Official 2009 USMLE Step 1 Experiences and Scores Thread

[VFib911]

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Two days premature, but I thought I would get it started anyway as I just took the exam this morning!!!!!

Overall impressions:
- Path, path, path - been said before and I'll say it again "know it Goljan style"
- Don't forget the biostats. I prob had 10-13 questions here.
- UW is gold... both for content and material presentation. Get comfortable with the interface and it will help you test day as it is very similar.
- FA was very helpful, but I used it for review rather than primary study source.

Today:
- In at 8:30, out at 2:30.Finished each block with 10-15 minutes left.
- Three breaks, one quick trip to the BR, one 10 minute Red bull/ powerbar refresher, and one 20 minute monster/ MetRx "lunch" and walk.
- I didn't find a large difference in content difficulty between the different module. The second-to-last was my most difficult and I was have ing a little difficulty concentrating, but I think my brain was pre-toast.

I'm feeling pretty relieved at the moment as it was not as difficult as I thought it was going to be. In NO WAY was it easy, but certainly doable. I had planned on taking this in July after the COMLEX, but I convinced myself I was not ready for it. Retrospectively, I feel I still would have done well after my COMLEX prep, but the last 6 months has filled in a lot of gaps.

Pre-COMLEX:
- Goljan mp3's 1st and 2nd years commuting to-from school. I did a ton of commuting. Highly valuable.
- Kaplan Biochem DVD(felt it was my weakest) and Micro DVD(lots of content).
- MedEssentials and FA for system-based content review. Big Robbins for reference only.
- CMMRS, know the virus charts, staph and strep algorithms, systemic mycoses, immunocompromised opportunistics.
- Costanza text for physio. Tried to review BRS physio (also Costanza), but I am strong in physio and I felt I was wasting my time.
- Lippincott pharm. Cover-to-cover, but overkill. Easy read though if you know your pharm.
- Kaplan and FA for biostats.
- Flash cards from eBay, both electronic and paper. Great way to review - at least for me - but be aware there are occasional errors. Prob went through 5-7000, really.
- BRS flash cards - Micro, Pharm, Biochem.
- (Savarese for any DO's - know the green book and you are golden.)

COMLEX - 06/08.

Post- COMLEX

UWorld - Thank god I did this. Wish I had done this before the COMLEX. Did tutor mode, took notes, looked each unknown up. I ended up with about 40 pages of topics with key notes written next to each topic. VERY HIGHLY RECOMMENDED.
HY Histo, Cell Bio, Immuno. By this time it was mostly review, but they all helped tie things together and are quick reads.

One week before test:

Goljan cover-to-cover. Goes quick when it is review.
HY Neuroanat - overkill for my exam. Still good topics if you have the time.
FA cover-to-cover.
Reviewed UW notes/ answers.

UW - 100% completed, overall 68%. Last 450 questions mid 70's. Tutor, random, unused.


That's it. I have been meaning to post this for a while after my COMLEX grade posting, but never got around to doing it... been too damn busy reading. I'll update when result is in.

BTW - anyone know if it takes longer to receive your grade this time of year since fewer people are taking the exam?

 

[Scotty_G]

The only bs equation was VO2max. Most of the others were normal stuff. SV/ F.F. kidney/ PPV/Hardy which i didn't go over ha. Like people are saying, the test def has more molecular type of ques. (biochem/cell bio/mol bio/genetics)

 

[fruitloops]

Took the the test yesterday. Ugh, plenty of gay ques or calculations blah blah etc. My question is how many ques wrong is a 220-230? I'm hoping to get in that range, but I know I made some bonehead mistakes in the heat of the moment.

Can you expand upon this? What is a gay question or calculation? Is your use of gay a substitute for terrible, offensive, or bad? Or, are you just a homophobe?

 

[psychforme]

Can you expand upon this? What is a gay question or calculation? Is your use of gay a substitute for terrible, offensive, or bad? Or, are you just a homophobe?

Maybe behavioral science questions about sexuality?

 

[NCF145]

What is most beneficial to slow the progression of COPD in a smoker? Smoking cessation or tiotropium?

 

[pseudoknot]

I think the only intervention more beneficial than smoking cessation is probably applying a tourniquet to an arterial bleed or something like that 🙂

 

[NCF145]

I think the only intervention more beneficial than smoking cessation is probably applying a tourniquet to an arterial bleed or something like that 🙂

My thinking was along those lines as well.

 

[Instatewaiter]

For the COPD question the only 2 things that prolong survival in COPD are smoking cessation and use of oxygen when the pt becomes chronically hypoxic

 

[gsmithers68]

For the COPD question the only 2 things that prolong survival in COPD are smoking cessation and use of oxygen when the pt becomes chronically hypoxic

New studies are also showing ipratropium bromide use in COPD increases lifespan

 

[rahulb]

New studies are also showing ipratropium bromide use in COPD increases lifespan

yea we had a pfizer rep pimping spiriva a while back and i think he mentioned this.

he brought tacos too 👍 👍

 

[ENThopeful]

quick question to those who took it, does the real test mimic UWorld more or NBMEs more? I find UWorld more focused on basic principles while NBMEs like to test really esoteric knowledge, along the lines of cell biology.. I do well on UWorld, but get rocked on NBMEs according the the score calculator conversion thing

 

[NCF145]

quick question to those who took it, does the real test mimic UWorld more or NBMEs more? I find UWorld more focused on basic principles while NBMEs like to test really esoteric knowledge, along the lines of cell biology.. I do well on UWorld, but get rocked on NBMEs according the the score calculator conversion thing

The real one does both.

 

[ENThopeful]

The real one does both.

how do you attack the esoteric questions? do you happen to know them from something you read way back or do you try to make the most educated guesses?

 

[NCF145]

how do you attack the esoteric questions? do you happen to know them from something you read way back or do you try to make the most educated guesses?

Some of the ones I got right, were just because I remembered them from lecture. Other than that, you have to make an educated guess and move on. Don't sweat it. Chances are if you are like wtf?!! when you read the question, then most people are in the same boat as you.

 

[ENThopeful]

haha i wish i knew how to study for boards since day 1. im not really a lecture person and have learned way more medicine from studying boards then I ever did in class. Im hitting a peak and it seems that most people who get beyond where I am get most of it from random tidbits of lecture..

oh well.

 

[Entgegen]

haha i wish i knew how to study for boards since day 1...

The best way to study for boards from day one is learn it well the first time around.

 

[psychforme]

New studies are also showing ipratropium bromide use in COPD increases lifespan

A quick google gets the result " -- In patients with COPD, an anticholinergic drug used to prevent bronchospasm, ipratropium bromide (Atrovent), significantly increased the risk of cardiovascular death, researchers here reported. [...] Ipratropium use was also associated with an increased risk of all-cause mortality (OR 1.11, 95% CI 1.08 to 1.15)."

 

[abecedarianMD]

6/17/09 was the day

studied for a few months and did pretty much everything (rr path/biochem, hy cellmolec/gross/neuroanatomy, brs physio/path, q bank kaplan/uw, webpath, fa cases/fa, doctors in training course)

stats
uw 74% (r/t/u)
uwsa1 252 4 weeks
uwsa2 252 3 weeks
nbme3 253 2 weeks
nbme4 249 1 week

the real test was harder than uw, 10-15% questions straightforward, obscure facts, obscure presentations, obscure anatomy (3 questions). they are really good question writers

questions that i asked myself during the test in order to reason out the questions (this is mental process stuff, NOT the actual question):
what does c. immitis look like as a mold?
does metoprolol have a mild affinity for b2 receptors?
what answer is best for the "quote" questions if they all sound good?
are they really asking me a third order question about c.psittaci?

went in expecting 80% straightforward recall from fa.
came out after getting a tough form and realizing not much could be done to help me "know I knew it" for this one.

i knew my stuff; really well.

bottom line: i agree with a previous poster that performance on test day may be half your score, since the test really does make you think about things 50% of the time. learn as many facts and concepts as you can; go in there, take a break every block to eat some complex carbs, sip some caffeine+theanine, and prepare for a mental gountlet.

this test is no joke; they know what we are studying and modifying their questions accordingly.

 

[slippy22]

6/17/09 was the day

studied for a few months and did pretty much everything (rr path/biochem, hy cellmolec/gross/neuroanatomy, brs physio/path, q bank kaplan/uw, webpath, fa cases/fa, doctors in training course)

stats
uw 74% (r/t/u)
uwsa1 252 4 weeks
uwsa2 252 3 weeks
nbme3 253 2 weeks
nbme4 249 1 week

the real test was harder than uw, 10-15% questions straightforward, obscure facts, obscure presentations, obscure anatomy (3 questions). they are really good question writers

questions that i asked myself during the test in order to reason out the questions (this is mental process stuff, NOT the actual question):
what does c. immitis look like as a mold?
does metoprolol have a mild affinity for b2 receptors?
what answer is best for the "quote" questions if they all sound good?
are they really asking me a third order question about c.psittaci?

went in expecting 80% straightforward recall from fa.
came out after getting a tough form and realizing not much could be done to help me "know I knew it" for this one.

i knew my stuff; really well.

bottom line: i agree with a previous poster that performance on test day may be half your score, since the test really does make you think about things 50% of the time. learn as many facts and concepts as you can; go in there, take a break every block to eat some complex carbs, sip some caffeine+theanine, and prepare for a mental gountlet.

this test is no joke; they know what we are studying and modifying their questions accordingly.

If half the test is your performance on test day, why are actual scores so close to the NBMEs most of the time?

 

[sebsvenmdc]

6/17/09 was the day

studied for a few months and did pretty much everything (rr path/biochem, hy cellmolec/gross/neuroanatomy, brs physio/path, q bank kaplan/uw, webpath, fa cases/fa, doctors in training course)

stats
uw 74% (r/t/u)
uwsa1 252 4 weeks
uwsa2 252 3 weeks
nbme3 253 2 weeks
nbme4 249 1 week

the real test was harder than uw, 10-15% questions straightforward, obscure facts, obscure presentations, obscure anatomy (3 questions). they are really good question writers

questions that i asked myself during the test in order to reason out the questions (this is mental process stuff, NOT the actual question):
what does c. immitis look like as a mold?
does metoprolol have a mild affinity for b2 receptors?
what answer is best for the "quote" questions if they all sound good?
are they really asking me a third order question about c.psittaci?

went in expecting 80% straightforward recall from fa.
came out after getting a tough form and realizing not much could be done to help me "know I knew it" for this one.

i knew my stuff; really well.

bottom line: i agree with a previous poster that performance on test day may be half your score, since the test really does make you think about things 50% of the time. learn as many facts and concepts as you can; go in there, take a break every block to eat some complex carbs, sip some caffeine+theanine, and prepare for a mental gountlet.

this test is no joke; they know what we are studying and modifying their questions accordingly.

Well, that's encouraging. I guess I'm not surprised to hear that the test writers are a bunch of vain pricks out to destroy the ego of each student. Honestly, if the writers are looking at FA or RR path to check that information that's critical to solving their questions is NOT in there...well, I guess they can win then. I didn't know that medicine was such a trip through prick alley.

 

[ENThopeful]

Well, that's encouraging. I guess I'm not surprised to hear that the test writers are a bunch of vain pricks out to destroy the ego of each student. Honestly, if the writers are looking at FA or RR path to check that information that's critical to solving their questions is NOT in there...well, I guess they can win then. I didn't know that medicine was such a trip through prick alley.

haha well med students are at the very bottomest of the bottom on the food chain, so dont expect any favors just yet

 

[sebsvenmdc]

6/17/09 was the day

studied for a few months and did pretty much everything (rr path/biochem, hy cellmolec/gross/neuroanatomy, brs physio/path, q bank kaplan/uw, webpath, fa cases/fa, doctors in training course)

stats
uw 74% (r/t/u)
uwsa1 252 4 weeks
uwsa2 252 3 weeks
nbme3 253 2 weeks
nbme4 249 1 week

the real test was harder than uw, 10-15% questions straightforward, obscure facts, obscure presentations, obscure anatomy (3 questions). they are really good question writers

questions that i asked myself during the test in order to reason out the questions (this is mental process stuff, NOT the actual question):
what does c. immitis look like as a mold?
does metoprolol have a mild affinity for b2 receptors?
what answer is best for the "quote" questions if they all sound good?
are they really asking me a third order question about c.psittaci?

went in expecting 80% straightforward recall from fa.
came out after getting a tough form and realizing not much could be done to help me "know I knew it" for this one.

i knew my stuff; really well.

bottom line: i agree with a previous poster that performance on test day may be half your score, since the test really does make you think about things 50% of the time. learn as many facts and concepts as you can; go in there, take a break every block to eat some complex carbs, sip some caffeine+theanine, and prepare for a mental gountlet.

this test is no joke; they know what we are studying and modifying their questions accordingly.

Hey, thanks for the feedback (albeit that it p****d me off). 🙂 Could you comment on the length of the question stems? I have a habit of asking about this, but students often say they're more pressed on the real thing vs. UW or NBMEs. Were the stems much longer than UW questions on average?

 

[pseudoknot]

Well, that's encouraging. I guess I'm not surprised to hear that the test writers are a bunch of vain pricks out to destroy the ego of each student. Honestly, if the writers are looking at FA or RR path to check that information that's critical to solving their questions is NOT in there...well, I guess they can win then. I didn't know that medicine was such a trip through prick alley.

I find this impossible to believe. The core of the curriculum is pretty standard and the test is there to see if you covered that material. The scores are adjusted for difficulty. If there is a question that is hard for someone then it will probably be hard for most people.

If you look back in this thread or last year's you will find countless people who said they hoped they passed after leaving the exam and then posted 250+ scores. I wouldn't freak out based on one or two experiences.

 

[Whats_up_doc]

I find this impossible to believe. The core of the curriculum is pretty standard and the test is there to see if you covered that material. The scores are adjusted for difficulty. If there is a question that is hard for someone then it will probably be hard for most people.

If you look back in this thread or last year's you will find countless people who said they hoped they passed after leaving the exam and then posted 250+ scores. I wouldn't freak out based on one or two experiences.

Agreed. Just give him 3 weeks and he will come with his fantastic 250+ SDN score.

 

[Cliff Huxtable]

Blah. I took the test today. My first block rocked me. It took a little time to recover from it.
Overall impression: I'm not even sure. I felt like there were a decent amount of "easy" questions that were just straight recall/associations (which would have been great if my mind has recalled that information). I feel like I had a couple questions that I'd seen on NBMEs before (although, I managed to miss them this time around). I made a bunch of stupid mistakes early on which kind of unnerved me until I could recoup at lunch. Like people have been saying, I feel like there was a fair amount of reproduction/endocrine on the test. Not as much cardio as I would have thought. I had a CRAPLOAD of pharm on my test. I had drugs I'd never seen before. I had some drugs that had been on the market for very little time. I was definitely surprised. I had some questions on my test where I had NO IDEA what they were talking about; I know some of it wasn't in FA (and I don't recall it in Goljan either). Audio questions weren't good quality, so that blew.

NBME 1 (pre-study): 190
NBME 6 (half way through the first pass): 218
NBME 4 (first pass through material complete): 220
NBME 5 (after second pass through FA): 249
UWSA1 (same day as NBME 5): 256
UWSA2 (after my third, and last, pass through FA): 244

It's hard to make so many little mistakes and not think you made giant ones somewhere else. I just want to hit 220. Ugh.

When you say repro, do you mean physiology, cancers, . . . ?

 

[odoole]

the real test was harder than uw, 10-15% questions straightforward, obscure facts, obscure presentations, obscure anatomy (3 questions). they are really good question writers

went in expecting 80% straightforward recall from fa.
came out after getting a tough form and realizing not much could be done to help me "know I knew it" for this one.

i knew my stuff; really well.

bottom line: i agree with a previous poster that performance on test day may be half your score, since the test really does make you think about things 50% of the time. learn as many facts and concepts as you can; go in there, take a break every block to eat some complex carbs, sip some caffeine+theanine, and prepare for a mental gountlet.

this test is no joke; they know what we are studying and modifying their questions accordingly.

I just took it too. I agree with this post. There was a lot of stuff I had to pull from my memory from coursework these past two years -- stuff I did not see in any review books during the past 6 weeks of Step 1 study (much more so than with Kaplan or UW). I guess what they say is really true: best thing you can do for Step 1 is study hard first two years.

For me, the timing thing was HUGE. I had heard that on these boards, but I still was not prepared for that. Before the exam, the best thing you can do to help you prepare is practice RACING through practice questions -- don't read the whole question unless you absolutely have to, particularly for the easy questions. I never spent a disproportionate amount of time on any question in particular, they just all took a little more than 1 min. 10 seconds -- or whatever amount of time you're supposed to allot to each question. I flagged at least 1/4 of the questions for each question block, but I only had time to go back and look at them for two out of seven blocks. The other five I just barely finished. I know that probalby hurt my score some. I think, at least for the form I had, the people who will do best on the exam will be the ones who can take tests very quickly. The questions themselves weren't SO so hard if you actually had time to consider them, which, unfortunately, I did not.

Oh, and one last thing -- I'm a total idiot and didn't realize that you could move the stethoscope around for the cardio murmur audio questions. I thought that the circle they highlighted was where the sound was best heard. I didn't figure it out until the last cardio question. That probably cost me a couple points as well. Grrrr. Stupid stuff like that -- goes to show you how rushed I felt all day.

Frankly, I don't understand the point of making us take the test so fast. I understand that you should get to the point that you understand the material so well that you don't need to mull over every question -- on the other hand, we as developing doctors should be encouraged to fully consider every option when dealing with real patients, and not just develop a knee-jerk reflex when presented with a case, as you have to do in order to complete the questions in the amount of time they give you. That seems to me to be encouraging the WRONG kind of behavior.

 

[metallo]

I find this impossible to believe. The core of the curriculum is pretty standard and the test is there to see if you covered that material. The scores are adjusted for difficulty. If there is a question that is hard for someone then it will probably be hard for most people.

If you look back in this thread or last year's you will find countless people who said they hoped they passed after leaving the exam and then posted 250+ scores. I wouldn't freak out based on one or two experiences.

It really is amazing how many people on this forum think the test is extremely difficult, apparently testing material not covered in any of the usual review resources. If this is what the SDN posters think (whose scores are frequently 250+), then I can't imagine how the average and below average med students feel after the exam. Personally, it's making me paranoid. I have less than two weeks until my exam, and now I'm not sure what to do with my time. Maybe I should just move my test up and add to my vacation time if the extra runs through FA, Goljan, and UW aren't going to improve my score anyway.

 

[sebsvenmdc]

I just took it too. I agree with this post. There was a lot of stuff I had to pull from my memory from coursework these past two years -- stuff I did not see in any review books during the past 6 weeks of Step 1 study (much more so than with Kaplan or UW). I guess what they say is really true: best thing you can do for Step 1 is study hard first two years.

For me, the timing thing was HUGE. I had heard that on these boards, but I still was not prepared for that. Before the exam, the best thing you can do to help you prepare is practice RACING through practice questions -- don't read the whole question unless you absolutely have to, particularly for the easy questions. I never spent a disproportionate amount of time on any question in particular, they just all took a little more than 1 min. 10 seconds -- or whatever amount of time you're supposed to allot to each question. I flagged at least 1/4 of the questions for each question block, but I only had time to go back and look at them for two out of seven blocks. The other five I just barely finished. I know that probalby hurt my score some. I think, at least for the form I had, the people who will do best on the exam will be the ones who can take tests very quickly. The questions themselves weren't SO so hard if you actually had time to consider them, which, unfortunately, I did not.

Oh, and one last thing -- I'm a total idiot and didn't realize that you could move the stethoscope around for the cardio murmur audio questions. I thought that the circle they highlighted was where the sound was best heard. I didn't figure it out until the last cardio question. That probably cost me a couple points as well. Grrrr. Stupid stuff like that -- goes to show you how rushed I felt all day.

Frankly, I don't understand the point of making us take the test so fast. I understand that you should get to the point that you understand the material so well that you don't need to mull over every question -- on the other hand, we as developing doctors should be encouraged to fully consider every option when dealing with real patients, and not just develop a knee-jerk reflex when presented with a case, as you have to do in order to complete the questions in the amount of time they give you. That seems to me to be encouraging the WRONG kind of behavior.

Please can you explain why it was such a rush...were the stems like 250 words long? Or were you just trying to be uber cautious and reading carefully? I'm concerned about the amount of reading/length of questions. I'm not the fastest reader. If you could use UW question length comparisons that would be awesome. Thanks!

 

[metallo]

Please can you explain why it was such a rush...were the stems like 250 words long? Or were you just trying to be uber cautious and reading carefully? I'm concerned about the amount of reading/length of questions. I'm not the fastest reader. If you could use UW question length comparisons that would be awesome. Thanks!

I have the same question. When I took the CBSE through my school, the stems were MUCH longer than World (probably twice as long on average). However, the NBME exam stems are actually pretty short, and on the thread comparing the CBSE to the real exam, people seemed to agree that the real thing is more like the World.

 

[psammomabody]

Took it today and can't believe I'm done. It was all a blur.

Stats:
Pre study/post 2nd year NBME 5: 600/244
1 week before the test NBME 3: 680/262
UW: all random/timed, 100% complete, scored 84% the first time through

Goal: 245
Score: 270/99

Study tools:
Kaplan home study series (2 general principles, 2 organ system books)
First Aid
Goljan RR (only read the first 8 chapters, used the rest for reference)

Studied 4.5 weeks. On weekdays I read for 8ish hours and then did questions in the evening. Weekends I did extra qbank questions or caught up on my reading schedule, and took most weekend evenings off. I also took a random Wednesday night off b/c I was feeling burnt out.

I really liked Kaplan, but it was a lot to get through. I read it and kept FA open the whole time making sure I knew what FA had to say about everything. Took notes on every UW wrong answer and spent a lot of time reading all the explanations. I had planned on reading all of Goljan RR but it just didn't happen. I read most of it throughout the year though. Same with the audio. I feel that Goljan audio is good for understanding or keeping stuff straight, but not so good for memorizing.

Physiology was definitely my weak point and my lowest grade in medical school. Did MUCH better 2nd year than 1st year. I probably should have read BRS phys, but honestly I studied my ass off for phys first year and it still doesn't make sense to me. I suck at the questions with a bunch of arrows. Every time I see one I just skip it and leave it until the end. Probably one of the most high yield phys topics in acid/base - make sure you know that cold. I didn't memorize all those formulates though - except Winter's for metabolic acidosis. I probably had 10-12 questions on my test about acid/base crap.

In my last few days of studying I focused hardcore on biochem and micro b/c these are very "crammable" in terms of details. The day before all I did was the HY photos and lists in FA and took most of the day off. I got a great night's sleep the night before AND the couple nights before that to make sure I was all ok on sleep. Also, I did NOT skip my coffee this morning, and I drank a doubleshot between blocks 5 and 6 because I felt like I was getting slow.


The test. In terms of timing, I am a fast test taker, but I took the whole time on most of my sections today. 75% of the questions were 2 sentences or less, but then there were some random ones that were like a whole paragraph, 10 or 12 sentences. Some of the clinical vignettes were 3-4 sentences with a bunch of lab values. On the longer questions I always read the last sentence first. I still got through the questions in about 25-30 minutes, but instead of just clicking submit like I would on UW, I spent a lot more time going over my marked questions. That's what sucked away my time. Most blocks I skimmed over all my answers in the last 5-6 minutes, which again sucked away a lot of time.

In terms of content, about 35% asked about a fact (one jump), about 50% were two jumps (for example, blah blah has these sx what is the treatment for this disease). Very few 3 jump questions (unlike UW). A few were about THINKING (not memorizing) - especially around concepts in pharmacology and physiology. A couple formula questions. The pharm was SO easy. Please do not worry about the pharm. I had a question about epinephrine reversal and like 3 questions about ACE inhibitors. Classic classic stuff.

I took a break between every section and I am glad I did. I'm sure the testing people thought I was crazy. I didn't take a lunch break, I just ate a snack and took a sip of water and went to bathroom (7-8 minutes) between every block. I had a little extra time towards the end so I took a 15 minute break between blocks 5 and 6 (drank my doubleshot, played a little sudoku) because I felt like I was wearing down. I was surprised at how hard it was to keep going. I zoned out a lot during my test, but tried to remind myself this wasn't just another UW block... lol. It's hard to remember, b/c the screen looks practically identical.

Lots of labs and pictures. It probably helps to know a lot of the normal values, especially if you are running out of time. I would focus on knowing electrolytes and CBC if you want somewhere to start.

wooHOO I can't believe I'm done. I didn't feel that great leaving. I'm pretty sure I passed but not sure if I made my goal of 245. I guess we shall see on July 15th. Good luck everybody!!

 

[KingsFan21]

umm, i'm pretty sure you destroyed it according to your baseline and assessment of the test haha

 

[odoole]

I have the same question. When I took the CBSE through my school, the stems were MUCH longer than World (probably twice as long on average). However, the NBME exam stems are actually pretty short, and on the thread comparing the CBSE to the real exam, people seemed to agree that the real thing is more like the World.

I'm sure a small part of it was nerves, but it was almost as though I had to go at such a breakneck speed I didn't have time to be nervous. I guess in that sense it was good. Also, I never had the chance to second-guess myself, which was also probably a good thing.

Yeah, I think the stems were just longer. And as the poster above mentioned, they'd include more lab data -- not just the pertinent stuff, but pretty much everything. It wasn't as though every question was super-long; a lot of them were similar to UW in terms of length. But there were just enough longish questions per block to eat up that extra 5 minutes or so you would normally use to peruse the flagged questions.

I agree also the pharm wasn't too bad at all. And yes, lots of pictures -- though not necessarily something I would have wanted to study more. I also took a break between each block, which felt better to me than taking a lunch break. I made sure to bring an ipod so I could listen to a couple of high-tempo, motivational songs while I drank my caffeine.

 

[odoole]

The test. In terms of timing, I am a fast test taker, but I took the whole time on most of my sections today. 75% of the questions were 2 sentences or less, but then there were some random ones that were like a whole paragraph, 10 or 12 sentences. Some of the clinical vignettes were 3-4 sentences with a bunch of lab values. On the longer questions I always read the last sentence first. I still got through the questions in about 25-30 minutes, but instead of just clicking submit like I would on UW, I spent a lot more time going over my marked questions. That's what sucked away my time. Most blocks I skimmed over all my answers in the last 5-6 minutes, which again sucked away a lot of time.

You're lucky! I wish I had had time to go over my question blocks. Honestly, maybe it wouldn't have helped me much anyway, but it would have been nice to have had the opportunity.

And yes, though I really don't feel like I lingered over any questions, it probably would have been smarter to skip them like you did and come back to them later.

 

[Skelfie]

I've been holed up studying for the past month (and before that holed up trying not to let second year totally kill me, haha), but I wanted to post my experiences since I've really benefited from lurking on this forum! 🙂

Took it today -- overall, I didn't think it was so bad. My caveat for this, though, is that I tend to have an overdeveloped coping mechanism for med school type exams -- if a test is totally a killer, I tend to laugh and joke at how ridiculously hard the questions were and how bad my memory is. I also have an unfortunate tendency to have "multiple choice confabulation" in which I will choose a totally wrong answer but feel completely confident that it's right.

I'm an extremely average student in my class -- generally score at or around the mean, with a few scattered spectacular highs (= endo and micro) and lows (= physiology 🙄). My school only gives us about 4.5 weeks between second and third year. I know that if I had eight weeks to study I could have had a shot at knocking it out of the park because I'm really disciplined and good at time management (thanks mostly to getting a graduate degree in history, I think!), even though my memory is generally hit-and-miss.

But since I didn't have eight weeks my goal was to work my butt off and stay focused so that, no matter what my score, I could feel happy that I really, truly gave it my all. I started reading FA and Goljan along with classes in winter quarter, and I did practice questions using Kaplan just to consolidate what I was reviewing. Then over spring break I did a "test run" study week in which I did an 8-6 schedule reading HY Molecular (the one Taus recommended), Big FA (the one that came out this year), and regular FA. I studied for boards pretty intensely during the first half of our spring quarter, then tapered off during midterms and finals.

Once school got out I dived right into studying -- doing a half day the first day since my brain was tired, then doing 12-13 hour days for the next three weeks, and finally going down to 10 hour days the week before the test so my brain would be rested. I read Goljan a second time, FA three more times, and scattered other books like HY Histopathology, HY Behavioral Science, HY Neuroanatomy (I SUCK at Neuro!), and BRS Physiology. I also did PharmCards every day. I love PharmCards, because I hate Pharm and going over those cards helped all those random details stick in my head as much as they possibly could.

I did about 75% of Kaplan and finished UWorld. My UWorld score is 61%, I think, but I did start scoring in the low to mid-70's by the end. Well, sometimes.

Test day: Slept about 4 hours (too much on my mind), then got up early and went over as many of those annoying little tidbits of information that I forget if I don't study them constantly (Bone tumors, Murmurs) as I could.

Got to the test center early, reviewed some more, then I did about 20 questions in Kaplan's Q Book to get my mind working (I noticed while doing UWorld that I would choose really stupid answer choices on the first 20 questions I did first thing in the morning, so I was trying to avoid that...)

My test was scheduled for 8am but they let me start at 7:40. Yay!

Dude, the test looked almost EXACTLY like UWorld. I was really glad I'd spent so much time doing UW, because, as a previous poster mentioned, Step I was consequently sort of just like doing more UW. I'd had a surge of nervousness when I was filling in my ID number to start the test, but once I saw the familiar format it helped me to calm down a little.

Overall: Questions seemed a little easier than UW. There were a fair number that were as difficult as some UW questions, but a lot were a little easier, and a fair number that were so straightforward I was like, "Wait, what's the trick?" (But there wasn't one, as far as I could tell).

Content:
I got SO many softball Biochem/Molecular Bio questions (I had a bunch of Biochem before Med school and my school goes crazy with Biochem our first quarter so...).

I got a TON of Pharm questions -- lots of mechanisms, some drug interactions, some of those weird graph ones with Atropine/whatever and "which drug would cause the line to go down?". I think I had like 2 calculation ones, both of which were fine, even for a math-challenged person like myself.

Lots of Micro questions, but nothing that wasn't in FA. Oh, I got at least 4-5 antibiotic questions -- I really suck at those, despite PharmCards' best efforts, so, blah. And one really, really weird question where the patient had a fungus and there was a list of a bunch of Antivirals (like Acyclovir) and Antibiotics and then question was: "Which one would be the most INeffective in treating this patient?" I had to read that one like 10 times and I still couldn't figure it out. I'm sure it'll come to me, maybe...

For organ systems: My test had Cardio >>>>>>>>>> Renal = Respiratory = Diabetes >> the rest. Oh, and I got those weird CGI Murmur People, where you have to click on the different circles to hear the A-P-T-M spots. I'm crappy at murmur questions in general, and I've had really paltry experience with listening to murmurs, so... those were pretty much a wash for me. They sounded different but I couldn't tell what they were supposed to convey.

I had a few Neuro and Derm questions and a bunch of Immunology ones, most of which were fine. There were a couple questions that gave me an answer to a later question in a different block, so I was like, "Thanks, USMLE test!" And I had two nearly identical derm questions about poison ivy.

No pelvis questions, nothing on sunscreen. Darn! The Psych/Behavioral Science questions I got were mostly straight out of FA or UW or even Kaplan QBank... Except one head-scratcher about a reformed IVDA with HIV that I narrowed down to "Intellectualization" or "Rationalization" because I knew the others were wrong. Hrmph.

I tend to be a fast reader and a little antsy so I pushed through the first 6 blocks before taking any sort of break because I knew I wouldn't be able to "relax" on a break if I had a bunch of blocks hanging over me. I only took about 30 minutes for lunch since I'd brought my own and I'm not one for dilly-dallying over meals. 🙂

I finished with about 1.5 hours to spare. I went over the last two blocks at a more leisurely pace, but going slow makes me question my answers more, so I don't think the leisureliness helped. I honestly got a little verklempt (sp?) when I submitted that last block because it's like the end of an era, or something. Haha, I'm so lame. 😳

Looking back, I feel good that I accomplished my goal of studying as hard as I could in the time that I was given. I don't think I got anywhere near an SDN score, but I feel that I didn't fail the test, so... yay. I'll find out in July for sure.

Anyway, sorry to ramble so much! Congrats to everyone who's done and to people who are taking it soon!!


P.S. Someone posted something about a smoker with COPD and "what's the most helpful intervention" or something, either on this thread or on the June support group (??). OMG -- I had that identical question, with the two choices the poster posted listed as my first two answer choices!! 😀

 

[sebsvenmdc]

I've been holed up studying for the past month (and before that holed up trying not to let second year totally kill me, haha), but I wanted to post my experiences since I've really benefited from lurking on this forum! 🙂

Took it today -- overall, I didn't think it was so bad. My caveat for this, though, is that I tend to have an overdeveloped coping mechanism for med school type exams -- if a test is totally a killer, I tend to laugh and joke at how ridiculously hard the questions were and how bad my memory is. I also have an unfortunate tendency to have "multiple choice confabulation" in which I will choose a totally wrong answer but feel completely confident that it's right.

I'm an extremely average student in my class -- generally score at or around the mean, with a few scattered spectacular highs (= endo and micro) and lows (= physiology 🙄). My school only gives us about 4.5 weeks between second and third year. I know that if I had eight weeks to study I could have had a shot at knocking it out of the park because I'm really disciplined and good at time management (thanks mostly to getting a graduate degree in history, I think!), even though my memory is generally hit-and-miss.

But since I didn't have eight weeks my goal was to work my butt off and stay focused so that, no matter what my score, I could feel happy that I really, truly gave it my all. I started reading FA and Goljan along with classes in winter quarter, and I did practice questions using Kaplan just to consolidate what I was reviewing. Then over spring break I did a "test run" study week in which I did an 8-6 schedule reading HY Molecular (the one Taus recommended), Big FA (the one that came out this year), and regular FA. I studied for boards pretty intensely during the first half of our spring quarter, then tapered off during midterms and finals.

Once school got out I dived right into studying -- doing a half day the first day since my brain was tired, then doing 12-13 hour days for the next three weeks, and finally going down to 10 hour days the week before the test so my brain would be rested. I read Goljan a second time, FA three more times, and scattered other books like HY Histopathology, HY Behavioral Science, HY Neuroanatomy (I SUCK at Neuro!), and BRS Physiology. I also did PharmCards every day. I love PharmCards, because I hate Pharm and going over those cards helped all those random details stick in my head as much as they possibly could.

I did about 75% of Kaplan and finished UWorld. My UWorld score is 61%, I think, but I did start scoring in the low to mid-70's by the end. Well, sometimes.

Test day: Slept about 4 hours (too much on my mind), then got up early and went over as many of those annoying little tidbits of information that I forget if I don't study them constantly (Bone tumors, Murmurs) as I could.

Got to the test center early, reviewed some more, then I did about 20 questions in Kaplan's Q Book to get my mind working (I noticed while doing UWorld that I would choose really stupid answer choices on the first 20 questions I did first thing in the morning, so I was trying to avoid that...)

My test was scheduled for 8am but they let me start at 7:40. Yay!

Dude, the test looked almost EXACTLY like UWorld. I was really glad I'd spent so much time doing UW, because, as a previous poster mentioned, Step I was consequently sort of just like doing more UW. I'd had a surge of nervousness when I was filling in my ID number to start the test, but once I saw the familiar format it helped me to calm down a little.

Overall: Questions seemed a little easier than UW. There were a fair number that were as difficult as some UW questions, but a lot were a little easier, and a fair number that were so straightforward I was like, "Wait, what's the trick?" (But there wasn't one, as far as I could tell).

Content:
I got SO many softball Biochem/Molecular Bio questions (I had a bunch of Biochem before Med school and my school goes crazy with Biochem our first quarter so...).

I got a TON of Pharm questions -- lots of mechanisms, some drug interactions, some of those weird graph ones with Atropine/whatever and "which drug would cause the line to go down?". I think I had like 2 calculation ones, both of which were fine, even for a math-challenged person like myself.

Lots of Micro questions, but nothing that wasn't in FA. Oh, I got at least 4-5 antibiotic questions -- I really suck at those, despite PharmCards' best efforts, so, blah. And one really, really weird question where the patient had a fungus and there was a list of a bunch of Antivirals (like Acyclovir) and Antibiotics and then question was: "Which one would be the most INeffective in treating this patient?" I had to read that one like 10 times and I still couldn't figure it out. I'm sure it'll come to me, maybe...

For organ systems: My test had Cardio >>>>>>>>>> Renal = Respiratory = Diabetes >> the rest. Oh, and I got those weird CGI Murmur People, where you have to click on the different circles to hear the A-P-T-M spots. I'm crappy at murmur questions in general, and I've had really paltry experience with listening to murmurs, so... those were pretty much a wash for me. They sounded different but I couldn't tell what they were supposed to convey.

I had a few Neuro and Derm questions and a bunch of Immunology ones, most of which were fine. There were a couple questions that gave me an answer to a later question in a different block, so I was like, "Thanks, USMLE test!" And I had two nearly identical derm questions about poison ivy.

No pelvis questions, nothing on sunscreen. Darn! The Psych/Behavioral Science questions I got were mostly straight out of FA or UW or even Kaplan QBank... Except one head-scratcher about a reformed IVDA with HIV that I narrowed down to "Intellectualization" or "Rationalization" because I knew the others were wrong. Hrmph.

I tend to be a fast reader and a little antsy so I pushed through the first 6 blocks before taking any sort of break because I knew I wouldn't be able to "relax" on a break if I had a bunch of blocks hanging over me. I only took about 30 minutes for lunch since I'd brought my own and I'm not one for dilly-dallying over meals. 🙂

I finished with about 1.5 hours to spare. I went over the last two blocks at a more leisurely pace, but going slow makes me question my answers more, so I don't think the leisureliness helped. I honestly got a little verklempt (sp?) when I submitted that last block because it's like the end of an era, or something. Haha, I'm so lame. 😳

Looking back, I feel good that I accomplished my goal of studying as hard as I could in the time that I was given. I don't think I got anywhere near an SDN score, but I feel that I didn't fail the test, so... yay. I'll find out in July for sure.

Anyway, sorry to ramble so much! Congrats to everyone who's done and to people who are taking it soon!!


P.S. Someone posted something about a smoker with COPD and "what's the most helpful intervention" or something, either on this thread or on the June support group (??). OMG -- I had that identical question, with the two choices the poster posted listed as my first two answer choices!! 😀

Wait, there are only 7 blocks...not 8...so you pushed thru the first 5, and then did the last 2 slowly? Or am I in for an insane surprise. Lol.

2nd question...can you cross out answers on the step 1 software like on UW Fred v2?

 

[Skelfie]

Wait, there are only 7 blocks...not 8...so you pushed thru the first 5, and then did the last 2 slowly? Or am I in for an insane surprise. Lol.

2nd question...can you cross out answers on the step 1 software like on UW Fred v2?

It's really weird, but, I'm pretty sure I had 8 blocks... I kept clicking on the little status thingy down in the lower left corner because I had thought there would only be 7, but on my last block it said "Block 8." I thought that maybe they were counting the tutorial as a block, but then the way the times were listed it didn't seem like it. *shrug* Maybe I just got confused. It was a long day, haha.

And yes, you can cross out answers, and highlight, just like in UW Fred v2.

 

[SeminoleFan3]

It's really weird, but, I'm pretty sure I had 8 blocks... I kept clicking on the little status thingy down in the lower left corner because I had thought there would only be 7, but on my last block it said "Block 8." I thought that maybe they were counting the tutorial as a block, but then the way the times were listed it didn't seem like it. *shrug* Maybe I just got confused. It was a long day, haha.

And yes, you can cross out answers, and highlight, just like in UW Fred v2.

Block 1 = Tutorial
Block 2-8 = Actual test

 

[abecedarianMD]

nbme performance also reflects test taking skills and endurance
nodoubt.

question lengths markedly more cluttered and extensive; lots of labs and the like; some extraneous.

my test was more demanding on working memory than world

period.

time was almost an issue; and i have heard this from others who also commented on their form's difficulty

 

[sebsvenmdc]

nbme performance also reflects test taking skills and endurance
nodoubt.

question lengths markedly more cluttered and extensive; lots of labs and the like; some extraneous.

my test was more demanding on working memory than world

period.

time was almost an issue; and i have heard this from others who also commented on their form's difficulty

Did you do any CBSEs? I feel like those had longer stems than NBMEs. Only problem is that they are in written format, and reading speeds on paper and the computer are not the same. Btw, did any of you click on lab, and leave it open the whole time...for like all 48q? In UW, it closes it after I hit the next arrow, but on the NBMEs, I could have it open the whole time. The reason I ask is because I find reading a paragraph with many lines easier than one with few but all the way across the screen. It's definitely a solid strategy for some...IF it's actually a possibility with Fred 2.

 

[odoole]

Did you do any CBSEs? I feel like those had longer stems than NBMEs. Only problem is that they are in written format, and reading speeds on paper and the computer are not the same. Btw, did any of you click on lab, and leave it open the whole time...for like all 48q? In UW, it closes it after I hit the next arrow, but on the NBMEs, I could have it open the whole time. The reason I ask is because I find reading a paragraph with many lines easier than one with few but all the way across the screen. It's definitely a solid strategy for some...IF it's actually a possibility with Fred 2.

The lab box goes away when you click to the next question.

 

[Sislo]

Well, that's encouraging. I guess I'm not surprised to hear that the test writers are a bunch of vain pricks out to destroy the ego of each student. Honestly, if the writers are looking at FA or RR path to check that information that's critical to solving their questions is NOT in there...well, I guess they can win then. I didn't know that medicine was such a trip through prick alley.

"...the writers are looking at FA or RR path to check that information that's critical to solving their question are NOT there.."
I will add those guys have subscription to USMLE world, do all the questions and like to pick up concepts in those crazy questions that only 6% of us suckers got right

 

[kryptik]

"...the writers are looking at FA or RR path to check that information that's critical to solving their question are NOT there.."
I will add those guys have subscription to USMLE world, do all the questions and like to pick up concepts in those crazy questions that only 6% of us suckers got right

if writers are going for nit picky stuff, will it be wise to do kaplan qbank on top of uworld to cover all bases?

 

[SeminoleFan3]

I definitely thought there was some nit-picky stuff on my test yesterday that wasn't in FA or Goljan. I did 70% of Kaplan as well, and I didn't recall it being it there, either.

After having a day to recover from the massacre that was my test, I hope it wasn't as bad as I think it was yesterday after taking it. I agree with whoever posted above that if there was more time, you could probably knock it out of the park. I think since the initiation of the audio questions we should get more time just because it takes time to listen to them, put the headphones on/off, etc. I'd ALWAYS finished UW question sets and NBME sections of test with at least 15-20 minutes left over. However, timing ended up being an issue. I finished one section with mere seconds left. Aside from block 6 or 7 where I finished 15 minutes early, I finished with less than 2 minutes left in each block. The question stems were a bit longer than UW & NBMEs (at least for my test), there were lots of lab values, etc. BUDGET YOUR TIME WISELY. If you don't know it within a minute, mark something, flag it, and move on. You don't want to miss an easy question at the end because you wasted so much time on a hard one you have a decent chance at not getting right anyway.

To whoever asked about the repro stuff on my test: it wasn't one thing in particular, it just seemed that a lot of questions dealt with infections, hormones, and things of that nature.

To whoever said that the pharm on their test was "classic," that definitely wasn't my experience. I had a couple drugs NOT in FA (especially ones that have been on the market for less than 5 years), side effects not listed in FA, and interactions not listed in FA. While I feel like some, even most, of the pharm was decent and manageable, I was shocked to see some of the stuff I had on my test.

 

[quietude]

Just a general thought on timing and reading speed now that I've had a couple of days to get past the I'm-sure-I-failed zone.

I was a fast test-taker in school, and I would go through NBMEs and both qbanks in about 30-40 min a block. I was a bit worried that I might go too fast on the real thing and thus somehow miss an important clue. But in my last marathon 2000 questions in the three days before I tracked my answer changes and found that changing it was the wrong choice at least 80% of the time. There's a reason why they recommend going with your first hunch.

So if you've been going at that speed the whole way through, that's how the test is going to be as well (except the first block, where I inexplicably marked 25 questions and barely finished on time: test shock, I think.). You'll finish with plenty of time to spare even with marking questions and double-checking. I took four 15-20 minute breaks and finished about an hour early. I don't think reading the questions at half-speed would have changed my answers. By test day, you either know it or you don't.

 

[GeorgeMichael B]

Took the test yesterday. Brutal is the only word that comes to mind. Here's my experience. I really came out thinking I failed.

NBME 1 before studying, after classes: 192
UWorld and First Aid were my only resources...68% on timed blocks, unsused but doing each organ system according to what I was studying in first aid and reviewing the block right after
NBME 6 - in the 220 with 2 weeks to go

My Test Day:

Killer. As echoed by many others, timing was a MUCH bigger issue than I thought. Not to scare anyone, but I had been finishing UWorld blocks with 10-15 min. Yesterday, I had AT MOST 5 min left, on several blocks I was finishing the last question with SECONDS on the clock. You cannot dwell on questions in this test....PICK AN ANSWER AND KEEP MOVING. Stems were longer thab in Uworld

As far as content, I cannot even beging to tell you how much micro I had. micro micro micro and more micro......including pharm. Seriously, I think all my pharm questions were micro related. Antibiotic mechanisms, adr's, and the worst....specific antibiotics to use for each bug. I seriously got asked what antibiotic combo to use for what felt like every friggen bug out there.

Interestingly, I had about 2 immuno questions on the entire test. Absolutely no biostats and very little respiratory from what I remember.

I studied really hard for this test and I felt like it was almost unfair at some points. Even the classic questions were taken to a new level. I also agree that these people know most people use first aid and write accordingly....without going into specifics, I got asked a specific gene defect of an obscure disease (covered in 1 line in first aid, and I made sure to know most of the gene defects listed in there).... that im pretty sure 95% of students would get wrong because it was simply a weird fact you had to know.

The easiest part of the test for me was actually pysio....pretty classic questions in that area.

Had about 10 ethics questions that were a joke.....only one really obvious answer for each one. I had absolutely zero psych questions, 1 or 2 embryo, some obscure anatomy questions that I was clueless on, and very little pharm (aside form antibiotics) as well.

Basically, I felt like I took a big long nasty micro test with some other subjects thrown in (i know it sounds ridiculous....it probably is, but thats how it felt.)

Waiting for this score is going to SUCK........

 

[bola]

So.... I did my test yesterday. I def felt like loads of crap when I walked out and kept remembering questions that I missed. All my blocks were fair but I had a 50-50 guessing day I think. We'll see how it goes.


TEST
My only advice to those coming up is that don't just read and cram FA - when they list the various causes/side effects of something and they don't explain each thing - go look it up and understand what they are talking about eg what the heck is fetal hydrantoin syndrome, cinchonism? (not on my test but just examples). The boards are going to describe things & not just use those buzzwords (although I have to say that there were a few of the buzzwords on my test that had me reading the questions a few times over!)

Also Goljan's book and audio, USMLE World!! were excellent. I did abt 20% of Kaplan and honestly it wasn't useful for even one question but there were repeats from UWorld and NBME 6 blatantly on there. There were also a bunch of things that our professors had hammered home that somehow made their way onto my test and were not in any review book. And many things that I was just curious about from FA and looked up in external sources that showed up on my test. My point is, like I said above, don't just sit and passively memorize FA, use it as a foundation and also be an active learner in class.

On my test there was a lot of Neuro, Repro, Thyroid, Molecular bio and BEHAVIORAL/BIOSTATS! I was glad I prepared for behav/biostats. The Biostats questions were very basic but the key was reading the question right- like them giving you values in percentages but then having the answers in actual numbers...happened twice and I had to catch myself from picking the wrong answer. The anatomy was mostly classic too.

Time was not an issue until the last block. On most other blocks I always had abt 5 minutes left to go over marked questions. But on the last block, I think I was a bit down b/c of some of the questions on the previous one that gave me some trouble so I started out slowly and had to fly through 30 questions in 25 minutes but I somehow still had 10 minutes left to go back over them again. I barely read through some of the questions on that block esp the micro questions where you can pick out a few buzzwords and know the right answer.

I didn't take a lunch break but took 5-10 minutes after each section to regroup and snack...I guess bringing food enough for a four person picnic wasn't necessary

PREPARATION:
I had 4.5 weeks to prepare and I was initially worried about not having enough time to get through everything but in the end I finished going over everything once and some sections twice in the first 4 weeks and then using about 5 days to review all of FA. Honestly I think regardless of how much time you have it all comes down to recramming everything again the last week b/c the whole primacy-recency dynamics is ever shifting as you shove new things into your brain. Also be realistic with your schedule and allow one day each week for reviewing or catching up on things you did not get to. It was very important for me mentally to see myself progressing through my schedule and it kept me going.

I used First Aid, UWorld, BRS Physiology, Goljan's RR, Goljan's Biochem, Levinson Immuno, HY Neuro, BRS Behav (mostly for the biostats-FA is enough for the behavioral) and KAPLAN notes as reference. It is very important to not use too many resources in my opinion b/c the more resources I tended to reference the more things seemed to contradict each other and sometimes the more confused I was. I also skipped through Robbins and Rubins for pictures (it was good to actually know what bladder exostrophy looked like rather than just cramming it into your already bursting brain)

I studied about 10+ hrs a day. I had initially tried to do the whole waking up at 8am thing to do some questions but that quickly changed 3 days into studying. Do what works for you. I realized that no matter how early I woke up I was going to study till 2am anyways so I just started not setting my alarm and somehow starting work b/w 10-11am each day. I also took a 5 min break probably after every hour and a long 2-3 hr dinner break everyday. 12-2am usually entailed me sitting in bed with the TV on and doing some of the Kaplan Qbook questions or just looking up things that weren't very clear in other sources.

I listened to Goljan's audio during the school year but did not listen to much more of it during study time cus there was really no time. I relistened to the cell injury and repro sections again though. He was very useful in helping me know how to figure things out rather than just cramming- and reinforces the fact that everything should make sense and pathophys is not magic. Reading only his book during the review period was almost like listening to him again because he almost goes word to word from it.

NUMBERS:
UWorld - 100% done, 77% correct
Kaplan - 18% done, 78% correct
NBME 1 - 231
NBME 3 - 244
UWSA 1 - 265
NBME 6 - 255

Like I said, I felt like crap walking out the exam and I also felt like crap after all my practice tests. But I feel the practice tests are done under so much more relaxed conditions that the emotions of test day (eg getting palpitations when you realize you still have more than half a section left and 25 mins to do it) do not play as much of a role. I don't think I did as well as last two NBMES and I'm still trying to untie the knot in my stomach...

______________________________________________________________________
07/18/09

Update: 275/99

In retrospect:

The NBME grading system will forever be a mystery to me.

I thought I lost accuracy b/c I did the test faster than I would have done such a big exam and realized I missed some easy questions because of this (eg amyloid) but somehow it balanced out. I also feel like a bit of a whiner for complaining so much after the test but those were my genuine feelings walking out.

Thanks to all SDNers who posted in previous experiences thread and/or answered my PMs including UCLAStudent, LankySudanese, Blesbok (whose schedule I used to plan mine since we had about the same amount of time to prepare), DwayneWade & Riverie. The most useful thing I did was spend summer after first year (and before medical school - I am a bit compulsive) reading through the past experiences and picking out what I thought will work for me. Everyone studies for this thing but what makes the difference is studying smart and using a few resources very well rather than spreading yourself thin.

I stopped doing practice tests after 1.5 wks of studying (before I covered the systems). I did NBME 6 last and when I saw the score was in the range I wanted, I stopped for mainly psychological reasons and time constraints also. I realized that if I did more NBMEs and happened to score higher, I was more likely to set myself up for disappointment if I didn't get that high on the real thing or get complacent and start to slack off. On the other hand, if I scored lower, I didn't have time to spend trying to recover mentally. I looked at NBME 4 offline to get an idea of questions and would have done the same for NBME 5 if I had the time. I still don't know what to make of the UWSA in terms of their ability to predict one's score. But I also didn't do the UWSA2 b/c I didn't want to get too excited since I thought its scoring was a bit generous.

For the first & second years reading this: It is important to know how you learn. I learn best audio/visually - by hearing something and then going back to read (see) it myself. This was why I went to every class in med school and if I missed it, I listened to the recording soon afterwards. If I thought the lecture was important, even if I attended it, I listened to it again later in the term. If you don't learn this way quickly figure out what works for you and stick to it but don't blow off the material presented in class. A lot of class stuff showed up blatantly on my test and I was very glad that I took my behind to class at 8am every morning (cursing and gnashing teeth frequently).

Also don't let the ghosts of tests past haunt you on this exam. The MCAT was just not my exam and time was a big issue. I learnt from this and this is why I picked up the pace significantly (at the expense of a few questions) on the boards and did not dwell on questions I didn't know, I picked my best guess and moved on, and if there was more time came back to it.

I hope someone finds this helpful and again, thanks to SDN posters for all their tips.

Here's my study calendar (look for April - June 2009)
http://www.google.com/calendar/embed?src=usmle1prep%40gmail.com&ctz=America/New_York
PM me if you have questions on the calendar or anything else

 

[boyblu32]

I have never posted on this forum before, but wanted to contribute because I felt it has been very helpful to me in the past year. Just a little background: I got to a US med school, and began immediately after college.

For my prep I enrolled in Kaplan's intense prep and went to classes for biochem, immuno/micro, pharm and path. The classes took about 3 weeks and then I had 3 weeks to study on my own. Looking back, I think the Kaplan classes were excellent (especially biochem and path - Barone is amazing and got me some points on the test).

While I was taking the classes (which were some looong days) I would come home and try to review as much of the material as I could, then do Kaplan Q bank questions for at least an hour based on that subject. I didn't really find questions to be very helpful at that time. It was good just to start becoming familiar with questions in general, but I can't say I learned a lot that way at first. I began USMLE world after Kaplan classes were over and loved it. Here are my numbers:
USMLE world 100% complete, finished with a 70% cumulative (started out in the mid 60's, was in the mid 70's the last 15 blocks or so).
NBME 1 about 3 weeks into studying: 236
free 150 at the Prometric site: 249.
NBME 5:223
NBME 4 one week before the real test: 236 again. I was kind of bummed my scores on the NBMEs were not going up, but I did my best not to let it bother me and kept moving. My goal is to score above 240.

Path: I used Rapid review throughout the year, and listened to Goljan's audio too. However, I thought Dr. Barone did a wonderful job with path during Kaplan's classes. I was able to rapidly recall all of that info on my exam which was helpful. He doesn't get through everything though, so I used rapid review to cover the rest of the material.
Micro: We had Dr. Ruebush for micro during kaplan. I really liked her mnemonics, especially for which viruses are dsDNA, ssRNA, etc. I transferred most of my notes to CMMRS and used the charts to study.
Biochem: Kaplan brought in Dr. Turco for this - I thought he did a fantastic job. The kaplan biochem book is really great. I tried to also use the First aid section, but in retrospect I think just sticking to Kaplan would have been a time saver.
Immuno: Again, Dr. Ruebush. I thought this subject (which only took a day) was taught extremely well. I also really liked Kaplan's book for this, and that was all I used.
Physio: I didn't attend these Kaplan lectures, mostly because the book was gigantic and by that time i was tired of sitting in class. I just read my beloved BRS physio, and that was fine. I think UWorld's physio questions were the most representative of the real exam - take time to make sure you know how those arrow questions play out.
Behavioral/Biostats: I started out using HY behavioral sciences, which was great for the behavioral material. For some reason, I was struggling with the biostats questions, so I listened to a few of the Kaplan lectures online. Very helpful for me to hear some of those concepts out loud.
Pharm: I thought Kaplan's pharm was great (Dr. Davis). That was all I used again.
Neuro: I tend to have trouble with this subject, but forced myself to spend a lot of time re-learning material from neuroanatomy during my 2nd year neuro module. This was so helpful to me during boards studying, because it was fresh in my mind. I liked Kaplan's neuroanatomy section (within the gross anatomy book) and mostly used that, along with some HY neuro pages here and there.
First Aid: Looking back, i wish I had just tossed first aid. Yea, it was helpful to have a "list" of topics that you had to know, but I htink I became too obsessed with getting all of my notes into there.

Test day: I got there very early. I was sooo happy I had taken a practice test there first. It really helped me to be familiar with the site/bathrooms and surroundings. I started the tutorial, skipped to the page that tests the headphones and just did that, then skipped to first block of questions.

Overall Impression: I don't really know what to think. My first block was so hard, I thought I was going to throw up. I could feel my heart beating through my chest, and I tagged at least 20 questions to come back to. I don't even remember what was on it thought, so oh well. I took a break immediately after, went to the bathroom and gave myself a little pep talk. I came back and the next block was better. I did: block, break, block, break, 2 blocks, break for lunch, 2 blocks, break, then last block (also killer). I was very pushed for time, like most everyone else who has written here. I had 3 heart sounds questions, all hard, probably got all wrong. I had no idea what I was even listening to, and i had actually prepared and listend to the UCLA site.

Path: I think this was the majority of the test (can you tell how I'm trying to block out the experience). Some of the questions were very basic and I was kind of shocked that they were asking it that way. Others were bizarre, and I was positive that what they were asking was NO WHERE in rapid review or anywhere in my 2nd year path course. I had a lot of cardio questions, a topic I am usually good at, and I thought some of them were very difficult.
Physio: A lot of straight up physio... some were just like USMLEworld - arrows arrows.
Gross Anatomy: I had a good amount of gross anatomy. Some uterus questions, some on topics that I knew cold like rotator cuff, but the way the showed the picture and labels had me stumped.
Immuno: Probably 10-15 total. I recall one about myeloid/lymphoid precursors, another that showed up THREE times, and of course i got wrong 3 times... nice.
Biochem: I had a few that I recall - tetrahydrobiopterin... one about insulin/adipose.
Pharm: Probably less than 10. I was shocked. I had really studied this and the questions I did have were pretty basic.
Micro: Ughh. I did not expect micro to kill me. but it was. They asked about toxins/antibodies that I didn't even know existed. And I still don't kow what they are because I did look that up, and it was nowhere to be found.
Behavioral: I had a good number of behavioral questions, some of them were repeated. Not that many sensitivity/specificity. One PPV.
Neuro: I had about 10 neuro questions probably. I actually found myself calming down with those since I had spent so much time going through it. For all those studying the brainstem cross sections and disorders - i had one on my test! hooray.


I feel very uneasy about my performance. I was really stretched for time, and think I could have done better if I had time to figure out the questions. But the time crunch made it seem like I had to rapidly recall every answer, otherwise I had to move on. It was jarring. I will post my score when I get it. For now, deep breaths and a few days off.

Step 1 score: 241/99 (SO happy)

 

[defcon8]

Lots of Micro questions, but nothing that wasn't in FA. Oh, I got at least 4-5 antibiotic questions -- I really suck at those, despite PharmCards' best efforts, so, blah. And one really, really weird question where the patient had a fungus and there was a list of a bunch of Antivirals (like Acyclovir) and Antibiotics and then question was: "Which one would be the most INeffective in treating this patient?" I had to read that one like 10 times and I still couldn't figure it out. I'm sure it'll come to me, maybe...

😱

 

[ENThopeful]

😱

yea wow thats killer. sounds like a internal medicine board exam question then a step 1 q... hopefully it was experimental

 

[SMA]

Wanted to post my experience. The first thing I would like to say is that I feel like when I read this forum I actually got more stressed out than when I didn't. Just throwing that out there. There is no way you can prepare for everything they throw at you and everyones exam is so different.

NBME 2: 242 Before studying, 2 months out
NBME 4: 242 Right after school ended and studied some
NBME 3: 253 4 weeks out
NBME 6: 258 3 weeks out
UW self assessment 1: 265 1 week out
UW self assessment 2: 263 1 day out
NBME free 150: 93%
UW qbank: 83%
Kaplan qbank: 72%

My advice about Kaplan qbank is DON'T WASTE YOUR TIME AND MONEY. The questions were very poorly written and a lot of minutae. Their answers were basically just a description of the disease process without telling you why the others weren't right. I didn't learn anything from it and actually quit using it halfway through. I only did 50% of the questions. If anything, do the UW questions again.

My exam was very fair and straight forward. I don't know if I had psyched myself out, but they had tons of buzzwords and straight forward presentations. The questions were NOT long at all. It was just like UW, some are short 1 liners and others are longer. I didn't finish anything early, but I had time to look back over everything. The key is to not linger on a question you don't know. Oh yeah, I am also a very slow test taker.

I had probably 50 behavioral/stats/psych. I used BRS for this and am so glad I spent time here. I have no idea what I got right and wrong. The psych was really straight forward. The stats were really straight forward. The quote questions weren't bad, its just unfortunate that I am not good at that part.

I had A LOT of biochem. It was all really straight forward stuff and I'm glad I had it because it is something I am really good at.

I had A LOT of micro/immuno. I didn't really have anything obscure. Very straight forward.

I had quite a few pharm questions. Most of the drugs were in FA, but the mechanisms and side effects were not. So I missed a few here. I had a lot of questions about what is the appropriate treatment for a certain disease or microbe. Nothing really far out, but I had trouble here.

I had a lot more anatomy than I would have liked. I probably had 30 questions. Unfortunately I am afraid this ruined my score. Every anatomy question I looked up, I got wrong. I had the classic brachial plexus/leg anatomy. But I also had ligaments. I had only 1 muscle insertion and it was really easy. I didn't have any pelvic anatomy. I had Head and neck anatomy and thats where I missed a bunch.

Embryo was very easy and straight forward.

Physio was just what would be expected.

I had a lot of neuro. It was all very easy stuff. There was one question where they described the deficit and I couldn't think of where it would be. It was also on my last block. So, I know I missed that one. I had MRI's, brainstem slices. Study this, because everyone seems to say they have had a lot of neuro.

Now, to the part I am most dissapointed about. I didn't have very much path. I can't believe it!!! I am incredibly good at path. I may have had 30 path questions and that is pushing it. I didn't have very many path pictures, maybe 3. Most of the path I did have was testing basic concepts like apoptosis or dysplasia, metaplasia, etc.

The body system most represented on my exam was cardio. I can't even think of another body system because I had so much general first year crap.

As for the experimental questions, everything represented on my exam was stuff that we should have known. There wasn't a single ambiguous, poorly written question. I'm not even sure I had a question that I had never heard of. Unfortunately, I didn't know that answers to all of them.

I also had quite a few repeat questions from UW, UW self assessments and NBME's. That was kind of cool.

I am very disappointed. I will be lucky to pull off a 220/230. I have already looked up tons that I got wrong. The 2 things that I hope I echoed in this post is that you never know what you will get and to study everything if you want to do well. I mean, I've never even heard of an exam without pathology. But the point is, it is very doable. Eventhough I had a bad experience, I still think the exam was very straight forward. Don't psych yourself out!!!

 

[bola]

Hey SMA, if it's any comfort for you I felt the same way too and late yesterday and today I started to remember questions that I got right also, rather than just those that I got wrong. It's hard to actually remember those b/c one tends to breeze through the ones they know and it doesn't register as well as the ones that confused us where one might have lingered a little bit more.

I also agree with you that I could not label any question as experimental on mine which wasn't very comforting either. Time will tell.