Hey guyz.
So I wrote my step I last week, and if I could describe how I felt walking out in one word, it would be “annoyed”. I did not feel like the exam justified all the time, effort, sweat and blood I put into this. It felt like one big weird IQ exam. The difficulty level seemed a bit bimodal with not too many medium-medium difficult Qs which is where I excel most. The easy Qs were quite straightforward and did not require much preparation….the difficult Qs were completely left field and almost impossible to prepare for. In short…a majority of my preparation was in vain. I spent soo much time memorizing first Aid, but feel like I only got to demonstrate about 1% of my knowledge/preparation. I didn’t feel much different from someone who didn’t put too much effort in their preparation because a great majority of the so called “high yield” stuff I studied simple was NOT tested. The entire exam was like a big blurry episode, and I cant seem to recall more than 3 Qs…is that a terrible sign?. I honestly don’t understand how people can remember over 100 Qs.
A little bit about my stats and preparation:
- Uworld First pass: 72% (82nd percentile)
- Uworld second pass: 90% (98th percentile)
- NBME 7: 237 (Raw: 540)
- NBME 11: 234 (Raw: 534)
- NBME 12: 260 (Raw: 650)
- NBME 13: 260 (Raw: 650)
- NBME 15: 251 (Raw: 610)
- NBME 16:266 (Raw: 680)
The online NBMEs were completed three weeks before dooms day. I also completed the offline NBMEs (1-6) but not under exam conditions so my scores don’t count. Free 150: score in the 90s. I did not bother writing the Uworld assessments because the consensus seems to be that that they greatly overestimate your score.
RESOURCES:
- First Aid, QnA, Cases, Flash cards
- Uworld twice through and 60% of Kaplan Qbank
- NBMEs and free 150
- BRS physiology
- Pathoma
- Goljan Audio and notes
- Robbins Review Question book.
THE ACTUAL EXAM:
TIMING:
Time was a bit of an issue but not too pressing. I decided before hand that no matter what I was NOT spending more than 90 seconds on any particular Q. I consistently completed every block with 13-15 min to spare, which afforded me time to quickly scan through my answers, but definitely not enough time to give difficult marked Qs a proper think through. So I had to be at peace with letting go of Qs that were taking a bit too long and just kept it moving. I caught mind fart errors like mistakenly clicking on lymphoma instead of thymoma for M.Gravis mediastinal mass. So I think its very important to ensure you have a couple of minutes to spare to at least screen answers for clumsy mistakes. There was a fair mixture of both long and short stems. Learn to be able to quickly scan through the longer stems because too much time on any one particular Q can quickly and easily set a bad/stressful tone for the rest of the block and you will miss out on the easier Qs.
CONTENT:
Every exam is different so the content of my exam is irrelevant. However, I had a heavy focus on the reproductive system, general principles and genetics. I love cardio, nephrology and GI, but sadly these systems were only lightly tested. I had a TON of hypothetical research Qs (mice and gene mutations) and that’s an example of the type of Qs you can’t really prepare for. Know the histology of the bone tumours and physiology of female repro (hormone changes in menopause, polycystic ovarian syndrome, stuff like that). I hope I’m not giving out excessive info or breaking any rules here.
THE RUMOURS:
Ive been reading a lot about a lot of neuroanatomy being heavily tested and spent a good 5 days on the subject. I had only 5 neuro Qs in total, three were neuroanatomy, and one was an exact repeat from NBME 15 or 16. Certainly not enough Qs to jusify investing a whole lot of time on High yield neuro or anything like that. Be familiar with identifying nerves on a gross brain stem image and the brain haemorrhage types (bread and butter type Qs).
I also heard a lot about pelvic anatomy being heavily tested, so I got scared and put in a lot of time on that. I only got two pelvic anatomy Qs: one was on penile innervation and the other was on the pelvic floor muscles (thankfully I was able to get the Q right because I google imaged “pelvic floor muscles" ). So in short , the rumours turned out to be true but a little exaggerated.
ADVICE:
- After writing the exam, I truly believe that the most important skill you need to master before writing this exam is
time management. You can come in with the entire Robbins Book memorized, but if you find yourself fighting a battle with time, its easy to lose out on tens of points from careless errors or not having time to reason through easy Qs.
- Woosaah. Be relaxed. Im the type of person that will have my book whipped open up until the last second. I now understand why people emphasize that you should it take it easy the day before. Having a relaxed and calm mind is a countless times more beneficial than cramming a bit more info (that might not even show up) + being stressed. If you are stubborn like me, you will only appreciate this simply but important point after the fact. So be smart and heed to this advice.
- Resources: First Aid and Uworld is more than sufficient. As much as I love Pathoma and Sattar, Pathoma did not score me any additional points on facts not already included in First Aid. Use additional resources to address your weaknesses only, and not for the sake of completing a check list of “resources used”. Google image is your best friend. Google image all the MRIs of bone tumours, histology of leukemias, do you know how a parietal cell looks like on histology? Stuff like that. From solving Qs, try to get a sense of what type of images are board favourites and maybe create a power point filled with gross/MRI/CT/electron microscope/Histology pics that are likely high yield.
- Qs Qs Qs During your dedicated period, make sure you solve Qs every single day from whichever source. Uworld is your best friend. I had a lot of repeat concepts from this Qbank that were not in First Aid.
- Be smart and reasonable with your time allocation. Don’t get caught up spending so much time studying a certain subject area because one person on SDN supposedly got 20 Qs in that area. Every exam is different. Focus on understanding/ mastering key general concepts on each system and towards the end memorize the high yield minutiae. Focus on weak areas but don’t forget to reinforce strong areas or they could easily become new weak areas.
- Take it easy. Yes, you need to pull solid hours every day and be EFFICIENT with your time. However, this doesn’t mean you cant have a life. Take a day off here and there, spend time with your family/significant other, etc. don’t miss out on significant life moments (convocations, birthdays, weddings). As long as you are being reasonable about your non-study time, you will find yourself with a better receptive mind than going on extreme nerd mode with zero breaks, taking your First Aid book with you to the bathroom and stuff.
To all those preparing the exam, this is not an impossible exam…have faith in yourself...you can do this. Dont kill yourself because you dont have everything on First Aid memorized....322 Qs is not a whole lot of Qs and it is impossible to examine every concept/fact. . Good luck to all those awaiting their results. I have absolutely NO clue how I did….not sure whether I failed, passed, did well or performed average….anything is possible, which is pretty scary and unsettling to be honest. I feel sick and my tummy does a little Listeria tumble whenever I think about the step. For now I’ll try to block out any thoughts about the exam by catching up on Game of Thrones. Thanks to all those who’ve been really resourceful with their invaluable input on this forum
