I took the exam yesterday, here are a few of my thoughts:
- Difficulty was similar to Free 150.
- I didn't really bother with biostats until 4 days before my exam. I spent 4 hours going through through the uworld biostats package and thought that it prepared me for every single one of the biostats questions.
- High yield: adrenergic pharmacology (~10 questions), anti-parasitic drug mechanisms, fungal/parasite identification, anti-viral side effects, epidemiology ie most common cause... (~5-6 quesions), Heart murmurs (~4 without media, 3 with media), cytokines and inflammatory mediators (~6-7 questions), ethics
- Medium yield: pelvic anatomy, imaging (describing what you are seeing ie R/L pneumothorax +/- tension), brachial plexus, virulency factors
- Low yield: biochemistry, genetics, virology, renal/cardiovascular/pharm calculations
- Week before the exam "10 points worth of cramming": Pathoma chapters 1, 2, & 3; Phloston ppts (I can't vouch for abx but I thought his bacterial and viral were pretty high yield); FA chapters on microbiology (don't gloss over parasite, worms, and each of their respective medications), immunology (end of the chapter > early chapter), and pharm (adrenergic pharmacology questions were more abundant and more difficult than I was expecting), path paraneoplastic syndromes, oncogenes/tumor suppressors, and common mutations.
- Waste of time: Flashcards (FA microbiology + pharmacology + Phloston's ppts were sufficient for all but 1 or 2 questions)
- Days -3 and -2 I took took NBME 15 and NBME 16 at night after 9-10 hours studying. I wanted to see how well I could reason even though I was totally worn out. Downside: my NBME 15 and 16 went down ~10 points and that effed with my head a bit especially since it was the days leading up to the exam. Upside: I felt no fatigue during blocks 5, 6, and 7 on test day.
- One thing that caught me by surprise was the media heart murmurs. You have to click on what part of the heart that you want to focus in on and you can alternate (in mitral area) between diaphragm and bell. I'm not sure if you know this or not, but I found out about it during the tutorial and had a serious omfgwtf moment. Turns out it's great and makes diagnosing the murmur significant earlier (ie the murmur will be significantly louder in one location, or the diaphragm elicits the murmur while the bell helps you to hear s1 & s2, +/- s3 & s4 thus making it incredibly easy to distinguish systolic/diastolic/OS/MS)
- Recommended pandora station for studying: copeland/ellington's "In a sentimental mood" and Grant Green (great background music for those 4-6 hour marathon sessions)
- For other parents with very young children: It sucks missing out on 6-8 weeks of milestones, but here is the upside: all today I keep saying over and over to my 16 month old: "Woh! When did you learn to do that?"
- I highly recommend taking the exam at 11 am. The USMLE was less about knowing minutiae and more about noticing small but common details in the question stems that most people know but may not pay attention to. I think that all people will have a much more difficult time picking up on those small details (esp in the later blocks) if they've gotten under 7.5 hours of sleep.
Good luck, I'm off to Mexico and have vacation until early September when my MPH coursework begins!
