# Official 2012 Step 1 Experiences and Scores Thread

Discussion in 'Step I' started by amavir281, Feb 15, 2012.

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1. ### shan564Below the fray 7+ Year Member

Because everybody wants to score higher. We can all argue about how important a higher score really is, but there's no question that it's better to get a high score and I respect the people who can do it.

This is probably the most important test we'll ever take - and most of us have taken quite a few big tests over the years. It's perfectly normal to want to try your best. That's really the point of this discussion.

Also, this discussion is barely going beyond two standard deviations. This year, the mean is 225 and the SD is 21. Two standard deviations would be 267. 250 is barely one standard deviation above the mean. And it's not a normal distribution, so we can't really estimate accurately.

3. ### JackShephard MD

895
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Oct 17, 2011
New York
Well, we're all looking forward to your 267+!

4. ### shan564Below the fray 7+ Year Member

Ha... if I were to get within 20 points of that, I'd probably throw a party.

5. ### PhlostonLifetime Donor 5+ Year Member

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Osaka, Japan
Physician
For a second, I wasn't going to point this out only bc +2SD still = 267, but the bottom of page 8 of FA2012 says a recent mean of 221, with a SD of 23. Where did you get those above figures, Shan?

6. ### shan564Below the fray 7+ Year Member

Charting Outcomes in the Match 2011, page 9
http://www.nrmp.org/data/chartingoutcomes2011.pdf

Those numbers are just for US students. The IMG numbers are a bit lower, but the oft-quoted 221 +/- 23 number is also just for US students in past years, so it's a fair comparison.

I think FA may not have been updated for the 2011 data.

7. ### kaleerkalut 2+ Year Member

495
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Jan 5, 2011
Thanks. By the way, what did you use for an image review right before the test?

8. ### DoctwoB 7+ Year Member

1,360
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Jan 10, 2010
Just got my score and am incredibly pumped. 271/91.

First off let me throw my (probably biased) 2c into the ring on debate about the value of high scores. There is most definitely diminishing returns to increasing step1 score in that the gap from a 230 to a 250 is much much more important then the gap between 250 and 270. That being said I believe that people who think improving scores beyond the 250ish range doesn't help are probably deluding themselves. It definitely isn't the only part of an application, and a 240 w/ good grades, research, and interviewing skills can certainly be a better applicant then a 270 without any/all of those things. It of course will vary highly between specialties (higher scores probably more important in more competitive specialties) as well as between programs (some value step1 highly, others very little). Thats why I am very skeptical of any anecdotal "well my PD said this . .", and there is undoubtedly a range between programs. Anyways, enough of that. These threads were very helpful to me in my preparation, so I hope to give back a bit with what I did and what I would/wouldn't change.

Study resources: By far the most important was gunner training. I started this winter of first year, and it was absolutely essential for hammering in the facts. Reading first aid for the first time felt like a review, as GT had already hammered in most of the factoids into my brain. It also has lots of things that aren't in first aid, and so is a great supplemental resource. That being said, it is a system that takes A LOT of time to work, so start early and stick with it, or it may not be worth using at all. If only they had it for wards/step 2 . . .

I used Kaplan qbank along with 2nd year classes, with a second pass during my study period. Kaplan is a decent Qbank. Generally good questions and explanations, but some overly nitpicky questions. Definitely not as good as Uworld, but I'd rate it as #2 (and newly inexpensive, only \$150 w/ AMA discount for many months)

I did 2 passes of Goljan audio along w/ 2nd year classes, w/ 2 more during the study period (while at the gym). This is great because he completely emphasizes the HOW and WHY of pathology, which is much more useful then trying to memorize his book, which was garbage IMO (except for the pictures, which I used along w/ the audio). As I explain later, understanding the how and the why is essential, as they love to ask questions about classic diseases but w/ a new twist that makes it very difficult to just memorize the answers.

I did a quick pass of first aid along w/ 2nd year classes, then 2 passes during my study period, w/ a last only on pages I'd marked as weak spots. Great review, terrible for trying to learn material. Not much more to say.

I did 2 passes of Uworld on untimed tutor mode during my study period. This Qbank is solid gold, with multi-step/conceptual questions and amazing explanations. I highly recommend using tutor mode (or thoroughly going over all answers afterwards, including correct answers). Even if you got the answer right, make sure you got it right for the right reasons by reading the explanations.

I also read through BRS physio along w/ classes and once more during my study period. This book is great for understanding of basics of physio, which is essential for reasoning your way through tough questions.

Finally, work hard on your classes in the first 2 years. There is no review book/memorization set in the world that can replace a solid foundation in physiology and pathophysiology.

About the test itself: First off, I won't talk about areas of focus. I've talked to enough people to know that your distribution of questions is basically random e.g. I had 4 ACE inhibitor questions and not a single lasix or thiazide one. Doesn't mean the latter concepts aren't important, just that it is totally, 100% random what will be emphasized on your test.

Thus to all the "are UW + First aid enough" questions, I'd say it depends. Those 2 resources will certainly provide you with enough of the factoids to memorize that you can do very well with just those 2 IF you also have a good understanding of physio and pathophys. If you don't, then use whatever resources you need until you feel you have a good understanding of how the organ systems work and what is happening when things go wrong. Also know that no matter how many resources you use, there WILL be things you haven't seen before, and so your ability to make educated guesses is essential.

Numbers:
GT = 100% completed, 75% mastery
Kaplan Qbank = 84% first pass, 90% 2nd
Uworld Qbank = 89% first pass, 96% 2nd (though I remembered many questions)
NBME 11 = 255 (5 weeks out, after finishing classes before study period, GT, kaplan 1x, goljan/FA 2x)
NBME 12 = 265 (2 weeks out, after first thorough pass of FA in my study period, first Uworld pass, another goljan pass, and some of kaplan)
UWSA1 = 265+ (1 week out)
NBME13 = 275 (5 days out)
UWSA2 = 265+ (3 days out)
Actual test = 271/91

Hope this helps.

9. ### RedSoxSuck 7+ Year Member

729
5
Jan 30, 2009
I Love L.A
Now how the hell am i suppose to top that? Damn you SDN!

BTW, Congrats on an insanely spectacular score

10. ### kaleerkalut 2+ Year Member

495
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Jan 5, 2011
Which practice test did you feel most resembled your exam (in terms of difficulty)? I'm going to take either 13 or 11 but not sure which one. Thanks and congrats.

11. ### DoctwoB 7+ Year Member

1,360
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Jan 10, 2010
I didn't particularly think that one was "better" then the other. They all had a similar range of hard and easy questions. How difficult they are relative to each other likely depends on the subjects weighted more heavily in a given test and how that compares to your strengths or weaknesses.

619
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Mar 10, 2009

13. ### JasonE 5+ Year Member

904
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Aug 7, 2008
did you find the test similar to the NBME's? or harder?

14. ### mmmcdoweDuke of minimal vowelsGold Donor SDN Moderator 7+ Year Member

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That meme, to me, is much more applicable to his/her study regimine. Incredible application of will power. How much time did you have in your final study period after classes, out of curiosity.

15. ### JackShephard MD

895
13
Oct 17, 2011
New York
Agreed, finishing GT alone is rough. With multi passes of FA and Qbanks = earning the score.

16. ### SteinUmStein 7+ Year Member

1,907
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Mar 30, 2009
I hope you 270ers use your powers for good and not evil.

I'm half-joking... but seriously, I hope that massive brain and pure steel willpower don't end up languishing in a dermatology clinic.

17. ### loveoforganic-Account Deactivated- 2+ Year Member

Jan 30, 2009
Not surprised at all DoctwoB, based on what you've said previously - congrats on the outrageous score

Edit: Also, have a very similar schedule to what you did, subbing a couple things here and there, so for even a tiny hint of mirroring, lol

Question - How beneficial did you find going through FA with all the GT background? And what was the time commitment for each of the two passes?

Last edited: Apr 30, 2012
18. ### shan564Below the fray 7+ Year Member

Dermatology? When you could be doing rhinoplasties in 90210?

19. ### LadyLightning20 7+ Year Member

269
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May 26, 2007
MDApps:
So this was what I can remember from my list, but keep in mind that obviously it's tailored to my already-weak areas.

Also, in response to RedSox fan, I did my last pass through FA for 2 days (days -3 and -2) and then spent the last day (day -1) just on random stuff I felt I was weak on or needed to cram.

Cytokines
Antibodies
Biochemical enzymes (When I say this, I mean like seriously knowing and understanding each pathway, not just knowing the 3 regulated steps of glycolysis. But I was a biochem major so for me, looking at many of those was an "oh yeah, I remember that now" as opposed to "meehhh")
Metabolic disorders and how to differentiate them (lysosomal storages, mucopolysaccharidoses, fructose vs galactose intolerance, etc)
Antiarrythmics
Antiepileptics
Cancer drugs/uses
Vitamins and deficiencies
FA's "Rapid Review" - I have to say this is a nice sheet for review but if you don't know most of it already by the day before when you get to the random cramming stuff, you're in trouble.
The equation sheet I made over studying (more than FA's equation sheet in the Rapid review section)

20. ### PhlostonLifetime Donor 5+ Year Member

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Physician
Great job on crossing the 270-barrier.

I'm curious as to the 91. I wonder if that's the % correct on the test.

21. ### bmr6819 2+ Year Member

28
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Aug 16, 2009
Anyone have anything to say about the media clips on the real deal? The heart sounds in Uworld are terrible. I can usually figure out the answer based on the question stem, but without that I would for sure miss it. The sounds on the Kaplan High Yield lecture videos are really good...and you can move the position of the stethoscope to different areas which is nice. Is the real test more like Kaplan or Uworld where it is just an poor quality audio clip?

22. ### futuredoctor10 10+ Year Member

1,632
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Jan 25, 2007
^I'm also curious if they have expanded to audio beyond heart sounds (e.g. breath sounds) or done video. I know Kaplan QBank has some questions with videos integrated to the question stem, offering a unique way to really bring clinical findings alive on the exam!

I don't know if such questions show up in USMLE World (none yet so far) or the real exam though.

23. ### PhlostonLifetime Donor 5+ Year Member

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I honestly hope we don't have to deal with that crap. As much as we obviously need (and should) know that stuff because we're all aspiring to be competent doctors, I would still hope they'd just give us some peace of mind and leave it for 2CK, not Step1.

24. ### shan564Below the fray 7+ Year Member

I've seen them in Kaplan Qbank, but not UW.

25. ### MoistHands

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Apr 20, 2012
Congrats to DoctwoB!

Could you possibly tell us the review books you used for each of the step 1 subjects during your 1st and 2nd year?

Thanks

26. ### auburnO5 5+ Year Member

1,362
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Dec 15, 2008
271?!? Ridiculous!

I'll take that minus 30 and be thrilled.

27. ### DoctwoB 7+ Year Member

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Jan 10, 2010
I had some heart sound questions but not breath sounds. The heart sounds have an interface that is pretty awesome, where you can move around the stethoscope, see the jugular pulsations, etc. Of the two Qbanks, it is much more comparable to kaplan (but even better). I agree that UWorlds audio implementation was pretty terrible.

I also had some physical exam findings, but they were images, not videos like in kaplan. Once again, the things you do get are random, so take it FWIW.

28. ### DoctwoB 7+ Year Member

1,360
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Jan 10, 2010
Nothing too crazy. BRS physio is great (read it for understanding, not memorization), and if I had to look up something on path I'd use goljan. On the whole though I didn't use too many review books. My school courses were quite comprehensive, so outside sources usually weren't necessary.

29. ### MoistHands

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Apr 20, 2012

Once again... out of the world score.

267
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Aug 10, 2011

31. ### bmr6819 2+ Year Member

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Aug 16, 2009
DoctwoB, thanks for the info on heart sounds!

269
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May 26, 2007
MDApps:
33. ### Bernoull 7+ Year Member

Mar 24, 2007
Ischioanal fossa
34. ### RapplixGmedLooking for the Ether 7+ Year Member

712
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Nov 27, 2007
I'd like to point out this data summary that I did a year ago that already looked at the step 1 percentiles in depth.

35. ### goop 5+ Year Member

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Jan 26, 2012
To anyone who's taken the test recently, can you confirm that most questions don't require you to absolutely know the image? As in, they are helpful but you can come up with the answer from the stem alone. I heard this is how it was for the majority of questions, but that was from people who took the test more than a year ago.

36. ### auburnO5 5+ Year Member

1,362
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Dec 15, 2008
I would say that for most of my images, I actually had to know what the image was. For example, there would be a picture of a brain/spinal cord section labeled 1, 2, 3, 4, 5.... And you would have to know the correct answer. Same with limbs, arteries, nerves, etc.. Not terribly hard though.

37. ### mmmcdoweDuke of minimal vowelsGold Donor SDN Moderator 7+ Year Member

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There were definitely a number of images that weren't absolutely necessary, but it was definitely reassuring to know the picture. There were a few "what is this" kind of questions which gave no supplementary info.

38. ### goop 5+ Year Member

7
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Jan 26, 2012

Thanks. I realize there are diagrams/images where you have to correctly identify the structure. My question was more about histology/micro so I guess this sounds about the same as what I thought (majority are helpful but not essential). I hope the ones you do have to be able to recognize are on the easier side, as I'm only relying on FA/UW for my image base.

39. ### LaCasta 7+ Year Member

523
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May 21, 2007
I got my school administered CBSE results, and I got a 185. I was just wondering how much to read into it. I knew I wouldn't know a lot of the questions since I haven't really touched step 1 stuff yet besides pathoma alongside my path course (and kaplan pharm videos). Anyone with a similar diagnostic score end up getting a 240+?

Thankfully I have 8 weeks to study.

40. ### shan564Below the fray 7+ Year Member

I haven't taken the real thing yet (most people tend to stop posting on this forum after they get their scores back), but I went from 192 on UWSA1 (which supposedly overestimates by about 10 points) to 247 on NBME 12 in about 8-9 weeks.

41. ### LaCasta 7+ Year Member

523
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May 21, 2007
Awesome improvement and makes me feel better.

Thanks

42. ### Aclamity 2+ Year Member

388
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Jul 6, 2011
Big Apple, USA
Anyone know if they tend to throw red herrings into the question stems that much? I didn't really think they would (i.e. most or all of the info in the question stem is relevant), but I've seen some UW questions that have seemingly unrelated info. I realize there might be some questions here and there, but it's definitely the minority, right?

43. ### Radonkulous 5+ Year Member

268
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Feb 27, 2011
Anywhere but here
DoctwoB, what is your take on Anatomy for Step 1. Was FA + UWorld sufficient? Should I supplement with BRS?

Last edited: May 2, 2012
44. ### bfg

5
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May 2, 2012
Just activated a new account. SDN has helped me out a lot so I thought I'd contribute. I took step 1 in the first week of april after about 7 weeks of dedicated study time. I used world and annotated in first aid. I finished one pass then did all my missed and marked again. If I found anything confusing I used other books as references, mainly brs physio, pathoma/goljan, and katzung and trevor pharm.

uworld, first pass, random timed: 80%, started high 60's finished mid 80's.
uwsa 1 (7 weeks out): 256
nbme 11 (6 weeks): 254
uwsa 2 (5 weeks): 265+
School cbse (4 weeks): 98, 265+
nbme 12 (3 weeks): 250
nbme 7 followed by free 150 (2 weeks): 257, 91%
nbme 13 (1 week): 264

Step 1: 264/90

Thanks to all at sdn for this great resource.

45. ### colts 5+ Year Member

144
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Aug 23, 2008
Did you find that all the questions could be answered from First aid and uworld?

46. ### Angel1982 7+ Year Member

47
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Aug 17, 2009

THank you! I have had a clinical depression since my Step 1 on Monday. I feel that I missed really easy questions by simply overthinking them. I am so embarrassed to even think about it. I am hoping to get 220+ and your post gives me hope! I really feel like I have failed it. On the other hand I felt the same way about MCAT and that worked out...

47. ### PhlostonLifetime Donor 5+ Year Member

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Jan 17, 2012
Osaka, Japan
Physician
These NBME exams and "free 150" are right on the money. Nice work.

Do you have any thoughts about how the NBMEs / UWorld, etc., relate to your actual exam?

48. ### bfg

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May 2, 2012
Yes. There were some exceptions to this, but like others have said, the questions not covered by uworld or first aid were just random and I honestly think it is not practical to try and prepare for them. Taking nbme exams is the only thing I found that helped prepare me for material not found in world or FA.

49. ### bfg

5
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May 2, 2012
Uworld questions are more difficult in that they require more 2-3 step reasoning, and the depth of knowledge tested is greater. NBMEs are very similar to the real thing. At least for me, NBMEs usually felt easier than world, and difficult NBME questions were not usually 2-3 step but rather they had bizarre answer choices or tested obscure material. Step 1 seemed like a well written NBME. It felt fair, not easy, but fair. Uworld is masterpiece and some of my questions seemed like they had been taken directly from world. Overall, both were crucial to my study plan, and I highly recommend repeating missed and marked questions from world and taking multiple NBMEs plus the free 150.

50. ### MoistHands

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Apr 20, 2012
Hey bfg, Congrats on your score.

I have been trying to use Katzung board review for pharm but it is taking an awful lot of time though I was understanding the material better... I have scouted through the forum about katzung but since you are a recent exam taker would like to have your opinion.... am an img and have four months of dedicated study time...

Did you read only those drugs on FA from katzung?
How much did the questions help you? Are the questions anywhere close to the uworld or the real deal?

51. ### bfg

5
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May 2, 2012
I did not read Katzung cover to cover. I only used it as a reference when I had a question about a drug I was unfamiliar with, or when I repeatedly missed questions about certain drug class (for me those were anti-arrhythmics). I think the questions in Katzung are high quality. The diagrams are also excellent. In fact, if you look at FA and Uworld you'll see that many of their diagrams relating to pharm, and even sometimes phys, are almost direct copies from katzung. I found the pharm in uworld to be much, much harder than anything on the NBME or on my step 1.