Official 2014 Step 1 Experiences and Scores Thread

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I slept in today, eased-up a bit on my studying and am feeling better. Took some time to reflect on the step backwards and realized that I was just damn tired: had taken an NBME, 7 block Kaplan test, and another NBME in a three-day stretch. Who's not going to be mentally fatigued after that? So if you're like and pushed yourself to an unreasonable limit then try backing off a moment and taking some time to chill out.

Lol que? You trying to build porn star stamina? That's insane.
How was the Kaplan full length though? Early on I intended to do it, but I don't plan on going through every block, so I'm not sure if it would be worth the time investment if it doesn't even give a score estimate.
 
Hey guys, I am looking for advice on how to proceed over the next few weeks. Im three weeks out from my exam. My dedicated period is 5 weeks out. Stats so far:

40% thru Uworld 85% average, Timed, Random
NBME 16 4 weeks out: 251
NBME 15 3 weeks out: 258

I am only about halfway through FA. Should I hurry up and try to finish FA over the next few days, and spend the rest of my time hammering questions or continue to do a little bit each day over the next weeks and switch to straight questions over the last week. Also, when do you think I should take the UWSA? Thanks!
I would hurry through FA and then focus on questions entirely. Obviously you must know what's in FA to be scoring in the range you're in, but I always thought it was better to have seen all of the material in FA before trying to apply it to questions. Otherwise you could be getting questions wrong and wasting time on material already listed plainly in FA.

Actually I spent all of my time while going through USMLERx trying to learn FA so I'd be ready for UWorld. I made it through the vast majority of it but never got to Endocrine and Micro. I finally finished Endocrine yesterday and made it through the virus and systems sections of Micro in random pieces whenever I had some free time, but I don't think I'll get to review fungi/parasites, bacteriology and general bacteriology in the level of detail I wanted to (test is on June 1st). Micro is actually one of my strongest sections on UWorld so I don't think it hurt me but I'll always wonder if I'm missing something because I didn't spend as much time with those sections as I did with others. In other words, don't make the mistake I did and power through it.
 
Lol que? You trying to build porn star stamina? That's insane.
How was the Kaplan full length though? Early on I intended to do it, but I don't plan on going through every block, so I'm not sure if it would be worth the time investment if it doesn't even give a score estimate.

It was long. I thought the 1st exam was better than the 2nd one. I didn't go through every block.

The whole doing that many questions over two days was because I wanted to get as many q's done as I could before hitting my last week of studying.
 
Looking for a little advice on what to focus on these next 13 or so days. Goal score is a 255.

NBME 11: 256 (6 weeks out)
NBME 12: 258 (3 weeks out)
NBME 13: 251 (2 weeks out)
UWSA 2: 265 (2 weeks out)

I've got NBME 15 & 16 coming up. Lately, I've just been grinding Pathoma/Uworld/FA. I'm on my second pass Uworld - 47% left (97% correct).

I think I should be able to finish my second pass through Uworld, though it'll be close.
Should I dive into any other resources at this point or just stick with the golden trio?
 
Is anyone else kind of interested to see what the heck Step 1 is going to throw at you? It's so weird hearing that the exam is so different from the questions on NBME and UWorld. Gonna be interesting.
 
Looking for a little advice on what to focus on these next 13 or so days. Goal score is a 255.

NBME 11: 256 (6 weeks out)
NBME 12: 258 (3 weeks out)
NBME 13: 251 (2 weeks out)
UWSA 2: 265 (2 weeks out)

I've got NBME 15 & 16 coming up. Lately, I've just been grinding Pathoma/Uworld/FA. I'm on my second pass Uworld - 47% left (97% correct).

I think I should be able to finish my second pass through Uworld, though it'll be close.
Should I dive into any other resources at this point or just stick with the golden trio?
I can't imagine other resources helping at this point; those 3 are more than enough to attain a very high score. Keep working on minimizing mistakes and addressing any weakness you may have and you'll likely do very well. When taking NBMEs, be on the look out for what kind of mistakes you're making. Mistakes due to careless errors, overanalyzing etc. can be avoided and should be addressed. Mistakes made due to lack of knowledge might require you to dig a little deeper into those topics unless it's complete minutiae and isn't worth the time. For example, failure to localize a lesion in a pt. presenting with stroke means you should go through some brainstem slices to make sure you know where everything is. Failing to recognize every drug listed in the answer choices (if that drug wasn't the answer) is not a good reason to go searching for another resource for pharm outside of FA and UWorld.
 
Is anyone else kind of interested to see what the heck Step 1 is going to throw at you? It's so weird hearing that the exam is so different from the questions on NBME and UWorld. Gonna be interesting.

The trend I've noticed is that there are lot more anatomy questions than there used to be. My exam had ~20 anatomy questions with a lot of them not in FA. I had to dig through my dusty memory banks to recall some of the info from anatomy class.

If I had the time, I would have gone through the Blue Boxes in Big Moore just to jog my memory, but that's just me because I actually enjoyed reading it back then.
 
The trend I've noticed is that there are lot more anatomy questions than there used to be. My exam had ~20 anatomy questions with a lot of them not in FA. I had to dig through my dusty memory banks to recall some of the info from anatomy class.

If I had the time, I would have gone through the Blue Boxes in Big Moore just to jog my memory, but that's just me because I actually enjoyed reading it back then.

I'll pick up a McDonald's application on the way home if I get an anatomy-heavy exam.
 
The trend I've noticed is that there are lot more anatomy questions than there used to be. My exam had ~20 anatomy questions with a lot of them not in FA. I had to dig through my dusty memory banks to recall some of the info from anatomy class.

If I had the time, I would have gone through the Blue Boxes in Big Moore just to jog my memory, but that's just me because I actually enjoyed reading it back then.

Yeah I have heard that too. I just don't really know where to begin with it all. Like is it important to know innervations and actions of muscles that you long forgot? I feel like there is going to be some head and neck anatomy that is gonna suck.
 
Yeah I have heard that too. I just don't really know where to begin with it all. Like is it important to know innervations and actions of muscles that you long forgot? I feel like there is going to be some head and neck anatomy that is gonna suck.

Anything that can be clinically correlated is fair game. If I had my way, I would have just flipped through the Blue Boxes in Big Moore; I did well in anatomy so I feel like a quick refresher would have been enough, and the questions I had on Step 1 I am pretty darn sure were covered in Big Moore. The anatomy questions weren't complex. They were, more or less, recall questions.
 
Looks like I'll be joining some of you for the home stretch (step 1 on June 1st). I've got an NBME scheduled later this week regardless, but I'll have about 2 flexible days after I finish UWorld tomorrow. Should I use those two days to hit 3 NBMEs or do 1 NBME and the 2 UWSAs?

I'm all for taking as many NBMEs as possible both for the sake of pointing out my weaknesses and score prediction, but the explanations for the UWSAs are learning points that I'll miss out on if I skip them entirely. If I only review the learning objectives quickly and spend most of my time reviewing my incorrects, I could probably knock out both UWSAs in one day. Does this sound ok? Or are these explanations really worth spending as much time as I normally would for going over UWorld blocks?
 
Which NBME's do you have left? I haven't done 16 yet but everyone says it's the most similar to the real deal. I'm taking that one this week so we'll probably see each other in that thread.

I'd say if you still haven't touched 15/16 (the latter, especially) then I'd do that. I don't know about you but it takes me forever to get through wrong answers on the NBME's. I felt that 15 was a good exam, pretty well-balanced questions.

I think you can get through both UWSA's in one day, but it'll be a long day and a bit difficult to focus/learn anything after doing 8 blocks and going through those incorrects. UWSA2 has a more generous curve than UWSA1, so if you just want some confidence going into the exam than do the second one.

Make sure to throw the Free 150 into your plan if you haven't done those questions yet.
 
Looks like I'll be joining some of you for the home stretch (step 1 on June 1st). I've got an NBME scheduled later this week regardless, but I'll have about 2 flexible days after I finish UWorld tomorrow. Should I use those two days to hit 3 NBMEs or do 1 NBME and the 2 UWSAs?

I'm all for taking as many NBMEs as possible both for the sake of pointing out my weaknesses and score prediction, but the explanations for the UWSAs are learning points that I'll miss out on if I skip them entirely. If I only review the learning objectives quickly and spend most of my time reviewing my incorrects, I could probably knock out both UWSAs in one day. Does this sound ok? Or are these explanations really worth spending as much time as I normally would for going over UWorld blocks?
You're taking the test on a Sunday?
 
Took UWSA2 this morning and got a 248, looking back, I made some really dumb mistakes too. I finished UWORLD this week with a 70% average (timed, random). Took UWSA 1 in April and got a 219 so it was really nice seeing the improvement after doing UWORLD. I've gone through Pathoma and FA once in my dedicated study, my question is what should I focus on for the next 15 days (USMLE on June 10)? Re-reading FA and going over UWORLD incorrects? I would be happy if I got a 248 on the real deal, I plan on taking a NBME sometime this week or next.
 
Took UWSA2 this morning and got a 248, looking back, I made some really dumb mistakes too. I finished UWORLD this week with a 70% average (timed, random). Took UWSA 1 in April and got a 219 so it was really nice seeing the improvement after doing UWORLD. I've gone through Pathoma and FA once in my dedicated study, my question is what should I focus on for the next 15 days (USMLE on June 10)? Re-reading FA and going over UWORLD incorrects? I would be happy if I got a 248 on the real deal, I plan on taking a NBME sometime this week or next.

I would try to make another pass of Pathoma & FA, while doing Uworld incorrects. How many NBMEs have you taken?
 
I realize buzzwords aren't used often (if ever), but how valuable is it to be good at recognizing common associations? I've been going through MS1 basically learning associations because our exams use obvious ones all the time. I thought I was kind of "cheating" myself since I figured things wouldn't be this easy when it came to actual board questions. However, lately I've been using USMLERx a lot and I've noticed that many of the questions are answered quite easily if you can recognize the associations.

I tend not to focus too much on obvious/common associations because I feel like NBME writers won't give it to us on a silver platter... but now I'm starting to think that these associations show up a lot more than I previously thought they did.

For example, pneumonia in a maintenance worker (legionella) or umbilical stump still around after 3 weeks (LAD).

I guess my real question is this. How well can you do if you know the forest extremely well, but aren't that familiar with the individual trees?
 
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I realize buzzwords aren't used often (if ever), but how valuable is it to be good at recognizing common associations? I've been going through MS1 basically learning associations because our exams use obvious ones all the time. I thought I was kind of "cheating" myself since I figured things wouldn't be this easy when it came to actual board questions. However, lately I've been using USMLERx a lot and I've noticed that many of the questions are answered quite easily if you can recognize the associations.

I tend not to focus too much on obvious/common associations because I feel like NBME writers won't give it to us on a silver platter... but now I'm starting to think that these associations show up a lot more than I previously thought they did.

For example, pneumonia in a maintenance worker (legionella) or umbilical stump still around after 3 weeks (LAD).

To me, the associations are the baseline. We should all have the associations/buzzwords down before we sit for STEP. Uworld has been good for me because it presents diseases in a different light. It allows you the opportunity to develop your ability to think laterally. I think that's where the big jumps in scores are made.

USMLERx is not known for multiple-step thinking. Most of their questions are straight forward, word recognition type questions. These questions serve a purpose though. Imo, they help you get to that initial baseline. And it'll help you learn the minutiae in FA.

Just from the NBMEs I've taken, I've seen some very easy questions that look like USMLERx questions. I assume that the vast majority of test takers get these questions right. It's the many many other questions that require lateral thinking that are separating our scores. But idk if the multiple step questions could be answered well if you didn't have the common associations down.
 
I realize buzzwords aren't used often (if ever), but how valuable is it to be good at recognizing common associations? I've been going through MS1 basically learning associations because our exams use obvious ones all the time. I thought I was kind of "cheating" myself since I figured things wouldn't be this easy when it came to actual board questions. However, lately I've been using USMLERx a lot and I've noticed that many of the questions are answered quite easily if you can recognize the associations.

I tend not to focus too much on obvious/common associations because I feel like NBME writers won't give it to us on a silver platter... but now I'm starting to think that these associations show up a lot more than I previously thought they did.

For example, pneumonia in a maintenance worker (legionella) or umbilical stump still around after 3 weeks (LAD).

I guess my real question is this. How well can you do if you know the forest extremely well, but aren't that familiar with the individual trees?
I have noticed that the whole buzzword things is pretty silly. There some buzzwords that are just dead obvious like on our written school exams, but more importantly you need to know the associations and big pictures. Unfortunately for me, and probably many medical schools, we don't get this in our education until board studying time. Connecting all the dots was not something my school was exceptional at, and thus it has been a rough few months. Further, RX is terrible at showing questions at various angles, instead they ask 1 dimensional questions. You need to recognize HIV pt with cd <200 = PCP, not Patient comes in with chest xray that is ground glass appearance. blarh

I actually tend to get some of the easier questions incorrect because I am trying to look for every association possible. Once you do a few thousand questions though, the associations, especially from a test writer's perspective tend to iron themselves out nicely.
 
It's interesting. People think associations are a cheap "shortcut," but this is actually what makes medicine - patterns. It's also interesting that up to a certain point, these will help you make the diagnosis...but beyond that it starts hurting because lines begin to blur and especially when fatigue hits, you grab onto anything you can logically justify and miss the subtleties.
 
Don't forget to stay sane by exercising and trying to eat right and get SOME sleep.

I was listening to the Goljan audio lecture on GI while bench pressing. He made a joke about getting a prostate exam and I almost dropped the barbell from laughing so hard. People in there thought I was crazy.
 
Don't forget to stay sane by exercising and trying to eat right and get SOME sleep.

I was listening to the Goljan audio lecture on GI while bench pressing. He made a joke about getting a prostate exam and I almost dropped the barbell from laughing so hard. People in there thought I was crazy.

"Prolapse. It's when ya rectum falls outta ya butt."
 
Don't forget to stay sane by exercising and trying to eat right and get SOME sleep.

I was listening to the Goljan audio lecture on GI while bench pressing. He made a joke about getting a prostate exam and I almost dropped the barbell from laughing so hard. People in there thought I was crazy.

I think many people can remember what they were doing when they heard that part bahaha. I was at the beach enjoying some beverages and busted out laughing. I've never had so many odd looks thrown my way.
 
Buzzword would be Schiller-Duval bodies. However, if you know what a Schiller-Duval body looks like, then "tumor forms glomeroid structures" might as well be a buzzword. In this case, you'd pick yolk sac tumors because that's where Schiller-Duval bodies are located.

I mean, there's only so much they can do to obfuscate the point being tested. If you understand what's going on, everything looks like buzzwords. When I take NBMEs and UWSAs, everything sounds like a buzzword because they are just describing what's going on. Dude comes in with pneumo + diarrhea, might as well tell me it's Legionella, etc etc. Now some people will say "those aren't buzzwords", but I disagree. To me, the real thinking comes in the physiology or research questions. Everything else is just associations. To me, the entire exam feels like a giant vocab/analogy test because that's pretty much what they are testing.

It's only in physio/pharm that you have to know how to think and play with the rules of the system.

Maybe, I'm wrong, but so far, prep for Step 1 has been underwhelming. Uworld is just an analogy/vocab test, the NBMEs are basically a fancy game of matching (save for maybe 10 questions on the exam), and everything is coming down to associations.

We'll see what it's like on the big day, but if it's anything like the NBMEs or Uworld, I don't think I'll be surprised at the vast majority of questions.
 
Buzzword would be Schiller-Duval bodies. However, if you know what a Schiller-Duval body looks like, then "tumor forms glomeroid structures" might as well be a buzzword. In this case, you'd pick yolk sac tumors because that's where Schiller-Duval bodies are located.

I mean, there's only so much they can do to obfuscate the point being tested. If you understand what's going on, everything looks like buzzwords. When I take NBMEs and UWSAs, everything sounds like a buzzword because they are just describing what's going on. Dude comes in with pneumo + diarrhea, might as well tell me it's Legionella, etc etc. Now some people will say "those aren't buzzwords", but I disagree. To me, the real thinking comes in the physiology or research questions. Everything else is just associations. To me, the entire exam feels like a giant vocab/analogy test because that's pretty much what they are testing.

It's only in physio/pharm that you have to know how to think and play with the rules of the system.

Maybe, I'm wrong, but so far, prep for Step 1 has been underwhelming. Uworld is just an analogy/vocab test, the NBMEs are basically a fancy game of matching (save for maybe 10 questions on the exam), and everything is coming down to associations.

We'll see what it's like on the big day, but if it's anything like the NBMEs or Uworld, I don't think I'll be surprised at the vast majority of questions.


I feel the same, they are just associations. As soon as you said Pneumonia + diarrhea I knew legionella.
That's why the rapid review section in FA at the end is pretty cool.

It's like doing hundreds of questions really fast, who needs all those stupid words, give me the symptoms, lab and exam findings, 5 answer choices, and lets move on.
 
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How much time at the end of each NBME block did you guys have for reviewing? I took form 15 ~two weeks ago and form 7 today, and in both cases I had anywhere from 1-6 minutes left on the timer. This is seriously freaking me out, because I tend to change quite a few answer choices (from incorrect to correct) when I do have time to review marked questions.

My score on form 15 (two weeks ago) was a 243. Believe it or not I marked four questions wrong even though I had mentally picked the right answer (e.g., I knew answer (B) was right, but ended up somehow clicking on (C), or (D)).... On form 7 (today) I scored a 245. I was thinking it would be possible to be in the ~250 range at around test day (13 days from now). I don't think that is quite possible now, but I least want to improve my timing a bit in the ~2 weeks I have left. Any advice?
 
How much time at the end of each NBME block did you guys have for reviewing? I took form 15 ~two weeks ago and form 7 today, and in both cases I had anywhere from 1-6 minutes left on the timer. This is seriously freaking me out, because I tend to change quite a few answer choices (from incorrect to correct) when I do have time to review marked questions.

My score on form 15 (two weeks ago) was a 243. Believe it or not I marked four questions wrong even though I had mentally picked the right answer (e.g., I knew answer (B) was right, but ended up somehow clicking on (C), or (D)).... On form 7 (today) I scored a 245. I was thinking it would be possible to be in the ~250 range at around test day (13 days from now). I don't think that is quite possible now, but I least want to improve my timing a bit in the ~2 weeks I have left. Any advice?

You can definitely break 250. It sounds like you just need to be sharp on test day.
 
Anybody recommend running through the Rapid Review section in the end of FA the day before the test? I might do that, like spend 3 hours in the morning. Then relax later.
 
Anybody recommend running through the Rapid Review section in the end of FA the day before the test? I might do that, like spend 3 hours in the morning. Then relax later.

I hate that section, so I categorically refused to look at it.
 
Why? Its the simplest part of the whole book.

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Took NBME 15 last Thursday: 251. Originally only planned doing NBME 16 and the Free 150 before the exam in 2 weeks, but I decided to add another this Thursday. From what I can gather by lurking in this thread, NBME 7 seems to be tricky but the later NBMEs are generally more representative of the current exams. Should I a) do UWSA1, b) NBME 13 or c) NBME 7? I'm sitting at an 86% in UWorld and feel that they are heavily inflated so I'm leaning more towards the NBMEs despite the fact I have two free UWSAs. Thoughts?
 
Anybody recommend running through the Rapid Review section in the end of FA the day before the test? I might do that, like spend 3 hours in the morning. Then relax later.

I'm subscribing to the camp of "don't do sh*@ the day before the test". I'm going to sleep in, visit with my family, hang out at the pool, go see a movie, get a massage, and go to bed at a decent hour. You know, stuff we've been neglecting for the entire dedicated study period.
 
Took NBME 15 last Thursday: 251. Originally only planned doing NBME 16 and the Free 150 before the exam in 2 weeks, but I decided to add another this Thursday. From what I can gather by lurking in this thread, NBME 7 seems to be tricky but the later NBMEs are generally more representative of the current exams. Should I a) do UWSA1, b) NBME 13 or c) NBME 7? I'm sitting at an 86% in UWorld and feel that they are heavily inflated so I'm leaning more towards the NBMEs despite the fact I have two free UWSAs. Thoughts?

Your scores are great. I'd lean towards something that can give me some explanations and potentially bring my score up even more: UWSA

Quality feedback > Googling answers in poor English on USMLE forums.
 
Got a question on Uworld today that has me pretty confused. Basically asked the mechanism for forming gallstones in Crohns disease.

I put increased oxalate absorption (based on the reasoning: Ca-oxalate stones are most common in CD, formed d/t fat malabsorption saponifying calcium and more oxalate being free to be absorbed, and then deposited in kidneys as stones)

The answer was increased biliary acid wasting.

Decreased bile acids promotes gallstone formation, but it seems to be a general mechanism vs. the specific mechanism outlined in (I believe?) Pathoma. Also, the explanation goes on to say that "none of the other answer choices are involved in gallstone formation in Crohns".

Confused on why oxalate absorption would be wrong...
 
Got a question on Uworld today that has me pretty confused. Basically asked the mechanism for forming gallstones in Crohns disease.

I put increased oxalate absorption (based on the reasoning: Ca-oxalate stones are most common in CD, formed d/t fat malabsorption saponifying calcium and more oxalate being free to be absorbed, and then deposited in kidneys as stones)

The answer was increased biliary acid wasting.

Decreased bile acids promotes gallstone formation, but it seems to be a general mechanism vs. the specific mechanism outlined in (I believe?) Pathoma. Also, the explanation goes on to say that "none of the other answer choices are involved in gallstone formation in Crohns".

Confused on why oxalate absorption would be wrong...
Ha they are trying to trick you. As you said, Oxalate causes kidney stones, not gallstones. They are asking specifically about gallstones.
 
Got a question on Uworld today that has me pretty confused. Basically asked the mechanism for forming gallstones in Crohns disease.

I put increased oxalate absorption (based on the reasoning: Ca-oxalate stones are most common in CD, formed d/t fat malabsorption saponifying calcium and more oxalate being free to be absorbed, and then deposited in kidneys as stones)

The answer was increased biliary acid wasting.

Decreased bile acids promotes gallstone formation, but it seems to be a general mechanism vs. the specific mechanism outlined in (I believe?) Pathoma. Also, the explanation goes on to say that "none of the other answer choices are involved in gallstone formation in Crohns".

Confused on why oxalate absorption would be wrong...

Sounds like you were thinking of the mechanism of kidney stone formation when the question was asking about gallstone formation.
 
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