Hi everyone. I did not use SDN much until after I took Step 1, and it provided a lot of reassurance these past 3 weeks, so I thought I'd try to help out whoever is still preparing for the exam.
First, I go to a mid-level allopathic medical school in the US and I did not study for Step 1 at all during the first two years of medical school. I chose to focus solely on the curriculum and can honestly say I never opened FA or any other board-related resource during this time. I had just about 8 weeks of dedicated study time and that's all. Before my study period, I had taken my Neurology and Psychiatry rotations for 3rd year already, and would recommend this (if this is an option), as I found the neuro on the exam much easier because I had spent a lot of time with the neuroanatomy atlas already. That being said, my goal was anything 250+, thinking that 240 was reasonably in reach for me.
I did not take a baseline NBME, as I was pretty sure I would not pass. I started with DIT and did all of the lectures in 19 days. I find that DIT is not that helpful unless you don't know ANYTHING from First Aid (which I didn't). If that is the case, I would recommend doing DIT first, as I did, rather than in the last 30 days before your exam. I annotated FA with this, and did 2-3 sets in USMLERx during this time in order to try to memorize as much of FA concurrently as possible. I also squeezed in 5 chapters of Pathoma during this time and annotated them into FA as well. After DIT, I did 1 NBME (and did not do very well).
The practice exams that I took (all online):
NBME 11 (5.5 weeks before): 430/205 This made me panic as I had just over 5 weeks left to improve
NBME 13 (3 weeks before): 590/242 (YAY!)
USMLE Free 150 (2 weeks before): 90% I did this on-site and liked getting comfortable with the testing center
NBME 15 (10 days before): 630/252 Peaking too early?
NBME 12 (7 days before): 610/247
NBME 7 (4 days before): 610/247
I did not do any Kaplan or UWorld assessments.
QBank Percentages:
USMLERx: 69% Did 1 pass, finished in just over 3 weeks
Kaplan: 72% Did 1 pass, finished in 2 weeks
UWorld: 68% Did 1 pass, was in the upper 70s and low 80s in the days before my test
I chose to never read FA cover to cover, as I knew that I can't focus on a textbook for that long. I read small sections that were relevant to the QBank questions. By the time that I was finished with DIT, I was nearly done with USMLERx. I used Lange Biochemistry cards and the Microbiology cards and found this sufficient for my exam. I also used BRS Physiology (one of my weakest subjects), which I found particularly helpful for renal. I also struggled with the cardiovascular system and spent an entire day watching YouTube lectures on heart sounds, conduction system and murmurs and found this very helpful. I also used Pathoma, which I did not find as useful as most people have reported. Perhaps I used this too early (midway through studying) to really appreciate the concepts. Other than these sources, I did not use any other books/flashcards. I did not find any pharm flashcards necessary.
So, after finishing DIT, I finished up USMLERx, did NBME 11 and was very worried about my score. That motivated me to finish Kaplan in 2 weeks (all annotated into FA), and I improved significantly. During this time, I had finished reading BRS Physiology, Pathoma lectures, and the biochemistry flashcards. I only ever made it about halfway through the microcards, so can't really comment on how useful they are. Then, I started on UWorld, did the flashcards twice more and in the week leading up to the exam, I read the drug section at the end of each chapter in FA daily.
I cannot stress the importance of taking breaks while you study. I tried to study 12-14 hours/day, but after 3 weeks was so burnt out that I knew I couldn't do it. After that, I took 1-2 days off per week, and only worked 7-9 hours per day. I was much happier and relaxed.
I was pretty confident that I would be OK for time on test day because I generally finished each NBME or UWorld section with >20minutes to spare for checking. I am, however, a fast test-taker and I rarely recheck because I find that my gut answer choice is much more accurate than anything else.
Test experience:
I found this exam significantly harder than any NBME or UWorld. My first block was terrible. I marked 30+ questions. I was so discombobulated by this that in the 2nd section, I couldn't focus enough to do the exam questions in order and ended up hopping around (e.g. question 1--> question 12 --> question 34). This was very inefficient (and bad), so after the 2nd block, I took a 20 minute break. Blocks 3-7 were "better", but I was worried that I was so frazzled by the first two that I wasn't reading the questions clearly. I only took two more 5 minute breaks. I was worried that I was just going through the motions and clicking answers. Another strange thing was that I was taking the full time for each block to answer the questions. I literally had maybe 1-2 minutes left at the end. Overall, I left feeling terrible. Things I thought I knew suddenly became hazy and uncertain. I left feeling certain that I had failed, and even talked to my dean and PI about other plans for residency (I am leaning towards derm).
Test categories:
CV: I had at least 4 heart sounds and 3 EKGs (including normals). Not sure how I managed to do well in this category considering I dread it so much, but I guess I was good at guessing on test day.
Neuro: TONS of brain sections (>8). often the same slice but with a different question.
Pharm: Very straightforward. Only 1 drug not mentioned in FA, and I am convinced that this was an experimental question as little data is known on this drug anyways
Micro: Very few questions, very straightforward. A couple of HIV questions. Nothing that is not in FA
Renal: Lots of questions on ATN and renal tubular acidosis. 1 question on nephrotic syndrome. Heavily concentrated in my first block of questions.
Pulm: I cannot honestly remember any questions (though I'm sure there must've been 1-2)
Derm: 1 question
Biostats: 2 calculation questions. I was upset about this, as biostats is one of my strongest subjects
Ethics: Very difficult and ambiguous questions. I spent a lot of time on these, and clearly didn't learn enough since I didn't score particularly well in behavioral
Biochem: A few questions, including one on Hartnup disease. Nothing that was not in the flashcards.
Genetics: very straightforward. Make sure to remember modes of inheritance for common sydnromes.
Imaging: I had 3 CTs (non-neuro), all of which I did not know the answer to. I did not spend time on imaging at all.
No histology questions.
Embryology: 2 questions, one was a tracheo-esophageal fistula.
That's all I remember system-wise. I had a lot of strange questions: mechanism of estrogen decreasing blood pressure? where is the ATP binding site on the Na/K channel? etc. There was a lot of molecular biology, which ended up being guesses for me. I felt very unlucky as my worst subjects were over-represented on my exam (I felt). If I could go back and study again, I would have spent some time on imaging.
For the last three weeks, I have had nightmares about the exam, looked up answers to every question I can remember (bad idea), and tried to replan my career (was already on a research year in derm and considered rejoining my class for clinicals if my score was too low). I was convinced that I had actually failed as I can honestly say that I thought I had only solidly known the answers to 10-15% of questions. I was very upset about the stupid mistakes I had caught-- had a question on Reye syndrome and whether aspirin or acetaminophen caused it, and somehow convinced myself that since acetaminophen can cause hepatic damage, it must cause Reye's in children (haha..).
Anyways, I got my score today and it was a
253!
I am ecstatic that I reached my goal and all that worrying was for nothing. Perhaps not a stellar score according to SDN, but much higher than I expected and enough to give me a shot at the specialty I am interested in. Also, I did a bit better on the actual exam than my NBME average (excluding the 1st one), but close enough that I believe they are good predictors. What is shocking to me is that I felt confident on the NBMEs and the exact opposite about the exam, but in the end, it worked out.
So, moral of my story is: even if you don't focus on this exam during the first two years of med school, it's possible to get a good score. It's a lot of pattern recognition and being able to apply concepts forwards and backwards. We are all more than capable of doing well. Good luck everyone! Hope this helps, and feel free to message me if you have questions.
Cheers to 2013 
(skimmed like 1/5 of it) and still scored in 240's.
