Hey guys, just had my test yesterday. My experience was very predictable after reading a bunch of other people's experiences. In other words, it was very difficult, but not more than you would expect from what people tell you about.
I could go into detail on all the crazy questions that were on there (there were some truly WTF minutiae), but that would only unnecessarily worry you. There's absolutely no way to know these questions, trust me. You will be tested on things that have one paragraph or less of a Wikipedia article on them (obviously not in any review book). You will be tested on things that come from a recent case study of an exceedingly rare infection. You will not be able to study for these, no matter what you do. All you can do is infer with the massive amount of knowledge you've accumulated, and eliminate answer choices. The power of eliminating answer choices is truly enormous; only when you can confidently eliminate every other answer choice can you confidently select an answer you've never heard of.
I walked out of my exam actually feeling really good about my preparation. I can truly say that every single one of the following resources got me a question right by itself (not just due to overlap - the resource contributed something unique):
-FA
-UWorld
-Pathoma
-UWorld Subject Review
-Goljan lectures
-Goljan RR (wouldn't recommend reading it if you're limited on time...but what little I did read alongside classes turned out to score me a couple Q's)
-BRS Physio
-http://w-radiology.com/chest_ct.php (far more helpful for me than others have reported)
Oh and DO students -- laughably, I got a question right solely because of OMM (e.g. sympathetic innervation to the arm = T2-8).
Of course, the FA+UWorld+Pathoma trinity was truly deserving of kudos. I was amazed how helpful they were above all. Pathoma and UWorld gave a unique contribution through their emphasis on the small stuff that wasn't in FA. Don't dismiss this stuff, guys, it's there for a reason. Even those really rare diseases -- I got a histiocytosis question and a Sezary syndrome question. Pathoma popped into my head describing "cerebriform nuclei", and that's exactly what the picture looked like.
One big point I'd like to make: Judging from my test and the NBME's I've taken, the Biostats and Epidemiology stuff in FA is insufficient. The content more closely resembles what's in UWorld. The UWorld Subject Review has a lot of gold too -- somewhere between the unnecessary detail that I never got asked anywhere else, there are several questions that I got right on NBME's and the real deal solely because they were just like what I got in the Subject Review.
Another thing: There was a lot more "next step in management" and "best prognostic factor" questions -- probably about 6. The best prognostic factor ones are easier to infer from FA, but the next step in management stuff got pretty tough.
Incredibly, I used an example of a Step 2 level management question that they wouldn't test on the real deal in reply to a thread...and actually got that exact question on my test! Unbelievable. I actually made up the question from a fact I remembered from a Goljan lecture, where he said the screening test of choice for the gallbladder is an ultrasound. That question was the hardest -- others were more obvious (e.g. you need to diagnose some visceral pathology, but 4/5 answer choices are GI tract imaging). So, for you M1's: Definitely try and get through the Goljan lectures and pick up on his Step 2 level stuff if you can. For M2's: Probably too late to go through the Goljan lectures, but pay attention to the clinical management stuff in the blue text if you have time to do it (6+ weeks or something).
I got a ton of CT's, mostly chest CT's. Some of them were just supplementary and unnecessary to answer the question, but a couple of them you definitely needed to read the CT fairly well. Amazingly, I actually got a question where you had to put several CT's in order of progression -- I think I had a shot at getting it right purely due to that radiology website I referenced.
Got like 3-4 incontinence questions...heard this from people who have taken it throughout May as well. Easy points, worth mastering the types.
I used
@ChessMaster3000 's method of plowing through the questions 1x through attempting to leave 25 minutes (my goal), then going through marked (usually around 1/4 - 1/3 of my Q's were marked) until 8-10 minutes left, then going through all non-marked once again. This worked very well -- as he said, you'll amaze yourself how many questions you can answer instantly just based on some key words. Or the amount of context you can get by skimming a question (BMI = 17 + gymnast...going to be an anorexia/bulemia question). Thanks for the tip Chess, you're the man.
The NPV of marking questions (i.e. the probability of an unmarked Q being correct) of my NBME's was around 98%. That meant on a 322 question test, there would be about 6-7 Q's that I thought I got right that were incorrect -- 1 per block. So especially if you're shooting for 260+, there is huge utility in going back through unmarked ones if you can. I caught 1 question that was guaranteed wrong because I read "increased" instead of "decreased", and it was unmarked.
All in all, I feel decently well about it. I absolutely got plenty of questions wrong, which was certainly discouraging. It was just something where you'd have to take a break after that block, take a swig of a caffeinated drink, go in the bathroom, and give yourself a pep talk in the mirror. I'd love to help anyone out with anything else they were wondering about test day (when to take breaks, what the locker situation is like, etc.) or their prep situation. Feel free to PM me! Good luck guys.
I'll update with my score + NBME score history when it comes.