Official 2010 USMLE Step 1 Experiences and Scores Thread

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FMD212

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Good luck all. I have my exam end of March and hope to be the 1st one to post here for 2010.

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I have bad news for you, Real Name. I have it on good authority that everyone who scored a 250 or higher is planning on applying to the same residency programs as you. Also, program directors have now decided that things such as grades, research, letters, and extracurriculars are no longer important and will be basing their rankings based solely on Step 1 scores. Interviews will now consist solely of a single question, namely, asking you directly "What did you get on Step 1?" so they can confirm that there isn't a typographical error on your residency application. It's over man.... I'm so sorry.
 
We should totally create CAGE questions for these types on SDN!

Have you ever felt you should cut down on your Step 1 score obsession?

Have people ever annoyed you by criticizing your neuroticism?

Have you ever felt bad or guilty about your score?

Do you need an eye opener to shut up about your score?

hahaha...thanks for making me laugh this early in the morning :laugh:
 
247 - I am a little disappointed. I feel like this is a low score. I should've gone through FA one more time . . .

I have a friend who scored around a 247 also, and he had a lot of success in the scramble getting a psych spot. gl

edit: okay, sorry... I know we're totally beating you up over this, but it's only because we're jealous. :) Keep in mind that you're in the >90th percentile!
 
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I have a friend who scored around a 247 also, and he had a lot of success in the scramble getting a psych spot. gl

edit: okay, sorry... I know we're totally beating you up over this, but it's only because we're jealous. :) Keep in mind that you're in the >90th percentile!

Don't encourage his denial. The sooner he accepts the fact he'll be doing rural family medicine, the better.
 
I guess I should update this for completeness's sake.
MilkmanAl said:
Okay, let's write this up the proper way now that I'm not completely exhausted.

Study materials:
RR Path
UW
FA
BRS phys
BRS gross (chapter summaries only!)

In truth, my studying started 2 months ago with the subject NBMEs which serve as finals for us. I did all the M2-related UW questions plus all the biochem questions by subject during those 2 weeks. After that, I started doing a Taus pass by organ system with the gross BRS chapter summaries thrown in where appropriate. I did a block or two of UW questions between each source so that I'd get some active learning going on. That took about 3 weeks of ass busting to get through, and then I took UWSA1 to see how I was doing. After that, I read through FA from cover to cover and got through half of Goljan's margin notes before deciding I was burnt out on reading. I started doing USMLERx questions, but after so much experience with UW, those were just insufferable. I had to quit after about 8 blocks or so. That all took a little more than a week, and NBME7 was next on the chopping block. Next, A full run through of UW in random blocks followed by a FA review of some subjects I'd noted along the way, UWSA2, and another FA run through those same subjects. I took the day before the test off completely and rotted my brain with soccer and CoD: Modern Warfare 2.

Practice tests (helps with the timeline considerably, if that's something you're curious about):
CBSE: 193 (mid-March or so)
Free 150: 82%/243 (early May)
UWSA1: 230 (5/30)
NBME 7: 249 (6/8)
UWSA2: 247 (6/18)

Real deal: 228

UW percentage: 68 overall after 3 passes, 85-ish on the last pass

In general, the test was exactly what I expected. There were quite a few easy questions, several that I could easily narrow down to 2 answers, a few more that you could get correct if you knew enough about the answer choices but didn't necessarily know the answer after reading the stem, and maybe 2-3 per block that I was just totally clueless on. The worst of those was one that had a solid 9-10 lines of text describing a baby with botulism in painful detail. The whole time, I was thinking, "Okay, it's botulism - just have to read through this to make sure I don't miss some weird twist in the question." At the end, it tells you the baby has botulism. To avoid giving anything away, I'll just say that it ends up being a very specific molecular biology question. there were also a few questions that were just plain written terribly. One of them was a two-sentence question regarding antigen presentation (I think...) that I literally spent a good 10 minutes staring at. It pissed me off that I couldn't figure out WTF they were trying to ask because chances were that I knew the answer. I'm hoping those were experimentals that they'll take back to the drawing board.

In terms of difficulty, NBME7 is a great example. I'd say the real thing is a bit harder than that by virtue of the crazy left field questions, but for the most part, it's close enough. The stems are no longer than anything in UW or NBME7, so don't worry a bout that at all. I still had plenty of 1-3 sentence questions. In fact, I'd say most of them are short paragraphs or less. There were very few of the 8+ line monsters some people have been crying about, and most of those were so full of info that you'd have to be comatose to get the question wrong unless they decided to be douchebags and ask you, say, a molecular bio question about the condition at hand. *ahem* There were at least 2 questions taken directly from NBME7 and several taken almost verbatim from UW. Still more were UW questions with slightly different wording. The format of the test is exactly like UW.

In case it wasn't clear from those last couple sentences, UW was very clearly the most important study tool I used. Nothing even came close to being as useful, in my opinion. FA and Goljan are still excellent and indispensable, but UW is the star of the show. BRS phys was definitely nice to have, and given that the gross BRS chapter summaries took next to no time to read, it was also helpful. I'd recommend all of those. I definitely liked the source/questions alternation I used throughout my studying. That really helped me a lot.

The gritty details of the test by subject:

Anatomy: My favorite. Like I said above, it definitely sounds like there was more on this new version than there has been historically, but there still wasn't a lot. I'd say I had around 20-25 on the whole test. Most of them were pretty easy even for someone like me who really couldn't give less of a **** about the subject, but some were hard. Realistically, the BRS, FA, and UW are more than sufficient for the anatomy. If you can't get the question from those plus what you recall from class, you weren't going to get it anyway.

Embryo: Maybe 4-5 questions on the whole exam, all of them super easy except one CT scan. CT's look like a jumbled mass of crap to me anyway, but when you're asking me to pick out some GI malformation, there's no chance in hell. Seriously, you don't even need FA for this. If you have the big stuff down (genitals, heart, neural tube), you'll be fine.

Cell bio: Probably 10-ish questions, all told. I recall them being above-average in difficulty, but cell is another subject I really just do not care about and never did. It's one (and probably the only) area that really isn't adequately covered in any of the main sources, in my opinion. You'll need something else if you're trying to scrap for the 3-4 extra questions knowing cell inside and out will get you.

Phys: BRS is money. I didn't have very many straight phys questions, but the ones I did have were pretty much just common sense if you have a bit of background. Heart phys was big for me.

Biochem: 3-4/block or so. Most were straightforward enzyme or cofactor questions. UW is a hell of a lot harder than the real thing, for the most part, but the question style is pretty much the same.

Histo: I don't think I had any unless you want to count path slides, in which case there were a few. Fewer than 10 on the exam, and most were pretty obvious.

Neuro: I was going to report that I had next to no neuro on my exam, but now that I think about it, there was quite a lot. There were maybe 3 neuroanatomy questions which I could tell were pretty easy (Here's a brainstem. Which one is the facial nerve?) but I just missed. Like I said, if you want to get those, you need a neuro atlas. The rest was mostly vision and seizure stuff. Know your neuro micro well, for sure. Cranial nerve lesions are a big deal, too, as you might have guessed. For everything that isn't neuroanatomy, the usual offenders are just fine.

Micro: FA plus UW is golden. Seriously, if you know those two sources decently, you will murder the micro on Step 1. At least on mine, most of the micro was buzzword-related, so all those cheesy groupings FA has are gold. In general, know unique symptoms and other distinguishing factors.

Pharm: Second messengers! I had a lot of ACE inhibitor questions, too. It's all pretty easy, for the most part, but make sure you know your recombinant antibodies.

Path: Not nearly as much as I'd anticipated. I'd say it accounted for maybe 30-35% of the questions. That's obviously still a lot, but it isn't the >50% SDN led me to believe would be on there. Goljan is priceless. FA is meh. UW is great for solidifying Goljan and giving some extra details.

BS/Ethics: Man, I had some hard questions. There's also a lot of this stuff. I didn't think there's be anywhere near as much as there was. I probably had 5 questions per block, and most of them lacked the obvious feel-good answer choice. I was not pleased. I'd counted on these being a source of easy points, but it was anything but that. I honestly don't think there's any way to prepare for this stuff. Just go in knowing the basics of patient interaction (which FA covers just fine) with the mentality that choosing the carebear answer is almost always the best way to go, and hope for the best.

Biostats: Awesome! 3-4 per block, and I loved every minute of it. These questions are EASY with a capital high school cheerleader. Some may disagree, but man, med (read: middle) school math on a test of this magnitude is like the USMLE question writers coming out of the Prometric office and offering you sexual favors during your exam. Seriously, these are points just handed to you on a silver platter. The biostats portion of FA is quite literally the highest yield thing you can possibly study. All of it WILL be on the test. Of the dozen-ish people who took the test with me yesterday, every single one of them had a question over each of the main biostats concepts (sensitivity/specificity, normal distributions, study design, risk, etc.). Know this cold.

The moral of this story is that you could do a lot worse than memorizing UW to the question. Again, it was far and away the most useful study tool I had, and there were numerous question ripped from it. I'm incredibly glad I saw all of it 3 times. A fourth pass certainly would not have hurt at all.

I think that's about it. If I left anything out, let me know. Good luck to everyone taking the beast soon!
My true blue score, 228, is bolded. I really couldn't tell you what happened. Like I said, I didn't think I hit my practice scores, but the test really didn't feel all that difficult to me - maybe just a little worse than NBME 7. Maybe I made bad educated guesses? Got an unusually large percentage of experimental questions correct? Just had a bad test and/or bad question draw and didn't know it? All of the above? Whatever. It's good enough for what I want to do (anesthesia or possibly PM&R in some Midwestern city), so I'm not going to bum too much about it. I'd be totally full of crap if I told you I wasn't disappointed, though. Dropping a standard deviation from practice tests was not at all what I was expecting, and it's pretty tough to keep at bay that nagging thought that I essentially wasted my study time after UWSA1. Obladi oblada, life goes on. Congrats to everyone kicking the **** out of this test. Very impressive, indeed!
 
I guess I should update this for completeness's sake.
My true blue score, 228, is bolded. I really couldn't tell you what happened. Like I said, I didn't think I hit my practice scores, but the test really didn't feel all that difficult to me - maybe just a little worse than NBME 7. Maybe I made bad educated guesses? Got an unusually large percentage of experimental questions correct? Just had a bad test and/or bad question draw and didn't know it? All of the above? Whatever. It's good enough for what I want to do (anesthesia or possibly PM&R in some Midwestern city), so I'm not going to bum too much about it. I'd be totally full of crap if I told you I wasn't disappointed, though. Dropping a standard deviation from practice tests was not at all what I was expecting, and it's pretty tough to keep at bay that nagging thought that I essentially wasted my study time after UWSA1. Obladi oblada, life goes on. Congrats to everyone kicking the **** out of this test. Very impressive, indeed!

I'm sure that was tougher to deal with than you make it seem Milkman, but I'll tell you this: With a personality like you've got, I bet you could get in just about anything. Why do you think some of those 260+ people don't match while 200s do to the same program?
 
I'm sure that was tougher to deal with than you make it seem Milkman, but I'll tell you this: With a personality like you've got, I bet you could get in just about anything. Why do you think some of those 260+ people don't match while 200s do to the same program?

The reason is corruption. Are your parents program directors MilkmanAl?
 
I believe the word you're looking for is nepotism.

Lucky for you, knuckles was here to save the day!
 
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I used a modified Taus method since I didn't have 3+ months.

Gojan Audio
Goljan RR
Goljan Sildes
FA 2009
Micro made easy
USMLE-World

Get to school to start studying by 7:30
Uworld from 8:00-noon, 50 questions+review, 100Q+review for last 2 weeks.
Noon-1 break
Topic of the day: listen to gojan at 1.5x and follow along in his book and slides
5-6pm Break
Read FA and Gojan for the rest of the night until 9pm.

I made it through each section in the taus method in about 2 days and then did his 2 week scramble/cram method. The first day of a subject was mostly listening to Goljan and the second was reading. I didn't have time to annotate FA, I just read the relevant sections in FA and RR. I had 35 days from the end of school until my test. I was not a stellar student during years 1 and 2, average-ish or to the left on the bell curve compared to other students.


Practice exam at prometric 2 weeks from actual test date: 91%
Final Score: 248/99

Work your tail off and follow the Taus method (tweak it to your schedule). U-World is also awesome. Do at least 50 questions a day and keep at it even if you are not doing as well. Make sure to read the explanations for every question. This sucked big time but working hard and not goofing off when I was supposed to be studying (like right now as I type this) is the reason why I believe I did so well. You can too.

For 2nd years just starting out, get the Goljan book, audio files, slides, Micro made ridiculously easy, and FA now. Use these books to study during the year and you will be ahead of the game. Memorize each FA section during the year. When I did use Gojan's book during our pathophys sections my test scores went up.
 
218/92. I can't really justify feeling disappointed, since my score improved by more than 40 points from my first NBME (175) and my final score was better than my best NBME (216, taken 9 days before the test. None the less I'm disappointed. I hate having fewer options than other people. I mean, my top interests are family medicine and psych, so obviously my scores are fine for that, but I still hate feeling like I'm shut out of ortho before I've even rotated in it. Oh well.

I don't feel like looking up my exact progression of NBME scores, but it was a pretty linear rise from a 175 to a 218 over the course of a 9 week study period (2 weeks studying for finals + 7 weeks dedicated step one studying).

What I did:

weeks 1-2 (studying for finals): A rapid review of Goljan's book and Goljan audio for path, and the pharm review textbook for pharmacology. USMLERx and Uworld questions throughout the day. Took the weekend after finals off.

Weeks 3: Focused review of Microbiology using flash cards, FA, MicroRecall, and USMLERx questions. 48 random/timed UWorld questions/day

Weeks 4-6: First pass of FA, with a particular emphasis on biochem (3.5 days dedicated just to biochem). 48 random/timed UWorld questions/day + USMLERx questions if I was feeling weak in that particular subject. Did an NBME about midway through. Took the weekend off at the end of week 6.

Weeks 7-9: Second pass of FA with DIT. 48 random/timed UWorld questions/day. NBMEs during the first two weekends. Used the weekends to go through the last couple of chapters I didn't have time to review during my pass of FA. I always finished my first pass before I reviewed again with DIT.

Last 3 days before the test: rapid review of embryo, biochem, and pharm. Finished UWorld the day before the test. Slept VERY badly the night before, which I still regret, but honestly I felt pretty focused on test day.

Test day itself: Used all but 1 minute of my alloted break time. Took at least a 5 minute break between every block and one 15 minute break where I forced myself to choke down a lunch. Reviewed before the test but not during. Got three questions from that last minute review.

What I did that worked:

The obvious stuff: Finish UWorld, at least 2 passes of FA, Goljan text and audio.

Taking more time: I was told by several people that there was no point in using some of my vacation to study, and that if I couldn't get a score in 4 weeks I couldn't get it at all. Well, my NBME at the end of 4 weeks was still below 200, so I think that it ended up being a good investment.

Pharm recall: every single medical student should have a copy of this book. Microrecall was good but less high yield (FA is probably good enough).

Made flashcards out of the lysosomal storage diseases page in biochem and reviewed them every day. That 5 minute ritual got me half a dozen questions.

Forcing myself to exercise: every single day.

What might have worked:

DIT: I'm honestly not sure if doctors in training helped or hurt. On the one hand I'm not sure I could have worked nearly that hard during weeks 7-9 of step one studying withut that kind of structure. On the other hand it honestly was not the highest yield way to study. I would strongly recommend that no one with less than 6 weeks of dedicated study time use DIT. For everyone else it's 50/50.

What I wish I had done:

Reviewed: Everyone in my school told me that when I hit step 1 I would discover that I recalled much more than I thought, and shouldn't waste weekends/breaks doing review. Those people were wrong: I was a pretty good student and I clearly didn't retain much of anything. I strongly recommend that everyone set aside one afternoon a week, starting the second semester of first year, and review old topics using a Qbank and FA. This is particularly important for the subjects that are stright memorization: biochem, micro, and pharm. If those names go out of your head odds are you'll be starting from nothing when you start USMLE prep.

Another pass of Uworld: I only got through it once and I think that cost me points. I wish I had set aside one more week to run through the entire Qbank again.

The Kaplan videos: particularly for Pharm. I just never made the time.

HY Neuro: again, I just couldn't find the time to get it done.
 
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I'm sure that was tougher to deal with than you make it seem Milkman, but I'll tell you this: With a personality like you've got, I bet you could get in just about anything. Why do you think some of those 260+ people don't match while 200s do to the same program?
Wow, quite the compliment. Thanks! I doubt I've shot myself in the foot or anything, but it would've been nice to have a bit more say in where I matched. There's always Step 2, I suppose...

The reason is corruption. Are your parents program directors MilkmanAl?
No, but my dad's cousin is, and so is one of my parents' really close friends from high school. :D :p Both of them are PD's in places I'd like to go, incidentally.
 
247 - I am a little disappointed. I feel like this is a low score. I should've gone through FA one more time . . .

Don't be such a fool.

If you were being serious in that post, then you are an idiot. Your score is good enough to open the door to ANYTHING. And you are complaining? Pathetic.
 
I didn't mean to piss people off, it was a joke! I posted it because it seems like I am low compared to all of the 255+ on here. Thanks for the perspective. PS I am a female
 
218/92. I can't really justify feeling disappointed, since my score improved by more than 40 points from my first NBME (175) and my final score was better than my best NBME (216, taken 9 days before the test. None the less I'm disappointed. I hate having fewer options than other people. I mean, my top interests are family medicine and psych, so obviously my scores are fine for that, but I still hate feeling like I'm shut out of ortho before I've even rotated in it. Oh well.
Out of curiosity, how were your UW scores for your 1st pass? Did you do all timed random?
 
hey perrotfish-
i honestly want to say congrats though, you were really dedicated with your time, and i hope you get what you want! quick question-did you feel like your test was more uworld based or FA based? did you feel like maybe if you had done a 2nd pass at World it would've helped? best of luck with step 2! :)
 
hey perrotfish-
i honestly want to say congrats though, you were really dedicated with your time, and i hope you get what you want! quick question-did you feel like your test was more uworld based or FA based? did you feel like maybe if you had done a 2nd pass at World it would've helped? best of luck with step 2! :)

Thanks. I'm honestly not sure how to rank UWorld vs FA, they were both really important. Yes I do think a second pass of UWorld would have added 5-10 points, but I'm honestly not sure how I could have fit it in without dropping something else from my study routine. If I could have gone back and done it again I guess I would have done a less complete second pass of FA, skipping the sections I was stronger in, and would have done a second pass of UWorld instead, but who knows if that would have helped.
 
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hate having fewer options than other people. I mean, my top interests are family medicine and psych, so obviously my scores are fine for that, but I still hate feeling like I'm shut out of ortho before I've even rotated in it. Oh well.

A 218 is a not that bad of a score, compared to the average being around 220. Just don't shut your own doors even before you start applying to residencies. I am sure if you do decent on step 2, have glowing letters of rec, some real nice audition rotations, and good 3rd year/4th year Evals you can still do whatever you want.

Even someone with stellar board scores has to have the rest of the package to get their residency of choice. A 250 don't mean anything if you have absolutely zero social skills, don't know how to talk to a patient, and are ruder than Monique. I personally know plenty of residents that did not have real good board scores but are in Radiology, ER, Anes, Cardio, ENT, etc... They all had one thing in common they worked hard and busted their arse on rotations.
 
As a regular folk who absolutely killed this test, in large part due to advice I found here, I'm adding my two cents. This is very much so just what I did, but it worked beyond my expectations so hopefully it will for some of you as well.

1. I read through the ENTIRE 2009 Step 1 experience thread in Dec 09 before my June 10 test. I made a word doc compilation of the study plans of those people in the 240/250+ range, which I felt was achievable for me. I ignored the 260+ people as being superfreaks, which apparently, not all of them (holy **** US!) are - so I'd suggest taking a look at these as well. I was trying to cull the common factors, which ended up being a wide review of varying sources for first pass, but in almost EVERY case came down to core essentials of Goljan RR, Goljan audio, FA, UW. PERIOD, END OF STORY, dear god listen to this advice. Caveat being additional essential sources individual weaknesses, which I'll get into below. A few brave souls were able to do very well on some other plan, but why mess with proven success.

2. I made a schedule in January, starting in Jan, ending in June. I planned to take the test in June, with the last 4-5 weeks pure boards (classes were done) study period. During classes, I decided to do 1 basic science topic every week, then follow that with 1 week for each organ system, giving me one run through of everything before school got out in May and my study period began in earnest. After finding the 'Taus method,' I decided that 2 passes (once during school and once during study period) wouldn't be enough. So I condensed my in-school study schedule so that I got through all basic sciences and most organ systems TWICE between Jan and May (the organ systems which I had last, I didn't feel the need to harp on three times) and ONCE more during dedicated study time, for a total of 3 complete passes. This was followed by a 1 week final/superficial pass of everything. Lots o passes. I'll see if I can upload my schedule somehow…

3. Sources:
Goljan RR - used pretty much instead of Robbins during 2nd year. It's physically lighter, includes interesting micro in each chapter, and doesn't emphasis esoteric pulmonary interstitial diseases. I loved this book, used it from day 1 of organ systems, so should you. Some people have trouble with outline format, which I don't have an answer to. This is how review books are, at least this one has glossy photos too. I ended up reading through each chapter at least 2 times, most of them 3 times.

Goljan audio - convert it to a podcast in itunes, then play on double speed. You'll get used to it. Listened to each subject once while I studied it during the school year (with class), and at least once again while studying it for boards during school time or dedicated study period. On the bus, train, in the car, in the gym, in the shower - everywhere but sitting down at a desk. It's studying during time you’d be wasting anyway. You'll come to love/hate his transgressions, but by god, does the info get ingrained. I don't know why he doesn't sell this on his own, every single medical student would buy it every year.

FA - started using the 2009 in week 1 of 2nd year, so should you. Every word in every sentence is meaningful. I'm a speed reader who tends to gloss over detail which isn't helpful with a book like this. So repetition was absolutely key. I ALWAYS had it open to relevant subject matter when I was studying for class, regardless of topic. I read each chapter front to back, EVERY SINGLE WORD, the weekend before each block exam in second year. Doing it this way (every word) made me catch some things which I'd glossed over before. Sometimes I'd read aloud just to make sure I was doing it. Although I always had it open during the year, I made at least 3 dedicated straight reads through each chapter from Jan - June. I'm an FA purist, I didn't feel the need to add much of anything from other review books (besides BRS physio). Frankly, I think the authors are more familiar with the test than I am, so I'll trust that they know what to include or not. I did annotate from UW and practice tests, pretty much every UW question and only those I didn't know from practice tests. Plus some anatomy, which I felt was especially weak (can I get a leg diagram perhaps?)

UW - 2 passes. 1st time - 74%, subject based, mix of tutor and timed. I did each section according to what I was studying for class or boards during the school year. Started in Jan, finished about April I think. 2nd pass - 92%, random, timed. You'll remember some on this 2nd pass, most not really, make the same mistake twice, etc. I marked those I wanted to see again, and did all of those plus incorrect during my final week. I did all my incorrect until I had none. It was a lot, but worth it.

Other sources:
I think this is a bit discretionary depending on your style/strengths.

Biochem: I'd never taken a biochem course ever (including during med school) so this was an obvious weakness. I started with Lippencorts, which was too dense, moved to Goljan, which I just couldn't really understand having never taken it, then finally went after the true holy grail - Kaplan biochem. Which was worth it (ps, I'm selling it!) Granted it was my 3rd pass, but finally, FINALLY, I understood what the hell these cycles were. My test wasn't biochem heavy and one of the questions I know I got wrong was biochem, but after reading Kaplan, I got a star in that section on every practice test (plus the real deal) since. FA biochem sucks without context. It's ok to read through once you're solid, but it is entirely not helpful as a primary source. If you have this or some other major weakness, find it early, do it over and over and over, make it your strength. Because it will be on the test and even if you can afford to miss those questions, you cannot be psyched out by the knowledge that you have a weakness. You must be STRONG!

Anatomy: I used High Yield. Which worked out, but is tough to get through. Obviously know what's in first aid, plus pelvis from HY. Netter is also good for leg/arm anatomy. I thought FA's nerve dysfunction tables were horrible, HY is better for this.

Neuro: HY NA is what I used during my first pass, and then again for brain section pictures towards the end. WAYYYY too much detail regarding cerebellum, cranial nerves, etc. focus on BRAIN SECTIONS SPINAL CORD SECTIONS BRAIN SECTIONS. Also tumors, but I guess that's more path, for which Goljan is king.

Embryo: I bought HY new, which was a mistake in the sense that, although I had a lot of embryo on my test, I don't think I'd have been better off on the questions I got if I'd only studied embryo for 5 weeks. There were things I'd just never heard of and then those for which FA is fine.

Physio: BRS is all you need. Good for general 2nd year as well, I used to read it during the first week of each organ system. This is the one book I'd recommend annotating somewhat into FA, so that you don't have to keep rereading it. Some of the pathways, especially endocrine, that are lacking in FA are done very nicely in this book.

Micro: Microcards, CMMRS. I used microcards at the gym. Memorized FA. These critters are cool and interesting. Find a visual system/mnemonic to memorize the viruses. Just accept you have to do it and do it early, then reinforce. I got some really crazy bugs on my test that were in FA, but the detail just wasn't enough. Microcards saved me here.

Pharm: ugh, I hate you pharm. I went through all the drugs in FA and compiled them from pharm cards from 3 different store-bought packs I'd gotten through older friends. I bundled them by system, and drilled endlessly. Just has to be done, sucks for everyone. Mechanisms and side effects were big on my exam. Unfortunately, I don't think UW is enough because they just can't test every drug. Know antibiotics, antivirals, cholesterol, diabetes, autonomics, neuro drugs especially.

Behavioral: I used BRS and did all the questions I could find on biostats. My test was VERY biostats heavy, but mostly simple stuff. Please do not give these potentially easy points up. Just know the equations and practice them every chance you get.

Histology/Cell bio: I didn't really sweat this too much. I read HY Cell Bio 99 (also selling!!!!) as part of Taus, but most of this is 2nd messenger stuff which is now in FA pharm and endocrine sections (ps know that sh#t cold, it came up a lot). Know what blood/bone marrow smears look like. Goljan is great for lovely pictures of path.

School: We have pass/fail (thank you jesus) so tests are as stressful as you make them. They tend to test lecture material instead of textbook, which I have mixed feelings about. In any event, I shot for 1 SD above the mean on all the tests, which I hit fewer times than I missed, but I was always in the ballpark.

Mental prep: The attitude you bring to game day is a huge factor in performance. For the MCAT, I was consistently killing it on practice tests than mentally fell apart in panic during the test and got 4 points lower on the real thing (recall 4 points MCAT is like kind of a big deal). So I did not want that to happen again.

I studied for this test every single day (except 4 I took off for a wedding) from Jan 4-June 4. Some were 14 hour marathons, other days were just a practice test or a few hours of something. But I was consistent, stuck to my schedule and DID NOT PROCRASTINATE. In my experience, procrastination is my biggest stressor, so I just took it out the equation. During the school year, I was also able to work an 8 hr/week job and run a school club, but I didn't work out at all or have anything close to a social life at all. During dedicated boards prep time, I stopped working/extracurriculars and started exercising everyday and seeing friends once a week. This helped tremendously in lowering stress and reminding me that this test isn't the end-all-be-all of my existence.

I did yoga, breathing exercises, got myself a mantra that I was going to do the best I can, but no matter what, the result of a test would not determine the quality/happiness of my life. We all have a lot at stake here in terms of career aspirations, locations close to family/significant others, or whatever, but having come back from a disastrous undergrad experience, I know that you can't live and die by your failures and successes. Having my head on straight was absolutely HUGE in terms of my test day performance. I mentally prepared for seeing questions asking for things I had never heard of before, that I was going to get things wrong, and was not shooting for 100% on this thing. When I got those questions that were simply unknowable, I didn't perseverate. I tried to logically work things out, made my best educated guess and moved on. There is no point in beating yourself up for not knowing everything, it's just not helpful.

In terms of dates, I'd originally scheduled my test for a week later than I actually took it. When I got 2 250+ scores on practice tests before school got out, I decided to carpe the diem and moved my test up a week. At the time, I thought '250 is obviously good enough, no need to kill myself an extra 7 days for the 260+ when I can be lying drunk on a beach somewhere instead.' And oh how I laid drunk on that beach...

For sleep, I maintained a strict schedule and used zolpidem sparingly. I worked out a lot which also helped. I did use zolpidem the night before the test and slept well. I'd recommend figuring out something that works for you without hangover early, starting weeks before, so that you're not lying awake drilling yourself on causes of anion gap acidosis the night before the real thing.

Test day strategy: I scouted out a center off the beaten track for my med school, since I didn't want to be sitting next to someone who was going to psych me out/ask me about some question he'd gotten. I took my practice 150 there, for which I was honestly more nervous than the real thing. I HIGHLY recommend coughing up the $54 and taking your practice test at the center. Everything will be so much better the 2nd time around. I brought TONS of food and drinks, and had scheduled a get together with some non med school friends after. I brought FA as well. I took a break after every section, which gave me enough time to scarf some food/drink, pee, and look up questions in FA. The timing was tight, but it worked very well for me. Make sure you go to a center where you can eat in the reception area. I was so practiced with UW and practice test timing that I finished every section with 20+ minutes left, and was able to get through every question a 2nd time (not just the marked ones). I've realized that I often make mistakes on questions that I don't mark, so it's worth it to go through them all again if I have time. I first went through the marked ones (10-12 per block) then the others.

Practice tests:
This was overkill, but I didn't know it at the time, plus is was spread out over 6 months. I'd recommend doing at least NMBE 6,7 and UW 1,2. Tips: pay the extra $15 for feedback. You will be maddened by the inaccurate answer keys floating around the internet for the versions which don't have this option. They are so so so wrong on many questions. Go over those wo answer keys with a smart friend. As several people have noted, there were questions straight from NMBE 7 on my test. I'm pretty sure I got some UW ones as well. At the time I didn't put stock in free 150, UW as they were so much higher than my NMBE estimates, but in the end, these were the closest predictors.

March NMBE 2: 234
April NMBE 4: 242
April 150: 92% 264
May 1st week NMBE 5: 251
May 2nd week NMBE 3: 253
End of school/start of boards prep
May 3rd week UW1: 261
May 3rd week NMBE 6: 255
May 4th week UW2: 265
May 4th week NMBE 7: 255 (1 week before)

June 1st week REAL THING: 266

Good luck to you all.
 

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As a regular folk who absolutely killed this test, in large part due to advice I found here, I'm adding my two cents. This is very much so just what I did, but it worked beyond my expectations so hopefully it will for some of you as well.

Congrats on the score and thanks for going into so much detail. I plan to make at least 3 passes myself. Glad the hard work paid off for you.
 
Final Score: 206/85%

USMLE World average: 48%
NBME 4 (4 weeks before exam): 190
NBME 6 (2 weeks before exam): 198

Study Plan:
February – questions and some reading from First Aid and Doctors in Training (DIT) – wish I had done the questions every week from DIT instead of worrying about starting Qbank so early
March – more questions, finished first half of First Aid
April – mostly questions, finished second half of First Aid
May – Doctors in Training class
June – reviewed First Aid again and went through a small part of the DIT notebook, listened to some of Goljan Audio last minute
Kept all notes in a notebook and in First Aid for easy access.

Actions throughout med school:
Read Robbins as much as I could, which was probably about 50% of the reading assignments
Read some of Goljan pathology

Things I probably should have done:
Listen to Goljan Audio 2-3 times throughout the first two years
Read BRS pathology and physiology and do the questions in those books
Started studying with only books in February and March with a few questions that are provided in the books (The Taus method seems well planned and balanced. I wish I had discovered that method before the exam.)

I am a kinesthetic and visual learner and need to write the entire time I am studying. If I don't write and make pictures, I don't learn. This makes studying very exhausting and time consuming, so finding a good kinesthetic plan would have been really helpful. Also, test anxiety probably knocked off around 10-20 points in the end. If you have test anxiety, seek help in your first year of medical school and keep looking for resources until you find one that works. You may go through several counselors and feel frustrated, but it is well worth seeking a resolution.

I used USMLE World and found the format similar to the real exam. But, so many people said that they learned a ton while doing the questions. That is not how it worked for me. I spent much time doing questions and did not learn much from that. The questions built stamina, but for me, did not build knowledge. This is why I should have studied a lot more in February and March rather than focusing on questions.

I received an estimated score of 230 based on previous years data (numbers from about two months before the exam from past students), but I guess my studying did not go as well as the people who got 230s in the prevous year.

If you want a better score, do a lot of research about study methods and don't just do questions without much studying if you find that questions don't help you learn much. They are essential for stamina but may not be a valuable teaching tool depending on individual learning styles.
 
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I guess I should update this for completeness's sake.
My true blue score, 228, is bolded. I really couldn't tell you what happened. Like I said, I didn't think I hit my practice scores, but the test really didn't feel all that difficult to me - maybe just a little worse than NBME 7. Maybe I made bad educated guesses? Got an unusually large percentage of experimental questions correct? Just had a bad test and/or bad question draw and didn't know it? All of the above? Whatever. It's good enough for what I want to do (anesthesia or possibly PM&R in some Midwestern city), so I'm not going to bum too much about it. I'd be totally full of crap if I told you I wasn't disappointed, though. Dropping a standard deviation from practice tests was not at all what I was expecting, and it's pretty tough to keep at bay that nagging thought that I essentially wasted my study time after UWSA1. Obladi oblada, life goes on. Congrats to everyone kicking the **** out of this test. Very impressive, indeed!

With those practice scores, it's clear you know a ton more than the "real" score would suggest... meaning you'll kick ***** in rotations.
 
Well took it yesterday, it was the 46q version. Timing wasnt an issue at all really. There were plenty of very short and normal length vignettes, with some of the mixed in long vignettes. Some of the longer ones you didnt need the whole thing to answer but maybe 75% of them you did (example. patient with a history of 5 different cancers and what is the cause of his current metastasis). The test i would say was overall a little easier than world, but there were a few questions each block that just have you scratching your head.

Anatomy: Prob the most annoying part of the test cause they arent really hard but I just hadnt seen some of the material in a while. You can get them down to 2 or so answers and kinda give your best stab. You can maybe run through brs anatomy, i didnt and not sure if it would help.

Embryo: Had multiple "chicken embryo was exposed to this/or this was removed from development --> what is the result" Maybe 4 on the test total.

Biochem: Luckily for me not too many, and the few they had instead of saying aldolase B they said fructose 16 bisphosphate aldolase which made me second guess myself. Overall FA is enough for biochem.

Microbio: Prob 15 questions, def know gram - coccobacilli type descriptions and those charts in FA that have all those spelled out.

Physiology: Lots of the cause effect arrow charts that are all over world. BRS phys is a good choice along with FA.

Path: All over the test, RR path and FA are all you will really need.

Immuno: 5 to 10 questions, pretty straightforward, FA is all you need. CD markers, what immune cell responds and is seen in tissue, things like that.

Neuro: Lots of identify the location of the lesion, had 1 spinal cord section, medial medullary syndrome and a few stroke questions

Repro: A decent amount of clinical scenarios involving pregnant women, had one weird placenta previa with partial placenta accreta question. Besides that nothing too screwy.

Pharm: Not nearly as much as I was expecting and a decent amount of drugs I had never seen before. But its hard to prepare for those really

Renal/Cardio: 10+ questions, media questions, glomeruli stains, images and path questions. Be very familiar with these inside and out

Biostats and Epi: A lot of "what should you say to initiate the conversation" and a lot of the biostats calculations questions (50% easy 50% a little bit more involved) - FA is enough really just know ALL the equations.

75% Usmleworld 100% complete timed and random
75% UsmleRX over 80% complete

cbse in march 208
nbme2 in april 218
DIT started wk 2 of may
After 1 wk DIT - nbme6 234
After 2 wk DIT - uwsa1 244
After 3 wk DIT - uwsa2 256
weekend before test - nbme7 251

Hard to tell how I did, my first 5 blocks felt like every other practice test but my last 2 blocks were tough, hoping I was able to reason through those tough questions. best of luck to everyone

Real thing: 242/99

I was hoping for that 250 but nonetheless a great score and I am thankful everything worked out. My lowest subjects were anatomy/embryo and respiratory (shocking since I was awesome at respiratory, oh well). Anatomy is a crap shoot really and you gotta hope all them u have down to 2 answers go your way, in my case they didnt but I dont know how i would have even tried to prepare for them.

I would just like to echo everyone else that uworld, goljan rr and FA are your best resources. If you hit those hard you could avoid using other resources. Overall good luck to all those who are still studying, this test is one you really can dominate if you study efficiently.
 
For those of you who scored above 240, when did you stop studying 2 days before the test, 1 day before the test? My original plan was to take 2 days off before, but now feel guilty and want to study more stuff and want to do only 1 day off...

From personal experience, I always did well on exams when I took one day off before the test. But, since this test is so long, I was thinking two.

I would appreciate any advice..

Thank you.:thumbup:
 
For those of you who scored above 240, when did you stop studying 2 days before the test, 1 day before the test? My original plan was to take 2 days off before, but now feel guilty and want to study more stuff and want to do only 1 day off...

From personal experience, I always did well on exams when I took one day off before the test. But, since this test is so long, I was thinking two.

I would appreciate any advice..

Thank you.:thumbup:

My plan was to take one full day off. But I did a few things anyway. Couldn't help myself. But mostly relaxed, or tried to.

I had a very disappointing NBME about a week before the test which increased my anxiety level tremendously. Avoid that!!!

I would focus on what methodology to use to ensure a good night's sleep the night before. Critical.
 
For those of you who scored above 240, when did you stop studying 2 days before the test, 1 day before the test? My original plan was to take 2 days off before, but now feel guilty and want to study more stuff and want to do only 1 day off...

From personal experience, I always did well on exams when I took one day off before the test. But, since this test is so long, I was thinking two.

I would appreciate any advice..

Thank you.:thumbup:

Do what makes you feel comfortable. If studying so close to the test is going to make you nervous then don't.

I personally was getting anxious/nervous because I felt like I wasn't doing enough the last couple of days before my exam so it calmed me down just to look at some HY stuff in FA, FA pics, and rads stuff.

I didn't do any hardcore studying to make sure I was getting rest and relaxation but looking at HY areas like Immuno markers again was a smart idea as there were a good number of straight recall questions and it would have been terrible to miss "easy" questions just because I didn't spend an extra few hrs studying
 
For those of you who scored above 240, when did you stop studying 2 days before the test, 1 day before the test? My original plan was to take 2 days off before, but now feel guilty and want to study more stuff and want to do only 1 day off...

From personal experience, I always did well on exams when I took one day off before the test. But, since this test is so long, I was thinking two.

I would appreciate any advice..

Thank you.:thumbup:

I took off about one day, with about 1 hour of studying in the morning just looking at the high yield stuff (like equations and buzzwords) right in first aid right before the test. Watched a movie and relaxed the rest of the day.

I would suggest doing whatever you are comfortable with while avoiding burnout. If you are burned out, then take the day off, it's worth facing the test with a fresh mind.
 
For those of you who scored above 240, when did you stop studying 2 days before the test, 1 day before the test? My original plan was to take 2 days off before, but now feel guilty and want to study more stuff and want to do only 1 day off...

From personal experience, I always did well on exams when I took one day off before the test. But, since this test is so long, I was thinking two.

I would appreciate any advice..

Thank you.:thumbup:

Breaking the cardinal rule it seems, I studied everyday up to the test. I probably studied harder the day before the test than any other. My reasoning was that you only get one shot at the bastard, might as well give it everything you got.
 
Breaking the cardinal rule it seems, I studied everyday up to the test. I probably studied harder the day before the test than any other. My reasoning was that you only get one shot at the bastard, might as well give it everything you got.

Same here. Studied up until 1:30 AM the night before. Figured I couldn't sleep anyway...

Will find out tomorrow if that was a wise idea.
 
Thanks everyone, I think I'm going to just take a semi day off. Will review High Yield FA before the test along with radiographs and whatnot.....But definately not breaking the cardinal rule. lol. Thanks!!
 
Same here. Studied up until 1:30 AM the night before. Figured I couldn't sleep anyway...

Will find out tomorrow if that was a wise idea.

Better still... I had an afternoon test time (1:00), and it was about a 40 minute drive so my girlfriend drove me so I could look at First Aid in the car on the way there.

But like other people said this is entirely based on what you're used to. This is what I do for every test I don't feel 100% ready for (well not study in the car, but you get the point), and I don't think it's possible to ever feel 100% ready for this test. I'm sure it didn't help me at all, but it just made me feel better about it, which is what's most important.

And yeah, the day before the test I studied probably harder than any other day.
 
Thank you SO MUCH to everyone providing the info, it is so generous of y'all to pass along your wisdom. :D

Special shout-out to Milkman...I understand being disappointed that you didn't hit your expectations, but your score is fine in the grand scheme of things, and you're awesome, so I'd be surprised if you don't land where you want to when it comes down to it. :luck:
 
NMBE 3 (4/9/10): 205
NBME 5 (5/9/10): 229
UWSA1 (6/2/10): 239
NBME 6 (6/12/10): 244
UWSA2 (6/17/10): 232
Free150 (6/23/10): 261
NBME 7 (6/24/10): 253

Real Deal (6/30/10): 254

I'm going to give advice that worked for me. I would consider myself, in terms of intelligence, like the average medical student. What got me my decent Step 1 score was hard work and dedication. A great score is possible on Step 1 if you put in the time.

I'm not going to do a breakdown of subject by subject, because everyone's test is going to be different. I had a lot of anatomy that I may have missed questions on, but it wasn't worth going nuts over anatomy, even though I spent a few hours reading BRS Gross Anatomy summaries. Still didn't help me get those anatomy questions. The nerves got me (not facial, I had those down). I think I had an x-ray of the shoulder that I probably missed as well.

Here is what I used, and what I believe can get people to a great score.

First Aid- I probably read this beast around 5 times. I read it 1 time during classes, 1 time over our spring break and winter break, and 2 times in the 1 month I had before Step 1. Obviously the most high yield thing out there.

UWORLD- The best question bank out there. I went through this twice. The answers are awesome, be sure to go through them. Twice is better. The great thing about questions is that once you take the real exam, a lot of the questions you will just get because you are so used to seeing questions asked in a certain way. Remember that these question banks don't just pull questions out of their butts, they've studied old Step 1 tests and know what kinds of things are asked, and how they are asked. Go through this at least twice.

Goljan- I listened to the audio 2x, while exercising and while walking around campus, driving, etc... I actually read the Goljan book 2x, and that was great, but there was so much information in there. I probably forgot half of that book by Step 1, but there were a few concepts that were really reinforced quite well by the book, and some nifty details were thrown in here and there. I liked reading it twice, but it took me FOREVER to do it. Maybe not the most high yield thing out there, but it definitely got me some points.

Kaplan/Rx- I completed both of these Qbanks. I liked them both equally. Kaplan wasn't too bad, many have complained about it but I thought the questions and explanations were well done.

Other books: Spent a few hours in BRS Anatomy.
I also had micro and pharm flashcards that I used quite a bit, in the car and such.

Last pearls for you all: Don't get too many books, PLEASE. At least for me, I wanted to master FA and Goljan as my two books. Don't get caught up in other things. At least for me, I remember something I read over and over again 5 times better than if I read about the same thing 5 different ways. That's just me though. I probably forget things faster that way, but that's okay.

Questions are key. On the test, things felt normal, I was nervous and if the questions didn't seem familiar I would have not done well on the test. Questions really help you know if you understand the material.

If you have any specific questions PM me.
 
Just wanted to put my 2 cents in, I redid all of the biostats in UW the day before and was able to get them all right (i think) on the real test without spending much time on it. I was very glad I had done that.
 
sad story ..... real deal = 232/99 ...

Start (7wks out): NBME 7: 178
2wks out: NBME 6: 234
USMLE World last 2 weeks of studying (1st and only time thru): 69% avg, 100% complete


Basically those last two weeks were a waste ... ugh ... wanted 240 so bad ....
 
Practice tests:
NBME 6 (school sponsored, prestudying) : 188
UWSA1: (three weeks later): 214
NBME 7: (4 weeks out from test, 2 weeks into dedicated studying): 227
UWSA2: (2.5 weeks out from test): 252
UW: 69% (92% finished)

Just got my score today: 244


I'm super excited about this score.:D:D Given that my last few days before the exam were very stressful and I was disappointed that I didn't finish UW, I was just hoping to break 230 (and secretly hoping for a 243). So I'm content with the final results.

Time to move on to the Step 2 forum... :) Thanks to everyone on here who posted their experiences. I definitely gained A LOT from all your contributions!
 
great to see all the solid scores.

School Sponsored NBME COMP - 235
USMLE World Bank - 71% (100% complete)
NBME 2 - 240
NBME 4 - 236

Actual - 244/99

very happy with the score; obviously 250+ was my ultimate goal, but I gave it my all and left everything on the field. I figure this should be a solid score for general surgery.
 
great to see all the solid scores.

School Sponsored NBME COMP - 235
USMLE World Bank - 71% (100% complete)
NBME 2 - 240
NBME 4 - 236

Actual - 244/99

very happy with the score; obviously 250+ was my ultimate goal, but I gave it my all and left everything on the field. I figure this should be a solid score for general surgery.
 
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