Official 2014 Step 1 Experiences and Scores Thread

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Would RR Path be a good source for these next step in management questions? Seems like he throws in some extra advanced stuff throughout that isn't really discussed in FA if at all for certain conditions.
 
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orchitisphlebitis said:
Metal with spikes. You forgot the spikes. And waaaaay ahead of ya
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Hey I remember reading your other 260 thread some time ago. Just wanted to come in and reassure you - you are going to be fine. After the test it's easy to dwell over all the really hard questions and forget about all the really easy questions that you just answered instinctively. I felt anxious for a while after my test too but it turned out just fine. And as other posters have said, take it easy and throw back a few beers!
 
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These recent reports by people who did well on NBMEs saying that step1 is "prohibitively difficult" are freaking me out. My latest NBME (16) I scored 256 but I feel like I don't really know that much and my test is in 2 days so I can't really do anything about it at this point. Is this something that happens every year or is this year particularly bad?
Anybody else losing their mind right now?
 
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twolittlebears said:
These recent reports by people who did well on NBMEs saying that step1 is "prohibitively difficult" are freaking me out. My latest NBME (16) I scored 256 but I feel like I don't really know that much and my test is in 2 days so I can't really do anything about it at this point. Is this something that happens every year or is this year particularly bad?
Anybody else losing their mind right now?
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Literally stop whatever you're doing and relax until test day would be my advice.
 
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THH said:
Don't stress, man. I bet you end up 255+.
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I hope so. Honestly feeling like there's no way that's going to happen, despite what I've heard and despite preaching the same thing to others on this board haha. Really made me feel like I didn't know **** compared to what I though I knew.

FA2014 said:
If there were that many, how should we prepare for them?
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Just happen to know what's going on. Stuff like this is why doing as well as possible in class is the most important step.
 
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I need some advice. I've done DIT, gone through FA once (while doing DIT) and uworld once. Here are my scores:

NBME 7 (5 weeks out, post-DIT/FA): 224
NBME 11 (4 weeks out, 25% uworld completed): 217-I took it at night, after a day of studying; probably why I scored so poorly.
uworld completed (Randomized, timed blocks): 73%
NBME 15 (2 weeks out, uworld completed): 249- Not sure if this was a fluke, due to my poor performance on NBME 11
UWSA1 (12 days out): 800/265

I have 11 days till the big day. I'm debating whether or not I should go through my uworld wrongs or just blast through FA/BRS physio. My two weakest sections are physiology and anatomy. The NBME 15 and UWSA1 scores brought up my confidence, but I am still a little nervous because of my performance on NBME 11. I plan to take UWSA2 and NBME 15 the week prior to the exam. Do you guys think I should spend time going through uworld again or just focus on FA?
 
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Chemdude said:
I need some advice. I've done DIT, gone through FA once (while doing DIT) and uworld once. Here are my scores:

NBME 7 (5 weeks out, post-DIT/FA): 224
NBME 11 (4 weeks out, 25% uworld completed): 217-I took it at night, after a day of studying; probably why I scored so poorly.
uworld completed (Randomized, timed blocks): 73%
NBME 15 (2 weeks out, uworld completed): 249- Not sure if this was a fluke, due to my poor performance on NBME 11
UWSA1 (12 days out): 800/265

I have 11 days till the big day. I'm debating whether or not I should go through my uworld wrongs or just blast through FA/BRS physio. My two weakest sections are physiology and anatomy. The NBME 15 and UWSA1 scores brought up my confidence, but I am still a little nervous because of my performance on NBME 11. I plan to take UWSA2 and NBME 15 the week prior to the exam. Do you guys think I should spend time going through uworld again or just focus on FA?
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I recommend going over u-world wrongs. I completed my first pass of u-world at 71% on mostly timed-random 46q blocks. And I have certainly reinforced some details after re-doing the wrongs. And the review is much quicker. If you buckle down, you can get it done in 3 days or less, giving you time to touch on weak areas.
 
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NeuroLAX said:
He says 1) first, stick a needle in the 2nd IC space to relieve pressure. 2) Then you stick the chest tube in.

If I remember correctly, UWorld's explanation is:
Midclavicular line: 5-7
Midaxillary: 7-9
Posterior: 9-11
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Thanks guys (Neurolax and Notbobtrustme)! Neurolax that's what I thought too but i was confused about the 2nd ic-Mc part...so a question will probably ask about the 5-7, 7-9, stuff b/c the 2nd IC MC is just a random place that's in the space where the lung would be so as to relieve the pressure right? This is odd to me though b/c what are you supposed to do in real life with that hole in the 2nd mc? Lol. Just leave it there and then do the 5-7 thing? Whaaaaaaaaa, haha sorry to dwell. I guess i'm getting confused b/c emedicine says Chest tube 4-5th ic MidAX and wiki says 8,9th midax. WHAT is going on? ughhhhhh

Orchitis, can you shed ANY light on what "safety and quality control" are?
 
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i am really starting to worry about ppl saying that heartsounds are presented without history and skin pics r put in again without history and anat pics put in also to identify the muscle or area and saying lots of biostats and genetics question(ofcrse which i am weak in) and management questions......i am just freaking out at this point..
FA+UW+Pathoma is the only thing i hav looked at
Any word of advice to improve on the above stuff thats been stirring up mind for some days now
 
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Annabelle27 said:
i am really starting to worry about ppl saying that heartsounds are presented without history and skin pics r put in again without history and anat pics put in also to identify the muscle or area and saying lots of biostats and genetics question(ofcrse which i am weak in) and management questions......i am just freaking out at this point..
FA+UW+Pathoma is the only thing i hav looked at
Any word of advice to improve on the above stuff thats been stirring up mind for some days now
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Don't worry about it. If something is hard for you and hasn't shown up in the main study resources, odds are that most everyone will struggle with those questions. Just use the information you know to arrive at the best answer. Remember that the exam is curved and it's unlikely that a few questions on low yield topics will make or break your score. Most people who have taken the exam say that they regret missing the questions that are straight out of first aid much more than the obscure, out-of-nowhere questions.

Keep in mind that many people who take longs exams such as this will remember mainly the questions they struggled with and forget about most of the easy questions that took 10 seconds to answer.
 
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Annabelle27 said:
i am really starting to worry about ppl saying that heartsounds are presented without history and skin pics r put in again without history and anat pics put in also to identify the muscle or area and saying lots of biostats and genetics question(ofcrse which i am weak in) and management questions......i am just freaking out at this point..
FA+UW+Pathoma is the only thing i hav looked at
Any word of advice to improve on the above stuff thats been stirring up mind for some days now
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The heart murmur identifications should honestly be pretty easy points. If you are able to #1 identify where the murmur is (A, P, T, M) and #2 whether it's diastolic or systolic, that gets you probably 90% of the murmurs right there. S3 and S4 will be made pretty obvious, and PDAs and muffled heart sounds are even more obvious.

As for anatomy, just hope for the best...I wouldn't bother with any resources outside of the three you're using.
 
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@RandomHero117 @Que Thanks guys...makes me feel a lot better..i just got so overwhelmed by just hearing how hard the exam has gotten with all these new randoom stuff..
I would rather stick with my main resources!FA+UW+Pathoma
 
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Heart sounds aren't too bad imo. It's not like they're going to invent NEW heart sounds just for this exam. Just know where you hear them best and what the phonogram looks like and you're solid. I personally think that's one of the topics that is a bit difficult to "trick" someone on, if you understand each heart sound very well (including conditions associated w/ each one, what increased/decreased afterload will do it it/etc). And there aren't too many. There's no reason NOT to know them well since as mentioned there aren't too many and you're bound to get asked about them.
 
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THH said:
Don't stress, man. I bet you end up 255+.
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AlmostAnMD said:
Heart sounds aren't too bad imo. It's not like they're going to invent NEW heart sounds just for this exam. Just know where you hear them best and what the phonogram looks like and you're solid. I personally think that's one of the topics that is a bit difficult to "trick" someone on, if you understand each heart sound very well (including conditions associated w/ each one, what increased/decreased afterload will do it it/etc). And there aren't too many. There's no reason NOT to know them well since as mentioned there aren't too many and you're bound to get asked about them.
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I had few heart sounds on the exam. One or two, however, were pretty much just a one-two line vignette and the sound. Using the little info in the vignette, the location where it was loudest and whether it was systolic/diastolic I was able to narrow it down.
 
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1dayatatime said:
Thanks guys (Neurolax and Notbobtrustme)! Neurolax that's what I thought too but i was confused about the 2nd ic-Mc part...so a question will probably ask about the 5-7, 7-9, stuff b/c the 2nd IC MC is just a random place that's in the space where the lung would be so as to relieve the pressure right? This is odd to me though b/c what are you supposed to do in real life with that hole in the 2nd mc? Lol. Just leave it there and then do the 5-7 thing? Whaaaaaaaaa, haha sorry to dwell. I guess i'm getting confused b/c emedicine says Chest tube 4-5th ic MidAX and wiki says 8,9th midax. WHAT is going on? ughhhhhh

Orchitis, can you shed ANY light on what "safety and quality control" are?
Click to expand...

It's like stuff they'd teach at teamwork and interprofessional seminars. Honestly don't remember one of the terms they threw at me, but that's exactly the kind of stuff it struck me as.
 
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I wasn't going to post here, but I think I should to alleviate the doom-and-gloom. I took the test a few days ago and it is not as crazy as everyone is making it out to be. Preparing with UWorld + FA + Pathoma prepared me very well, I feel. It is much like the NBMEs. There are less "trap" answers than there are in UWorld, making it possible to "back into" some correct answers that I would've otherwise taken the trap bait on. Sure, they will throw some random stuff you've never heard of at you (MELAS? Polyglandular Autoimmune Syndrome?), but you can deal with it if you understand principles of pathology.

You can tell that each test is randomly generated from the master question pool due to the variation in which topics were emphasized between person-to-person posting here. I'm sure the NBMEs are engineered to cover a broad range of topics, so any "lumpiness" in topic selection is smoothed out by a human hand; I don't think real deal has that kind of intervention. My point is that you will get several questions on a specific topic and nothing on others, and that is OK. I got four questions on Burkitt lymphoma and none on any other leukemias/lymphomas. I got zero questions on GU cancer. I had two questions in the same block asking about the interaction between ACE-I's and thiazides w.r.t. serum K+. Don't let it freak you it. And also don't listen to others about what which topics were emphasized and which were de-emphasized, because yours will likely be very different. I read everyone's posts about how much anatomy there was and wasted my time studying BRS Anatomy, because I didn't have much. Just rely on the studying you've done and you'll be fine.
 
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HatWobble said:
I wasn't going to post here, but I think I should to alleviate the doom-and-gloom. I took the test a few days ago and it is not as crazy as everyone is making it out to be. Preparing with UWorld + FA + Pathoma prepared me very well, I feel. It is much like the NBMEs. There are less "trap" answers than there are in UWorld, making it possible to "back into" some correct answers that I would've otherwise taken the trap bait on. Sure, they will throw some random stuff you've never heard of at you (MELAS? Polyglandular Autoimmune Syndrome?), but you can deal with it if you understand principles of pathology.

You can tell that each test is randomly generated from the master question pool due to the variation in which topics were emphasized between person-to-person posting here. I'm sure the NBMEs are engineered to cover a broad range of topics, so any "lumpiness" in topic selection is smoothed out by a human hand; I don't think real deal has that kind of intervention. My point is that you will get several questions on a specific topic and nothing on others, and that is OK. I got four questions on Burkitt lymphoma and none on any other leukemias/lymphomas. I got zero questions on GU cancer. I had two questions in the same block asking about the interaction between ACE-I's and thiazides w.r.t. serum K+. Don't let it freak you it. And also don't listen to others about what which topics were emphasized and which were de-emphasized, because yours will likely be very different. I read everyone's posts about how much anatomy there was and wasted my time studying BRS Anatomy, because I didn't have much. Just rely on the studying you've done and you'll be fine.
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True. Definitely fired up right after my exam - didn't mean to scare anybody. You're completely right about the following:

1. Uworld+Pathoma+FA is an excellent trio, and will prepare you better than anything imo.
2. Forms will definitely vary, so don't freak out. Just be prepared to get asked questions in ways you're not familiar with. I had two pharm questions in the same block asking literally the same thing. I was like what?
3. Speaking of APS, there's a new section of Pathoma out, which I just happened to notice because someone mentioned it. Turned out I got a question straight from it. I cannot say enough amazing things about Dr. Sattar; Pathoma was an amazing resource.
 
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HatWobble said:
I wasn't going to post here, but I think I should to alleviate the doom-and-gloom. I took the test a few days ago and it is not as crazy as everyone is making it out to be. Preparing with UWorld + FA + Pathoma prepared me very well, I feel. It is much like the NBMEs. There are less "trap" answers than there are in UWorld, making it possible to "back into" some correct answers that I would've otherwise taken the trap bait on. Sure, they will throw some random stuff you've never heard of at you (MELAS? Polyglandular Autoimmune Syndrome?), but you can deal with it if you understand principles of pathology.

You can tell that each test is randomly generated from the master question pool due to the variation in which topics were emphasized between person-to-person posting here. I'm sure the NBMEs are engineered to cover a broad range of topics, so any "lumpiness" in topic selection is smoothed out by a human hand; I don't think real deal has that kind of intervention. My point is that you will get several questions on a specific topic and nothing on others, and that is OK. I got four questions on Burkitt lymphoma and none on any other leukemias/lymphomas. I got zero questions on GU cancer. I had two questions in the same block asking about the interaction between ACE-I's and thiazides w.r.t. serum K+. Don't let it freak you it. And also don't listen to others about what which topics were emphasized and which were de-emphasized, because yours will likely be very different. I read everyone's posts about how much anatomy there was and wasted my time studying BRS Anatomy, because I didn't have much. Just rely on the studying you've done and you'll be fine.
Click to expand...


reminds me of NBME 16, when everything related to the gut had to do with gastrinomas.
 
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I could use your advice, peeps.

Step 1 is 11 days out. I'm finishing up UWorld and should be done tomorrow. After that I've got a two-day block in my schedule. Do you think I should:

A. Quickly review my UWorld and USMLERx incorrects, or
B. Power through USMLERx and finish it off (I'm 70% done)

I'll be one week out when I'm done with either A. or B.
 
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Fox800 said:
I could use your advice, peeps.

Step 1 is 11 days out. I'm finishing up UWorld and should be done tomorrow. After that I've got a two-day block in my schedule. Do you think I should:

A. Quickly review my UWorld incorrects, or
B. Power through USMLERx and finish it off?

I'll be one week out when I'm done with either A. or B.
Click to expand...

Rx is way more helpful than Uworld incorrects.
 
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Thanks to those that have posted their exam experiences. Definitely interesting to hear. Took NBME 16 this am and got a 260. So far my progression has been:

3 weeks out- NBME 15- 251
2 weeks- UWSA1- 265
1 week- NBME 16- 260

Hope to just maintain this level and hit 260 this time next week. I'm kind of concerned that I may have peaked too early and hope I don't forget things, but nothing I can really do about it at this point.
 
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Fox800 said:
I have a pretty good short-term memory, my fear is that I'll recognize the answers right away and then get really bored reading the same explanations all day long for two days in a row.
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yea, so many of Uworld's explanations are basically saying nothing, but in 5 paragraphs.
 
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Polymyxin said:
Yeah, especially because many questions in the pool of "incorrects" after finishing UWorld are low-yield.
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This makes sense. When I re-do a block of incorrects, the averages are usually in the 40s and low 50s. Never in the 60s. When I first started u-world, random block averages were high 50s-low 60s.
 
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Polymyxin said:
Yeah, especially because many questions in the pool of "incorrects" after finishing UWorld are low-yield.
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Fry-can-t-tell-meme-generator-not-sure-if-sarcasm-or-serious-e14739.jpg
 
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no no...not being sarcastic. If you finish with a 70% average or something (not me, btw), you're left with only 30% of questions. These aren't just a random bag of questions. They likely represent the toughest questions (esp if you finished with >70% average). Granted, it is important to solidify the knowledge in those questinos, but you run the risk of forgetting the higher yield info.
 
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My exam is in coming up (week and a half) and I was hoping for advice. My goal is to get a 250.
Practice scores are:
NBME 11: 230 (4 weeks out)
NBME 12: 241 (3 weeks out)
NBME 13: 243 (2 weeks out)
NBME 15: 245 (1.5 weeks out)

I am going to take NBME 16 a few days before the actual test, as well as the Free 150 (both are set in stone in my schedule). But as far as trying to boost into the 250s, what would be the best approach? I am going through First AID memorizing as much as possible, but as far as doing practice questions, I am looking for advice. Should I redo UWorld, continue doing more Rx questions, do a mix of the two? and most importantly, should I try to squeeze in UWorld self-assessment exam? Since time is running out, I just want to maximize my chances of getting into 250. The more questions the better, but should I waste time with UWorld SA?
 
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notbobtrustme said:
chin up, just about every single poster in this thread who felt the same as you ended up scoring right where they were predicted to.

In fact, I don't recall anyone doing worse than what they were predicted to do. Quite a few people made some significant jumps. Go drink a beer or 50 and relax. I know it's tough to "turn it off" but try!
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Trust me, I did exactly where my NBMEs averaged out.
Something seldom written about is the post-exam experience.

I came out of the exam feeling light, and my friends who came to pick me up asked me how it went. I said "Fine, I don't know. It could either way on 50% of that test." As I sat in the back of the car I started to have flashbacks to questions. "****, that s.hit was uremia! How the f.uck did I screw that up?" "Holy S.hit was that nerve the obturator?" "F.uck that other answer was temporal, wtf!" I came home and started to have a few drinks with my friends → getting drunk. My friends caught me upstairs at 3:00 AM looking through Netter's. "F.UCK YEAH, it was obturator!" I exclaimed. They shook their head and took me to their home.

Over the course of the next week I recalled 40 "iffy" questions. On some I would check the books and find that I was right. On others I would check and find that I was wrong. A few of them were just grey area. It was a melodramatic bipolar roller coaster. I went to the gym. I checked out supplements. I started working on what was next. I made phonecalls to everyone I blew off during the prep stage. I fought with my girlfriend every day over mundane bull and damn near broke up with her.

I started to expect 200s at a point. I started to see what my options were. I started cursing myself for being an idiot. I started running calculations based on how many flagged errors I had in Uworld vs unflagged errors and my nbme errors correlated with step 1 scores and anecdotal evidence from SDN and every other forum on the net. These calcs were NEVER reassuring.

It sucked ass. It really did. It was uncomfortable as hell. I really should have just not thought about it. In hindsight I should have simply made a plan that would keep me busy as hell for 4 weeks.

I ended up getting a 254. It was exactly how my averages on the exams were. The exam is a pretty just one 99% of the time. If a question makes you go wtf and you can't figure out what it is, it's like that for everyone else and that's why it's still an "experimental." Uworld doesn't have that. The NBMEs don't have that. Messed up questions, aren't removed on them. That's why you will generally always score at your average or better on the steps.
 
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My experience so far:

Resources: UWorld, Pathoma, First Aid, DIT, SketchyMicro

Practice scores:
NBME 16 (10 weeks out, baseline before beginning studying): 185
NBME 13 (5 weeks out): 247
NBME 12 (4 weeks out): 245
UWorld finished (4ish weeks out): ~70%? I don't remember, and I reset my account..
NBME 11 (3 weeks out): 260
NBME 7 (10 days out): 260
NBME 15: (7 days out) : 258
Free 138: 94%
UWSA2: 265​

I used UWorld + Pathoma + First Aid for my first pass which took about 5 weeks. I went through FA in order. Biochem/micro/pharm took me a while; I read the FA chapter and searched google/youtube for clarification with concepts I didn't understand. Honestly, I just tried to read as much as possible, because FA felt like bare bones especially for biochem. I also did the corresponding UWorld questions on untimed, tutor mode (sets of about 10 questions each). This was an immense help early in the process because I started to realize which concepts were emphasized and which weren't, and obviously UWorld explanations are extremely thorough so it was a great addition to FA. SketchyMicro was amazing for bacteriology, especially for people who are visual learners like me. My performance on UWorld micro section jumped from 50% to 80-90% after completing it. Once I got to pathology/immunology and the organ systems, my strategy changed and became more focused. I watched Pathoma while actively taking notes in the margin (extremely important, in my opinion) and then read the chapter again after having watched the video. I then read FA and again did the corresponding UWorld questions (untimed, tutor).

After my first pass through all of the material, I took NBME 13 to assess my progress and was pretty happy with the result. Since I still had 5 week left, I started the DIT course; I just watched the videos and re-read the corresponding chapters in FA and was done in about 3 weeks. I found the DIT study guide to be a waste of time, but I guess I can see how it would be useful if you had a lot more time left before the exam. I was definitely wiped after that, since I was watching 4-5 hours of videos a day. It felt too passive, but my scores did jump after having completed it. I'm honestly not sure if it's because of DIT or because of the second pass through FA... As for practice questions, I started UWorld second pass and did 20ish question sets whenever I felt like it. I haven't found it helpful in terms of learning anything new, but I do think it's great for retaining information. It's extremely important to constantly do questions and keep your mind engaged.

I'll update with my test day experience when it comes, and then hopefully a happy ending a few weeks after that, haha.

Goal: 245
Actual: ???
 
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Do any of you all have a good understanding of the timing of aspirin overdose in terms of respiratory alkalosis (early) vs metabolic acidosis (late)? I got a question wrong about it in UWorld, and then using that knowledge I subsequently missed another one on the new "Free 138".
 
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Renaissance Man said:
Do any of you all have a good understanding of the timing of aspirin overdose in terms of respiratory alkalosis (early) vs metabolic acidosis (late)? I got a question wrong about it in UWorld, and then using that knowledge I subsequently missed another one on the new "Free 138".
Click to expand...
Early, stimulates the respiration center. Late is because aspirin is an acid and promotes an anion gap metabolic acidosis.
 
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Hey can anyone who took the test talk about the length of the questions relative to say UWORLD or NBME, and what you thought about the timing? That's something that I'm fairly concerned about not being prepared for during test day.
 
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Renaissance Man said:
Yeah I get that much...as far as patient X presents "3 hours after ingestion 50 aspirins" is that early or late?
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yeah i got this question wrong solely because i didn't know how many hours meant early or late. i narrowed it down to resp alkalosis and metabolic acidosis and it ended up being the latter. from what the explanation said, since it was HOURS since she took the pills it had to be late. so metabolic acidosis. i'm guessing if it was w/in the first hour or mins then it's resp alkalosis. what was the free 138 q like? did it say hours too? regardless i thought this was a stupid question.
 
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crazyozone said:
Hey can anyone who took the test talk about the length of the questions relative to say UWORLD or NBME, and what you thought about the timing? That's something that I'm fairly concerned about not being prepared for during test day.
Click to expand...

Have you been using UWorld on timed mode yet? Have you taken an NBME? Doing both of those things will help.
 
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orchitisphlebitis said:
3. Speaking of APS, there's a new section of Pathoma out, which I just happened to notice because someone mentioned it. Turned out I got a question straight from it. I cannot say enough amazing things about Dr. Sattar; Pathoma was an amazing resource.
Click to expand...

Is this 2.4 Autoimmune disorders?
 
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FA2014 said:
Is it worth it to go over DIT 2012 if you don't have the latest?
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I used the 2014 course, but prior to starting it I downloaded the 2011 version online. I watched a few of the biochem videos and found it somewhat helpful, but it was also frustrating not being able to flip to the page references in my 2014 FA. The quality of the lectures and explanations was also lacking in my opinion (a lot of reading straight out of FA), but they've really improved their 2014 course. Although I'm still not sure it's worth the money they charge. I have no idea how 2012 compares to 2011 or 2014, but I'd suggest giving it a try if you've already gone through the material yourself. You'll be able to figure out pretty quickly if it's for you. However, if you have less than 3-4 weeks until your exam, I'm not sure that it's worth the time and effort.
 
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Fox800 said:
Have you been using UWorld on timed mode yet? Have you taken an NBME? Doing both of those things will help.
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Yeah I did UWORLD on timed/random and I've taken 1 NBME so far. I'm just wondering how the step stacks up in terms of question length.
 
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jambio said:
I used the 2014 course, but prior to starting it I downloaded the 2011 version online. I watched a few of the biochem videos and found it somewhat helpful, but it was also frustrating not being able to flip to the page references in my 2014 FA. The quality of the lectures and explanations was also lacking in my opinion (a lot of reading straight out of FA), but they've really improved their 2014 course. Although I'm still not sure it's worth the money they charge. I have no idea how 2012 compares to 2011 or 2014, but I'd suggest giving it a try if you've already gone through the material yourself. You'll be able to figure out pretty quickly if it's for you. However, if you have less than 3-4 weeks until your exam, I'm not sure that it's worth the time and effort.
Click to expand...

When is the ideal time to use DIT? In dedicated period?
 
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