Official 2011 USMLE Step 1 Experiences and Scores Thread

[ProtossCarrier]

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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.

 

[NF2]

Ok...so I have been reading these forums alot and it helped calm my nerves while preparing for step 1. I'll share my experience incase it helps someone. I took the test today after about 6 weeks of prep. I didn't use DIT or anything formal to prepare. I read Goljan RR during the school year, some chapters, but it was hard to keep up with it because the organization didn't really go with what we were learning and I would have to skip stuff that wasn't covered in class...in short it was a pain trying to use goljan to review for class tests so I ditched it second semester. I read alot of review books during the second year. In btn summer of M1 and M2 I started in BRS Path, Physiology and randomly reviewed some Biochem techniques in BRS Biochem. I was doing research at the time so I only studied like ~5 hrs/wk for step. At the beginning of second year I read Baby Robbins Pathology according to what we were learning in class. I just wanted to get used to seeing pictures but honestly I don't know it helped with tests. I would say I worked pretty hard second year but overall I would say I am a "B" student even though I feel I understood alot of what I did. So in short, during second year, the books I read along with class notes were MMRS (most of it), BRS Path, Kaplans Immunology LN and Kaplan Pharmacology LN. I listed to most of Goljan audio...and I think it was helpful because he tries to integrate alot of different things like labs and why things go wrong as opposed to just stating facts....

-In January I also started reading sections of First Aid 2011, overall I got thru the whole FA once before the end of second semester. I also started Kaplan Qbank doing ~40 questions every other day mostly on stuff we were learning in class so I didn't feel like I was wasting time. I 599 questions (57% correct) before I stopped using the Qbank at the start of my dedicated study period. I kept hearing that Kaplan Qbank was a waste of time and I needed to start UWorld anyway....

-School got out early May. We took an NBME basic comprehensive science in March and I made a 63 (=~183ish)...so I knew I wasn't going to fail step 1 which helped take down the stress level.

-At the beginning of my study period my plan was to start a different review book every three days but after rading 4 chapters of BRS Physio I realized that I wasn't really getting anything out it and my mind was wandering so I ditched this plan pretty early. So for the rest of my prep I focused on UWORLD questions and annotated into FA. I also took notes in a separate notebooks on some days because it would help speed up the review. Here are the major highlights of my review for each subject.

Pharm and Biochem: Kaplan videos...seriously if you have time, watch these, it helps if you have the review books so u just follow along and it keep you engaged as opposed to just watching without anything to take notes on.

Immuno:I read the first 7 chapters of immuno lecture notes during the spring

Micro: CMMRS...most of it except the viruses

Neuro: This is my weakest subject, I started to read HY Neuro but...more on this later

Anatomy: I looked at Netters here and there but realized most of it would just have to be figured out based on things I already knew or from FA

Path: BRS Path during the year, most of it complete, also read Robbins Path during the year ALOT

Behavioral Science: I just memorized the stuff in first aid and hoped it would be enough

Physiology: BRS Physio (Renal, cardio, Resp, and GI) during dedicated study time

FA: read once during the spring, 2 more times during dedicated study time (except GI, Endocrine, Psych, MSK, Reproductive because I ran out of time).

UWORLD: I only went through the whole thing once (58%correct) but was finishing in the high 60s and a few in the 70s. I didn't really have the strength for another run but I see how it can be useful...

Practice tests:

UWSA- 1.5 weeks out---236
NBME 12- 1 wk out----214 (this made me sad and I almost moved my test date)
UWSA 2--4 days out ----254 (atleast I knew I was safe from completely bombing step 1)


As far as the real thing, it was a mixture of UWORLD and NBME type questions...here are the highlights:

Anatomy: Pelvic anatomy and some GI anatomy, FA NOT ENOUGH

Immuno and Micro: FA is enough for both ...not alot of AIDS questions, not alot of nit picky viral structure as I was expecting, UWORLD goes overboard with this...just common diarrhea stuff

Psych: FA more than enough. Immature defences and the like...

Behavioral science: Know the major definitions and calculations, Sens, Spec, NNH etc...FA enough

Path: alot of cardio, MSK, and renal infections and neoplasm, respiratory---not alot of smokers surprisingly, ..most of it is in first aid. 2 heart sounds, one easy, one not sure about...some pictures on respiratory infections--...GI ---alot of hepatitis from alcohol, GI and sickle cell

Biochem: Not as much as I was expecting, easier than UWORLD but then I had also reviewed this separately

Pharm: U world pharm and FA mostly covers most of it but with pharm I believe it is much less painful if you really understand the mechanism and Dr. Ramon of Kaplan does a great job of explaning things you wouldn't otherwise pick up from reading a review book(took four days to listen to all of Kaplan Pharm lecture notes because I didn't really learn it during the school year). If you are weak in Pharm, I highly recommend this...other than that on the test, there was Kinetics, interactions, alittle of ANS and most of the agonist/antagonist stuff in FA ...also the FA pharm sections at the end of the system chapters are helpful and a good quick review

Neuro: Not as specific as I was expecting....a few infections, blood supply, hemorrhages and a lot of MRI and locations of stuff...not alot in the way of ipsilateral/contralateral confusing stuff so not hard...I felt my Neuro class in med school was way harder than the stuff tested on Step 1. Try to understand EVERYTHING in the FA Neuro section

Miscellaneous:

I took a break after every 2 blocks, no big meals in between, just snacks--pudding, chips, coffee, water and used the bathroom during each break. The first section is the most nerve racking because you are in a new environment. Marked about 10 questions per section and had enough time to review in the end. Used up the whole time for each section.

Overall, I prayed alot in the last few days before the test. I would say I am not the most efficient person but I am okay with my effort. This is a hard test so you definitely have to study....how hard is up to you. Some people can study all day but others are not made that way so just do what you can and one more thing...if you need more time to prep than others, that's okay too. If I could review faster I would have but some days I am just more productive than others so I definitely needed that whole 6 weeks. If you have questions, let me know. Good luck to everyone who still hasn't taken this test🙂.

 

[bbydoc]

thanks for the writeups, guys!
hope you all killed it!

 

[dude1344]

.

 

[Step1Hash]

Time for my writeup that I promised. As i said I thought my test was quite difficult and a lot wasn't found in FA....

Alot of people have been mentioning how difficult genetics is...is it just not knowing the inheritance pattern of diseases or is there something else that makes it difficult? Any idea how to better prepare?

Thanks for the post..i'm sure everyone who took your form found it difficult as well. Congrats on being done!

 

[justaregularmed]

I always find it amusing when people say stuff isn't in first aid. Most of the time it probably is, as a side note, somewhere random. Almost any question that involves reasoning wont be spelled out in first aid, its a fact book, not a text book. This is why you don't memorize the book before you understand it (or if you do memorize it, don't forget to work out those associations and concepts), because it is in first aid, you just had to string together 2 or 3 facts to get the answer. Obviously First Aid doesn't contain EVERYTHING (and we are well aware of specifics), but you would be hard pressed not to find nearly everything in there if you really went looking.

I'm very particular about this because using too many resources (taus method) is going to leave most people in the weeds. If they had just really focused on a few resources (assuming you didn't need extra extra help) you WILL do better.

 

[speedyk]

I always find it amusing when people say stuff isn't in first aid. Most of the time it probably is, as a side note, somewhere random. Almost any question that involves reasoning wont be spelled out in first aid, its a fact book, not a text book. This is why you don't memorize the book before you understand it (or if you do memorize it, don't forget to work out those associations and concepts), because it is in first aid, you just had to string together 2 or 3 facts to get the answer. Obviously First Aid doesn't contain EVERYTHING (and we are well aware of specifics), but you would be hard pressed not to find nearly everything in there if you really went looking.

And i find it amusing when people pretend to know what questions i had on my test.

 

[dude1344]

I always find it amusing when people say stuff isn't in first aid. Most of the time it probably is, as a side note, somewhere random. Almost any question that involves reasoning wont be spelled out in first aid, its a fact book, not a text book. This is why you don't memorize the book before you understand it (or if you do memorize it, don't forget to work out those associations and concepts), because it is in first aid, you just had to string together 2 or 3 facts to get the answer. Obviously First Aid doesn't contain EVERYTHING (and we are well aware of specifics), but you would be hard pressed not to find nearly everything in there if you really went looking.

I'm very particular about this because using too many resources (taus method) is going to leave most people in the weeds. If they had just really focused on a few resources (assuming you didn't need extra extra help) you WILL do better.

Have you taken the test yet? There will be many things that are not mentioned at all in FA. I memorized FA completely (AND understood everything) and I knew what page every disease could be found etc. And there was a ton of stuff that is not in it.

 

[TheLoneWolf]

👍

 

[TheLoneWolf]

I love this forum so I have to post my experience. Nobody comment on the grammar because I have had about 5 martinis and 3 shots so I'm wasted but my dedication to this forum forces me to still post so I must.

I gotta say guys the test is not bad. I hope that I did well but I felt it was fairly "easy" in the sense that we have been preparing for it for so long. I think FA + Uworld is more than enough. I even think UWorld is too much because it makes you think the world is trying to trick you.

The highest I ever got on a practice test was a 242 on NBME 7 I think so I am not sure how I did on the real thing. There were probably 15 qs that FA could not prepare me for on the entire test out of 322 so I don't think that is bad. The rest you could reason out or pick up from FA or UWorld.

I saw people studying before the test form FA...dont' do that. What is wrong with you people. It's an 8 hour test. Chill out and relax, don't study. Come on man. Why would you do that.

My test was Immuno, Cardio, and Renal heavy. Here is the breakdown for you guys.

Renal: Did someone unleash all the possible kidney diseases on me? Just understand the two pages of the nephro versus nephri and you should be good I feel. Also understand the ATN versus DIC, the simple stuff and there is no way you won't kill this section.

Histo: Was there anything there except one question?

Micro: Thank the lords of the Step 1 this was one of my strong points and man did I get 30 Qs on this. The common stuff with the common presentations, it is so doable.

Pharm: Easy stuff with the common side effects for most drugs. Just know FA. One drug in there that I had never heard of but the rest were in FA. Don't sweat it.

Pulm: Pretty easy stuff. You can do this if you have a basic understanding of this stuff. Just study FA and you are set. Know a little anatomy too.

Neuro: Was so easy that I am pissed I spent 1 full day on HY Neuro. Really I am floored by the stuff I saw. You could figure this out if you looked at FA.

Genetics: WTF??? Everyone was mating with their Mom and Dad I swear. I had no clue on this crap. This was the worst for me.

Behavioral: Was so easy that I was thanking the pregnant teens across the U.S. for it. It is doable. Maybe 1-2 Qs that make you think but the rest are easy.

Pshcy: Easy! These points you should bank. If you don't, I will find you in your dreams and do things to you that you won't like.

Pathphys: My booty hurts, that's how rough it was. I don't even know how to prepare. There were some that were ridiculous.

Repro: You know it or you don't. Some easy give me stuff you expect. Other stuff has more path phys involved. The usual presentation of the common stuff will be there that is in first aid. Don't know how else you can prepare for it.

Hepatic stuff: Know alcoholics and know them well. Also know the anatomy of the liver. It might be important.

HIV: Know the drugs and know the infections that can happen.

Musculo: Know innervations and the common stuff that can happen...ex: ALS.

Endo: Some rought Qs but most easy stuff. The usual typical stuff. You know what I mean. You can't go wrong with it. Why does the little girl have a penis kind of stuff.

GI: Pretty Easy from what I remember. This hormone does what in the stomach? Oh you take this medication to do what?

Cardio: Heart sounds were a joke. You can figure them out. The Qs were rough around some of the pathology but most of the stuff you can figure it out. Nothing more to add to this.

Biochem: Vitamin Def, Common Enzymes for pathways. So easy for the amount I studied.

Embryo: I had maybe 3 Qs, 2 from FA...1 from who knows where.

Anatomy: You can do this, it is easy. Maybe 2 Qs out of 10 that I didn't have a clue on but even those I reasoned out and I'm trashed!

Heme: Dear God, could they have made this any easier. I felt like I was going to cream myself when I saw the qs they had...the usual stuff, boy eating paint, guy eating him. The usual stuff. You can do this. The cancers are there too. You got this. If you don't get this, I will show up in your dreams again. Cancer!

Immuno: A little easier than I expected but there were a few Qs that were smoking me. But the usual cytokines and receptors kind of stuff. Nothing major.

Did I miss anything? Please let me know. I love you guys. You guys are the best. This test is doable. Don't lose hope. You got this. FA+UWorld is gold. Trust me, I used every resource under the sun. I could cite FA pages as I did the qs.

Oooh by the way, I had about 5 qs from the practice NBMEs. They do show up...it's impossible for them not to.

I hate complement def stuff. Can't wait for the scores but not sweating it too much.

That was by far the most entertaining and informative post I had read all year. I nearly fell off of my chair by having to grab my sides. I'm sure you killed it.

 

[englishpatient]

Have you taken the test yet? There will be many things that are not mentioned at all in FA. I memorized FA completely (AND understood everything) and I knew what page every disease could be found etc. And there was a ton of stuff that is not in it.

I believe it. FA isn't an official syllabus for the step so it's to be expected. I'm sure you still did great tho. Could have just had an exam with tougher questions so nicer curve. Or they could have been experimental

 

[SeekerOfTheTree]

Dude, I was so trashed last night I don't even remember writing this. Oddly enough after going to sleep at 1 I still woke up at 4...happy I didn't have to study though! Party time baby.

Good job to everyone on here. I am sure you guys killed it. There are definately Qs on there that seems like you can't find anywhere. Not even with google.

 

[iA-MD2013]

OK I'm up next (in 20 hrs!!!)...wish me luck seeker 🙂 You're so good at these lil pep talks...and I need one, please!

 

[justaregularmed]

Have you taken the test yet? There will be many things that are not mentioned at all in FA. I memorized FA completely (AND understood everything) and I knew what page every disease could be found etc. And there was a ton of stuff that is not in it.

Oh I didn't say everything. But I would say at least 50% (probably bordering 75%) of the time somebody says "x isn't in first aid" I know where it is generally a side note in a margin in a very odd section not in the index, that all I mean. Not to mislead you need to do an entire question bank on top of FA to weed out the missing stuff and test your understanding. I'm agreeing with you in a way I think FA is terrible because of how fragmented it is but there is a lot in there. You prove my point as well, it wont be on the disease page, it'll be somewhere stupid in the margin.

I also said what I said on the advice of a neurosurgeon (use as few comprehensive resources as you can i.e. FA + Qbank) but maybe he was just smart in the first place.

But we are all different and each test is different so to each their own.

The advice in short I guess would be more amicably put "don't spread yourself too thin" and that's about all I have to say about that.

 

[dude1344]

Oh I didn't say everything. But I would say at least 50% (probably bordering 75%) of the time somebody says "x isn't in first aid" I know where it is generally a side note in a margin in a very odd section not in the index, that all I mean. Not to mislead you need to do an entire question bank on top of FA to weed out the missing stuff and test your understanding. I'm agreeing with you in a way I think FA is terrible because of how fragmented it is but there is a lot in there. You prove my point as well, it wont be on the disease page, it'll be somewhere stupid in the margin.

I also said what I said on the advice of a neurosurgeon (use as few comprehensive resources as you can i.e. FA + Qbank) but maybe he was just smart in the first place.

But we are all different and each test is different so to each their own.

I agree with you that FA is a starting base - you should at least try to learn everything in there. If you worked hard during basic sci FA reviews concepts and has details that is very high yield, that's why everyone uses it. It will probably vary how high yield it is for each individual depending on how their test makeup is.

FA even writes in the book that it should not be used as the main studying tool (though at this point I think it is for the majority of people) as it only contains things they consider must know high yields for the exam.

 

[iA-MD2013]

I know each testing centers differ, but can my FA binder fit in their small lockers?

 

[318038]

OK I'm up next (in 20 hrs!!!)...wish me luck seeker 🙂 You're so good at these lil pep talks...and I need one, please!

Me too! Good luck, let's kill it 🙂

 

[justaregularmed]

I agree with you that FA is a starting base - you should at least try to learn everything in there. If you worked hard during basic sci FA reviews concepts and has details that is very high yield, that's why everyone uses it. It will probably vary how high yield it is for each individual depending on how their test makeup is.

FA even writes in the book that it should not be used as the main studying tool (though at this point I think it is for the majority of people) as it only contains things they consider must know high yields for the exam.

I'm 100% positive you probably know first aid better then I do. I mention the side note thing because every time it happens and I'm aware of it makes me curse at the book and hate it a little bit more and ask them why they didn't put it in the correct section as well, must help with retention. I sort of wish they actually repeated stuff in the actual disease section and not leave out the information you can find about it spread out across 5 different chapters.

 

[iA-MD2013]

Me too! Good luck, let's kill it 🙂

Eeekkk good luck to you too!!!! 🙂

 

[jfgavina]

I doubt FA does not have about 85% of the material tested in step 1.

 

[SeekerOfTheTree]

OK I'm up next (in 20 hrs!!!)...wish me luck seeker 🙂 You're so good at these lil pep talks...and I need one, please!

You got this man, you got nothing to worry about. The only thing you should be thinking about is what you are going to do to celebrate tomorrow. Go in there knowing they throw stupid idiotic questions into every block just to mess with us but we are better than them. Don't get stuck on the stupid stuff and let your muscle memory take over. I swear that crap works. Everytime I didn't know an answer, the first thing that came to my mind I picked and bam, it was right (I double checked!).

Don't let me see you talking about First Aid later today. You need to relax and watch a movie. Don't think about opening that book tomorrow either. It's evil!

I just want you to walk in there and ask the Step 1 people one question tomorrow..."who is your daddy?" and you know what Step 1 will say..."You!!!!"

I LOVE DRINKING! I got you in my toast tonight! Go smoke this like Will Smith smoked Carlton's career.

 

[iA-MD2013]

You got this man, you got nothing to worry about. The only thing you should be thinking about is what you are going to do to celebrate tomorrow. Go in there knowing they throw stupid idiotic questions into every block just to mess with us but we are better than them. Don't get stuck on the stupid stuff and let your muscle memory take over. I swear that crap works. Everytime I didn't know an answer, the first thing that came to my mind I picked and bam, it was right (I double checked!).

Don't let me see you talking about First Aid later today. You need to relax and watch a movie. Don't think about opening that book tomorrow either. It's evil!

I just want you to walk in there and ask the Step 1 people one question tomorrow..."who is your daddy?" and you know what Step 1 will say..."You!!!!"

I LOVE DRINKING! I got you in my toast tonight! Go smoke this like Will Smith smoked Carlton's career.

You're so awesome! I was smiling the whole time I read that and I'm going to read it again tomorrow morning 🙂 Thank you!

 

[Dissected]

I know each testing centers differ, but can my FA binder fit in their small lockers?

It might be close...I don't think it would have fit very well in mine. Just leave it in your car! You can leave the test center on your breaks.

 

[richse]

I took the test today and all I can say was I thought it was way harder than the NBME tests and at least as hard as Uworld Qbank maybe harder. If I only got about 60% of the questions right does anyone know what kinda score range that equates to historically? I'm really not sure how I did because I made a lot of educated guesses. I'm feeling pretty down right now... maybe I can write more later.

 

[HalladayWeekend]

Took it today and didn't think it was too bad. Most was either directly from UW/FA or could be reasoned out from info gained in there. Pharm was especially easy. Of course there were questions that seemed to be out of left field (3-4 per block), but honestly don't think you can really prepare for those outside of knowing everything about everything.

 

[septoplasty]

Took it today and didn't think it was too bad. Most was either directly from UW/FA or could be reasoned out from info gained in there. Pharm was especially easy. Of course there were questions that seemed to be out of left field (3-4 per block), but honestly don't think you can really prepare for those outside of knowing everything about everything.

What about Immuno? Was it heavily tested for you?

 

[dozitgetchahi]

I always find it amusing when people say stuff isn't in first aid. Most of the time it probably is, as a side note, somewhere random. Almost any question that involves reasoning wont be spelled out in first aid, its a fact book, not a text book. This is why you don't memorize the book before you understand it (or if you do memorize it, don't forget to work out those associations and concepts), because it is in first aid, you just had to string together 2 or 3 facts to get the answer. Obviously First Aid doesn't contain EVERYTHING (and we are well aware of specifics), but you would be hard pressed not to find nearly everything in there if you really went looking.

I'm very particular about this because using too many resources (taus method) is going to leave most people in the weeds. If they had just really focused on a few resources (assuming you didn't need extra extra help) you WILL do better.

One thing that I found to be true on the real thing is that while knowing FA cold may not necessarily lead you directly to the answer on hard qs, it usually gives you enough background knowledge to dump some (or even all) wrong answer choices.

The rest of your reasoning ability on this test will largely come from doing lots of qs (and I mean more than just UW).

 

[dozitgetchahi]

I took the test today and all I can say was I thought it was way harder than the NBME tests and at least as hard as Uworld Qbank maybe harder. If I only got about 60% of the questions right does anyone know what kinda score range that equates to historically? I'm really not sure how I did because I made a lot of educated guesses. I'm feeling pretty down right now... maybe I can write more later.

If you prepped solidly, I can almost guarantee you got more than 60% correct (and probably way more). According to FA, a passing score has historically involved getting 65-70% correct. If you were serious enough about studying to do multiple NBMEs, I can pretty much assure you that you at least passed (and probably did way, way better than that).

 

[richse]

If you prepped solidly, I can almost guarantee you got more than 60% correct (and probably way more). According to FA, a passing score has historically involved getting 65-70% correct. If you were serious enough about studying to do multiple NBMEs, I can pretty much assure you that you at least passed (and probably did way, way better than that).

I did really well on my practice tests, literally all between 230 and 250. The real thing felt totally different. When I did the practice tests I felt good about the tests. This thing felt like I was guessing way too much. After the first block I felt like this 😱 After the 4th block I felt like this 🙁 and now I just feel like this

BTW, where did you see the part about historically 65-70% correct to pass in first aid? I can't find that part.

 

[happylunchbox]

Took the test today, and because I got so much good info from ya'lls I'm posting this quick write up before I return to drinking for the rest of tonight...and all of tomorrow....I'll write a longer thing later...

Overall, today was a blood bath, or at least it feels that way now...

The good: I got a fair amount of random questions that I happened to know the answer too but were def NOT in FA, easy pharm, pretty easy micro

The bad: neuro/neuroanatomy and anatomy were ALL over my exam...I'm talking like 5-12 neuro questions per block and easily 8-12 anatomy questions per block. Neuro was my weakest subject...I magically "forgot" all the tracts today and had about 6 or 7 brainstem slides...yay me. I only one question about bleeds which I have down cold...Oh, and I'm pretty darn solid in biostats and behavioral (~80% on UW) and every question that needed a calculation was either a) NOT in FA or b) presented in a 13-line paragraph that required 3-4 to understand what the hell they were saying. Also, I swear some of the ethics questions had two right answers...or should I say both sucked equally...

THE UGLY: The first block and the last block. The first 10 questions of my exam were insane and given some exam day jitters I allowed myself to spend ~20 minutes on them. The last block was filled with 50% WTF!?! questions and I basically found myself with 8 minutes for the last 12 problems. So, when combined with being short on time in the first block, I LITERALLY GUESSED ON ~15 QUESTIONS ON STEP1!!!! The worst part of it all...as I fired through them clicking at random I saw just how friggen easy 60% of them were. Time has never been an issue for me, but I basically lost track regarding how long I spent on some of the questions.

I took the free 150 and got a predicted score in the 240s on medfriends and my UW% was in the low 60s at the end...at this point, I just wanna pass. I really thought things were gonna be OK until the last block, and then boom!

Anywho, nobody feels good coming out of this I guess, so here's to hoping...oh man please let me pass!

My short-term advice for anybody taking it soon: WATCH YOUR TIME!

Good luck to all!

 

[Fillabuster]

Took the test today, and because I got so much good info from ya'lls I'm posting this quick write up before I return to drinking for the rest of tonight...and all of tomorrow....I'll write a longer thing later...

Overall, today was a blood bath, or at least it feels that way now...

The good: I got a fair amount of random questions that I happened to know the answer too but were def NOT in FA, easy pharm, pretty easy micro

The bad: neuro/neuroanatomy and anatomy were ALL over my exam...I'm talking like 5-12 neuro questions per block and easily 8-12 anatomy questions per block. Neuro was my weakest subject...I magically "forgot" all the tracts today and had about 6 or 7 brainstem slides...yay me. I only one question about bleeds which I have down cold...Oh, and I'm pretty darn solid in biostats and behavioral (~80% on UW) and every question that needed a calculation was either a) NOT in FA or b) presented in a 13-line paragraph that required 3-4 to understand what the hell they were saying. Also, I swear some of the ethics questions had two right answers...or should I say both sucked equally...

THE UGLY: The first block and the last block. The first 10 questions of my exam were insane and given some exam day jitters I allowed myself to spend ~20 minutes on them. The last block was filled with 50% WTF!?! questions and I basically found myself with 8 minutes for the last 12 problems. So, when combined with being short on time in the first block, I LITERALLY GUESSED ON ~15 QUESTIONS ON STEP1!!!! The worst part of it all...as I fired through them clicking at random I saw just how friggen easy 60% of them were. Time has never been an issue for me, but I basically lost track regarding how long I spent on some of the questions.

I took the free 150 and got a predicted score in the 240s on medfriends and my UW% was in the low 60s at the end...at this point, I just wanna pass. I really thought things were gonna be OK until the last block, and then boom!

Anywho, nobody feels good coming out of this I guess, so here's to hoping...oh man please let me pass!

My short-term advice for anybody taking it soon: WATCH YOUR TIME!

Good luck to all!

Wow! very similar to my test taking experience. I didn't have much problem with time, but other than that we are in the same boat. First block: insane! Last block: even more insane! My free 150 also predicted 240's and UW was also in the low to mid 60's.

 

[hyrule]

Took the test today, and because I got so much good info from ya'lls I'm posting this quick write up before I return to drinking for the rest of tonight...and all of tomorrow....I'll write a longer thing later...

Overall, today was a blood bath, or at least it feels that way now...

The good: I got a fair amount of random questions that I happened to know the answer too but were def NOT in FA, easy pharm, pretty easy micro

The bad: neuro/neuroanatomy and anatomy were ALL over my exam...I'm talking like 5-12 neuro questions per block and easily 8-12 anatomy questions per block. Neuro was my weakest subject...I magically "forgot" all the tracts today and had about 6 or 7 brainstem slides...yay me. I only one question about bleeds which I have down cold...Oh, and I'm pretty darn solid in biostats and behavioral (~80% on UW) and every question that needed a calculation was either a) NOT in FA or b) presented in a 13-line paragraph that required 3-4 to understand what the hell they were saying. Also, I swear some of the ethics questions had two right answers...or should I say both sucked equally...

THE UGLY: The first block and the last block. The first 10 questions of my exam were insane and given some exam day jitters I allowed myself to spend ~20 minutes on them. The last block was filled with 50% WTF!?! questions and I basically found myself with 8 minutes for the last 12 problems. So, when combined with being short on time in the first block, I LITERALLY GUESSED ON ~15 QUESTIONS ON STEP1!!!! The worst part of it all...as I fired through them clicking at random I saw just how friggen easy 60% of them were. Time has never been an issue for me, but I basically lost track regarding how long I spent on some of the questions.

I took the free 150 and got a predicted score in the 240s on medfriends and my UW% was in the low 60s at the end...at this point, I just wanna pass. I really thought things were gonna be OK until the last block, and then boom!

Anywho, nobody feels good coming out of this I guess, so here's to hoping...oh man please let me pass!

My short-term advice for anybody taking it soon: WATCH YOUR TIME!

Good luck to all!

Similar experience here. I had to completely guess on 2 Biostats questions (close my eyes and pick and answer) out of maybe the 4-5 total I had on the test.. the Q stems were too long. And I pretty much aced UW Biostats. Even if you're amazing at Biostats, if the majority of questions in your specific block are super long or challenging, you're going to have to triage and save Biostats for last. I'm hoping the magical curve in the end somehow takes all this into account. From what I understand and from even reading the 2010 Experiences thread, a small number of us are getting very difficult forms/blocks. I'm not sure if they just pool together questions randomly within a block like UW does, or whether the blocks themselves are pre-determined. Either way, 2/7 of my blocks I'd call "fair." The rest were downright ridiculous.

 

[heyyouduh]

hey all, I stopped reading SDN after getting into med school, but found this thread recently and got some good info and figured I give back and show some solidarity for everyone going through this process.

background: read RR once and FA throughout the year, went through FA 1.5x and UW 2x during dedicated step1 studying. Did free 150, NBMEs 1, 2, 4, 12, and got anywhere from 238 to 250+. First pass through UW (~60%) second pass (~75%).

I took it on 6/22, the night before I slept less than 2 hrs (been sleeping at 6am for a month and couldn't adjust my sleeping schedule in time) and had to drinkk 2 5hr energies and 2 cans of rockstar (0 calories though) throughout the day just to stay awake, so that definitely affected how I performed and feel about the exam.

The actual exam: it was challenging, the exam had some easy questions, a lot of medium questions, some hard ones and some that just felt out of the scope of what we should know. It felt like my exam had a heavy dose of neuro and anatomy and not enough micro or pharm, but I may be biased since I'm good with micro and pharm, not so much with neuro and anatomy.

Timing wasn't an issue, if you can finish a block of UW you can do it, just pay attention to the clock. I flagged about 8 or 9 per block, and for most of them I was down to 2 answers. Each block would have 1 or 2 that I had no idea about, most of them were anatomy related. The exam was definitely more of a thinking exam than just regurgitation, the NBME was very clever with the way they asked the questions, figuring out what they are actually asking for is most of the battle.

As far as prep material: what you learn in school and FA + UW is enough to do well. If you want a stellar score you'll need RR and a source for anatomy. FA is very condensed, there are things you catch on your second and even third read through, it's good to make notes in it. The NBME exams are similar to the real thing, seems like they just trimmed more of the hard and wtf questions out before releasing them online. I honestly have no idea how I did other than I'm decently sure I passed, it's frustrating walking out without any idea how well you did.

Hope this helps, good luck to all of you!

Edit: I would pay attention to physio, FA is more than sufficient, but most of us haven't had any physio classes since year 1.

 

[Dissected]

I did really well on my practice tests, literally all between 230 and 250. The real thing felt totally different. When I did the practice tests I felt good about the tests. This thing felt like I was guessing way too much. After the first block I felt like this 😱 After the 4th block I felt like this 🙁 and now I just feel like this

BTW, where did you see the part about historically 65-70% correct to pass in first aid? I can't find that part.

According to the USMLE website it is somewhere between 60-70% (I think it is in the FAQ page somewhere...I was bored and neurotic one night).

What about Immuno? Was it heavily tested for you?

Not much Immuno here. The immuno I did have was not that bad either.

I did have a crap-load of biostats though. I felt like every 10th question I was calculating an odds ratio or relative risk.

 

[KingSemeloDO]

Took my test on Saturday. I have absolutely no idea how I did, although I have to say that I felt exactly this unsure when I took nbme 7, uwsa 1 and uwsa 2, so I'm hoping my performance was consistent and I scored at least around the same range, though I was really hoping I'd feel better about the real exam. I freaked out a little in my last block because I finished with a little bit more time than other blocks, was looking at my marked questions and changing my answers a lot, and then worrying that I was changing them arbitrarily and screwing myself over.

A few easy questions felt kind of like a Captcha "Are you a human or a spambot?" questions, lots of "Huh, I know what you're talking about but I'm not 100% sure how to answer this" and only a very small handful of "Woah! I have absolutely no idea how to answer this or I really just don't have this crucial fact memorized."

Other people have given better write ups on content. Only other thing I wanted to add about the whole experience was that they did take my phone away from me. 🙁 Which I really wish they hadn't because I had a few unknown answer choices that I saw in one block that I wanted to look up during break, that then came up in the next block. And I hadn't brought my copy of First Aid with me. Ah well.

I definitely got at least one question right because someone had mentioned a drug in a topic on SDN and I looked it up, so thanks guys! 😀 I really wish I'd bought UWorld earlier and done it twice (or that my school had given me more time to study; I used 4 weeks of my available 5). I got quite a few questions right using knowledge I'd learned from the qbank, and even from the self assessments.

Anyway, good luck to those who haven't taken it yet! And to those who have, damn this is going to be a long wait for our scores, but at least we're free!

You are going to be just fine....Wishing you all the best..

 

[godchaser1016]

I know everybody has been saying (for the most part) that UW + FA is great study tool. What about Kaplan Q bank? Did anyone do UW and Kaplan Q bank together? How would you rate the benefit of Kaplan or Rx?

 

[Lizloveslilies]

I know everybody has been saying (for the most part) that UW + FA is great study tool. What about Kaplan Q bank? Did anyone do UW and Kaplan Q bank together? How would you rate the benefit of Kaplan or Rx?

I thought UW was a "complete" question bank that featured a lot of things that I considered high-yield. I thought that UW had questions that hit a good bit of the of the important high points of each subject and had some questions that tested concepts that one does not pick up on their first, second, third, ... pass of FA, Goljan pathology, ... such as the hardcore pathophysiology (being able to tell the story of a disease process). UW also had good explanations for the wrong answers and showed what % of people chose each answer. I also thought that UW had more questions that tested in the same breadth of knowledge as the questions on my real USMLE Step 1 test.

In my opinion, Kaplan is a peg below UW. I felt that some of the questions COULD NOT be answered correctly unless you read med-essentials, and these questions featured details were a little low-yield. Other Kaplan questions were comparable to UW but the explanations to some of the answers were not satisfactory. The little video tutorials for the extra-super-duper hard questions are hit or miss (hit if done by Dr. Wazir Kudrath or Dr. Lionel Raymon, more miss if by others). The behavioral science section in Kaplan is a little crazy with super long question stems and 8 different, ambiguous, sometimes poorly worded answer choices. I definitely liked some of the physiology questions on Kaplan.

In retrospect, I was glad I used both question banks. I went through each question bank multiple times and took notes on each question that I missed/got right for the wrong reasons. Kaplan filled in some of the nit-picky little stuff that I would have ignored and would have netted me very few points on the actual test. UW covered more of the big picture stuff better.

Just my 2 cents 🙂

 

[Encephalectomy]

I know everybody has been saying (for the most part) that UW + FA is great study tool. What about Kaplan Q bank? Did anyone do UW and Kaplan Q bank together? How would you rate the benefit of Kaplan or Rx?

I actually thought that behavioral was the best part of the kaplan qbank. I think that doing more than 1 qbank is a great idea and that kaplan is the second best (I did kaplan and UW twice and got through about 1000 questions of rx)

 

[engineeredout]

I know everybody has been saying (for the most part) that UW + FA is great study tool. What about Kaplan Q bank? Did anyone do UW and Kaplan Q bank together? How would you rate the benefit of Kaplan or Rx?

Personally, I did USMLERx and Kaplan Q bank earlier on in board studying. Used them to get the major stuff down (excluding the stupidity of some of kaplan's questions which they couldn't even reference their own review books on), and then used Uworld near my exam to focus on the little details.

 

[aniusmle]

i have been following sdn forum since quite some time and i loved it....personally my exam was scheduled on september 2nd and due to whole lot of personal problems i was unable to study but now im out of it and hav started 2 study since today...u guys think i can do it in 2 mnths....i have seen lot of gud souls with great advice on this forum,i would really appreciate if sum1 cud guide me with this or even encourage...im **** scared and petrified and i jus cant postpone the exam again due to personal reasons...so guys pls pls help......

 

[noob1]

hey guys, to those of you done with the test, congrats...a quick question though; everyone seems to be talking about how tough the pelvic/ repro anatomy on the exam is this year. I went through HY anatomy yesterday and today, and though the 'clincal' cases in there are helpful, there is barely anything in there not covered in FA or uworld...the anatomy questions you guys had, are they very detailed in regards to vasculature and the blood vessels of the pelvis/thorax/reproductive structures? i'm just not really sure what to review. thanks.

 

[justaregularmed]

Nothing exceptional to report.

Had one pretty screwy ethics question. Had some specialist surgery questions. I had a lot of a 50/50 person with x generic sx what is the most common, except they were uncommon things. I had some step two combination feeler questions that were very obvious. I would say the worst part was they were being deliberately confusing or misleading my test was a workshop in test making trickery, conceptually wasn't that bad. Was very much closer to uworld type confusing then NBME straightforwardness, reminded me of a normal medical school exam and made me die inside a little, i expected more.

 

[Tig2575]

The bad: neuro/neuroanatomy and anatomy were ALL over my exam...I'm talking like 5-12 neuro questions per block and easily 8-12 anatomy questions per block.

Out of your test's 322 questions, 130+ of them were either neuro or anatomy? I think you may be exaggerating just a tiny bit..

 

[Quinone]

Whoa, long post...

So, I took the beast today. It wasn’t terrible but I wasn’t exactly sailing through all the blocks, either. It also didn’t help that there was a chick in the next cubicle who sounded like she had pneumonia. She kept coughing and making these weird hiccuping noises. I wanted to throw my headphones over the divider and whack her on the head.

Anyway, here’s what I remember:

Behavioral: Lots of biostats. Some were easy, and some I couldn’t quite interpret their charts so I guessed. Many of the “What do you say to the patient in this situation?” questions were dumb and I had to guess between two choices. You really can’t prepare for those so don’t sweat them.

Biochem: Pretty basic stuff. FA was sufficient for me. Enzyme deficiencies and lab techniques were hit hard. Very few nutrition questions.

Embryo: Not too much on my exam, though there was one that was definitely not in FA (I looked during a break). If you have time, you might want to supplement with another resource here.

Micro: Straight out of FA. Lots of bacteriology, only a few viruses, and (thankfully) no weird protozoans. Not much hepatitis or HIV, either, which kind of surprised me. Almost no antibiotics, which was also surprising.

Immuno: My exam was pretty immuno heavy. Know ALL the interleukins, immunodefinciencies, and hypersensitivity reactions. There was one IL question that wasn’t in FA and I had to guess. The rest were pretty obvious. I had some repeat questions too, which was nice. 🙂

Path: Had a few tumor markers, oncogenes, and the like. Nothing that wasn’t in FA.

Pharm: Lots of autonomics (definitely know all the second messengers) but they weren’t crazy like some of the ones in UWorld. A few graphs with the “Drug x alone, then drug x + drug y; what is drug x?” questions, but UWorld more than prepares you for those.

Cardiovascular: I had a fair amount of this. 2 heart sounds but I think I got the answer just by reading the question stem. Lots of questions about MIs, HTN, and pharm.

Endo: Seemed like I had a lot of this. A few were kind of wtf. 🙄

GI: Again, had a fair bit. Liver and pancreas seemed to come up a lot. FA was sufficient.

Heme/Onc: I thought this section was somewhat difficult. A lot of questions were easy but for many I found myself debating between two possible choices. Seemed like I had a lot of non-Hodgkin’s lymphomas and coagulation disorders.

Musculoskeletal: Nothing that wasn’t in FA. Review the brachial plexus and lower extremity innervation. This was probably my weakest area at the beginning of the study period but I didn’t think the questions were too terribly difficult.

Neuro: Lots of “Patient had a stroke in location x; what is the deficit?” I had to guess on a few but after looking them up I think most were in FA. Definitely be comfortable with cerebral blood flow and spinal tracts.

Renal: I had a lot here but they seemed pretty straightforward. Classic presentations of GN and such. One calculation of net filtration. Renal pharm showed up a lot in association with cardio and endocrine disorders.

Repro: DEAR GOD. So many pelvic anatomy questions! Ugh. Again, if you have time, definitely review pelvic stuff. I think this was the area where I marked the most questions. Know your hormones too!

Resp: The expected mix of infections, COPD, asthma, heart failure, and vasculitis. Nothing ridiculous.


Overall, I think it was a fair test. There were many subjects which I didn’t see at all and some that were hit over and over, but I think FA and UWorld were sufficient for the majority (probably 70-80%) of the questions. Goljan audio + RR was helpful for me throughout the year to understand the material, but I for this exam I mainly used FA + UWorld and kept RR as a reference. For physio review I used BRS and it was sufficient. I recommend reading the margin notes in RR the day or two before the exam and looking at the pictures; I definitely got a few points today by doing that.

Also, I saw a LOT of repeat questions/images from the NBMEs and Free 150. Granted, they were the easy ones and I probably could have answered them anyway, but it was comforting to see a familiar question in the midst of a string of really baffling ones. 😀

And, if anyone is interested, here are my practice scores:
UWSA 1 (5/27): 232
NBME 7 (6/3): 224
UWSA 2 (6/11): 252
NBME 12 (6/14): 235
Free 150 (6/20): 92%

So, good luck to all of you who will be taking the exam soon! SDN has been a great resource for me and I hope this information helps.

 

[w00tz]

Just took it.

I feel sorry for anyone that has to go through this experience in the future (knock on wood). Like someone posted above, I had been going to bed at 4ish and tried to readjust the week before. Couldn't do and got like 4 hours of sleep. Had to down lots of coffee to keep me going. As for the test...

I thought there was a lot anatomy and that's probably my weakest subject. Maybe it just seemed like a lot?

Some sections were definitely better than others. But there were two sections where I marked 20+ questions. No idea if it was just the section or my mind wasn't there.

Anyways, glad to be done for now. Drinking it up tonight. Will complain in more detail later.

 

[cjtm05]

I took the test yesterday, it was a long day but I'm really glad I am done with that. I've been reading this forum for long time and it helped me a lot I hope someone finds this useful.

Overall it wasn't so bad, specially when I compare it with some of the experiences of my friends that took it the same day and of some of the people that posted in the forums.

my first block was pretty good and I was feeling awesome, then the fun started 2nd and 3rd block ooohhh god! I went from 5-6 marked to 10-15 because there were 3-4 in each block that I was like WTF?
these guys love the what is increased, decreased Q. I got about 40 Q of what would be the finding and they will put ^, decreased, no change. you have to be very careful because it can be in serum, in urine, even how is absorption, excretion affected. So you have to read really well! the last 3 blocks I felt pretty good I was back to having 6-7 marked per block. I was laughing a lot in the last 2 blocks b/c I got two Q that didn't know well the answer, but I remember watching the daily show. stuart making fun of obama's trip to Puerto rico and reading the FA at the same time and the answer was right there. So thanks daily show.



Its incredible how much the test varies b/w people , my friends got a lot of anatomy, I barely got 5-6 Q of anatomy and it wasn't that bad. I felt that endocrine was the only system that I really got a lot of questions. And 20-30 Q of micro(this was good for me and my background) and some really weird ones. Tx Anaplasma phagocytophilum I think its doxy. barely got musculoskeletal, only RA, one lupus and one sarcoidosis. I got killed in the what should the physician say, dammit, that was hard. and the bastards!! put an obvious case of SCID but had ADA and IL-2 R as answers! that sucks. I got no nephritis at all, but a lot of ATN, fanconi and that crap. There was a skin photo of a cherry hemangioma and the guy watching the tape must be laughing his ass of because i was checking my abdomen and back because I have one, just to see if it looks the same.

Preparation:
6 weeks
UW during 2nd year- 75%
did like 65% again during the 6 weeks and was getting 86% but I don't know if that really helps b/c you remember a lot of the questions and don't really test knowledge.
FA is a must, I think >75% is in the FA and complement with UW >80% of the test. I read it 2 times and reproductive, respiratory, endocrine and cardio >3 b/c I was weak in these subjects.
RR and audios, I actually got like 5 Q that were exactly like goljan said.
did NBME 6-12 and was getting >335 but I varied a lot between them.
UW assessment I think overshoots and overestimates. because I got 245 and UW assess 2 260 so I don't know if they are a good estimate, will find out soon

for neuro: some of the high yield helped me a lot.

biochem used FA and BRS, but FA is more than enough.

pharm you really need to add to the FA, I did kaplan and it was awesome for the test, and the french guy from the videos was very helpful and fun to see.

repiratory- FA is not enough specially when you get hammered in the UW questions... I got very frustrated after that, but in the step it wasn't so bad

anatomy is pure luck- what was in my test: 5/6 Q were in the FA, but my friends got some really weird ones that I haven't heard before. I don't know if its worth it to use anatomy review b/c of time.

I think the key is to keep to what works for you! and study really hard 2nd year! When I started studying almost two months ago I felt that 6 weeks was not enough but at the end I really wanted to change the test date to take it earlier because I was sick of studying and was getting burnt out!
Its a long test with the intention of failing everybody that underestimates it. But is a du-able test. Its exactly like gambling, you decide what to focus your studying time and hope that they ask the subjects that you have strength and little about your weaknesses.

any question feel free to ask anything.

 

[iA-MD2013]

DONNEEEE! I'll write up later. Nothing I could have studied more that would have helped...and I wish I could have taken it earlier. Buncha biostats, renal, anatomy, pelvic, biochem, behavioral (the most annoying!!!), and drugs/side effects not in FA. But seriously not at alll bad. Totally doable.

 

[Bifteck]

Hey everyone, thought I would post considering I've been reading throughout this process.

Study Time ~9weeks
Materials - FA, UW, Qbank >>> Goljan (Of course, if you do not understand things in Goljan, you should supplement)
Assessments
NBME 7 - 184 - Before Studying
NMBE 12 - 228 - 2 weeks in
UWSA1 - 252 - 4 weeks in
UWSA2 - 262 - 6 weeks in
NBME 11 - 264 - 7.5 weeks in
Free 150 - 94%-268 - 8 weeks in

I've come to realize that people freak out too much on this board. Overall, the exam was fair. Not to say that there weren't any "WTF" moments or, "really, you're going to ask that?" moments, but overall it wasn't thaaaaat bad. Stick to your studying pattern people, whatever that may be. What people say on here shouldn't influence what you do very much.

I'd say one of the major challenges of the exam is staying focused. It is very easy to let your mind wander and continue thinking about that last question or how you can't wait until it is over. Try to use your breaks wisely to prevent this. I took 2 blocks in a row at most and I think it helped me keep focus throughout. It is very easy to press that Start Next Block button just so you can be done faster but I would suggest that you use your breaks.

With that said, here's a brief breakdown of what I can remember (which to be honest I'm not sure how much it is since it was all a blur - and because I'm drinking... but whatever)

Behavioral - What Would you Do questions were either kind of tricky or ******ed easy. I think it's just a crap shoot - narrow it to 2 and make a guess --> this part of the exam has got to go... it's stupid

Biostats - nothing difficult, all in first

Biochem - To be honest, I can't remember many. Maybe a few glycogen storage/lysosomals. (Oh, and know why your asian friend is always red after 1 drink... apparently this is important enough to ask 2 questions on... lucky i get wasted with asians)

Embryo - don't even think i had 1...

Micro - pretty straightforward actually. Know FA, know it well.

Immuno - very few IL's etc. was this even tested? I don't know.

Path - apparently memorizing all those random chromosomes was worthless.

Pharm - a good amount of questions on drugs, but they were all fairly common. A couple you just had to make a point of memorizing in order to remember it. Not much on kinetics

CV - good amount on MIs, HF, etc. 2 heart sounds which weren't that bad (1 could be had by the stem if you looked carefully...)

Endo - I don't even know, I think it was easy?? know about DM, DI, etc. etc.

GI - uhhh, basically just malabsorption problems

Heme/Onc - Not too much on anemias, but a good amount on lymphomas, tranplants

MSK - ummm lupus, sarcoid, Heberdon's nodes... what else can I say?

Neuro - know your brain lesions, all the basic only really. other than that, nothing out of the ordinary

Psych - easy, know FA only

Renal/Pulm/Repro - I'm getting lazy at this point and to be honest don't remember anything about this... such a blur

Overall, I'd say some of the trickier ones were anatomy-based. But don't do study your anatomy books - had absolutely zero questions on brachial/lumbosacral plexus, nothing about innervations etc. etc. instead they feel that stones in your salivary ducts are important (wtf?)

Anyways, this exam is doable. Don't freak out, use your breaks and just keep doing what you're doing.

Any questions, just ask.

ps. apparently chinese food restaurants still use MSG - watch out....

 

[fizzle]

Just took it today, and I will just say that the real exam was helluva lot harder than the NBME exams and much more random than the UWorld QBank. It wasn't even in the "If I'd spent a bit more time reviewing this material or thought smarter, I'd have known this" category but rather the "I know this disease/anatomy but WTF I've never heard of the obscure detail this question is asking for" category. Lame. At this point, all I can do is rely on the curve. Frankly, I thought UWorld was easier than the real exam. Pretty much most of UWorld can be answered using the information from FA, but I'd say only about 70% of the material on the real exam covered details I had seen in FA.

Not to mention, many of the questions had long and extensive clinical vignettes...I finished each block in time, but I was sometimes cutting it close there and seldom had much time to review (as opposed to the NBME exams, where I had around 15 minutes left after my initial run).

Edit: Just to give you an idea of where I'm coming from: Got 245 on the last 3 NBME exams I took (11, 7, and 6).

 

[BS81]

It seems like I was on autopilot the whole time. I don't remember the first three blocks at all, other than getting obsessed with a renal clearance question which I thought I could just figure out... that killed a lot of time. Once I popped some caffeine gum after the third block, things went a lot better. Barely enough time for 5/7 of the blocks. That's never happened before. Almost every question you could throw out 2-3 answers right from the get go. Then you either know it, or you got a 50% shot. Pharm questions that throw out beta-blockers and antibiotics for treatment for depression is an example of what you will see.
Everything was so doable. You need to get the basics down. Like completely down through and through. Then you can fill in the gaps with minutia to move above that 220-230 range. That's why FA is crap if you don't know the core concepts, but it's golden to go through for the little crap. I feel like the exam catered to what I knew, or I just selectively forgot the ones I got wrong. Really can only remember three questions, the stupid clearance question, and two other ones that I got right. Sidefanil mechanism for the win.

 

[BlondDoctor]

Hey BlondDoctor,

It can be hard to get things moving when motivation is at an all time low. But remember why you are doing what you are doing! 🙂 Take it one day at a time, make a specific plan at the start of the day and make sure you take small breaks every now and then. At the end of the day, you can look back at ALL that you have accomplished and that will fuel the fire for the next day 🙂

It looks like you are on the right track with doing questions. Doing practice questions is a really important part of studying for the Step 1 in my opinion. Knowing the content, however, is paramount. Just remember that you can't study for every possible question out there! 5 weeks (the time between now and your test) is plenty of time to do both! Use your primary sources well and do a few blocks of questions each day. A few days of that routine should put you in a nice schedule.

Regarding NBME practice tests: Sit down and think about days that you are willing to take those practice exams like the real deal! I'm a big believer in practice making perfect and if you set aside time in your schedule to do some (1, 2, 3, ... as many as your heart desires) of those tests, your scores will be more meaningful 🙂

Interpreting % points on the Q-banks can be tricky so I stay the heck away from it. Don't get caught up in it! 😀 I know, I know, It's easy to get sucked into it, but DON'T! The best thing you can do with the Q-banks is that you can do a good number of questions in the timed and random mode, thereby allowing you practice in a low-stakes environment. You also have access to all the answers! I would suggest keeping notes on all the questions that you miss and all those you get right for the wrong reasons. It's a lot of work, but it will pay off on test day. 🙂

Finally, you seem to have some concerns regarding certain subjects. It's ok, the three subjects you listed in your post are some of the more anxiety provoking subjects for students on this forum. This is what I did in preparation for these subjects:

Anatomy: Divide it into sections (limbs, thorax, abdomen, pelvis & perineum, head & neck); Review major arteries, nerves and innervation, muscles and miscellaneous landmarks for each section. This doesn't take as long as it sounds. Here's an example: Let's work with limb anatomy; here is what I would review:

- major branches of the axillary and external iliac arteries and downstream smaller vessels (what comes off the brachial artery?, ...)
- Brachial plexus + Lumbosacral plexus; know how to draw the brachial plexus real quick --> there's a great schematic in FA! As far as the lumbosacral plexus, know the big ones! superior and inferior gluteal nerves, sciatic nerve, ...; know what happens to the large branches of the brachial and lumbosacral plexuses/plexi (where does the anterior interosseus nerve come off?)
- Know the dermotomes for the limbs; look at a dermatome diagram and match them up to landmarks (the tips of the dorsum of the index and middle finger are innervated by what nerve?)
- Know the muscles (duh 🙂 ) and their innervation. Try to do this by compartments, I swear it will make it easier. Try to know exceptions and keep your memorizing to a minimum (only intrinsic muscles of the hand that are NOT innervated by the ulnar n.?)
- Know your landmarks (why is the adductor canal important?)
- Know clinically important procedures! (Where are large bore IV's placed? Where is the best location to put in a needle to perform a thoracocentesis?)
- Finally, Look at some CTs and XRs...this should work on your spatial abilities

Neuro: Do this section after your head and neck anatomy section; I've organized this list below in a hierarchical order (the last bullet is puts together all the other parts of neuro well in my opinion)

- Know your surface anatomy well. Any rigorous neuroanatomy atlas will do. If you don't own one, the BRS neuro-book, or wiki does just fine 🙂
- Know the blood supply to the brain! Try to complete this arterial tree: Vertebral arteries --> Basillar artery --> ? --> ? ... Know try to complete this arterial tree: Internal carotid artery --> ? --> ?; know how the circle of willis works
- Know the MAJOR tracts - Spinothalamic, DCML, corticospinal, ... and know the major nuclei of the thalamus and hypothalamus (Why is the VPM important? What is produced in the preoptic nucleus of the hypothalamus)
- Know your stroke syndromes: Wallenberg, anterior spinal, pontine, MCA, ACA, ...

Pharm: This section is a wild card. Go through pharmacology sections in first aid and if possible use Lippincott's illustrated review of pharmacology. I really like that book. The question banks will help you ALOT with this subject so that you can tease out the nitty-gritty details of side effects, ... (Why does someone on thoridiazine need regular eye exams?).

I hope this helps BlondDoctor! You get your motivation up, and there is no goal that you set that you can't achieve! 😉

Thank you for this!!!
I have taken your tips to heart, and printed this out so I can keep up my motivation! Thank you again for taking the time to write this up 🙂