1/10 Kaplan Diagnostic - 59%
4/20 NBME 7 - 234
5/2 School Administered NBME - 248
5/24 UWSA1 - 260
——— started “dedicated” 5/29
6/25 NBME 15 - 249 (90%)
7/3 UWSA2 - 265 (86%)
7/6 Free 150 - 90%
7/9 NBME 16 - 262 (94%)
Uworld Qbank - 81% random timed
Kaplan Qbank - 72% by subject
USMLERx - 83%, but I only finished about 25% of it
I used Firecracker, banked 90% of it and had an 86.7% mastery rate. I stopped it about 2 weeks into dedicated period because I was slacking on studying and I wasn’t being efficient enough with my time to do FC and try to get through Uworld/FA
7/11 actual score: 265
Beneath this paragraph is everything I wrote the day after my exam. I just wanted to say that whatever score you want is attainable. It might not come easy, but the beautiful thing about med school is that you don’t have to be smart. Your score and class success will be a direct representation of the amount of work you put in over time. I actually think the work I did over the last year is what contributed the most to my score and not the 6 weeks prior to my exam, which was more for fine tuning. After I unbound my FA and put it in a binder, on the label I put a fairly lofty goal just so I had something to always look at and remind me of what I was working towards. That number ended up being my exact score. I literally just sat in disbelief for 10 minutes at how eerie that was after seeing the report.
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Exam Day
Content-wise, it seemed to be well distributed. The only things that seemed disproportionate in my eyes was the amount of straight anatomy/embryo (between 30-40) and the amount of BHS/biostats questions (between 20 - 30). I noticed that neuro wasn’t on my exam much, maybe a max of 10 questions, but there may be other subjects that weren’t as well represented. I just subjectively thought Neuro/Genitourinary were weaknesses coming into the exam so it was a lot easier to assess the presence of those on my exam. DISCLAIMER: really the content of my exam doesn’t matter, I’m just adding it for completeness sake. Your exam may be the exact opposite.
Question difficulty: Some were a little tricky, but extremely doable, i.e. question regarding mechanism of Metoclopramide where both D2 antagonist and 5HT3 agonist were answers; if you don’t read the stem properly, you could easily get it wrong if you don’t know what they’re asking. I hope this doesn’t constitute giving exam information, since I’m not speaking about the stems or what the answer was, I just want to illustrate that at times there will be best answer type questions or questions that are actually easy, but you need to think about it for a second to make sure your answer matches that needed from the question stem specifically. I saw someone else post a 40/40/20 breakdown as far as difficulty and I would agree, but switch it to 40/50/10. 40% of the questions will be easy if you’ve studied, some of them even joke easy like you could have answered before medical school. The next 50% are very doable if you’ve studied and had a good mastery of the material - this includes the physio type questions that ask you to interpret arrows and graphs and it requires you to relate a couple different things in order to answer the questions, these are really the questions that if you had unlimited time and prepped well, you would get a majority right, but the time crunch makes it tough. The next 10% are the difficult ones. These comprise the questions that require random knowledge, fine detail of major topics, outside exposure to current research, or just lucky guessing. I had a question about the mechanism of a drug that isn’t in FA, Uworld, or Firecracker, but was on the last slide of one of my Pharmacology course lectures. I got it wrong, but I thought it was interesting to see where I could have potentially gotten that point had I been more thorough with my studying. On average I probably marked about 9 questions per block. On the only block I finished with more than 5 minutes to go, I only marked 4. Marked 11 on a few of them.
I didn’t have any break time left so I didn’t get to do the survey at the end. I skipped the tutorial so I had an hour worth of break time. For some reason from reading posts on here it seemed like you only got 45 minutes WITH the extra tutorial time, but it’s actually 45 base, kicking you up to 1 hour if you skip the tutorial. Skipping the tutorial didn’t matter, the only thing that was new was the couple heart sounds I had, which let you click different auscultation sites to see where you heard the murmur the loudest, which you DO have to do, as it makes a difference in the diagnosis. I saw someone here previously post that you could switch between the diaphragm and the bell, but I did not notice that feature with mine, and the auscultation page was the only thing I looked at in the tutorial because of that post. Testing interface, including the format of the lab values was almost the exact same as Uworld.
My dedicated prep plan:
- finished up Uworld. I went into dedicated period with about 20% of Uworld done. I marked any questions that I got correct that I completely guessed on and marked questions that I knew, but liked the way the question was presented as far as making me think on different levels or just giving me exposure to something I subjectively felt I could use again. I also marked any of the auscultation media questions as I felt that those should be gimmes on the exam if I was familiar with the sounds. I did all my marked questions and incorrects after finishing my first pass. Finished the day before the exam.
- Want to say I stand by the fact that I think Uworld should be done last and as close to prep period as possible. People have varying opinions on it, but I had seemed to agree more with the people that said save it for last and I think it not only helped me peak at the right time, but got me a couple questions on the exam as well.
- Almost a full past of First Aid. I didn’t get to go over the Biochem section, but my actual first pass of FA was from January - May along with courses and the biochem section was actually the last one I read. Biochem on my exam was sparse and easy, so I may have lucked out there. **Edit: I just remembered that I never completely read the pharm section of Micro. I hated antimicrobials during my Pharm course and never had a chance to look at it then, and I also skipped this section during dedicated because I remembering falling asleep during it, saying I would do it in the morning, and I never did. Luckily, I don’t recall having 1 antimicrobial pharm question on the exam.
- NBMEs/Uworld exams. I actually only planned on taking 1 during dedicated, but the 249 kind of killed my buzz, so I decided to take another. My goal was a 260, a dream goal of 265, and an “I’ll settle for it” goal of 255. I feel that taking a bunch of NBMEs isn’t really necessary. It is a more efficient use of your time to study than to just keep taking tests to see what you’re getting wrong. We’re all adults by now. Everyone should be able to objectively say what their weaknesses may be. Doing a bunch of stuff for the fact that you might see it the same way again is a waste. The questions will never be the same. In my whole exam I remember having 1 question with the exact same stem as a question from the free 136 except the last line which ended up asking something different. Who knows though, maybe if I had done more I would have gotten a few repeats. NBMEs are invaluable as an assessment tool. I noticed a trend in errors I was making that lead to me getting questions wrong that I really shouldn’t have. I was also normally solid on my 1st block or two, then progressively declined. I tried my best to minimize these errors for NBME 16 and it paid off.
- Watched some of the Kaplan Pharm videos on anti arrhythmic drugs and a few other areas I didn’t feel strong in.
- listened to Goljan while driving or at the gym. I had a few questions that were almost word for word things he spoke about. Amazing how clutch it still is. Listened on my phone and had it sped up to anywhere between 1.5-1.7x. Makes a big difference, the 1x of getting through it during dedicated was probably my 4th time just passively listening since January.
- Outside of my first couple days of studying and maybe 2 other days when no sports games were on and I had the motivation to do nothing else all day, I probably averaged about 5-6 hours of studying/day excluding the probably 7 days off I took inadvertently. This was not my intent and even though I know how stressed I already was, I do wish I had averaged around 10 hours and had a tighter schedule. I was pretty much set up to be a slacker having the NBA playoffs happening AND the World Cup at the time that I had to be studying for the step. I tried to resist, but I couldn’t.
If I had to list the things that I feel contributed the most: Firecracker > Pathoma > Uworld/Kaplan > Goljan Audio >> UsmleRx > First Aid
Firecracker: listed first because in retrospect, the greatest thing that contributed to me getting questions right often was from knowing things well the first time I learned them from classes. The effort you put in your first 2 years is by far the most important factor in step prep; FC can help solidify that. I’m not trying to push the product as much as I’m emphasizing what people have said before in that doing well your first two years will make this process so much easier. Anki or any spaced repetition program can also help solidify things, if you like an alternative. I just think Firecracker is currently the best medium of doing that.
Pathoma: I’m also a big proponent of understanding rather than memorizing, which is why Pathoma is rated so highly for me. I wanted to use it during dedicated, but I had to cut a lot of things out after I realized there way no way I was going to finish it all at my leisurely dedicated period work-rate, but having been through it almost twice within the last year, I think the foundation for comprehension was set so it served its purpose
Uworld/Kaplan: Same value to both for me because I think the beauty in question banks is just reinforcing things you learned. When I did my pass through of FA, it was crazy to see the things I still had a good grasp on, because I remembered getting a question on it. There were things I remembered reading about either in class or in my first reading through FA, like Gitelman syndrome, but that looked brand new every time, because I had never had a question on it to reinforce it. I would say Uworld is a little bit better than Kaplan bank, but not by much. I don’t really get where the Kaplan hate comes from; I thought it was solid. Uworld was straight forward IMO. For the most part, questions I got wrong were things I hadn’t learned yet. I think Kaplan may do a better job of having questions that make you think deeper in to things in order to get an answer. It also could just be that doing 1 bank before Uworld will make it seem easier, I don’t really know. First Aid is the lowest down because I actually feel it’s the least useful, for me at least. There was a lot of stuff in First Aid that wasn’t in FC, so it isn’t even that I knew it already indirectly. As I was going through it there was A LOT I didn’t know in there, but I don’t think those small detail things make much of a difference. I would venture to guess if you were an A or high B student, you could probably skip FA, use Uworld as your bible, and still do really well. I wouldn’t risk it or tell anyone to do that, but I do want to acknowledge that FA is not the end all be all it is made out to be.
Things I wish I had done:
- Read BRS Behavioral. This was a weakness of mine according to both qbanks. Behavioral questions are guaranteed to be on the exam and they ended up being the hardest questions for me.
- Finish Firecracker and finish it early. I don’t think there is an easier way to keep retention of learned material. The sections I didn’t finish were Anatomy and Neurology. I looked up a bunch of questions after the exam and also looked to see if they were in FC and it wouldn’t have made a difference though so I can’t be too hard on myself. I think another major reason I wished I had continued was that Firecracker will increase your recall speed as long as you’re doing it. I typically finished Uworld blocks with between 10-20 minutes left to spare. However, after I stopped FC I noticed it was taking me a bit longer and I usually finished with 10 or a little less time left. Around the time I quit FC, my Uworld blocks were consistently 85% + with a few >90%, after I quit, it seemed like they slowly started normalizing again to between 78-82%. Could be coincidence. I normally only had about 2 or 3 minutes left at the end of blocks, if that, on the real deal so FC could have helped in that aspect. Like Goljan said, most students would probably do well on this exam if you had unlimited time and could just sit there and reason things out. Having more time to spend on the difficult/multi-step questions or reviewing marked questions is invaluable. I changed multiple things to the correct answer that I had marked, when I had the time.
Things I bought or intended to use but didn’t:
- Rapid Review: I remember reading a bunch of posts from prior experience threads and I saw a few people that scored really well say they used rapid review. It’s great, but way too dense now for it to be used effectively for a first pass during dedicated period. I only used it for clarification during classes or something else. It has almost everything though and if you could manage to get a few read throughs in, I’m sure you would kill this exam.
- HY Neuro: I always thought Neuro was a weakness for me as I just coasted through my Neuro course and did the bare minimum to keep a satisfactory grade. 2 months before the exam if you asked me what the function of the PPRF was, I couldn’t have told you. Plan was to read 8-10 pages/day and finish it by the halfway mark of dedicated. I think I made it 4 days. I guess I didn’t read enough to give a great review of it, but I can say that it is a bit dull and the format wasn’t amazing. As with antimicrobials, I got lucky and neuro wasn’t really well represented on my exam.
- Deja Review Micro: Micro I thought was another weakness for me as it isn’t taught well at my school. I saw this book have a high rating in the back of FA so I ordered it. The only way I can see this book being useful for someone is if you just want to quiz yourself on some Micro facts every night before you go to sleep. I didn’t really like the format of it for the purpose of step studying.
- Lippincott Microcards: seems like these always have amazing reviews on here. I wasn’t a big fan either. At times there can be too much info on the cards IMO. I liked them and used them a little during my Micro course, but I probably wouldn’t recommend them to people.
- Usmle rx: It’s okay. I actually don’t mind it, I just think the other 2 major banks are better. I planned on finishing this during dedicated before doing a second pass of Uworld; none of that actually happened.
Good luck to everyone else who has to take it. I hope this helps people because I religiously read these threads for the last 2 years and I can honestly say you could probably subtract 30 points from my score if I didn’t learn so much about how to prep on here and what type of scores were possible. And thanks to anyone I PM’d or directly asked questions, the support here is great and I’ll definitely try to pass it on. Also, sorry for the long ass post. I don’t know how to be concise and I always actually loved the posts where people explained as much as possible and made this a thread where people could learn instead of an area for individuals to gloat.
