Official 2013 Step 1 Experiences and Scores Thread

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Phloston

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I figure now is a good time to jump-start this thread.

Even though some of us who had taken the exam in late-2012 are still awaiting our scores (amid the holiday delays) and could technically still post within last year's thread, it is after all mid-January now, so it's probably apposite that we move forward and hope for a great year.

:luck: Cheers to 2013 :luck:

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I took mine on August 17 and my permit link disappeared yesterday morning, so I'm pretty sure that that day will be reported. Not sure about other dates
 
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Hey all-
My score stung a little, but overall I feel ok about it (trying to match in peds, so stratospheric scores are not super necessary)
Exam Score: 218

Prep:
Kaplan- averaging 63% per block by the end of my study period
Uworld- averaging 63% per block by the end of my study period
Only took NBME 11: scored 219 equivalent, 2 weeks before the exam
Used FA and BRS for Micro and Physio

Notes: I took the exam two years after completing basic sciences because of Duke's weird curriculum and the second degree I am pursuing.

Good luck to all those still waiting
 
Hey all-
My score stung a little, but overall I feel ok about it (trying to match in peds, so stratospheric scores are not super necessary)
Exam Score: 218

Prep:
Kaplan- averaging 63% per block by the end of my study period
Uworld- averaging 63% per block by the end of my study period
Only took NBME 11: scored 219 equivalent, 2 weeks before the exam
Used FA and BRS for Micro and Physio

Notes: I took the exam two years after completing basic sciences because of Duke's weird curriculum and the second degree I am pursuing.

Good luck to all those still waiting

Congratulations! It's an honor to receive that score. I took the test two weeks ago and am still waiting and would be ecstatic with that score. Full disclosure -- I'm going for fam med. :)
 
Hi

I did NBME 12 today got 191/370

previous exams are UWSA's 216 (few weeks back)
NBME 11 few weeks ago 182

I know these are crappy scores...
exam is in two weeks...any advice?

thank you

postpone?

Postpone.

I would postpone it at least three months. You're in the stage where you need to sit down, memorize FA and go through at least one more entire QBank. If this were like the MCAT and you could sit it more than once, I'd say just go for it, but don't screw around closing doors on your future here. That's my fitty cents.
 
I would postpone it at least three months. You're in the stage where you need to sit down, memorize FA and go through at least one more entire QBank. If this were like the MCAT and you could sit it more than once, I'd say just go for it, but don't screw around closing doors on your future here. That's my fitty cents.
I have to take it latest Oct.10th to start rotations in november or ill have to wait until may of next year :(

thank you for your response
 
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Hi
I have a question regarding Tyrosine kinase signaling pathways...

in FA 2013, there are two groups 1) Intrinsic TK which is growth factors and MAP kinase pathway and 2) receptor associated which is cytokines, GH, prolactin and JAK/STAT pathway

On a uworld question, they present a patient with PV and ask what pathway is it associated with, i picked Receptor tyrosine kinase but the answer is non receptor tyrosine kinase. PV is a JAK2 mutation....

Does anyone understand how this doesnt fit into the FA classification on page 294 that has JAK listed as "receptor-associated TK"? :confused:

Thanks
 
Hi
I have a question regarding Tyrosine kinase signaling pathways...

in FA 2013, there are two groups 1) Intrinsic TK which is growth factors and MAP kinase pathway and 2) receptor associated which is cytokines, GH, prolactin and JAK/STAT pathway

On a uworld question, they present a patient with PV and ask what pathway is it associated with, i picked Receptor tyrosine kinase but the answer is non receptor tyrosine kinase. PV is a JAK2 mutation....

Does anyone understand how this doesnt fit into the FA classification on page 294 that has JAK listed as "receptor-associated TK"? :confused:

Thanks
 
Hi
I have a question regarding Tyrosine kinase signaling pathways...

in FA 2013, there are two groups 1) Intrinsic TK which is growth factors and MAP kinase pathway and 2) receptor associated which is cytokines, GH, prolactin and JAK/STAT pathway

On a uworld question, they present a patient with PV and ask what pathway is it associated with, i picked Receptor tyrosine kinase but the answer is non receptor tyrosine kinase. PV is a JAK2 mutation....

Does anyone understand how this doesnt fit into the FA classification on page 294 that has JAK listed as "receptor-associated TK"? :confused:

Thanks

What do you mean by PV? EDIT...oh Polcythema Vera, got it lol. You are right, it is a JAK2 mutation. I just looked through U world and found the question you are talking about; I think FA is wrong. I have annotated into my FA that JAK2 mutations are non receptor tyrosine kinase. I guess FA just dropped the ball on this one...
 
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Hi
I have a question regarding Tyrosine kinase signaling pathways...

in FA 2013, there are two groups 1) Intrinsic TK which is growth factors and MAP kinase pathway and 2) receptor associated which is cytokines, GH, prolactin and JAK/STAT pathway

On a uworld question, they present a patient with PV and ask what pathway is it associated with, i picked Receptor tyrosine kinase but the answer is non receptor tyrosine kinase. PV is a JAK2 mutation....

Does anyone understand how this doesnt fit into the FA classification on page 294 that has JAK listed as "receptor-associated TK"? :confused:

Thanks

I think FA is wrong. I have annotated into my FA that JAK2 mutations are non receptor tyrosine kinase. I guess FA just dropped the ball on this one...

The first time I ran into this seeming discrepancy, I was confused as well.

So here's the deal: FA and UWorld are both correct. They are just using different terminology.

  • Receptor tyrosine kinase (UW) = intrinsic tyrosine kinase (FA) - the receptor itself has kinase activity; insulin and growth factors use this pathway; MAPK pathway
  • Non-receptor tyrosine kinase (UW) = receptor-associated tyrosine kinase (FA) - in this case, the kinase is not a receptor (hence non-receptor) but it is associated with a receptor (hence receptor-associated)

The terminology is not optimal, but it makes sense. The UW picture explaining the difference between the two types is excellent.
 
The first time I ran into this seeming discrepancy, I was confused as well.

So here's the deal: FA and UWorld are both correct. They are just using different terminology.

  • Receptor tyrosine kinase (UW) = intrinsic tyrosine kinase (FA) - the receptor itself has kinase activity; insulin and growth factors use this pathway; MAPK pathway
  • Non-receptor tyrosine kinase (UW) = receptor-associated tyrosine kinase (FA) - in this case, the kinase is not a receptor (hence non-receptor) but it is associated with a receptor (hence receptor-associated)

The terminology is not optimal, but it makes sense. The UW picture explaining the difference between the two types is excellent.

oh yes i see it now, thank you :). Yeah the way FA words it makes it confusing and it would make you pick the wrong answer. Thats why i just annotated it from UWorld next to where FA talks about PV.
 
Anyone expecting scores tomorrow? Think August 31 scores will be released?

Hello FuturePirateMD, I believe that if you took your exam on Saturday the 31st you are likely going to have to wait until next Wednesday, sorry :(

is anybody who took their test on 29th august recevied score?

Yes jooul, I took my exam August 29th and received my score report this morning
 
Gratz!What is your score?
What should i do if i didn't recevied my scores on this wensday even though i took it on 29th aug?(I'm IMG)
 
jooul - You'll probably get your score next Wednesday. If you don't, you might have to call NBME!

Score - 236! Which I'm happy with.

If anyone was interested in my stats, my last 3 practice scores were (I did more than three though)...

Early August (forgot date): UWSA - 254

Aug 05: NBME 11 - 219

Aug 20th: NBME 15 - 238 (read FA twice in the two week period + started doing my UWorld incorrects).

My Uworld average first time through was high 60s. Doing my incorrects, I was ranging mid 70's to high 80s. Not that it matters much, but I started Uworld before the 'dedicated study period'. By the end of the study period, I was averaging 75s to high 80s.
 
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The first time I ran into this seeming discrepancy, I was confused as well.

So here's the deal: FA and UWorld are both correct. They are just using different terminology.

  • Receptor tyrosine kinase (UW) = intrinsic tyrosine kinase (FA) - the receptor itself has kinase activity; insulin and growth factors use this pathway; MAPK pathway
  • Non-receptor tyrosine kinase (UW) = receptor-associated tyrosine kinase (FA) - in this case, the kinase is not a receptor (hence non-receptor) but it is associated with a receptor (hence receptor-associated)

The terminology is not optimal, but it makes sense. The UW picture explaining the difference between the two types is excellent.


thank you!!!! :thumbup::thumbup:
 
jooul - You'll probably get your score next Wednesday. If you don't, you might have to call NBME!

Score - 236! Which I'm happy with.

If anyone was interested in my stats, my last 3 practice scores were (I did more than three though)...

Early August (forgot date): UWSA - 254

Aug 05: NBME 11 - 219

Aug 20th: NBME 15 - 238 (read FA twice in the two week period + started doing my UWorld incorrects).

My Uworld average first time through was high 60s. Doing my incorrects, I was ranging mid 70's to high 80s. Not that it matters much, but I started Uworld before the 'dedicated study period'. By the end of the study period, I was averaging 75s to high 80s.

:thumbup:
 
Hi everyone,

There is a Uworld question that refers to the prevention of influenza, the answer is circulating Ab's against hemagglutinin.

the answer choice I picked: T cell response against neuraminidase is wrong.

In the explanation is specifically states that that anti-neuraminidases can decrease viral invasion and shedding but can not PREVENT disease.

In FA 2013 page 187, drugs that inhibit neuraminidase are listed as treatment and PREVENTION.

anyone care to clarify?

Thank you very much!!
 
Hi everyone,

I debated posting my score and a write-up because I feel like I'm kind of late to the game, and it seems like some people get annoyed with people who have never posted and then bust into the party all like HAYYY GUYS CHECK MY SCOREEEE.

However, this thread was pretty quiet this Wednesday and I pretty much have read the entire 104 pages of it over the past couple weeks while waiting for my score, compulsively comparing NBME scores and step scores and on and on, trying to give myself some reassurance! I've gained a lot from reading previous posts, and so thought I should contribute something to those still waiting to take the exam or waiting for your results. I honestly can't add much study advice to what has already been said here, my wisdom and advice seems to pale in comparison (seriously, just go read Phloston’s PDF….wow!). But, I can offer my stats (because honestly, that's what I always skipped to anyways) and a few other things to encourage those still waiting! I took an NBME after each pass through First Aid, and taken in this order:

NBME 6- 207 (after first pass, about 2.5 weeks in)
NBME 7- 228
NBME 11- 247
NBME 13- 247
NBME 12- 254
uWorld avg- 74%, timed, random, first pass
free 150- 91% (three days before exam)

Step 1- 264

If you want to feel encouraged....

- My first NBME was only a 207! And this is after already studying for 2.5 weeks. So know that you certainly can improve by leaps and bounds throughout your prep.
- My final score was 10 points higher than my last NBME! (I attribute this partially to the super fast read through of FA I did in the last 2 days before my exam- it boosted my confidence and everything felt fresh in my mind for exam day).
- You don't need to buy a million textbooks and review books. I used First Aid and uWorld for the core of my prep. I had done Pathoma along with my Path course, but didn't re-watch the videos during my study time. I learned the most additional information from uWorld Q's and felt like I had a strong basic sciences background, so I'm sure that helped. But still, I didn't read any complete textbooks during my prep. The closest I came was with Goljan’s Rapid Review, which I actually wish I had purchased sooner!
- My study timeline was just under three months (Caribbean IMG). I had been told 3 months was far too quick to take the exam for an IMG, but that is absolutely not true. It's completely up to you how hard you will work in basic sciences and how hard you will study for this exam. I wanted to do well in step 1 from day 1 basic sciences, and I carried that attitude with me for the next 2 years. It's a knowledge-based exam; hard work can go a long ways towards a good score, regardless of who you are or what med school you go to. Sure, natural intelligence and great education will help, but they are not the whole story.

Honestly, I did not expect my score to be quite so high. I used to think you'd have to be a genius to break 260, and I am by no means a genius. I know how to work my butt off, but a genius, no. I was aiming to break 250 and would have been pumped to get that. I did feel good about the exam itself (which actually REALLY worried me) but you just never know what to expect, some people walk out feeling like crap and walk away with 270 so I don't know how much "feelings" actually depict your score.

To sum it up, don't freak out or get discouraged about this exam. I mean, my summer sucked and I may have been brought to tears more than once, so don't get me wrong, you shouldn't brush it off. But I made it through still in one piece. To me, the Step questions felt a lot like uWorld. Use NBMEs to show you where you're at, and if you're doing consistently well, then have confidence in yourself!! I feel a little bad seeing as I am completely contributing to the reporting bias here, but like I said I hope to encourage others like I was encouraged from this forum! If I can do it, you can too :)
 
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Awsome score Ontario, gives a fellow USIMG like me hope (i went to school in India). I really struggle with testing on this sort of scale and i have bassically been studying on my own since January (took the kaplan class online from September to December of last year). I made a lot of mistakes and rushed a lot of stuff, really did awful in my NBMEs...decided to just hit Pathoma, Uworld and FA hard...and the results have really paid off...i hope i can take the exam very soon, i feel nearly ready :).
 
Hi,

I have another question...
According to UW, in any hemolysis the haptoglobin levels go down...
But I thought they only go down in intravascular hemolysis because you lose Hb in your blood and haptoglobin binds it in order to save some of it, hence its levels decreasing.

In extravascular (ex. Sickle cell), the macrophages eat the RBC's and leave the byproduct bilirubin which binds to albumin.

According to UW, in sickle cell, haptoglobin also decreases.

Any opinions?

Thank you
 
congrats! amazing Job, Im always so stocked to hear a caribbean IMG, or any IMG do well.
 
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Awsome score Ontario, gives a fellow USIMG like me hope (i went to school in India). I really struggle with testing on this sort of scale and i have bassically been studying on my own since January (took the kaplan class online from September to December of last year). I made a lot of mistakes and rushed a lot of stuff, really did awful in my NBMEs...decided to just hit Pathoma, Uworld and FA hard...and the results have really paid off...i hope i can take the exam very soon, i feel nearly ready :).

You've been studying since January? Holy moly, i started mid/end June and am planning on taking it in 2 weeks...My scores suck to be honest, but I am so burnt out.
 
Hi,

I have another question...
According to UW, in any hemolysis the haptoglobin levels go down...
But I thought they only go down in intravascular hemolysis because you lose Hb in your blood and haptoglobin binds it in order to save some of it, hence its levels decreasing.

In extravascular (ex. Sickle cell), the macrophages eat the RBC's and leave the byproduct bilirubin which binds to albumin.

According to UW, in sickle cell, haptoglobin also decreases.

Any opinions?

Thank you

In sickle cell disease, there is extravascular hemolysis and also some degree of intravascular hemolysis (leading to decreased haptoglobin levels). [Source]
 
So u world says tricuspid regurgitation murmurs are heard loudest at the left sternal border.. But FA says they radiate to right sternal border... This thing tripped me up on one of the questions.. Who is right?
 
So u world says tricuspid regurgitation murmurs are heard loudest at the left sternal border.. But FA says they radiate to right sternal border... This thing tripped me up on one of the questions.. Who is right?

TR murmurs are best heard at the (lower) left sternal border and classically don't radiate. However, if the murmur does radiate (likely in more advanced TR), the turbulent blood flow (radiation) will be best heard at the right sternal border. In other words, both resources are correct. As far as Step 1 is concerned, TR murmurs are best heard at the lower left sternal border.
 
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TR murmurs are best heard at the (lower) left sternal border and classically don't radiate. However, if the murmur does radiate (likely in more advanced TR), the turbulent blood flow (radiation) will be best heard at the right sternal border. In other words, both resources are correct. As far as Step 1 is concerned, TR murmurs are best heard at the lower left sternal border.

got it, thank you :). Yeah I was sure that TR murmers are best heard at the lower left sternal border, but then FA threw in that radiate to right border thing...i guess FA needs to make it more clear that that would happen in a more severe TR.
 
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I'm interested in having biweekly one-hour subject based reviews with anyone on this forum who is currently studying for Step 1. My exam is less than six weeks away and ultimately I think we both would benefit with having a study buddy to grill us with questions. Two minds are better than one. No Bull**** and no kidding around, this is serious business. Please privately message me if you're interested. Anyway, back to slaying the dragon and congratulations to all of you who have cleared this exam!
 
hey guys,

What is recommended the week before the exam...question blocks or first aid? I have heard mixed things.

thanks
 
Hi,

I have another question...
According to UW, in any hemolysis the haptoglobin levels go down...
But I thought they only go down in intravascular hemolysis because you lose Hb in your blood and haptoglobin binds it in order to save some of it, hence its levels decreasing.

In extravascular (ex. Sickle cell), the macrophages eat the RBC's and leave the byproduct bilirubin which binds to albumin.

According to UW, in sickle cell, haptoglobin also decreases.

Any opinions?

Thank you
Increase in heme will decrease free haptoglobin by forming heme-haptoglobin complex. Also, excessive RBCs destruction can increase iron overload which further inhibit Haptoglobin production? Check it though.
 
Hi,

I have another question...
According to UW, in any hemolysis the haptoglobin levels go down...
But I thought they only go down in intravascular hemolysis because you lose Hb in your blood and haptoglobin binds it in order to save some of it, hence its levels decreasing.

In extravascular (ex. Sickle cell), the macrophages eat the RBC's and leave the byproduct bilirubin which binds to albumin.

According to UW, in sickle cell, haptoglobin also decreases.

Any opinions?

Thank you
Increase in heme will decrease free haptoglobin by forming heme-haptoglobin complex. Intravascular vs extravascular hemolysis is the key point to remember. Patient with spelnoectomy may have normal level of haptoglobin. Also, excessive RBCs destruction can increase iron overload which further inhibit Haptoglobin production? Check it though.
 
I am planning to take the practice test at the prometric center, are the questions the same thing as this: http://www.usmle.org/pdfs/step-1/2012content_step1.pdf , or are they something else? I am mainly taking the practice test to get the feel of the center and the procedures and stuff. I dont want to be worrying about all of that on the real test day...
AFAIK they are the same questions. I did the same and it helped to get rid of test center anxiety as well as to know how quickly times flies under test conditions. Also, if you are taking it @ Philly then add 30 sec for each sign-in/out.
 
AFAIK they are the same questions. I did the same and it helped to get rid of test center anxiety as well as to know how quickly times flies under test conditions. Also, if you are taking it @ Philly then add 30 sec for each sign-in/out.

i'll be doing it in Los Angeles :). I am going to take the afternoon session cause my brain only turns on by like 11 am (i study long hours into the night..up untill 3-4 am some days). I havent taken any standardized testing in a settting like this, so i want to get used the procedures and not be anxious doing them for the first time on real test day. How well do these questions correlate to the real performance?
 
No more prep strategies / test experiences? Is is at that point where it's redundant, or...?
 
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