Official 2014 Step 1 Experiences and Scores Thread

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^ what like staphylococcus aureus? Pseudomonas aeruginosa? Chlamydia tracomatis and chlamydia pneumoniae?

yes. It is clinically relevant. How would you be able to identify a microorganism without both genus or species?

there's plenty named pneumoniae, plenty named streptococcus
 
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".

I really like this idea, but I already finished UW. Would you recommend doing two NBMEs back to back in a day to build stamina? I was going to do 7, 11, 12, 13, 15 all on separate days. I could do 7, 11-12, and 13-15 on three different days. While I like the idea of seeing my performance and figuring out how to improve my test-taking skills, which for me is what NBME is about (less about assessment), I could use it for stamina-building purposes itself.
 
@ChessMaster3000 Two NBMEs are just as perfect! I did the same thing too at times 😉

Just be sure to do the following: On the first NBME of the day, when you get to the last question (and you've checked your answers and there's a 30 seconds left) exit the test.
This way you won't see the score report. Wait until you've completed both.

Seeing a score generally makes me not do the second NBME.
 
@ChessMaster3000 Two NBMEs are just as perfect! I did the same thing too at times 😉

Just be sure to do the following: On the first NBME of the day, when you get to the last question (and you've checked your answers and there's a 30 seconds left) exit the test.
This way you won't see the score report. Wait until you've completed both.

Seeing a score generally makes me not do the second NBME.
 
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However it works, I don't recall as I took them like 3-4 months ago. The basic point is don't look at the score report for the first till both are complete. 🙂
 
UWSA1 6 days out from test = 257
UWSA2 260 3 days out from test = 260

you guys know if there are good correlations using these self assessments? shooting for 250+

a lot of people say uwsa over predicts but from looking at a lot of posts here and elsewhere that doesn't seem to pan out consistently by any means. Are you doing any nbmes?
 
For anyone that's taken it this year ( January 2014) already...any info on the extremely vague "quality improvement" and "safety science" new info? Any real clue as to what they're referring to? Also...does anyone have a ppt/file/website where we can see the DSM-V changes used for this year's exam?...I've got FA2013 and trying to figure out what to use/not use.

http://www.usmle.org/pdfs/Changes_to_USMLE_2014-2015_handout_FINAL.pdf
 
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UWSAs tend to over-predict mid-range scores, but they're extremely accurate for scores >260. The QBank % only means something if you had done it timed-random within the last 6 weeks. But a 79% generally correlates with high-240s or 250s.

Yet again, there are always outliers. There had been a guy in 2012 (his username was actually luckiestone) who scored 76% on UW and had NBMEs in the 240s, and he came out with a 267 on the real deal. There was also a guy the same year who got 84% on UW and had two 270+ NBMEs, and he got a 259 on the real deal.

If you want an accurate gauge, you need to sit 3+ NBMEs within the final week. The average of those exams will be +/- a few points from your real deal.
 
Hey guys ! Have been a silent reader of this forum till now ! Took my step 1 yesterday ! Some background info : I'm an IMG ! Total prep time 7months!
Feels amazing to to get done with this monster exam 😀 any questions are welcome 🙂
 
Hey guys ! Have been a silent reader of this forum till now ! Took my step 1 yesterday ! Some background info : I'm an IMG ! Total prep time 7months!
Feels amazing to to get done with this monster exam 😀 any questions are welcome 🙂
Yay u!!
This will probably the longest three weeks of ur life.
What prep materials did u use?
 
I read some old posts that talked about reading HY Cell and Molecular Biology book. Anyone using that book?
 
Yay u!!
This will probably the longest three weeks of ur life.
What prep materials did u use?
I used Kaplan lecture notes excluding patho for which I used goljan path with audios! Fa 2013..kaplan qbank(offline) and uworld! 🙂
 
I read some old posts that talked about reading HY Cell and Molecular Biology book. Anyone using that book?

I bought the 1999edition from half.com for about $4 (~$3 shipping) and I'd say it's worth it. It's really short and concise and overlaps with FA and Kaplan.

Edit: And by $4, I meant including the $3 shipping.
 
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I used Kaplan lecture notes excluding patho for which I used goljan path with audios! Fa 2013..kaplan qbank(offline) and uworld! 🙂

Anything you would do differently if you had to study for Step again? I hope you passed, just asking if your study approach would be different.
 
What area of medicine are you interested in?

The fact is, the further in time you get from the exam the rarer you'll realize your score actually is. On SDN, it seems like everyone gets really good scores, but I've never actually met anyone in real life who's broken 255 on the exam. And ultimately, it's not a numerical score that defines your character as much as it is the willingness and determination you had to learn for yourself and grow. And you'll find that your maturity and sense of conviction in your direction and goals in life have augmented considerably now that you've been through this process.

That's surprising. I know 3 people (All in the same class at a mid-tier USMD school) who got 254, 256, 257. I've only actually seen the 257 sore report, but the 254/256 are people I know and trust.
 
What would be the mechanism of hyperparathyroidism causing stomach ulcers? UW says it does, and I can't figure out why.
 
The guy who had the two 270+ NBMEs and a 259 on the real deal actually thought he had a super-easy Step1. After he got the score back, he made it clear that the grading between different versions of the exam will forever remain an enigma, and that his "low" score was due to a double-edged sword. The way you score high on Step1 is if you get questions right that others get wrong. So it's actually unfavorable having an easy form. The best case scenario is getting a really hard exam where you come out feeling somewhat slammed, but you still feel you managed to get most of the questions right.
 
The guy who had the two 270+ NBMEs and a 259 on the real deal actually thought he had a super-easy Step1. After he got the score back, he made it clear that the grading between different versions of the exam will forever remain an enigma, and that his "low" score was due to a double-edged sword. The way you score high on Step1 is if you get questions right that others get wrong. So it's actually unfavorable having an easy form. The best case scenario is getting a really hard exam where you come out feeling somewhat slammed, but you still feel you managed to get most of the questions right. He did eventually get a 264 on 2CK, although he had NBMEs in the 270s for that exam as well.
 
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Would you say that people who tend to do well on UW and who end up doing "relatively poorly" (as in the guy who got 259) on NBME/real deal do so because they end up missing easy (or easier) questions? I'm sitting at 84% but the questions and while I am happy with that, the questions I miss tend to have a high percent correct, which is equally frustrating.

I know you're not going to want to hear this, but the latter is how your real deal will eventuate as well. You'll find that you'll actually get the hardest questions on your Step1 correct, but will miss questions that you'd swear >70% got right.
 
I know you're not going to want to hear this, but the latter is how your real deal will eventuate as well. You'll find that you'll actually get the hardest questions on your Step1 correct, but will miss questions that you'd swear >70% got right.
 
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Any thoughts on what order to tackle practice exams? I've heard the latter NBMEs are more predictive, but I'm not sure what the cut off for the more useful NBMEs is. Do most people save the UWSA for the end of their studying? Or as a benchmark half way?
 
Anybody know if it is high yield to know which drugs are primarily metabolized by Phase I and which drugs are metabolized by phase II? If so, any pointers as to how to memorize this?
 
,
Anything you would do differently if you had to study for Step again? I hope you passed, just asking if your study approach would be different.[/quote]
Ummm I would spend more time on uworld explanations! The questions I encountered on the exam weren't exactly similar to uworld but the concept behind was similar ! So yup that would be it 🙂
 
Anybody know if it is high yield to know which drugs are primarily metabolized by Phase I and which drugs are metabolized by phase II? If so, any pointers as to how to memorize this?
do just the main main drugs ! I can't disclose the questions but I did get just one or two questions about it! Uworld has the relevant info !
 
do just the main main drugs ! I can't disclose the questions but I did get just one or two questions about it! Uworld has the relevant info !
Thanks--I am trying to find something online that lists different drugs and Phase 1/2, but can't find anything. any suggestions where to learn these?
 
http://forums.studentdoctor.net/thr...pharm-cards-heres-some-info-not-in-fa.915419/

The list took some criticism at the time because most of those drugs you don't need to know for Step1. All of what you need for Step1 is literally in FA and QBanks. That's it.

(However I will point out that by the time you're on the wards and are prepping for 2CK, most of those drugs are actually not a big deal and are fairly basic; it's just that for Step1 most are beyond the scope)
 
@ChessMaster3000 , I delved into my heavily annotated FA2012 for you (from when I took my exam), and what I have written:

In blue font:

"Drugs that DO NOT undergo phase I metabolism: oxazepam, lorazepam. Be very ******* aware that a doctor can give these to older patients b/c older people lack phase I metabolism; these drugs are simply metabolized via phase II conjugation. Liver disease also tends to knock out phase I first, so oxazepam and lorazepam can be given in liver failure."

In black font:

"Lorazepam/oxazepam undergo extra-hepatic conjugation. Izoniazid, morphine, 6MP and acetaminophen undergo phase II metabolism."

In green font:

"Diazepam + midazolam --> oxidative reduction; lorazepam/oxazepam --> glucuronidation. Chlorthiazide is eliminated from the body unchanged. Phenol & chloramphenicol are metabolized via sulfate conjugation. Procaine, lidocaine & aspirin undergo hydrolysis. Pentobarbital/phenobarbital undergo hydroxylation."

--------------

Blue/black font = USMLE Rx and/or Gunner Training QBank
Green font = UWorld

You can see that in three different resources, including UWorld, lorazepam and oxazepam are described as phase-II. I don't remember why I had gone on a tirade while annotating that blue font comment, but I must have encountered a question on it.

Hope that helps,
 
@ChessMaster3000 , I delved into my heavily annotated FA2012 for you (from when I took my exam), and what I have written:

In blue font:

"Drugs that DO NOT undergo phase I metabolism: oxazepam, lorazepam. Be very ******* aware that a doctor can give these to older patients b/c older people lack phase I metabolism; these drugs are simply metabolized via phase II conjugation. Liver disease also tends to knock out phase I first, so oxazepam and lorazepam can be given in liver failure."

In black font:

"Lorazepam/oxazepam undergo extra-hepatic conjugation. Izoniazid, morphine, 6MP and acetaminophen undergo phase II metabolism."

In green font:

"Diazepam + midazolam --> oxidative reduction; lorazepam/oxazepam --> glucuronidation. Chlorthiazide is eliminated from the body unchanged. Phenol & chloramphenicol are metabolized via sulfate conjugation. Procaine, lidocaine & aspirin undergo hydrolysis. Pentobarbital/phenobarbital undergo hydroxylation."

--------------

Blue/black font = USMLE Rx and/or Gunner Training QBank
Green font = UWorld

You can see that in three different resources, including UWorld, lorazepam and oxazepam are described as phase-II. I don't remember why I had gone on a tirade while annotating that blue font comment, but I must have encountered a question on it.

Hope that helps,

You are the MAN. That is precisely what I needed to the word. I can't thank you enough.
 
I should also point out that on the wards, we had an alcoholic in with a tremor. Consultant pimped us on delirium tremens and alcoholic hallucinosis (easy). I asked about chlordiazepoxide because the QBanks were obsessed with this drug being used as the long-acting benzo in alcohol withdrawal. Maybe it's just an Australia vs US thing, but the consultant hadn't heard of it before. But she did say that lorazepam is specifically used in liver failure, but if there's no liver failure they can use classic diazepam. So I guess the fact that lorazepam is phase II-metabolized makes sense regarding this clinical decision.
 
I should also point out that on the wards, we had an alcoholic in with a tremor. Consultant pimped us on delirium tremens and alcoholic hallucinosis (easy). I asked about chlordiazepoxide because the QBanks were obsessed with this drug being used as the long-acting benzo in alcohol withdrawal. Maybe it's just an Australia vs US thing, but the consultant hadn't heard of it before. But she did say that lorazepam is specifically used in liver failure, but if there's no liver failure they can use classic diazepam. So I guess the fact that lorazepam is phase II-metabolized makes sense regarding this clinical decision.

Either chlordiazepoxide or diazepam should work in that situation. I can't imagine them putting both in an answer choice. If they did I would flip a *** and wouldn't even put an answer down (not really)
 
aren't all the forms supposed to be equalized for difficulty? There should be an alog that picks questions out of buckets or pods and makes sure everyone has about the same level. I don't think there are 10 or 15 forms, but rather 2500-3k questions and some variation will show up on your phone. I'm a little bit worried about this, maybe I got an easier form and did ok, but not compared to everyone else. we'll see, I guess



The guy who had the two 270+ NBMEs and a 259 on the real deal actually thought he had a super-easy Step1. After he got the score back, he made it clear that the grading between different versions of the exam will forever remain an enigma, and that his "low" score was due to a double-edged sword. The way you score high on Step1 is if you get questions right that others get wrong. So it's actually unfavorable having an easy form. The best case scenario is getting a really hard exam where you come out feeling somewhat slammed, but you still feel you managed to get most of the questions right.
 
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!

Thank you, was helpful for starters like me, and i wish you good luck :luck:
 
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