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

 

[Zzmed]

FA and uworld are good for review but you MUST know your foundation. If you did well the first 2 years of medical school and things are still fresh than that type of review is probably all you need. I was in a different situation because I had taken 2 years off between first and second year so I had to rebuild my foundation. I wish I spent more time doing some of the book reviews that they mention in the back of first aid like BRS and high yield. Especially biochem. I started reading rapid review but got bored.
Plus it seems everybody's test is a little different. I happened to get a test heavy on 2 areas I don't feel as strong in. And as for histo Staging I am praying it was a test question and not the real deal.

First of all, i believe you did great. Correct me if I am wrong but your NBMEs were solid. They won't let you down.
Secondly, let me get it straight. When you say FA didn't suffice, you mean that you couldn't pretty much handle the info in FA and deal with the Exam or that you faced facts not mentioned in FA at all.

 

[jenniferleigh]

First of all, i believe you did great. Correct me if I am wrong but your NBMEs were solid. They won't let you down.
Secondly, let me get it straight. When you say FA didn't suffice, you mean that you couldn't pretty much handle the info in FA and deal with the Exam or that you faced facts not mentioned in FA at all.

There were some questions not at all mentioned in first aid which is why your foundation is important but there is no reason why you can't get a great score without doing other sources. I am just saying I wish I had viewed some other resources because it had been so long since I had seen neuro and anatomy but I think the plans mentioned in the past are solid and can easily get you 250+. I have no idea how I will do but I am feeli a little better about it this morning because I feel like most questions I had doubts on I was at least able to nail it down to. 50/50.

 

[CDI]

There were some questions not at all mentioned in first aid which is why your foundation is important but there is no reason why you can't get a great score without doing other sources. I am just saying I wish I had viewed some other resources because it had been so long since I had seen neuro and anatomy but I think the plans mentioned in the past are solid and can easily get you 250+. I have no idea how I will do but I am feeli a little better about it this morning because I feel like most questions I had doubts on I was at least able to nail it down to. 50/50.

To help others reading my posts vs your experience: I think the reason you felt FA was not enough at all, is because without even realizing it you had done well on the easier FA recall Qs. There are a lot of them scattered throughout the exam. They're the 'staple' or filler Qs, and the rest of the Qs put people in their place based on their prep above and beyond FA.

We tend to remember what we screwed up or questions we were unsure about. I was still stuck trying to get FA down when heading into the exam, so I still struggled with those auto-clicks and thats why you keep hearing me say FA is so crucial. Knowing FA well is the most direct way to lock up the 220-230. Then you build on that further. I think you did just that, and were fighting for that next 'level'.

 

[jenniferleigh]

To help others reading my posts vs your experience: I think the reason you felt FA was not enough at all, is because without even realizing it you had done well on the easier FA recall Qs. There are a lot of them scattered throughout the exam. They're the 'staple' or filler Qs, and the rest of the Qs put people in their place based on their prep above and beyond FA.

We tend to remember what we screwed up or questions we were unsure about. I was still stuck trying to get FA down when heading into the exam, so I still struggled with those auto-clicks and thats why you keep hearing me say FA is so crucial. Knowing FA well is the most direct way to lock up the 220-230. Then you build on that further. I think you did just that, and were fighting for that next 'level'.

Yeah that is true. I agree the easier questions were directly from first aid and made up 50% or more of the exam. The challenge was the stuff that was testing the ability to reason on core knowledge.

 

[Phloston]

That is insane... damn... tumor staging from histo...

Should be fairly black and white as they will either show you BM penetration or not (but be aware of cervical cancer CIN-I --> CIN-III histology. That's the usual exception).

USMLE Rx had also assessed the Ann Arbor Hodgkin's staging system, so I would know that (quite honestly though, just know that for the sake of being a doctor).

First of all, i believe you did great. Correct me if I am wrong but your NBMEs were solid. They won't let you down.
Secondly, let me get it straight. When you say FA didn't suffice, you mean that you couldn't pretty much handle the info in FA and deal with the Exam or that you faced facts not mentioned in FA at all.

The latter NBMEs (11-15) should be extremely accurate, especially if you sit them within 10 days of your real deal.

One's perception of the extent to which FA covers the exam questions is and forever will be varied. FA is a mere skeleton, and probably about one-half of the Step1 questions are more or less directly answerable from it. Of the remaining half, 4/5 are concepts related to the info in FA, but require integration and inferences that extend beyond the text itself in order to actually get them correct.

This is why when some people say FA covered 90% of their exam but others (including myself) say it covers 60% +/- 10%, there's no right or wrong.

 

[Phloston]

My inbox is drowning in PMs btw. I'm sorry about the delays and I'm not ignoring anybody.

 

[suji0]

when you say the exam tests you on core concepts that aren't like written straightforward in FA, do you mean reasoning through questions like they are in uworld, or was this a step above that? and i know you aren't allowed to write exact questions from exam but can you give an example of the level of thinking needed?

congrats again on being done, based on your prep and your high predicted scores I am sure you killed it. very rarely do highly intellectual people truly feel content with their work and im sure that is what is going on with you as well

 

[jenniferleigh]

when you say the exam tests you on core concepts that aren't like written straightforward in FA, do you mean reasoning through questions like they are in uworld, or was this a step above that? and i know you aren't allowed to write exact questions from exam but can you give an example of the level of thinking needed?

congrats again on being done, based on your prep and your high predicted scores I am sure you killed it. very rarely do highly intellectual people truly feel content with their work and im sure that is what is going on with you as well

There were a lot of questions that asked what when up and down when such and such goes wrong in the body. A simplistic example would be like what happens to hydrostatic and oncotic pressure during CHF and this takes your knowledge of concepts in first aid that aren't directly stated but you can apply to reason out the question.

 

[redpanda]

Should be fairly black and white as they will either show you BM penetration or not (but be aware of cervical cancer CIN-I --> CIN-III histology. That's the usual exception).

It sounds like this person had a particularly different test that I had. Mine had maybe 1-2 questions which involved obvious BM penetration or not.

 

[Greenbayslacker]

it seems like BRS physio & RR would fill in pretty much all the blanks that first aid doesn't "cover" that everyone is talking about so far. except for epidemiology/research error stuff of course.

 

[jenniferleigh]

it seems like BRS physio & RR would fill in pretty much all the blanks that first aid doesn't "cover" that everyone is talking about so far. except for epidemiology/research error stuff of course.

Yeah. Those both help a lot.

 

[Jonari]

True but all the neuroanatomy makes me super anxious.. I really feel like this area is being tested so much more then last year (most of my friends who wrote it last year barely had any)

This. It seems like the topic is becoming asked more and more now on the exams according to the latest previous test takers. However, for neuro, we know that there are certain topics that are periodically asked time and time again, those include:

1. Tumors
2. Blood supply and if cut off what will we see
3. Cranial nerves
4. Dermatome supply
5. Tracts
6. Reflexes
7. Thalamus nuclei

 

[step1april2013]

This. It seems like the topic is becoming asked more and more now on the exams according to the latest previous test takers. However, for neuro, we know that there are certain topics that are periodically asked time and time again, those include:

1. Tumors
2. Blood supply and if cut off what will we see
3. Cranial nerves
4. Dermatome supply
5. Tracts
6. Reflexes
7. Thalamus nuclei

honestly this is basically all of neuro. FA definitely isn't good for knowing the tracts and its missing some of the thalamic nuclei, but everything else you listed is in there. With that being said I'm interested to know what your plan of attack will be for neuro.

 

[Jonari]

honestly this is basically all of neuro. FA definitely isn't good for knowing the tracts and its missing some of the thalamic nuclei, but everything else you listed is in there. With that being said I'm interested to know what your plan of attack will be for neuro.

- Pathoma and Goljan's RR for the pathology portion. One of the few chapters I'm reading from RR.
- Kaplan videos, I think they do a good job, especially with the tracts, ANS, blood supply, the direct/indirect pathway. I find actually reading the Neuro portion is beneficial, instead of just relying what the lecturer says. There's a lot of additional information in the text, that I've seen get asked on UWorld questions and on the NBME exams.
- High Yield Neuro
- FA: want to make sure I know these 40 pages inside & out, since it's my weaker area.
- Looking through WebPath at various CTs/MRIs/X-Rays of the whole body at different sections just to get myself familiarized with the outline.

Link to WebPath: http://courses.path.utah.edu/classes/webpath/webpath.htm

- Also this site is good for looking at cross sections and seeing where everything is placed.

Link: http://isc.temple.edu/neuroanatomy/lab/atlas/instructions.html

Use the black bar at the top to navigate and see various cross sections.


**Patiently, waiting till ijn comes in and tells me my studying plan is too detailed & it won't help me on the exam**

 

[suji0]

- Pathoma and Goljan's RR for the pathology portion. One of the few chapters I'm reading from RR.
- Kaplan videos, I think they do a good job, especially with the tracts, ANS, blood supply, the direct/indirect pathway. I find actually reading the Neuro portion is beneficial, instead of just relying what the lecturer says. There's a lot of additional information in the text, that I've seen get asked on UWorld questions and on the NBME exams.
- High Yield Neuro
- FA: want to make sure I know these 40 pages inside & out, since it's my weaker area.
- Looking through WebPath at various CTs/MRIs/X-Rays of the whole body at different sections just to get myself familiarized with the outline.

Link to WebPath: http://courses.path.utah.edu/classes/webpath/webpath.htm

- Also this site is good for looking at cross sections and seeing where everything is placed.

Link: http://isc.temple.edu/neuroanatomy/lab/atlas/instructions.html

Use the black bar at the top to navigate and see various cross sections.


**Patiently, waiting till ijn comes in and tells me my studying plan is too detailed & it won't help me on the exam**

is there much info present in high yield neuroanatomy that isn't in the kaplan notes? I went through the kaplan notes lil over a month ago and found it quite beneficial, but didn't think that using two different sources for almost similar material would either be inefficient or just confuse me. although there is definitely merit in using both I guess if one is lacking in something?

I had a similar question about kaplan phys vs brs phys, since I didn't want to review both haha

 

[step1april2013]

- Pathoma and Goljan's RR for the pathology portion. One of the few chapters I'm reading from RR.
- Kaplan videos, I think they do a good job, especially with the tracts, ANS, blood supply, the direct/indirect pathway. I find actually reading the Neuro portion is beneficial, instead of just relying what the lecturer says. There's a lot of additional information in the text, that I've seen get asked on UWorld questions and on the NBME exams.
- High Yield Neuro
- FA: want to make sure I know these 40 pages inside & out, since it's my weaker area.
- Looking through WebPath at various CTs/MRIs/X-Rays of the whole body at different sections just to get myself familiarized with the outline.

Link to WebPath: http://courses.path.utah.edu/classes/webpath/webpath.htm

- Also this site is good for looking at cross sections and seeing where everything is placed.

Link: http://isc.temple.edu/neuroanatomy/lab/atlas/instructions.html

Use the black bar at the top to navigate and see various cross sections.


**Patiently, waiting till ijn comes in and tells me my studying plan is too detailed & it won't help me on the exam**

I've never seen those two sites before...very nice. When is your exam by the way?

 

[Jonari]

is there much info present in high yield neuroanatomy that isn't in the kaplan notes? I went through the kaplan notes lil over a month ago and found it quite beneficial, but didn't think that using two different sources for almost similar material would either be inefficient or just confuse me. although there is definitely merit in using both I guess if one is lacking in something?

I had a similar question about kaplan phys vs brs phys, since I didn't want to review both haha

im only doing it to cover all the grounds, but there is overlap of material where info in kaplan neuro is found in hy, but not the other way around.

 

[Jonari]

I've never seen those two sites before...very nice. When is your exam by the way?

yeah the former is good because it also has a built in qbank of 2,900 questions...only down side is the bank is broken down by systems, so you can't mix them up like as in uworld/kaplan/rx.

lol, test is coming up soon - not saying when.

 

[drk]

American Citizen FMG here. Went to Medical School in India.

Took the exam March 18th 2013.

I had no guidance as not many people from my school have gone for the USMLE and the ones who did, did not do very well, and the even fewer who did do decently, none had matched from what I knew.

These forums and others like it were quite helpful in starting me out on my studying so I figured I would give back what I can. I have always felt learning how to take an exam is just as important as learning the material that will be tested. So any and all practice exams/the Prometric practice session/NBME tests are of great importance. Not only in predicting your score but also in giving you a familiarity with the exam style. The more comfortable you are on the exam day the more you will be able to concentrate on the content at hand rather than trying to figure out how to pull out the calculator or look up a lab value.

My preparation time was broken up and not consistent as when I started my preparation I was in India, wrapping up my life there, closing accounts, closing up my house, and basically preparing for leaving the country to head back home to the states. I studied for a month or 2 there, then took the entirety of December off for getting things in order. I started a serious preparation of 8-10 hours a day starting January 8th 2013. Exam was on March 18th 2013 as I mentioned so I guess total prep time was about 5-6 months but actual solid USMLE only studying was closer to 3 months.

Sources I used were:
Kaplan Lecture Notes, invaluable for people taking the exam a few years after their basic sciences.
Kaplan Lecture Videos - While I did most of them I would suggest just sticking to Pharm/Physio/Neuroanatomy
For Pathology I did not like Kaplan and used Pathoma - excellent source and saved me a lot of time.
I also went through the Goljan Audio Transcripts quickly - a great source, wish I had more time/known about it earlier to really learn it.
First Aid - I only went through it once, I was unsure of its value but after now taking the exam I would suggest everyone read it at least twice and if possible thrice.

Q banks: Uworld of course. Kaplan Qbank towards the end just because I had finished up uworld and still had 2-3 weeks left and wanted more and new questions.

My overall stats on everything was:

Uworld: 68% correct
Kaplan: Only did about 45% of it and it was the last 3 weeks of my prep but I was averaging 88% correct I think.
Uworld SA 1: 237, took it about a month and a half before the actual exam I believe.
NBME 13: 231, 3 weeks out
NBME 7?: 231, 2 weeks out
NBME 15: 231, 1 week out
Prometric Practice Test: 88%, 1 week out
Uworld SA 2: 254, 3-4 days out


With the NBME exams I had no idea what was going on and was pretty frustrated I was getting the same exact score. I had read somewhere that after a certain amount of studying you reach a peak and I had honestly thought that must be the explanation. Form 7 is supposed to be more difficult than form 13 so I took that as an improvement but then getting the same score again on the newer form confused me.

Anyways, the final score I ended up with was a 244. I was pretty happy as I had set my goal to 240. Best advice I would give is to wait until your scoring above 220 on NBME to give the exam. Also the last 2 weeks before your exam, don't waste them. Take your primary source and run through it. I re-did as much of the Kaplan Lecture notes as I could in those last 2 weeks. It would have been more efficient/better if I had used FA as my primary source but alas I did not.

Good luck to everyone!

 

[CDI]

American Citizen FMG here. Went to Medical School in India.

Took the exam March 18th 2013.

I had no guidance as not many people from my school have gone for the USMLE and the ones who did, did not do very well, and the even fewer who did do decently, none had matched from what I knew.

Congrats on the 240+ and being done!

Tough transition between the two systems, dealt with it myself. However, I know plenty who wound up matching (particularly the US-IMGs) from over there. Those with scores as high as yours had no difficulty at all, at least in IM. I know of one with a lower score than you matched into a well known Gen Surg program. Others even pre-matched this year, I guess the interview process went in their favor.

Good luck with CK! Hope to see you on that thread.

 

[lpmarcus010]

I took my Step 1 on April 11th. I did well during my first 2 years of med school, and my studying involved 2 passes through UWorld, 1/2 pass through Kaplan Qbank (didn't really like it), 3 reads through FA, and 2 passes through Pathoma. My stats were:

UWorld First Pass (over 6 month period): 71%
UWorld Second Pass (over three weeks): 86%
UWorld Self Assesment 1 (5 weeks out from test): 242
School Administered NBME assessment (4 weeks out): 257
NBME 11 (3 weeks out): 248
NBME 15 (1.5 weeks out): 256

All this being said, I left the exam feeling like I just was slapped in the face. There was tons of stuff that I had never seen before, and ridiculous immune transcription factors and cytokines that were completely foreign to me (i.e.: C3 receptor inactivating factor). I had like three questions with the up down arrows asking me about how hormones change throughout various trimesters during pregnancy (like iodine uptake, T3, T4, colloid synthesis at 14 weeks vs. 30 weeks). 😀At any rate, I am hoping that I am having selective recall of the problems I missed. For the first couple of nights after my exam, I would wake up after remembering a question that I was unsure about, and I would have to look it up. I am really curious to see how I did, and I hope that the assessments I did were accurate indicators. Nevertheless, as I write this post I am sitting in a hammock in Nicaragua overlooking a barreling pointbreak after a morning of surfing. Life is good for now...http://dkmg2azsloi0e.cloudfront.net/images/smilies/biggrin.gif

 

[step1april2013]

I took my Step 1 on April 11th. I did well during my first 2 years of med school, and my studying involved 2 passes through UWorld, 1/2 pass through Kaplan Qbank (didn't really like it), 3 reads through FA, and 2 passes through Pathoma. My stats were:

UWorld First Pass (over 6 month period): 71%
UWorld Second Pass (over three weeks): 86%
UWorld Self Assesment 1 (5 weeks out from test): 242
School Administered NBME assessment (4 weeks out): 257
NBME 11 (3 weeks out): 248
NBME 15 (1.5 weeks out): 256

All this being said, I left the exam feeling like I just was slapped in the face. There was tons of stuff that I had never seen before, and ridiculous immune transcription factors and cytokines that were completely foreign to me (i.e.: C3 receptor inactivating factor). I had like three questions with the up down arrows asking me about how hormones change throughout various trimesters during pregnancy (like iodine uptake, T3, T4, colloid synthesis at 14 weeks vs. 30 weeks). 😀At any rate, I am hoping that I am having selective recall of the problems I missed. For the first couple of nights after my exam, I would wake up after remembering a question that I was unsure about, and I would have to look it up. I am really curious to see how I did, and I hope that the assessments I did were accurate indicators. Nevertheless, as I write this post I am sitting in a hammock in Nicaragua overlooking a barreling pointbreak after a morning of surfing. Life is good for now...http://dkmg2azsloi0e.cloudfront.net/images/smilies/biggrin.gif

congrats on finishing. You will be fine.
Anyone know how thyroid hormones change during pregnancy? I figure they would increase when comparing 14 weeks to 30 weeks because of involvement in maturing the nervous system.
On the other hand thyroid-binding globulin increases in pregnancy, therefore free T3/T4 would be decreased causing increase in iodine uptake and colloid synthesis.

Any thoughts?

 

[lira126]

congrats on finishing. You will be fine.
Anyone know how thyroid hormones change during pregnancy? I figure they would increase when comparing 14 weeks to 30 weeks because of involvement in maturing the nervous system.
On the other hand thyroid-binding globulin increases in pregnancy, therefore free T3/T4 would be decreased causing increase in iodine uptake and colloid synthesis.

Any thoughts?

I think the testable points of any condition that increases estrogen are that TBG increases which increases the total T4 pool but free T4 should remain normal. Therefore TSH and thyroid gland activity should remain normal and iodine uptake would remain unchanged.

 

[lira126]

But I also think that this thread isn't for speculating about questions that recent test-takers have identified as challenging 😛

 

[NickNaylor]

congrats on finishing. You will be fine.
Anyone know how thyroid hormones change during pregnancy? I figure they would increase when comparing 14 weeks to 30 weeks because of involvement in maturing the nervous system.
On the other hand thyroid-binding globulin increases in pregnancy, therefore free T3/T4 would be decreased causing increase in iodine uptake and colloid synthesis.

Any thoughts?

See Lira's response above - total thyroid hormone levels will increase due to increased TBG (secondary to increased estrogen), but free hormone levels - which are really what "matter" - will remain unchanged.

 

[abelabbot]

hey

 

[abelabbot]

My inbox is drowning in PMs btw. I'm sorry about the delays and I'm not ignoring anybody.

Phloston no problem! Take your time in replying man, you're doing us a favor so the least we can do is wait patiently!

 

[step1april2013]

See Lira's response above - total thyroid hormone levels will increase due to increased TBG (secondary to increased estrogen), but free hormone levels - which are really what "matter" - will remain unchanged.

I think the testable points of any condition that increases estrogen are that TBG increases which increases the total T4 pool but free T4 should remain normal. Therefore TSH and thyroid gland activity should remain normal and iodine uptake would remain unchanged.

The total T4 and T3 pool would increase, but the free T4/T3 should decrease. I see it as like in men who have an increase in sex hormone-binding globulin causing their free test to fall and causing gynecomastia. Unless you can show me I don't really understand why the T4/T3 would remain normal

 

[calvnandhobbs68]

The total T4 and T3 pool would increase, but the free T4/T3 should decrease. I see it as like in men who have an increase in sex hormone-binding globulin causing their free test to fall and causing gynecomastia. Unless you can show me I don't really understand why the T4/T3 would remain normal

Their responses are right. The concept is straight from UWorld if I remember correctly.

Edit: Yep found it Q 772.
"Increase in levels of TBG lead to increase in circulating total T4 and T3. However, the level of free thyroid hormone is normal. Increase in TBG is typically seen in pregnancy, with use of oral contraceptives or with hormone replacement therapy."

 

[jenniferleigh]

I had that exact same question. So weird. I remembered it from uworld though.

 

[tiedyeddog]

Their responses are right. The concept is straight from UWorld if I remember correctly.

Edit: Yep found it Q 772.
"Increase in levels of TBG lead to increase in circulating total T4 and T3. However, the level of free thyroid hormone is normal. Increase in TBG is typically seen in pregnancy, with use of oral contraceptives or with hormone replacement therapy."

Uptodate says the same thing. If you search for "maternal endocrine and metabolic adaptations to pregnancy" and then control+f for thyroid gland the article will give the sources. As nick said, estrogens causes a huge increase in TBG that causes increased T3 and T4, which more or less equals out to keep free T4 the same. Thus TSH levels don't change.

 

[step1april2013]

okay, so overall there will be a normal free T4/T3 with an increased total. Got it

 

[Greenbayslacker]

congrats on finishing. You will be fine.
Anyone know how thyroid hormones change during pregnancy? I figure they would increase when comparing 14 weeks to 30 weeks because of involvement in maturing the nervous system.
On the other hand thyroid-binding globulin increases in pregnancy, therefore free T3/T4 would be decreased causing increase in iodine uptake and colloid synthesis.

Any thoughts?

come on now, this is a pretty basic concept. pg 481 & 489 of rapid review has the answer plain & simple (increased estrogen during pregnancy -> normal free TH & TSH, increased total TH).. this book is a must read. please note that it is NOT due to the maturing fetus' nervous system.

 

[MLT2MT2DO]

come on now, this is a pretty basic concept. pg 481 & 489 of rapid review has the answer plain & simple (increased estrogen during pregnancy -> normal free TH & TSH, increased total TH).. this book is a must read. please note that it is NOT due to the maturing fetus' nervous system.

In his/her defense, if the Free thyroid hormones stay the same but the total goes up, at some point there had to be an increase in hormone production.

 

[Greenbayslacker]

In his/her defense, if the Free thyroid hormones stay the same but the total goes up, at some point there had to be an increase in hormone production.

yeah i totally understand if there could be a misconception.. which is why i'm saying, RR & brs physio need to be part of their regiment

also just wanted to point out that while increased estrogen causes increased TBG, decreased thyroid hormone causes decreased SHBG, which will actually cause a increased free testosterone (as opposed to the normal free TH with an increase in TBG).

 

[NickNaylor]

yeah i totally understand if there could be a misconception.. which is why i'm saying, RR & brs physio need to be part of their regiment

also just wanted to point out that while increased estrogen causes increased TBG, decreased thyroid hormone causes decreased SHBG, which will actually cause a increased free testosterone (as opposed to the normal free TH with an increase in TBG).

I didn't realize these facts were present only in RR and BRS physio.

 

[tiedyeddog]

yeah i totally understand if there could be a misconception.. which is why i'm saying, RR & brs physio need to be part of their regiment

also just wanted to point out that while increased estrogen causes increased TBG, decreased thyroid hormone causes decreased SHBG, which will actually cause a increased free testosterone (as opposed to the normal free TH with an increase in TBG).

I am using BRS physio for some sections but RR is just too dense for me.

 

[calvnandhobbs68]

I am using BRS physio for some sections but RR is just too dense for me.

Yeah RR just looks like a big wall of text to me.

 

[aaaaaaaa]

congrats on finishing. You will be fine.
Anyone know how thyroid hormones change during pregnancy? I figure they would increase when comparing 14 weeks to 30 weeks because of involvement in maturing the nervous system.
On the other hand thyroid-binding globulin increases in pregnancy, therefore free T3/T4 would be decreased causing increase in iodine uptake and colloid synthesis.

Any thoughts?

I just recently took the test the first of this week as well. I felt like it was the biggest bunch of garbage I had ever seen. Very few concepts were tested. Most questions were of specific obscure facts not very well covered in first aid. I'm in a little bit more of a precarious position as I'm an advanced standing med student and my last basic science class was 4 years prior. That being said I did fine on the NBME 7 and 13, making a 210 and 230 respectively after only 1.5 and 2.5 weeks of studying. The real deal was NOTHING like the NBME's. The NBME's test concepts and broad knowledge with hitting specifics about more of the common pathologies or drugs. The real test placed pathology in atypical places, asked about some of the less commonly used drugs, and the history given to you to try and diagnose the patient in my opinion was inadequate. I have never been so frustrated with a test and felt that the knowledge base that should have been tested was ill represented. I'm not sure how to tell you to prepare for the exam as I'm not sure that a full year of studying would have helped me with many of the questions that were asked. Hopefully for everyone else's sake they do not get the same exam I did!

 

[CDI]

I just recently took the test the first of this week as well. I felt like it was the biggest bunch of garbage I had ever seen. Very few concepts were tested. Most questions were of specific obscure facts not very well covered in first aid. I'm in a little bit more of a precarious position as I'm an advanced standing med student and my last basic science class was 4 years prior. That being said I did fine on the NBME 7 and 13, making a 210 and 230 respectively after only 1.5 and 2.5 weeks of studying. The real deal was NOTHING like the NBME's. The NBME's test concepts and broad knowledge with hitting specifics about more of the common pathologies or drugs. The real test placed pathology in atypical places, asked about some of the less commonly used drugs, and the history given to you to try and diagnose the patient in my opinion was inadequate. I have never been so frustrated with a test and felt that the knowledge base that should have been tested was ill represented. I'm not sure how to tell you to prepare for the exam as I'm not sure that a full year of studying would have helped me with many of the questions that were asked. Hopefully for everyone else's sake they do not get the same exam I did!

You sure you took Step 1? Just kidding.

Perfectly normal to feel that way if it didn't focus on your strengths. You probably did pretty well and its selective memory causing you to remember the obscure (possibly experimental) Qs.

 

[jenniferleigh]

I'm seeing a trend. No one comes out of step 1 feeling good. I guess it is a given.

 

[crushon]

.

 

[IwannabeDrP]

Forum is great. Here's my breakdown.

Studied 7 weeks.

week 1: read RR
week 2-4: FA pass 1+pass 2, world questions after each chapter (1-2 blocks/day or so)
Week 5/6: World only
Week 7:
UWSA 1: 250
UWSA 2: 263
plus a little review

overall World avg. (85% complete): 73%

Real Deal: 253

Only used the three resources. Finished 85% of world. In retrospect, would have done more world and FA. Def. could have memorized more. Test was easier than world questions. Had lots of time at the end of each section, could have been more careful about reviewing at the end of each block. Lots of neuroanatomy.

Good luck you guys!

This is what I keep hearing - neuroanatomy is huge. Is it straight pictures and clinical correlates? or just stems? Would it be best to run through utah images? Granted, I'm a week out, but would it even be worth it to run through the neuroanatomy review book? I feel pretty good about the other subjects.

 

[crushon]

.

 

[Goober11]

Forum is great. Here's my breakdown.

Studied 7 weeks.

week 1: read RR
week 2-4: FA pass 1+pass 2, world questions after each chapter (1-2 blocks/day or so)
Week 5/6: World only
Week 7:
UWSA 1: 250
UWSA 2: 263
plus a little review

overall World avg. (85% complete): 73%

Real Deal: 253

Only used the three resources. Finished 85% of world. In retrospect, would have done more world and FA. Def. could have memorized more. Test was easier than world questions. Had lots of time at the end of each section, could have been more careful about reviewing at the end of each block. Lots of neuroanatomy.

Good luck you guys!

And then there's this guy... haha.

Congrats on your score.

 

[tiedyeddog]

Id say it was a mix of cross-section brain slides (where you identify where the characteristic lesion is a certain disease), identify the lesion questions (stroke/focal lesion with a set of symptoms, identify where in the brain it would be), and some CT/MRI questions showing the findings of classic diseases (ie NPH, hydrocephalus, etc).

I guess where it got hard was when they tested more obscure lesions (all the random brainstem area lesions which are all named and have too many characteristic findings) and when you knew where the lesion was (lets say thalamus), but in a view youre not comfortable seeing (instead of coronals, they gave you axials or sometimes gross dissection images).

If I had to do it again, dont know if reviewing a book on neuroanatomy would have necessarily helped. Id say the most high yield would be being comfortable naming high yield neuroanatomy structures from different modalities (different cross sectional views etc). and knowing the regions affected of the classic neuro diseases (make a list of the 10/15 brain related lesions, and where the lesions usually are) and how to find them.

Thanks for commenting on this!!! I was really wondering what else to cover in neuro.

 

[reasonabledoubt]

How much does the test change from person to another? Should I be paying attention to what past test takers are saying concerning the content of their examinations (ex. more neuroanatomy)?

 

[calvnandhobbs68]

How much does the test change from person to another? Should I be paying attention to what past test takers are saying concerning the content of their examinations (ex. more neuroanatomy)?

Nobody really knows although the fact that we've had quite a few people from this year say that there was a lot of neuro on their test might indicate that they're putting more neuro questions from their bank on the test. However, this could also be a function of people just happening to remember more neuro questions from their exam.

 

[reasonabledoubt]

Nobody really knows although the fact that we've had quite a few people from this year say that there was a lot of neuro on their test might indicate that they're putting more neuro questions from their bank on the test. However, this could also be a function of people just happening to remember more neuro questions from their exam.

NBME/USMLE ppl should do an AMA on reddit or something. There is a lot of questions I want to ask.

 

[jenniferleigh]

Does it really take 3 weeks to get your score or is it longer?