Official 2014 Step 1 Experiences and Scores Thread

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Regarding heart sounds, in Marfan's you'd be looking for MVP or AR. I had a question on my real Step1 that required you moved the stethoscope to the right location to get it right. Then it was the characteristic murmur as expected.

I think it's HY for Step1 to know what S3/4 are/signify, but I'd actually be amazed if a student were required to identify them on the exam. In real life, they're actually not that common. I've seen lots of cardio patients and every time I've thought I might have heard that extra diastolic sound it was just AF (you can call my auscultation skills inept, but it is what it is). AF is insanely common (8% over age 80). On the Step1, I'd say AS/AR + MR/MS + MVP are all you need to know murmur-wise. And if it's an IV drug user then just use your common sense.

But just upgraded from my dad's old 1984 Littmann to the Master Cardiology. Was hoping to get through med school with the throwback but I've finally given in.
 
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Damn, I've been keeping my fingers crossed for having to identify a PDA.

I'm assuming if we get an IVDA I'd go straight for the lower left sternal border.
 
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NeuroLAX said:
Damn, I've been keeping my fingers crossed for having to identify a PDA.

I'm assuming if we get an IVDA I'd go straight for the lower left sternal border.
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I know someone who had a PDA murmur on the real exam. For some reason I wasn't in paeds mode when I made my last post, but yeah, PDA definitely shows up.
 
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FA2014 said:
Looking at your scores, I think I should include DIT too with the trio. I won't be losing anything and it will only be a good review if not more. Also, what do you think about redoing an NBME if you haven't gone over the quesitons?

p.s. I think I will follow your steps and pray I get scores in your range.
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I'll warn you, you may get discouraged with DIT at the end of your first week in, as I did. I felt like I was wasting my time because I was hearing things that I (thought I) already knew and could be spending time on things I didn't know as well... but stick to it. It's good to solidify the basics (if you have the time). It never hurts to hear the important stuff multiple times.

I think your time would be better spent doing a new NBME that you haven't done (if you have any left) and then just go over the wrong answers of the ones that you already did. Especially if it means you have to pay $60 to redo it.
 
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As I finish up uworld I've run into 2 questions from the lac operon thing. Ugghhhhh I knew it well in undergrad for biochem but that already hit my mental wastebasket long ago. I don't even think my med school biochem class covered that.

Started to review it but then realized test is on Tuesday. Ain't got time for that s*** yo. Hoping I just don't get a Q on it but with my luck I'll get an entire block of lac operon questions

then burn down prometric
 
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AlmostAnMD said:
As I finish up uworld I've run into 2 questions from the lac operon thing. Ugghhhhh I knew it well in undergrad for biochem but that already hit my mental wastebasket long ago. I don't even think my med school biochem class covered that.

Started to review it but then realized test is on Tuesday. Ain't got time for that s*** yo. Hoping I just don't get a Q on it but with my luck I'll get an entire block of lac operon questions

then burn down prometric
Click to expand...

I am due on Wednesday 🙂
 
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04/03: CBSE: 215
04/10: UW SA1: 224
05/04: NBME 11: 241
05/19: UW SA2: 265
05/26: NBME 15: 254
05/28: 2013 Free 150: 92%
05/30: NBME 13 offline: 93%
06/2: NBME 16: 262
06/5: 2014 Free 150: 96%
Second pass UWorld %: 87%

I take the exam tomorrow; I will post back here with my thoughts. I also plan to write up how I studied and what materials I used, since I didn't start particularly well (low CBSE score) I thought it might be nice to see that you can actually improve a lot with hard studying.
 
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Diggidy said:
04/03: CBSE: 215
04/10: UW SA1: 224
05/04: NBME 11: 241
05/19: UW SA2: 265
05/26: NBME 15: 254
05/28: 2013 Free 150: 92%
05/30: NBME 13 offline: 93%
06/2: NBME 16: 262
06/5: 2014 Free 150: 96%
Second pass UWorld %: 87%

I take the exam tomorrow; I will post back here with my thoughts. I also plan to write up how I studied and what materials I used, since I didn't start particularly well (low CBSE score) I thought it might be nice to see that you can actually improve a lot with hard studying.
Click to expand...

Best of luck! I too am looking forward to hearing about your study plan



Sent from my iPod touch using Tapatalk
 
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AlmostAnMD said:
As I finish up uworld I've run into 2 questions from the lac operon thing. Ugghhhhh I knew it well in undergrad for biochem but that already hit my mental wastebasket long ago. I don't even think my med school biochem class covered that.

Started to review it but then realized test is on Tuesday. Ain't got time for that s*** yo. Hoping I just don't get a Q on it but with my luck I'll get an entire block of lac operon questions

then burn down prometric
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Glucose Inhibits the CAP
Lactose Inhibits the Repressor

The CAP promotes transcription
The repressor inhibits it

Therefore Glucose is against transcription
And Lactose is for it

You need Low Glucose and High Lactose for it to work because you need that CAP to start, but the represser is a huge cock block for transcription and you don't want it there.
 
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Modeselektor said:
Glucose Inhibits the CAP
Lactose Inhibits the Repressor

The CAP promotes transcription
The repressor inhibits it

Therefore Glucose is against transcription
And Lactose is for it

You need Low Glucose and High Lactose for it to work because you need that CAP to start, but the represser is a huge cock block for transcription and you don't want it there.
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Lol, thanks for this.
 
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Just think of the repressor as a cock block and lactose is your wingman ready to take it down.

You look jacked as hell since you been on this low carb (no glucose) diet so you looking good and ready for action.
 
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This is something I've been wondering -- does everyone take the same exam on the same day? I've heard no, but how else can they set a curve and give you a standardized score if everyone's exam is just randomly generated from the question bank.
 
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Diggidy said:
This is something I've been wondering -- does everyone take the same exam on the same day? I've heard no, but how else can they set a curve and give you a standardized score if everyone's exam is just randomly generated from the question bank.
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It's probably on a % of those who answered correctly on a question by question basis.

I'm not sure if it's balanced out overall by test beforehand either; ie one person could wind up with form, that when after graded/reviewed, has a much higher number of questions which only 30% of takers got right. I had a friend with whom I took the test with practice scores hovering below average-average, and he didn't think it was as bad as me. Either that, or I just **** the bed on test day.
 
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Took it today. Definitely a fair test. Thought most of it was straightforward. Almost every question can be narrowed down to 2 options and reasoned out. There were 1-2 questions per block that were total wtfffff type questions (for some I had never even heard of the answer choices), but nothing you can do there. Make a guess and move on and don't let it get you down. (I'm hoping some were experimental).

For those who are interested, I had a ton of questions on renal stones (probably 9 or 10) and a quite a few really tough CTs, but everyone's test will vary. Pathoma was huge and probably got me 3-4 points I would have missed otherwise.

I'll write a full post when I get my score report. But for now I'm gonna drink until i forget everything I know about biochemistry.....
 
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Diggidy said:
how else can they set a curve and give you a standardized score if everyone's exam is just randomly generated from the question bank.
Click to expand...

orchitisphlebitis said:
It's probably on a % of those who answered correctly on a question by question basis.
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Yep, they probably generate an average % correct based on the averages of % correct for your questions and map your % correct to a score on a bell curve.

This way you are not actually competing with people taking the test on your day-- just people who took it before you.
 
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So is this the point of experimental questions? To get database of test-takers for a certain question before they start comparing people to them and scoring them?
 
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Diggidy said:
So is this the point of experimental questions? To get database of test-takers for a certain question before they start comparing people to them and scoring them?
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Nobody really knows. People speculate what experimentals are for and how they are implemented, but nobody actually knows.

I think what you are suggesting is right, which makes me think they may make all questions experimental for some point in time. However, most people here seem to think experimental = ridiculously hard off the wall questions, and that relatively easy questions will not be experimental.
 
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tartrate said:
Hmm...what about food/drink to bring for the big day?
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I packed a ton of stuff (sodas, waters, coffee mug, sandwiches, yogurt, cookies, etc etc etc) but barely ate any of it. Your adrenaline and nerves will power you through the day. Pack whatever makes you happy. I did have a hearty breakfast beforehand and I would say that's pretty clutch.
 
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whomikejones said:
I packed a ton of stuff (sodas, waters, coffee mug, sandwiches, yogurt, cookies, etc etc etc) but barely ate any of it. Your adrenaline and nerves will power you through the day. Pack whatever makes you happy. I did have a hearty breakfast beforehand and I would say that's pretty clutch.
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Is there an extra break time for lunch? Or just eat quickly between test blocks?
 
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Ionian said:
Is there an extra break time for lunch? Or just eat quickly between test blocks?
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Just eat quickly. You get an allotted time for the day to use as you see fit. Skipping the tutorial adds an extra 15 minutes. Pretty sure you can leave and go get Chinese across the street if you budget the time for it.

I took break after each of the last 4 blocks, just to get some water, some food in. I needed it towards the end. I ended up with like 5 minutes of break left.
 
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Papist said:
Hard to truly feel ready.

As I wind down my prep (taking on Monday), I keep recalling concepts I need to review but there's just no more time.
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Agreed. I have been doing fine on practice exams, but as I keep going through things I see details that previously went overlooked or I've just forgotten, which always gives me some momentary anxiety. Just gotta go with the flow I guess and trust that you'll be able to answer what they throw at you in the moment.
 
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Congrats to those who took it today! Do you think the question length affected your fung shui? Or do you think your previous practice prepared you well for the ridiculously long stems?

How was biostats/behavioral? I'm using brs behavioral but I'm worried even these is outdated compared to the things usmle is throwing up.
 
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Took it today. It is a very surreal feeling being done. Here's my two cents.
First off, it felt just like the NBMEs on the UWorld interface. Question length was very similar to nbme 15/16. I did not feel "influenced" to answer an answer based on my nbmes as someone asked earlier. I didn't have any repeats but very similar questions to NBME and uworld. Trust your prep.
Obviously there were 2-3 questions per block that you have never seen anything on and make an educated guess, but there is no way you can prepare for them-EXCEPT take as many questions as possible. You start to recognize patterns and are better served to answer WTF questions. I agree with the above poster who described it as fair. I at no point felt overwhelmed by obscure things.
My exam was well pretty well balanced. I had a good mix of anatomy, Phys with arrow questions, and just straight annoying behavioral "what's the best response out of these 5 things that you would never actually say to a patient". I also had a ton of difficult micro-here's a picture and two clinical facts then tell the organism/tx/mechanism of virulence. I felt like mine was more than 90% path. Probably an exaggeration but It was very path heavy which played to my strengths. I didn't get the feeling of "experimental questions" but I'm sure they were there. Minimal next step questions but a few and they were not fun. I hate that s***.
The majority came straight from first aid, pathoma, Rx and uworld. But I can't emphasize enough the idea of learning things the first time. I pulled info out of my arse that I never thought I would use from first year. Especially anatomy. Pathoma was gold. I would kiss sattar if I could.
Honestly, everyone puts the exam p**** on a pedestal but it is doable if you prepare. Put in the work and you will feel it on exam day. For those of you who are taking it in the next few days you'll feel like you don't know anything but you'll start the exam and get rolling. Review micro and the pharm section of FA. It was high yield and stuff that's so much easier when it's fresh. But seriously relax and trust your prep.
I was scoring 260+ on NBME exams and have no idea where I will end up. My goal from the beginning was 250+ and I will be happy with that. 322 questions is a lot and you're bound to get some wrong. I have tried to forget but your neurotic brain will remember stupid ones that you will look up and get wrong. That's how it goes. You honestly can't judge where you're at when it's done. I will update when I get my score back. Good luck to everyone taking it soon, it's the best damn feeling submitting that last block.
 
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Took my exam yesterday and it feels so good to be done. Felt like crap leaving the exam though, just like everyone says. I hope that I score anywhere close to what my nbme scores were. I'll give a more detailed write up after I get my score back.
 
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FA2014 said:
Ok, I'll do DIT after I'm done with UW. Did you review everything before taking an NBME or do you review everyday?
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I'm not sure how you could even review "everything" before taking an NBME. I took my second NBME immediately after finishing my first pass through the material that took about 5 weeks, but I didn't do anything special the day before. The rest of the NBMEs I just took 1 week from each other spaced out between DIT (1 week into DIT, 2 weeks into DIT, and after finishing DIT).
 
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Don't understand what the big deal is over the "updates" to Pathoma. Granted I only bought it within the last 3 months, but I only noticed a couple of things that were said to be "updated" and it was nothing major. APS? 3 sentences in Robbins gives you all you need to know about it.
 
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The burnout is real. I'm eight days out.

Yesterday I was so sick of looking at UWorld that my muscles were tensing up and I was starting to get a headache. I was having a physical aversion to looking at any more questions.

So, I decided to take the night off. Got an hour-long deep tissue massage, drank some beer, and watched Dr. Strangelove with a friend. Slept from 12:30-9:30. I think that was a smart move.
 
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Fox800 said:
The burnout is real. I'm eight days out.

Yesterday I was so sick of looking at UWorld that my muscles were tensing up and I was starting to get a headache. I was having a physical aversion to looking at any more questions.

So, I decided to take the night off. Got an hour-long deep tissue massage, drank some beer, and watched Dr. Strangelove with a friend. Slept from 12:30-9:30. I think that was a smart move.
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I feel ya. I'm almost at that point. Last night I found myself mixing up TTP and vWF-defiency on a question....decided to call it a night.
 
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4thQTHailMary said:
Don't understand what the big deal is over the "updates" to Pathoma. Granted I only bought it within the last 3 months, but I only noticed a couple of things that were said to be "updated" and it was nothing major. APS? 3 sentences in Robbins gives you all you need to know about it.
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The diseases updated in Chapter 2.4 were, in my opinion, not high yield. this update is not essential to your studying. Therefore, in typical formal fashion, I suggest that everybody PANIC.
 
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