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?

 

[Cliff Huxtable]

Just got my score yesterday

265!!! I'm really happy with the result since my initial goal when I started studying was 235ish. I'm an atheist and I thanked God when I got this score.

NBME 4: 258 (about two months out)
UWSA1: 260 (~6 weeks out)
UWSA2: 265 (one weeks out)
(I think this is the correct timeline...)

A word on estimating your performance: I was certain I had answered about 90% of the questions correctly. I think I made good guesses on most of the rest and was stumped on a few.

I did USMLE World twice...some of the questions more than twice. I allowed about 2.5 weeks to pass between my initial go around and my second run through. I a lot of Kaplan Q Bank before I started world and I did some of USMLERx (don't use this unless you're bored and have money to burn). I worked through NBME 5, 6, and 3 untimed. I looked at the path slides and graphs from 1 and 2 because I heard they reused these. Do as many Q's as possible and re-do all questions to make sure you really understand how the question was presented, why the wrong answer's are wrong, and what kind of related concepts could be tested.

I studied everything I came across. Don't blow anything off (including behavioral science).

Did you use any books?

 

[sendwich]

Just got my score yesterday

265!!! I'm really happy with the result since my initial goal when I started studying was 235ish. I'm an atheist and I thanked God when I got this score.

NBME 4: 258 (about two months out)
UWSA1: 260 (~6 weeks out)
UWSA2: 265 (one weeks out)
(I think this is the correct timeline...)

A word on estimating your performance: I was certain I had answered about 90% of the questions correctly. I think I made good guesses on most of the rest and was stumped on a few.

I did USMLE World twice...some of the questions more than twice. I allowed about 2.5 weeks to pass between my initial go around and my second run through. I a lot of Kaplan Q Bank before I started world and I did some of USMLERx (don't use this unless you're bored and have money to burn). I worked through NBME 5, 6, and 3 untimed. I looked at the path slides and graphs from 1 and 2 because I heard they reused these. Do as many Q's as possible and re-do all questions to make sure you really understand how the question was presented, why the wrong answer's are wrong, and what kind of related concepts could be tested.

I studied everything I came across. Don't blow anything off (including behavioral science).

could you provide a list of books you've used?

 

[Elfy]

Just got my score yesterday

265!!! I'm really happy with the result since my initial goal when I started studying was 235ish. I'm an atheist and I thanked God when I got this score.

NBME 4: 258 (about two months out)
UWSA1: 260 (~6 weeks out)
UWSA2: 265 (one weeks out)
(I think this is the correct timeline...)

Congrats. You started with a really high NBME score. It looks like everyone who scored 260+ lately went into their preparation with high scores on diagnostic tests.

 

[theophylline]

What are your specific qualms with USMLERx?

Again I am baffled by the amount of representation on SDN by individuals that score > 250 on the exam. There are, undoubtedly, a couple of factors for this:

1) Students that don't score well don't post their results.
2) Students that are obsessed with the exam tend to do well and utilize all resources available (including forums like SDN).

Cycling through the questions at that pace would require that you spend minimal amounts of time reading (2.5 weeks for > 2000 questions). What is your take on the parallels between the actual exam and USMLEWorld?

 

[Knucklehead]

i used the following to varying degrees:
BRS physio, lippincott's pharm (followed along with pathophys courses), lippincott's biochem (used it first year), micro made ridiculously simple, BRS behavioral science, Kaplan notes here and there, Kaplan Pharm lecture vids, Kaplan behavioral science vids, Kaplan Immuno vids, Kaplan path vids (not that great), Goljan QBank, and some others.

My main sources:
I followed along second year with medessentials and goljan path. I listened to goljan path lectures until his voice annoyed me (on the way to school, while jogging, etc). I made my own flash cards for topics I found difficult to remember (drug side effects, some bugs, difference between breast lesions, etc). In the last month or so I started reading through first aid to make sure I hadn't missed anything. First Aid was great for consolidation and review but I wouldn't necessarily recommend learning a ton of new information from such a skeletal book, as many attempt to do. Last but not least: the QBanks! The Qbanks are the most important piece of the puzzle! I'll bet one could pull a 240+ from just working through Kaplan and World and reading through FA a few times.

Final note: studying becomes very low yield at some point. Once you get into a certain range hurry up and take your friggin exam and get on with your life.

thanks for the congrats, all. This board has been really useful.

 

[Knucklehead]

What are your specific qualms with USMLERx?

Again I am baffled by the amount of representation on SDN by individuals that score > 250 on the exam. There are, undoubtedly, a couple of factors for this:

1) Students that don't score well don't post their results.
2) Students that are obsessed with the exam tend to do well and utilize all resources available (including forums like SDN).

Cycling through the questions at that pace would require that you spend minimal amounts of time reading (2.5 weeks for > 2000 questions). What is your take on the parallels between the actual exam and USMLEWorld?

You misunderstood. The first time I worked through world it took a few months because we were still in class. During that time I would go over answers extensively and do blocks of missed questions only. Then I took a 2.5 week break from UW to go back and do some Kaplan QBank and read up on various topics. When I reset USMLE World and worked through it again, I completed 6 blocks of 48 questions every day and reviewed the answers. Then I took about two days to read through Medessentials and first aid to see if there was anything I missed, then I took my exam.

 

[Veronicacronica]

You misunderstood. The first time I worked through world it took a few months because we were still in class. During that time I would go over answers extensively and do blocks of missed questions only. Then I took a 2.5 week break from UW to go back and do some Kaplan QBank and read up on various topics. When I reset USMLE World and worked through it again, I completed 6 blocks of 48 questions every day and reviewed the answers. Then I took about two days to read through Medessentials and first aid to see if there was anything I missed, then I took my exam.

What's your take on Kaplan Qbank? Did it really help?

 

[Elfy]

First Aid was great for consolidation and review but I wouldn't necessarily recommend learning a ton of new information from such a skeletal book, as many attempt to do.

Words of wisdom.

 

[cgk]

Just got my score yesterday

265!!! I'm really happy with the result since my initial goal when I started studying was 235ish. I'm an atheist and I thanked God when I got this score.

NBME 4: 258 (about two months out)
UWSA1: 260 (~6 weeks out)
UWSA2: 265 (one week out)
(I think this is the correct timeline...)

A word on estimating your performance: I was certain I had answered about 90% of the questions correctly. I think I made good guesses on most of the rest and was stumped on a few.

I did USMLE World twice...some of the questions more than twice. I allowed about 2.5 weeks to pass between my initial go around and my second run through. I a lot of Kaplan Q Bank before I started world and I did some of USMLERx (don't use this unless you're bored and have money to burn). I worked through NBME 5, 6, and 3 untimed. I looked at the path slides and graphs from 1 and 2 because I heard they reused these. Do as many Q's as possible and re-do all questions to make sure you really understand how the question was presented, why the wrong answer's are wrong, and what kind of related concepts could be tested.

I studied everything I came across. Don't blow anything off (including behavioral science).

Just Curious... What percentile does a 265 correlate with?

 

[SupaManu]

Knucklehead, congrats awesome score. Just wondering what your thoughts were on the Kaplan Pharm videos, im contemplating going thru the intro, ANS, and cardiopharm, maybe more just curious what you thought.

 

[Elfy]

Just Curious... What percentile does a 265 correlate with?

Assuming the mean is 220 and the standard deviation is 20, that's over two SDs above the mean, so a 265 would be in the top 2.5%?

Did I get the stats question right?

 

[future_dr_house]

Assuming the mean is 220 and the standard deviation is 20, that's over two SDs above the mean, so a 265 would be in the top 2.5%?

Did I get the stats question right?

That sounds right. I have a stats question though. I've heard the Step 1 is likely has a positive skew (could just be a rumor). Does this affect the tails, or is a 95% confidence interval the same no matter what type of skew or distribution there is?

 

[rabbitsfeet777]

I always thought for the bell curve to "work" or be most predictable mean=median=mode. If there is a skew it throws of SD, but I'm just speculating, may be totally wrong.

On side note, any suggestions on how to not drive yourself nuts while playing the wait game? It wasn't bad at first, but now all my classmates are getting scores and I'm driving crazy on how i might have done, what will I tell myself if I did bad, what will I do if I did well, etc. It's like my brain subconsciously won't let me have fun cuz it keeps worrying about my score floating in cyberspace and statistical calculators.

 

[Elfy]

That sounds right. I have a stats question though. I've heard the Step 1 is likely has a positive skew (could just be a rumor). Does this affect the tails, or is a 95% confidence interval the same no matter what type of skew or distribution there is?

Apparently for positive skews one should calculate the confidence interval as a range from the median as opposed to a range from the mean:

http://books.google.com/books?id=H7...sYD_Bg&sa=X&oi=book_result&ct=result&resnum=9

Is that what you're asking?

 

[Elfy]

On side note, any suggestions on how to not drive yourself nuts while playing the wait game? It wasn't bad at first, but now all my classmates are getting scores and I'm driving crazy on how i might have done, what will I tell myself if I did bad, what will I do if I did well, etc. It's like my brain subconsciously won't let me have fun cuz it keeps worrying about my score floating in cyberspace and statistical calculators.

Spring cleaning. I'm not kidding. Clean/scrub/sort out something tiring and boring in your home with a nice audio background. It will help you get your mind off super-challenges and sleep better afterward.

 

[future_dr_house]

Apparently for positive skews one should calculate the confidence interval as a range from the median as opposed to a range from the mean:

http://books.google.com/books?id=H7...sYD_Bg&sa=X&oi=book_result&ct=result&resnum=9

Is that what you're asking?

Yeah I think that answers it. Was just wondering if 2 SDs above the mean is really the top 2.5% in a positive skew sample. But like the site says, it may be prudent to use the median.

and just so i don't get flamed for bringing positive skew up...it's discussed in FA 🙂

 

[pseudoknot]

That sounds right. I have a stats question though. I've heard the Step 1 is likely has a positive skew (could just be a rumor). Does this affect the tails, or is a 95% confidence interval the same no matter what type of skew or distribution there is?

I don't think that's a confidence interval. The 95% confidence interval would describe a range of values that the mean would fall between at least 19/20 times if repeatedly measured. You're just talking about percentiles.

 

[Elfy]

It's true that the confidence interval and the percentile range are two different matters.

I thought House was asking something else though. I'm not sure what he was asking. But does it say anywhere that the Step 1 scoring curve translates into an unimodal symmetric distribution? What if it's bimodal? What if it's positively/negatively skewed? Do the same rules about the percentage of scores that fall within one SD, two SDs etc. apply?

It may sound like a basic concept, but I wasn't able to figure this out from test books, generally speaking (forget the scoring system for now). All the calculations of 68% of values falling within one SD, 27% of values withing two SDs etc. are given in review books as examples for a normal (gaussian) distribution. Are they still valid for bimodal or skewed curves as well?

 

[future_dr_house]

Elfy has my question right, but I did misuse the term confidence interval. Thanks for looking into it Elfy but if you don't know it off the top of your head, don't worry about it. I'm sure there's a lurking stats whiz that could help us out.

 

[pseudoknot]

Although it's outside of the scope of this thread, yes, the fact that 1SD spans 68% of values and 2SD 95% does depend on a normal distribution. However, I think this is pretty close for Step I, if not perfectly correct. One check is to look at Charting Outcomes in the Match 2007, where you see that for the 13,263 matched US seniors:
25th %ile: 206
50th %ile: 222
75th %ile: 236

So given that the 75th %ile corresponds to about 0.7SD, this means that 1SD at the low end is around 23 and 1SD at the high end, about 20. Close enough, I say.

 

[Redrox]

Just Curious... What percentile does a 265 correlate with?

The Clinical Review Calculator rabbitsfeet mentioned is much better than what I had found.

 

[Sublimelvc]

Although it's outside of the scope of this thread, yes, the fact that 1SD spans 68% of values and 2SD 95% does depend on a normal distribution. However, I think this is pretty close for Step I, if not perfectly correct. One check is to look at Charting Outcomes in the Match 2007, where you see that for the 13,263 matched US seniors:
25th %ile: 206
50th %ile: 222
75th %ile: 236

So given that the 75th %ile corresponds to about 0.7SD, this means that 1SD at the low end is around 23 and 1SD at the high end, about 20. Close enough, I say.

I'm sure most people understand this but just to clarify those percentiles are for US seniors that matched and not all test-takers worldwide.

 

[rabbitsfeet777]

Spring cleaning. I'm not kidding. Clean/scrub/sort out something tiring and boring in your home with a nice audio background. It will help you get your mind off super-challenges and sleep better afterward.

Ya I've been working out a whole bunch so that I just pass out when i hit the bed. It's so crazy. One day I feel like I prolly got a 220 and others a 260. Just few more days I guess. I just really hope that USMLE Clinical Review Calculator is predictive.

 

[rabbitsfeet777]

Does anyone know how or what the 3 digit score correlates to? Does it have to do with number raw correct out of 336?

 

[Sublimelvc]

Ya I've been working out a whole bunch so that I just pass out when i hit the bed. It's so crazy. One day I feel like I prolly got a 220 and others a 260. Just few more days I guess. I just really hope that USMLE Clinical Review Calculator is predictive.

The Clinical Review Calculator using UW overall % predicted my score to within 1 pt

 

[pohma]

I worked through NBME 5, 6, and 3 untimed. I looked at the path slides and graphs from 1 and 2 because I heard they reused these.

never heard of that before. did it end up coming in handy?

 

[gsmithers68]

Ok...

So here is my experience... took the test yesterday. I studied for about 7 weeks... primary sources were DIT, FA, RR Path, HY Neuro Anat, HY Behavioral Sci, HY Embryo, BRS Phys, BRS Biochem. I used FA as my primary book and then made annotations of high yield info in the margins. I also photocopied pages and when I debound my first aid and put into a 3-ring binder, I put the pages into the FA too that way I could go through a book once, take what I wanted from it, and consolidate information. Here were my numbers...

CBSE Exam (6 weeks out) 240
NBME 1 (5 weeks out) 240
NBME 6 (3 weeks out) 247
NBME 5 (2 weeks out) 251
UW 1 (1 week out) 256
UW 2 (3 days out) 264

So, I studied in a little different way than most I think... I did Doctors In Training for 2 weeks at the beginning as my first pass through FA and additional information gathering... After the 5 hours of lecture I read the corresponding section in either RR Path or BRS biochem. I spent the next 2 weeks compiling information from all my other sources I listed... making annotations in my FA on anything my filter decided was either pertinent or high yield. Then for the last two weeks I did two more passes front to back on FA looking over my notes... with one day on general anatomy and another on general neuro. I got 65% through Kaplan Q Bank and finished USMLE World... I averaged about 100 Q's a day I'd say, maybe more towards the end... I was doing 150 or so a day towards the end.

After taking the first NBME I realized that the primary emphasis on this test was going to be diseases and pathophysiology of the primary UNITED STATES problems. So I spent extra time focusing on obesity, DM, CVD, etc. The big topics that are rampant in our healthcare system. I would like to reiterate that my hunch held true for this test too. I had ABSOLUTELY ZERO questions that began with a Russian immigrant or a person from the Far East, etc. I had a ton of questions on all the big time problems in healthcare right now. My quote questions all had to do with presenting bad news or talking to young adolescents about smoking or sex. The pharm was cake and freebees if you do UW... that qbank really preps you for any pharm that they could possibly throw at you. The pathophys segment of the test is tricky, but I thought it was not as many third order questions as UW... lots of 2nd order, but I really had only a handful of third. Pathology was honestly not nearly as in depth as Goljan, but I was glad I read RR for the pathophys because that's really what it helped for... BRS phys saved my $%^ for respiratory and renal physiology which I had at least 5 q's on each... I also had a surprisingly dense number of Q's on muscle physiology ranging from extrafusal, intrafusal, GTO, etc. Very surprised on that end. Behavioral science was free Q's and FA was sufficient for that. Anatomy questions were so random that anymore time than one day reviewing the shoulder, brachial plexus, and leg would have been a waste... they were completely unpredictable and sporadically sprinkled throughout. Just a couple more notes:

Lowest yield subjects on my test (meaning 3-5 Q's on each): Embryo, Histo, General Path, Derm, Multi-Organ System Diseases.

Middle Yield (5-8 Q's on each): Hem/Onc, Anatomy, Neuroanatomy/Neuro, Psych, Rheum, Cell/Mol Bio, Musculoskeletal, Autonomics, Biochem (Diseases/RLS Enzymes/Vitamins).

Highest Yield (10-15 Q's on each): Repro, Renal, Endocrine (PTH/Ca, Ins-Gluc axis, Thyroid), Resp, Cardio, Behavioral, Immuno, Micro/Antibiotics.

Couple more notes about my actual test... I had 4 concepts that were repeated twice, a picture used twice, 5-6 q's straight from NBMEs and about 2/3 were either concepts I had seen in UW or Kaplan Qbank. There was about 3-5 questions on each section that I marked, came back to, and made an educated guess... and about 1-2 questions that I had no idea what to do with or why in the hell they wasted a question pimping me with this crap. Oh well. I also couldn't tell what questions were the test questions and which were trial like some people have posted on here... I only had about 2-3 that I could tell were newer and were definitely under construction just because of the phrasing or answer choices, etc.

I walked out feeling OK. Each section I finished in 45-50 minutes and I marked 7-10 questions from each. I made about 5-6 dumb mistakes that I'm aware of... primarily on questions where the presentation was just a slight variation from the normal or in more depth than I had ever seen and I second guessed myself. So I'm guessing I didn't do as well as I did on the UW, but who knows. I took two breaks of 20-30 minutes each... I did 3 sections, break, 2 sections, break, 2 sections. So, for now, I'm just crossing my fingers and we'll see... hoping for the best! I'll check back in on this thread if anyone has questions or would like to follow up. I'll be around.

 

[remo]

Hey gsmithers68 - thanks for the great feedback. Just curious what % you were getting in UW towards the end.

 

[gsmithers68]

Hey gsmithers68 - thanks for the great feedback. Just curious what % you were getting in UW towards the end.

I had a cumulative 72% with 75% average for the last two weeks or so. I think... I had a couple outliers on either side, but that's my best guess. I did the qbank on complete random and timed. No repeat questions and all 48 block sections.

 

[remo]

I had a cumulative 72% with 75% average for the last two weeks or so. I think... I had a couple outliers on either side, but that's my best guess. I did the qbank on complete random and timed. No repeat questions and all 48 block sections.

From reading all the reviews that 75% number in UW seems to be the target for hitting 260+. I'm sure you crushed the real deal!

 

[gsmithers68]

From reading all the reviews that 75% number in UW seems to be the target for hitting 260+. I'm sure you crushed the real deal!

Ah I overthought and made some dumb mistakes honestly... I'll be happy with a 240... I got caught off guard by presentation of stuff I had seen but presented just slightly different or with a couple extraneous tid bits to throw you off a little. When you are taking the test, just always remember to ask yourself what they are really looking for from the question...

 

[rabbitsfeet777]

My stats are almost exactly like yours. Had Uworld 72% and 260+ on UWSA and NBME 3 close to test day. I thought the test was pretty tough. I mark questions pretty heavily though. I mark any question I'm not 95% sure about. So usually anywhere from 10 to 22 questions were marked on each block. I have absolutely no clue how this went, but I too really hope I broke 240 mark. I will know on Wed.

 

[cgscribe]

I can promise you guys broke 240 on the real deal. Getting that high on those practice tests is really solid and your %'s are solid.

 

[THE armada]

Ok...

So here is my experience... took the test yesterday. I studied for about 7 weeks... primary sources were DIT, FA, RR Path, HY Neuro Anat, HY Behavioral Sci, HY Embryo, BRS Phys, BRS Biochem. I used FA as my primary book and then made annotations of high yield info in the margins. I also photocopied pages and when I debound my first aid and put into a 3-ring binder, I put the pages into the FA too that way I could go through a book once, take what I wanted from it, and consolidate information. Here were my numbers...

CBSE Exam (6 weeks out) 240
NBME 1 (5 weeks out) 240
NBME 6 (3 weeks out) 247
NBME 5 (2 weeks out) 251
UW 1 (1 week out) 256
UW 2 (3 days out) 264

So, I studied in a little different way than most I think... I did Doctors In Training for 2 weeks at the beginning as my first pass through FA and additional information gathering... After the 5 hours of lecture I read the corresponding section in either RR Path or BRS biochem. I spent the next 2 weeks compiling information from all my other sources I listed... making annotations in my FA on anything my filter decided was either pertinent or high yield. Then for the last two weeks I did two more passes front to back on FA looking over my notes... with one day on general anatomy and another on general neuro. I got 65% through Kaplan Q Bank and finished USMLE World... I averaged about 100 Q's a day I'd say, maybe more towards the end... I was doing 150 or so a day towards the end.

After taking the first NBME I realized that the primary emphasis on this test was going to be diseases and pathophysiology of the primary UNITED STATES problems. So I spent extra time focusing on obesity, DM, CVD, etc. The big topics that are rampant in our healthcare system. I would like to reiterate that my hunch held true for this test too. I had ABSOLUTELY ZERO questions that began with a Russian immigrant or a person from the Far East, etc. I had a ton of questions on all the big time problems in healthcare right now. My quote questions all had to do with presenting bad news or talking to young adolescents about smoking or sex. The pharm was cake and freebees if you do UW... that qbank really preps you for any pharm that they could possibly throw at you. The pathophys segment of the test is tricky, but I thought it was not as many third order questions as UW... lots of 2nd order, but I really had only a handful of third. Pathology was honestly not nearly as in depth as Goljan, but I was glad I read RR for the pathophys because that's really what it helped for... BRS phys saved my $%^ for respiratory and renal physiology which I had at least 5 q's on each... I also had a surprisingly dense number of Q's on muscle physiology ranging from extrafusal, intrafusal, GTO, etc. Very surprised on that end. Behavioral science was free Q's and FA was sufficient for that. Anatomy questions were so random that anymore time than one day reviewing the shoulder, brachial plexus, and leg would have been a waste... they were completely unpredictable and sporadically sprinkled throughout. Just a couple more notes:

Lowest yield subjects on my test (meaning 3-5 Q's on each): Embryo, Histo, General Path, Derm, Multi-Organ System Diseases.

Middle Yield (5-8 Q's on each): Hem/Onc, Anatomy, Neuroanatomy/Neuro, Psych, Rheum, Cell/Mol Bio, Musculoskeletal, Autonomics, Biochem (Diseases/RLS Enzymes/Vitamins).

Highest Yield (10-15 Q's on each): Repro, Renal, Endocrine (PTH/Ca, Ins-Gluc axis, Thyroid), Resp, Cardio, Behavioral, Immuno, Micro/Antibiotics.

Couple more notes about my actual test... I had 4 concepts that were repeated twice, a picture used twice, 5-6 q's straight from NBMEs and about 2/3 were either concepts I had seen in UW or Kaplan Qbank. There was about 3-5 questions on each section that I marked, came back to, and made an educated guess... and about 1-2 questions that I had no idea what to do with or why in the hell they wasted a question pimping me with this crap. Oh well. I also couldn't tell what questions were the test questions and which were trial like some people have posted on here... I only had about 2-3 that I could tell were newer and were definitely under construction just because of the phrasing or answer choices, etc.

I walked out feeling OK. Each section I finished in 45-50 minutes and I marked 7-10 questions from each. I made about 5-6 dumb mistakes that I'm aware of... primarily on questions where the presentation was just a slight variation from the normal or in more depth than I had ever seen and I second guessed myself. So I'm guessing I didn't do as well as I did on the UW, but who knows. I took two breaks of 20-30 minutes each... I did 3 sections, break, 2 sections, break, 2 sections. So, for now, I'm just crossing my fingers and we'll see... hoping for the best! I'll check back in on this thread if anyone has questions or would like to follow up. I'll be around.

How was the test on pharm?

 

[theophylline]

Ok...

So here is my experience... took the test yesterday. I studied for about 7 weeks... primary sources were DIT, FA, RR Path, HY Neuro Anat, HY Behavioral Sci, HY Embryo, BRS Phys, BRS Biochem. I used FA as my primary book and then made annotations of high yield info in the margins. I also photocopied pages and when I debound my first aid and put into a 3-ring binder, I put the pages into the FA too that way I could go through a book once, take what I wanted from it, and consolidate information. Here were my numbers...

CBSE Exam (6 weeks out) 240
NBME 1 (5 weeks out) 240
NBME 6 (3 weeks out) 247
NBME 5 (2 weeks out) 251
UW 1 (1 week out) 256
UW 2 (3 days out) 264

So, I studied in a little different way than most I think... I did Doctors In Training for 2 weeks at the beginning as my first pass through FA and additional information gathering... After the 5 hours of lecture I read the corresponding section in either RR Path or BRS biochem. I spent the next 2 weeks compiling information from all my other sources I listed... making annotations in my FA on anything my filter decided was either pertinent or high yield. Then for the last two weeks I did two more passes front to back on FA looking over my notes... with one day on general anatomy and another on general neuro. I got 65% through Kaplan Q Bank and finished USMLE World... I averaged about 100 Q's a day I'd say, maybe more towards the end... I was doing 150 or so a day towards the end.

After taking the first NBME I realized that the primary emphasis on this test was going to be diseases and pathophysiology of the primary UNITED STATES problems. So I spent extra time focusing on obesity, DM, CVD, etc. The big topics that are rampant in our healthcare system. I would like to reiterate that my hunch held true for this test too. I had ABSOLUTELY ZERO questions that began with a Russian immigrant or a person from the Far East, etc. I had a ton of questions on all the big time problems in healthcare right now. My quote questions all had to do with presenting bad news or talking to young adolescents about smoking or sex. The pharm was cake and freebees if you do UW... that qbank really preps you for any pharm that they could possibly throw at you. The pathophys segment of the test is tricky, but I thought it was not as many third order questions as UW... lots of 2nd order, but I really had only a handful of third. Pathology was honestly not nearly as in depth as Goljan, but I was glad I read RR for the pathophys because that's really what it helped for... BRS phys saved my $%^ for respiratory and renal physiology which I had at least 5 q's on each... I also had a surprisingly dense number of Q's on muscle physiology ranging from extrafusal, intrafusal, GTO, etc. Very surprised on that end. Behavioral science was free Q's and FA was sufficient for that. Anatomy questions were so random that anymore time than one day reviewing the shoulder, brachial plexus, and leg would have been a waste... they were completely unpredictable and sporadically sprinkled throughout. Just a couple more notes:

Lowest yield subjects on my test (meaning 3-5 Q's on each): Embryo, Histo, General Path, Derm, Multi-Organ System Diseases.

Middle Yield (5-8 Q's on each): Hem/Onc, Anatomy, Neuroanatomy/Neuro, Psych, Rheum, Cell/Mol Bio, Musculoskeletal, Autonomics, Biochem (Diseases/RLS Enzymes/Vitamins).

Highest Yield (10-15 Q's on each): Repro, Renal, Endocrine (PTH/Ca, Ins-Gluc axis, Thyroid), Resp, Cardio, Behavioral, Immuno, Micro/Antibiotics.

Couple more notes about my actual test... I had 4 concepts that were repeated twice, a picture used twice, 5-6 q's straight from NBMEs and about 2/3 were either concepts I had seen in UW or Kaplan Qbank. There was about 3-5 questions on each section that I marked, came back to, and made an educated guess... and about 1-2 questions that I had no idea what to do with or why in the hell they wasted a question pimping me with this crap. Oh well. I also couldn't tell what questions were the test questions and which were trial like some people have posted on here... I only had about 2-3 that I could tell were newer and were definitely under construction just because of the phrasing or answer choices, etc.

I walked out feeling OK. Each section I finished in 45-50 minutes and I marked 7-10 questions from each. I made about 5-6 dumb mistakes that I'm aware of... primarily on questions where the presentation was just a slight variation from the normal or in more depth than I had ever seen and I second guessed myself. So I'm guessing I didn't do as well as I did on the UW, but who knows. I took two breaks of 20-30 minutes each... I did 3 sections, break, 2 sections, break, 2 sections. So, for now, I'm just crossing my fingers and we'll see... hoping for the best! I'll check back in on this thread if anyone has questions or would like to follow up. I'll be around.

This is a very detailed post, thanks. It seems that many are reporting an emphasis on repro. and a handful of questions from the NBMEs.

You began with a 240 heading into the study period. What kind of curriculum does your school use in the first two years? It's interesting and somewhat ironic but many of the upper tier schools are at a disadvantage relative to some Board-oriented schools because of the former's emphasis on clinical medicine and not basic science.

Another thing that strikes me going through both USMLEWorld and Kaplan Qbank is how similar some of their questions are. Do they update their banks according to student feedback? Obviously the NBMEs serve as a huge foundation for UW, Kap, Rx, and the others, but there must be some mechanism for updating the questions.

How about the USMLE practice exam? Did anyone find utility in that?

 

[cgscribe]

"It's interesting and somewhat ironic but many of the upper tier schools are at a disadvantage relative to some Board-oriented schools because of the former's emphasis on clinical medicine and not basic science."

--UCSF kind of has his reputation, so I thought I'd comment. Our school's curriculum is very clinically oriented, which makes some boards studying extra hard (the rote memorization biochem, and a lot of the pathology syndromes that are total memorization), but also helped in lots of different areas too. Bottom line, regardless of your school's curriculum, you can do excellent on boards given the right amount of time and preparation.

"Another thing that strikes me going through both USMLEWorld and Kaplan Qbank is how similar some of their questions are. Do they update their banks according to student feedback? Obviously the NBMEs serve as a huge foundation for UW, Kap, Rx, and the others, but there must be some mechanism for updating the questions."

--I think it's a mix of student feedback but also the fact that there's only so much you can ask on boards. Granted, there's a lot of total information, but it's still limited. And after going through FA several times, and an entire q-bank, you've definitely seen most questions/topics and the different ways it can be assessed. This is another reason why doing tons of questions is advantageous.

How about the USMLE practice exam? Did anyone find utility in that?

--If you're referring to the free 150, there's some utility. The consensus seems to be that the questions are very high yield topics, but most are a little easier compared to the real boards exam. I would try and get my hands on any NBME questions you can, just because as I said, more questions seen = big advantage.

 

[jackbauer]

It's interesting and somewhat ironic but many of the upper tier schools are at a disadvantage relative to some Board-oriented schools because of the former's emphasis on clinical medicine and not basic science.

Would you be willing to elaborate? You may be correct, I have no idea, but I would have expected that the upper tier schools would have a greater emphasis on basic science because they have so many researchers who know the basic science well, vs. an unranked school where they might be taught by a greater number of clinicians who do not simultaneously run a bench lab. I've only been at one school so I don't know how to compare...

Separate question: I've seen a lot of posts that 70% on Uworld or Qbank is about right for a 240 (Kaplan's score estimator says 242), but the Qbank overall user's average is ~60% and 70% right on World is around the 75th percentile or so compared to other World testers, so I'm just wondering if anyone has a good explanation for this? All I can come up with is that people reuse questions (higher percent 2nd time around), only people who really want a high score use these question banks (seems unlikely but I certainly don't have evidence), or I am not destined to be a professional statistician (quite possible).

 

[Deferoxamine]

Anyone ever do 7 timed sets of 48 (unused) on Kaplan as a bit of a practice test? If so, how closely did your percentage follow how you did on the real thing?

I got 67% today on the 336 total. Right now I'm 6 weeks out from the test and am wondering what to make of this score.

Thanks in advance.

 

[Knucklehead]

Would you be willing to elaborate? You may be correct, I have no idea, but I would have expected that the upper tier schools would have a greater emphasis on basic science because they have so many researchers who know the basic science well, vs. an unranked school where they might be taught by a greater number of clinicians who do not simultaneously run a bench lab. I've only been at one school so I don't know how to compare...

Separate question: I've seen a lot of posts that 70% on Uworld or Qbank is about right for a 240 (Kaplan's score estimator says 242), but the Qbank overall user's average is ~60% and 70% right on World is around the 75th percentile or so compared to other World testers, so I'm just wondering if anyone has a good explanation for this? All I can come up with is that people reuse questions (higher percent 2nd time around), only people who really want a high score use these question banks (seems unlikely but I certainly don't have evidence), or I am not destined to be a professional statistician (quite possible).

some schools don't teach towards the boards because (1) they feel like they shouldn't have to and (2) they want to prepare the students for the wards. Clerkship directors complain to the basic science profs if the third years hit the wards with a poor fund of knowledge.

as for UW %age, don't worry about it unless its really low. Just keep truckin and redo the Qs if you can, especially the ones you miss. Do as many questions as you can handle.

 

[mikkey]

Hey Knuklehead,
Did you follow a specific schedule? If so, would you mind posting it?
Thanks!

 

[Teee]

wrong thread, my bad.

 

[theophylline]

Ok...

After taking the first NBME I realized that the primary emphasis on this test was going to be diseases and pathophysiology of the primary UNITED STATES problems. So I spent extra time focusing on obesity, DM, CVD, etc. The big topics that are rampant in our healthcare system. I would like to reiterate that my hunch held true for this test too. I had ABSOLUTELY ZERO questions that began with a Russian immigrant or a person from the Far East, etc.

Thanks again for your post. What kind of resources did you use to cover the major topics in US healthcare? Robbins I can see to some degree, and perhaps a NEJM article or two might be fairly good-yield. Any other nice sources for covering these issues?

Also, this is the first time I'm hearing of Doctors in Training. How did you like it?

 

[SouthernSurgeon]

Thanks again for your post. What kind of resources did you use to cover the major topics in US healthcare? Robbins I can see to some degree, and perhaps a NEJM article or two might be fairly good-yield. Any other nice sources for covering these issues?

Also, this is the first time I'm hearing of Doctors in Training. How did you like it?

Unless you have a LOT of time to study, trying to read through Robbins as board prep is probably not going to work too hot...and trying to gather together a bunch of NEJM reviews might similarly be kind of a low yield use of time, IMHO.

I didn't even think of trying to prep extra for "US healthcare" questions.

 

[gsmithers68]

Unless you have a LOT of time to study, trying to read through Robbins as board prep is probably not going to work too hot...and trying to gather together a bunch of NEJM reviews might similarly be kind of a low yield use of time, IMHO.

I didn't even think of trying to prep extra for "US healthcare" questions.

What I was trying to say is that you should think about that when you are studying... spend the most time on those concepts which are very apparent in our healthcare system like obesity, CVD, MI's, COPD, DM, etc. Those are the highest yield sections of each organ system, that's what I was trying to say.

And I actually read Robbins front to back during my 2nd year for each organ system... it was definitely the best source of information for the boards and goljan just reinforced the information and added clinical info/pathophys. I would highly recommend the first 7 chapters for the boards... I had maybe 15 questions on intro path concepts and on random cellular detail that can be found in those first chapters. That is the one area RR Path really doesn't hit in the greatest detail.

Also, in reference to pharm, as someone posted earlier... This test was not challenging on pharm for 90% of the questions on my test. They were very straight forward as others have said. Especially if you have done the intense UW pharm questions that really hammer down concepts in 3rd order fashion. The one area that the step is very hard in is physio. That was by far the most difficult area on the test IMHO... It was very complex and involved tons of arrows so you really had to know what you were talking about... UW was equivalent in terms of difficulty.

 

[gsmithers68]

Also, this is the first time I'm hearing of Doctors in Training. How did you like it?

http://forums.studentdoctor.net/showthread.php?t=517212

 

[SupaManu]

What I was trying to say is that you should think about that when you are studying... spend the most time on those concepts which are very apparent in our healthcare system like obesity, CVD, MI's, COPD, DM, etc. Those are the highest yield sections of each organ system, that's what I was trying to say.

And I actually read Robbins front to back during my 2nd year for each organ system... it was definitely the best source of information for the boards and goljan just reinforced the information and added clinical info/pathophys. I would highly recommend the first 7 chapters for the boards... I had maybe 15 questions on intro path concepts and on random cellular detail that can be found in those first chapters. That is the one area RR Path really doesn't hit in the greatest detail.

Also, in reference to pharm, as someone posted earlier... This test was not challenging on pharm for 90% of the questions on my test. They were very straight forward as others have said. Especially if you have done the intense UW pharm questions that really hammer down concepts in 3rd order fashion. The one area that the step is very hard in is physio. That was by far the most difficult area on the test IMHO... It was very complex and involved tons of arrows so you really had to know what you were talking about... UW was equivalent in terms of difficulty.

What would you recommend using for physiology?

 

[gsmithers68]

What would you recommend using for physiology?

I used BRS Physio and I thought it was very good prep. I've heard the Kaplan Phys section is good. The FA is OK for phys, but this is one of those subjects that I, at least, felt like 'I knew really superduper well because I'm a 2nd year and I pwned 1st year stuff' but in reality, I had to review this material pretty thoroughly lol.

 

[theophylline]

Unless you have a LOT of time to study, trying to read through Robbins as board prep is probably not going to work too hot...and trying to gather together a bunch of NEJM reviews might similarly be kind of a low yield use of time, IMHO.

I didn't even think of trying to prep extra for "US healthcare" questions.

At this point I need to work on those +1 point options that take some extra time. Robbins, by the way, is perhaps the most useful preparatory source for the Boards and you may be underestimating its utility if you think it is low-yield. Reading chapters is too time-consuming during the final prep period, but using it to clarify diseases that you do not understand is critical. If you are continually memorizing and forgetting the characteristics of a disease, one read of it through Robbins will help to solidify your foundation and I bet you won't forget again (at least, before your exam).

 

[rabbitsfeet777]

251/99!!

NBME 3: 260
UWSA1: 261
UWSA2: 264
UW (100%): 72% fist time (timed/random)

 

[Skillz2]

Hi!
I've been silently reading for a few months now on this great forum and after I got my score today I thought I wanna contribute and thank everyone for all those great hints! You guys are awesome!
I'm a foreign student from Germany (so please ignore spelling and grammar mistakes 😉 ) and took the test 3 weeks ago:

official score: 256/99

NBME 3 (2 weeks out): 249
free 150 Qs: 87%
UWorld: 69% (100% complete) mostly untimed and sorted by subject which I would study at that time

Preparations:
Basically I used taus method (thank you!) and modified it a bit according to my weaknesses (path micro genetics). Used BRS Phys, CMMRS, HY behavioral science, hy molecular (2nd edition was absolutely worthless!), Goljan path and of course FA and UW.
I studied 11 weeks in total, starting with about 4 h/day and finishing with about 10h/day (I never thought I could study that much on one day. BUt UW made that possible. Everytime I thought I had everything covered on a subject, there would be another tricky question which I got wrong. I was getting so mad I sometimes almost wanted to throw my computer out the window! I hated it, but it seems that it serves its purpose 😀 )

About the test itself:
First of all, I've never taken a test which made me freak out like this one! I personally think that your score depends a lot on whether you can deal with the stress. When I took the first ~20questions on my first block I was so nervous, I couldn't even read the qs properly and only stared at the answers and at the clock which seemed to be racing against me! But after taking a few deep breaths, I got my clear mind back and things started to run more smoothly.

From what I remember, there were a whole lot of easy, straightforward qs in each section . Especially those with long stems are mostly given away within 1 or 2 sentences towards the end of the question, so don't bother with all those comorbidities they give you in the beginning. Pharm was mostly straightforward as was micro. There were a few tricky anatomy, phys and path qs but most of it was doable.
I thought genetics and biochem/immuno were the hardest subject. I had a whole bunch of immuno qs about some strange cd markers and stuff like that I had never read about in FA or UW. And behavioral science was pretty tough too.
Those strange(experimental?) qs and a few silly mistakes I had made (which I discovered during breaks) stuck in my mind and I went out there feeling totally crappy. I thought the test was wayyy harder than the free 150 qs or the NBME I took and I had a feeling I would be lucky with a 220 (my goal was 235). I got a BIG surprise today when I opened my score report 🙂))