Official 2014 Step 1 Experiences and Scores Thread

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Congrats to Coug, Ms89, BioCF on those stratospheric scores!

Question about the level of memorization needed walking into the exam. Did you have FA nearly rote memorized? Or did you have it mostly memorized? As I go through practice question banks, I'm finding I can often pick the right answer even though I don't know that piece of info in FA 100%. For example, for a question like:
In 5 yr old girl w/ abdominal pain, acts erratically, in an old house being remodeled, which enzyme is most likely not functioning properly.
A: aminolevulinic acid dehydratase
B: adenosine deaminase
C: glucose-6-phosphatase
D: porphobilinogen deaminase
E: sphingomyelinase


Obviously the girl has lead poisoning. If you were to ask me which enzyme is inhibited by lead, I wouldn't be able to tell you off the top of my head. But given the answer options, I can then recall aminolevulinic acid...I'd be tempted by prophobilinogen deaminase. But, I would select (A) with certainty.

So my question is did you:
(A) Rote memorize the whole heme pathway as listed in FA (ex: FA 2013,pg 358, FA 2014,pg 388), including hydroxymethylbilane, which has no clinical correlate (but is written out in FA).
(B) Rote memorize just the 5 enzymes listed in the diagram and the 5 diseases associated with each one.
(C) Did not rote memorize the whole pathway nor the 5 enzymes nor the 5 diseases (ex: if I asked you on the morning of your exam which enzyme is affected in acute intermittent porphyria, you wouldn't be able to answer 'Porphobilinogen deaminase'). Instead, over the course of reading/re-reading FA and doing 2 question banks, you were familiar enough to recall the info when prompted. You might confuse 'porphobilinogen deaminase' & 'uroporphyrinogen decarboxalyse' as causative for Porphyria cutanea tarda....but since they typically don't put those two answer choice together...you'd pick Uropor. decarb.

This is a solid question.
 
Has anyone tried using step2 ck qbooks? I've heard/read that it's useful to do them and just skip the part about the treatment plan.[/
If by any chance i get ahead of my schedule and am done with FA as many times possible i might go through Pretest Family Medicine.
 
Congrats to everyone who recently got their score back?


I'm wondering the same and had the same plan as BlueArc, but I've now heard people say to use either a Step 2 book, a family medicine book, or an internal medicine book. I don't know which would be the most beneficial, assuming of course that all the major step 1 sources are already mastered.
 
Congrats to everyone who recently got their score back?


I'm wondering the same and had the same plan as BlueArc, but I've now heard people say to use either a Step 2 book, a family medicine book, or an internal medicine book. I don't know which would be the most beneficial, assuming of course that all the major step 1 sources are already mastered.

I'd strongly advise against using 2CK resources. There is a difference between recognizing there being step 2-like material on Step 1 (which there certainly is) and taking the step of using a CK resource. Doing so will serve no purpose except to detract from focusing on your main step 1 resources. Think of the step 2-like questions on the test just like the step 1 level minutiae (some really random anatomy) that you simply can't prepare for.
 
I'd strongly advise against using 2CK resources. There is a difference between recognizing there being step 2-like material on Step 1 (which there certainly is) and taking the step of using a CK resource. Doing so will serve no purpose except to detract from focusing on your main step 1 resources. Think of the step 2-like questions on the test just like the step 1 level minutiae (some really random anatomy) that you simply can't prepare for.

My understanding was that using a 2CK qbook would actually help with the big picture ideas and keep you from getting lost in step 1 minutiae. So it's not like you're trying to learn 2CK level things, but rather 2CK qbook is helping you predict things from the clinical presentation even when you don't know the mechanism or other minutiae. Obviously don't devote a ton of time to it.

Obviously I don't know since I'm nowhere near either of these exams. Just what I've heard from MS3/MS4s.
 
My understanding was that using a 2CK qbook would actually help with the big picture ideas and keep you from getting lost in step 1 minutiae. So it's not like you're trying to learn 2CK level things, but rather 2CK qbook is helping you predict things from the clinical presentation even when you don't know the mechanism or other minutiae. Obviously don't devote a ton of time to it.

Obviously I don't know since I'm nowhere near either of these exams. Just what I've heard from MS3/MS4s.

Maybe if you have some extra time prior to your dedicated study period, you can use kaplan step 2 ck qbook and just do the internal medicine chapters.
 
Anyone else find that UWorld uses different names for the enzymes? For example, it gives three names for enzyme that causes Acute Intermittent Porphyria:
Hydroxymethylbilane Synthase, Uroporphyrinogen I synthase, and Porphobilinogen Deaminase.

There are quite a few of other examples (eg methylmalonyl coA mutase instead of synthase, etc) where they use the version that is least likely to give away the answer.

I think I know the pathway and then occasionally Im getting tripped up because they're using a name I never heard of...I guess just try to memorize them all sinces theres no way to know what the step will use?
 
M3 reporting.

I think to use step 2 books, you really have to justify it by saying to yourself that you're a master of at least FA and Uworld for step 1. It's just not very time efficient in my opinion. Would it help? Probably. But not as much as going over FA+uworld+pathoma+goljian audio+probably kaplan qbank which all probably net you more questions correct than step 2 stuff. Not to mention, step 2 stuff will not cover many areas of step 1.

Now I know someone will post about how they got a 250, 260 or 270+ and used step 2 books, but I don't think it means everyone should do it. Also, we get caught up sometimes with trying to use every resource that everyone who's ever done well on step 1 has used. Master of few>acquainted with many. Doing well in classes + FA + uworld + feedback nbmes +/- pathoma +/- goljian audio. If you even manage to master those, which you probably won't, +/- other qbanks like kaplan, and I think that will be all you can muster. If not, then usmlerx. If you are very very poor at neuroanatomy then HY neuroanatomy quick glance at this. I think gross anatomy, use your logic and test taking skills for what's not in the above resources. After all that, then go for step 2 books lol
 
Anyone else find that UWorld uses different names for the enzymes? For example, it gives three names for enzyme that causes Acute Intermittent Porphyria:
Hydroxymethylbilane Synthase, Uroporphyrinogen I synthase, and Porphobilinogen Deaminase.

There are quite a few of other examples (eg methylmalonyl coA mutase instead of synthase, etc) where they use the version that is least likely to give away the answer.

I think I know the pathway and then occasionally Im getting tripped up because they're using a name I never heard of...I guess just try to memorize them all sinces theres no way to know what the step will use?
You can memorize all enzymes, but also remember this is a test. Use your test taking skills. There is not going to be both a MMCoA mutase and MMCoA synthase as choices. Know your pathways, and you're choosing one of the above, not another enzyme, right? Test taking skills are important for this exam. When you get to a question you have no idea about, you need to think logically to come up with your best guess- and honestly, I did this a lot on step 1. Always remember, if you don't know, don't panic, think logically.
 
People have used, and have done well. I think the grand majority think it's a waste of time including myself. Just get your ass in your chair and study the resources you know you need to study.

Did u actually use it to make that judgement?
 
Congrats to Coug, Ms89, BioCF on those stratospheric scores!

Question about the level of memorization needed walking into the exam. Did you have FA nearly rote memorized? Or did you have it mostly memorized? As I go through practice question banks, I'm finding I can often pick the right answer even though I don't know that piece of info in FA 100%. For example, for a question like:
In 5 yr old girl w/ abdominal pain, acts erratically, in an old house being remodeled, which enzyme is most likely not functioning properly.
A: aminolevulinic acid dehydratase
B: adenosine deaminase
C: glucose-6-phosphatase
D: porphobilinogen deaminase
E: sphingomyelinase


Obviously the girl has lead poisoning. If you were to ask me which enzyme is inhibited by lead, I wouldn't be able to tell you off the top of my head. But given the answer options, I can then recall aminolevulinic acid...I'd be tempted by prophobilinogen deaminase. But, I would select (A) with certainty.

So my question is did you:
(A) Rote memorize the whole heme pathway as listed in FA (ex: FA 2013,pg 358, FA 2014,pg 388), including hydroxymethylbilane, which has no clinical correlate (but is written out in FA).
(B) Rote memorize just the 5 enzymes listed in the diagram and the 5 diseases associated with each one.
(C) Did not rote memorize the whole pathway nor the 5 enzymes nor the 5 diseases (ex: if I asked you on the morning of your exam which enzyme is affected in acute intermittent porphyria, you wouldn't be able to answer 'Porphobilinogen deaminase'). Instead, over the course of reading/re-reading FA and doing 2 question banks, you were familiar enough to recall the info when prompted. You might confuse 'porphobilinogen deaminase' & 'uroporphyrinogen decarboxalyse' as causative for Porphyria cutanea tarda....but since they typically don't put those two answer choice together...you'd pick Uropor. decarb.
U don't have to rote memorize FA ! But u should be able to recall info when u see the questions ! That's important in the exam ! I personally can answer ALOT of questions after I see the choices than just reading the questions and answering at once 😀 it's okay as long as u get the questions right ! I did not memorize any pathways as whole but just focused on the main enzymes and the diseases associated with the deficiencies !and that's what I got in my exam ! Ur on the right path ! Don't worry and stay confident 🙂
 
Congrats to everyone who recently got their score back?


I'm wondering the same and had the same plan as BlueArc, but I've now heard people say to use either a Step 2 book, a family medicine book, or an internal medicine book. I don't know which would be the most beneficial, assuming of course that all the major step 1 sources are already mastered.
I agree with what chess master is saying! If you have already mastered the material then try to get ur hands on some step 1 practice questions and do them! Stay away from ck books..
 
Apart from uWorld and the NBME's and maybe Kaplan, what other question banks are excellent for step 1?
 
So i can skip the blue boxes in goljan? The pics are enough?

Do you mean the blue notes in the margins or the charts, figures, etc? Definitely look at charts. I skipped the blue notes because a lot of the material was already in FA/UWorld/Pathoma in text form. Again, if you have the time, the notes are great too. I just ran out of time.

What's a "~270"? 😀

I thought most everyone uses Pathoma instead of Goljan (or uses both)? Did you use the newest version of Lippincott microcards?

Congrats on the score, btw! Don't know the reference though, sadly. We also have a clerkship prep course.. an entire week of it. Cuts down on prep time quite a bit.

A "~270" is the number you throw out to confuse the representatives from your school - it gives you some plausible deniability if they read the forums 😀.

I am probably the worst person to ask about a Pathoma/Goljan preference. Pathoma was a great resource for my dedicated period, but he seems to oversimplify some concepts or add his own spin to the pathology. I love the detail in Goljan (despite the errors in both RR and Pathoma) but would have struggled to re-read it during my studying. I used the latest microcards - good resource actually... liked them much more than I thought I would.

For "high anxiety," see http://en.wikipedia.org/wiki/High_Anxiety. Totally a legit diagnosis.

Well god-freaking-damn!!!! Two freaking seventy!!!! Freaking ****t!
Freaking AMAZING!!!!
How long was ur prep time?

I studied for eight weeks in a dedicated period. Starting Pathoma in November allowed me to finish the videos and fully annotate the book before my study period. That saved some time.
 
Thanks Ms89 for that info. Eases anxiety a bit.
I studied for eight weeks in a dedicated period. Starting Pathoma in November allowed me to finish the videos and fully annotate the book before my study period. That saved some time.

Hi BioCF,
If you don't mind can you elaborate a little about your 8-week dedicated period. Specifically, what was your knowledge base BEFORE and what prep you did BEFORE the 8-week...you mentioned you finished Pathoma with annotations, what else? Did you have a 1st pass of FA before the 8wk? Did you complete/start a question bank prior to the 8-wk time? Did you already have a pretty good understanding of Biochem before the 8-wk time?

During your 8-week dedicated time, what did you do exactly? Did you study only FA/Pathoma at this time? Did you study by organ system? Random questions? Any details you can share would be helpful.

Thanks!!
 
Anyone else see a huge decrease in their predicted score on USMLE-Rx since the migration? I know it's generally useless in terms of predictive ability but logging into a 70+ pt reduction was a little crazy.
 
Congrats to Coug, Ms89, BioCF on those stratospheric scores!

Question about the level of memorization needed walking into the exam. Did you have FA nearly rote memorized? Or did you have it mostly memorized? As I go through practice question banks, I'm finding I can often pick the right answer even though I don't know that piece of info in FA 100%. For example, for a question like:
In 5 yr old girl w/ abdominal pain, acts erratically, in an old house being remodeled, which enzyme is most likely not functioning properly.
A: aminolevulinic acid dehydratase
B: adenosine deaminase
C: glucose-6-phosphatase
D: porphobilinogen deaminase
E: sphingomyelinase


Obviously the girl has lead poisoning. If you were to ask me which enzyme is inhibited by lead, I wouldn't be able to tell you off the top of my head. But given the answer options, I can then recall aminolevulinic acid...I'd be tempted by prophobilinogen deaminase. But, I would select (A) with certainty.

So my question is did you:
(A) Rote memorize the whole heme pathway as listed in FA (ex: FA 2013,pg 358, FA 2014,pg 388), including hydroxymethylbilane, which has no clinical correlate (but is written out in FA).
(B) Rote memorize just the 5 enzymes listed in the diagram and the 5 diseases associated with each one.
(C) Did not rote memorize the whole pathway nor the 5 enzymes nor the 5 diseases (ex: if I asked you on the morning of your exam which enzyme is affected in acute intermittent porphyria, you wouldn't be able to answer 'Porphobilinogen deaminase'). Instead, over the course of reading/re-reading FA and doing 2 question banks, you were familiar enough to recall the info when prompted. You might confuse 'porphobilinogen deaminase' & 'uroporphyrinogen decarboxalyse' as causative for Porphyria cutanea tarda....but since they typically don't put those two answer choice together...you'd pick Uropor. decarb.


something just happened to me that reminded me of this post.
was doing a uworld question, essentially gave a patient with RA but did not have rheu. factor and then asked what infection could she have
EBV, HSV, PB19, etc etc and out of the blue i recalled that PB19 can cause rheu. like symptoms in adults; it was almost a subconscious thing. I havent looked at micro in 2 weeks [forgotten a good deal of it and ill have to review it again at some point] but still I think the harder you hit the material the more it will stick, maybe you cant recall it all verbatim but i think [and hope] it is buried in there subconsciously.
 
Anyone else see a huge decrease in their predicted score on USMLE-Rx since the migration? I know it's generally useless in terms of predictive ability but logging into a 70+ pt reduction was a little crazy.

just checked mine. It says <160. It was at 240 a few days ago.

Also, I find it annoying that I cant see the percentage of ques i got right for the organ systems.
 
Congratulations to all of you who have succeded...
What is the best genetics/immuno/microbio ressources ?? thank you all
 
My understanding was that using a 2CK qbook would actually help with the big picture ideas and keep you from getting lost in step 1 minutiae. So it's not like you're trying to learn 2CK level things, but rather 2CK qbook is helping you predict things from the clinical presentation even when you don't know the mechanism or other minutiae. Obviously don't devote a ton of time to it.

Obviously I don't know since I'm nowhere near either of these exams. Just what I've heard from MS3/MS4s.

M3 reporting.

I think to use step 2 books, you really have to justify it by saying to yourself that you're a master of at least FA and Uworld for step 1. It's just not very time efficient in my opinion. Would it help? Probably. But not as much as going over FA+uworld+pathoma+goljian audio+probably kaplan qbank which all probably net you more questions correct than step 2 stuff. Not to mention, step 2 stuff will not cover many areas of step 1.

Now I know someone will post about how they got a 250, 260 or 270+ and used step 2 books, but I don't think it means everyone should do it. Also, we get caught up sometimes with trying to use every resource that everyone who's ever done well on step 1 has used. Master of few>acquainted with many. Doing well in classes + FA + uworld + feedback nbmes +/- pathoma +/- goljian audio. If you even manage to master those, which you probably won't, +/- other qbanks like kaplan, and I think that will be all you can muster. If not, then usmlerx. If you are very very poor at neuroanatomy then HY neuroanatomy quick glance at this. I think gross anatomy, use your logic and test taking skills for what's not in the above resources. After all that, then go for step 2 books lol

Using Step2 material is NOT a good idea when you're studying for Step1. There is too much material for Step1 to begin fishing around in 2CK territory. I would actually say it's more important to learn minutiae for Step1 than to begin prep for Step2. Plus, you'll find later on that a lot of the "minutiae" for Step1 is actually basic stuff you need to know for Step2 anyway.

There are definitely 2CK-ish concepts that show up on Step1 forms, but they're generally workable through intuition if they do arise. But you would never get a question on a Step1 exam asking for the most diagnostic vs best initial test.
 
just checked mine. It says <160. It was at 240 a few days ago.

Also, I find it annoying that I cant see the percentage of ques i got right for the organ systems.

Same here, though I was hovering about ten points less than you. Agree about the lack of percentages, both the discipline percentages and overall usage percentages as well. Not a fan of these changes.
 
me and Rx butted heads tonight. anyone do the path section for musculoskeletal in rx....holy crap ambiguous at its best!!!!!


I did that tonight. Did UWorld before and way better questions. Man it was awful. Could have been like three things. Worst part was figuring out lab values with the ambiguous stems
 
I did that tonight. Did UWorld before and way better questions. Man it was awful. Could have been like three things. Worst part was figuring out lab values with the ambiguous stems
Preach! lol
I am finding that Rx is either really good or so "WTF!?!?!", it makes kaplan questions seem reasonable lol. Ya and with uworld it is good because you know if you get something wrong YOU are wrong, not always the case with rx!
 
me and Rx butted heads tonight. anyone do the path section for musculoskeletal in rx....holy crap ambiguous at its best!!!!!
Did it last night, thought the questions were easy. They asked stuff like " which HLA sub type is associated with RA" ...
 
not those ones, the random xray questions, etc

I didn't think the section was THAT bad. There were only a few oddball questions.

To all:

I am 98% done with Rx now and am wondering if I should move on to the Kaplan qbank or UWorld--I have both resources. My exam is the first week of June and I have about a month of dedicated study time, so should I focus on UWorld then or just start it now?
 
Do NOT use step 2CK materials, about 25% of your correct answers in step 1 are INCORRECT in step 2ck (I'm pretty much done 80% of my first pass of uworld for CK). Sure Uworld makes their step 1 qbank "hard" by throwing in a few step 2ck questions. (Actually they make their step 2 CK qbank hard by throwing in step 1 questions), BUT do not study step 2 for step 1.

That moment in chemistry 101 when you found out those nicely layed out Niels Bohr valence diagrams were wrong as hell, its about to be re-lived a few times next year.

I didn't think the section was THAT bad. There were only a few oddball questions.

To all:

I am 98% done with Rx now and am wondering if I should move on to the Kaplan qbank or UWorld--I have both resources. My exam is the first week of June and I have about a month of dedicated study time, so should I focus on UWorld then or just start it now?

You have lots of time. I would just do kaplan right now. Save Uworld for a bit.
 
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Hey guys I'm new to the forum and i just took my step 1

Let me tell u,it was a doozy.

There were some easy questions and then there were a lot more hard questions which made u really think.

The answer choices ur given are so similar that i felt confused throughout the exam
 
@Da_1_2_N_V Congrats on being done. how did you feel on the exam compared to when you were doing UW blocks? Did it have a completely different feel?

To tell u the truth, i thought it was a little harder than world questions. There were a lot of answer choices that were similar so u really had to know ur stuff. My test was not a lot on anatomy of neuroanatomy as many ppl before me said, Instead, my test was heavy on physiology with those stupid arrow questions and increase decrease questions, which is my weak point so i was upset about that.

There were definitely some gimme questions that were easy but a lot of the questions made u think about the answer choices.

I just used FA and Uworld but i truly believe u need to do look over brs physiology to get those questions right
 
Instead, my test was heavy on physiology with those stupid arrow questions and increase decrease questions, which is my weak point so i was upset about that.
Can you please give examples of the topics that were tested via arrow questions? And how can i prepare myself for questions like that? Also I am studying BRS physiology like you have suggested in your post.
 
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Any thoughts on how to use QBanks during my dedicated study period? I have 5 weeks starting next week, and have used about 50% of Kaplan subject specific throughout the year, and have access to UWorld and Rx. Was planning on doing 2 blocks most days, one focused on what I've studied and one random, both timed, moving up to 4+ blocks a day the week before the test. Should I just be doing UWorld again and again and again since it's the best resource and wind up seeing questions multiple times? Or should I try to work Kaplan or Rx into my program somehow just to see more questions?
 
just did uwsa1; holy cr*p that was tough! For the people who have taken step 1, was it the same difficulty? So many things I had to narrow it down to two or just did not know. I was reading on various posts that it over predicts your scores? My NMBEs have been higher tho. thoughts?
 
Can you please give examples of the topics that were tested via arrow questions? And how can i prepare myself for questions like that? Also I am studying BRS physiology like you have suggested in your post.

know what happens to laminar blood flow in hypertension, oxygen consumption when a kidney arteriole constrics or decreased, stuff like tht
 
Lets put
Any thoughts on how to use QBanks during my dedicated study period? I have 5 weeks starting next week, and have used about 50% of Kaplan subject specific throughout the year, and have access to UWorld and Rx. Was planning on doing 2 blocks most days, one focused on what I've studied and one random, both timed, moving up to 4+ blocks a day the week before the test. Should I just be doing UWorld again and again and again since it's the best resource and wind up seeing questions multiple times? Or should I try to work Kaplan or Rx into my program somehow just to see more questions?

No man don't do uworld again and again, I did it once, got 67% random times. Then i did my wrong answer choices.

Doing uworld multiple times is not going to help that much. My advice is to go over uworld once, and THOROUGHLY go over the explanations of the ones u got wrong.

My other advice is tht if ur weak in physio, go over any and all physio books u can. My test had pathology but i felt like it had more physio on it.
 
Lets put


No man don't do uworld again and again, I did it once, got 67% random times. Then i did my wrong answer choices.

Doing uworld multiple times is not going to help that much. My advice is to go over uworld once, and THOROUGHLY go over the explanations of the ones u got wrong.

My other advice is tht if ur weak in physio, go over any and all physio books u can. My test had pathology but i felt like it had more physio on it.

But if I'm planning on doing 2-3 blocks per day, I'm going to run through the UWorld bank and probably my incorrects before the end of my study period. If I get to that point do I start looking into other banks? Or use other resources concurrently to sort of pad out how long UWorld "lasts"?
 
just did uwsa1; holy cr*p that was tough! For the people who have taken step 1, was it the same difficulty? So many things I had to narrow it down to two or just did not know. I was reading on various posts that it over predicts your scores? My NMBEs have been higher tho. thoughts?
I think uwsa1 was definitely harder. I looked at the percentage I got right and compared it to the averages, and I found that more a useful assessment of my performance than the score or even perceived difficulty of the test. For example, if the average was 60% and you got a 68%, and your UW average is generally about 8% higher than the cumulative average, you performed on par with how you usually do.

On a side note, a lot of people say that UWSA overpredicts, but after reading a lot of forums it doesnt seem like that is really the case. It certainly can overpredict, and Id definitely trust the NBME averages over it, but if its below NBMEs I wouldnt worry about it since it isn't validated in the same way.
 
But if I'm planning on doing 2-3 blocks per day, I'm going to run through the UWorld bank and probably my incorrects before the end of my study period. If I get to that point do I start looking into other banks? Or use other resources concurrently to sort of pad out how long UWorld "lasts"?

One thing I did was simply just go through as many of the explanations again as possible, starting from the beginning (using the previous tests tab). I took notes on highyield material ON THE UWORLD SOFTWARE itself, then generated a list of the notes and printed them, then studied that the last week.
 
One thing I did was simply just go through as many of the explanations again as possible, starting from the beginning (using the previous tests tab). I took notes on highyield material ON THE UWORLD SOFTWARE itself, then automatically generated a list of the notes and printed them, then studied that the last week.
 
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