Official 2014 Step 1 Experiences and Scores Thread

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Probably Renal, it's the one section I never enjoy studying, yet renal problems are so commonplace that I can't even try to act like it isn't worth my time to master it.


Anyone know why drinking alcohol exacerbates carcinoid signs? This is probably some simple biochem principle, but I haven't reviewed it yet. Searched online, but it just says eating a lot and drinking alcohol can make it worse. The food makes sense, the alcohol I don't get.
 
Probably Renal, it's the one section I never enjoy studying, yet renal problems are so commonplace that I can't even try to act like it isn't worth my time to master it.


Anyone know why drinking alcohol exacerbates carcinoid signs? This is probably some simple biochem principle, but I haven't reviewed it yet. Searched online, but it just says eating a lot and drinking alcohol can make it worse. The food makes sense, the alcohol I don't get.
Check out dat second enzyme

Serotonin_2_clip_image006_0000.gif


would be a shame....if it were to be too busy (saturated) with some other work.... A poor liver digesting all the serotonin coming to it by portal vein would be unable to handle it all.


metabolic.gif
 
I know this has been asked a lot but is FA + UW sufficient for molecular biology ? I read HY molecular bio earlier in my prep,can anyone please suggest if I should go through it one more time? I am freaking out cuz my exam is in 10 days and wondering if its effective use of my time. Thanks !
 
Thank you @Modeselektor ! I know the alcohol metabolism pathway, knew about MAO, and the urinary product to look for being HIAA, but completely missed the step where aldehyde dehydrogenase was part of the pathway.


Which makes me wonder... would it be a mistake to leave biochem for first week of dedicated study? I only did that because I really don't have anywhere to easily fit it into my schedule through my last term. I thought I wouldn't be doing myself too big of a disservice since I'm covering literally everything else from basic sciences throughout this term, but things that should be simple like that make me wonder :/ Maybe I'll just try to flag those topics earlier on FC.
 
Thank you @Modeselektor ! I know the alcohol metabolism pathway, knew about MAO, and the urinary product to look for being HIAA, but completely missed the step where aldehyde dehydrogenase was part of the pathway.


Which makes me wonder... would it be a mistake to leave biochem for first week of dedicated study? I only did that because I really don't have anywhere to easily fit it into my schedule through my last term. I thought I wouldn't be doing myself too big of a disservice since I'm covering literally everything else from basic sciences throughout this term, but things that should be simple like that make me wonder :/ Maybe I'll just try to flag those topics earlier on FC.

For me, biochem is something I touch on over and over. The pathways just do not want to stick in my head, but it helped a lot when I drew everything out and included everything that was asked in uworld. And I was a biochem major.

It wouldn't hurt to leave biochem to your dedicated study. Once you start doing questions on it, it begins to stick, but keep the big picture in mind to help solidify all the details. Because they like to ask about the details. The important details. You learn which details they consider important by doing questions, but until then, I think it's something you can put off, but look things up as they come up, like the carcinoid syndrome and drinking connection.
 
I try to review biochem with FC, but nothing ever seems to really stick for me either. I think that as long as you have the basics down now you can cram the details later.
 
How are guys incorporating board studying with schoolwork? I'm a MS2 at a md school on organ systems curriculum. P/F too. Starting post winter break, I have focusing mainly on board studying. For example, doing all the renal uworld questions while on renal block plus also reviewing stuff from last semester...like trying to finish up cardio questions. I am aiming about 20 questions per day with 10 new block stuff and 10 review stuff. Problem is, it takes me 3 hours to annotate into first aid and review the questions. Even with that, I feel like I'm not really understanding the concepts since everything is so scattered. I'm also trying to incorporate RR but havent had much time to read it. Any suggestions?
 
How are guys incorporating board studying with schoolwork? I'm a MS2 at a md school on organ systems curriculum. P/F too. Starting post winter break, I have focusing mainly on board studying. For example, doing all the renal uworld questions while on renal block plus also reviewing stuff from last semester...like trying to finish up cardio questions. I am aiming about 20 questions per day with 10 new block stuff and 10 review stuff. Problem is, it takes me 3 hours to annotate into first aid and review the questions. Even with that, I feel like I'm not really understanding the concepts since everything is so scattered. I'm also trying to incorporate RR but havent had much time to read it. Any suggestions?

My advice to you (feel free to ignore it/take it with a grain of salt):

Stop doing Uworld. Now. It's undoubtedly your best source for boards study (after FA), and it's best used once you have a good understanding of the material. It's supposed to teach you, yes, but it's a great platform for learning how to think like you're supposed to for the test. If you want to do a qbank - and that's a very legitimate desire - do USMLERx. It's based off First Aid so much that it gives you the page number for each question. Not all of Uworld is in FA. Sometimes none.

If you were to switch to Rx, you'd be annotating directly into FA, and it shouldn't take you as long because most of the information is already there. I have found it useful to read a section, do some questions, annotate, and then reread everything in context. You reduce the "scatter" of material, because Uworld can be random at times, and you focus on improving your background knowledge. Once you start your dedicated time, then it's time to switch to Uworld.

Good luck!
 
I am sucking it up :-/

My test is May 5th. Currently reviewing different things and it is not going too well. In UWorld, I get a lot of questions wrong even though I feel I have a strong mastery of the subject. I seem to not get what they are asking, which is a problem. For example, I knew renal cold and I still get in the 56% range - not good. I can't figure out what they are asking. Any advice?

Side note: do you think Pathoma, FA, UWorld, and BRS Physio would be good enough to get a 240+?

Thanks all!
 
I am sucking it up :-/

My test is May 5th. Currently reviewing different things and it is not going too well. In UWorld, I get a lot of questions wrong even though I feel I have a strong mastery of the subject. I seem to not get what they are asking, which is a problem. For example, I knew renal cold and I still get in the 56% range - not good. I can't figure out what they are asking. Any advice?

Side note: do you think Pathoma, FA, UWorld, and BRS Physio would be good enough to get a 240+?

Thanks all!

Do u review all the answer choices? That's a good way of knowing why you got the answer wrong and figuring out what they are asking. You could also talk to a prof or a top notch student, that could help. I use to have the same problem too.

If you have a solid basic science background, your study material is good enough for your target. Maybe add Kaplan Q bank to your pile since u are having trouble with questions. The more questions you do, the better you become at figuring out what they are asking.
 
For a late may exam, would starting UWorld at the beginning of March sound adequate? March is also the beginning of the last block of classes, which goes through mid-may.

I want to save it after I've a couple of passes of FA and gotten through RX.
 
I am sucking it up :-/

My test is May 5th. Currently reviewing different things and it is not going too well. In UWorld, I get a lot of questions wrong even though I feel I have a strong mastery of the subject. I seem to not get what they are asking, which is a problem. For example, I knew renal cold and I still get in the 56% range - not good. I can't figure out what they are asking. Any advice?

Side note: do you think Pathoma, FA, UWorld, and BRS Physio would be good enough to get a 240+?

Thanks all!


Jaysus, I have the same problem!
 
Any thoughts on what order to take the NBMEs and other practice tests (I think there are 2 in UWorld, and one in Kaplan maybe)?
I am taking it in early April, shooting for a 250+ but I know that is reaching real hard. I have a six week dedicated period starting at the end of February, trying to figure out a good schedule. Probably going to use some combination of FA, UWorld, Kaplan, Pathoma, +/- Rx.
 
Thank you @Modeselektor ! I know the alcohol metabolism pathway, knew about MAO, and the urinary product to look for being HIAA, but completely missed the step where aldehyde dehydrogenase was part of the pathway.


Which makes me wonder... would it be a mistake to leave biochem for first week of dedicated study? I only did that because I really don't have anywhere to easily fit it into my schedule through my last term. I thought I wouldn't be doing myself too big of a disservice since I'm covering literally everything else from basic sciences throughout this term, but things that should be simple like that make me wonder :/ Maybe I'll just try to flag those topics earlier on FC.

1) don't sweat it I just googled serotonin metabolism and saw it in the images. I had actually assumed robbing all the NAD was how alcohol would do it, but I guess they use the same enzyme. 😉

2) I actually did biochem first, and I felt it kinda made certain aspects of physiology and pathology make more sense, but I don't think the sequence of subjects studied is anything to lose sleep over. At some point in the juggling act that is step 1 studying you'll have all the subjects remembered in your head at one time and things will click really nicely. 🙂
 
2) I actually did biochem first, and I felt it kinda made certain aspects of physiology and pathology make more sense, but I don't think the sequence of subjects studied is anything to lose sleep over. At some point in the juggling act that is step 1 studying you'll have all the subjects remembered in your head at one time and things will click really nicely. 🙂

LOL

Taking my test this week. This statement is somewhat true, but it made me laugh.
 
How many questions is everyone planning on doing per day during the dedicated study time? Should I spend more time doing questions or more time reading FA?
 
Are you guys doing questions on timed mode? I'm currently doing Rx random, untimed, however I find that my % correct falls 5-10% when doing timed questions.
 
LOL

Taking my test this week. This statement is somewhat true, but it made me laugh.

Its true man, I had to revise some stuff to keep it in my head, and then something else had fallen out of memory, so then I'd focus on that for a bit, then something else had come out. It literally felt like juggling.

edit: Good luck!!!
 
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Its true man, I had to revise some stuff to keep it in my head, and then something else had fallen out of memory, so then I'd focus on that for a bit, then something else had come out. It literally felt like juggling.

edit: Good luck!!!

Thanks, I appreciate it. I've been doing dedicated studying for 2 months now, and I'm ready to be done. I'll do a write-up of my test on Saturday, kick this thread off.

I feel like I'm catching little facts as they slip out of my ears and I have to shove them back in. I'm still not certain that I know very much, but going with my gut has seemed to work out pretty well on my practice tests. There is a lot of logic involved, and once you learn the way they like to ask questions, a lot of the trickier questions can get simplified. There's usually a method to the madness.
 
i was gonna go with Staph and H. flu--per pathoma. I haven't verified with that source but am pretty sure thats what it says.

I generally go with strep for any pneumonia consolidation. Staph only happens (on Step) after a viral infection. And H flu only happens in the unvaccinated. Either way, the stem will have to tell you one of those in medical history.
 
I generally go with strep for any pneumonia consolidation. Staph only happens (on Step) after a viral infection. And H flu only happens in the unvaccinated. Either way, the stem will have to tell you one of those in medical history.

H flu UNTYPEABLE happens in anyone--these are the strains that cause pna
 
H flu UNTYPEABLE happens in anyone--these are the strains that cause pna

I knew you were going to say that.

Of course it does, but in the scope of the boards, they will almost always tell you the vaccination status if it's relevant. I've yet to see a question that talked about any type of pneumonia where it's been H flu and the person was vaccinated. I haven't done every question, but I've done a lot.
 
I generally go with strep for any pneumonia consolidation. Staph only happens (on Step) after a viral infection. And H flu only happens in the unvaccinated. Either way, the stem will have to tell you one of those in medical history.

Sorry if this is dumb, but the term consolidation is not generally used for bronchopneumonia right? Would you still say its S.pneumo?


freaking new first aid and january.
 
Sorry if this is dumb, but the term consolidation is not generally used for bronchopneumonia right? Would you still say its S.pneumo?


freaking new first aid and january.

I'm sorry - I should have chosen my words more carefully. I meant for any non-atypical pneumonia, my gut reaction is S pneumo unless there are other clues, like alcoholic/history of seizures/non-vaccinated/recent viral illness. Though technically FA 2013 does refer to a bronchopneumonia as a consolidation, usually 'consolidation' is saved for lobar pneumonia.

Some sources don't even separate out lobar from bronchopneumonia. It's somewhat of a moving target, anyway. Both involve at least 1 area (but it may spread!), though the pathophys of broncho is different, and I've had a question on that. Lobar = intra-alveolar exudate. Broncho = inflammatory infiltrates from bronchioles that leak into alveoli. Different mechanism, very similar result, which is why they're difficult to tell apart.
 
UW discusses how platelet activating factor utilizes a PLC-IP3 signalling mechanism to cause its effects (bronchoconstriction, vasoconstric, platelet aggregation). For platelet aggregation specifically, do other molecules causing platelet aggregation (ADP, gp2b3a binding) also utilize a PLC-IP3-Calcium mechanism?
 
Oh yeah guys. Here's my schedule.

Step%20Schedule.jpg


This is all adaptable as per your schedule. There were obviously times where I only had sundays off. So I would do 12 blocks of questions on Sunday then and revise 2 every day during the weekdays.
 
Revise means: Go through the material covered today in FA 2 more times. And go through your "qbank sheets". Not just today's but try to work through as many of your sheets as feasible.

Some things in FA you'll have to revise more often: 2nd messengers, upper limb nerves, etc. These are personal and you ought to revise them as often as you see fit.
 
I would just like to say good luck everyone! This forum has taught me so much, especially about what works for me. Goal is 270+ with a miss-and-fall-on-a-cloud of 240+

I'm looking forward to this.
 
Yep good luck to everyone taking the test this year...I'll be paying close attention for my test in 2015 eek
 
IMG, Exam in 3 weeks. Kinda scared....need some advices.....
did NBME 13,15,12, scored 220 on last two, while each with 10+ careless/fact ignorant/first-right-change-to-wrong answers oh well. Went through FA like 3 times with massive annotations on it, DIT once(just the workbook Qs, not the Q-sheet), UW random block is 80-95%. now i am wondering what I should do to secure my marks and possible boost it up to 230?.
I got two plans in mind:
Morning: UW 5 blocks (each is like half hour job for me) and review incorrect ones.
Afternoon: FA cramming...this part i really hate....
Evening: DIT workbook casual review/HY neuroanatomy(my weak part).

or

Morning: USMLErx (never did before but some said it's really helpful in 2013 thread...confused) to consolidate FA facts.
Afternoon: FA cramming....again...
Evening: casual UW blocks...

So which one is better?
Other resources i have not done: Pathoma, Kaplan bank (40% done only, being told that anatomy/behavior Sci/Neuro part is great)
 
Hey guys:

So I took the test on Monday. I'm a DO and took COMLEX back in September and wasn't going to take the USMLE until I got a good score on Path, Pharm and behaviour (crappy score on OMM 🙁) So I took a couple practice tests end of December and got 200 on one NBME and 193 on the other. So I was like ****, I suck at this, time to stop. But I promised myself (and the sig other) I would do one NBME in a test setting (previous two were in bedroom, the 193 was laying in bed). Additionally, I went over the old ones and decided I'm just going to go with the most common answer choice instead of trying to pysch myself into thinking it's not right. I took NBME 15, I think, and got a 219 and 221 on NBME 12? (490 and 500 on the score system). I also got a 221 and 224 on USMLE world. Unforunetly, I dropped a couple points on last the two NBMEs I took that were sandwiched around the 224 Uworld.

So the exam wasn't as bad as I thought it was going to be. I was really nervous the last few days--esp since my scores dropped a bit, but decided to go ahead and take the exam since I had put the last 4-5 weeks studying pretty seriously for the exam, plus a couple hours a day before that while on rotations. I think one reason it wasn't as bad was because I'm a really fast test taker, always have been, so I wasn't crunched for time and generally finished with 8-12 minutes per section. I did skip over 3-4 questions I was getting stuck on and came back to them. Better to do this then waste 15 minutes on them.

What really helped settle my nerves was that 3 of the first 7-10 questions were covered by Pholston in his amazing powerpoints. Two of the q I might have gotten anyway, but no way was I going to get one on metastastic cancer unless I had read his PPTs the nights before. I also got one question straight from pathoma earlier. Dr. Sattar said, they're not going to list X as an answer choice, because everyone knows that. Instead, they're going to list Y." Well, Y was an an answer choice and honestly, I wouldn't have known that because that bug was in maybe 2-3 questions on Uworld.

I got killed on the neuro. Lot of cross sections and that was my weakness. Cross sections for anatomy too and I'm not sure they went much better, but only I knew a few of those. Rest of anatomy wasn't so bad. I thought the biochem, micro, immuno, pharm and behavioural wasn't that bad--very doable and fair. The comlex micro was probably harder than the Step 1 micro, but everything else was harder on USMLE.

In terms of questions, I thought they were about the same style and difficulty as the NBMEs--same length too for the most part. I thought all the questions were going to be 2-3 paragraphs each, but luckily they weren't. Maybe 20-25% were longer and those are the ones that screw people over, I think. Gotta skip them and come back to them rather than wasting time. Hopefully being a fast test taker will help me as other people may struggle and that'll drop their points some in comparison to mine (yeah, sucky way to think about it, but this is graded in relationship to how others have done in the past). I actually had the same question three times on the exam. Not identical, but they were looking for the same immuno deficiency and just asked it different ways. One of my professors had mentioned this and I got a practice question on it 2 weeks ago, so I think I knew it. I was surprised by this, but one of the NBMEs has the same micro q 3x as well. Different question, though--although that question was on my exam too. One of the graphs from the NBMEs was also on the real deal. The graph was changed and wasn't the same shape, but x and y axises were the same as was the subject. The USMLE alog probably has tons of different pods and probably picks a question (or more) from each pod to balance out the difficulty, so I could see this happened. Hopefully it was the same question they were asking and not me imagining it!

As for scoring, hopefully I'll do well. So I know there has been a lot of controvery on scoring and what percentage you need right, etc. So my professor who teaches for Kaplan said you generally need a 74% to get a 240. Obvioulsy I wasn't in that category on the practice exams, in fact, I was getting a little higher than that on the NBMEs--not great but decent. But he put it down as, if you KNOW 1/3 of the questions and can narrow the other 2/3 down to 2 and get half right, you're at 67%. You'll need to hit a few more right, but if you know you're stuff, you can--it is a doable exam.

One thing I was surprised about was how much basic physio there was on it. There's a lot on the NBMEs and maybe even more on the exam. If you know the concept, the questions are easy. If you don't, then youre screwed. I got screwed on one that I knew because they asked it in a weird way. Same thing for a anti-viral drug I knew well. I've seen the videos for how it works, but it got me. I thought every answer choice was going to be asked in a weird way, but I think 50-60% of the answer choices were pretty straight forward (like in the NBMEs) and maybe 15-20% were were asked in a totally oddball way with the rest somewhere in between.

here's to a couple tough weeks waiting for my score!
 
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Guys,
my exam is on monday ; I took all nbmes except 13. Do you recommend taking it? I heard that its a tough one and I dont want to lower my confidence close to test day !! Please help thxx
 
Hey guys:


What really helped settle my nerves was that 3 of the first 7-10 questions were covered by Pholston in his amazing powerpoints. Two of the q I might have gotten anyway, but no way was I going to get one on metastastic cancer unless I had read his PPTs the nights before. I also got one question straight from pathoma earlier. Dr. Sattar said, they're not going to list X as an answer choice, because everyone knows that. Instead, they're going to list Y." Well, Y was an an answer choice and honestly, I wouldn't have known that because that bug was in maybe 2-3 questions on Uworld.

here's to a couple tough weeks waiting for my score!


I hope your rocked it amigo! What are Pholstons ppts and where can I find them?
 
Guys,
my exam is on monday ; I took all nbmes except 13. Do you recommend taking it? I heard that its a tough one and I dont want to lower my confidence close to test day !! Please help thxx

Damn, so close!
If u know ur ****, ur score should be consistent, regardless of what NBME u take. Might as well go for it. You might slay the NBME 13 and that would be an awesome boost to ur confidence. Remember, positive thinking!
If you are hitting ur target, you could use this little time to review ur weak subject(s)?

I wish you all the best! You got this!
 
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Oh yeah guys. Here's my schedule.

...

This is all adaptable as per your schedule. There were obviously times where I only had sundays off. So I would do 12 blocks of questions on Sunday then and revise 2 every day during the weekdays.

Dude, this is awesome. I especially love the phase B approach. Very different from everything I've seen others do, which is like 2-3 blocks per day every day. Do you feel like doing the blocks of 8 on a regular schedule helped you build stamina for the real deal or were you feeling burned out by the end? How many weeks did you do the phase B part? Appreciate the info.
 
The Kaplan 2010 micro lectures are making me realize how crap our faculty are at teaching. Seriously, if you're weak in micro and can get your hands on these, they're really nice.
 
Dude, this is awesome. I especially love the phase B approach. Very different from everything I've seen others do, which is like 2-3 blocks per day every day. Do you feel like doing the blocks of 8 on a regular schedule helped you build stamina for the real deal or were you feeling burned out by the end? How many weeks did you do the phase B part? Appreciate the info.

I did the 8 blocks specifically to build stamina. It sucked the first few times I did, but by the end I had adjusted fully. When I walked into the real thing there was zero fatigue or brain fog. I didn't start studying phase II style till the last 2 months. I wish I had come up with this plan before, most of the juniors at my college who ask me for help follow this plan I've laid out for them now. It never made sense to me to do 2-3 blocks a day for an exam that's 7 blocks in length. Your Uworld score would only reflect your "fresh blocks".
 
This is from Microsoft's Windows Sysinternals:
http://technet.microsoft.com/en-us/sysinternals/cc817881.aspx

Desktops allows you to organize your applications on up to four virtual desktops. Read email on one, browse the web on the second, and do work in your productivity software on the third, without the clutter of the windows you're not using. After you configure hotkeys for switching desktops, you can create and switch desktops either by clicking on the tray icon to open a desktop preview and switching window, or by using the hotkeys.
 
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