Official 2014 Step 1 Experiences and Scores Thread

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How many hours are guys studying every week? I am only averaging like 12 hours a week because I still have to study for internals (busy work, 1 more organ block left, etc). Aiming for early June exam.
 
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ChessMaster3000 said:
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.
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Thanks, i appreciate it. Have you sat for step 1 yet? If so was it as difficult as this/ uworld?
 
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Lysinee said:
How many hours are guys studying every week? I am only averaging like 12 hours a week because I still have to study for internals (busy work, 1 more organ block left, etc). Aiming for early June exam.
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I'm letting my grades take a bit of a hit so I can focus on prep.
 
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jayareus said:
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"?
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Finish do u world, go over the explanations, do ur incorrect ones and then move on and use another qbank like usmlerx .

It's best to be exposed to as many different types of questions as possible
 
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Lysinee said:
Yeah, I am trying to incorporate as much step 1 prep as I can, but also making sure I can at least pass the block lol.
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Probably depends on your curriculum. I know MS2s at my school who do lecture once and then study step 1 stuff the rest of the time and are right at the class average usually.
 
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Is there an easy way to tell the difference between presentation of LGV and chancroid due to Haemophilus? The ulcer of primary Syphilis isn't associated with inguinal lymph node findings or pain so that's easy to differentiate. But it seems like the presentations could be similar for the first two. Just reviewing and came across that. Haven't had a question on it yet.
 
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I wrote my exam on the 6th of this month so I should be expected my results back this Wednesday correct? Also, does anyone know when the 'permit link' is supposed to disappear (Sunday before, Monday before?), because I've read that if it disappears it means you have passed.
 
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Bancrofti said:
Is there an easy way to tell the difference between presentation of LGV and chancroid due to Haemophilus? The ulcer of primary Syphilis isn't associated with inguinal lymph node findings or pain so that's easy to differentiate. But it seems like the presentations could be similar for the first two. Just reviewing and came across that. Haven't had a question on it yet.
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Gram staining would help. Haemophilus is gram neg cocoobacillus whereas chlamydia wouldn't gram stain because it's obligate intercellular.
 
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Polymyxin said:
Hi BioCF,
If you don't mind can you elaborate a little about your 8-week dedicated period...
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Sure! I did almost nothing during the school year. I used Goljan RR, but that was to help with my classes, not prepare me for the Step. In November, I decided to finish Pathoma so I would not have to annotate it later. Then I waited until the last week of classes and reviewed biochem (I have a biochemistry background from college so that section went quickly) and micro in FA. I would count this as part of my dedicated period. I went home (halfway across the US from my school - long trip, but I felt being home would make me more comfortable) to start a seven-week "true" dedicated study period.

First 3 weeks:
1st day: Behavioral science-FA + BRS Behavioral Science (took no notes - too much material to add)
2nd day: Biochem-I read FA with some of my notes from class and Lippincott Biochem as supplements. I annotated these into FA as needed.
3rd-7th days: Microbiology - I annotated all of Lippincott Microcards and some of Clinical Microbio into FA. Made sure I focused on the diseases that had not been covered well in class.
2nd and 3rd WEEKS: I moved through the systems as they were organized in FA. A typical day followed this generic pattern:

Read Embryo section of the organ system in FA --> Read BRS Embryo and annotate into FA (not sure I would recommend this - was useless on my exam) --> Read Physiology section of the system in FA --> Read BRS Physio and annotate into FA --> Read the FA Pathology section on that system --> Read the associated Pathoma section and annotate into FA

This required two days for the larger chapters and one for the smaller systems. Some sections were a bit different, such as Neuro, where I mostly used FA, HYA Neuro, and Pathoma. BRS Behavioral Science has some good sections on Psychiatry, so I used those as a supplement to FA Psych. Each night for the first three weeks I finished ~92 questions in UsmleRx to help me memorize FA. Never finished it, but the questions served their purpose.

I started UWorld with four weeks left and completed it in two weeks with 85% tutor mode random, annotating as I went. I reviewed (1-2 hours) some of my annotated FA each night. After finishing UWorld once, I went through my wrong answers plus some lucky guesses. Two weeks out I started practice exams - UWSA 1: 265. 1 1/2 weeks out UWSA 2: 265. 1 week out NBME 15: 275. ~3 days out NBME13: 273. I crammed my annotated FA every single day when I wasn't taking an exam. Two days before the exam, I reviewed the images in Goljan and skimmed Learning Radiology for some high-yield images. Took the exam near the end of January.
 
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Bancrofti said:
Is there an easy way to tell the difference between presentation of LGV and chancroid due to Haemophilus? The ulcer of primary Syphilis isn't associated with inguinal lymph node findings or pain so that's easy to differentiate. But it seems like the presentations could be similar for the first two. Just reviewing and came across that. Haven't had a question on it yet.
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Chancroid: Painful ulcer (Haemophilus ducreyi---do cry)

Lymphogranuloma venereum : Painless ulcer which usually goes unnoticed (especially in women). Lymph nodes tender and suppurating. It is mainly an infection of lymphatics and lymph nodes.
 
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BioCF said:
Sure! I did almost nothing during the school year. I used Goljan RR, but that was to help with my classes, not prepare me for the Step. In November, I decided to finish Pathoma so I would not have to annotate it later. Then I waited until the last week of classes and reviewed biochem (I have a biochemistry background from college so that section went quickly) and micro in FA. I would count this as part of my dedicated period. I went home (halfway across the US from my school - long trip, but I felt being home would make me more comfortable) to start a seven-week "true" dedicated study period.

First 3 weeks:
1st day: Behavioral science-FA + BRS Behavioral Science (took no notes - too much material to add)
2nd day: Biochem-I read FA with some of my notes from class and Lippincott Biochem as supplements. I annotated these into FA as needed.
3rd-7th days: Microbiology - I annotated all of Lippincott Microcards and some of Clinical Microbio into FA. Made sure I focused on the diseases that had not been covered well in class.
2nd and 3rd WEEKS: I moved through the systems as they were organized in FA. A typical day followed this generic pattern:

Read Embryo section of the organ system in FA --> Read BRS Embryo and annotate into FA (not sure I would recommend this - was useless on my exam) --> Read Physiology section of the system in FA --> Read BRS Physio and annotate into FA --> Read the FA Pathology section on that system --> Read the associated Pathoma section and annotate into FA

This required two days for the larger chapters and one for the smaller systems. Some sections were a bit different, such as Neuro, where I mostly used FA, HYA Neuro, and Pathoma. BRS Behavioral Science has some good sections on Psychiatry, so I used those as a supplement to FA Psych. Each night for the first three weeks I finished ~92 questions in UsmleRx to help me memorize FA. Never finished it, but the questions served their purpose.

I started UWorld with four weeks left and completed it in two weeks with 85% tutor mode random, annotating as I went. I reviewed (1-2 hours) some of my annotated FA each night. After finishing UWorld once, I went through my wrong answers plus some lucky guesses. Two weeks out I started practice exams - UWSA 1: 265. 1 1/2 weeks out UWSA 2: 265. 1 week out NBME 15: 275. ~3 days out NBME13: 273. I crammed my annotated FA every single day when I wasn't taking an exam. Two days before the exam, I reviewed the images in Goljan and skimmed Learning Radiology for some high-yield images. Took the exam near the end of January.
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Thank you! Huge help.
 
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Phloston said:
Funny enough, scores like this have less to do with prep and more to do with the test-taker.
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This is so true, and I bet a lot of others, like me, who have taken this test would confirm this sentiment. Knowing how much sacrifice I put in in an attempt to score in ranges like this (270+), and not getting close to them, it always takes me back when these scores are posted (especially when the review plan described seems pretty ordinary and without excessive sacrifice). I would LOVE to meet the faces behind these scores. Is there some kind of pattern? Is it the stereotype nerd who avoids all human contact and sunlight (in which case we'll probably never see him/her) or the charismatic extrovert who is so damn smart that he doesn't have to study as much as the next guy and outperforms him by 3 SD with 3x less prep?
It always amazes me that Step 1 experience is virtually only shared honestly through anonymity, yet we all wonder who are the faces behind these scores? Maybe it would be easier to quantify USMLE goals (and beyond) with a better understanding of what type of person is in the top 10th percentile and therefore is the barrier of competition that all of us striving to score very high must face? I guess one can only wonder.
 
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IMHO no amount of hard work can beat doing well in Med school.
That's how the questions on the real deal are designed.
 
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madcowz said:
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.
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I just found out that using the new tutor mode feature (guess until you get it right) will give you 100% on the block... Kinda disappointing that it doesn't grade you based upon your first choice.
 
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RandomHero117 said:
I just found out that using the new tutor mode feature (guess until you get it right) will give you 100% on the block... Kinda disappointing that it doesn't grade you based upon your first choice.
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Yeah, I didn't realize for a while and I thought I was killing it, ha ha. If you want to keep track of your right/wrong, make sure you leave the incorrect answer ticked when you end the block. It will then register that as "incorrect"
 
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jorgensenca said:
Took Step 1 on Jan 30th. Used Uworld, First Aid, and Pathoma for 4 week dedicated study block. Got 257 and 263 on Uworld practice exams. 242 on Step 1. Got my grade exactly 2.5 weeks after the test
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CONGRATULATIONS!
 
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PiBond said:
I've got about ~3 weeks until my test and time management has never been a strength of mine, so I'm wondering what y'all would recommend I do in terms of practice questions, practice tests, & resources.

So far, I've done Pathoma (x1) & all of UWorld (83%). Not a big fan of First Aid so it's just been collecting dust on my shelf. Haven't taken any practice tests yet.

Should I do: more practice Q's (eg UWorld x2, another Qbank, etc), use other resources to focus on weak areas, read First Aid (all I have is 2011 version), or just do practice tests (and if so, which one's?)

Based on UWorld: my weak areas anatomy (80%), biochem (79%), biostats (70%), pharm (82%). Does anyone have any particularly good resources they would recommend for these areas? I can spend up to $100 total

Thanks for your input
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Questions>NBME> Questions > NBME > Questions >NBME & UWSAs>Test, 007.
 
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Lysinee said:
How many hours are guys studying every week? I am only averaging like 12 hours a week because I still have to study for internals (busy work, 1 more organ block left, etc). Aiming for early June exam.
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I've been able to get about 25 hours a week. I usually spend 3-4 hours a day on board stuff, then about 6 on class material. So far my grades haven't slipped at all.
 
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Transposony said:
Chancroid: Painful ulcer (Haemophilus ducreyi---do cry)

Lymphogranuloma venereum : Painless ulcer which usually goes unnoticed (especially in women). Lymph nodes tender and suppurating. It is mainly an infection of lymphatics and lymph nodes.
Click to expand...
Oddly enough, I just got a question on this today. God it right btw 🙂, so thanks. However, in the explanation it does say that the draining lymph nodes can be very painful for LGV. So I'm still not sure that it can be differentiated in terms of the pain.
I'd assume questions won't try to screw us and if it's chancroid they will make it clear cut that the primary pathology is a painful ulcer and in LGV they'll make sure to highlight lymphadenopathy with or without sinus tract drainage. Or as mentioned above a culture or gram stain would make things simple.
 
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Should I rewatch pathoma during dedicated study time? Ive watched them once during the school year and annotated into the book. Just wondering if it is worth the time to rewatch them instead of re-reading pathoma.
 
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MilkIsGood said:
Should I rewatch pathoma during dedicated study time? Ive watched them once during the school year and annotated into the book. Just wondering if it is worth the time to rewatch them instead of re-reading pathoma.
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Are there sections that you still don't quite understand? It might actually help in that case. Hopefully someone who has taken the exam can offer their opinion.
 
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Bancrofti said:
Oddly enough, I just got a question on this today. God it right btw 🙂, so thanks. However, in the explanation it does say that the draining lymph nodes can be very painful for LGV. So I'm still not sure that it can be differentiated in terms of the pain.
I'd assume questions won't try to screw us and if it's chancroid they will make it clear cut that the primary pathology is a painful ulcer and in LGV they'll make sure to highlight lymphadenopathy with or without sinus tract drainage. Or as mentioned above a culture or gram stain would make things simple.
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was it the question about the old sailor?
 
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Transposony said:
Chancroid: Painful ulcer (Haemophilus ducreyi---do cry)

Lymphogranuloma venereum : Painless ulcer which usually goes unnoticed (especially in women). Lymph nodes tender and suppurating. It is mainly an infection of lymphatics and lymph nodes.
Click to expand...


Look for draining sinuses in LGV!
 
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Bancrofti said:
Oddly enough, I just got a question on this today. God it right btw 🙂, so thanks. However, in the explanation it does say that the draining lymph nodes can be very painful for LGV. So I'm still not sure that it can be differentiated in terms of the pain.
I'd assume questions won't try to screw us and if it's chancroid they will make it clear cut that the primary pathology is a painful ulcer and in LGV they'll make sure to highlight lymphadenopathy with or without sinus tract drainage. Or as mentioned above a culture or gram stain would make things simple.
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I thought it was just the ulcers that were painful with Ducreyi?
 
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Fatalis said:
was it the question about the old sailor?
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Nope. Just some 35 year old guy with the symptoms

ChessMaster3000 said:
I thought it was just the ulcers that were painful with Ducreyi?
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You're correct. LGV may have ulcers as well, but they are painless. I was referring to the fact that the buboes in LGV can be painful, not the ulcers. To confuse things even more though, just looked at wiki and it says 50% of the people that develop swelling of the inguinal lymph nodes will progress to a point where the nodes rupture through the skin, producing draining abscesses...
 
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Maybe you are over-thinking it?

If the patient presents with painful ulcer on genitalia >Chancroid

If the patient presents with painful swelling in groin +/- draining sinuses > LGV

LGV might even present with localized lymphedema of scrotum/vulva later in the disease process due to destruction of lymphatics.

L - Lymph (Nodes/Lymphatics)
G - Groin
V - Variable presentation (depending on stage of the disease process)
 
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I agree, I definitely am. It's just that when I was first thinking about it I was realizing they could word the questions in such a way that the physical presentation given could be for either due to overlap of findings. I was just wondering, hypothetically speaking, if both answers were there, what is a defining feature that could differentiate them.
I guess I'm overthinking Micro. Maybe it's because I just got done reviewing cardio and I have to be hyper-vigilant about finding the one word in the stem that differentiates things... i.e. a 50 year old man presenting with chest pain and diaphoresis
 
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Bancrofti said:
I agree, I definitely am. It's just that when I was first thinking about it I was realizing they could word the questions in such a way that the physical presentation given could be for either due to overlap of findings. I was just wondering, hypothetically speaking, if both answers were there, what is a defining feature that could differentiate them.
I guess I'm overthinking Micro. Maybe it's because I just got done reviewing cardio and I have to be hyper-vigilant about finding the one word in the stem that differentiates things... i.e. a 50 year old man presenting with chest pain and diaphoresis
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I don't think you're overthinking it, but I do think they will give you some more info than purely clinical presentation. I had a ton (like a LOT) of micro on my test, but it was all incredibly easy except one question. One thing I would keep in mind is the haemophilus ducreyi is still a haemophilus organism, so the culturing requirements for h. influenza apply to this organism as well (seen that in several practice ?s)
 
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Hey just got my results today; 260+. Im more than happy with this score as I exceeded my NBME average by more than 5 points. My advice is to stick to first aid and dont go crazy getting other books especially for biochem and embryo (of which I had 1 question each). Know first aid COLD, dont just memorize facts but make sure you really understand what youre reading. Also do as many NBMEs as you can. I did 10 NBMEs, U world (just once), and FA (many, many times).

Good luck
 
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congrats! would you encourage doing the older NBMEs also? like 1-6? did you find they were similar to the real deal?
 
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CallmeDrFrank said:
Hey just got my results today; 260+. Im more than happy with this score as I exceeded my NBME average by more than 5 points. My advice is to stick to first aid and dont go crazy getting other books especially for biochem and embryo (of which I had 1 question each). Know first aid COLD, dont just memorize facts but make sure you really understand what youre reading. Also do as many NBMEs as you can. I did 10 NBMEs, U world (just once), and FA (many, many times).

Good luck
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Wow! Major congrats. I'm having a tough time remembering stuff in FA.

When you go through FA do you make it a point to memorize things. Like, do you memorize that Crohns is associated with migratory polyarthritis, erythema nodosum, ankylosing spondylitis, pyoderma gangrenosum, aphthous ulcers, uveitis, kidney stones. UC is associated with pyoderma gangrenosum, erythema nodosum, 1° sclerosing cholangitis, ankylosing spondylitis, apthous ulcers, uveitis.

Did you actually memorize all this stuff? Like be able to recite more or less before exam. Or, after reading FA several times and going through questions you can recognize which is which?
 
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Doing older NBMEs helped me. Although they tend to have shorter stems and test more memorization than the current step its still a good tool. Its fast and reliable and if its on an old NBME its something you have to know so its good for that. I didnt time them or anything i just did them as fast as possible and offline. Try to memorize as much of FA as you can. But if you can identify which of those is associated with Crohns vs UC in a question, that works too. But if its not memorized you will tend to second guess yourself when a question presents itself. Again, the more FA you know the better prepared you will be.
 
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CallmeDrFrank said:
But if its not memorized you will tend to second guess yourself when a question presents itself. Again, the more FA you know the better prepared you will be.
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That makes sense to have it memorized. Did you do anything in particular or do have any tips on how to memorize the nitty gritty details. I have no problem memorizing/understanding the big and medium picture stuff. But its the details. Did you make flash cards? Re-read FA in a particular way?
 
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Polymyxin said:
That makes sense to have it memorized. Did you do anything in particular or do have any tips on how to memorize the nitty gritty details. I have no problem memorizing/understanding the big and medium picture stuff. But its the details. Did you make flash cards? Re-read FA in a particular way?
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Doing questions helped me most, if you miss a question because of a factoid you usually wont forget it. I made a word doc with one-liners from questions I missed and explanations etc. I ended up with like 50 pages which I read a few times right before my step. That helped a lot. Also I used mnemonics a lot. Whatever works try diff techniques.
 
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Hi All!

I'm looking for a little guidance regarding my Step 1 study plan.

I will be entering my ~40-day study period having completed: 1. ~75% of UWorld (always reading and annotating the FA portions relevant to any given question); 2. Goljan RR Path; 3. Pathoma

During my study period I hope to complete: 1. FA a few times; 2. UWorld again; 3. USMLERx for the first time; 4. Review Pathoma; 5. BRS Physiology

I'm curious as to what other activities I should partake in with my time? Particularly, I'm considering reading Goljan RR Path once more (2x total). I'm not sure what is the most efficient use of my time, so I'm here asking you all!
 
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Thoughts on taking a first NBME today vs. waiting til next week when apparently the grading scale is changed? Am I wrong in thinking the value of the NBME is in its predictive ability, and less so it's function as "practice" or "review," and therefore I should just wait to take one? Or if I'm planning to take a bunch anyway does it not really matter that my score won't be scaled according to the new standards?
 
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ulikedaggers said:
How long have you been going at that rate? I'd personally probably be burned out after a month or two.
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About 2 months. If I start feeling burned out, I take a day or night off.

Considering some of the study schedules/plans I see around this website, I felt like 65-70 hours a week was fairly modest.
 
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Donald Juan said:
About 2 months. If I start feeling burned out, I take a day or night off.

Considering some of the study schedules/plans I see around this website, I felt like 65-70 hours a week was fairly modest.
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Impressive man. I think 65-70 hours a week mainly reviewing (i.e. dedicated prep period) will be more manageable than 65-70 hours a week reviewing and learning new things (i.e. school plus board prep) in terms of avoiding burnout.
 
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brownie said:
did anyone else find that the uworld biochem questions have a ton of details not mentioned in FA?
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I don't know about a ton but theres definitely some things in Uworld that are very nitpicky when it comes to biochemistry. You have to know ur enzymes and substrates real well and what goes wrong in a specific setting like alcoholism, hyperammonemia, etc.. But I took the real deal not too long ago and thought First Aid sufficed. You just have to know First Aid real well.
 
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FA is purposely succinct on biochem because it's already one of the book's longest chapters and there's so much to talk about.

The good news about biochem is that FA is the only resource you need (i.e., don't go buying flashcards or DejaReview Biochem, etc.)

The bad news about biochem is that you have to do an incredible # of questions to see the different angles in which the USMLE assesses the stuff.

Don't forget that QBank questions are written by people who've sat the exam. People somehow think that minutiae in QBanks is not necessarily what would be on the exam, which is true in some cases, but this is why the pedantic student will score well, because a lot of the QBank material really is floating around on the real deal.
 
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Phloston said:
FA is purposely succinct on biochem because it's already one of the book's longest chapters and there's so much to talk about.

The good news about biochem is that FA is the only resource you need (i.e., don't go buying flashcards or DejaReview Biochem, etc.)

The bad news about biochem is that you have to do an incredible # of questions to see the different angles in which the USMLE assesses the stuff.

Don't forget that QBank questions are written by people who've sat the exam. People somehow think that minutiae in QBanks is not necessarily what would be on the exam, which is true in some cases, but this is why the pedantic student will score well, because a lot of the QBank material really is floating around on the real deal.
Click to expand...
Thanks pholston,

I have a question- do you think its better to do Uworld over again or to do another qbank?
 
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