Official 2009 USMLE Step 1 Experiences and Scores Thread

[VFib911]

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?

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[docbill]

Good job everyone on your scores. I am pleased with mine.. nothing like SDN higher ups.. but better than the national average. I guess I will be moving to Step2 forum.

 

[RocketSurgery26]

Before I go into my performance on Step 1, I will make a disclaimer: I am no genius. I studied like a freak during the first two years of med school and I feel like it paid off. Hopefully what I have to say will make a difference for an upcoming test taker.

MCAT - 29 M (that M represents a man completely devoid of writing skills. Some cavemen have written more legible things on a wall than my MCAT essays)
Biochem Shelf Exam - 48th Percentile - I think I was smoking crack during this test. Or maybe somebody entered the numbers in my percent backwards. Either way, pathetic.
Anatomy Shelf Exam - 84th Percentile
Micro Shelf Exam - 84th Percentile
Path Shelf Exam - 85th Percentile
Pharm Shelf Exam - 96th Percentile

USMLE Rx - Can't remember, but I used this program as well.
Kaplan Avg - 72%
U World Avg - 71%

NBME In Class Practice Test (Before studying) - 230
NBME Form 2 (After 2 weeks) - 227 Don't even ask me how you go down on your score after studying for two weeks; I'm still mad
NBME Form 6 (1 week later) - 237

USMLE Step 1 - 243/99

Strategy - I studied very hard during the school year. When I actually got free time during the summer, I took it relatively easy. Not by choice, but by duress (I got a girlfriend). I did not get completely through First AID. It was not my bible. I looked at FA for the topics I had trouble with. I devoted most of my energy to Q-Banks. I did around 4,000 questions on Rx, Kaplan, and UW combined, spending approximately 2-2.5 hours per 48 question block (50 minutes for the exam, 1.5 hours on the review). I feel that Q-Banks and studying hard during 2nd year are the keys to success. You don't need to kill yourself to perform well on Step 1. Maybe I should have destroyed my retinas and pounded through First Aid 3 or 4 times. Maybe I should have studied 11 or 12 hours a day like I had planned on. Who knows? My point is, my performance on Step 1 clearly shows that efforts made during the year can make the difference, rather than a 4 week mad scramble before boards.

Anyway, after studying for a month or so for boards, my averages on Kaplan and UW were high enough that I figured that even on a bad day, I'd do well enough to be competitive in my specialty of choice (ER). Because of that, I moved my test up two weeks. I ended up being correct in that appraisal, plus I had a sweet vacation.

Overall impression of studying stuff - UWorld has the same format and style of questions as Fred V2. The layout to the screen is identical. U World was very difficult, but I feel Kaplan had some excellent questions as well. USMLE Rx was probably my favorite of all, despite having little acclaim in this Forum. It was also the cheapest program. I suggest using USMLE Rx during the school year for subject based exams and then using World for the actual exam.

Instead of studying for boards, why not just go to the Bahamas and catch some rays? Sure you might flunk, but you might have flunked anyway, and I guess that's my point. -Derived from a Jack Handey quote

 

[jazzman84]

Score Report 8/5: 251/99. Of course a great pleasant surprise!

Awesome job! Our practice test and UW stats are very similar and I'm at the end of my 7 weeks so you've given me hope
Hope I get a test with straightforward questions on Monday!

 

[jocko95]

Did anyone do poorly on the MCAT, but do well on the USMLE STEP I? Also, I am a very slow worker and was wondering if anyone here has similar issues but was able to do well. If so, which strategies were used.

I made a 27 on my MCAT and made a 249 on the Step 1. I used the Doctors in Training online study course (based in Texas, but I'm from Arkansas), FA, and USMLE World questions. Every now and then I would cross reference with other sources but that's pretty much it. The online course took 3 weeks and had quizzes during the lectures and I just read FA 3 times by test day, and presto - 249. Furthermore, I'm an A-B student - the key to this test is when you start to study a month before the test -- you need to actually study and plan to do nothing else. Pretty much balls out for four weeks and you'll be ok.

 

[vero ad]

Im an IMG taking my STEP 1 on sept 18th so I have a little more than 5 weeks. Any tips for what qbanks or practice test to do? I have planned on doing the UW q bank and 2 practice tests as well as 1 of the NBME. When do u recomend me to do the first UW test? and the second? thanks

 

[marissa*]

.

 

[smiley737]

I'm wondering what's causing the delay of the release of my scores. I took the exam back in June and still haven't heard anything. Any insights? Thanks in advance.

I got my score on Wednesday morning of the 4th week after my test (took it 7/13, got score 8/5). Maybe you should try to look into it at this point

 

[Valek_PM]

Well, here is my story…

I am an MD student aiming for a score above 240. I started "studying" for the Step 1 since the beginning of my second year. During that time I read through most of FA, Pathophys for the B&W, Goljan RR, & listened to Goljan Audio. Also, I watched most of Kaplan Vids (at least Path, Pharm, Micro, Immuno, Behavioral Sciences & Neuro). I also worked very hard with my MSI & MSII courses.

I studied for approximately 7 weeks. During the first 4 weeks studied about 8 hrs per day. During the next 3 weeks I increased the study hours per day to almost 13. I used a subject-based approach for most of my studies, although I did path and pharm together. After finishing each subject, I worked on my UW Qs.

Assessment:

CBSSA NBME: equivalent of 235 (offered by our Med School before finishing MSII year)
NBME 6: 580 equivalent to 240 (5 weeks before the exam)
NBME 1: 650 equivalent to 255 (1 week before my test)
Test date: 27th of July 2009.

Sources:

• Physiology - BRS Physiology (all book covered) + Kaplan Notes & Vids (Cardio, Respi, MSK, Cell Biology)
• Microbiology & Immunology - Kaplan Notes & Vids
• Pathology - Goljan RR, Goljan Audio, Pathophysiology for the B&W & Kaplan Vids (mostly during MSII year)
• Anatomy, Histology, Neuro & Embryo - Kaplan Notes & Vids, ½ Anatomy HY, Clinical Correlations from Anatomy & Neuro Road Maps
• Biochemistry – Kaplan Notes (few chapters), Goljan Biochem RR (all book covered)
• Behavioral Sciences – HY + Kaplan Lecture Notes (few chapters) + Vids (vids mostly during MSII year)
• Biostatistics – HY (during MSII year) + Kaplan Notes & Vids
• Pharmacology – Pharm Cards, HY & Kaplan Notes (few chapters) + Vids (mostly during MSII year)
• UW Qs – 99% used, 78% correct.
• FA 2009


Test experience:

I Froze @ Q #1 of block 1. Then, decided to skip to Q #48 and work my way backwards (old tradition in my test taking Hx). Blocks 2 & 3 went +/- smoothly while marking about 5-7 Qs per block. At block #4 I got burned out so I took a 10-minutes break. Did blocks 5 & 6 and then I took a break to eat something. Then I returned to finish my last block. All blocks were about the same difficulty.

Regarding content, I got around 3-4 pharm Qs per block (mostly autonomics & antibiotics), lots of path & physio, WHOLE LOTS OF MOLECULAR BIOLOGY RANDOM FACTS & EXPERIMENTS (lots of RNA, cell signaling, DNA stuff & toxins site of action), maybe 6-8 Qs per block. Anatomy was heavily tested (considering it a low-yield subject) with maybe 3-4 Qs per block (mostly arteries, upper & lower limb and abdomen). Maybe 4 Qs of histo (EM & LM images) & 3 Qs of biostats per block. Quote Qs were straightforward. Lots of neuro and micro Qs (mostly experimental genetics, antibiotic resistance mechanisms, parasites and viruses – including shapes, replication & general Dx). Multimedia Qs were not answerable from the stem (maybe 1 was), but ½ were fairly easy.

Post-test I felt "confident" but weird since Qs that you may've found easy could just have been traps that you may've fallen for. Nevertheless, this is an exam that you'll "never" feel really good about, so I have my reserves. Now I shall wait for my results hopping for the best and knowing that I worked as hard as possible for it. I'll update you guys as soon as I receive my scores and I will be glad to answer any PMs. Good luck to everybody!

 

[sylviayasmin]

Im an IMG taking my STEP 1 on sept 18th so I have a little more than 5 weeks. Any tips for what qbanks or practice test to do? I have planned on doing the UW q bank and 2 practice tests as well as 1 of the NBME. When do u recomend me to do the first UW test? and the second? thanks

You should take an NBME form early to see where are you standing on your prep line. That will give you an idea where are your weakness.
How long since you got out of med school?
Thats important to take in consideration.
Any how...you need to get enough sources like Kaplan, First Aid, Goljan audios...
Let me know if you need any more help.
Thats my humble advice.

 

[Perudoc]

Im an IMG taking my STEP 1 on sept 18th so I have a little more than 5 weeks. Any tips for what qbanks or practice test to do? I have planned on doing the UW q bank and 2 practice tests as well as 1 of the NBME. When do u recomend me to do the first UW test? and the second? thanks

Vero since you are an IMG, I would recommend you to check the following forums.
In those forums everybody is IMGs.
Good luck

www.usmleforum.com

www.prep4usmle.com

 

[mq123]

I Froze @ Q #1 of block 1. Then, decided to skip to Q #48 and work my way backwards (old tradition in my test taking Hx).

I do this all the time!! My friends make fun of me for doing it, but it works great for me

 

[Whats_up_doc]

Well, here is my story…

I am an MD/PhD student aiming for a score above 240. I started “studying” for the Step 1 since the beginning of my second year. During that time I read through most of FA, Pathophys for the B&W, Goljan RR, & listened to Goljan Audio. Also, I watched most of Kaplan Vids (at least Path, Pharm, Micro, Immuno, Behavioral Sciences & Neuro). I also worked very hard with my MSI & MSII courses.

I studied for approximately 7 weeks. During the first 4 weeks studied about 8 hrs per day. During the next 3 weeks I increased the study hours per day to almost 13. I used a subject-based approach for most of my studies, although I did path and pharm together. After finishing each subject, I worked on my UW Qs.

Assessment:

CBSSA NBME: equivalent of 235 (offered by our Med School before finishing MSII year)
NBME 6: 580 equivalent to 240 (5 weeks before the exam)
NBME 1: 650 equivalent to 255 (1 week before my test)
Test date: 27th of July 2009.

Sources:

• Physiology - BRS Physiology (all book covered) + Kaplan Notes & Vids (Cardio, Respi, MSK, Cell Biology)
• Microbiology & Immunology - Kaplan Notes & Vids
• Pathology - Goljan RR, Goljan Audio, Pathophysiology for the B&W & Kaplan Vids (mostly during MSII year)
• Anatomy, Histology, Neuro & Embryo - Kaplan Notes & Vids, ½ Anatomy HY, Clinical Correlations from Anatomy & Neuro Road Maps
• Biochemistry – Kaplan Notes (few chapters), Goljan Biochem RR (all book covered)
• Behavioral Sciences – HY + Kaplan Lecture Notes (few chapters) + Vids (vids mostly during MSII year)
• Biostatistics – HY (during MSII year) + Kaplan Notes & Vids
• Pharmacology – Pharm Cards, HY & Kaplan Notes (few chapters) + Vids (mostly during MSII year)
• UW Qs – 99% used, 78% correct.
• FA 2009


Test experience:

I Froze @ Q #1 of block 1. Then, decided to skip to Q #48 and work my way backwards (old tradition in my test taking Hx). Blocks 2 & 3 went +/- smoothly while marking about 5-7 Qs per block. At block #4 I got burned out so I took a 10-minutes break. Did blocks 5 & 6 and then I took a break to eat something. Then I returned to finish my last block. All blocks were about the same difficulty.

Regarding content, I got around 3-4 pharm Qs per block (mostly autonomics & antibiotics), lots of path & physio, WHOLE LOTS OF MOLECULAR BIOLOGY RANDOM FACTS & EXPERIMENTS (lots of RNA, cell signaling, DNA stuff & toxins site of action), maybe 6-8 Qs per block. Anatomy was heavily tested (considering it a low-yield subject) with maybe 3-4 Qs per block (mostly arteries, upper & lower limb and abdomen). Maybe 4 Qs of histo (EM & LM images) & 3 Qs of biostats per block. Quote Qs were straightforward. Lots of neuro and micro Qs (mostly experimental genetics, antibiotic resistance mechanisms, parasites and viruses – including shapes, replication & general Dx). Multimedia Qs were not answerable from the stem (maybe 1 was), but ½ were fairly easy.

Post-test I felt “confident” but weird since Qs that you may’ve found easy could just have been traps that you may’ve fallen for. Nevertheless, this is an exam that you’ll "never" feel really good about, so I have my reserves. Now I shall wait for my results hopping for the best and knowing that I worked as hard as possible for it. I’ll update you guys as soon as I receive my scores and I will be glad to answer any PMs. Good luck to everybody!

I am pretty sure you rocked this test as you did with tests at our school! Good luck on your future endeavors.

 

[Whats_up_doc]

First of all I want to thank all those who have helped me one way or another to prepare for this exam.

General Advice:

The best single piece of advice is to DO WELL DURING 2nd YEAR. This means that 5,6,7, or 8 weeks of preparation will not substitute for your first 2 years of Medicine. My first year I honored most of my courses with a B on here and there. Second year, I tried to honor most of my courses and put more effort into it, since this was the year about the “diseases” and things were more important than knowing anatomy factoids (IMO). During my second year, I did Robbin’s Review of Pathology Questions along my Pathology Course. I read the relevant sections of the Rubin’s pathology book (Yes, I actually read the book) for my pathology coursework. I tried to participate as much as I could of the pathology small group discussions because it helped me solidify concepts. I believe that it is really important that we learn to think rather than memorizing stuff (anyone can do that). This book (Robbin’s Question book) is great for laying down a foundation for concepts. It is very challenging but it is worth it. I would not recommend it for Boards Prep (there is Uworld for that). I also did questions from the Rubin’s Lippincot Path book and the Pre-Test series for all courses (since we have a systems based approach in 2nd year) but I wouldn’t recommend pre-test that much, even though doing more questions for practice won’t hurt.

-Study to Understand. It will make review easier.

-Listen Goljan Audio along your courses and again during board prep, if time permits..
-Use RR path or BRS path ALONG your courses. I used BRS path and added RR path notes to the BRS. Then, I used this during board prep. It made the Path path smoother…
-I wish I had read FA more intensely along my courses but couldn’t.

-Set up a Plan and stick to it. This has been said many times in this forum but it is important to be focused. Friends will try to advice you about X or Y review book that is “really” good. Explore it, but if it doesn’t fit your plan, dismiss it. I ended up buying USMLE Step 1 Secrets and read a couple of pages and that’s it. Hopefully, I can sell it to somebody else.

Schedule:

Studied for approximately 7.5 weeks averaging 8 hours per day (range 6-10).

Style : Started with 1 week of pure physio (BRS) and anatomy (FA). Then did general path , micro, general pharm, embryo principles.From there on, I switched to a systems-based approach. I did blocks of 48 timed, unused, non-random (topic that I studied) of USMLE World, which I found very helpful. I did this for the first 65% or so of the questions. On the last weeks, I switched to random mode of all Q’s.

Sources:

FA 2009 (be sure to check errors on Firstaidteam.com)
BRS Phys
BRS Path (annotated with RR path during 2nd year)
USMLE World (100% used, averaged 68%).Keep in mind first 65% was topic based and last 35% was random. All were timed. Never used tutor mode. Be sure to read ALL explanations unless you are really cool with the concept being asked. I read those I got right too.
Goljan Audio- For people who want to understand…
Underground Clinical Vignettes – Good book for classic presentations. It is not a high yield source, it just helps you put things in a clinical scenario with a couple of buzzwords. However, the NBME are not using that many “buzzwords” on the exam. You have to know the description. NOT actual Q  they will not say “pearly papule”, they will say something like “ elevated lesion with dilated blood vessels”
HY Neuro (skimmed through it) Watched Kaplan Vids. This subject was weakly taught at my school so I had to put extra effort.
Kaplan Biochem (really good book) – not represented in my test at all. 10 Q’s at most.
Micro -CMMRS – during 2nd year. Mostly used as reference or for cool associations. FA is enough.
Behavioral- FA and HY was more than enough.
Pharm – FA was enough.
Immunology- HY and FA.


Assesments (from what I remember now…)

Goal: 230 +. 220: OK. 230: Happy , 240: Unbelievable!!. I want Internal Medicine for now, so let’s see.
CBSA: equivalent of 200 , Begginning of studying.
NBME 6: 530 equivalent to (229), 1 week out.
Free 150: Skimmed through it but didn’t do it like a “test” because I was burnt.
Test: July 24, 2009.
Score: August 12, 2009. 233/97. Mean 221 sd 23




Test Day:

Materials:

- Puerto Rican Coffee
- Granola Bars with Almond
- Ham and Cheese Sandwich
- 2 green apples
- Bottle of Water, Gatorade
- ID and Permit
- Imodium (loperamide) , Acetaminophen
- Prayers (not only on test day, always)


Woke up at 5 30 am, listened to “eye of the tiger” while waking up and started jumping. 2 minutes later I started to get ready, did prayers and got ready. Arrived early to test site where everything went pretty smooth although the guy in charge at Prometric had a paranoic attitude.

Test:

I was a little nervous at the beginning of my first block and was in a time constraint at the end. Try to stay as calmed as possible because it may cost you easy points. I marked 15 on my first block and then 8-10 on the others. I felt the first block was the hardest because of my nervousness rather than not knowing the concept. TIME YOURSELF!!

I would say 2 blocks were “easy”, 4 were intermediate and 1 was hard (the first one).

Ethics questions are interesting (sometimes you believe 2 answers look good). Mark the one you think is correct and move on.

Unfortunately, Neuro was overrepresented on my test so I don’t know how it will affect me. There were bunch of experiments where a concept was trying to be applied so I don’t know if those were experimental or not. For some reason, I think I got a “hard” version of the test. I also had 2 angiograms which I tried to answer from the stem of Q.

Anatomy: One of my weak spots, surprisingly wasn’t that bad. I had a question that I remembered as an obscure detail of my anatomy course. I got lucky here. Also I was tested not an insertion question but on a TENDON question. Yep. I was surprised too.

Immuno: FA enough.

Behavioral: Classic Presentations.

Public Health : Easy calculations.

Path: MUY IMPORTANTE (that is, VERY IMPORTANT). This is integrated with Micro and physiology. I had a lot of questions (see “intermediate difficulty) blocks that presented a clinical vignette, paragraph and all answer choices were long sentences. Be prepared to analize as you go through sentences. You need to train your mind to do this because it can be time consuming. Know your mechanisms well! Goljan does a good job at this. On the other hand, you might have an exam full of pictures or full of descriptions. Be prepared for anything. Ask yourself : What do these guys want me to know in this Question? Look for the classic stuff.

Pharm : Straightforward.FA is enough. Couple of experiments that you have to apply your knowledge on autonomic system.

Embryo: Probably 2 Q’s. FA enough.

Micro: Classic Presentations. Mostly bacterias. I think 1 or 2 viruses. Couple of fungi. 2 parasites. No random RNA +,- sense twisted encapsulated viruses, thank God.

Phys: Mostly integrated with Path. Couple of arrows here and there.

Multimedia : 2/3 answerable from stem. 1/3 had to actually listen and didn’t have a clue!

Biochem: 10 Q’s at most. Doable from Kaplan, FA and U world.

2 blocks – break – 1 block- break – 1 blocks – food – 1 block – break – 1 block – break – 1 block-- FREE


After test: I felt “weird” after the test. I really don’t know how I did but since that is a general feeling among SDN’ers, I felt ok. I was very tired. Actually be sure to get appropriate breaks because you will get exhausted at some point (it happened to me at Q 28 of block 6, hehe), you have to motivate yourself! Keep focused!

Please pardon my grammar errors. I will be very happy to answer any messages via PM. I wish everybody the best of luck and thank all fellow SDN’ers who have helped me get through this process.

GO JULY GO!!!!

Indeed, very happy with my score. I am not a 99 SDNer but I accomplished my goal of a nice step 1 score. I want to thank all who contributed in one way or another. Oh and by the way, I had a 22 N MCAT (for those who think MCAT's measure relate somehow to scores..). Best of luck to everybody!

 

[PBandJ]

Indeed, very happy with my score. I am not a 99 SDNer but I accomplished my goal of a nice step 1 score. I want to thank all who contributed in one way or another. Oh and by the way, I had a 22 N MCAT (for those who think MCAT's measure relate somehow to scores..). Best of luck to everybody!

WUD, congrats!!

 

[Deferoxamine]

Nice job, WUD!

 

[vero ad]

You should take an NBME form early to see where are you standing on your prep line. That will give you an idea where are your weakness.
How long since you got out of med school?
Thats important to take in consideration.
Any how...you need to get enough sources like Kaplan, First Aid, Goljan audios...
Let me know if you need any more help.
Thats my humble advice.

thanks, I just graduated last december....I will start the UW Q bank and tests and I will do a NBME to see where I stand, thanks!

 

[sebsvenmdc]

Geez, repro and cardio like crazy.

Ok, here's my stuff.

Studied review books pretty hardcore.

Path: RR (like 4x)
Physio: RR (2x), BRS (2x)...love physio
Pharm: FA (~12-15x for the drugs)
Biochem: RR (like 2-3x)
Micro: Microcards (3x)
Neuro: HY (2x)
Behavioral: HY (3x)
Cell Bio: 2/3 of BRS skim-reading
DIT: (1x)
FA (~5x)

Some of this studying was shelf studying...definitely didn't read this stuff that many times in 7 weeks...talking about 2 years, kids!

UW: ~71% (98% done)
Kaplan: ~70% (42% done)

CBSE (mid-March): 232.5 (83 = 230-235)
CBSE (early May): 255
NBME 2 (late May): 249
NBME 5 (late May): 251
UWSA 1 (early June): 252
NBME 4 (2 weeks ago): 251

Free 150 (4 days ago): 89%

So, I thought the test wasn't too bad, but I had a hard time with some of the questions. Had a ton of repro. Cardio too. Made about 4 or 5 dumb mistakes. Some questions were kind of tricky. Unfortunately, I think I needed to get most right to get a good score because the questions didn't seem to be that bad.

I have my faith though, and I'm going to trust God with the result...however it turns out.

255/99. It took a while to get back and post this!

 

[jp104]

255/99. It took a while to get back and post this!

Great score!

 

[Mortal_Lessons]

Summited today. I've been using this forum (and recently this thread) for a while now and thought I'd share my experience.

I'm a US allopathic student and spent approximately 7 weeks studying with a 1 week travel interruption.

Pre-test:
Qbanks:
Kaplan Q-bank (100 % complete): 78% (subject-specific, timed)- I started using this over winter break after having won a subscription. I answered subject-specific questions along with the remaining blocks left in school, as well as during my dedicated summer study time.
USMLEWorld (100 % complete): 80% (random, timed, unused)- I started this during the last 4 weeks of my study time after having gone through the subjects.

Practice Tests:
NBME 3: 560/236: I took this with approximately 3 weeks left of school.
NBME 4: 670/260: I took this approximately 3 weeks into my dedicated study time.
NBME 5: 660/258: I took this approximately 5 weeks into my dedicated study time.
NBME 6: 720/271: I took this approximately 6 weeks into my dedicated study time. (1 week before the test)
Free 150: 93 %/266 (per medfriends calculator): 6 days before the test.
UWSA 2: 800/265+ (I got antsy): 2 days before the test.

Overall, I went through the first half of FA (basic principles) and annotated HY Embryology, HY Behavioral Sciences, and RR Biochemistry into it. I also read the Immunology portion of Levinson. I then went through the second half of FA (organ systems) and annotated Goljan and HY Neuroanatomy into it. I was concurrently answering questions in Kaplan Q-Bank related to the subject of the day.

Afterwards, I purchased a subscription to UWorld and answered questions everyday (~3-5 blocks) with annotation into FA.
UWorld is the best and I highly recommend it. Kaplan Qbank was useful for hammering in some of the fine details but might be a little overkill if you're already reading through the material.

In general, the most important thing is learning the material well during your first two years of medical school. There's really no way around it. Aside from that, FA + USMLE World is excellent. Also, you'll be sure to see very similar (if not duplicated) questions from the NBMEs on the real exam. There wasn't anything on my exam that wasn't covered within these two sources (aside from a few questions I don't imagine seeing in any review source).

Test:
Overall, it was very fair. I think it was most similar in style to NBME 6. After having reading some of the early experience posts, I was expecting a lot more long-winded clinical vignettes with lots of lab values (there were some but not a ridiculous number). There were many straight-up questions that you'll come across in FA and USMLE World. I left the exam feeling well overall but am definitely apprehensive about several I'm sure I missed. In terms of timing, I had approximately 10-15 minutes left at the end of each section (I'm an average test taker) and my sequence was: 2 blocks/short break/2 blocks/longer break/1 block/break/1 block/break/1 block.

Post-test:
I'll update this section soon (hopefully).

Thanks again for making this thread so useful during this important time in our careers.

265+/99-Free 150 & NBME 6 were very predictive.

 

[kryptik]

265+/99-Free 150 & NBME 6 were very predictive.

impressive, good job.

question, how did you annotate goljan into FA?

 

[Mortal_Lessons]

impressive, good job.

question, how did you annotate goljan into FA?

i had goljan and FA opened to corresponding sections, and would annotate goljan into the corresponding FA sections, only including information that wasn't already in FA-it was pretty time consuming but was a thorough review of the organ systems.

 

[Deferoxamine]

265+/99-Free 150 & NBME 6 were very predictive.

You beast.

And thank you for providing everyone here with a nice rundown of your preparation. We all know your scores are legit, because you're not one of those classic SDN d-bags with a total post count of 3.5 claiming the test was easy, all they used was FA, and they scored a 287/99!!!!1!!!

 

[vimsacin]

May I know the books to be referred before appearing in USMLE

 

[FreakofMeds]

I just completed my Step 1 exam yesterday. I will start by introducing myself a bit. If you want to read about the exam preparation and studying part, skip the background section

The Background:

I am an IMG, and I graduated back in 2006. In our country, we are also forced to do one year after graduation of internship to become fully licensed to practice medicine. So in reality it feels more like a 2007 graduation.

Anyhow, my story with Step 1 starts more than 3 years ago, right around the time I was about to graduate. Our med school is heavily geared towards exporting students as residents to the United States, we have many many generations of graduates that have completed their residencies in the US and some even came back as Attendings at med school here. So, needless to say, we have plenty of experience from upperclassmen over preparation for Step 1. More importantly, more than 80% of all our graduates that attempt to match in the US, get straight 99s on their first and second steps. I call it USMLE fever.

I started gathering sources around 2006, reading about step 1, asking for advice here and there, and preparing myself. I registered for the CS before I graduated because I hoped I'd do it along with my elective which I completed in Canada and the US for 3 months. Sadly that didn't work out due to some delays in the US visa, so I settled for an elective in Canada only.

Anyhow, thanks to the year long eligibility period, I managed to reschedule right after my graduation date by about a month. Clinical knowledge was fresh, my English language is very strong, and I had trained for the CS with a couple of friends over a weekend or two. I passed in one attempt. Nothing to brag about, but it is important for an IMG to do so.

Anyhow, I registered for Step 1 right after that, sadly some social issues came in the way, and I had a tough time during the internship that I didn't have any of the "solid 4 month" preparation time we IMGs need for Step 1. So there goes the first time I payed for step 1. I didn't go to prometric or attempt the exam, I just let my eligibility expire.

A second attempt at getting the damn thing done was sometime during mid 2008, I was working as a transitional internal medicine resident at a cancer center, and I also failed to get the time to do the exam, and I had even more social issues, in addition to inability to concentrate on the material, so I again let this one expire.

Finally at last, I decided to "take a break" from the transitional residency I am doing because I felt it was going nowhere, and decided to focus entirely on matching and starting over in the US.

Step 1 preparation:

I started studying around april of this year. My sources were:

First Aid 2008
BRS pathology (No goljan, never touched it, never checked any lectures It's popular on SDN it seems. Let's hope my score lends to the idea that you could survive step 1 without Goljan )

Kaplan Lecture notes Biochemistry: I loved it. I'm very good at Biochem. If you pick two random organic molecules, I probably will find a pathway to convert one into the other

High Yield: Immunology
High Yield: Embryology
High Yield: Gross Anatomy
High Yield: Neuroanatomy (Excellent)

BRS Behavioral: I think I failed the Behavioral part of the exam... My greatest weak point.
BRS physiology

Kaplan Lecture notes Pharamacology: I hate this subject. I just hate to memorize a tedious number of names. and associate them with some random piece of information. I got cardiovascular and autonomic pharmacology well, but I hated antibiotics. The book though is good, with First Aid that's all you need.

Microbiology made ridiculously simple. For a text book, it sure is. For Step 1, it is anything but simple. My advice is to read it, but consolidate the info in your First Aid and add any high yield tidbits to the first aid. Just don't dwell on the details, and try to keep mental images of the pictures in it. They could actually help memorize some of the tougher parts of the subject.

So I started four months out, sort of studying in a haphazard manner. I finished the Biochemistry first, then Microbiology. Both took a whopping 2 months of my time. I started to focus more and moved to physiology and pathology. I changed my strategy though. Instead of studying the entire subject, I used a system-based method. I would read cardiovascular physiology from BRS phys, then cardiovascular pathology from BRS path, then Kaplan pharma, then finally consolidate all that with corresponding First Aid Chapter.

Finally, two weeks out, I finished my system-based review, and I already read through First Aid once. I focused entirely on First Aid, trying to memorize as many concepts as possible.

As to the question banks, I used USMLE world, despite friends recommending Kaplan for Step 1, but agreeing on USMLE world for step II.

I decided to go with USMLE world. The entire time I used USMLE world, I used it with 48 question random blocks including all material, unused and timed, from the beginning of my study till the last days before the test. I rationed USMLE world a bit so as to be able to gauge my progress with first time unused questions from the beginning to end, and not run out of questions. The first 6 blocks I did before I started any studying and in the early first few days, I scored 60%-66%, averaging around 64%. I attribute the relatively good starting scores to the fact that I am a good guesser in MCQ questions even when I have a vague clue about the question, in addition to the fact that I studied really hard during med school. I graduated with honors top 10% of my class. So those people that are saying the best way to prepare for step 1 is to study well during your basic years, that is partly true.

Anyhow, sometime 2 months out, I suddenly started to see a surge in USMLE world, up till that point I was scoring tops 66%, lots of 64%, but only once I dipped below 60% to 58%. 2 months out, I made my first break through the 70% barrier, and soon after that I started getting scores all over the place, from a low 62 to a high 79%. The cumulative average crept up slowly, but surely to around 67%.

Finally 2 weeks out, I broke the 80% barrier, all the time still using random 48 unused timed question blocks. The last 8 blocks had an average of 76% and my cumulative average was after I finished USMLE world 69% with a first run, taking into consideration almost half of that was weighted two months out.

My anxiety flew sky high during the night before the exam. I did not sleep one second for my exam. Thank God for adrenaline though, because while doing the exam, I didn't feel like a person who was awake for the last 24 hours. My number one advice:

STOP READING SDN AT LEAST 4 WEEKS BEFORE YOUR TEST DATE

Best thing to do is just read SDN experiences before you start studying, get a feel for the material you need to cover and the Qbanks you need to use, and stop reading it afterward. Seriously, SDN can be such a bummer when you are so mentally fragile days to weeks out. Seeing all those people with 80%+ or 90%+ cumulative on USMLE world and all that, not to mention some of the more stupid experiences that come over claiming their exam IS ALL subject X, or Subject Y.

"omg it was all anatomy!" "Omg I got 200 histo questions" etc. Just forget it, and don't let the experiences here affect your study, or what you focus on. Anatomy is still low yield, and Histo is even lower.

The Exam:

I am very poor at remembering the questions I took, not that I am going to reiterate them since that is illegal, but I am not good at categorizing stuff.

I noticed the exam was fair, it was balanced. If I am to fail this exam (hopefully not) the problem would clearly be me. I accept whatever score I get, because I am convinced I couldn't have performed any better.

I noticed they had a fetish with ADH. I think I got 5-6 questions about that. They also had many questions about TNF. The murmurs I think were fair, and most of the questions that were accompanied with pictures were answerable without the picture, save for the ones that asks you to identify something on the picture.

USMLE world reigns supreme. I think I got 3-4 questions that were almost EXACTLY like what I got on the real test from USMLE world. The format is most definitely similar. One thing that USMLE world lacked though, it was stupid questions.

Seriously, sometimes you would get a rather beefy stem, only to be asked a silly question and have a direct answer. I used to scratch my head wondering whether or not I was missing something.

In general USMLE world questions were tremendously helpful, and the explanations were even more so.

Finally, I do think that the real thing is easier than USMLE world to some extent. The questions themselves were not necessarily easier, it was the mix. The real thing has a higher ratio of simple straightforward questions than USMLE world. I definitely marked a smaller number of questions on the real thing than on USMLE world.

As to the time, I discovered that I barely had time to revise on the real thing. I always finished 3 -4 minutes before the end of the block time, but that time rarely was enough to revise more than 1 - 2 questions seriously. The entire day flew by real fast. It's odd to say this, but I actually enjoyed doing the exam. They didn't allow me to bring in an analog watch though. I made sure I took a break and *ahem* emptied my bladder between every two blocks. I was already tired when I started the exam due to me not being able to sleep the night before, it was imperative that I am relaxed through each block. I took on average 5-10 minute breaks, then managing to squeeze in one 20 minute break before block 5. Of course I skipped the tutorial, but not directly. I just jumped to the audio testing part of the tutorial to make sure my headphones work well and the videos work well. I don't want any surprises during the blocks. I didn't get any videos on the real thing, but I got two cardiac murmurs.

I'll update when I get the scores, hopefully proving that you don't need Goljan to pass step 1, or even better, to get a competitive score. Of course to each his own preferences. I'll be sad if I get anything below 90. I'll be content with anything above 90. I'm aiming for something above 95. I am hoping to get a 99. A 250+ score I think is very far fetched. But honestly I could not really gauge how well I did on the test, thus I have a wide range of expectations. Some might say that in 4 months you should ace the test, and I agree. But the study schedule for IMGs that have last visited their Basic knowledge books 5-6 years ago needs to be 4 months on average.

 

[Valek_PM]

Well, here is my story…

I am an MD/PhD student aiming for a score above 240. I started "studying" for the Step 1 since the beginning of my second year. During that time I read through most of FA, Pathophys for the B&W, Goljan RR, & listened to Goljan Audio. Also, I watched most of Kaplan Vids (at least Path, Pharm, Micro, Immuno, Behavioral Sciences & Neuro). I also worked very hard with my MSI & MSII courses.

I studied for approximately 7 weeks. During the first 4 weeks studied about 8 hrs per day. During the next 3 weeks I increased the study hours per day to almost 13. I used a subject-based approach for most of my studies, although I did path and pharm together. After finishing each subject, I worked on my UW Qs.

Assessment:

CBSSA NBME: equivalent of 235 (offered by our Med School before finishing MSII year)
NBME 6: 580 equivalent to 240 (5 weeks before the exam)
NBME 1: 650 equivalent to 255 (1 week before my test)
Test date: 27th of July 2009.

Sources:

• Physiology - BRS Physiology (all book covered) + Kaplan Notes & Vids (Cardio, Respi, MSK, Cell Biology)
• Microbiology & Immunology - Kaplan Notes & Vids
• Pathology - Goljan RR, Goljan Audio, Pathophysiology for the B&W & Kaplan Vids (mostly during MSII year)
• Anatomy, Histology, Neuro & Embryo - Kaplan Notes & Vids, ½ Anatomy HY, Clinical Correlations from Anatomy & Neuro Road Maps
• Biochemistry – Kaplan Notes (few chapters), Goljan Biochem RR (all book covered)
• Behavioral Sciences – HY + Kaplan Lecture Notes (few chapters) + Vids (vids mostly during MSII year)
• Biostatistics – HY (during MSII year) + Kaplan Notes & Vids
• Pharmacology – Pharm Cards, HY & Kaplan Notes (few chapters) + Vids (mostly during MSII year)
• UW Qs – 99% used, 78% correct.
• FA 2009


Test experience:

I Froze @ Q #1 of block 1. Then, decided to skip to Q #48 and work my way backwards (old tradition in my test taking Hx). Blocks 2 & 3 went +/- smoothly while marking about 5-7 Qs per block. At block #4 I got burned out so I took a 10-minutes break. Did blocks 5 & 6 and then I took a break to eat something. Then I returned to finish my last block. All blocks were about the same difficulty.

Regarding content, I got around 3-4 pharm Qs per block (mostly autonomics & antibiotics), lots of path & physio, WHOLE LOTS OF MOLECULAR BIOLOGY RANDOM FACTS & EXPERIMENTS (lots of RNA, cell signaling, DNA stuff & toxins site of action), maybe 6-8 Qs per block. Anatomy was heavily tested (considering it a low-yield subject) with maybe 3-4 Qs per block (mostly arteries, upper & lower limb and abdomen). Maybe 4 Qs of histo (EM & LM images) & 3 Qs of biostats per block. Quote Qs were straightforward. Lots of neuro and micro Qs (mostly experimental genetics, antibiotic resistance mechanisms, parasites and viruses – including shapes, replication & general Dx). Multimedia Qs were not answerable from the stem (maybe 1 was), but ½ were fairly easy.

Post-test I felt "confident" but weird since Qs that you may've found easy could just have been traps that you may've fallen for. Nevertheless, this is an exam that you'll "never" feel really good about, so I have my reserves. Now I shall wait for my results hopping for the best and knowing that I worked as hard as possible for it. I'll update you guys as soon as I receive my scores and I will be glad to answer any PMs. Good luck to everybody!

Got back my scores today... I have to say that I"m really happy with it. Thanks to all the people who makes this forum possible, and although I am not an aggressive replier to threads I have been reading a lot @ SDN...

PASS: !!!!!!

 

[tallash]

i had goljan and FA opened to corresponding sections, and would annotate goljan into the corresponding FA sections, only including information that wasn't already in FA-it was pretty time consuming but was a thorough review of the organ systems.

What did you think about the First Aid Basic Principles/Organ Systems books, and how did you use those in relation to little FA? Any wisdom on the best way to use those books (little FA and the two big FA)? Just wanted a little more clarification/wisdom . Congrats on the score...

 

[Mortal_Lessons]

What did you think about the First Aid Basic Principles/Organ Systems books, and how did you use those in relation to little FA? Any wisdom on the best way to use those books (little FA and the two big FA)? Just wanted a little more clarification/wisdom . Congrats on the score...

I did not use the FA Basic Principles/Organ Systems books. When I refer to basic principles and organ systems in previous posts, I'm referring to the general names of the two halves of "little" FA.

 

[tallash]

Ahhh, I see. Thanks, though!

 

[AllUpOnYoMama]

Got my score.... 210/87... blows!

I'm really bummed. lower than my NBMEs... was scoring mid 220s. Wow, its hitting like a ton of bricks right now. Section in FA shows that the average residencies that take below 210 are OB, peds, and family... today is a **** day. Good luck to all studying

 

[ChronicAnxiety]

Got my score.... 210/87... blows!

I'm really bummed. lower than my NBMEs... was scoring mid 220s. Wow, its hitting like a ton of bricks right now. Section in FA shows that the average residencies that take below 210 are OB, peds, and family... today is a **** day. Good luck to all studying

Right now, my advice may not be so appealing, but if you look at it again in a couple weeks, I believe it'll sound better. Use this to your advantage! I'm not chattin' breeze when I say you can still get into some of the most competitive residencies with your score .. but it all depends on how you spin it! Destroy Step 2, back it up with your academic grades, and you might actually have a better standing than those with high scores! Best wishes your way!

 

[AllUpOnYoMama]

Right now, my advice may not be so appealing, but if you look at it again in a couple weeks, I believe it'll sound better. Use this to your advantage! I'm not chattin' breeze when I say you can still get into some of the most competitive residencies with your score .. but it all depends on how you spin it! Destroy Step 2, back it up with your academic grades, and you might actually have a better standing than those with high scores! Best wishes your way!

Thanks for the words. Im a caribbean student so Im pretty screwed going in with a 210. Wanted to go radiology but thats more than too far of a reach now. Sucks... good luck to those still studying

for the few who want an experience from a 210 Id say WORLD + FA +BRS physio are the most important. Id even go as far as saying do world twice if you have the time. I read all the BS like goljan RR, HY neuro, micro made simple, hy behavior and did DIT. What helped most was WORLD and FA. I would also like to stress that you try and take 2 NBMEs back to back maybe two and three weeks before the exam to see what its like to have to concentrate for that long with little break. Id also advice to schedule the exam at noon if your not a morning person.... I was scoring mid 220s and even had a 232 on the free 150 but the real deal was 20 points lower... So Im really stressing the two NBMEs back to back! Try and get used to that 7 hr mind crunch. hope this helps

 

[johnmiller]

thanks for the advice alluponyomomma. i hope everything works out for you, man.

 

[512TA]

Thanks for the words. Im a caribbean student so Im pretty screwed going in with a 210. Wanted to go radiology but thats more than too far of a reach now. Sucks... good luck to those still studying

for the few who want an experience from a 210 Id say WORLD + FA +BRS physio are the most important. Id even go as far as saying do world twice if you have the time. I read all the BS like goljan RR, HY neuro, micro made simple, hy behavior and did DIT. What helped most was WORLD and FA. I would also like to stress that you try and take 2 NBMEs back to back maybe two and three weeks before the exam to see what its like to have to concentrate for that long with little break. Id also advice to schedule the exam at noon if your not a morning person.... I was scoring mid 220s and even had a 232 on the free 150 but the real deal was 20 points lower... So Im really stressing the two NBMEs back to back! Try and get used to that 7 hr mind crunch. hope this helps

i have not done neuro and behavioral for quiet some time now. i took free 150 questions today and i found out that i was scoring a 68%, 58% and 48% in blocks as i progressed and scored 67% in audio/video. now i am not taking the exam in near future but i will want to score a 250 in next 3 weeks of prep. any advice how i can do it. major thing i found lacking in me was management of time. i freeked out with time and marked some questions randomly to finish the block and ended up scoring less. i am have done UW subject wise along with FA except for biostats and neuro. first-- do you think it is possible for me to get a score of 250 in next 3 weeks. 2nd- how should i proceed.
thanks

 

[AllUpOnYoMama]

i have not done neuro and behavioral for quiet some time now. i took free 150 questions today and i found out that i was scoring a 68%, 58% and 48% in blocks as i progressed and scored 67% in audio/video. now i am not taking the exam in near future but i will want to score a 250 in next 3 weeks of prep. any advice how i can do it. major thing i found lacking in me was management of time. i freeked out with time and marked some questions randomly to finish the block and ended up scoring less. i am have done UW subject wise along with FA except for biostats and neuro. first-- do you think it is possible for me to get a score of 250 in next 3 weeks. 2nd- how should i proceed.
thanks

I dont want to go off topic. If you start another thread Ill try my best to answer any questions

 

[512TA]

I dont want to go off topic. If you start another thread Ill try my best to answer any questions

i have pasted the same under the thread 'CBT practise test vs FRED 2 '
i would appretiate any inputs
thanks

 

[FreakofMeds]

Got my score.... 210/87... blows!

I'm really bummed. lower than my NBMEs... was scoring mid 220s. Wow, its hitting like a ton of bricks right now. Section in FA shows that the average residencies that take below 210 are OB, peds, and family... today is a **** day. Good luck to all studying

Damn. Can't say that I'm not worried about my score after reading that. Still waiting 10 more days and preparing for Step 2 CK in the process....

 

[mTOR]

Damn. Can't say that I'm not worried about my score after reading that. Still waiting 10 more days and preparing for Step 2 CK in the process....

Glad to hear I'm not the only one who had to resort to Step 2 prep to keep myself occupied during that BRUTAL wait period

 

[lukazo]

Hi guys! well, congratulations to everyone who passed step 1 with success and others I hope u all gonna make it in best way.

well boys and girls, some day I'll have to take that exam too. I need an advice about review books. In this thread there are 1,189 replies posted, so I can't read them from the very beginning, so I must ask you a question, which has already been asked for sure, but I couldn't find the answer....

here's the question: which are the best review books for USMLE STEP I ? which books would you recommend? of course there is an option: Google.com but I need an advice fro experienced people and not some advertisement: WoW we've got best books, buy our books..... bla-bla-bla..... see what I mean?

if there already is such a reply, containing this kind of information, please give me the link. I can't find it myself among 1,189 posts.

thanks beforehand! any advice would be highly appreciated!

 

[FreakofMeds]

Hi guys! well, congratulations to everyone who passed step 1 with success and others I hope u all gonna make it in best way.

well boys and girls, some day I'll have to take that exam too. I need an advice about review books. In this thread there are 1,189 replies posted, so I can't read them from the very beginning, so I must ask you a question, which has already been asked for sure, but I couldn't find the answer....

here's the question: which are the best review books for USMLE STEP I ? which books would you recommend? of course there is an option: Google.com but I need an advice fro experienced people and not some advertisement: WoW we've got best books, buy our books..... bla-bla-bla..... see what I mean?

if there already is such a reply, containing this kind of information, please give me the link. I can't find it myself among 1,189 posts.

thanks beforehand! any advice would be highly appreciated!

Hello. Best of luck on your step 1 endeavor. Almost every lengthy experience on this thread lists the review books they used. Just scroll a couple of posts up and you will find my lengthy post about my preparation which includes the review books that I used for my study.

Cheers.

 

[lukazo]

Hello FreakofMeds and thanks for your reply! Yes, I found your post above and really seems to be very very helpful. thanks a lot! Now I'm going to hospital for night duty, so I'll read your post a bit later. and if you don't mind it, I'll ask you a few questions if something is vague for me in your post, OK?

 

[FreakofMeds]

Absolutely feel free to ask / pm if you wish. In the interest of full disclosure I still have not received my step 1 scores, so I have no idea how I performed on the real thing yet, nor do I claim to have performed well.

 

[lukazo]

Thank you again I'm at hospital at this moment and still have no time to read your post entirely. shame on me.... I'll read it after the duty!

I hope you did step 1 well. I wish all the luck to you! Everybody deserves a good score..... everbody who works hard.....

 

[clement]

Thanks for the words. Im a caribbean student so Im pretty screwed going in with a 210. Wanted to go radiology but thats more than too far of a reach now. Sucks... good luck to those still studying

for the few who want an experience from a 210 Id say WORLD + FA +BRS physio are the most important. Id even go as far as saying do world twice if you have the time. I read all the BS like goljan RR, HY neuro, micro made simple, hy behavior and did DIT. What helped most was WORLD and FA. I would also like to stress that you try and take 2 NBMEs back to back maybe two and three weeks before the exam to see what its like to have to concentrate for that long with little break. Id also advice to schedule the exam at noon if your not a morning person.... I was scoring mid 220s and even had a 232 on the free 150 but the real deal was 20 points lower... So Im really stressing the two NBMEs back to back! Try and get used to that 7 hr mind crunch. hope this helps

I second AllUpOnYoMama folks. Don't set yourself up for a lously WTF moment...I also scored a solid 20 points lower than what UWSA-2 (taken 48 hours before the exam) and the free 150 predicted for me (few days before UWSA-2). NBME forms 5 and 6 were MUCH closer even though I had taken them 3 and 4 weeks before the exam. I felt 5 was most representative. But as a disclaimer, I also felt I had an "easy form" and the curve probably sucked beans for me as well.
PS: Dumb as it sounds (and I can't deny that this may have impacted my score), the exam begins as BLOCK 2. I was tachycardic and my head was spinning during my first set because I thought I had skipped an entire block...So I finished my first set with 10 minutes to spare to rush outside and ask if I had really skipped a block or not. The surly proctor lady yelled at me and informed me that had I read the tutorial, I would have known...Um, I don't remember seeing this in the tutorial which I read at home....But she also insisted the tutorial at the center is "different." Really?
PS2: DO NOT completely neglect anatomy. No it's not high yield, but can give you the extra boost you may be looking for. I know people that did neglect anatomy and performed much better than me, but still, at least know your extremity and GI if nothing else.
PS3: First Aid is money. I read it 6 times. Also, listened to Goljan audio 2X and read RR once (RR is overkill IMO if you already have a decent path foundation...Maybe read it once and then start using BRS path to keep stuff fresh in your head closer to the date of your exam....Path was also my highest performance area on my score report, even though apparently I didn't get all that many path questions).

 

[weizzmann]

Life is good- got 248 on Step 1! I rocked the biochem section-- got through the 1999 High Yield Cell/Molecular book 2 days before taking the test and it helped a bunch-- I had a good idea on every question I got.

 

[FreakofMeds]

Life is good- got 248 on Step 1! I rocked the biochem section-- got through the 1999 High Yield Cell/Molecular book 2 days before taking the test and it helped a bunch-- I had a good idea on every question I got.

Congratz great job. When did you sit for your exam and when did you get your score?

 

[FreakofMeds]

I just completed my Step 1 exam yesterday. I will start by introducing myself a bit. If you want to read about the exam preparation and studying part, skip the background section

The Background:

I am an IMG, and I graduated back in 2006. In our country, we are also forced to do one year after graduation of internship to become fully licensed to practice medicine. So in reality it feels more like a 2007 graduation.

Anyhow, my story with Step 1 starts more than 3 years ago, right around the time I was about to graduate. Our med school is heavily geared towards exporting students as residents to the United States, we have many many generations of graduates that have completed their residencies in the US and some even came back as Attendings at med school here. So, needless to say, we have plenty of experience from upperclassmen over preparation for Step 1. More importantly, more than 80% of all our graduates that attempt to match in the US, get straight 99s on their first and second steps. I call it USMLE fever.

I started gathering sources around 2006, reading about step 1, asking for advice here and there, and preparing myself. I registered for the CS before I graduated because I hoped I'd do it along with my elective which I completed in Canada and the US for 3 months. Sadly that didn't work out due to some delays in the US visa, so I settled for an elective in Canada only.

Anyhow, thanks to the year long eligibility period, I managed to reschedule right after my graduation date by about a month. Clinical knowledge was fresh, my English language is very strong, and I had trained for the CS with a couple of friends over a weekend or two. I passed in one attempt. Nothing to brag about, but it is important for an IMG to do so.

Anyhow, I registered for Step 1 right after that, sadly some social issues came in the way, and I had a tough time during the internship that I didn't have any of the "solid 4 month" preparation time we IMGs need for Step 1. So there goes the first time I payed for step 1. I didn't go to prometric or attempt the exam, I just let my eligibility expire.

A second attempt at getting the damn thing done was sometime during mid 2008, I was working as a transitional internal medicine resident at a cancer center, and I also failed to get the time to do the exam, and I had even more social issues, in addition to inability to concentrate on the material, so I again let this one expire.

Finally at last, I decided to "take a break" from the transitional residency I am doing because I felt it was going nowhere, and decided to focus entirely on matching and starting over in the US.

Step 1 preparation:

I started studying around april of this year. My sources were:

First Aid 2008
BRS pathology (No goljan, never touched it, never checked any lectures It's popular on SDN it seems. Let's hope my score lends to the idea that you could survive step 1 without Goljan )

Kaplan Lecture notes Biochemistry: I loved it. I'm very good at Biochem. If you pick two random organic molecules, I probably will find a pathway to convert one into the other

High Yield: Immunology
High Yield: Embryology
High Yield: Gross Anatomy
High Yield: Neuroanatomy (Excellent)

BRS Behavioral: I think I failed the Behavioral part of the exam... My greatest weak point.
BRS physiology

Kaplan Lecture notes Pharamacology: I hate this subject. I just hate to memorize a tedious number of names. and associate them with some random piece of information. I got cardiovascular and autonomic pharmacology well, but I hated antibiotics. The book though is good, with First Aid that's all you need.

Microbiology made ridiculously simple. For a text book, it sure is. For Step 1, it is anything but simple. My advice is to read it, but consolidate the info in your First Aid and add any high yield tidbits to the first aid. Just don't dwell on the details, and try to keep mental images of the pictures in it. They could actually help memorize some of the tougher parts of the subject.

So I started four months out, sort of studying in a haphazard manner. I finished the Biochemistry first, then Microbiology. Both took a whopping 2 months of my time. I started to focus more and moved to physiology and pathology. I changed my strategy though. Instead of studying the entire subject, I used a system-based method. I would read cardiovascular physiology from BRS phys, then cardiovascular pathology from BRS path, then Kaplan pharma, then finally consolidate all that with corresponding First Aid Chapter.

Finally, two weeks out, I finished my system-based review, and I already read through First Aid once. I focused entirely on First Aid, trying to memorize as many concepts as possible.

As to the question banks, I used USMLE world, despite friends recommending Kaplan for Step 1, but agreeing on USMLE world for step II.

I decided to go with USMLE world. The entire time I used USMLE world, I used it with 48 question random blocks including all material, unused and timed, from the beginning of my study till the last days before the test. I rationed USMLE world a bit so as to be able to gauge my progress with first time unused questions from the beginning to end, and not run out of questions. The first 6 blocks I did before I started any studying and in the early first few days, I scored 60%-66%, averaging around 64%. I attribute the relatively good starting scores to the fact that I am a good guesser in MCQ questions even when I have a vague clue about the question, in addition to the fact that I studied really hard during med school. I graduated with honors top 10% of my class. So those people that are saying the best way to prepare for step 1 is to study well during your basic years, that is partly true.

Anyhow, sometime 2 months out, I suddenly started to see a surge in USMLE world, up till that point I was scoring tops 66%, lots of 64%, but only once I dipped below 60% to 58%. 2 months out, I made my first break through the 70% barrier, and soon after that I started getting scores all over the place, from a low 62 to a high 79%. The cumulative average crept up slowly, but surely to around 67%.

Finally 2 weeks out, I broke the 80% barrier, all the time still using random 48 unused timed question blocks. The last 8 blocks had an average of 76% and my cumulative average was after I finished USMLE world 69% with a first run, taking into consideration almost half of that was weighted two months out.

My anxiety flew sky high during the night before the exam. I did not sleep one second for my exam. Thank God for adrenaline though, because while doing the exam, I didn't feel like a person who was awake for the last 24 hours. My number one advice:

STOP READING SDN AT LEAST 4 WEEKS BEFORE YOUR TEST DATE

Best thing to do is just read SDN experiences before you start studying, get a feel for the material you need to cover and the Qbanks you need to use, and stop reading it afterward. Seriously, SDN can be such a bummer when you are so mentally fragile days to weeks out. Seeing all those people with 80%+ or 90%+ cumulative on USMLE world and all that, not to mention some of the more stupid experiences that come over claiming their exam IS ALL subject X, or Subject Y.

"omg it was all anatomy!" "Omg I got 200 histo questions" etc. Just forget it, and don't let the experiences here affect your study, or what you focus on. Anatomy is still low yield, and Histo is even lower.

The Exam:

I am very poor at remembering the questions I took, not that I am going to reiterate them since that is illegal, but I am not good at categorizing stuff.

I noticed the exam was fair, it was balanced. If I am to fail this exam (hopefully not) the problem would clearly be me. I accept whatever score I get, because I am convinced I couldn't have performed any better.

I noticed they had a fetish with ADH. I think I got 5-6 questions about that. They also had many questions about TNF. The murmurs I think were fair, and most of the questions that were accompanied with pictures were answerable without the picture, save for the ones that asks you to identify something on the picture.

USMLE world reigns supreme. I think I got 3-4 questions that were almost EXACTLY like what I got on the real test from USMLE world. The format is most definitely similar. One thing that USMLE world lacked though, it was stupid questions.

Seriously, sometimes you would get a rather beefy stem, only to be asked a silly question and have a direct answer. I used to scratch my head wondering whether or not I was missing something.

In general USMLE world questions were tremendously helpful, and the explanations were even more so.

Finally, I do think that the real thing is easier than USMLE world to some extent. The questions themselves were not necessarily easier, it was the mix. The real thing has a higher ratio of simple straightforward questions than USMLE world. I definitely marked a smaller number of questions on the real thing than on USMLE world.

As to the time, I discovered that I barely had time to revise on the real thing. I always finished 3 -4 minutes before the end of the block time, but that time rarely was enough to revise more than 1 - 2 questions seriously. The entire day flew by real fast. It's odd to say this, but I actually enjoyed doing the exam. They didn't allow me to bring in an analog watch though. I made sure I took a break and *ahem* emptied my bladder between every two blocks. I was already tired when I started the exam due to me not being able to sleep the night before, it was imperative that I am relaxed through each block. I took on average 5-10 minute breaks, then managing to squeeze in one 20 minute break before block 5. Of course I skipped the tutorial, but not directly. I just jumped to the audio testing part of the tutorial to make sure my headphones work well and the videos work well. I don't want any surprises during the blocks. I didn't get any videos on the real thing, but I got two cardiac murmurs.

I'll update when I get the scores, hopefully proving that you don't need Goljan to pass step 1, or even better, to get a competitive score. Of course to each his own preferences. I'll be sad if I get anything below 90. I'll be content with anything above 90. I'm aiming for something above 95. I am hoping to get a 99. A 250+ score I think is very far fetched. But honestly I could not really gauge how well I did on the test, thus I have a wide range of expectations. Some might say that in 4 months you should ace the test, and I agree. But the study schedule for IMGs that have last visited their Basic knowledge books 5-6 years ago needs to be 4 months on average.

Results back, 229/95. Like I suspected I failed the Behavioral Sciences. I got what I aimed for I guess. Looking back at it my biggest mistake was not doing enough NBMEs. Not the cookie cutter 99 SDN score, but I am glad I am done with it though.

 

[lukazo]

Results back, 229/95. Like I suspected I failed the Behavioral Sciences. I got what I aimed for I guess. Looking back at it my biggest mistake was not doing enough NBMEs. Not the cookie cutter 99 SDN score, but I am glad I am done with it though.

Congratulations! great job. 95 is a very good score, indeed ! I'd be glad to get 95.... yeah sure!... so, keep up with Step 2 CK. 99 this time!

 

[Danger]

Results back, 229/95. Like I suspected I failed the Behavioral Sciences. I got what I aimed for I guess. Looking back at it my biggest mistake was not doing enough NBMEs. Not the cookie cutter 99 SDN score, but I am glad I am done with it though.

how do you think the NMBE would have helped? Do you mean in regards to stamina for the real test?

 

[FreakofMeds]

how do you think the NMBE would have helped? Do you mean in regards to stamina for the real test?

No I mean in regards to identifying my weaknesses. I assumed I would do moderately well in the Behavioral, apparently not. And like everyone says, USMLE world is best used as a learning tool not as an assessment tool. I was slightly deceived by the high scores I got especially towards the end where I scored more than 80% in 5 out of the last 10 blocks in USMLE world timed unused random blocks, and a cumulative of 69% on a first run. But all that does not matter, what matters is the performance on the real thing obviously.

@Lukazo

Thanks a lot. I'll work hard on CK, I'm also applying for the match with the CS and a step 1 score only.

I wonder if I'll get any calls at all lol.

Best of luck on your step 1, I'm sure you'll be able to score more than 95 if you want to and work for it.

 

[da me ka don]

What is the best review book for Immuno?