Official 2013 Step 1 Experiences and Scores Thread

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Phloston

Osaka, Japan
Removed
Lifetime Donor
10+ Year Member
Joined
Jan 18, 2012
Messages
3,880
Reaction score
1,676
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:
 
I can see 275 being possible for someone scoring 260-265 on the practice NBMEs, but it would mostly be dependent on luck: did he luckily get tested on topics he happened to know pretty well, did we guess right, etc. There is a statistically unlikely, albeit existent, probability that someone already scoring high on the practice NBMEs will jump up into the 275 range based on random luck alone. Or maybe he just had a great memory and grasp of the material...

He himself said he thought it was luck, but it's hard to say. There are 30 versions of Step1 floating around. Based on the random form any one person receives, it's possible that he or she might score similarly to his or her NBMEs on 22 of them, for instance, but might get significantly lower or higher on 8 (4 and 4). Out of those 4 test versions in which a person might perform substantially better/worse, perhaps one or two are pure outliers (e.g. person scores 260s on all NBMEs and gets 275 or 245 on real deal). We do see this "phenomenon" every year though. There will always be people on this forum who jump through the roof or get really depressed.
 
lol, I see why my classmates, who got a 251, said it was a mistake to look at this thread - suddenly my 247 isn't looking so hot 😛.

In 2009, only 359 people out of 26,651 worldwide scored >260 (261+ had a lower-bound percentile of 98.65 when taking into account all applicants to the match). If even just 20 people out of those 359 post on this thread simultaneously, it will suddenly look like everyone is scoring that high. Bear in mind that the SDN-driven score distribution is a complete and utter fantasy. About half of the med school population in the United States scores below 227. Fact. If anything, this thread just serves to keep all of us humble. And in the end, no three-digit score determines anyone's value in life. It's the discipline that one gains from all of his or her hard work that really determines his or her professional character.
 
I am sorry if this is the wrong place to ask this, but I am a little confused about the score releasing schedule. I know there is some variability on NBME's end as well. But typically, if I write the exam on, say, Thursday July 25th... would I then expect the score to be available on Wednesday Aug 14th or Wednesday Aug 21st?
 
Last edited:
I consulted this thread often during prep, so I will contribute my experience. Context: I am an average student at an average MD school.

Day
CBSSE -63 183 (ouch, haha)
UWSA 1 -30 214 This was the first day of my dedicated prep.
*Finished first pass of UWorld (was doing it throughout M2 second semester), had about a 63% overall*
UWSA 2 -25 256
NBME 11 -18 235
NBME 13 -11 247
NBME 15 -5 242
*Finished 2nd pass of UWorld, can't remember exact average, but it was between 85 & 90%*
Free 150 -2 88


Step I 249


Over-represented on my exam: NEURO, Reproductive/GU anatomy/path/phys, Reproductive Endocrine, Biochem, Genetic disorders, Lymphatic drainage (sooo many of these, haha), Ethics, "Easy" (rapid recall type) questions.

Under-represented on my exam: Micro, Pharm, Biostats, "Difficult" questions (a lot my difficult questions were more obscure or vague than challenging in the more common sense)

----

In summary, my test was a very easy exam compared to people I talked with. Somewhere between 30 and 50% of my questions were complete gimmes. There was a high variability in the difficulty of individual blocks for me. I flagged about 40 questions combined just on blocks 2 and 7, whereas I probably flagged about that amount or less for the other 5 blocks combined.

Many of my difficult questions were VERY obscure, especially biochem and anatomy. I got at least 3 anatomy questions from just flipping through Netter for 45 minutes the day before my exam, and there were another 2 at least which I probably would've guessed right anyway but I was able to answer instantly with confidence thanks to Frank.

Many of my ethics questions were very vague. I had 5 or 6 "what would you do next" questions, where for every one my answer was some variation of "facilitate more discussion." I don't think you can go wrong with that, haha.

I had SO much neuro on my exam: anatomy, path, phys, clinical. I had at least 80 neuro questions in total, some of which were quite difficult. Nothing for neuro was out of the blue, everything could be found in FA or HY neuro.

My biggest advice for future test takers is to make your own schedule, try to stick to it, and don't get caught up in what others are doing. I am a huge proponent of identifying your most productive studying pace. For me, that meant taking 6 hours a couple of evenings to hang out with friends and have some drinks, even though I was behind on my schedule. If you schedule in catch-up days for things like this, you will be fine. I also think that if you are an average student and are able to study for 10 hours a day on average, you probably won't need more than 3 to 4 weeks to study for this exam. Obviously that doesn't apply to everybody, but it is a generalization that I think applies to MOST med students. Many of friends (myself included) ended up wishing they had scheduled their exam at 3 weeks out. Good luck, everybody.
 
Agree. I understand the sentiment of others providing that term to denote someone who is dedicated to school and no social life or friends, however, I also understand that the term and connotation must have been created from envious classmates. What if YOU got a 260+? Would you want others to hate you for knowing your material? And let's admit it, whether you are an US student or an IMG, we are all paying heavy tuition fees. What is so wrong about making sure that money is not spent for nothing.

It is a different story though, if they get that score and belittle others for their lower scores. Although, I most of the time see the high scorers trying to explain and help others with their plan of actions for conquering this test...

Totally agree.
 
I just wanted to say congrats to everyone.

Based on your nbmes leading up to the real deal, you were already in the ballpark for your real scores.

Hard work and smart work never goes wasted.

Enjoy your freedom!!
 
In 2009, only 359 people out of 26,651 worldwide scored >260 (261+ had a lower-bound percentile of 98.65 when taking into account all applicants to the match). If even just 20 people out of those 359 post on this thread simultaneously, it will suddenly look like everyone is scoring that high. Bear in mind that the SDN-driven score distribution is a complete and utter fantasy. About half of the med school population in the United States scores below 227. Fact. If anything, this thread just serves to keep all of us humble. And in the end, no three-digit score determines anyone's value in life. It's the discipline that one gains from all of his or her hard work that really determines his or her professional character.

👍👍👍👍👍
 
I got a 260. Are there that many people waiting to take this thing for me to write out a post of what I did?

There's Still HalF A Year Of Step 1 Takers ToGo (& Next Years' Who'll ReadThis Thread), So I'd Say Yeah.... But Really, Only do A Write-Up IfYouActually Want ToHelp Future Testers.
 
In 2009, only 359 people out of 26,651 worldwide scored >260 (261+ had a lower-bound percentile of 98.65 when taking into account all applicants to the match). If even just 20 people out of those 359 post on this thread simultaneously, it will suddenly look like everyone is scoring that high. Bear in mind that the SDN-driven score distribution is a complete and utter fantasy. About half of the med school population in the United States scores below 227. Fact. If anything, this thread just serves to keep all of us humble. And in the end, no three-digit score determines anyone's value in life. It's the discipline that one gains from all of his or her hard work that really determines his or her professional character.

Although I'veBeeN On SDN A While & Should Be Used To ThIs, ... I WaSn't.
This Post Helped. Thanks
 
Posting this as a confidence booster for people who didn't do great in 2nd year classes. Also for people who only want to use one or two resources.

School administered exam (possibly CBSE?) - 205
2 wks in, NBME 13- 226
4.5 wks in, NBME 12 - 254
6 wks in, Real Exam - 250

Read FA + annotated with google - took me about 14 days.
Then Read FA 3 more times. Would do two or three blocks whenever I was too tired to read.
Completed 50% of UWorld - 78% average.

Before the study period I was worried that FA was not enough coming off of an average classroom performance. Many people who had done well told me it absolutely was, so I trusted them. Guess it worked out 👍.

👍👍👍
 
He himself said he thought it was luck, but it's hard to say. There are 30 versions of Step1 floating around. Based on the random form any one person receives, it's possible that he or she might score similarly to his or her NBMEs on 22 of them, for instance, but might get significantly lower or higher on 8 (4 and 4). Out of those 4 test versions in which a person might perform substantially better/worse, perhaps one or two are pure outliers (e.g. person scores 260s on all NBMEs and gets 275 or 245 on real deal). We do see this "phenomenon" every year though. There will always be people on this forum who jump through the roof or get really depressed.

a guy in my school (he is almost 4.0) scored 275 in december of 2012
another guy (less than average barely 2.5) took the exam with him in the same day and same exam center and scored 248
do they take the same exam in the same exam center?
If so then 100% their exam version was easy, cuz that average guy couldn't score 248 unless the exam was a piece of cake
the A guy was set for 260+ but I guess his luck with an easy exam gave him 275
 
hey everyone! i just wanted to share my story because i think that i broke a lot of 'rules' when it comes to studying for step one and because i think that i had a little bit of a unique situation that could help some people out! i know i was looking for some similar stories on sdn and was a little disheartened when i didnt find any so here goes!

base line score CBSSA provided by school: 225 (6 weeks out)
USAW 1: 230 (3.5 weeks out)
NBME 11: 226 (2 weeks out - needless to say i was having panic attacks (who studies for a month and gets the same score they did before they started studying?) and started looking for hope on sdn. this was also right after i had to go home for a week for my brother's college graduation and i was the maid of honor in my best friend's wedding. my uworld percents dropped from 80 to 65 and a few days after i took this my grandma needed emergency surgery and a day or so later i found out my aunt was diagnosed with stage 4 lung cancer and told she had around 6 months to a year to live. i go to school a short plane ride from my family and i was devastated and alone. this is where i started breaking rules.... i was advised not to push my test date and to just buckle down and push my family out of my mind but i couldnt do it. i was crying every day and just wanted to be home. one day on the phone with my mom she asked me 'do you want to come home tomorrow? i said YES and 12 hours later i had my test pushed back and in a location by my home and i was on a plane)
USAW 2: 258 (2 weeks out)
NBME 13 and 15 back to back: 247 (5 days out)
uworld percents once home : 80 to 85

step 1 - 241 and i am THRILLED

the moral of my story i think is you really cant listen to what anyone else says in person or on sdn. you have to look inside yourself and figure out what you really need and what i really needed was to be home with my family. i cannot stress how important it is to be around those that love and support you. it really makes all the difference.

good luck everyone!
 
hey everyone! i just wanted to share my story because i think that i broke a lot of 'rules' when it comes to studying for step one and because i think that i had a little bit of a unique situation that could help some people out! i know i was looking for some similar stories on sdn and was a little disheartened when i didnt find any so here goes!

base line score CBSSA provided by school: 225 (6 weeks out)
USAW 1: 230 (3.5 weeks out)
NBME 11: 226 (2 weeks out - needless to say i was having panic attacks (who studies for a month and gets the same score they did before they started studying?) and started looking for hope on sdn. this was also right after i had to go home for a week for my brother's college graduation and i was the maid of honor in my best friend's wedding. my uworld percents dropped from 80 to 65 and a few days after i took this my grandma needed emergency surgery and a day or so later i found out my aunt was diagnosed with stage 4 lung cancer and told she had around 6 months to a year to live. i go to school a short plane ride from my family and i was devastated and alone. this is where i started breaking rules.... i was advised not to push my test date and to just buckle down and push my family out of my mind but i couldnt do it. i was crying every day and just wanted to be home. one day on the phone with my mom she asked me 'do you want to come home tomorrow? i said YES and 12 hours later i had my test pushed back and in a location by my home and i was on a plane)
USAW 2: 258 (2 weeks out)
NBME 13 and 15 back to back: 247 (5 days out)
uworld percents once home : 80 to 85

step 1 - 241 and i am THRILLED

the moral of my story i think is you really cant listen to what anyone else says in person or on sdn. you have to look inside yourself and figure out what you really need and what i really needed was to be home with my family. i cannot stress how important it is to be around those that love and support you. it really makes all the difference.

good luck everyone!

Damn, sounds like a crazy stressful situation. Glad it worked out great for you!
 
In 2009, only 359 people out of 26,651 worldwide scored >260 (261+ had a lower-bound percentile of 98.65 when taking into account all applicants to the match). If even just 20 people out of those 359 post on this thread simultaneously, it will suddenly look like everyone is scoring that high. Bear in mind that the SDN-driven score distribution is a complete and utter fantasy. About half of the med school population in the United States scores below 227. Fact. If anything, this thread just serves to keep all of us humble. And in the end, no three-digit score determines anyone's value in life. It's the discipline that one gains from all of his or her hard work that really determines his or her professional character.

This is what I totally agree with. You get one shot at step 1. You might get a great exam for you or a bad one. The difference between a 250 and 260 is rather marginal.

You will have the next thirty years to determine what kind of physician you are. Your life is not determined be step 1. Your life was not made or broken based on the MCAT, SAT, or ACT. It will also not be determined by a three digit magic number generated by the NBME. As Pholston said, your life will be determined by the countless minutes, hours, days, and years you get in residency and beyond.

Think of it like this. Step 1 is like an individual patient you see in the clinic. Maybe you did great with this patient or maybe you failed the patient, most people do in between with the patient. You will have thousands and thousands of other patient contacts to build your career on.

I just want the people feeling crushed and desperate in here, especially the ones not posting, to know the world is still turning. If you did poorly or great, you will survive.
 
I felt like this too, but the curve ended up bein generous

This seems to happen to most people who felt like this as well, so I am sure you will be fine

I understand what everyone is saying and im hoping and praying im wrong, but i really missed so many easy questions, not to mention the ones i changed from right to wrong. So much work and time down the drain. I know for a fact of 23 i missed already

For everyone still studying, my advice is to stop studying or thinking about anything 2 to 3 days before your exam. Do whatever it takes to relax and clear your mind
 
I understand what everyone is saying and im hoping and praying im wrong, but i really missed so many easy questions, not to mention the ones i changed from right to wrong. So much work and time down the drain. I know for a fact of 23 i missed already

For everyone still studying, my advice is to stop studying or thinking about anything 2 to 3 days before your exam. Do whatever it takes to relax and clear your mind

I think this depends on how your mind works. It also largely depends on how and how well you're prepared. I have always been a last minute crammer. Often, it was a little fact I read right before the test that I would remember the most vividly (whereas I would have surely forgotten 3 days later). With this test I got soft (hey now!) the last few days of studying. When I sat for my test I was kicking myself for forgetting the easiest little things. I did not stay sharp. For my mind, I should have stayed engaged. Certainly I would not suggest powering an all nighter before the test, but I could never come to terms with doing nothing. It felt all wrong. I did it anyway and shut things down the last few days, and it possibly proved to be my undoing in the end.

It's been mentioned before but I think each individual knows what is best for them. If you need a break for clarity then take it. If you need to remain locked in, then absolutely stay locked in. Do not go against what feels right to you because someone else suggested it (I realize the self-deating nature of this advice.. ).
 
I poured over board threads since MSI. Looking back I wish I wouldn't have wasted so much time on these threads. My original goal was 250s (reach for the moon and land among the stars type of thing).

About me:
I am an average (literally the middle of my class) DO student. I bought FA my second semester of MSI and opened maybe a handful of times before my prep. During my first 2 years I d!cked around, thinking my work ethic/cramming skills would carry me to my goal of 250. As much as I hate to admit it, the best prep is how hard you work during your first two years and how much you truly understand the information.

Prep:
I "started" in Jan but was really too inconsistent to call it prep. I would begin with one method, then find some "step I experience" that had some success and start over using that method. I started over probably about 10 times and was really just spinning my wheels.

My real prep began after spring break when I got uworld. My goal was to get through it once before school was out then make a second pass after finals. In the beginning, I just focused on the organ systems and totally ignored the basic sciences. I broke each system down using the Taus Breakdown, did uworld, and annotated. My second pass I started from the beginning of FA and read it as many times as I could. At first I couldn't get through FA in a month but by the end I could get through it all in ~2 days.

Dedicated Period (4 weeks)
I took a practice test at the beginning of my prep (baseline) then one a week for 4 weeks
NBME 7, 11: <200 - realizing that the basic sciences was actually high yield, I began to hit those hard.
NBME 13: 215
NBME 15: 224
Real Deal: 230s

Main resources: Pathoma, Uworld, FA (+wiki/google for clarification)
Uworld average: started in 50s ended in mid 70s to 80

Hind Sight Thoughts:
The three resources above are all you need. I feel like I missed my goal of 250 due to inconsistency (in the beginning) and spending too much time looking for the best resource/study method. There was not a question on the test that I did not recognize what they were trying to get me to think of, or that I had not seen in FA/Uworld. I missed questions because I did not know FA well enough. It wasn't because I didn't read CMMRS/HY neuro/some other prep book. Juggernaut your way through FA as many time as you can and look up (google/wiki) the things you don't understand. Annotate for clarification. Keep in mind just about every sentence in FA is high yield. If you see a question you don't recognize or feel it is out of left field, chances are you just skimmed over it in FA.

Keep it simple and you will do well. There is no sexy way of preparing for this test. There is just information and you have to know it and be able to synthesize it. Lucky for you, all the information is compiled for you in a single book and in question format.

After my test I was just hoping for average so I am stoked with my score. Study your @ss off, walk into the test knowing that you went to bed empty every single night, and enjoy your score, no matter what it is. I don't care that I didn't hit the SDN average, I know I did the absolute best that I could, the best way I knew how. Would I have changed how I studied? Of course, but hindsight is always 20/20.

If you have any questions just PM me.

P.S. reading about scoring 250 does not translate to actually scoring 250 - so get off this thread and get to studying. I wish someone would have smacked me in the face and said those words to me.
 
I understand what everyone is saying and im hoping and praying im wrong, but i really missed so many easy questions, not to mention the ones i changed from right to wrong. So much work and time down the drain. I know for a fact of 23 i missed already

For everyone still studying, my advice is to stop studying or thinking about anything 2 to 3 days before your exam. Do whatever it takes to relax and clear your mind

We won't look down on you for not breaking 250 🙂. Just focus on being happy. And do share your score when it comes out.

P.S. reading about scoring 250 does not translate to actually scoring 250 - so get off this thread and get to studying. I wish someone would have smacked me in the face and said those words to me.

I totally get where you're coming from and I agree to some degree with most of what you've said, but there appear to be patterns to scoring in different ranges. There is obviously more than one way to skin a cat, but some ways are less arduous and the members of this forum have helped with that. - for example, if I tried FA+google, that's a black hole from which I would never return

I spend time on the forums too, but always take away something useful...and leave motivated. I'm a chronic procrastinator and just reading about the hard work everyone is putting in helps keep me motivated. Works for me.
 
Last edited:
I totally get where you're coming from and I agree to some degree with most of what you've said, but there appear to be patterns to scoring in different ranges. There is obviously more than one way to skin a cat, but some ways are less arduous and the members of this forum have helped with that. - for example, if I tried FA+google, that's a black hole from which I would never return

I spend time on the forums too, but always take away something useful...and leave motivated. I'm a chronic procrastinator and just reading about the hard work everyone is putting in helps keep me motivated. Works for me.

Of course there are many different ways to study for this beast - I tried almost all of them. This is just my individual opinion. In the end, if I had spent half the time actually studying for step I than I did trying to figure out how to study for step I then I have no doubt I would have scored much higher.

SDN is definitely a great resource. I just got caught up in the endless search of the best neuro/biochem/pharm/etc review book and I think it cost me. Just need to look at the big picture and realize there is no magic book that will make up for your deficiencies and hand you the keys to a stellar score. Only hard work and consistency will give you that.

It seems like you know what works for you and trash what doesn't. I am sure you will do well.
 
Long time lurker (5+ years). I finally found time to do a small write-up. This thread was great, so I'm going to do my part to give back.

Baseline: 178 (6 months out)
Other forms: 235 average (>3 weeks out)
Form 13: 250 (2 weeks out)
Form 15: 252 (1 week out)
Real deal: Upper 240s

The exam wasn't that difficult for me. I performed strongly in my best subject(s) and weakly in my worst subject, which probably "destroyed" my score according to SDN standards, but I am very happy with my performance. In retrospect, I probably would have scored a little higher if I had worked on the glaring weakness (borderline performance), but I'm happy with how everything turned out! Some of the nicest and most intelligent people in my class struggled to pass this exam, so I am truly thankful for doing so well. I do think SDN distorted my perception of how difficult it would be to do well on Step I, but now I am both grateful and humbled by my score.

I focused on USMLE World, Pathoma, and First Aid 2013 (in order of importance for me). Good luck to future test-takers. Study hard, and never lose perspective.
 
Last edited:
I understand what everyone is saying and im hoping and praying im wrong, but i really missed so many easy questions, not to mention the ones i changed from right to wrong. So much work and time down the drain. I know for a fact of 23 i missed already

For everyone still studying, my advice is to stop studying or thinking about anything 2 to 3 days before your exam. Do whatever it takes to relax and clear your mind

I counted more than that the following day, when I started to study for COMLEX.

Also, on one section, for some reason it wouldnt let me scroll down far enough, so I didn't even see question #46 until I had 20 seconds on the clock

I quickly skimmed it and the just hit C, and it was a Lambert Eaton mechanism question, one I could have gotten easily if I had not been so rushed. Another easy point lost.


On the other hand, my buddy thought the USMLE was easy, and underperformed. Also, i took the COMLEX a few days later, and thought it was pretty easy, and did worse than I expected.

I'm almost starting to believe that it is a blessing to get a hard test
 
Here's a little bit of hope for those who started studying late or got overwhelmed with all the resources and just decided to limit it to a couple resources.

I focused only on my classes throughout M2 year and did well in them, didn't even open first aid or start Uworld during the school year. Once school was over I had 6 weeks to study.

I used only first aid and Uworld as resources. I studied by organ system/section in first aid and split up Uworld this way too. I would go through an organ system in first aid in 1-2 days and would do Uworld timed tutor questions on that organ system each night with usually 1-2 blocks of questions, occasionally more. I would then spend one last day going through that organ system quickly and then do some more Uworld. So I basically went through each chapter 2 times total at this point.

I had maybe 7-9 days left after I had been through all of first aid so I spent that last week going through first aid one more time therefore I had seen everything a total of 3 times.

Uworld: 98% complete in timed tutor mode with 71% correct, I read every explanation of every question and made notes in my first aid book, I used google if I needed clarification on anything.

UWSA1 and UWSA2 both about 1.5 weeks out: 255 and 259 respectively.

USMLE test date 6/21, final score: 253.

I also bought pathoma, usmle secrets, and 3 sets of flash cards but didn't end up using any of these resources, I just decided I would memorize first aid. I am proof that you can get >250 with just 2 resources but this probably varies depending on test form. Uworld and first aid had most of the stuff that I was tested on but I'd say maybe 10 questions came from remembering something mentioned in lecture during M1-M2 years. Another 10 or so questions were the type of out of left field questions that you can't study for at all. I felt fine walking out of the test, but I didn't really think back through any questions at all. During the test I made sure I had selective amnesia, if I was stuck on something I would just make an educated guess and then move on and not think about it again. Hope this write up helps someone.
 
Last edited:
I've been avoiding this thread like the plague after my score report because everybody on SDN scores a 260 (and I certainly didn't), but I also got a great score that anybody should be happy with (not saying this to humble brag, but just to add some authority to my next point). Only 3 things to add to this discussion that I don't think have been brought up yet:

#1. Trust your NBME scores. I got the exact same score as my last NBME even though I walked out of the test feeling like it could've been about a 15 point swing in either direction. So let me repeat- DO NOT spend your month or so waiting for scores stressing out. You will score relatively close to your practice tests, and hopefully you're at a place you're happy with just prior to taking step 1.

#2. Goljan and First Aid on .pdf!!! Wow these were helpful. I also purchased the books in case the NSA is spying on me, but the ability to search the pdf file in order to quickly make connections between different meds/organ systems/stupid enzymes is invaluable. I found that Step 1 tests a lot of "crossover" type questions in which the organ systems influence one another. Search the damn pdf and you'll be able to make these connections a lot more quickly.

#3. If you take multiple NBME's spread out over several weeks and your score doesn't change, then guess what? You've hit the peak of your abilities. This was tough for me to swallow, and I tried to deny it while I was trudging through that last week of studying, but ultimately nothing changed. If you can add 6 months to your test date, then yes, of course you'll do better. But once you've hit that peak, then 5 weeks versus 6 weeks will make no difference. Just get that test over with and enjoy your vacation.
 
I've been avoiding this thread like the plague after my score report because everybody on SDN scores a 260 (and I certainly didn't), but I also got a great score that anybody should be happy with (not saying this to humble brag, but just to add some authority to my next point). Only 3 things to add to this discussion that I don't think have been brought up yet:

#1. Trust your NBME scores. I got the exact same score as my last NBME even though I walked out of the test feeling like it could've been about a 15 point swing in either direction. So let me repeat- DO NOT spend your month or so waiting for scores stressing out. You will score relatively close to your practice tests, and hopefully you're at a place you're happy with just prior to taking step 1.

#2. Goljan and First Aid on .pdf!!! Wow these were helpful. I also purchased the books in case the NSA is spying on me, but the ability to search the pdf file in order to quickly make connections between different meds/organ systems/stupid enzymes is invaluable. I found that Step 1 tests a lot of "crossover" type questions in which the organ systems influence one another. Search the damn pdf and you'll be able to make these connections a lot more quickly.

#3. If you take multiple NBME's spread out over several weeks and your score doesn't change, then guess what? You've hit the peak of your abilities. This was tough for me to swallow, and I tried to deny it while I was trudging through that last week of studying, but ultimately nothing changed. If you can add 6 months to your test date, then yes, of course you'll do better. But once you've hit that peak, then 5 weeks versus 6 weeks will make no difference. Just get that test over with and enjoy your vacation.

This.
 
Real score: 263

Practice Exams:
CBSE(10 weeks prior): 220
NBME 11(4 weeks before): 242
NBME 15(1 week before): 252
UWSA 1(3 days before): 265+(90% correct)

QBanks:
UWorld(used 7 weeks leading up to exam, random, timed): 83%
Avg of last 10 blocks in UWorld: 87%
Avg of starting blocks in UWorld: 70%
UsmleRx: 85% correct, 80% done

Resources:
First Aid (everyone uses it for a reason)
Pathoma (amazing, I had his voice running through my head for several questions on the real exam)
Goljan audio (snagged a few points from this, really brings concepts together, some stuff out dated now, you should start listening to it in the car day 1 of second year)
UWorld (the best questions, everyone knows this)
UsmleRx (amazing way to learn FA facts, especially through out MS2, might not be so great closer to your exam)

A little bit about me:
Pretty average student, probably around 50% in my class. Had 7 weeks of dedicated study time. Probably really started focusing 10 weeks before the exam. As others have said, the best thing to do is to work hard during MS2 and be consistent! That doesn't mean you gotta get 95% on all the exams, but do not cram the night before an exam because you won't retain it. It's better to get a 90% and really learn the basics, than to cram and get a 95%. Read the slides, know the lectures, study, read the associated chapter in FA, and do a few hundred practice questions from UsmleRx the week before each exam. There is no secret to doing well, you just have to continually memorize and re-memorize. Don't avoid FA during the school year, FA is daunting but you need to know your way around it before you get to dedicated studying.

A few tips I found very useful:
-Review all the drugs the day before the exam(MoA, clinical use, and at least the #1 side effect)
-Review drugs at night using note cards or a note card program.
-Find a friend and have them quiz you on all the charts in FA(lysosomal storage disease, toxins and their antidote, the large drug reactions list in the pharm chapter, etc)
-Never wait to start doing questions because you're not ready, and power through as many questions as you can handle every day(at least 2 sets, it will be painful but worth it). I only got through 90% of UWorld and I wish I had finished it
-Taking an evening off to relax every couple days, have a glass of wine, watch some crappy TV.
-This test doesn't determine whether you will be a good doctor or not. But at the same time you don't want to look back and feel that you didn't give it 100% so avoid any of your distractions(video games, reading SDN, etc) during your dedicated study time.
 
What should we make of this 227 test average?

I think a big part of it is random variance. Some of it is certainly due to question pool compromise and testing material optimization. Unfortunately we won't be getting any NRMP data until August of 2014. 🙁

Congrats to all the test takers.
 
Real score: 264

I'm an AMG, with a dedicated study time of about 5 weeks.

I was absolutely ecstatic when I saw my score! It was 10 points higher than the highest score I had on practice NBMEs. After leaving the exam, I would've been very happy with a 235, since I was so unsure of how everything went. It also didn't help that I found out that 5 of my answers were wrong pretty immediately after the exam!

I was the guy who was freaking out the night before my Step 1 exam because I hadn't read half of FA yet, at that point. The only thing I had done during dedicated study time was UWorld questions (randomized + timed) and a few chapters of Pathoma. I did spend the 3 days leading up to my exam doing the FA sections on micro, pharm, and biochem. Unfortunately, there were relatively few questions on those topics and the ones that did show up were didn't require spending an entire day on that topic. I still maintain that the two most important resources are UWorld and Pathoma. The sections of FA that did read were absolutely useless. I know a lot of people say that the MCAT is a thinking exam, while Step 1 tests how well you can memorize things -- I don't think that's true at all, at least with my exam. I had to do a hell of a lot more thinking on Step 1 than I did on the MCAT. It was tough, but if you work hard throughout M1/M2 years to build a solid foundation of the material, you can reason your way to the right answers -- I think that's the best thing anyone can do to put themselves in a position to score highly on Step 1, and I worked my butt off during M1 and M2 years (especially M2 year). Thanks again to everyone who helped calm me down the night before my exam! It's much appreciated.

Hey guys, I could really use some reassurance to help calm me down. I'm taking my exam tomorrow and there are still 5 or 6 chapters in FA that I haven't even looked at yet and I'm really freaking the eff out. I know I messed up. However, I've done really well on UWorld (78% correct -- randomized, timed, first pass) and really well on 4 practice NBMEs (averaging about a 247 or so).

Please tell me I'll be okay tomorrow! I know there's still a lot to go through, but I read a lot of FA and UW explanations after I took my last NBME (15 -- scored around a 250 on it), so I feel like I've only added more information to my foundation.

Any advice for these last few hours? I'm planning on going through the neuro and reproductive sections in FA (haven't read them yet) and quickly looking at the behavioral sciences section either late tonight or tomorrow morning on my commute to the test center. I don't think I'll have time to really review anatomy of embryo (both of which I'm weak at, but am hoping they're low-yield). Any advice or reassurance would be immensely appreciated! Thank you!

Hey guys, took the exam today. First of all, I want to give a heartfelt thanks to the people who posted words of reassurance yesterday! They really did help have a calming effect on me. Thank you for that! 🙂

On my exam, I honestly felt like a lot of the stuff wasn't explicitly found in FA (at least, not the sections that I read). A significant portion of it required reasoning your way through the question and figuring out what the answer is -- I thought the difficulty was somewhere between an NBME and UWorld questions. I'll echo what people have said: the question stems are longer and you're given lab values more often on the real deal. That definitely slows you down when you have to go back and check your answer. You do fall into a rhythm fairly quickly though -- I was terrified before starting, but as the questions started rolling by and I realized that they're pretty similar to the practice questions I did, I calmed down and tackled it just like another practice NBME/UWorld block.

Content-wise:

Path/pathophys -- pretty broad coverage. It didn't seem like a particular system was emphasized. It was perhaps slightly skewed toward endocrine/reproductive, but for the most part, I felt like it was pretty comprehensive. Some of the questions were "gimme" questions; others, you really had to reason your way through and just hope you got to the right answer. I thought Pathoma was absolutely crucial for this section -- I only read a few chapters of it during dedicated study time, but I did it religiously during the school year (went over each chapter several times while learning the system during M2 year). If you have time before your exam, I would definitely recommend reading through Pathoma again -- I would argue it's one of the best things you can do to prep yourself to answering pathology questions.

Physio -- lots of arrow questions. These were actually a bit tougher than I thought they would be, but were doable for the most part. Time consuming though because there were so many answer choices to pick through and rule out/rule in. I don't remember there being any calculations I had to worry about.

Biochem -- not as much as I expected, thankfully. Most were straight up disease stuff with occasional insulin/glucagon regulation stuff. Nothing like the detailed pathway questions that UWorld asked. A decent number of genetics questions actually, regarding inheritance patterns, pedigrees, etc. Know what disease are AD vs. X-linked vs. AR vs. mitochondrial, etc.

Neuro -- not as much neuro as I thought there would be. Covered the usual stuff regarding stroke territories, degenerative diseases, etc. Couple of CT images that may look difficult at first but, if you flip through HY neuro or any other neuro atlas the night before and know what structures different pathologies affected, they were very doable. Not too much brainstem stuff either, luckily. The ones that were on there were fairly straight-forward.

Pharm -- surprisingly, not that much. Mostly had to do with side-effects, with the occasional question on MOA. There weren't any weird drugs or anything and pretty much all of them were covered in FA. Know your side-effects well. A few kinetics and dynamics stuff (so know those dose-response curves and all that jazz). There were also a couple of questions that covered material not in FA, but definitely tested on in UWorld.

Behavioral sciences -- more questions on this material than I expected. Lots of questions on "what should the physician say next" and biostats calculations (most were relatively easy, but there were a few calculations regarding stuff I've never heard of and are definitely not in FA -- there was nothing I could've done to prepare for those few questions). Overall, they weren't too bad -- I thought the ethics/physician response questions were tougher than the ones in UWorld. It seemed like many of those questions had more than one response that I could see being a reasonable answer.

Pscyh -- not much. The big stuff popped up (depression, bipolar, schizo, etc) and drug side-effects were emphasized.

Anatomy/embryo -- more questions than I thought (anatomy, not too much embryo). They were also tough! I don't think most of that stuff was in FA -- there was a focus on GU and H&N anatomy, both of which are, unfortunately, weak areas for me. You have to read a review book in order to answer these questions because I don't remember the material being in FA or UWorld. With that being said, I still don't think spending extra time beyond FA and UWorld for anatomy is worth the time, unless you've pretty much done everything else and are confident in that stuff.

Overall, I felt about the same as I do after each UWorld block and every NBME I've taken -- unsure of how it went. However, things have always worked out in UWorld and NBMEs, so I hope that this feeling means that I did about the same (I'd be absolutely ecstatic if that was the case!). I had maybe 10-15 questions marked in each block (a little more than how many I marked in the NBMEs). I feel like I lost a bunch of points on the anatomy questions -- there were even some simple ones that I simply overthought and changed my answer from the right one to the wrong one. It definitely didn't feel as bad as I thought it might be, though. I'm just so glad that it's done! I can finally relax and watch TV without feeling guilty! All I can hope now for is a good score so that I don't ever have to worry about this awful exam again. These past 2-3 weeks have been absolutely hellish!

TL;DR -- Pathoma and UWorld were clutch, IMHO. FA did save my ass a few times, but I felt that UWorld and Pathoma gave you the tools to tackle the reasoning-heavy types of problems that were common on my exam. I didn't read all of FA, so take that with a grain of salt.
 
Last edited:
I have done fairly well in most of my classes throughout first 2 years. Mostly Honors, 2-3 HP, and 1-2 P.

Resources used in order of benefit provided
1) Pretty much knew FA in and out
2) Went through DIT over course of 25 days. Took detailed notes on high yield topics, and tried to review all of my notes 2-3 times per week.

3) UWorld
1st pass: around 70% (took detailed notes on all questions missed, and reviewed notes 2x per week)
2nd pass: was averaging 85-95% and remembered most of questions from first pass, so I quit after about 30% complete, since not that high yield

4) Took detailed notes in margins of DIT workbook. Kept writing out topics that I needed to memorize until they stuck.

School administered NBME test (6-7 weeks out): 200 (Test was right after finals, so I was exhausted. Also, I had gone out to celebrate the night before, so I had a slight hangover)

UWORLD Self-Assessment 1 (4 weeks out): 238

UWORLD Self-Assessment 2 (2 weeks out, after finishing DIT): 261

NBME 11 (1.5 weeks out); 242

REAL DEAL: 246

I am happy with my score, and it is better than what I was originally aiming for. Not sure why the UWSA 2 overestimated my score so much, but that was also the case with my friends that have performed similarly to me in classes.

I wish that I had scheduled my test 1 week earlier. Towards the end I really wasn't sure what else to study, and I felt like I probably lost more info than I gained. Also, it sucks having all of your friends finish before you.

I studied about 8-10 hours per day. Didn't do any Step 1 prep prior to end of classes except for a few UW questions here and there to help prep for the shelf exams. I mostly just tried to do well in my classes, and then focused on Step 1 for 6 weeks.
 
The number of people scoring 260+ on this 7/10 score release is insane! Is the selection bias on SDN this strong every year?
 
What should we make of this 227 test average?

I think a big part of it is random variance. Some of it is certainly due to question pool compromise and testing material optimization. Unfortunately we won't be getting any NRMP data until August of 2014. 🙁
Congrats to all the test takers.

Do you guys think that this will lead to a greater number of unmatched positions for those in the class of 2014/2015? ... I ask this because if the average increased, more people will compare high scores vs the 2011 charting outcomes which have lower averages (than current match scores) and will think they have a better shot at matching when in actuality, their score may not be as outstanding as they think.
 
I walked out of m 5/22 exam feeling super depressed because I thought I totally failed the test and it was such a waste of time for me to study 12hr/day for 5 weeks. I thought my test was very anatomy heavy with lots of pelvic questions that I have never seem in UWorld so I could only use my blurry memory from M1 anatomy to answer those questions. Btw I also sucked at my anatomy class during M1. Anyways, I almost cried that night after my exam and wasn't feeling so great for the past few weeks while waiting for my score. I was expecting something like a 220 honestly...

Following is what I did for preparation:

Dedicated studying time: 5.5 weeks

I started using UWorld around December (~6 months before my exam) and just did questions in tutor mode during my med school organ system module. I ended up doing around 30-40% of all the qbank this way. I highly recommend this because it really helped me to be more comfortable with the step 1 format early on and also realize how bad/useless my school's tests are... Also very useful to use it as a tool to learn the information!! I loved the UWorld explanation.

I also did pathoma during the school year. I highly recommend it since the teaching is 100X better than my school's.. and it's so affordable! I would watch the videos on my iPad while I workout in the gym and such.

During my dedicated studying time I used the following sources:

First Aid: I thought it's a good book not for "studying" but to look up answers that you have studied already but have forgotten the exact detail. I unbound my first aid and 3 hole punched them so I could carry it in a binder. I think it was very useful because I could add extra pages when I find a particular useful chart from UWorld or other sources. Highly recommend anyone to do this!

UWorld: I would do about 2-3 blocks in random mode per day and then make flashcards out of the questions I got wrong. In the beginning of my dedicated study time, I did the block by subject and annotated things into my first aid. However I soon realized it was taking forever and wasn't that effective so I switched into making flashcards.

Pathoma: I re-watched/re-read all chapter for ~1-2X depending on how comfortable I am with the subject. I also annotated some of the pathoma into my first aid. I thought the pathology section of first aid is pretty weak and that's why I like to start with reviewing pathoma and then move to first aid after I read pathoma already.

Microcards: Started during the micro module and then read them again 1x during the study period.

Pharm recall: Went through the little book 1x pretty casually at night during the dedicated study period

Goljian: Listened to all the recording 2x during school year and the study period. Awesome recording! I highly highly recommend it.


Some other resources that I thought were very helpful but I didn't have enough time to finish them up throughly:

1. Step 1 secret: I started using this book during the last few blocks of my school's organ system class and thought it was great! I wished I had known this book earlier on and used it throughout school year. It's not so good during the dedicated studying time because the chapters are too long and 5.5 weeks is not enough to finish this book.

2. Kaplan Qbank: I got an access code from a friend and was doing the qbank casually but did only ~300 questions or so because I was running out of time. I realized later on that you can purchase the "until your test" for around $250? I think doing questions and reading the explanation in full is the best way to prepare for this test and if I could go back I would just do the Kaplan qbank throughout school year as well..

I did 3 NBME:
NBME 6, 5 weeks out (after reviewing biochem and immuno) 225

NBME one of the newer form, 4 weeks out: 228
I freaked out and started studying harder...

NBME one of the newer from, 2 weeks out: 250

UWSA #1, 3 weeks out: 255
UWSA #2, 3 days out: 265

Real deal: 255

I am really really really happy with my score! What can I say?.. I mean I guess you must be able to get a lot of the questions wrong and still get a great score. I am so glad the stupid wait is finally over and I can stop googling which residency program requires the lowest possible step 1 score. 🙂 good luck everyone and don't freak out post exam like me!
 
Do you guys think that this will lead to a greater number of unmatched positions for those in the class of 2014/2015? ... I ask this because if the average increased, more people will compare high scores vs the 2011 charting outcomes which have lower averages (than current match scores) and will think they have a better shot at matching when in actuality, their score may not be as outstanding as they think.

dang i do feel like i did really well, but this does scare me too!
 
i thought the average was like 218 or something? i dont know thats what it was at my school and they told us it was close to the national
 
First of all, congrats to all who completed Step 1. It is a bear, and tackling it takes not only a lot of dedication but also some impressive mental toughness.

Second, I wanted to provide some insight to any of those who haven't taken it yet and to those of you who have been haunted by standardized exams in the past. I am pretty new to SDN, but it didn't take long to realize that the majority of posts are made by (seemingly) highly intelligent people. When I was preparing for Step 1, all it took was a couple of days spending 10-15 minutes sifting through threads to really freak me out, and make me feel like there are so many more intelligent people out there than myself. Don't let this fool you!

From the many posts and replies that I read, I gathered that most people seem it is necessary to spend 2+ months preparing for Step 1. I could not DISAGREE with anything more (unless you are a foreign IMG). If you did OK during the first 2 years of school, then Step 1 studying should take no longer than 6 weeks.

Let me provide you with potential self-esteem:
I am from a pretty small town who was given a less-than-average high school education. I went to college, worked hard, got good grades, and was lucky enough to get into medical school with an MCAT that was a few points below the national average. Once in med school, I worked hard during the core classes but dreaded the summer after M2 year. I have never been a good standardized test taker. My ACT? 25. Forgot to mention that. So, with those 2 less-than-stellar scores, I began my Step 1 studying hoping to at least get the national average.

From what I had heard from older students and classmates, studying for Step 1 was gonna take anywhere from 4-6 weeks. I have to owe my preparation to others and the internet, because without their input my studying would have been atrocious. I'll provide a quick outline of what I did:

On my first day of studying I took a USMLEWorld self assessment and got a 206. Then I heard that UWorld tends to exaggerate your score by 10-15 points. This scared the ***t out of me. I did nothing the rest of that day except plan out the rest of my study schedule.

First Aid -- I began reviewing First Aid intensely the week after school got out, about 5 and a half weeks from test day. I ended up only getting through it 1 and a half times.

Pathoma -- I wish I would have known about Pathoma at the beginning of 2nd year. Taught by Dr. Satar, it provides a PHENOMENAL baseline understanding of pathology and really teaches you how to strip diseases right down to the fundamental problem that's occurring. I was able get through his concise book almost twice (about 1 and 3/4). Make sure to emulate his drawings in the space provided in his book.

USMLEWorld QBank -- I started questions about 4 weeks out, and tried to do 92 questions a day. Definitely did not average 2 blocks of questions a day, but whatever. Doing questions was BY FAR THE MOST HELPFUL. The "Review" portion of UWorld questions is SO VALUABLE. SPEND A LOT OF TIME REVIEWING ALL THE QUESTIONS, EVEN IF YOU GOT THEM CORRECT. I took random notes on blank sheets of paper, which I accumulated and then read through 2 days before my test. I did about 1800 of the UWorld questions and ended up with a 73% average (started ~60 and ended mid-80s). I took another UWorld self assessment 2 weeks from my test and got a low 250. It didn't seem possible. A 50 point jump in 3 weeks???

NBME -- I took 3 NBMEs. 216, 242, 248 (4, 2, and 1 week out, respectively). I think these are really important to do. The newer ones seem more representative of the actual thing.

Took the real thing and got mid 250s. For once in my life, I did well on a standardized exam.

If I did this well on Step 1, anyone can. I am certainly no genius. Reserve at least 8 hours/day for studying. TAKE DAYS OFF. Either a full day or a couple half days. Exercise. Eat well. Get drunk a couple of times. You need to remember life outside of studying. Don't put so much pressure on this test and take the real thing as if you were in your little cubicle taking a practice one. Your life could be a lot worse than having to study all day.

I hope this helps at least 1 person out there! 👍 Thanks for reading
 
Congrats to everyone who’s survived Step!


I’m not that active a poster on SDN but I’ve done a lot of lurking. I hope sharing my experience can help some people or is at least interesting 😛

Background: I’m an American allopathic student. My school makes us take NBME 6 in March with a voucher. This is in the middle of psych block and before derm/statistics. I made a 241, which I was very happy with at the time! I didn’t really start studying for step until about halfway through my last block(late April), and I started by doing only UWorld(I really hated reading FA at first). I did up to 6 blocks of questions per day and took notes on their explanations. When I did start FA I took all my old notes and added them to FA.

My school has grades and I made honors for every test except cardio, but I’ve never made top of the class. I also did well first year, but pretty much forgot everything. I study a lot; not gonna lie. I bought a year subscription for Firecracker/GT in the summer before and planned to use for block tests/keep up throughout the year, but I pretty much stopped in October(it was too much hassle/annoyance to keep up with every day, and I tried to pick it up again during committed step studying but I felt like the question algorithm kept me from studying subjects I knew I wanted to cover.

I did do GT micro over Christmas break, and that actually helped a lot for block tests and since it stayed relevant a lot of knowledge lasted until the summer.

I also bought a six month uworld account with the same hopes as for GT, but I didn't start doing questions until dedicated study time. It did allow me to reset my account and do the questions again however.

A note about my schedule: I’d say I studied around 12 hours a day on average, waking up at ten and studying til like midnight, with food, breaks, and exercise mixed in. I exercised every day, either lifting or playing some sports. There were many days where I took half days or a few hours to hang out with my girlfriend and friends. I would study at my school library four days out of the week but I would also go to coffee shops. Overall I found my study pace relaxed compared to some of my friends(but maybe they’re a bunch of gunners too…)

Before I started studying, I set goals for each day(one/two blocks of FA, a set number of uworld blocks, etc) and made sure I did that for the day. If I finished early for that day I either read ahead or just quit for the day. I spaced NBMEs after finishing benchmarks(a pass through FA, finishing Goljian, etc). I never fell behind my original schedule.

Timeline(I kept a more detailed diary as I studied to keep myself accountable, and these are highlights)

Test: June 17th

Mid-April: began doing Uworld blocks, but most focus on finishing school(end of April).

5/10/13: finished uworld. 79% correct. Done in review mode.
FA 1st pass starting with biochem. I had also started Goljian audio before this point; I never really made allocated time to do it but I would listen to him in the car and during workouts.
Began doing 3 Uworld blocks per day after resetting my account

5/12/13: NBME 13 610/247. I was actually disappointed that I didn't improve more after during UWorld first pass.

5/17/13 FA first pass done!

5/18/13 Finished all of Goljian! Took NBME 12, made a 650/257. Very happy with the improvement, though I thought the form was pretty hard; I think I marked like 40 questions.

5/20/13 Started Pathoma. 2-2.5x speed usually, at least 10 lectures a day.
Started 2nd pass FA going through biochem again. This pass took at least as much time as the first as I was really trying to get the details down.

5/31/13: Finished FA 2nd pass and Pathoma

6/1/13: Back to back practice tests to simulate the real exam. Took NBME 11 first. Made a 710/271! I was glad to see that all the studying appeared to be paying off. Then I took the UWorld Self-Assessment 1. I made 93% on 1 section and 87% in the other 3. My accumlated score was 800(the max) which equates to a 265+ for their system. I was also very happy with this.

6/4/13: Finished Uworld 2nd pass. 96%. Done in timed mode.

In this period I did a lot of practice tests. I got them from upperclassmen and timed myself. They may have been, uh, things that you can't find online anymore except from sites like ifileit. All I have to say about that >_>

6/8/13: NBME 15: 690/266. Missed 9. Made about 3 avoidable mistakes, 2 forgotten points, and 4 new concepts learned. Kinda discouraging. Needed to go through each question more thoroughly to make sure I'm not missing any of the question stem. Also Uworld self assessment 2. 91, 87, 91, 93%, 800/265.

6/9/13: NBME 7: 710/271.Missed 5. I felt like I was plateauing here but at a level I was very happy with. I also hadn't actually studied for a while at this point; I had been doing practice tests/question only for the past few days.

6/18/13: Spent the last week going through first aid 100 pages at a time. Also did Goljian another time. Two days before my test I went though uworld quickly, going through 35 blocks of questions one day and then 10 the next(with answers already filled in). Also went back through my uworld self assessments. I also looked at micro powerpoints someone in my class put up(by Phloston?): This was a mistake, it had a lot of stuff(that ultimately wasn’t on my test) I had no idea about and it made me freak. Finally, went through my missed questions on previous NBMEs.

The aftermath: I slept really poorly the night before, partly due to nerves I guess. I fell asleep around 4 and woke up at 7 to get ready for my 8:30 test. Definitely not optimal. I tried to rapid fire review drugs when I couldn't sleep but I don't think I saw much of it the next day.
The test felt a lot harder than I expected. There was a lot more thinking and piecing through vignettes than represented on the NBMEs. It was most similar in style to the Uworld self assessments. It required a lot more thinking rather than recognizing a stereotypical clinical situation. There were also a lot of WTF questions in my opinion.
Things I recall(with much bias):
General concepts/ethics: This was very frustrating. I was asked a lot of questions where the clinical situation seemed very vague. I think all you can do is go by the basic principles in First Aid.
Biochemistry: Probably the highest yield topic for the test. I got a lot of glycogen storage diseases. Some vitamin deficiencies, and plenty of biochemical pathways.
Micro: Lots of easier questions(here's water house-friedrichson syndrome, what is the organism) , but there's a noticeable amount of more obscure information as well. Many clinical vignettes about the viral exanthems in children.
Pathology: I don't really remember much about general path questions. I think there was one about types of necrosis.
Pharmacology: I think I had one question that was a straight calculation for half-life, and a michaelis-menton question came up near the end of my test.
Cardio: The questions here were pretty straightforward. Recognizing where murmurs were, diastolic failure, etc. There was a question about coxsackie virus.
Endo: Also straightforward, knowing relationships up and down and feedback.
GI: I actually had a lot of trouble here. People kept having vague abdominal pain and I found it hard to make definitive diagnoses rather than educated guesses. I also know I missed one about a HepA biopsy and I'm kicking myself for that.
Neuro: There were a LOT of tricky questions here. I got no questions about subdural hematomas and epidural hematomas etc. I got a lot of localizing the lesion after a stroke. There were more brainstem slices than I expected as well.
Pyschiatry: pretty straightforward, recognizing timeframes and depression etc
Renal: Lots of prerenal azotemia. Fanconi's syndrome came up. No path images of glomeruli.
Repro: I actually don't remember any branchial derivates being asked. Some questions about fibroids and sex cord tumors and breast fibroadenomas.
Respiratory: Mostly straightforward, but they try to trick you with pulmonary issues versus left heart failure with orthopnea. I had some questions that were supposed to be really tricky. One was a pet store owner who spelunked in old coal mines and had just started a vegetarian diet. Interestingly, none of the patients who had sarcoidosis were noted to be black.
Heme/onc: had a lot of trouble here distinguishing granulomatous pathologies in the lymph nodes.
Skin/MSK: Lots of serum sickness, viral exanthems, pictures of rashes.

Overall felt that I'd be fortunate to get a 250+.

Results out: Wednesday July 10th 2013 @ 11:00 am Eastern time

Score: 273!!!!
For my score report, I was * in all subjects except pulmonary.

Very exciting! Definitely jumped up and down a bit.

I guess sleep isn't important before the night of the exam...

Definitely satisfied with my score and happy that all that work paid off. Like I said my confidence was really shaky coming out of the exam.

Here's my prioritized advice to all people with Step in their future:

1. Do well in second year. No joke. During the organ blocks do the best you can, and then you'll remember the essential information when you start hitting FA. There's no need to hit FA or other step resources for block exams; they're probably not detailed enough to help you for the blocks. You will forget a lot of everything, but your job 2nd year should be to get a firm grasp of physiology and pathology of organ systems so that you can fill in the details for step later.
Like I mentioned in my exam experience, there were a lot of WTF questions that weren't in any of the resources I covered for Step. Many of these may have been experimental questions, but I'm sure some of them counted and I think I got most of them right from educated guesses using principles taught during actual medical school.

6 weeks to study is more than enough if you have a solid background already. Like I mentioned before, I got honors for most blocks, but I don’t think that’s essential. I think remembering what was important got me a 241 in March without much dedicated step studying, but I know I’m kind of a gunner(not in a malignant way[at least I hope] but I do dedicate a lot of time to school).
2. Read FA. A lot. I'd say it covers 70% of the tested material. Everyone studies different ways, but I'd suggest attempting to make FA your comprehensive resource as you continue in your studies. My FA is littered with notes in multiple colors with material from Goljian, UWorld, Pathoma, and internet searches. FA requires very active reading and filling in the blanks as you go will help you immeasurably.
I'd suggest 3x through including your annotations. Some people choose to use DIT for their first pass to motivate them through it; I say #$!@ it. You've known how to read for 20+ years and you've known how to study for a large part of that. It doesn't provide much new info and it'll slow you down for that first pass.
3. Goljian audio. Definitely the most high yield resource per time and concentration commitment. I don't know how old the recordings are but things he mentions are still essentially paraphrased in Step questions. I listened to him twice.
I looked through the pictures in the book but didn't read the text. In the end it wasn't very helpful. The path pictures on the exam are fairly classical/obvious, so FA covers it well.
4. UWorld. You gotta do it. I don't think there were any questions that were mirrored on the exam, but each question teaches you a concept and the explanations are great(if a bit too detailed at times). I did it 3x through, which is probably a bit much. 2x is fine, and I think 1x would've been adequate

FA, Goljian, and UWorld are the holy trinity in my opinion. If you have a good mastery of these three resources and you know fundamentals from block exams, I think you can get a 250+.

To reliably get above a 250 however I think you need to consider more resources.

5. Pathoma. Again, I only watched the lectures and didn't read the book. Pathoma would be good for block lectures too as it starts with basics and expands to more specifics. It's not nearly as high yield as Goljian but a few facts he mentioned that weren't elsewhere did appear on my exam.
6. NBME tests. I only saw one question that was repeated from old NBMEs, and I would’ve probably missed it if I hadn’t seen it before. I was surprised that so few questions were in circulation still, but I guess that means you can’t succeed by just giving the NBME all your money 😛. The tests are also very different in question style and length, but you can still learn a lot by going through the questions you miss and in the end the score predictions from NBMEs were most accurate for my real deal.
7. UWSAs. I think the questions are harder and more annoying than the real deal ones, but the question length and test format is spot on to the real thing.
8. Brainstem slices/cranial nerve locations. These WILL show up on your test and FA does NOT cover them. Some people get books, but there are a lot of great review websites that I found sufficient.
For most of my study period I had a partner and we would text questions/pimp each other. This helped me a lot in remembering things I had trouble with. He ended up taking the test a few weeks before me and scored very high as well.
If I had to redo it, I would’ve tried to add more question banks into my studying like Kaplan and USMLERx. I also would have thrown in GT/Firecracker in more since it has testable information that’s not seen in FA, but it’s a HUGE time commitment and I didn’t like it. My test had a lot of obscure facts that weren’t covered in FA or UWorld and the only way I can see how to tackle that is to have a huge knowledge base. Of course, you’re not supposed to get everything right on the test, and I know I made a few mistakes on mine. I also would not have done UWorld as the first thing I did; it’s a great review tool and though I learned a lot I didn’t make much improvement after doing it as my sole resource first.
I definitely spent a lot of extra money buying NBMEs, GT, and UWorld and I think I could’ve been more economical, but I don’t regret it too much.

Of course, there’s nothing about my plan that makes it better than anyone else’s. Everyone knows how to learn their own way. I think the key is making a goal and a systematic plan to reach it.

Thanks for reading. Good luck to everyone.
 
How can you make a 263 and at the same time maintain such a complete lack of awareness that a bump in average from 224-->227 isn't going to affect you? Lol

Constant anxiety is a common theme in some top students. It drives them to work incessantly and therefore it's rewarded then repeated.

Lots of high scores. Even 270s now.

Impressive.
 
The number of people scoring 260+ on this 7/10 score release is insane! Is the selection bias on SDN this strong every year?

Yeah! There is a big influx of 260s! I don't remember the last year thread had a similar thing.
Congrats to you all! 🙂
 
First of all, congrats to all who completed Step 1. It is a bear, and tackling it takes not only a lot of dedication but also some impressive mental toughness.

Second, I wanted to provide some insight to any of those who haven't taken it yet and to those of you who have been haunted by standardized exams in the past. I am pretty new to SDN, but it didn't take long to realize that the majority of posts are made by (seemingly) highly intelligent people. When I was preparing for Step 1, all it took was a couple of days spending 10-15 minutes sifting through threads to really freak me out, and make me feel like there are so many more intelligent people out there than myself. Don't let this fool you!

From the many posts and replies that I read, I gathered that most people seem it is necessary to spend 2+ months preparing for Step 1. I could not DISAGREE with anything more (unless you are a foreign IMG). If you did OK during the first 2 years of school, then Step 1 studying should take no longer than 6 weeks.

Let me provide you with potential self-esteem:
I am from a pretty small town who was given a less-than-average high school education. I went to college, worked hard, got good grades, and was lucky enough to get into medical school with an MCAT that was a few points below the national average. Once in med school, I worked hard during the core classes but dreaded the summer after M2 year. I have never been a good standardized test taker. My ACT? 25. Forgot to mention that. So, with those 2 less-than-stellar scores, I began my Step 1 studying hoping to at least get the national average.

From what I had heard from older students and classmates, studying for Step 1 was gonna take anywhere from 4-6 weeks. I have to owe my preparation to others and the internet, because without their input my studying would have been atrocious. I'll provide a quick outline of what I did:

On my first day of studying I took a USMLEWorld self assessment and got a 206. Then I heard that UWorld tends to exaggerate your score by 10-15 points. This scared the ***t out of me. I did nothing the rest of that day except plan out the rest of my study schedule.

First Aid -- I began reviewing First Aid intensely the week after school got out, about 5 and a half weeks from test day. I ended up only getting through it 1 and a half times.

Pathoma -- I wish I would have known about Pathoma at the beginning of 2nd year. Taught by Dr. Satar, it provides a PHENOMENAL baseline understanding of pathology and really teaches you how to strip diseases right down to the fundamental problem that's occurring. I was able get through his concise book almost twice (about 1 and 3/4). Make sure to emulate his drawings in the space provided in his book.

USMLEWorld QBank -- I started questions about 4 weeks out, and tried to do 92 questions a day. Definitely did not average 2 blocks of questions a day, but whatever. Doing questions was BY FAR THE MOST HELPFUL. The "Review" portion of UWorld questions is SO VALUABLE. SPEND A LOT OF TIME REVIEWING ALL THE QUESTIONS, EVEN IF YOU GOT THEM CORRECT. I took random notes on blank sheets of paper, which I accumulated and then read through 2 days before my test. I did about 1800 of the UWorld questions and ended up with a 73% average (started ~60 and ended mid-80s). I took another UWorld self assessment 2 weeks from my test and got a low 250. It didn't seem possible. A 50 point jump in 3 weeks???

NBME -- I took 3 NBMEs. 216, 242, 248 (4, 2, and 1 week out, respectively). I think these are really important to do. The newer ones seem more representative of the actual thing.

Took the real thing and got mid 250s. For once in my life, I did well on a standardized exam.

If I did this well on Step 1, anyone can. I am certainly no genius. Reserve at least 8 hours/day for studying. TAKE DAYS OFF. Either a full day or a couple half days. Exercise. Eat well. Get drunk a couple of times. You need to remember life outside of studying. Don't put so much pressure on this test and take the real thing as if you were in your little cubicle taking a practice one. Your life could be a lot worse than having to study all day.

I hope this helps at least 1 person out there! 👍 Thanks for reading

You got your 1 🙂 Thanks for taking the time for writing all that out--definite sigh of relief!
 
Got my score on the 10th.

Used Doctors in Training and Qbank exclusively (no First Aid)

I completed DIT and used the work book and found it very helpful.

Uworld Practice Exam 1: 257
NBME Practice Exam 7: 232

Real USMLE Score: 244


In short, Uworld overpredicts and NBME 7 under predicts by roughly the same amount.
 
Last edited:
Got my score on the 10th.

Used Doctors in Training and Qbank exclusively (no First Aid)

I completed DIT and used the work book and found it very helpful.

Uworld Practice Exam 1: 257
NBME Practice Exam 7: 232

Real USMLE Score: 244


In short, Uworld overpredicts and NBME 7 under predicts by roughly the same amount.

Gasp, no FA?!? Congrats on your score though!
 
Thanks homes. Any chance where you're hearing this (school or based on past year score release)?

I don't know if its changed since they redid testing things in the past two months, but usually it's the 3rd to 4th Wednesday after you take your exam. Again, it's not written anywhere officially that that's true, but it has been conservative in that nature. It was three Wednesdays for me.
 
Congrats to everyone who’s survived Step!


I’m not that active a poster on SDN but I’ve done a lot of lurking. I hope sharing my experience can help some people or is at least interesting 😛

Background: I’m an American allopathic student. My school makes us take NBME 6 in March with a voucher. This is in the middle of psych block and before derm/statistics. I made a 241, which I was very happy with at the time! I didn’t really start studying for step until about halfway through my last block(late April), and I started by doing only UWorld(I really hated reading FA at first). I did up to 6 blocks of questions per day and took notes on their explanations. When I did start FA I took all my old notes and added them to FA.

My school has grades and I made honors for every test except cardio, but I’ve never made top of the class. I also did well first year, but pretty much forgot everything. I study a lot; not gonna lie. I bought a year subscription for Firecracker/GT in the summer before and planned to use for block tests/keep up throughout the year, but I pretty much stopped in October(it was too much hassle/annoyance to keep up with every day, and I tried to pick it up again during committed step studying but I felt like the question algorithm kept me from studying subjects I knew I wanted to cover.

I did do GT micro over Christmas break, and that actually helped a lot for block tests and since it stayed relevant a lot of knowledge lasted until the summer.

I also bought a six month uworld account with the same hopes as for GT, but I didn't start doing questions until dedicated study time. It did allow me to reset my account and do the questions again however.

A note about my schedule: I’d say I studied around 12 hours a day on average, waking up at ten and studying til like midnight, with food, breaks, and exercise mixed in. I exercised every day, either lifting or playing some sports. There were many days where I took half days or a few hours to hang out with my girlfriend and friends. I would study at my school library four days out of the week but I would also go to coffee shops. Overall I found my study pace relaxed compared to some of my friends(but maybe they’re a bunch of gunners too…)

Before I started studying, I set goals for each day(one/two blocks of FA, a set number of uworld blocks, etc) and made sure I did that for the day. If I finished early for that day I either read ahead or just quit for the day. I spaced NBMEs after finishing benchmarks(a pass through FA, finishing Goljian, etc). I never fell behind my original schedule.

Timeline(I kept a more detailed diary as I studied to keep myself accountable, and these are highlights)

Test: June 17th

Mid-April: began doing Uworld blocks, but most focus on finishing school(end of April).

5/10/13: finished uworld. 79% correct. Done in review mode.
FA 1st pass starting with biochem. I had also started Goljian audio before this point; I never really made allocated time to do it but I would listen to him in the car and during workouts.
Began doing 3 Uworld blocks per day after resetting my account

5/12/13: NBME 13 610/247. I was actually disappointed that I didn't improve more after during UWorld first pass.

5/17/13 FA first pass done!

5/18/13 Finished all of Goljian! Took NBME 12, made a 650/257. Very happy with the improvement, though I thought the form was pretty hard; I think I marked like 40 questions.

5/20/13 Started Pathoma. 2-2.5x speed usually, at least 10 lectures a day.
Started 2nd pass FA going through biochem again. This pass took at least as much time as the first as I was really trying to get the details down.

5/31/13: Finished FA 2nd pass and Pathoma

6/1/13: Back to back practice tests to simulate the real exam. Took NBME 11 first. Made a 710/271! I was glad to see that all the studying appeared to be paying off. Then I took the UWorld Self-Assessment 1. I made 93% on 1 section and 87% in the other 3. My accumlated score was 800(the max) which equates to a 265+ for their system. I was also very happy with this.

6/4/13: Finished Uworld 2nd pass. 96%. Done in timed mode.

In this period I did a lot of practice tests. I got them from upperclassmen and timed myself. They may have been, uh, things that you can't find online anymore except from sites like ifileit. All I have to say about that >_>

6/8/13: NBME 15: 690/266. Missed 9. Made about 3 avoidable mistakes, 2 forgotten points, and 4 new concepts learned. Kinda discouraging. Needed to go through each question more thoroughly to make sure I'm not missing any of the question stem. Also Uworld self assessment 2. 91, 87, 91, 93%, 800/265.

6/9/13: NBME 7: 710/271.Missed 5. I felt like I was plateauing here but at a level I was very happy with. I also hadn't actually studied for a while at this point; I had been doing practice tests/question only for the past few days.

6/18/13: Spent the last week going through first aid 100 pages at a time. Also did Goljian another time. Two days before my test I went though uworld quickly, going through 35 blocks of questions one day and then 10 the next(with answers already filled in). Also went back through my uworld self assessments. I also looked at micro powerpoints someone in my class put up(by Phloston?): This was a mistake, it had a lot of stuff(that ultimately wasn’t on my test) I had no idea about and it made me freak. Finally, went through my missed questions on previous NBMEs.

The aftermath: I slept really poorly the night before, partly due to nerves I guess. I fell asleep around 4 and woke up at 7 to get ready for my 8:30 test. Definitely not optimal. I tried to rapid fire review drugs when I couldn't sleep but I don't think I saw much of it the next day.
The test felt a lot harder than I expected. There was a lot more thinking and piecing through vignettes than represented on the NBMEs. It was most similar in style to the Uworld self assessments. It required a lot more thinking rather than recognizing a stereotypical clinical situation. There were also a lot of WTF questions in my opinion.
Things I recall(with much bias):
General concepts/ethics: This was very frustrating. I was asked a lot of questions where the clinical situation seemed very vague. I think all you can do is go by the basic principles in First Aid.
Biochemistry: Probably the highest yield topic for the test. I got a lot of glycogen storage diseases. Some vitamin deficiencies, and plenty of biochemical pathways.
Micro: Lots of easier questions(here's water house-friedrichson syndrome, what is the organism) , but there's a noticeable amount of more obscure information as well. Many clinical vignettes about the viral exanthems in children.
Pathology: I don't really remember much about general path questions. I think there was one about types of necrosis.
Pharmacology: I think I had one question that was a straight calculation for half-life, and a michaelis-menton question came up near the end of my test.
Cardio: The questions here were pretty straightforward. Recognizing where murmurs were, diastolic failure, etc. There was a question about coxsackie virus.
Endo: Also straightforward, knowing relationships up and down and feedback.
GI: I actually had a lot of trouble here. People kept having vague abdominal pain and I found it hard to make definitive diagnoses rather than educated guesses. I also know I missed one about a HepA biopsy and I'm kicking myself for that.
Neuro: There were a LOT of tricky questions here. I got no questions about subdural hematomas and epidural hematomas etc. I got a lot of localizing the lesion after a stroke. There were more brainstem slices than I expected as well.
Pyschiatry: pretty straightforward, recognizing timeframes and depression etc
Renal: Lots of prerenal azotemia. Fanconi's syndrome came up. No path images of glomeruli.
Repro: I actually don't remember any branchial derivates being asked. Some questions about fibroids and sex cord tumors and breast fibroadenomas.
Respiratory: Mostly straightforward, but they try to trick you with pulmonary issues versus left heart failure with orthopnea. I had some questions that were supposed to be really tricky. One was a pet store owner who spelunked in old coal mines and had just started a vegetarian diet. Interestingly, none of the patients who had sarcoidosis were noted to be black.
Heme/onc: had a lot of trouble here distinguishing granulomatous pathologies in the lymph nodes.
Skin/MSK: Lots of serum sickness, viral exanthems, pictures of rashes.

Overall felt that I'd be fortunate to get a 250+.

Results out: Wednesday July 10th 2013 @ 11:00 am Eastern time

Score: 273!!!!
For my score report, I was * in all subjects except pulmonary.

Very exciting! Definitely jumped up and down a bit.

I guess sleep isn't important before the night of the exam...

Definitely satisfied with my score and happy that all that work paid off. Like I said my confidence was really shaky coming out of the exam.

Here's my prioritized advice to all people with Step in their future:

1. Do well in second year. No joke. During the organ blocks do the best you can, and then you'll remember the essential information when you start hitting FA. There's no need to hit FA or other step resources for block exams; they're probably not detailed enough to help you for the blocks. You will forget a lot of everything, but your job 2nd year should be to get a firm grasp of physiology and pathology of organ systems so that you can fill in the details for step later.
Like I mentioned in my exam experience, there were a lot of WTF questions that weren't in any of the resources I covered for Step. Many of these may have been experimental questions, but I'm sure some of them counted and I think I got most of them right from educated guesses using principles taught during actual medical school.

6 weeks to study is more than enough if you have a solid background already. Like I mentioned before, I got honors for most blocks, but I don’t think that’s essential. I think remembering what was important got me a 241 in March without much dedicated step studying, but I know I’m kind of a gunner(not in a malignant way[at least I hope] but I do dedicate a lot of time to school).
2. Read FA. A lot. I'd say it covers 70% of the tested material. Everyone studies different ways, but I'd suggest attempting to make FA your comprehensive resource as you continue in your studies. My FA is littered with notes in multiple colors with material from Goljian, UWorld, Pathoma, and internet searches. FA requires very active reading and filling in the blanks as you go will help you immeasurably.
I'd suggest 3x through including your annotations. Some people choose to use DIT for their first pass to motivate them through it; I say #$!@ it. You've known how to read for 20+ years and you've known how to study for a large part of that. It doesn't provide much new info and it'll slow you down for that first pass.
3. Goljian audio. Definitely the most high yield resource per time and concentration commitment. I don't know how old the recordings are but things he mentions are still essentially paraphrased in Step questions. I listened to him twice.
I looked through the pictures in the book but didn't read the text. In the end it wasn't very helpful. The path pictures on the exam are fairly classical/obvious, so FA covers it well.
4. UWorld. You gotta do it. I don't think there were any questions that were mirrored on the exam, but each question teaches you a concept and the explanations are great(if a bit too detailed at times). I did it 3x through, which is probably a bit much. 2x is fine, and I think 1x would've been adequate

FA, Goljian, and UWorld are the holy trinity in my opinion. If you have a good mastery of these three resources and you know fundamentals from block exams, I think you can get a 250+.

To reliably get above a 250 however I think you need to consider more resources.

5. Pathoma. Again, I only watched the lectures and didn't read the book. Pathoma would be good for block lectures too as it starts with basics and expands to more specifics. It's not nearly as high yield as Goljian but a few facts he mentioned that weren't elsewhere did appear on my exam.
6. NBME tests. I only saw one question that was repeated from old NBMEs, and I would’ve probably missed it if I hadn’t seen it before. I was surprised that so few questions were in circulation still, but I guess that means you can’t succeed by just giving the NBME all your money 😛. The tests are also very different in question style and length, but you can still learn a lot by going through the questions you miss and in the end the score predictions from NBMEs were most accurate for my real deal.
7. UWSAs. I think the questions are harder and more annoying than the real deal ones, but the question length and test format is spot on to the real thing.
8. Brainstem slices/cranial nerve locations. These WILL show up on your test and FA does NOT cover them. Some people get books, but there are a lot of great review websites that I found sufficient.
For most of my study period I had a partner and we would text questions/pimp each other. This helped me a lot in remembering things I had trouble with. He ended up taking the test a few weeks before me and scored very high as well.
If I had to redo it, I would’ve tried to add more question banks into my studying like Kaplan and USMLERx. I also would have thrown in GT/Firecracker in more since it has testable information that’s not seen in FA, but it’s a HUGE time commitment and I didn’t like it. My test had a lot of obscure facts that weren’t covered in FA or UWorld and the only way I can see how to tackle that is to have a huge knowledge base. Of course, you’re not supposed to get everything right on the test, and I know I made a few mistakes on mine. I also would not have done UWorld as the first thing I did; it’s a great review tool and though I learned a lot I didn’t make much improvement after doing it as my sole resource first.
I definitely spent a lot of extra money buying NBMEs, GT, and UWorld and I think I could’ve been more economical, but I don’t regret it too much.

Of course, there’s nothing about my plan that makes it better than anyone else’s. Everyone knows how to learn their own way. I think the key is making a goal and a systematic plan to reach it.

Thanks for reading. Good luck to everyone.

Thank you! This was excellent. 👍
 
Top