Good luck all. I have my exam end of March and hope to be the 1st one to post here for 2010.
Official 2010 USMLE Step 1 Experiences and Scores Thread
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Finally I get to post my experience on this thread! 🙂 I took the exam last week and was going to post here soon after but I was so tired and really didnt want to think about the exam so I went on vacation. I might not be as informative as some of the other great posts on here but Ill do my best to hit the high points of my experience. Also, some background on me: Ive honored/high passed most of my courses in the last two years, I need to read things over multiple times before they sink in (and once they do, Ill remember them for a long time
), and Im not the best standardized-test taker
My study sources: Before I even go into this, Ill be the first one to admit that I think I overdid the resources. Of course, I wouldnt have listened to anyone had they told me before, but in retrospect, I couldve done with a lot less.
1. First Aid 2010: I had 2009, but ended up buying the 2010 edition when it went half off on Amazon, and Im glad I did. I didnt really do a side-by-side comparison, but I think the new edition has more tables/better organization than the last one. This was the backbone of my studying, but I rarely referred to it during second year until almost February, when I started looking at it according to whichever blocks we were in at school.
2. Goljan RR 2010 + audio: Definitely essential. I started listening to the audio in fall/winter of second year and also started reading the textbook around the same time. At first, I was using the text to supplement class lectures, but by January, I was using it to replace my class notes. In fact, Goljan RR was my main study source after then, and I read some sections of it multiple times when studying for tests. It definitely helped bring up my school test scores and cut down my study time. Also, Im glad I started using it ahead of time, because even before I started dedicated board studying, I had read most of it once, some sections more than once.
3. UWorld Question bank: definitely important to have. I didnt try out any others, so I may be biased, but I think I learned A LOT from doing the questions people should use it as a learning tool and not for testing.
4. Question books: Robbins Review of Pathology and FA Q and A. I used both while doing a first pass of the material, and ended up using about 90% of each, and didnt get to finish them. All in all, probably added up to about 1600-1700 Qs? Robbins was definitely superior in content and questions styles. Their questions were very hard and are supposed to be used with the textbook. The FA questions were okay, nothing special, and I think theyre taken right out of USMLE Rx.
5. Webpath: I used this a lot, just to look at the slides. Plus, they have good explanations for the slides. I didnt use the Goljan slides, so used this instead.
So, these were my main study sources that I used throughout. Others that I supplemented with:
- HY Neuroanatomy: Good to read when youre doing the Neuro section in FA. I tried annotating into FA, but there was too much in it, so I decided to just read and refer to it later if needed.
- Kaplan Biochem: I had a friends lecture notes set from 2005. I decided to use the Biochem notes since I bought RR Biochem and could only read 5 pages in an hour before I passed out The Kaplan notes were pretty good and helped bring back what we did a year ago.
- CMMRS and Microcards: I read CMMRS last year with coursework, and re-read maybe half during studying now. I used Microcards exclusively for course work last year (replacing class notes) and referred to them now as needed. In the end, I just ended up pulling out the different classification flowcharts, the toxins card, etc and looked at them now and again. These two were probably my best sources for Micro, and since the Micro section in FA is pretty good, you could probably do without these
- Other books that I occasionally flipped through now and then but never cover to cover: Anatomy atlas, Pharm cards (stopped after a while since they were too many and too much detail), Lange Immunology (read a few pages of the Immuno section, but I had a pretty good undergrad background, so decided to skip it).
My study plan: Id like to mention here that I pretty much stopped going to lectures half way through second year (I was a die-hard lecture person in first year, so this was a huge change for me). I studied for class but focused on board studying (using Goljan a lot). So, like I said above, I had somewhat of a head start on the Goljan front when I started my dedicated studying.
I had 6 weeks post-school to study before the test. I decided that I wanted to do three passes of my material, and since I knew the first pass was going to be excruciatingly slow, I started a few days after coming back from spring break, right after I took a school sponsored NBME. This was a very, very slow pass and I stuck all the sections here that are long, tedious and that I had not done in a while (aka Biochem, etc). Just to give you an idea, it took me about 8 or 9 days to go over Biochem since we still had school going on, and I was going to some mandatory lectures as well. In fact, I was so slow that I ended up using 2 weeks of my 6 weeks to finish the first pass I wasnt too happy about that, since I had planned on starting using UW right when I started my second pass, so that left me with 4 weeks to start and finish UW. For the last few weeks, I was doing about 12-14 hours of studying a day 5-6 hours for 2 UW blocks, and the rest for FA/Goljan Review.
Also, about 10 days before my exam, I kind of had a breakdown I was exhausted and being so close to the exam was making me too anxious to be productive. I ended up taking 2 days off from my already tight schedule. During the last week of studying, I was barely doing 8 hours a day, and wasnt too thrilled about it since I was hoping to pull out all the stops the week before. But, I was at the point where starting each day was almost a nightmare, and I looked forward to going to sleep every night, just because it was one less day until the end. Sounds depressing, and it probably was, and Im SO glad its over . One of the things I modified in my plan just to get things moving was I stopped doing UW completely. I wasnt doing as well as I wanted and my block percentages were falling and I needed a boost
Anyway, what I ended up doing: Three passes of FA (with the last couple being memorization more than reading), 2 passes of Goljan RR path (excluding the stuff I did during the school year), 2+ passes of Goljan audio (some lectures more than once), UW 92% finished.
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)
I was going to take the Free 150 sometime in the last 2 weeks, but the whole anxiety thing messed up my schedule pretty bad, and I ended up not taking it. I was also very bummed about not finishing UW, since I had wanted to at least finish and review wrong answers. In my last few days in UW, I was averaging 75-80% on the blocks and in the end, and I had to make my peace with not finishing UW.
One last thing: A lot of people here suggest not studying the day before, and thats great if its what you usually do. If youre the kind of person who always relaxes the day before a test, do the same here. Im the kind of weird person who likes going into a test studying, meaning Id rather go to bed early, and wake up early, and study something for a few hours before the test. I just feel like it sharpens up my mind and wakes me up I could never roll out of bed and walk into a test So, I did take it easy the day before, flipped through some FA sections (Behavioral, Immuno, etc), had dinner with the family and went to bed at 11. I woke up at 5, and studied for a couple of hours, mostly stuff that I always forget (aka Pharm). I actually was able to go through the FA pharm capter and systems-based FA pharm completely, and so glad I did, because I got many questions on the test that I would have otherswise fumbled with. The point of all this: do what works for you, and try to stick to your normal routine.
TEST DAY: I was surprisingly calm and not very anxious, given the last few days had been pretty bad. I got to the test center very early (8ish) and was starting my test at 8:20.
I hadnt really planned breaks ahead of time, and just wanted to keep going until I had to stop. So, I ended up using my break time in the following order: 3 blocks -->break--> 2 blocks --> break --> 1 block--> break--> last block. Its pretty obvious I started out strong and started to burn out at the end. I also drank too much water and diet coke in my breaks, so I had to use the restroom a lot more by the end.
Difficulty/time management with blocks: I finished my first block in 30 minutes (I was shocked too, since I was doing UW blocks of 48 in 40 minutes). I had plenty of time to go over flagged Qs, some a couple of times. I guess this was my easiest block, since after this, I was finishing blocks with anywhere from 10 to 20 minutes left. As for flagging questions, I never flagged in UW, but since this was the real thing, I was more careful. I flagged any questions that I was even 10% unsure about, and I also flagged questions that were unbelievably easy (aka too easy to be true). I maybe flagged 16-20 per block. Overall, time wasnt a huge issue for me.
I think my 4th block was my hardest because I got back from a 10 minute break and it took me a while to get back into the test. I finished with less than 10 minutes to review and that kicked my butt into gear. The last few blocks were hard because I was getting tired and was once mortified to find myself zoning out I had been staring at the same question stem for almost 2 minutes. I had to keep telling myself to focus every few minutes.
As for the 46Qs/longer stems, there were definitely some very long stems but a lot of times they were full of distracting info or a ton of lab values. Also, there were some simple one-liners to offset the longer questions, so I think it balanced out in the end.
Questions breakdown by subjects: Overall, the test was mostly pathology and physiology, with the standard up/down arrow questions, with some anatomy sprinkled around.
1. Biochem: I think I have to vent here: there wasnt much Biochem on my test at all. Though I shouldnt complain, this was one section I could have definitely studied less for. I didnt have any rate limiting enzyme questions or any cofactors. I had one on OTC deficiency, one of the porphyrias, and thats probably it. There were probably more that I cant think of right now, but I was kind of annoyed since I had really crammed for Biochem. I didnt have a single lysozomal storage disease question Id say in retrospect that FA was definitely more than enough.
2. Molecular Bio/Genetics: Not much here either like biochem, very few questions, and I dont remember any right now, but it wasnt too bad. No lac operon, thanks goodness! Some receptor/downstream signaling questions. Again, FA is more than enough for this.
3. Immunology: fair number of questions, mostly out of FA. A couple of questions with flow cytometry pictures that I remembered from undergrad and thought were kind of cool🙂.
4. Micro: Almost all of it was in FA. A couple of questions about toxins and their mechanisms of action, one about when a live vaccine was contraindicated, a few questions on epiglotitis over and over, many STD questions (describing the initial lesions in detail and asking about the bug), very few micro pharm questions. Also, very few virus questions. None of the worms (thanks goodness I can never remember those). Overall, seemed pretty fair, and again, mostly all out of FA.
5. Pharmacology: one word of advice: KNOW this chapter well in FA. There was a question probably from every page of this chapter. Standard inhibitor +agonist questions with graphs, lots of cholinergic/anticholinergic poisoning questions, and many of those epi reversal experiment questions with graphs. I had reviewed this chapter the morning of my test and so glad I did. For the systems-based pharm, it was mostly mechanisms of action and very few side-effects if at all (nothing crazy like UW, but UW is great to learn the drugs in details)
6. Anatomy/Embryo: Standard anatomy questions. One brachial plexus, one lower limb nerve question, a few that I wouldnt remember unless I was studying for year one anatomy (like the origin of the some artery). There were a few MRs/CTs per block but nothing too hard. A very cool horseshoe kidney cross-section CT. I had planned on reading HY Gross Anatomy the day before I ended up not doing it probably wouldnt have helped that much.
7. Behavioral: pretty standard, FA is definitely more than enough (at least for me). Some tricky questions, but most were simple (where the wrong answers are very obvious and at times ridiculously funny ) . A couple of very simple calculate the sensitivity, PPV etc questions, and a couple of really tricky ones with NNT or NNH. I think I had maybe one per block of the calculations from behavioral.
8. Heme/Onc: Nothing too crazy. A few anemia questions, a couple of ALL/AML/Hodgkins questions, folate/B12 deficiency, etc. Most either had a long list of lab values, a picture, or both. FA was good for this, but Goljan was necessary to fill in the gaps. I think this was my strongest (and best) subject only because of Goljan 🙂
9. Cardio: A couple of media+murmur questions, one which you could figure out without the media, one that you really needed the media for. A few cardio drug questions like antiarrhythmics, B-blockers. There was this long one about an MI and description of the pain, etc, and ended with giving the patient a sublingual drug that helped immediately and then asked the mechanism of action of the drug 🙂 There was a calculation one asking to figure out maximal O2 consumption, and I almost blanked on that one but remembered that formula in FA
10. Renal: Pretty simple. An FF calculation, some GFR stuff, one about renal papillary necrosis. I dont remember anything that completely threw me off
11. Respiratory: Dont remember much but most of it was in FA a couple about the O2 dissociation curve, asthma, chronic bronchitis, some drugs mechanism of action, a couple about lung cancer, a couple about ARDS.
12. GI: I cant remember ANY at all (sorry ) but there were definitely some. Actually, I only remember one, and its half embryology Meckels and its pathophys. Oh, and a couple about Hepitits with lab values.
13. Reproductive: LOTS of STD questions for some reason, all describing a lesion (painless/painful, shape, size, color, how long theyve had it etc) and asked for the bug. A couple of repro drugs straight from FA. I cant think of any others, maybe because I keep thinking of all the STDs
14. Endocrine: Pretty standard questions, most in the style of UW but 2-step at the most. FA was good, but Goljan was great to supplement with.
15. Skin: A couple about skin cancer.
16. MSK: a couple about Rheumatoid arthritis and gout, one on dermatomyositis. Most of it was in FA.
17. Neuro: Not as bad as I had expected. One gross brainstem section asking to find a cranial nerve whose deficit was described in the stem. I got lucky and had no questions on those black and white brainstem sections. I also had no questions on spinal cord lesions. Maybe a couple of head MRs or CTs.
18. Psych: All out of FA. Nothing too unexpected, some UW style questions, some personality disorders.
It probably sounds stupid when I say over and over again that I dont remember much, but its true Ive really been trying hard not to think of the test, since Ill only remember the questions I got wrong. Also, when I stay standard, that doesnt mean it was easy just that I had probably seen a similar style questions in UW. I definitely got my share of WTF questions (maybe 5-7 per block) some where I narrowed it down to 2 choices and then guessed, and some where I just straight up guessed because some of the answer choices werent even English ..
Overall, Id say the exam was fair. There were many gimme questions like simple one-line stems and many that described a patient and asked for the diagnosis. However, I had many that I had to spend more time because they were more 2-step questions.
What I wouldve done differently:
1. Focus more on FA+UW+Goljan. I think 80-90% of the test was somewhere in these three resources. The rest was stuff you may have randomly come across in lecture, or while seeing patients, or in some class in undergrad. I wish I had not stressed out about extra resources and used them as reference instead of cover-to-cover reading.
2. Less annotation: I wish I had not annotated supplemental texts into my FA. Its very tempting to say, Ill never have to read that book since everything will be here. However, when you read and re-read FA, the annotations end up being distractions. Besides, I ended up taking very short notes from UW into a separate notebook, and read over them multiple times, and that was definitely a better idea than annotating into FA
3. Pharm flashcards: I realized that all (or most) of the pharm is in FA. I wish I had made flashcards earlier in the year (like make 2 or 3 a day starting in January) and refer to them throughout the semester. This way, you could always add details from UW. Pharm was a very weak area for me and our school does a pretty job with it. It turned out not too bad on the exam, but I wish I had done the flashcards to make my life easier.
4. Not stress so much: Weird, I know, but I really crashed and burned mentally and physically the last few days, which was bad timing, and I had to pace myself and wasnt at maximum potential. I would probably start early (ie before spring break) and not drive myself crazy in the dedicated study time before the exam, since I was pulling really long days in the first few weeks of my 6-week period.
I hope this helps someone. I know I definitely forgot many details of the exam and probably my study methods. Ill update back again if I remember anything. My goal score was 243 and even though I broke it with my UWSA2, I know those tend to overestimate and it was a few weeks out from my test. Im just really hoping to break 230 at this point. Anything higher would be a great surprise
Good luck to everyone whos taking the test. It will feel GREAT to be done, just the feeling of relief is amazing and something to look forward too 😀
Oh, and I just realized that this is a LONG post -- I don't have the energy to edit, so feel free to skim 😀
My study sources: Before I even go into this, Ill be the first one to admit that I think I overdid the resources. Of course, I wouldnt have listened to anyone had they told me before, but in retrospect, I couldve done with a lot less.
1. First Aid 2010: I had 2009, but ended up buying the 2010 edition when it went half off on Amazon, and Im glad I did. I didnt really do a side-by-side comparison, but I think the new edition has more tables/better organization than the last one. This was the backbone of my studying, but I rarely referred to it during second year until almost February, when I started looking at it according to whichever blocks we were in at school.
2. Goljan RR 2010 + audio: Definitely essential. I started listening to the audio in fall/winter of second year and also started reading the textbook around the same time. At first, I was using the text to supplement class lectures, but by January, I was using it to replace my class notes. In fact, Goljan RR was my main study source after then, and I read some sections of it multiple times when studying for tests. It definitely helped bring up my school test scores and cut down my study time. Also, Im glad I started using it ahead of time, because even before I started dedicated board studying, I had read most of it once, some sections more than once.
3. UWorld Question bank: definitely important to have. I didnt try out any others, so I may be biased, but I think I learned A LOT from doing the questions people should use it as a learning tool and not for testing.
4. Question books: Robbins Review of Pathology and FA Q and A. I used both while doing a first pass of the material, and ended up using about 90% of each, and didnt get to finish them. All in all, probably added up to about 1600-1700 Qs? Robbins was definitely superior in content and questions styles. Their questions were very hard and are supposed to be used with the textbook. The FA questions were okay, nothing special, and I think theyre taken right out of USMLE Rx.
5. Webpath: I used this a lot, just to look at the slides. Plus, they have good explanations for the slides. I didnt use the Goljan slides, so used this instead.
So, these were my main study sources that I used throughout. Others that I supplemented with:
- HY Neuroanatomy: Good to read when youre doing the Neuro section in FA. I tried annotating into FA, but there was too much in it, so I decided to just read and refer to it later if needed.
- Kaplan Biochem: I had a friends lecture notes set from 2005. I decided to use the Biochem notes since I bought RR Biochem and could only read 5 pages in an hour before I passed out The Kaplan notes were pretty good and helped bring back what we did a year ago.
- CMMRS and Microcards: I read CMMRS last year with coursework, and re-read maybe half during studying now. I used Microcards exclusively for course work last year (replacing class notes) and referred to them now as needed. In the end, I just ended up pulling out the different classification flowcharts, the toxins card, etc and looked at them now and again. These two were probably my best sources for Micro, and since the Micro section in FA is pretty good, you could probably do without these
- Other books that I occasionally flipped through now and then but never cover to cover: Anatomy atlas, Pharm cards (stopped after a while since they were too many and too much detail), Lange Immunology (read a few pages of the Immuno section, but I had a pretty good undergrad background, so decided to skip it).
My study plan: Id like to mention here that I pretty much stopped going to lectures half way through second year (I was a die-hard lecture person in first year, so this was a huge change for me). I studied for class but focused on board studying (using Goljan a lot). So, like I said above, I had somewhat of a head start on the Goljan front when I started my dedicated studying.
I had 6 weeks post-school to study before the test. I decided that I wanted to do three passes of my material, and since I knew the first pass was going to be excruciatingly slow, I started a few days after coming back from spring break, right after I took a school sponsored NBME. This was a very, very slow pass and I stuck all the sections here that are long, tedious and that I had not done in a while (aka Biochem, etc). Just to give you an idea, it took me about 8 or 9 days to go over Biochem since we still had school going on, and I was going to some mandatory lectures as well. In fact, I was so slow that I ended up using 2 weeks of my 6 weeks to finish the first pass I wasnt too happy about that, since I had planned on starting using UW right when I started my second pass, so that left me with 4 weeks to start and finish UW. For the last few weeks, I was doing about 12-14 hours of studying a day 5-6 hours for 2 UW blocks, and the rest for FA/Goljan Review.
Also, about 10 days before my exam, I kind of had a breakdown I was exhausted and being so close to the exam was making me too anxious to be productive. I ended up taking 2 days off from my already tight schedule. During the last week of studying, I was barely doing 8 hours a day, and wasnt too thrilled about it since I was hoping to pull out all the stops the week before. But, I was at the point where starting each day was almost a nightmare, and I looked forward to going to sleep every night, just because it was one less day until the end. Sounds depressing, and it probably was, and Im SO glad its over . One of the things I modified in my plan just to get things moving was I stopped doing UW completely. I wasnt doing as well as I wanted and my block percentages were falling and I needed a boost
Anyway, what I ended up doing: Three passes of FA (with the last couple being memorization more than reading), 2 passes of Goljan RR path (excluding the stuff I did during the school year), 2+ passes of Goljan audio (some lectures more than once), UW 92% finished.
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)
I was going to take the Free 150 sometime in the last 2 weeks, but the whole anxiety thing messed up my schedule pretty bad, and I ended up not taking it. I was also very bummed about not finishing UW, since I had wanted to at least finish and review wrong answers. In my last few days in UW, I was averaging 75-80% on the blocks and in the end, and I had to make my peace with not finishing UW.
One last thing: A lot of people here suggest not studying the day before, and thats great if its what you usually do. If youre the kind of person who always relaxes the day before a test, do the same here. Im the kind of weird person who likes going into a test studying, meaning Id rather go to bed early, and wake up early, and study something for a few hours before the test. I just feel like it sharpens up my mind and wakes me up I could never roll out of bed and walk into a test So, I did take it easy the day before, flipped through some FA sections (Behavioral, Immuno, etc), had dinner with the family and went to bed at 11. I woke up at 5, and studied for a couple of hours, mostly stuff that I always forget (aka Pharm). I actually was able to go through the FA pharm capter and systems-based FA pharm completely, and so glad I did, because I got many questions on the test that I would have otherswise fumbled with. The point of all this: do what works for you, and try to stick to your normal routine.
TEST DAY: I was surprisingly calm and not very anxious, given the last few days had been pretty bad. I got to the test center very early (8ish) and was starting my test at 8:20.
I hadnt really planned breaks ahead of time, and just wanted to keep going until I had to stop. So, I ended up using my break time in the following order: 3 blocks -->break--> 2 blocks --> break --> 1 block--> break--> last block. Its pretty obvious I started out strong and started to burn out at the end. I also drank too much water and diet coke in my breaks, so I had to use the restroom a lot more by the end.
Difficulty/time management with blocks: I finished my first block in 30 minutes (I was shocked too, since I was doing UW blocks of 48 in 40 minutes). I had plenty of time to go over flagged Qs, some a couple of times. I guess this was my easiest block, since after this, I was finishing blocks with anywhere from 10 to 20 minutes left. As for flagging questions, I never flagged in UW, but since this was the real thing, I was more careful. I flagged any questions that I was even 10% unsure about, and I also flagged questions that were unbelievably easy (aka too easy to be true). I maybe flagged 16-20 per block. Overall, time wasnt a huge issue for me.
I think my 4th block was my hardest because I got back from a 10 minute break and it took me a while to get back into the test. I finished with less than 10 minutes to review and that kicked my butt into gear. The last few blocks were hard because I was getting tired and was once mortified to find myself zoning out I had been staring at the same question stem for almost 2 minutes. I had to keep telling myself to focus every few minutes.
As for the 46Qs/longer stems, there were definitely some very long stems but a lot of times they were full of distracting info or a ton of lab values. Also, there were some simple one-liners to offset the longer questions, so I think it balanced out in the end.
Questions breakdown by subjects: Overall, the test was mostly pathology and physiology, with the standard up/down arrow questions, with some anatomy sprinkled around.
1. Biochem: I think I have to vent here: there wasnt much Biochem on my test at all. Though I shouldnt complain, this was one section I could have definitely studied less for. I didnt have any rate limiting enzyme questions or any cofactors. I had one on OTC deficiency, one of the porphyrias, and thats probably it. There were probably more that I cant think of right now, but I was kind of annoyed since I had really crammed for Biochem. I didnt have a single lysozomal storage disease question Id say in retrospect that FA was definitely more than enough.
2. Molecular Bio/Genetics: Not much here either like biochem, very few questions, and I dont remember any right now, but it wasnt too bad. No lac operon, thanks goodness! Some receptor/downstream signaling questions. Again, FA is more than enough for this.
3. Immunology: fair number of questions, mostly out of FA. A couple of questions with flow cytometry pictures that I remembered from undergrad and thought were kind of cool🙂.
4. Micro: Almost all of it was in FA. A couple of questions about toxins and their mechanisms of action, one about when a live vaccine was contraindicated, a few questions on epiglotitis over and over, many STD questions (describing the initial lesions in detail and asking about the bug), very few micro pharm questions. Also, very few virus questions. None of the worms (thanks goodness I can never remember those). Overall, seemed pretty fair, and again, mostly all out of FA.
5. Pharmacology: one word of advice: KNOW this chapter well in FA. There was a question probably from every page of this chapter. Standard inhibitor +agonist questions with graphs, lots of cholinergic/anticholinergic poisoning questions, and many of those epi reversal experiment questions with graphs. I had reviewed this chapter the morning of my test and so glad I did. For the systems-based pharm, it was mostly mechanisms of action and very few side-effects if at all (nothing crazy like UW, but UW is great to learn the drugs in details)
6. Anatomy/Embryo: Standard anatomy questions. One brachial plexus, one lower limb nerve question, a few that I wouldnt remember unless I was studying for year one anatomy (like the origin of the some artery). There were a few MRs/CTs per block but nothing too hard. A very cool horseshoe kidney cross-section CT. I had planned on reading HY Gross Anatomy the day before I ended up not doing it probably wouldnt have helped that much.
7. Behavioral: pretty standard, FA is definitely more than enough (at least for me). Some tricky questions, but most were simple (where the wrong answers are very obvious and at times ridiculously funny ) . A couple of very simple calculate the sensitivity, PPV etc questions, and a couple of really tricky ones with NNT or NNH. I think I had maybe one per block of the calculations from behavioral.
8. Heme/Onc: Nothing too crazy. A few anemia questions, a couple of ALL/AML/Hodgkins questions, folate/B12 deficiency, etc. Most either had a long list of lab values, a picture, or both. FA was good for this, but Goljan was necessary to fill in the gaps. I think this was my strongest (and best) subject only because of Goljan 🙂
9. Cardio: A couple of media+murmur questions, one which you could figure out without the media, one that you really needed the media for. A few cardio drug questions like antiarrhythmics, B-blockers. There was this long one about an MI and description of the pain, etc, and ended with giving the patient a sublingual drug that helped immediately and then asked the mechanism of action of the drug 🙂 There was a calculation one asking to figure out maximal O2 consumption, and I almost blanked on that one but remembered that formula in FA
10. Renal: Pretty simple. An FF calculation, some GFR stuff, one about renal papillary necrosis. I dont remember anything that completely threw me off
11. Respiratory: Dont remember much but most of it was in FA a couple about the O2 dissociation curve, asthma, chronic bronchitis, some drugs mechanism of action, a couple about lung cancer, a couple about ARDS.
12. GI: I cant remember ANY at all (sorry ) but there were definitely some. Actually, I only remember one, and its half embryology Meckels and its pathophys. Oh, and a couple about Hepitits with lab values.
13. Reproductive: LOTS of STD questions for some reason, all describing a lesion (painless/painful, shape, size, color, how long theyve had it etc) and asked for the bug. A couple of repro drugs straight from FA. I cant think of any others, maybe because I keep thinking of all the STDs
14. Endocrine: Pretty standard questions, most in the style of UW but 2-step at the most. FA was good, but Goljan was great to supplement with.
15. Skin: A couple about skin cancer.
16. MSK: a couple about Rheumatoid arthritis and gout, one on dermatomyositis. Most of it was in FA.
17. Neuro: Not as bad as I had expected. One gross brainstem section asking to find a cranial nerve whose deficit was described in the stem. I got lucky and had no questions on those black and white brainstem sections. I also had no questions on spinal cord lesions. Maybe a couple of head MRs or CTs.
18. Psych: All out of FA. Nothing too unexpected, some UW style questions, some personality disorders.
It probably sounds stupid when I say over and over again that I dont remember much, but its true Ive really been trying hard not to think of the test, since Ill only remember the questions I got wrong. Also, when I stay standard, that doesnt mean it was easy just that I had probably seen a similar style questions in UW. I definitely got my share of WTF questions (maybe 5-7 per block) some where I narrowed it down to 2 choices and then guessed, and some where I just straight up guessed because some of the answer choices werent even English ..
Overall, Id say the exam was fair. There were many gimme questions like simple one-line stems and many that described a patient and asked for the diagnosis. However, I had many that I had to spend more time because they were more 2-step questions.
What I wouldve done differently:
1. Focus more on FA+UW+Goljan. I think 80-90% of the test was somewhere in these three resources. The rest was stuff you may have randomly come across in lecture, or while seeing patients, or in some class in undergrad. I wish I had not stressed out about extra resources and used them as reference instead of cover-to-cover reading.
2. Less annotation: I wish I had not annotated supplemental texts into my FA. Its very tempting to say, Ill never have to read that book since everything will be here. However, when you read and re-read FA, the annotations end up being distractions. Besides, I ended up taking very short notes from UW into a separate notebook, and read over them multiple times, and that was definitely a better idea than annotating into FA
3. Pharm flashcards: I realized that all (or most) of the pharm is in FA. I wish I had made flashcards earlier in the year (like make 2 or 3 a day starting in January) and refer to them throughout the semester. This way, you could always add details from UW. Pharm was a very weak area for me and our school does a pretty job with it. It turned out not too bad on the exam, but I wish I had done the flashcards to make my life easier.
4. Not stress so much: Weird, I know, but I really crashed and burned mentally and physically the last few days, which was bad timing, and I had to pace myself and wasnt at maximum potential. I would probably start early (ie before spring break) and not drive myself crazy in the dedicated study time before the exam, since I was pulling really long days in the first few weeks of my 6-week period.
I hope this helps someone. I know I definitely forgot many details of the exam and probably my study methods. Ill update back again if I remember anything. My goal score was 243 and even though I broke it with my UWSA2, I know those tend to overestimate and it was a few weeks out from my test. Im just really hoping to break 230 at this point. Anything higher would be a great surprise
Good luck to everyone whos taking the test. It will feel GREAT to be done, just the feeling of relief is amazing and something to look forward too 😀
Oh, and I just realized that this is a LONG post -- I don't have the energy to edit, so feel free to skim 😀
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I think we literally had the same exact exam. I'm not kidding. 95% of what you mentioned rang a bell. If that's true, maybe there are randomized whole tests, as opposed to randomization of questions, or randomization of blocks of questions. Reading your post was like reading what my post would have said. I also thought our test was very fair. I liked the fact that there wasn't much biochem or antibiotics. Oh and that question with the horseshoe kidney, and the little inferior mesenteric artery lit up and curling around the bridge of the two kidneys, was indeed very cool.
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All right so I took the plunge yesterday and surprisingly came out alive and well. Folks, this test is very fair and doable. If you learned your stuff well this past 2 years, you will do more than fine. All right, the specifics.
My test was scheduled for 8 but I got there at 650 and it wasn't even open yet. So I waited till they opened and they processed me (haha) and I started at 720. They need your permit and valid government ID. They give you a locker to put your stuff and ask you to turn your phone off. You cannot bring anything (besides what I will tell you) into the testing area with you (they make you empty out your pockets everytime you take a break). Anyways, then they take your fingerprints and picture. They will give you laminated paper, where you will write your CIN number (which you use everytime to check in), an eraser and a marker which along with your ID and locker key is all you can take inside.
Time doesn't start until you enter your CIN number. The first block is a tutorial. Don't bother with it (just end the block and give yourself an extra 15 mins of break time added to your allotted 45mins). The only thing I recommend is to put on your earphones and hit next in the tutorial. If you hear a noise, it means your earphones are working. Then you can start your next block. There are 7 blocks with 1 hour allotted to each one. If you finish with time left, it gets added to your break time.
I took my breaks after each 2 blocks, I wasn't tired after the first 2 blocks but I took a break nonetheless, So 2 blocks, break, 2 blocks, break, 2 blocks, break. last block. This helped because I wasn't even tired after the last block. For food, I had a good breakfast. I didn't bring a big lunch or anything. When I studied I used to snack on nuts and dried fruit so I brought that. They say it helps to bring what you normally snack on while studying. During each break, I ate a little bit, I used the bathroom (even if I didn't have to go) got some water, and walked around outside for a bit in the sun.
Ok, now the meat of the email, the test. Honestly, it wasn't as bad as I thought it would be. Of the questions: 10-15% were ridiculously easy, 20-25% were the hard ones (of these, 1 or 2 were WTF is this english?, and the rest were the ones that only 30% get correct in UWorld type). The rest were mediocre where if you study well, you should be fine (these were usually 2nd-3rd order questions). Stem-length-wise, the test resembled NBME 7 the most (as in some were long and some were 2-3 sentences max but more of the long ones--hint: it really helps to read the last 2-3 sentences first because it helps you know what they want and sometimes they give you the diagnosis so you don't have to waste time reading and figuring it out yourself).
Some blocks were easy overall (I finished block 3 with 30 mins to spare) and some hard (block 4 with 5 mins to spare). I had, I would say, about 4-5 qs per block that had slides that weren't very hard and on which the stem really helped.
My test was heavy on pathophys and physiology (lots of up and down arrows). I also had a ton of immuno (they asked everything from simple mechanisms to detailed molecular and cellular interactions) but this could just be selective memory and know that not all the tests are the same. Everything else was evenly distributed, even embryo had a fair amount. There was CTs, X-rays, MRIs, and gross for anatomy and neuroanatomy (some hard, some easy). Micro and pharm weren't as detailed as I thought they would be (again not all tests are the same).
The questions are mostly conceptual, as in can you put together everything you've learned and answer this question (you can't go back and see if you got it right in FA because it's not that simple) and the general part of FA (before the organ systems) is most important I would say. Behavioral was simple (even the stats and epidemiology were very simple like PPV, specificity stuff, hard-weinberg type). Biochem could have been harder but thankfully it wasn't. Like I said, it was fair overall.
Oh, I had two audio questions which I thought were hard. It was the one where you move the stethoscope around the chest area.
My stats:
3/15-NBME 4: 231 (16 wks out)
4/30-USMLERx: 71% (9 wks out) (100% complete)
5/3 - NBME CBSE: 233 (9 wks out)
5/22-UWSA 1: 236 (6 wks out)
5/30-Free 143: 87% (5 wks out)
6/6 - NBME 3: 231 (4 wks out)
6/6 - UWSA 2: 244 (4 wks out)
6/20-NBME 5: 238 (2 wks out)
6/23-UWorld: 73% (2 wks out) (100% random, tutor)
6/26-NBME 6: 242 (1 wk out)
7/2 - NBME 7: 251 (4 days out)
Btw, this forum has helped me immensely. Thank you guys for everything. Good luck to all those who still haven't taken it and those awaiting their scores.
My test was scheduled for 8 but I got there at 650 and it wasn't even open yet. So I waited till they opened and they processed me (haha) and I started at 720. They need your permit and valid government ID. They give you a locker to put your stuff and ask you to turn your phone off. You cannot bring anything (besides what I will tell you) into the testing area with you (they make you empty out your pockets everytime you take a break). Anyways, then they take your fingerprints and picture. They will give you laminated paper, where you will write your CIN number (which you use everytime to check in), an eraser and a marker which along with your ID and locker key is all you can take inside.
Time doesn't start until you enter your CIN number. The first block is a tutorial. Don't bother with it (just end the block and give yourself an extra 15 mins of break time added to your allotted 45mins). The only thing I recommend is to put on your earphones and hit next in the tutorial. If you hear a noise, it means your earphones are working. Then you can start your next block. There are 7 blocks with 1 hour allotted to each one. If you finish with time left, it gets added to your break time.
I took my breaks after each 2 blocks, I wasn't tired after the first 2 blocks but I took a break nonetheless, So 2 blocks, break, 2 blocks, break, 2 blocks, break. last block. This helped because I wasn't even tired after the last block. For food, I had a good breakfast. I didn't bring a big lunch or anything. When I studied I used to snack on nuts and dried fruit so I brought that. They say it helps to bring what you normally snack on while studying. During each break, I ate a little bit, I used the bathroom (even if I didn't have to go) got some water, and walked around outside for a bit in the sun.
Ok, now the meat of the email, the test. Honestly, it wasn't as bad as I thought it would be. Of the questions: 10-15% were ridiculously easy, 20-25% were the hard ones (of these, 1 or 2 were WTF is this english?, and the rest were the ones that only 30% get correct in UWorld type). The rest were mediocre where if you study well, you should be fine (these were usually 2nd-3rd order questions). Stem-length-wise, the test resembled NBME 7 the most (as in some were long and some were 2-3 sentences max but more of the long ones--hint: it really helps to read the last 2-3 sentences first because it helps you know what they want and sometimes they give you the diagnosis so you don't have to waste time reading and figuring it out yourself).
Some blocks were easy overall (I finished block 3 with 30 mins to spare) and some hard (block 4 with 5 mins to spare). I had, I would say, about 4-5 qs per block that had slides that weren't very hard and on which the stem really helped.
My test was heavy on pathophys and physiology (lots of up and down arrows). I also had a ton of immuno (they asked everything from simple mechanisms to detailed molecular and cellular interactions) but this could just be selective memory and know that not all the tests are the same. Everything else was evenly distributed, even embryo had a fair amount. There was CTs, X-rays, MRIs, and gross for anatomy and neuroanatomy (some hard, some easy). Micro and pharm weren't as detailed as I thought they would be (again not all tests are the same).
The questions are mostly conceptual, as in can you put together everything you've learned and answer this question (you can't go back and see if you got it right in FA because it's not that simple) and the general part of FA (before the organ systems) is most important I would say. Behavioral was simple (even the stats and epidemiology were very simple like PPV, specificity stuff, hard-weinberg type). Biochem could have been harder but thankfully it wasn't. Like I said, it was fair overall.
Oh, I had two audio questions which I thought were hard. It was the one where you move the stethoscope around the chest area.
My stats:
3/15-NBME 4: 231 (16 wks out)
4/30-USMLERx: 71% (9 wks out) (100% complete)
5/3 - NBME CBSE: 233 (9 wks out)
5/22-UWSA 1: 236 (6 wks out)
5/30-Free 143: 87% (5 wks out)
6/6 - NBME 3: 231 (4 wks out)
6/6 - UWSA 2: 244 (4 wks out)
6/20-NBME 5: 238 (2 wks out)
6/23-UWorld: 73% (2 wks out) (100% random, tutor)
6/26-NBME 6: 242 (1 wk out)
7/2 - NBME 7: 251 (4 days out)
Btw, this forum has helped me immensely. Thank you guys for everything. Good luck to all those who still haven't taken it and those awaiting their scores.
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Robbinson's is a pain in the ass. I used it to look at pictures and SOME explanations that I didn't quiet get a good grasp with FA (I mean about 20 pages max) and I read 1/2 of the blue stuff on the side. FA + USMLERX (really picks out nit picky details so you know it cold) then bomb through UWORLD afterwards. HY neuro is good for the pictures which is helpful, but don't read through it. HY anatomy is good for some pictures but again I only picked out about 20 pages. Don't buy flash cards, just make your own since there's too much info to read anyways. KNOW CT, MRI, XRAYS and how to ID anything on there. Goljan gave me an extra 10 answers to the test, UWORLD gave me about 15-20, and the other 180ish I got from FA. 3 q's from HY neuroanatomy, 3 questions for HY gross. There's about 10 questions I had no idea. I think I had about 3-4 questions where I needed RR for the images and that's about it.
Thanks
How about NBME? a lot of people suggest that NBMEs are more important than anything else.
I am 2/3 done with Rx, now on UW+FA, reference to RR and BRS physiology. will read pictures from HY neuro and anatomy. Are these materials enough ?
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NBMEs are really only useful for gauging your preparedness and getting a slightly better idea of how the test is going to look that day. To that end, you only need to take one. To gauge how you're doing, do as many as necessary, but they have limited value for learning.
may 28 i tookk the step 1 waiting , waiting , i don´t know what to do , i just want to see that i passed with a good score .... what would be a good score to apply for a residence program in internal medicine ..😕😕😕😕
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260
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Just to be on the really safe side: 273
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Either that or you failed so you get nothing! You lose! Good day sir!
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Then I would get this:
[YOUTUBE]http://www.youtube.com/watch?v=yImkcG7IQeg&feature=related[/YOUTUBE]
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Mine is gone too. Hopefully something is in the works.
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Hey guys,
all the advice on here is great, it's been real helpful.
im taking the exam in 4 weeks. basically started prepping a couple of days ago. my goal is to do UW and FA as thorough as possible and listen to goljan audio. and using kaplan for biochm and behavioral.
my problem isnt what books to use or how to study...
its more like the moral support. i was hoping i could find it here on this forum. im getting real anxious. anything to help guys?
all the advice on here is great, it's been real helpful.
im taking the exam in 4 weeks. basically started prepping a couple of days ago. my goal is to do UW and FA as thorough as possible and listen to goljan audio. and using kaplan for biochm and behavioral.
my problem isnt what books to use or how to study...
its more like the moral support. i was hoping i could find it here on this forum. im getting real anxious. anything to help guys?
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hmm...for the start you could have written in a different thread and not in the experience thread.
that aside...neither the exam writer nor the exam itself is our enemy, it is us, the guy in our head discouraging us. remember this qoute: "We found the enemy, and it is us!"
if you can fight that little bastard in your head you should be sorted. It takes a lot of mental strength to work several weeks without burning out or losing touch.
What I do, before I start a session, I always think about the day the exam is done and I imagine how I see my great score on the screen and share the good news with my family and friends, how happy I will be. this and regular exercise helps a lot...obviously you can go and figure out your OWN best way to motivate yourself. just be aware of that little bastard in your head telling you "you cant do it", "give up!", "go and watch a movie instead"!
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hmm bbydoc, how long have you been hearing this 'little bastard' inside your head? Does he ever tell you to harm yourself or others?
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constantly my friend...the story of my life!
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This forum never cease to amaze.
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Thanks for confirming there are non neurotics in here
Psychoforme saves the day again
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He is best known for Path. He also has a RR for Biochem but it's not necessary.
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I am so NERVOUS! Ahhhhhhh lol...
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thought RRBiochem was fantastic but it's not as high yield as path.
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I set my countdown timer to 11:00 am Wednesday. I have heard that is approximately the time it is released.
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no need to be nervous... even fm docs earn a 6 figure salary in case you do bad
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yea... i know in like a decade or two family medicine will take off, a lot of undeservingly highly paid specialties will fall back to earth.
medicine is just. if i were running a country, i'd subsidize family medicine salaries the most.
medicine is just. if i were running a country, i'd subsidize family medicine salaries the most.
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Because it's what the cool kids do. Actually, I've talked with quite a few people in my school who did awesome on boards, were always telling people they were gunning for plastics/derm/ortho, and suddenly have taken a real liking to FM during 3rd year. While this certainly might not be typical, most people don't really understand what goes into a lot of the areas of medicine, particularly if they have limited/no experience with them prior to their third year of medical school.
Then again, keep in mind this "bashing" was coming from a guy who's apparently going into psych . . . 😉
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This was my test in a nutshell. 236 on UWSA2 and I felt like I got kicked in the balls by anatomy and female repro for about four straight blocks. Same advice as everyone else- dedicate your life to FA, RR, UW, and BRS phys.
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This makes me wonder if they give the same question set to test takers because those topics he mentioned in his post would summarize the largest part of my exam. I would say there was at least 5-7 straight anatomy questions per section as well as 1 or 2 immuno questions that had no clinical/medicine relation at all (IMO).
Lots of topics I considered to be rather obscure medical conditions when all along people told me the test was mostly on the common stuff. Not that I didn't know some of them, but I was surprised to be tested on them.
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I think I had this same exam too. It was insane how many pelvic CTs I had with so many tough immuno. I also noticed there was a decent amount of difficult Genetics involving lab analysis. I hope I guessed correct. I also feel like every case had someone with some kind of renal problem or proteinuria.
One thing I noticed was I had gotten so used to practicing on UWORLD and KAPLAN Q BANK that I got used to recognizing the "trap" answers. So a lot of times w/ practice questions I'd think Id know the answer but then I'd figure it was a trick answer and so I'd pick the other choice and I'd get the question correct. So basically I became a good UWorld and Qbank test taker and not necessarily at good USMLE test taker if that makes sense. Im just not sure if the USMLE has a lot of trap answers like that or not because sometimes some answers seemed so obvious but I was tempted not to pick it b/c of hte habits I developed w/ UWorld/ Qbank. So that definitely threw me off.
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This describes my test experience pretty well too, both in content and in my ability to think myself out of the obvious answer in favor of selecting a more obscure one.
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I cant log into my NBME exam services site anymore as of today. It sends me directly to a page about registering for Step 2. Did this happen to anyone else? Maybe it means they took the site down while they get the scores ready.
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just tried it and it's the same as it ever was for me.
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Idk, I feel like FM is one of those fields that'd be hard to get a good feel for in 3rd year. One of the biggest draws is the longitudinality and you wouldn't be able to see the same patients again for the most part, compared to IM etc.
Are you kidding? Okay, here is how to do well on Step 1. Study as hard as you can during the first 2 years of medical school. Get as full an understanding of pathology as you can during year 2. Don't overlook biochem and cell bio. Study for one month for the boards after 2nd year. Kill it.
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I dunno, I think UW gives you a pretty good summary of each question, etc. A lot of the questions on the exam were very similar, but the wrong answer choices were a lot more wrong. I think the key is using it for a learning tool as opposed to using it to try to assess where you stand. That's what self-assessments are for. I didn't even pay attention to what my scores were until I finished the bank.
