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Hello everyone. I am a second year who will write the exam in June 2011. Meanwhile let this be a good thread where everyone share their study progress and recent trend of the exam.
Official 2011 USMLE Step 1 Experiences and Scores Thread
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While there's a good chance I missed more than I recall, there are only five questions that have haunted me that I feel like I should have known. Two of those were pretty dumb slip-ups. The other three were neuroanatomy questions and that just happens to be one of my biggest weaknesses. The other questions I didn't know I felt like I probably couldn't have gotten no matter how much I studied - some VERY random facts tested. The only exception is behavioral (the situational questions) - I felt like they were terrible, arbitrary questions. I kind of wish I would have read BRS behavioral or something, but of course you can't know everything.
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I haven't posted in awhile but I found a lot of the posts useful before I took the exam so I figured I'd post as well. Disclaimer: I took the exam before they made all the changes.
I subscribed to UW in August and did questions along with the material in class and by the end of the year I'd done about 70%. Total I had just over 4 weeks to study (to be honest I would have been content with 3 weeks). I restarted UW when I started studying for boards full-time. I memorize questions pretty easily and I didn't want a falsely high percentage so I bought Kaplan Qbank about a week into hardcore studying. I think UW is a better source as a whole as Kaplan is pretty detail-orientated.
Materials-FA (reviewed some sections multiple times, others only once), Goljan RR and audio, Micro made ridiculously simple, BRS biochem. I think you need to minimize the number of materials you use. Use FA primarily and only use other stuff if you're confused. I did use RR with each of the systems and I think it was worth it because I was able to remember the concepts a bit better.
Week 1-3: I reviewed an entire system every day (all the anatomy, path, micro, pharm, etc) then worked problems from that system along with 1-2 random blocks. I studied about 9h/day the first week and by the 3rd I was up to about 12. I also spent a day on biochem (a week area and as it turns out the q's on biochem on my exam were pretty easy). One thing I'm really glad I did was keep a notebook of stuff that I frequently got confused or the explanations of higher-yield problems I missed. I also listened to Goljan throughout. I started out only doing a couple of question blocks each day and gradually increased the number of questions I did each day.
Week 4-I mainly memorized the details and reviewed my weakest areas while doing 4-5 question blocks per day.
My exam didn't have a theme and I left with mixed feelings. The first 1/2 was way easier than UW but the 2nd half was pretty tough. The first few sections I finished with about 20 mins to spare but the last few I needed every second. My exam had some pretty tough anatomy; stuff I hadn't seen since 1st year and wasn't in FA. It was a lot of random and off the wall stuff so I don't think it would be wise to study more than what's in FA. I think I got lucky and those questions were experimental as it ended up being one of my best subjects. My behavior q's were almost all common sense with only a couple of easy calculations (I got lucky as stats is my weakness). Most importantly, don't change your study habits because someone on SDN said that there was a lot of _______ on the exam. These tests are very different and it's the luck of the draw! There were so many things that people mentioned that I never saw and you never know what questions are experimental.
UWorld-~70% finished 1st pass, 80% fininshed 2nd pass with 68% correct.
Kaplan-~60% finished with about 62% correct.
NMBE 5-took before I started studying, predicted 205
NMBE 6-about a week in, predicted 215
NMBE 7-a week before my exam, predicted 220 (before I started memorizing all the details)
I never took a full length as I figured 12 hours of studying/answering questions was enough to build up my stamina and I wanted to spend more time memorizing/learning.
After the exam, I looked up the questions to the questions I spent some time on and it just made me feel like I failed. Just remember, you won't remember the questions you know you got right. Don't beat yourself up over missing stupid details either-it's going to happen. I marked tons of questions every block so don't let that get you down either. The only thing I wish I had known before the exam is the heart sounds are way different from UW or Kaplan. You have a stethoscope that you move around and none of my promts (3 q's) had any symptoms so you couldn't figure it out from the question alone like UW.
Most importantly, remember life on the wards is much better and isn't far away! It's just as exhausting but it's great to actually see the stuff I spent so much time reading about. Good luck!
I subscribed to UW in August and did questions along with the material in class and by the end of the year I'd done about 70%. Total I had just over 4 weeks to study (to be honest I would have been content with 3 weeks). I restarted UW when I started studying for boards full-time. I memorize questions pretty easily and I didn't want a falsely high percentage so I bought Kaplan Qbank about a week into hardcore studying. I think UW is a better source as a whole as Kaplan is pretty detail-orientated.
Materials-FA (reviewed some sections multiple times, others only once), Goljan RR and audio, Micro made ridiculously simple, BRS biochem. I think you need to minimize the number of materials you use. Use FA primarily and only use other stuff if you're confused. I did use RR with each of the systems and I think it was worth it because I was able to remember the concepts a bit better.
Week 1-3: I reviewed an entire system every day (all the anatomy, path, micro, pharm, etc) then worked problems from that system along with 1-2 random blocks. I studied about 9h/day the first week and by the 3rd I was up to about 12. I also spent a day on biochem (a week area and as it turns out the q's on biochem on my exam were pretty easy). One thing I'm really glad I did was keep a notebook of stuff that I frequently got confused or the explanations of higher-yield problems I missed. I also listened to Goljan throughout. I started out only doing a couple of question blocks each day and gradually increased the number of questions I did each day.
Week 4-I mainly memorized the details and reviewed my weakest areas while doing 4-5 question blocks per day.
My exam didn't have a theme and I left with mixed feelings. The first 1/2 was way easier than UW but the 2nd half was pretty tough. The first few sections I finished with about 20 mins to spare but the last few I needed every second. My exam had some pretty tough anatomy; stuff I hadn't seen since 1st year and wasn't in FA. It was a lot of random and off the wall stuff so I don't think it would be wise to study more than what's in FA. I think I got lucky and those questions were experimental as it ended up being one of my best subjects. My behavior q's were almost all common sense with only a couple of easy calculations (I got lucky as stats is my weakness). Most importantly, don't change your study habits because someone on SDN said that there was a lot of _______ on the exam. These tests are very different and it's the luck of the draw! There were so many things that people mentioned that I never saw and you never know what questions are experimental.
UWorld-~70% finished 1st pass, 80% fininshed 2nd pass with 68% correct.
Kaplan-~60% finished with about 62% correct.
NMBE 5-took before I started studying, predicted 205
NMBE 6-about a week in, predicted 215
NMBE 7-a week before my exam, predicted 220 (before I started memorizing all the details)
I never took a full length as I figured 12 hours of studying/answering questions was enough to build up my stamina and I wanted to spend more time memorizing/learning.
After the exam, I looked up the questions to the questions I spent some time on and it just made me feel like I failed. Just remember, you won't remember the questions you know you got right. Don't beat yourself up over missing stupid details either-it's going to happen. I marked tons of questions every block so don't let that get you down either. The only thing I wish I had known before the exam is the heart sounds are way different from UW or Kaplan. You have a stethoscope that you move around and none of my promts (3 q's) had any symptoms so you couldn't figure it out from the question alone like UW.
Most importantly, remember life on the wards is much better and isn't far away! It's just as exhausting but it's great to actually see the stuff I spent so much time reading about. Good luck!
D
deleted116380
Figure I'd post how UWSA 1 and 2 compare to the real exam.
UWSA 1 - 13 days prior to the exam (already finished studying by then) and it over-predicted by 3
UWSA 2 - 6 days prior to the exam...started to get bored re-reviewing...and it over-predicted by 6
So the average over-prediction was 4.5 post-studying. I went through FA many many times, which is my normal technique for block exams during school (I go through everything 10 times).
Did UWorld twice and didn't care about the percentage as I did it before I studied and then again while studying. Rapid Review path was overkill as was Kaplan qbank and NBME practice tests (only did 1 and UWSA was good enough).
Basically, stick to FA and UWorld qbank + SA1 and 2. I had several questions repeat on my exam and still missed some of them, lol. Overall happy with my score.
cliffs: don't dilute your studying by using a lot of resources. FA + UW = golden. Memorize every word from those and you will do fine. Doing well during 2nd year and getting the foundation was probably most key, but you need to know how questions are asked to succeed.
Glad this junk is over with...
UWSA 1 - 13 days prior to the exam (already finished studying by then) and it over-predicted by 3
UWSA 2 - 6 days prior to the exam...started to get bored re-reviewing...and it over-predicted by 6
So the average over-prediction was 4.5 post-studying. I went through FA many many times, which is my normal technique for block exams during school (I go through everything 10 times).
Did UWorld twice and didn't care about the percentage as I did it before I studied and then again while studying. Rapid Review path was overkill as was Kaplan qbank and NBME practice tests (only did 1 and UWSA was good enough).
Basically, stick to FA and UWorld qbank + SA1 and 2. I had several questions repeat on my exam and still missed some of them, lol. Overall happy with my score.
cliffs: don't dilute your studying by using a lot of resources. FA + UW = golden. Memorize every word from those and you will do fine. Doing well during 2nd year and getting the foundation was probably most key, but you need to know how questions are asked to succeed.
Glad this junk is over with...
Thanks for the post. Good to hear UWSA1/2 were quite accurate for you. Makes me feel nice and warm inside.
I just want to re-emphasize what he said about working hard in school. I haven't taken it yet, but I feel like I've been able to use FA and UW really effectively because I really tried to learn all the concepts during school.
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So people aren't reading the blue margins for Goljan? Just sticking to UW+FA?
+1 to this. unless i start doing terrible in path, but as of now i have other areas to focus on...speaking of: i just started doing my final review and looking for some advice. schedule is AM: do 2-3 blocks of UW marked questions. PM: review portion of FA and do questions in kaplan qbank. So, qbank seems a little...inferior (by a little I mean alot) to UW is just about every category (I think it has good anatomy). What if I just did UW questions from that specific subject at night? Obviously I'll be seeing UW alot, but I'm not worrying about % anymore (72% first pass, pretty good trend upward). Do you guys think the Kaplan bank is a good idea, or just review UW? Thanks for any advice.
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Why not UW plus kaplan anatomy?
Yea that's what I'm starting to think. Just started, but the behavior science questions are kind of stupid/annoying. I guess I was seeing if anyone did this...but yea, as someone mentioned above, nystagmus + acting strange = PCP. yes, even a 13 yo girl. Wayne brady style.
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Haha, I did, in fact. One NBME practice test for that one. Although I did have to re-take it once because that strategy totally sucks for verbal
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so, I'm kind of confused...which assessment is a more representative gauge of your progress -- UW assessments or NBMEs? I took UWA#1 about 2 weeks ago and got a 236. I'm 4 weeks out from my exam and wonder if this score is misleading. I'm going to take NBME #5 tomorrow and see 🙁
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Yeah, I'd reference anatomy and then pretty much all the formulas in physio and biostats elsewhere. Those are the only areas high yield enough to bulk up on.
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took the exam few days ago, was wondering if experimental questions are obvious or they can be easy, medium and hard? I'm asking because I probably missed 20 easy questions (bad 50/50 luck and changed answers... bad idea) and actually probably got most of the harder questions right.
Exam is very similar to uworld, some gimme questions (1 liners) and very very long stems. Had to mark like half the test for every block cuz wasn't 100% sure on every question. Had a decent amt of anatomy and very heavy on lungs and repro. Felt comfortable after the exam and then realized that i made have made more mistakes than I wish I had and made some stupid decisions on the test, so sort of down now. Nothing is too crazy on the test, even the things we've never heard of like ST14, there's a way to answer the question, it's not testing a detail but testing how you think and what you know already, dont get too bogged down on those. My practice scores were btwn 250-260. Hoping for just a 240 now, don't even know if i got 85% on the real thing. Hopefully 80%+ is good enough for 240. Good luck everyone.
Exam is very similar to uworld, some gimme questions (1 liners) and very very long stems. Had to mark like half the test for every block cuz wasn't 100% sure on every question. Had a decent amt of anatomy and very heavy on lungs and repro. Felt comfortable after the exam and then realized that i made have made more mistakes than I wish I had and made some stupid decisions on the test, so sort of down now. Nothing is too crazy on the test, even the things we've never heard of like ST14, there's a way to answer the question, it's not testing a detail but testing how you think and what you know already, dont get too bogged down on those. My practice scores were btwn 250-260. Hoping for just a 240 now, don't even know if i got 85% on the real thing. Hopefully 80%+ is good enough for 240. Good luck everyone.
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Question banks will probably directly hit about 50% of your anatomy Q's on the test, but memorizing a few basic things is enough to guess your way through most Q's. Obviously a combo is ideal. Definitely flip through Netters or something and just take a few minutes to remember what stuff looks like. This takes so little time but I seriously doubt a lot of people do it.
Highest yield is probably knowing the nerves that innervate the limbs and the dermatomes. 2nd would be the stuff in FA and the organ system embryo laid out in kaplan's anatomy chapters if you have the notes. Clinical correlates in kaplan and/or UW were equally good IMO and will probably give you a good chunk of freebies...so worth it if you have the time, but might not be super high yield.
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Congrats on being done. That's totally normal. I kept remembering new questions and stressing about the additional stuff I thought I got wrong for weeks afterward, even the morning after I got my scores back.
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The factoids in UW and Goljan are about equal yield in my opinion. Goljan has most of the UW ones but are harder to make stick than UW because you're not getting a whole clinical correlate with each one. But Goljan has more. Either way, neither is high yield for rote memorizing...you may get 2-3 extra questions right because you remembered a fact that wasn't in FA. I'd use UW to tie things together conceptually and learn the way they ask questions for certain topics, and stick to FA for memorization purposes.
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I intend to purposefully make myself constipated to avoid this from happening.
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Got my score yesterday, 8am EDT. 256/99. 😀 The score falls squarely within the 254-259 range predicted by my NBMEs. Glad I already have closure for this. Now I can finally start studying for CS, which I'll be taking in a week. Wish me luck!
Hmm...abdominal pains on that end are not that much more pleasant...
It's so funny how much of this thread has been dedicated to bowel control (there were some posts earlier about taking imodium).
Gastrointestinally, we are all about 80 years old right now.
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Congrats on being done. That's totally normal. I kept remembering new questions and stressing about the additional stuff I thought I got wrong for weeks afterward, even the morning after I got my scores back.
Thanks for the comfort, did you actually get those questions wrong? Bc I know I did get those wrong hahaa =/
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Thanks! I picked up a lot of great advice from SDN. I wish I'd known about this forum earlier.
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Congrats! You blew it out the water!
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Nobody can answer this because nobody knows. It's only rumored that there exist "experimental" items and, as far as I have seen, there is not an ounce of proof on these forums or elsewhere to confirm their existence. People keep bringing them up, I assume, as a USMLE defense mechanism: if you didn't understand a graph, recall an esoteric point about X bacteria, or only vaguely remember learning that muscle insertion, you can always call it an experimental and feel better about it. Just because it was not covered by FA does not an experimental item make. FA is gold, but at the end of the day it's a 150-200 page (spread over 550), $40 review book and is not intended to replace a 2 year pre-clinical med education.
With the standard 3 week score reporting delay, they could introduce new items and collect data from >1000 test takers in order to adequately evaluate the new questions before deciding how to grade / whether to include them. Imagine how many new items they could introduce with the yearly 8 week reporting delay in May-June.
Finally, how 'bout this for an N=1 anecdote: girlfriend and I took the exam 1 year apart and both had a question about a skull recess not mentioned in ANY review book (BRS/HY included), atlas, or even in Netter's. The question could be answered through reasoning and knowledge of skull bones, but I'd still put it at a "15% correct" type item. Was it experimental last year, both years? The likely answer is that it was introduced, evaluated, and decided to be a good question in a single year, but FA has not picked it up because it's terribly low yield and/or nobody has given them feedback on it yet.
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My thinking is that there are no "experimental" questions. To be honest, I have absolutely no clue why SDN is so convinced that there are. I feel like the folks over at NBME want a nice bell curve for their test so they are therefore required to include a fair amount of impossible questions. If they didn't, they'd have a negatively skewed distribution.
So, does anyone have any reference for the existence of these experimental questions? Otherwise, I think its probably healthier to just know that there are going to be some ridiculous questions because they need to make a curve.
All that said, i'm sure there are times that if a question is deemed to be terrible, say each answer choice getting 20%, then they may remove that question. That doesn't make it experimental, it just means that it turned out to be a poorly written question.
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It is actually the perfect segue into 3rd year. Congratulations on being done with Step 1! Now, go disimpact.
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I have mine June 15....and thanks. I prefer to maintain a little bit of an inferiority complex by believing that all of my classmates are more academically gifted and compensate by working my butt off like usual.
I also hold a bit of a grudge against a few schools for never giving me a chance, so I pretend it is like sports and that all the other teams that skipped over me can see the stats and go, "Damn, we messed up there!"
Hahaha, yessss....I know exactly what you mean. Honestly, it takes me a little longer than some of my classmates to "get" things. But I work hard and I'm going to hope that it's enough this time.
to you. You deserve it. Hope you hit that 258 on the real exam 🙂🙂
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I'm just talking about using the formulas. Sometimes it helps to have some text and examples of how they're used.
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Haha, I doubt it since I did pretty well and I seemed to keep second guessing tons of Q's. You never know for sure. Hang in there and don't stress too much 😉
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I'm going to agree with Sheldor here. If I were an organization writing a test, it would be pointless to have a bunch of questions that are chosen a-priori to be not graded. Not only does it decrease the dynamic range of the exam but it also has a greater chance of cheating students out of points when they are, by chance, more familiar with the experimental material.
If I wanted to include experimental questions, I would simply have them all be graded and exclude the ones that are "statistically bad." These would be the questions that people get correct by less than random chance (100%/number of choices) AND there is no trend of students getting this question correct more often if they score better overall on the test (if the smarter students get this question right more often, then its likely still a valid question, just very difficult).
Until I get positive proof otherwise, I'm going to believe that every question counts for something.
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Well ill see your "believe every question counts for something" and assume that every question I dont know on the real thing is actually experimental. So if I dont get a 280 imma be pissed and know that the NBME messed uppppp.
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I couldn't agree more with your addition to my original thought. I guess I am the most curious where the idea of "experimental questions" comes from? Has anybody heard this from anywhere other than SDN or "a friend" etc? I believe, and I could be wrong, that the MCAT admitted to having experimental questions, but again I could have just heard that from SDN and be perpetuating a myth, haha
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How come the practice tests don't have any "experimental" like questions and all seem legitimately fair questions?
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I agree that it is an SDN myth. I think the MCAT having an experimental passage probably contributed to the legitimacy of the "experimental questions" myth.
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It probably doesn't help that First Aid states outright that there are experimental questions. (pg 20 of 2011)
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Edit: Got my score back: 247!!!
Hey guys. Just took it this morning and oh it feels so good to be done.
I got a lot out of this and the 2010 thread so I'll make my donation to posterity.
Background:
ACT: 33 (wtf you're including your ACT score?)
MCAT: 38
Med 1 & 2 grades: Pass, just below average at a top 50 school. (I tend to get less than awesome grades but do well on standardized tests).
Practice Exam Scores
UWSA 1 Before studying: 209
NBME 11 2 weeks in: 219
UWSA 2 4 weeks in: 256
Free 150 5 weeks in: 260
NBME 7 6 weeks in: 235
Uworld estimate: 245
If UWSA tend to overpredict, then perhaps my predicted score is in line with NBME 7.
Study
My school gives us pretty much 10 weeks to study if we want it. I decided to give myself about 7 weeks so I could take it slow. Most upperclassmen at my school suggested 5-6 weeks. I know I can get burned out easily and definitely can't do the 10-12 day crap you read about on here. I averaged 6-7 hours a day and maybe 8-10 towards the end.
I took breaks throughout the day and week PRN. I used the CramFighter app to track what I needed to read. I would highly recommend it.
Initially, my resources were going to be FA, BRS Phys, RR, and Uworld. I ended up ditching BRS Phys and only reading the blue notes and looking at pictures in RR. I'm not much of a textbook guy. I want things to be as lean as possible so FA + Uworld was perfect for me.
For the first 5 weeks I did FA chapter by chapter and did corresponding questions in Uworld. I tried to throw in some random blocks and did increasingly more random questions as I studied more. Usually did and reviewed one full 46 question block per day. Maybe got in an extra 23 here and there.
The last two weeks I fiinished UW, went over a good number of incorrects, and reread FA. I also spent some time reviewing a few personal weak areas. Since I got a lot faster and wasn't annotating as much, I sometimes did 100-150 questions per day.
I think my allocated study time was appropriate. If I could redo things I might shave it down to 6 weeks. I was going crazy and felt like I was forgetting lots of things. However, after going through FA again at the end I regained a lot of confidence.
The Belly of the Beast
So much easier than I expected! I felt it was easier than Uworld, but more difficult than NBME 7. More or less in line with the UWSAs. Definitely several questions I was clueless about, but none of the ridiculous quaternary Uworld questions about some downstream biochemical pathway or effect.
I'm a speedy gonzalez test taker. I finished my Uworld blocks in about 30 minutes. I slowed down a bit on the real thing to think some questions through a bit more. Marked 1 or 2 per block (not saying that's the only ones I didn't know, just the ones I needed to think about more). Did about 35 minutes per block and was done in ~4 hours.
I felt the questions were very straightforward and not tricky. Difficult perhaps, but not tricky. There were definitely questions where you needed to pick up on a semi-subtle clue to help you make the diagnosis.
I don't think I could have been prepared for the hardest questions no matter how much I studied (CSF findings in acetaminophen toxicity???).
There were lots of questions where although I didn't know the exact answer, I could deduce a very good guess from what I did know.
As far as subject distribution, I felt my exam was very balanced. No single topic stuck out to me. It was strange that I had 2 shingles, 2 ADPKD, and 2 MS questions back to back at various points during the exam.
Anatomy questions weren't too bad. I have no idea how you would go about studying for anatomy if you wanted more than what's in FA. Seems far too broad of a topic.
I was scared to death of micro and biochem. All my biochem enzyme deficiencies were pretty straightforward "what's the defect?" questions. Had a vitamin deficiency or two that were pretty doable as well.
A lot of the micro was pretty straightforward "what's the organism" but there were a few more difficult ones. Nothing too crazy about having to memorize the entire gram positive/negative algorithm to figure out the bug. One question about what kind of virus herpes is.
One tough worm question gave a detailed description of an intestinal worm in terms of its anatomy. I thought it was describing a tapeworm (that is, not a roundworm) but there weren't any tapeworms in the answer options.
Had one about how Chagas disease is transmitted. Redduvid "kissing" bug right? Options were fecal oral, blood borne, respiratory, and mosquito. Wikipedia tells me bloodborne is possible too, but that sure isn't in FA.
Conclusion
Overall, I was way too stressed out about the exam. FA and Uworld are great preparation. Be confident in what you know. It's easy to go through FA and realize how many details you don't know. Realize that you do know the classic presentations of most diseases, most common drug mechanisms, basic side effects, and basic pathology of most diseases. You don't know all the details but that's ok. I think another 2 weeks of study would have gotten me maybe 5 more questions right if I were lucky.
Thanks SDN!
Hey guys. Just took it this morning and oh it feels so good to be done.
I got a lot out of this and the 2010 thread so I'll make my donation to posterity.
Background:
ACT: 33 (wtf you're including your ACT score?)
MCAT: 38
Med 1 & 2 grades: Pass, just below average at a top 50 school. (I tend to get less than awesome grades but do well on standardized tests).
Practice Exam Scores
UWSA 1 Before studying: 209
NBME 11 2 weeks in: 219
UWSA 2 4 weeks in: 256
Free 150 5 weeks in: 260
NBME 7 6 weeks in: 235
Uworld estimate: 245
If UWSA tend to overpredict, then perhaps my predicted score is in line with NBME 7.
Study
My school gives us pretty much 10 weeks to study if we want it. I decided to give myself about 7 weeks so I could take it slow. Most upperclassmen at my school suggested 5-6 weeks. I know I can get burned out easily and definitely can't do the 10-12 day crap you read about on here. I averaged 6-7 hours a day and maybe 8-10 towards the end.
I took breaks throughout the day and week PRN. I used the CramFighter app to track what I needed to read. I would highly recommend it.
Initially, my resources were going to be FA, BRS Phys, RR, and Uworld. I ended up ditching BRS Phys and only reading the blue notes and looking at pictures in RR. I'm not much of a textbook guy. I want things to be as lean as possible so FA + Uworld was perfect for me.
For the first 5 weeks I did FA chapter by chapter and did corresponding questions in Uworld. I tried to throw in some random blocks and did increasingly more random questions as I studied more. Usually did and reviewed one full 46 question block per day. Maybe got in an extra 23 here and there.
The last two weeks I fiinished UW, went over a good number of incorrects, and reread FA. I also spent some time reviewing a few personal weak areas. Since I got a lot faster and wasn't annotating as much, I sometimes did 100-150 questions per day.
I think my allocated study time was appropriate. If I could redo things I might shave it down to 6 weeks. I was going crazy and felt like I was forgetting lots of things. However, after going through FA again at the end I regained a lot of confidence.
The Belly of the Beast
So much easier than I expected! I felt it was easier than Uworld, but more difficult than NBME 7. More or less in line with the UWSAs. Definitely several questions I was clueless about, but none of the ridiculous quaternary Uworld questions about some downstream biochemical pathway or effect.
I'm a speedy gonzalez test taker. I finished my Uworld blocks in about 30 minutes. I slowed down a bit on the real thing to think some questions through a bit more. Marked 1 or 2 per block (not saying that's the only ones I didn't know, just the ones I needed to think about more). Did about 35 minutes per block and was done in ~4 hours.
I felt the questions were very straightforward and not tricky. Difficult perhaps, but not tricky. There were definitely questions where you needed to pick up on a semi-subtle clue to help you make the diagnosis.
I don't think I could have been prepared for the hardest questions no matter how much I studied (CSF findings in acetaminophen toxicity???).
There were lots of questions where although I didn't know the exact answer, I could deduce a very good guess from what I did know.
As far as subject distribution, I felt my exam was very balanced. No single topic stuck out to me. It was strange that I had 2 shingles, 2 ADPKD, and 2 MS questions back to back at various points during the exam.
Anatomy questions weren't too bad. I have no idea how you would go about studying for anatomy if you wanted more than what's in FA. Seems far too broad of a topic.
I was scared to death of micro and biochem. All my biochem enzyme deficiencies were pretty straightforward "what's the defect?" questions. Had a vitamin deficiency or two that were pretty doable as well.
A lot of the micro was pretty straightforward "what's the organism" but there were a few more difficult ones. Nothing too crazy about having to memorize the entire gram positive/negative algorithm to figure out the bug. One question about what kind of virus herpes is.
One tough worm question gave a detailed description of an intestinal worm in terms of its anatomy. I thought it was describing a tapeworm (that is, not a roundworm) but there weren't any tapeworms in the answer options.
Had one about how Chagas disease is transmitted. Redduvid "kissing" bug right? Options were fecal oral, blood borne, respiratory, and mosquito. Wikipedia tells me bloodborne is possible too, but that sure isn't in FA.
Conclusion
Overall, I was way too stressed out about the exam. FA and Uworld are great preparation. Be confident in what you know. It's easy to go through FA and realize how many details you don't know. Realize that you do know the classic presentations of most diseases, most common drug mechanisms, basic side effects, and basic pathology of most diseases. You don't know all the details but that's ok. I think another 2 weeks of study would have gotten me maybe 5 more questions right if I were lucky.
Thanks SDN!
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