Official 2013 Step 1 Experiences and Scores Thread

[Phloston]

---

Members don't see this ad.

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

 

[Pons Asinorum]

A heads up to those wondering about the cardiac auscultation questions: here's a screenshot of the interface (published by the NBME)

You can move the stethoscope around to the four different locations and also visualize the carotid pulse in the neck area.

Oh, and you can also see some parameters that the NBME uses to characterize question difficulty/quality in the top half of the pic.

Best part is there is a visible carotid pulse on the looping graphic that a toddler could pick out. Makes picking out which is first and second heart sound super easy. From there, 3rd/4th heart sounds and systolic/diastolic are pretty easy too.

 

[hardee17]

uhhhhhh answer is A, right?

 

[CDI]

uhhhhhh answer is A, right?

I didn't know 6 year olds even had gymnastics teams.

 

[CaptainSSO]

''''''

 

[xeroun]

Hopefully this doesnt happen during my 7th block tomorrow.

 

[Phloston]

anyone know if we are scaled against other people that had the same questions as us, or just against everyone else in general?

also, my 3rd and likely final question from my exam that i'm posting for you guys:

Male with trouble urinating, painless enlarged prostate, what is it?

If you open a Google images page and drag this picture into it, a surfeit of articles discuss chronic prostatitis.

When I first saw this, I didn't see any particular basement membrane penetration, which is what they'd definitely show you with adenocarcinoma.

It's definitely hypercellular, so BPH is a good guess, although it looks like the tissue is flooded with macrophages/granulocytes. I'm not a pathologist, but in similar USMLE pictures that are assessing pyelonephritis, they'll show you cellularity that looks exactly like this. It's likely an infection. If it were BPH, the image would probably show glandular hyperplasia (but there are not numerous lumina), rather than just many basophilic cells.

 

[Phloston]

Just out of curiosity, how do you know this?

Agree. Everyone feels the one exam they have exposure to is how they all are. My real deal felt very similar to NBME's 13 and 15. Def not as hard as UW. Everyone's mileage will vary.

Yeah, how do you know this?

I love your posts, but you didn't have the "new" exam.

I've spoken to a trusted individual who is certain that there are currently 30 versions of Step1 being tested. I know that is as vague / nebulous as could be, but that's all I can say.

 

[Zuhal]

Just took UWSA1 and made 234. Super devastated. 1 week out. Physiology is my lowest subject specifically Cardio and Resp. I feel like I understand the concepts presented in FA and I have read BRS physio twice already. I feel so horrible right now 🙁 I was honestly expecting something in the 250's. 234 is not even an accurate estimate. It could easily be 214. Any recommendations on what I can do to improve on those two areas?
Also does anyone know what "General principles of health disease" mean? Is that just general pathology? I seriously thought this was my strongest area lol
👎
p.s. is UWSA easier or harder than NBME's? I plan to take an NBME tomorrow.

 

[normtheniner]

I'm holding on to a small sliver of hope that they'll give us our scores this week... deep down I know it'll be another week though...

 

[redandblack07]

Anyone else take the exam and afterwards was able to remember around 20 or so questions they got wrong? They were mostly easy questions or 50/50s and it's been driving me insane and making me worried.

 

[g8orlife]

uhhhhhh answer is A, right?

Can't Hear The Heart Sound, But That's What IWould CHoose, Assuming ASD.

I didn't know 6 year olds even had gymnastics teams.

 

[g8orlife]

Hopefully this doesnt happen during my 7th block tomorrow.

Good Luck!

 

[g8orlife]

Nice

If you open a Google images page and drag this picture into it, a surfeit of articles discuss chronic prostatitis.

When I first saw this, I didn't see any particular basement membrane penetration, which is what they'd definitely show you with adenocarcinoma.

It's definitely hypercellular, so BPH is a good guess, although it looks like the tissue is flooded with macrophages/granulocytes. I'm not a pathologist, but in similar USMLE pictures that are assessing pyelonephritis, they'll show you cellularity that looks exactly like this. It's likely an infection. If it were BPH, the image would probably show glandular hyperplasia (but there are not numerous lumina), rather than just many basophilic cells.

Nice. I Was GoingTo Say Prostatitis, Too.

Just took UWSA1 and made 234. Super devastated. 1 week out. Physiology is my lowest subject specifically Cardio and Resp. I feel like I understand the concepts presented in FA and I have read BRS physio twice already. I feel so horrible right now 🙁 I was honestly expecting something in the 250's. 234 is not even an accurate estimate. It could easily be 214. Any recommendations on what I can do to improve on those two areas?
Also does anyone know what "General principles of health disease" mean? Is that just general pathology? I seriously thought this was my strongest area lol
👎
p.s. is UWSA easier or harder than NBME's? I plan to take an NBME tomorrow.

i Say add UW Incorrects In Your Specific Weaknesses Into Your Schedule. Im Still Unsure About GP Of Health Dz.

 

[g8orlife]

I'm holding on to a small sliver of hope that they'll give us our scores this week... deep down I know it'll be another week though...

Not Gonna Happen.

Anyone else take the exam and afterwards was able to remember around 20 or so questions they got wrong? They were mostly easy questions or 50/50s and it's been driving me insane and making me worried.

Perfectly Normal.

 

[operaman]

Just took UWSA1 and made 234. Super devastated. 1 week out. Physiology is my lowest subject specifically Cardio and Resp. I feel like I understand the concepts presented in FA and I have read BRS physio twice already. I feel so horrible right now 🙁 I was honestly expecting something in the 250's. 234 is not even an accurate estimate. It could easily be 214. Any recommendations on what I can do to improve on those two areas?
Also does anyone know what "General principles of health disease" mean? Is that just general pathology? I seriously thought this was my strongest area lol
👎
p.s. is UWSA easier or harder than NBME's? I plan to take an NBME tomorrow.

Well, when you say "lowest" are you only looking at the left side of the bar on your score report? Don't forget that those bars are a range in which they believe your actual performance lies. If your Cards/Resp bars are tiny narrow bars down near/below borderline, then you have a lot of work to do. However, if the bars go all the way or most of the way to the right AND also dip down to borderline, then that's a very different story.

The bars are generated by the difficulty level of the questions. If you get every question right in an area, then you'll have a tiny bar all the way to the right. If you get all the hardest questions right but blow a few easy ones, you'll see a bar that goes all the way to the right, but also may dip down to/below borderline. IF you're blowing a LOT of questions of mostly hard and medium questions, you'll see a narrow bar near borderline.

I put this out there because my strategy would be vastly different depending on how it looks. In my UWSAs, I had at least 1 or 2 subjects on each test dip down low, but also went all the way to the right. I took them both the same day and the lower-dipping bars were in completely different subjects on each test. This means I blew some easier questions in each subject, probably due to my not using FA, so I blew a couple easier ones that lots of other people got. As a result I made sure to get a full pass at the high yield material one more time before test day in addition to doing World (hadn't done it yet).

 

[operaman]

uhhhhhh answer is A, right?

A vignette like this is probably going after 1 of these concepts:

1) Can you recognize a normal exam and normal response to exercise? (A)
2) ASD (A again)
3) HCM (a little tougher - probably an echo although I'd be surprised if you'd see much in such a young child, so ECG might be the right answer as a first step in this particular case assuming you hear the harsh SEM at the LSB. In truth, Step 1 is probably not going to go after this kind of management detail because it isn't as deeply rooted in underlying physio as others. Also, if they wanted this, they would have given us an older patient and probably some syncope with exercise due to the dynamic outflow obstruction.)

Given that 80% of the people answer the question correctly without the media, it's almost certainly A. The correct response rate drops to 60% with media, so people probably make more mistakes and can't imagine they would put a normal child's exam on there. (I think the P-value on the question is not the same as p-values in stats, I think they just mean % who answered correctly)

 

[holycowww]

I need my scores in by august 19, 2013...when is the absolute last day I can take the test, and get my score back in time?

 

[CDI]

Well, when you say "lowest" are you only looking at the left side of the bar on your score report? Don't forget that those bars are a range in which they believe your actual performance lies. If your Cards/Resp bars are tiny narrow bars down near/below borderline, then you have a lot of work to do. However, if the bars go all the way or most of the way to the right AND also dip down to borderline, then that's a very different story.

The bars are generated by the difficulty level of the questions. If you get every question right in an area, then you'll have a tiny bar all the way to the right. If you get all the hardest questions right but blow a few easy ones, you'll see a bar that goes all the way to the right, but also may dip down to/below borderline. IF you're blowing a LOT of questions of mostly hard and medium questions, you'll see a narrow bar near borderline.

I put this out there because my strategy would be vastly different depending on how it looks. In my UWSAs, I had at least 1 or 2 subjects on each test dip down low, but also went all the way to the right. I took them both the same day and the lower-dipping bars were in completely different subjects on each test. This means I blew some easier questions in each subject, probably due to my not using FA, so I blew a couple easier ones that lots of other people got. As a result I made sure to get a full pass at the high yield material one more time before test day in addition to doing World (hadn't done it yet).

Never looked at it that way. I wondered about this because I scored below average on my actual exam but my score report had nothing to the left side of borderline, and instead everything from borderline to right, with no stars. I guess I hit (most of) the FA easy Qs because thats what I had focused on and just fired blanks on the tougher Qs.

 

[glossoph]

Just took UWSA1 and made 234. Super devastated. 1 week out. Physiology is my lowest subject specifically Cardio and Resp. I feel like I understand the concepts presented in FA and I have read BRS physio twice already. I feel so horrible right now 🙁 I was honestly expecting something in the 250's. 234 is not even an accurate estimate. It could easily be 214. Any recommendations on what I can do to improve on those two areas?
Also does anyone know what "General principles of health disease" mean? Is that just general pathology? I seriously thought this was my strongest area lol
👎
p.s. is UWSA easier or harder than NBME's? I plan to take an NBME tomorrow.

pretty much in the same boat, took uwsa 2 a few days later and get a similar score, and just took nbme 15 (my first one) and didn't do so great either with a 217, not really sure what to do, but just keep studying i guess, could be worse

 

[Zuhal]

pretty much in the same boat, took uwsa 2 a few days later and get a similar score, and just took nbme 15 (my first one) and didn't do so great either with a 217, not really sure what to do, but just keep studying i guess, could be worse

Oh so that means UWSA does in fact overestimate your score by 20 points! That's just crazy.

 

[Goober11]

After searching Google and SDNs threads I have not found any conclusive information so maybe you all can help.

I want to first say that I don't mean to derail the thread or cause any sort of unfounded anticipation. So I log onto the NBME's website today for whatever reason and my scheduling permit is gone. I then clicked "Check Exam Status" and under "Registration Status" it says "Complete". Could this just be that my eligibility period ended 6/30/13? BTW I took my exam on 6/14 and until now was dead set on receiving my score on the 10th. Still not holding my breath for an earlier report.

 

[Greenbayslacker]

If you open a Google images page and drag this picture into it, a surfeit of articles discuss chronic prostatitis.

When I first saw this, I didn't see any particular basement membrane penetration, which is what they'd definitely show you with adenocarcinoma.

It's definitely hypercellular, so BPH is a good guess, although it looks like the tissue is flooded with macrophages/granulocytes. I'm not a pathologist, but in similar USMLE pictures that are assessing pyelonephritis, they'll show you cellularity that looks exactly like this. It's likely an infection. If it were BPH, the image would probably show glandular hyperplasia (but there are not numerous lumina), rather than just many basophilic cells.

Correct. I know one other person that also had this question. Goljan helped me get it right.

I hope these questions that I posted help someone. If I remember any more I'll put them up.

 

[CDI]

Correct. I know one other person that also had this question. Goljan helped me get it right.

I hope these questions that I posted help someone. If I remember any more I'll put them up.

They probably just removed it from the testing pool.

 

[glossoph]

Oh so that means UWSA does in fact overestimate your score by 20 points! That's just crazy.

yea, for me it did, but I didn't feel particularly good while taking the nbme, so maybe that lowered my performance, I thought it was pretty tough, harder than the uwsa but you might feel different.

 

[hardee17]

What would decrease LV pressure and decrease LV ESV (eg increase stroke volume & contraxtility)?
Selective venodilation or pulmonary arterial vasoconstriction?

I would go with venodilation, decreased lvesv doesn't have to mean increase in contractility or stroke volume. pulomonary vasoconstriction could in theory do it as well, but its a much risker option to pick. there would be some serious compensatory actions going on

 

[hardee17]

After searching Google and SDNs threads I have not found any conclusive information so maybe you all can help.

I want to first say that I don't mean to derail the thread or cause any sort of unfounded anticipation. So I log onto the NBME's website today for whatever reason and my scheduling permit is gone. I then clicked "Check Exam Status" and under "Registration Status" it says "Complete". Could this just be that my eligibility period ended 6/30/13? BTW I took my exam on 6/14 and until now was dead set on receiving my score on the 10th. Still not holding my breath for an earlier report.

go look and see previous years at this time and see if the nbme broke their time cut off thingy

 

[Greenbayslacker]

Some more questions/concepts I remembered:

Vit E decreases Vit K-dep coagulation factors
Hyperthyroidism increases cholesterol synthesis
Resorption atelectasis
U-shaped scar on kidney surface
Cause of subarachnoid hemorrhage other than berry aneurysm?

 

[Genesea]

Goober11,
I only took mine this past Friday although my eligibility period also ended on 6/30. My permit is also gone, so I think it's more about eligibility rather than imminent score release.
Also my registration status says complete. (Though I think it's always said that? I could be wrong.)

 

[Stingarov]

Anyone else take the exam and afterwards was able to remember around 20 or so questions they got wrong? They were mostly easy questions or 50/50s and it's been driving me insane and making me worried.

Yep I identified about 6-8 I know I've gotten wrong and about 3-4 I moved into the wrong category from "right" because of boneheadedness. So probably not my best score but still hopeful I hit 250s because this appears to be a pretty normal thing for people to go through - identifying a bunch wrong and freaking out then still performing fine. And remember that some are experimental. At this point though I'm happy with 240s or upper 230s because I swear a couple of them didn't even have right answers it seemed like (or seemed that way anyway, probably did have correct answers but extremely esoteric).

 

[stronghold]

I am just to start UW. What's your advice, guys? do it tutor mode, random? also, how many hours you spend reviewing a block?

 

[normtheniner]

After searching Google and SDNs threads I have not found any conclusive information so maybe you all can help.

I want to first say that I don't mean to derail the thread or cause any sort of unfounded anticipation. So I log onto the NBME's website today for whatever reason and my scheduling permit is gone. I then clicked "Check Exam Status" and under "Registration Status" it says "Complete". Could this just be that my eligibility period ended 6/30/13? BTW I took my exam on 6/14 and until now was dead set on receiving my score on the 10th. Still not holding my breath for an earlier report.

Mine looks the same as it did the other day. My eligibility period ends 7/31/2013 and I took the test on 6/10

 

[IkeBoy18]

usmle announcements says this..

"The target date for reporting Step 1 scores for most examinees testing the week of May 13th through late June will be Wednesday, July 10, 2013."


So those of use that took it on June 26 should expect scores on this date? or when exactly is "late june?"

 

[anbuitachi]

Some more questions/concepts I remembered:

Vit E decreases Vit K-dep coagulation factors
Hyperthyroidism increases cholesterol synthesis
Resorption atelectasis
U-shaped scar on kidney surface
Cause of subarachnoid hemorrhage other than berry aneurysm?

How are we supposed to prep for these? I dont remember seeing these ever in FA or uworld... or pathoma,.. how did you get these right?!

 

[courtnes]

Goober, my permit is gone too. I still don't expect to get a score this week given the NBME bottom line is 7/10.

 

[anbuitachi]

anyone know if we are scaled against other people that had the same questions as us, or just against everyone else in general?

also, my 3rd and likely final question from my exam that i'm posting for you guys:

Male with trouble urinating, painless enlarged prostate, what is it?

Are we just supposed to be able to tell this alone from the path?! Is this common on step 1..? Cause i looked on wiki, and they said chronic prostatits is characterized by pain. So the case definite sounds like BPH, and may even 'rule out' chronic prostatitis. I know you should go with the image.. but just wondering how often something liek this occurs.. cause I don't even know how to prep for this [unless the other answer choices had nothin to do with prostate, which i doubt. ]

 

[redandblack07]

Yep I identified about 6-8 I know I've gotten wrong and about 3-4 I moved into the wrong category from "right" because of boneheadedness. So probably not my best score but still hopeful I hit 250s because this appears to be a pretty normal thing for people to go through - identifying a bunch wrong and freaking out then still performing fine. And remember that some are experimental. At this point though I'm happy with 240s or upper 230s because I swear a couple of them didn't even have right answers it seemed like (or seemed that way anyway, probably did have correct answers but extremely esoteric).

Yeah some of the mistakes I made were on such simple questions straight from FA, it's really making me annoyed that I missed them and then it seems like I missed every 50/50 I can think of. Plus there's all the questions that I'm not remembering or that were difficult questions. I hope it's a fairly nice curve like uworld.

 

[loveoforganic2]

How are we supposed to prep for these? I dont remember seeing these ever in FA or uworld... or pathoma,.. how did you get these right?!

I didn't use goljan, but I've heard people reference the VitE thing from him. Pathoma mentions hyperthyroidism as being associated with hypOcholesterolemia, but they don't go into the details (my assumption would have been decreased cholesterol synthesis, and I probably would have gotten this one wrong - it is actually increased HMG-CoA reductase activity it looks like). Resorption atelectasis I know I learned in class, don't remember if it's in a review book. I'd never heard of U-shaped scars (but they're assoc. w/chronic pyelonephritis). Either pathoma or UW mentions AVM as a possibility for subarachnoid hemorrhage. I think UW also mentions pituitary apoplexy as a possibility for that, but I'm not sure.

In short, 2 years of med school crap is too much to all have down pat. Some of this may be in some book, some of it may not be, but focus on learning all the higher yield stuff the best you can, and let the few off the wall questions go

 

[hardee17]

How are we supposed to prep for these? I dont remember seeing these ever in FA or uworld... or pathoma,.. how did you get these right?!

They seem pretty reasonable to me, you also have to remember that there's more information than just those snippets

The cholesterol one is wrong if you're talking about total cholesterol levels, hypothyroid reduces number of LDL receptors

 

[Phloston]

Oh so that means UWSA does in fact overestimate your score by 20 points! That's just crazy.

That's been known to happen with mid- to lower-range scores.

With scores >260, the UWSAs are fairly accurate.

 

[xeroun]

Yay I am done!!

Entire test made me nervous. The questions were way easier than I thought it would be. Its definitely very doable. 95% of my questions were in FA. One question was something I only learned from first year(mechanism behind progeria). Lots of gimmie questions, some thinking questions. Only one obscure anatomy question. Also behavioral science had some crazy answer choices.

I used alot of resources: FA(heavily annotated using tablet with Onenote), All kaplan lecture notes + 2010 videos(for reference), Kaplan High Yield, some of DIT, Pathoma, Goljan audio and Book, A document I made with all the Uworld educational objectives, High Yield Anatomy, Draw it to know it, Deja review, USMLE STEP 1 secrets, UWorld qbank-2x, Kaplan Qbank, Usmle weapon(has really easy 1 step questions to build route memorization). Also Pholston's PPT were awesome for Microbiology!!!

If I could go back 2 months in the Past I would:
Do all the above qbanks plus USMLE RX Qbank and videos
Read FA once. Then use the RX videos to go through FA 7x after that. The RX videos total about 28hours on normal speed. At 4 hours a Day you could go through FA in a week.
RX + helped me go through FA again in the last 5 days before my exam. Its just easier to follow along as they read it and show pages on screen.
Do USMLE RX Q bank ----> Kaplan ---> Uworld ----> NBME 1-7 ---->Uworld incorrects and NBME 11,12,13,15.

Treat the NBME 1-7 like they are qbank questions. Use a screenshot software or offline nbme. After you finish each NBME go through every question and option and try to come up with explanations for wrong options and right option(like you were a writer for uworld or something).

Also do the Kaplan Sim exams. They give you extra questions and build endurance.

 

[g8orlife]

How are we supposed to prep for these? I dont remember seeing these ever in FA or uworld... or pathoma,.. how did you get these right?!

I recall Goljan talking about 3 of these on his audio.

As others said above, not everything's in FA.

 

[anbuitachi]

^yea i know a lot of stuff aren't in there, but people here made it seem like those things are like obvious stuff you should know.. perhaps just sdn community.......

i was going to spend 2 days listening to pathoma. perhaps i should spend 2 days listening to goljian audio . .. i dont know how you guys remember all this with just listening to the guy once.. how do these little details stick.. lol.

 

[g8orlife]

Yay I am done!!

Entire test made me nervous. The questions were way easier than I thought it would be. Its definitely very doable. 95% of my questions were in FA. One question was something I only learned from first year(mechanism behind progeria). Lots of gimmie questions, some thinking questions. Only one obscure anatomy question. Also behavioral science had some crazy answer choices.

I used alot of resources: FA(heavily annotated using tablet with Onenote), All kaplan lecture notes + 2010 videos(for reference), Kaplan High Yield, some of DIT, Pathoma, Goljan audio and Book, A document I made with all the Uworld educational objectives, High Yield Anatomy, Draw it to know it, Deja review, USMLE STEP 1 secrets, UWorld qbank-2x, Kaplan Qbank, Usmle weapon(has really easy 1 step questions to build route memorization).

If I could go back 2 months in the Past I would:
Do all the above qbanks plus USMLE RX Qbank and videos
Read FA once. Then use the RX videos to go through FA 7x after that. The RX videos total about 28hours on normal speed. At 4 hours a Day you could go through FA in a week.

Do USMLE RX Q bank ----> Kaplan ---> Uworld ----> NBME 1-7 ---->Uworld incorrects and NBME 11,12,13,15.

Treat the NBME 1-7 like they are qbank questions. Use a screenshot software or offline nbme. After you finish each NBME go through every question and option and try to come up with explanations for wrong options and right option(like you were a writer for uworld or something).

Also do the Kaplan Sim exams. They give you extra questions and build endurance.

Congrats amconteh. Hope you reach your goals

 

[g8orlife]

o god. i was going to spend 2 days listening to pathoma. perhaps i should spend 2 days listening to goljian audio . .. i dont know how you guys remember all this with just listening to the guy once.. how do these little details stick.. lol.

Well, I listened to him more like 3 times b/c I listened throughout MS2.

 

[loveoforganic2]

^yea i know a lot of stuff aren't in there, but people here made it seem like those things are like obvious stuff you should know.. perhaps just sdn community.......

i was going to spend 2 days listening to pathoma. perhaps i should spend 2 days listening to goljian audio . .. i dont know how you guys remember all this with just listening to the guy once.. how do these little details stick.. lol.

I didn't use Goljan, but I'll have gone through Pathoma 5x. Nothing sticks after 1 pass

 

[anbuitachi]

I didn't use Goljan, but I'll have gone through Pathoma 5x. Nothing sticks after 1 pass

guess not your average medical students around here hahhaa.

 

[loveoforganic2]

guess not your average medical students around here hahhaa.

It's a skewed group, but I'm not talking about 5 passes just during dedicated, I'm including 2nd year

 

[g8orlife]

.... I'm including 2nd year

ditto

 

[JP2740]

It's a skewed group, but I'm not talking about 5 passes just during dedicated, I'm including 2nd year

lol I got through first aid once and pathoma once in 40 days dedicated. Idk how you guys kill this **** so fast.

 

[CDI]

lol I got through first aid once and pathoma once in 40 days dedicated. Idk how you guys kill this **** so fast.

That's cause you were reading for sh*ts n giggles, and banging out 260s in your sleep.