Official 2013 Step 1 Experiences and Scores Thread

[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.

Cheers to 2013

 

[cage92]

i finished gt i felt exhausteddd i stpped now do you feel anatomy in gt enough for solving q banks and in the exam?

 

[Goober11]

i finished gt i felt exhausteddd i stpped now do you feel anatomy in gt enough for solving q banks and in the exam?

Yep, not image wise but GT's content is enough. I thought the images, drawings and much of the bolded items in BRS Anatomy were fantastic. Especially the pelvic and abdominal sections since those receive little attention in the Qbanks.

 

[step1april2013]

Yep, not image wise but GT's content is enough. I thought the images, drawings and much of the bolded items in BRS Anatomy were fantastic. Especially the pelvic and abdominal sections since those receive little attention in the Qbanks.

How much of your anatomy was clinically correlated (i.e. foot drop, wrist drop) versus randomness (i.e. give me this insertion point, what is the origin of this, what nerve lays next to this tendon)?

I have a week and some change to go. I'm going to go ahead with your suggestion of scanning the images of brs anatomy.

Any suggestions for molecular biology? (Is kaplan enough?, I know of your undergrad background, so what helped you learn/reinforce the knowledge)

 

[doctoritis]

Stupid question but also important .. how does timing for breaks work?

How much total break time do we get (assuming the extra 15)?
Can you take it whenever you want (assuming between sections)?
If you are running a little behind does it come out of time from your last section? (I remember with the MCAT there was a 'timer' but the section did not actually begin without you and you still could take the full time for the section...)

How did you guys disperse it?

 

[as90]

Thanks for all the tips. To those that took it, in order to get a feel of the exam format/question length, I'm guessing you would definitely recommend taking NBME 15?

I understand that the exam was a mix between uworld and nbme in difficulty, but would NBME 15, be a good simulation in your opinion?

 

[Goober11]

How much of your anatomy was clinically correlated (i.e. foot drop, wrist drop) versus randomness (i.e. give me this insertion point, what is the origin of this, what nerve lays next to this tendon)?

I have a week and some change to go. I'm going to go ahead with your suggestion of scanning the images of brs anatomy.

Any suggestions for molecular biology? (Is kaplan enough?, I know of your undergrad background, so what helped you learn/reinforce the knowledge)

Good questions.

I would say pretty much everything was clinically oriented in some fashion however, 2 or 3 out of maybe 15-20 anatomy questions were to a more asinine level of knowledge (thanks GT). I hate GT but I have to give it credit when it's due.

My molecular biology was very milktose. I honestly can't even recall anything that Kaplan specifically hooked me up with in that category but doing those Kaplan questions did help me with lab techniques and my overall understanding of the subject which may have given me a leg up in other sections of the test.

 

[dduckyoda]

For everyone who has already taken step 1:

From what I've read so far, the exam is very heavily anatomy and neuroanatomy weighted. Anatomy is my worst subject, so I'm really, really concerned. I'm taking the exam this Friday, so I don't have much time left... Just have a couple of questions for you:
1. Compared to the NBME's, was there a significant increase in proportion and/or difficulty of anatomy/neuroanatomy related questions?
2. Was the focus more functional (i.e. midshaft injury in humerus --> loss of extensors) or radiology-heavy (i.e. clinical scenario, then identify the area most likely injured in this pt on a radiograph)?
3. For someone who sucks at anatomy, how would you recommend studying these last 5 days?

Thank you so much everyone! And congrats on making it to the other side!

 

[step1april2013]

Good questions.

I would say pretty much everything was clinically oriented in some fashion however, 2 or 3 out of maybe 15-20 anatomy questions were to a more asinine level of knowledge (thanks GT). I hate GT but I have to give it credit when it's due.

My molecular biology was very milktose. I honestly can't even recall anything that Kaplan specifically hooked me up with in that category but doing those Kaplan questions did help me with lab techniques and my overall understanding of the subject which may have given me a leg up in other sections of the test.

sounds good. Thx bro, hope you get the score you want

 

[Zareh Ali]

I dont mean t be en egoist, but everyone giving out what subjects are being tested more, is actually screwing theirselfs and others who presented the exam on the early may days od rhe new item pool, cuase we didnt have a clue and got smashed by it, since we are all being evaluated untill july 10 its easy too think that the so called curve is actually real, :/ so please dont make it unfair

 

[JP2740]

Good questions.

I would say pretty much everything was clinically oriented in some fashion however, 2 or 3 out of maybe 15-20 anatomy questions were to a more asinine level of knowledge (thanks GT). I hate GT but I have to give it credit when it's due.

My molecular biology was very milktose. I honestly can't even recall anything that Kaplan specifically hooked me up with in that category but doing those Kaplan questions did help me with lab techniques and my overall understanding of the subject which may have given me a leg up in other sections of the test.

15-20? geez. Any idea how many of those was outside of first aid type stuff?

 

[CDI]

I dont mean t be en egoist, but everyone giving out what subjects are being tested more, is actually screwing theirselfs and others who presented the exam on the early may days od rhe new item pool, cuase we didnt have a clue and got smashed by it, since we are all being evaluated untill july 10 its easy too think that the so called curve is actually real, :/ so please dont make it unfair

 

[TrueAntagonist]

I dont mean t be en egoist, but everyone giving out what subjects are being tested more, is actually screwing theirselfs and others who presented the exam on the early may days od rhe new item pool, cuase we didnt have a clue and got smashed by it, since we are all being evaluated untill july 10 its easy too think that the so called curve is actually real, :/ so please dont make it unfair

They have 20,000+ questIons in their pool. Quite frankly, nothing that ANYONE says about subject distribution means anything.

To those who're worried that the 'new' test seems heavy on (Insert-subject-here), relax. Everyone has a utterly different test. No reason to REFOCUS your attention on a particular subject just because two dudes on SDN are lamenting about having an x-topic heavy test. At the end of the day, Uworld/FA/Pathoma is the gold-standard regimen.

 

[JP2740]

They have 20,000+ questIons in their pool. Quite frankly, nothing that ANYONE says about subject distribution means anything.

To those who're worried that the 'new' test seems heavy on (Insert-subject-here), relax. Everyone has a utterly different test. No reason to REFOCUS your attention on a particular subject just because two dudes on SDN are lamenting about having an x-topic heavy test. At the end of the day, Uworld/FA/Pathoma is the gold-standard regimen.

Lmao yea 10 guys who actually change up what they do on sdn is gonna totally **** up the curve and destroy everyone's curve

 

[Goober11]

15-20? geez. Any idea how many of those was outside of first aid type stuff?

14-19
for realz tho

 

[JP2740]

14-19
for realz tho

lmao what the ****. You telling me that people who only did 1st aid got neeched on all of those questions

 

[Goober11]

I dont mean t be en egoist, but everyone giving out what subjects are being tested more, is actually screwing theirselfs and others who presented the exam on the early may days od rhe new item pool, cuase we didnt have a clue and got smashed by it, since we are all being evaluated untill july 10 its easy too think that the so called curve is actually real, :/ so please dont make it unfair

Saying you are not an egoist usually means, well...

 

[Goober11]

lmao what the ****. You telling me that people who only did 1st aid got neeched on all of those questions

Ok sorry maybe I exaggerated a bit, I honestly don't know. But, we did all have to take anatomy first year so everyone doesn't get "neeched" by those questions.

 

[ssdk]

Going back to the 2011 and 2012 threads, it seems like they change the item pool around mid-May every year.

Is there a reason why NBME would change it so dramatically this year as opposed the previous 2 years that we're seeing some of the post-exam responses on this thread?

 

[HoboCommander]

Going back to the 2011 and 2012 threads, it seems like they change the item pool around mid-May every year.

Is there a reason why NBME would change it so dramatically this year as opposed the previous 2 years that we're seeing some of the post-exam responses on this thread?

Probably because people are doing too well on the exam, with better study resources available now, and more schools teaching to the exam.

 

[CDI]

Going back to the 2011 and 2012 threads, it seems like they change the item pool around mid-May every year.

Is there a reason why NBME would change it so dramatically this year as opposed the previous 2 years that we're seeing some of the post-exam responses on this thread?

It's cause Phloston analyzed it into submission.

 

[TrueAntagonist]

Going back to the 2011 and 2012 threads, it seems like they change the item pool around mid-May every year.

Is there a reason why NBME would change it so dramatically this year as opposed the previous 2 years that we're seeing some of the post-exam responses on this thread?

Honestly though, what could have changed that much? The meat-and-potatoes questions are always going to be there...

 

[HoboCommander]

Honestly though, what could have changed that much? The meat-and-potatoes questions are always going to be there...

You don't think someone's exam score would be swayed by 15-20 hardcore anatomy questions and the same amount of pathology questions not seen in FA?

 

[CDI]

Honestly though, what could have changed that much? The meat-and-potatoes questions are always going to be there...

Easy: length of questions, phase-out of FA recall, more multi-step Qs

The more they go along those lines, the more the division in scoring. It'll eventually get to a point where people can't legitimately complete all the questions on the exam unless they can actually speed-read.

The biggest change I'm 'reading' here (post 2013 testing pool changes) is how crucial Pathoma has become in comparison to FA.

 

[Againstalloddz]

The questions were so friggen long. I'd say about 30% contained a super long vignette with 6-8 lab values. The question was so large you had to scroll pretty far just to get to the answers. Every block was a race to the finish at the end. On a random note I also felt like I calculated PPV and ARR at least 15 times (which I'm definitely cool with).

I will find who makes these questions and I will make their life unpleasant.

 

[kedrin]

I took it the other day. The questions were long and the majority were problem solving and not recall. Time was tight on the majority of blocks with maybe 5 mins to spare on some. Overall it was the hardest test I have completed in my life. It was harder than NBMEs and Uworld, but closer to Uworld in difficulty. Question style was very very similar to NBME 15. My test was heaviest in Neuro and Biochem and I hope that plays to my advantage. Be prepared to not know some questions and make sure you hold a consistent pace throughout a block as time is tight. Make sure you read the last sentence first before starting the stem, I was able to save time this way on several Qs.

TLDROverall advice: don't expect to have extra time, don't expect to get similar distributions of subject Qs as everyone else (although I did not follow my own advice and lucked out possbily haha), Focus on the pathophysiology, be ready to be dumbfounded by many Qs, no matter how well prepped you are, know your physio, and make sure to read HY neuro.

How I prepped:
-60% Uworld 1.5x since January spending 2-3 hrs each day going through 20-30 Qs and studying the explanations. Then during my dedicated I only did what I got wrong.
-DIT I did it before my dedicated study period. It was helpful for some sections that arent covered by FA but overall is just a good intro
-FA 3x straight passes, and I probably hit my weak areas around 6-8x each in total since january. I waited to do psyc and biostats until about 3 wks out and I am glad that I did.
-HY neuro, I invested in this incase I got a neuro heavy test and I did 😍
-RR path Goljan, I only looked at gross images and a couple charts
-Pathoma 1.5x, heme and the basics to pathology videos are a must

My progression (I dont have exact dates handy for some of these):
5/11ish Uworld1:231 @start of ~5 wk dedicated
5/18 NBME11: 231
5/24ish Uworld2:245
6/1 NBME12: 235
6/9 NBME13: 242, AM
6/9 NBME15: 231, PM
6/13 Free 150: 88%

Real deal: ?????? oh god I hope its good enough

I'm hoping 240+, I missed a lot of Qs on 13+15 that were biostats and psyc as I held until last minute to memorize those sections and formulas. On the real deal I am kinda expecting 235-240 but I am really hoping that I nailed the neuro and get a generous curve.


My test distribution:
Heavy on Neuro: 10+ aneurysm or cerebrovasc Qs, 12+ neuro anatomy questions with a many being pretty damn tough. I'm glad I went through HY neuro and did FA neuro the last few days of my studying. No angio though. EDIT: I should have mentioned nearly all of my neuro anatomy Qs were presented with a case presentation and then I was given a gross anatomy image, there was only maybe 1 image that was a drawing. I would definitely use real gross images to study with in the future.

Physio/Pathophysiology: This was the biggest block of my exam, there were so many arrows, it makes me sick thinking about them.

Anatomy embryo: 3-4 abd CTs, couple gimmi MSK Qs, ~5 cxr, 5-7 vasc anat excluding neuro of mostly heart and GI. CT of skull sinuses and the embryo was unfortunately 2 of those damn branchial/aortic bull****s and 1-2 of neural crest vs other derivatives.

Pathology: not a whole lot maybe 20 Qs total on straight path (ie not pathophys)

Ethics: holy god there were 2+ of these each section, I never ever expected so many. About half of the Qs were of the type where you really can only get it down to two choices and guess.

Biostats: maybe 1 hard Q the rest were gimmis. Careful with these though as they are time eaters

Renal: ZERO glom patho images I was amazed. maybe 10 Qs total on the exam for the subject

GI: lots of billirubin Qs that were tough, several arrows, and a bunch of gimmis

Biochem: Lots of Vitamin Qs and 2-3 pathways Qs and then a bunch congenital diseases that were presented very differently than Uworld. Lots of name that Gene which was great for me (like Tubeslercosis, sturge, hippel, and others).

Resp: maybe 20 Qs most dealt with arrows and made up the majority of the path images I had.

Micro: A lot of classics with several ball busters with vague long stems. Oddly enough DIT really helped with this section due to FA not having crabs, scabies, and lice in it. Yeah I got atleast 1 Q on each of those, which I did not expect at all.

Repro: Lots of Balls and by that I mean lots of testicle anatomy/embryo/neoplasia/pharm mix. very little female

Endo: they love the calcium but overall maybe 20Qs, almost entirely arrow Qs too.

Cardio: 3 heart murmurs, 2 of them were complete ball busters for me and 1 was a gimmi. You got nothing from the question stems, it was all off of ausc and location of ausc. several physio Qs here and not very many drug Qs. I memorized those damn antiarrythmics for nothing.

Immuno: ~5 immuno def diseases, rest were cytokines and then ball busters were complicated 3rd+ order ones mixing in micro, experimental, and molecular techniques into one Q.

Heme: I think I lucked out as there were not very many, maybe 3 leuk/lymphoma Qs and ~5 platelet/coag diseases. This was my weakest section and thank goodness it was mostly gimmis.

MSS: 20-30 Qs nothing special maybe a handful of these were complicated. Not much on skin which was great.

Psyc: 10 Qs maybe 2 were complicated.

Pharm: Mostly MOA but I would consider them gimmis. Not a lot of Antibiotic drugs which was great.

 

[loveoforganic2]

For all the peopel pumping pathoma right now, would you say the book itself or his audio too? I really don't care for his audio

It depends on the chapter. Some of the book chapters cover the videos well, some leave a lot to be desired. The gold is in the videos

 

[JP2740]

It depends on the chapter. Some of the book chapters cover the videos well, some leave a lot to be desired. The gold is in the videos

I actually fell asleep in my chair yesterdya listening, no joke. I stopped. Almost done reading lol

 

[skyblue2000]

Just took nbme 7 and got 193 today 🙁

I've read through FA once but haven't started UW (going to start tomorrow and plough through hard with 92q a day for first half and 115q the second half of UW).

I have 6 weeks till my exam.... And just trying to figure out how much I can realistically improve. So scared right now cuz I'm an IMG graduating 2015 so a bad score will crush me

 

[loveoforganic2]

I actually fell asleep in my chair yesterdya listening, no joke. I stopped. Almost done reading lol

I have a fully annotated pathoma text, but I'm just watching a video a day everyday during dedicated. I treat it as kind of a break, do some body weight exercises and whatnot during. Works out well to avoid the passiveness of just sitting and watching a video. Can still do it at 1.7 speed (though I'm on my 4th overall pass now)

 

[JP2740]

Just took nbme 7 and got 193 today 🙁

I've read through FA once but haven't started UW (going to start tomorrow and plough through hard with 92q a day for first half and 115q the second half of UW).

I have 6 weeks till my exam.... And just trying to figure out how much I can realistically improve. So scared right now cuz I'm an IMG graduating 2015 so a bad score will crush me

I think 230 is realistic

 

[skyblue2000]

Just took nbme 7 and got 193 today 🙁

I've read through FA once but haven't started UW (going to start tomorrow and plough through hard with 92q a day for first half and 115q the second half of UW).

I have 6 weeks till my exam.... And just trying to figure out how much I can realistically improve. So scared right now cuz I'm an IMG graduating 2015 so a bad score will crush me

I think 230 is realistic

I was still planning on just doing UW and FA...and optimizing that because I can't extend my test date without going into the next graduating class :/

 

[JP2740]

I would add Pathoma to that, the UWSAs, the extended feedback NBMEs. I think for where you're at that's all reasonable and could definitely collectively raise your score up. Listen to a pathoma vid a day like someone suggested above. Your baseline is low but I think these collectively can bring you up quite a bit, but who knows how much. 6 weeks is a long time. Get your butt off SDN and get to work.

 

[Benesyed]

I took 7.5 weeks of dedicated studying time.

Uworld: Did not finish had about 500 left. Started it after first pass and did it mixed. 81% average.
Kaplan: Did following the section as review. 70s

At 3.5 weeks: NBME 5 (i think it was 5): 238
At 4 weeks: NBME 13: 240
At 6.5 weeks: NBME 15: 257

Took UWSA1 the friday before my exam (on sunday). 265.

My impression of the real deal:

I felt it was much more difficult. I think there were a few factors for this.

1) Different kind of difficulty. World's more difficult questions tend to have an obscure pathogenesis but the answers are drastically different, the trick is knowing what the disease you are being shown is. On my NBME the hard questions had vague presentations and very similar answers. It also really did dig into path. I think most of the answers were answerable my first aid but you had to really draw out the details and be able to link different parts of first aid or really annotate and investigate further on things FA just skimmed. A lot of times it felt that the question went for things FA left unexplored (atleast 3 or 4 questions I got right only because I looked up a few things on up-to-date).

2) Timing. I personally this was the most difficult aspect of the test. I finished sections on NBME 15 and on UWSA1 with 15+ minutes per section with fewer questions marked as needing review. This made it easier to go back and really think out the more involved questions. I had much less of a chance to do this on the real deal and many more questions I wanted to review. The vignettes were much longer and in the harder questions there were many false flags. For example; someone might have had both exposure to anthrax AND to cyanide and they presented with respiratory distress. It was not sufficient to just catch one or the other but to really sit down and look at the labs and do some math. This really cut the time down to go back and review and look at things with a fresh eye.

 

[hardee17]

wow, cyandine and anthrax exposure? I don't think I've ever seen questions with total distractor details before. Just my luck that they totally change the exam before I take it. Does anyone know of a source of practice questions where there are tons of distractors?

 

[FIREitUP]

took the beast today. it was significantly harder than uworld and at least 10x harder than nbme's. obviously that will be reflected in the curve, but just a heads up. i had a lot of genetics/micro as well and a bunch of random q's. vignette's were crazy long and had many things that confounded the dx.

my averages for uworld ended in the mid eighties just as a reference and and still found the questions to be extremely difficult.

 

[JP2740]

took the beast today. it was significantly harder than uworld and at least 10x harder than nbme's. obviously that will be reflected in the curve, but just a heads up. i had a lot of genetics/micro as well and a bunch of random q's. vignette's were crazy long and had many things that confounded the dx.

my averages for uworld ended in the mid eighties just as a reference and and still found the questions to be extremely difficult.

Anything for the "what would you do differently" crowd?

 

[FIREitUP]

Anything for the "what would you do differently" crowd?

i wouldn't do anything differently. definitely go over biochem and micro before your exam. this saved me tremendously! others in my testing session echoed my sentiments on the difficulty of the exam; just accept that they are making it more difficult and you'll likely do as well as you've been doing on your practices.

 

[JP2740]

i wouldn't do anything differently. definitely go over biochem and micro before your exam. this saved me tremendously! others in my testing session echoed my sentiments on the difficulty of the exam; just accept that they are making it more difficult and you'll likely do as well as you've been doing on your practices.

congratulations brotha. i hope you come back with an awesome score.

 

[FIREitUP]

congratulations brotha. i hope you come back with an awesome score.

thanks, man. despite all the questions i flagged i feel pretty good. it was definitely the hardest test i've ever taken in my life, though. don't let it intimidate you.

 

[Benesyed]

Nothing really can be done differently in terms of dedicated study time. The level of detail the hard questions go into is hard to preempt since you do not know the distribution of your test and the limited time you have to study makes it impossible to really cover all those things well.

It felt as if they looked at first aid and intentionally picked things that FA and other reviews did not cover well.

Another example might be that they picked a very lightly covered virus in FA and asked how a researcher should target a treatment for that virus. This virus in real life has no treatment, purely supportive. The idea was to test your understanding of virilogy. The difficulty (and perhaps its because I am not as well read as others) was that this virus had two things that could be targeted and answers for each.

 

[CassieBagley]

I don't understand- did the USMLE Step 1 suddenly get more challenging or does this happen every year? I find it hard to believe that thousands of new questions are being dumped into the "new" rounds of tests rather than gradually replacing old ones over time. Some of the hard core studiers that have posted in the post 2-3 days make it seem like the USMLE Step 1 just transitioned into a new era of difficulty, but I'm willing to bet this happens every year as this is coincidentally also the time most students take the exam.

I imagine the USMLE is wants to prevent their mean score from inflating every year, but a drastic change in difficulty, as some of these posts make it seem, doesn't seem likely as that would involve dumping in either a bunch of new "difficult" questions or taking out the old "easy" questions.

 

[FIREitUP]

Nothing really can be done differently in terms of dedicated study time. The level of detail the hard questions go into is hard to preempt since you do not know the distribution of your test and the limited time you have to study makes it impossible to really cover all those things well.

It felt as if they looked at first aid and intentionally picked things that FA and other reviews did not cover well.

Another example was they picked a very lightly covered virus in FA and asked how a researcher should target a treatment for that virus. This virus in real life has no treatment, purely supportive. The idea was to test your understanding of virilogy. The difficulty (and perhaps its because I am not as well read as others) was that this virus was both enveloped and an RNA virus and there was an answers corresponding to each (impair desialyation OR inhibit RNA synthesis).

i agree; i was very surprised at how in depth and difficult the questions were, even the path (which is my strong suit). i'll reiterate that for sure the difficulty is reflected in the curve; and there are likely experimental questions.

@cassie the test I took was significantly harder than anything i've encountered in my prep

 

[JP2740]

Go check the 2012 thread and tell us what they said then

 

[CDI]

Maybe too many people were passing this year.

 

[CassieBagley]

nothing

 

[FIREitUP]

@JP2740 I mostly have, and there aren't many talks of difficulty like this year. But from a logical standpoint, I don't see how or why the level of difficulty would change so abruptly

Man, I just hope that a 260 is still a 260 and not a 240 (not like I'm going to actually get 260, but just saying).

i'm confident that a 240 will stay a 240 and a 260 will stay a 260. the curve will be adjusted accordingly

 

[loveoforganic2]

i'm confident that a 240 will stay a 240 and a 260 will stay a 260. the curve will be adjusted accordingly

This is the only way to look at it realistically. It's not like they're going to drop the average to a 190 with a test form change

 

[Benesyed]

I don't understand- did the USMLE Step 1 suddenly get more challenging or does this happen every year? I find it hard to believe that thousands of new questions are being dumped into the "new" rounds of tests rather than gradually replacing old ones over time. Some of the hard core studiers that have posted in the post 2-3 days make it seem like the USMLE Step 1 just transitioned into a new era of difficulty, but I'm willing to bet this happens every year as this is coincidentally also the time most students take the exam.

I imagine the USMLE is wants to prevent their mean score from inflating every year, but a drastic change in difficulty, as some of these posts make it seem, doesn't seem likely as that would involve dumping in either a bunch of new "difficult" questions or taking out the old "easy" questions.

I am not speaking to the difficulty of last year. I don't think anyone here is or really can since we only have taken it once.

We are speaking to how resources were much less difficult, be it mock NBME forms or UWSAs

 

[hardee17]

Go check the 2012 thread and tell us what they said then

That's the problem. The 2012 thread has about 10% the number of "the test was way way harder than anything I've ever encountered before" posts.

 

[KinasePro]

All the reports of absurdly difficult exams match my classmates (+ my own) experiences as Jan/Feb 2013 test takers. I doubt a new form is being seen here.. Instead, more SDNers are reporting their experiences & feelings honestly. Step 1 is and always has been a harsh mistress. You'll likely feel like sh:t walking out of the test center no matter when you take it.