so ended up getting to bed probably around 12:30 and waking up at 6.

I think I would fall into the category of people that had ridiculously long answer choices. Be aware of the question that describes symptoms a,b,and c....tells you the diagnosis, then asks the mechanism of drug that treats or something like that.


Preparations
Cornerstone: FA, UW, RR
All three are critical to the preparation for Step 1, but for different reasons.
FA: probably the MVP of the 3. It has everything. Bottom line. I was really tempted to purchase Step Up during the middle of my studying. I even went to the "checkout" screen on amazon before chickening out and not purchasing it. I did some google searching, and I realized that parts of Step-Up are available online in the google library (http://books.google.com/books?id=TcFZoBb3XhAC&source=gbs_summary_s&cad=0)
So, If i found a topic or two that was missed by FA, I would annotate them over from the Step-Up book. I think it's mostly pointless, but I know for a fact that 1 question that I had that came directly out of Step-up, but was not mentioned in FA.
RR: This is kinda the meat and potatoes of the path that covers most of the exam. Once again, like many others have said, use this along with the audio and you'll be glad you did. I definitely had a few "Goljan" moments, when I could imagine him explaining something that was on my test.
UW: Great resource. It really gets you to think like Step 1 wants you to think. Great explanations as well. 👍👍

Supplementals
BRS Phys
HY Anatomy
HY Behavior
HY Cell/Micro ('99)
HY Neuroanatomy

Closing Remarks
- I feel that I'm a fairly average student who works really hard.
- Don't try and check questions you're curious about after the exam. I think that would inevitably do more harm than good. What's done is done, so knowing about it to see if you got the right answer is a moot point.
- You have just completed a difficult exam for which you had been studying for a long time. Try to find some way to relax and just enjoy being done with studying.
- There will be some questions that you're constantly saying "wtf" on. Read, make educated guess, flag and come back to it if time permits.
- Time management

Last day
Had dinner with my parents and then tried to get to bed at a decent hour, but like i mentioned before, it wasn't happening.

Score: TBA

 

[CoolMusic]

Preparations
Cornerstone: FA, UW, RR
All three are critical to the preparation for Step 1, but for different reasons.
FA: probably the MVP of the 3. It has everything. Bottom line. I was really tempted to purchase Step Up during the middle of my studying. I even went to the "checkout" screen on amazon before chickening out and not purchasing it. I did some google searching, and I realized that parts of Step-Up are available online in the google library (http://books.google.com/books?id=TcFZoBb3XhAC&source=gbs_summary_s&cad=0)
So, If i found a topic or two that was missed by FA, I would annotate them over from the Step-Up book. I think it's mostly pointless, but I know for a fact that 1 question that I had that came directly out of Step-up, but was not mentioned in FA.
RR: This is kinda the meat and potatoes of the path that covers most of the exam. Once again, like many others have said, use this along with the audio and you'll be glad you did. I definitely had a few "Goljan" moments, when I could imagine him explaining something that was on my test.

In your opinion, would one be better served going through weak-points in FA one last time, or getting through the Goljan audio and weak-points in RR Path, assuming they would take an equal amount of time. I have a little under a week left and am planning on finishing UWorld in that time, but I can't decide whether it's best to hit FA or RR one last time. Thanks

 

[Blesbok]

The reason that I didn't just use FA - and couldn't just use FA - is that I need a variety of things. When I'm looking at the same page in FA for the fifth time, I just look at the things I know and go "Oh, yeah, I know that" without looking at the things I don't know. For me, having a book for each subject - say, BRS Phys - and knowing that I only have three days to get through the whole thing really put a fire under me to take it seriously. If I'd taken FA and said "Okay, I have four weeks to get through this," it would've been awful.

I think first aid is like the first 20-30 hours of studying for a test. Sure, there are plenty of smart people on here that could study for 20-30 hours and pay attention in class and probably have no problem making Cs all day long, but for those people that want to be more than average, it takes exponentially more work and that is where all those extra resources come in. There are plenty of smart cookies on this site that could walk out of class, take it the first day and make a 220-230 and there are plenty of people that could make a 240 with just first aid, but for those people that want to push their personal potential, it is going to take that extra mile of sorting through goljan and brs, etc.

 

[mstald1]

Took the test yesterday...did not come away with a fantastic feeling. Definitely not an easy test. I've done relatively well in the first 2 years, so I feel like I brought a pretty strong base of knowledge to this thing...

Studied for about 5.5 weeks:
Kaplan 4 book Home Study Series - Good books. Long. I used these because I felt only using First Aid would be like memorizing trivia...not how I learn. I need some context with my information, and this series did a pretty good job of that. Took about a month to get through.

First Aid - Used as a review for the final week of studying.

USMLE World - Great question bank (though I didn't used any other sources so I have no context for comparing others). Tough questions that I think best prepared me for the real thing...very similar.

NMBE Practice Exams - After taking the real thing my opinion of these is that they are not representative of the test I took. They seem like a joke now in retrospect. I guess they are helpful in giving you some way to track your progress, which is nice.

NBME 1 (after 1 week) - 219
NBME 2 (after 2 weeks) - 224
NBME 6 (after 3 weeks) - 224

Stopped spending $45 for these after I was only getting frustrated at my apparent lack of progress.


So the real thing...For me it was a pretty rough experience (and I am not one that is rattled by tests usually). The question stems were ridiculously long, longer on average than World. World was the closest thing to my test, maybe even not as hard as that beast I took yesterday. Lots more biochem than I was expecting, so that sucked. Overall, if I had to do it again I would do everything the same. I just don't think that preparing any differently would have changed my performance on this test. There were few to 0 gimme questions, most of the questions had very vague answer choices that left me feeling unsure about many of my answers, even when the question was regarding a scenario which I was familiar with...whatever, its over now. I'll see how it all turns out in July when I get the joy of receiving my score...Thanks to everyone who has posted their experiences and advice here, it was all very helpful.

 

[BrisketAttack]

I think I’ve recovered well enough over the past two days to recount my experience.

I really liked Cards21 format, so I’m stealing/modifying it (thanks):

Test date: 6/18

Academic Background
MCAT: 27
Med school GPA: 4.00
NBME 6: 238 (taken on day 1, prior to studying)
NBME 3: 263 (taken after 19 days of studying 16 hrs/day)
NBME Practice exam (150 free questions, taken at prometric 1 wk prior to step 1) – 94%
UW: 76% (85% complete, all random, highest score on single block was 92%)
Kaplan Qbank: 74% (55% complete. In general I did not like this resource)
Prep time: ~38 days, no breaks, total madness
Goal: 240+ (I’m shooting for derm. I realize 240 is sort of the cutoff for this field. In reality, I’d be thrilled with anything over 230, but I know the admissions monkeys really like that 240+).

Personal Background
I worked very hard in medschool to achieve the grades I did. As one can see, my MCAT was not stellar, and over my life I’ve underperformed on standardized tests. I was hoping very much that step 1 would be the place where I broke that trend. I have to say that when I scored 238 on NBME 6 prior to studying, I was blown away. I did not expect to score above 200. However, instead of being a confidence booster, it actually made me incredibly nervous, because I knew what my potential was, and I tend to freak out when the pressure is on (just the sort of quality you want in a future doctor, right?). When I scored the 263 on NBME 3, it had the same effect as my score on NBME 3, but 10X stronger. I began to panic and worry all day about whether I could perform on the real exam as I had been on these meaningless practice exams. My worry was so profound that it began to impact my studying. I tried to move my test date up, because I felt I had hit my peak, but no dates were available. So I had to wait until 6/18, stewing in my paranoia. It was a long couple weeks, let me tell you. I think if I had taken my exam earlier, I would have performed better, because I would have had two less weeks to worry and freak myself out.



Preparation materials/methods

I am a structured person, so I developed a study plan in my last week of second year, and stuck to it pretty damn closely.

Daily study schedule:
6:30 a.m. to 5:00 p.m.: Study materials
5:00 p.m. to 6:00 p.m.: Dinner
6:00 p.m. to 10:30 p.m.: Kaplan or UW (100 questions + breakdown)

Day 1: Take NBME 6 and analyze obscure questions
Days 2-12: Go through FA very slowly and methodically, annotating all the while with RR path and BRS phys.
Days 13-18: Go through FA again, moving at faster pace, while still consulting RR path and BRS phys regularly.
Day 19: Take NBME 3 and analyze obscure questions
Days 20-38: Go through FA two more times, listening to goljan audio pretty regularly. I did not make it through goljan audio in its entirety, but did find it to be very helpful in tying together disparate and complex concepts.

Primary materials: FA, RR path, BRS phys, CMMRS, UW, Kaplan qbank (abandoned this after 2 wks due to inferiority to UW)

Secondary materials (used quite sparingly, probably < 5% total of my studying time): HY neuro, HY behavior, lippencott biochem, Lange pharm (this actually helped me get a couple right on the real exam that I would have missed otherwise), HY embryo (evil ****ty book), and Netter.


Overall step 1 experience

I will mirror Cards21 sentiment that there was a fair mix of everything on step 1. It did seem to be a bit heavy in pulm phys, but every test is different and random, so I’d take that with a grain of salt. One thing I’ve been screaming about for the past two days is that the question stems are longer on the real thing than on UW. This is definitely true, so beware, but there are also a fair number of short and straightforward questions as well.



Step 1 breakdown by subject:

Behavior/biostats: Pretty dang heavy on this. Much more than I would have hoped. At least 30 questions total. Plenty of ethics and 2x2 tables. Lots of weirder stuff too, like NNT and ARR, and confidence intervals. Speaking of confidence intervals, my CI with this material is 0.85 – 1.07, and is therefore null. Only 1 question total on the whole exam from the psychiatry section of FA. Seriously. It was one of the defense mechanisms. Nothing on schizophrenia, personality d/o, none of that. I was really surprised.

Biochem: Wow, was this section low yield. I expected many more biochem questions. There were probably 10 on the whole exam. Mostly straightforward. There was a tough one with glucagon that I’m pretty sure I missed. One glycogen storage and one lysosomal dz. Pretty light on genetics overall. Probably 5-7 genetics questions. 1 hardy Weinberg, a couple genetic trees.

Micro: Fair amount of micro, as expected. Mostly classical stuff. Only 1 helminth question, which I did not know the answer to. Probably 5-10 yeast/protozoa questions. 10 virus, with some heavy emphasis on vaccines. 20+ bacteria with antimicrobials being highly tested.

Pharm: probably my best subject, and it seemed underrepresented overall. Being one of the big three, I expected 50+ questions on pharm, but there were probably more behavioral questions on my exam than pharm, which was really disappointing. The hardest pharm questions were those where a patient had HTN, heart failure, dyslipidemia, and major depression, was taking 7-10 drugs, and then you had to determine why they were experiencing the symptoms they were. This is tough and there were no UW questions that were like this. This was unfamiliar territory, to be sure.

Path: Huge, huge, huge!! Basically the whole exam. Easily 150 questions on this, minimum. Not easy kneejerk stuff. Usually always in some sort of pathophysiological contex. Really had to think about stuff. Some of the GI stuff was nuts, because so many damn things can cause abdominal pain. RR path is the way to go. Goljan is God. I can’t make this any more clear.

Neuro: very well represented, with ~40 questions. Lots of MRI images, brainstems, drawings of nerve terminals, drawings of action potentials, etc.

Embryo: hahaha, what a silly subject. 1 question on the exam. Man oh man do I wish I spent less time worrying about embryo (and psych too, for that matter).

Anatomy: less than 10 questions. Totally straightforward. Heed these words if you take nothing else away from this review: KAPLAN QBANK ANATOMY IS AN ABSURD WASTE OF TIME!!!

Stuff that was not on my exam in any way, shape or form: the whole minipath section in FA, HLA stuff, IL stuff in immuno section, virus table in micro section, optochin, bacitracin, novobiocin, EKGs, derm diseases, B9 or malign bone cancers, other stuff that I can’t remember.


Test day


I slept 3 hrs the night before the exam. Crazy dreams and fitful sleep. I knew this was going to happen so it did not frazzle me. Also, I got my best score ever in medschool (100% on tough path exam) after a sleepless night, so I used that tidbit to calm myself down. I arrived at the center at 7:30, popped in my earplugs and got down to business. Was visibly shaking for the first ten minutes of my exam, but calmed down considerably by the end of the first block. Took a pee break between every section, and went to my car to peek at FA. It did not help me answer any questions and was a total waste of time, but hey, I’m a compulsive psycho, so I could not be stopped. During the second block a grounds crew decided it was a good time to do all the edging of the bushes around the prometric center. That was a fun 15 minutes, let me tell you. I got good and distracted, and probably missed 2-3 questions that I would not have otherwise. It’s my own damn fault for being so distractible. I did not take a lunch. I ate two protein bars and drank water. I was done with the whole test by 3:00. I was so eager to get out of there. I surprised myself during the last block by cavalierly answering some questions without so much as a second glance. I was burned out, and even after 500+ hours of prep and everything riding on the line, I could not motivate myself to really attend to each question properly. During my prep I never did a full 350 question practice set, which was a mistake. I was burned out after 250 questions. Block 6 was a nightmare. Marked 8 questions, skipped an additional 8 without answering them. Got thru the block with 15 minutes left to go over the 16 questions I was unsure about. Pretty rough. I left the center feeling drained beyond belief but very happy to be done. My eyes were bloodshot in a crazy way that’s difficult to describe. It was comical, really. It looked like I had been shot in the eyes with a beebee gun. It actually scared me a little.


Closing Remarks

- I am an above average student who works insanely hard. Things do not come naturally to me, and I need to work like crazy for any academic success I earn. I’m not one of those people who would study the night before the exam and score a 98%. I hate those people and I envy them as well. My hardware is more plodding, but it’s good and reliable if you feed it the info enough times.

- I agree with cards21, don't try and check questions you're curious about after the exam. Actually, do what you please, but it’ll probably drive you bonkers, and there is truly nothing you can do about it. I need to try and take this advice too.

- Step 1 is hard. Here’s my equation encapsulating step 1:

(Typical UW block + longer question stems) – (obscure triple jump logic mandated by many UW questions) + (fair number of classical ‘easy’ questions) + (occasional crazy off the wall stuff you heard in some random lecture during 1st year and hopefully retained)


Last day
Studied FA HY at back of book, looked at FA images, looked over equations, tried to get basic lab values memorized, lysosomal dz, and glycogen storage. You know, all the stuff you’ll forget within 3 days of taking the exam. Not sure of the utility of having us memorize this stuff.

Score: 257/99

 

[Cards21aceking]

In your opinion, would one be better served going through weak-points in FA one last time, or getting through the Goljan audio and weak-points in RR Path, assuming they would take an equal amount of time. I have a little under a week left and am planning on finishing UWorld in that time, but I can't decide whether it's best to hit FA or RR one last time. Thanks

During the last week, I went through FA, looked at RR blue boxes (in the side margin) and went through a lot of my "missed questions" on UW. I felt weak in a couple of areas of path, so I went through and read those one more time to make sure I wasn't missing stuff.

Personally, I don't think it's worth spending time going through the Audio during the last week. 37 hours goes a long way when cramming some of the material that you inevitably will have to cram. good luck! 👍

 

[medstylee]

So, I took the exam yesterday. I'm finally emerging from my hangover/coma, so I will share my experiences. This thread has been very helpful to me, so I thank everyone for contributing such detailed posts.

My prep:
I gave myself 5 weeks to prepare. I took a total of 1 day off - I had planned 2 others, but those were thwarted by my p.i. pleading with me to come in and enter data all day (I was too much of a sucker to say no). I initially made a study schedule and I stuck to it for a good 2 weeks, then I started getting burnt out and fell off a bit. If you are a disciplined person, I think mapping everything out ahead of time is a great idea. Anyway, I spent probably 4 days on biochem, 1 on genetics, 1 on molecular, 2 on neuro, 1 on behavioral, 4 on physio, 4 on micro, 5 on pharm, 7 on path, 1 on immuno and the rest was just random review. I started kaplan's qbank and got through about 40% with an avg of 68%, but i really found it frustrating. I switched to USMLE world and loved it. I completed about 80% of the bank and finished with a 75% cumulative. I also took NBME 1 before studying (scored 226) and NBME 4 with about a week and half left (scored 247). I used a variety of resources, some which were great, some which weren't...

Path: Goljan RR was absolutely fantastic - it helped me score very highly on the pathology shelf and it helped me immensely on step 1. i like it much better than BRS because it incorporates a lot of pathophysiology which is really the bulk of the path & physiology content on step 1.
Micro: CMMRS was great. Great short chapter on HIV. I loved the charts (pretty much all I studied from) for bacteria, viruses, fungi and parasites. Some of them were a bit too extensive (ie, helminths, platyhelminths, yadda yadda), but you know what to cut out.
Biochem: The kaplan book was spot on. The chapters on Molecular biology are especially good.
Immuno: Kaplan book was, again, awesome. The charts at the end for interleukins, CD markers, etc are important.
Physio: Costanzo's BRS book is mostly adequate. You may need to supplement endocrinology and renal with something a little more detailed. I used Vander's Renal Physiology (short and wonderful) and just said some prayers for endocrine...
Behavioral/Biostats: HY Behavioral Sci was short and helpful - especially the biostats section which actually explains the different tests/equations. I needed to know formulas for NNT and ARR on my exam and this was the only source I found those in.
Pharm: I found it most difficult to pin down a good source for this. I flipped between Kaplan (sometimes good, sometimes too bare), FirstAid (great sections on chemotherapy and type II diabetes meds) and RoadMap Pharm (extremely good chapters on pharmacokinetics/dynamics and CNS drugs)
Neuro: HY neuro was way too extensive, but for the content that is actually important, it's incredibly helpful. Check out the pathways for sure.
Gross Anatomy: UW was the best for this, I thought. I checked out HY Gross but it was atrocious. Should be called Low Yield Gross Anatomy.
First Aid: honestly, I hated FA. It's just not how I study - I find it a waste of time to annotate things because I'm a slow studier in general. Some sections were helpful (see above - chemotherapy), but it's just a huge skeleton of a book (I guess that's the point, really). It seems like 75% of med students love this resource, but it just wasn't for me - total personal preference.

So, for the real deal... tossed and turned all night beforehand, and woke up feeling scared/naseous. 👍 Appointment was at 9, but got to prometric at 8:15. Even so, it was really crowded (people taking step 2 and 3 also), so I didn't get to start till 9. The center was really nice and the staff was great. The audio was actually pretty clear, I thought. I did 2 blocks, break, 1 block, break/caffeine, 1 block, lunch, 2 blocks, break, 1 block. I finished at 3:45.

Overall Impression: My exam was very straightfoward with a ridiculous question here and there. I was shocked at how many rapid recall questions there were. You either know it or you don't. For the most part my question stems, like others', were quite long - definitely as long or longer than the ones in UW. Some of them you read through only to find that the last sentence was simply "what is the solid arrow pointing to on the CT" while others you absolutely needed to read through. My exam was heavily skewed to pathophysiology. If i had to guess, the most heavily represented areas were pathology (by a long shot), physiology (more straight-up physio than i expected), gross anatomy (huge surprise), and behavioral sciences (another surprise). My exam was very scant on immunology, biochemistry, and neuro.

Path: more pathophys than just pathology. Heavily skewed to respiratory, endo and hepatobiliary. PLEASE know everything there is to know about the effects of alcohol abuse... Very weak on cardio and renal which really shocked me. More microscopic images than I had anticipated, but most were very hallmark. They DO expect you to be able to know how to manage these diseases (apparently that's not just for step 2 and beyond...)
Physio: there was more straight up physio than expected. Many, many arrows. My exam might as well been a female reproductive endocrinology exam. As others have said, they really make you think for these questions. My advice - if you have a question with 8 answer choices with combinations of arrows, just try to figure it out without looking at the choices first.
Gross Anatomy: I counted no less than 24 straight-up gross questions!! Real shocker. Almost all had images. I had NO upper/lower limb questions! Most were straightforward, others were ludicrous.
Immuno: No more than 5-6 questions - big surprise. I know many people who were shelled with immuno.
Biochem: another surprise - very little on my test. Mostly about important enzymes in major pathways and controls - very little on classic diseases. I did get a question that included chemical structures of amino acids with NO names, but it was pretty obvious what they were getting at, and that was the only one like that.
Pharm: Very very basic. No drugs that I had never heard of (thank god). Surprisingly big emphasis on pharmacokinetics. Definitely know your antimicrobials. I don't think I had more than 20 questions total on pharm, to be honest.
Micro: For the most part, basic. I had 12 questions on HIV! KNOW THIS! Mostly bacteria, few viruses (other than HIV), absolutely no fungi, and maybe 3 parasites.
Behavioral: Almost no psychology. No less than 10 quote questions - some are just head-scratchers. Biostats was actually fairly heavily represented, at least 4 per block. I felt that the biostats q's required a couple of read-throughs before I could understand what they were asking. Then, it just turned out that they wanted you to interpret some very basic graph. Definitely know your basic formulas, but more importantly understand what certain results mean.
Neuro: Almost NONE! I never would have expected that after reading previous posts. Everything I had (maybe 6 total?) was associated with a picture.
Embryo: At most 3 questions. Very basic.

So, in retrospect, I feel like I got very lucky with my exam. I did not get questions on many subjects I was nervous about. The exam did seem very fair to me albeit strange. There's really no way to predict what you will have on your test. I had no questions on sarcoidosis or cystic fibrosis and I had just assumed those were standard on everyone's exam. Anyway, I'm really glad it's over. It's a long day, but it's not as bad as you think it will be. I wish everyone the best of luck and I thank everyone for the very helpful advice/feedback. I will post my score when I get it in July.

 

[BusterDO]

medstylee and BrisketAttack...

Thanks for the awesome feedback 👍. Congrats on being done!

 

[lilnoelle]

All right, well I guess I'll write about my day yesterday.
I don't really have a lot to add to everyone else's responses... and I don't really even remember what was on my exam. I guess I've blocked it out already.😛
I actually think I got a pretty good exam. I expected it to be a lot worse. There were certainly a lot of questions that I didn't know the answer to, but it wasn't as bad as I thought it would be. I think UWorld was quite a bit harder.
I second the statement made above that its important to know the basics instead of depending on strict memorization. I spent some time this last week reading through a path review book and a cell bio review book and got quite a few questions right because of that.
Nearly everything was about mechanisms.
There was a lot of biochem on my exam and not very much pharm or micro. I had quite a few questions about risk factors for various cancers - some of which I hadn't paid attention to.

Anyway, I don't have a clue how I did. I'm relatively confident that I passed - but I'm not going to make any other conclusions. I'll wait until I find out my score before I conclude anything else.

Update: I got 244/99. I'm ecstatic. I improved 34 points over NBME 3, taken a little over a week before.

 

[opb]

Congrats to everyone for taking and finishing this beast of a test. For those still studying, keep at it and good luck!