Stream of consciousness, sorry. I'm tired and want some of that diazepam some old lady od'd on because she took cimetidine (why are we tested on this drug--anyone EVER use cimetidine anymore??)
My experience:
I was expecting question stems to be ridiculously long, but really they weren't that bad, about the same as a 3-4 sentence Uworld question. Longer on average than the practice NBME's, for sure. This was my biggest doubt before the test, so I thought I'd put that out there. Answer choices, usually a manageable 4-5, unless it was a physiology graph question (my advice is to eliminate based on some variable you know for sure, but this is just basic test-taking advice. There was sometimes a variable that I didn't know had to do with that condition, but based on elimination, I didn't need to think about that column). Sometimes they'd have 9 answer choices just because they were trying to cover up the OBVIOUS answer if you thought about it a little. The longer question stems were often the ones where you could look at the last sentence and re-read the question. Speaking of which, I had to re-read the question a lot. Maybe just test-day jitters preventing me from properly digesting the quotes.
Speaking of practice NBME questions, some pictures and questions were repeated directly (with some meaningless twist), so they are very high yield. Remember that stupid rat HLA AxB mother/father question from NBME 3? Yeah, that. With another couple of lines thrown in for a more sensible twist.
No HLA antigens regurgitation though.
I got ridiculously tired at the last block and it came really down to the wire. I ran out of energy/steam, and I wish I could have conditioned myself for this a little better. I still had 15 mins of break left at the end, and I felt fine for the first 20 mins of my block, but then I hit the mental 'wall' and my concentration started to go down the drain. You'll have to figure out how to deal with this yourself, as clearly I failed in this regard. I got through the first 5 blocks fine, then marked 10-15 on average for the last 2 blocks and jumped around all over the place just so I could grab the 'gimme' questions.
There was nothing on there that was too 'out there' that I didn't know or couldn't figure out, unless it was some subjective crap with no scientific basis.
Some of the quote questions were ridiculous. how are you supposed to ensure a young teen's *compliance* when engaging in (unnamed) unhealthy practice when all the 'right' answer choices make you seem like the enemy?? I put the "textbook" answer down, but it's so incompatible with compliance.
Some study design parameters were ******ed, and asked about effects with nondescriptive parameters like "compounding bias" that clearly some boring statistician came up with. Well, I just made up 'compounding bias', but but the answer choices were equally prosaic/unspecific (no eponyms like "Berkson's" etc. that were in UWorld). If you never understood confidence intervals, I suggest you learn how they work NOW. ARR/RRR are easy to reason out, but are tested and aren't really in books. No NNT for me.
Distribution? I thought it was somewhat evenly distributed, though every last joint disease was tested for me (including pseudogout! if you have no idea how this presents other than positive birefringence, I suggest you look it up). Tons and tons of repro for me. Every cause of bleeding, hormone abnormality tumor ever. So glad I don't menstruate and don't need to figure out why. Anatomy was super basic, just like some of the previous posts here suggest. No plexi or bladder. I was dreading acid/base/electrolyte questions, but luckily I didn't get anything that delved beyond the basic compensations. I got a couple of questions on Swan-Ganz values, which I thought was more clinical than should be expected of us at this stage. Other abdomen 'clinical management' questions too, but I'm thinking they're flirting with experimental questions in case they combine step 1 and 2, to see what we already know. Biochemistry was very routine! Fair number of of lysosomal / glycogen storage. I wish all diseases were named like MELAS. Some people warned about the extent of the molecular biology and various proteins, and they were right! *Learn the uworld educational notes on second messengers/transducers*
Lots of bread and butter microbiology ("which is gram-? all but 1 answer choice was gram+), immunology, and pharmacology (autonomic heavy). Thankful that someone mentioned scabies somewhere up there, or I wouldn't have figured that question 🙂 No strange drugs. Def easier than uworld pharm, but I feel like a better person now that I know all about fenoldopam. Incretins, sulfonylureas, gliptins. Classic side-effects, though they wanted to know the weirdo side-effect mechanism of a classic cancer drug. Who cares. I noticed a few interesting questions where they'd describe a million metastatic tumors, give some staining characteristic, and then figure out whether you knew the primary. Bunch of easy neuro, but some with really horrible pictures, like the world's first cerebral angiogram. Thanks, NBME.
RR path is way overkill, and I didn't get any atypical presentations of anything. Lots more simple recall q's than what uworld would have led me to believe.
My prep: Hated First Aid. Looked at it a few times, carried it around like all the other badass med students, then abandoned it. Not without its moments though. Someone tried flirting with me at Starbucks and mentioned a common interest in "First Aid" (as in cuts and scrapes) and remained convinced that I was studying for the Red Cross course. I was too stressed to clarify. 🙂
Books- I read big Robbins a few times throughout the year and flipped through it for path. Mainly RR path though. HY Anatomy: I'm the only one on SDN who likes this book I think, but it helped me since everything was clinically correlated. CMMRS for micro, absolutely perfect! HY Cell '99. Class notes for everything else.
Usmleworld: 100% complete, 70's. Assessment: 243. Best $105 ever. This is a solid product that helped me answer a good 50 questions on the real deal. Some questions *eerily* similar. I'm glad I got the uworld lipodystrophy question wrong. 😉 Demoralizing at times though, especially with multi-step reasoning questions. (brain atrophy as a paraneoplastic syndrome???? wtf). Most of my wrong answers were ones where 65-75% of people got correct, which made me doubt myself hardcore.
NBME: 2-261, 3-262, 4-260 week before test. 150 free: 89-90% correct?
Kaplan: 70's-80's. Till today, I thought this was a really crappy product with a horrible interface, but sad to say, for the majority of 'easy' questions on the real deal, qbank was right on track with difficulty. If you're looking to pass this test and spare yourself the uworld beatdown, go Qbank.
Bottom line: easier than uworld, ~same as uworld assessment, harder than NBME's.
