POST EXAM UPDATE
I took the exam on 6/16. Wanted to give myself about a week or so after taking the test before I made another update on here.
Here is how I performed on practice exams:
UWorld (Timed/Organ specific): 72%
NBME 7 (5 weeks out): 220
NBME 11 (4 weeks out): 245
NBME 13 (3 weeks out): 241
NBME 12 (2 weeks out): 230
UWSA1 (1.5 weeks out): 245
NBME 15 (1 week out): 239
Free 150 (1 week out): 83%
NBME 16 (3 days out): 242
UWSA2 (3 days out): 265
Coming out of the test, I felt it was substantially more difficult than any of the NBMEs. I felt UWSA2 was most representative of the difficulty of the real exam (albeit the scoring is clearly more lenient). My preparation consisted of DIT, FA, UWorld, Pathoma. I also worked really hard to make sure I put myself in the best position to get proper sleep the night before, (I made a routine of going to bed at 10:30 every night, and waking up around 7:00 every morning). I had no problems going to sleep during my dedicated study period, but lo and behold, the night before my test, I found myself tossing and turning in bed until 1 AM as I always do the night before the test. It's kind of a self fulfilling prophecy to be honest, and I refuse to take any sort of sleeping pills. At any rate, I did not feel fatigued or tired despite only getting about 4 hours of sleep, and I did not feel impaired at any point during the test.
Now that I am about a week removed from my exam, my idea of how it went has changed a bit. It was definitely not as bad as I thought it was when I had just finished. While I still think it is on par with UWSA2 as far as difficulty, I would generally distribute my tests difficulty like this (50%: Straightforward, straight recall, no laterally thinking type of questions; 30%: More thinking, unusual presentations that you just have to stick to your gut with; 10%: Hardly testing your medical knowledge and more of an aptitude test; 10%: Extremely difficult question that can still be narrowed down to 2-3 answer choices, but from there it's a toss up). There were only 2 questions on the whole test where I had absolutely no clue what was going on and I just picked my favorite letter in that moment.
Now for a few more specifics:
Biostats: No problems here. Maybe 7 questions that were plug and chug.
Ethics: I had A LOT of ethics. ~16-18 questions. Most of them were easy. 2-3 of them felt like had two right answers, and had to pick the BEST answer, and these were much harder obviously.
Biochem: One of my glaring weaknesses. Fortunately for me, this was hardly tested. I had maybe 8 biochem questions on the whole test, most of which were straightforward.
Micro: Straightforward, and well represented on the test. It's all in First Aid.
Immunology: Straightforward. This is like a 15 page section in First Aid, so there is really no excuse to not do well on immuno questions.
Pharmacology: Straightforward. All drugs I had heard of before. All in First Aid.
Pathology/Physiology: Bread and butter of the test. Felt like pathoma adequately prepared me for Path. Physiology has always been a weakness of mine however, but I did not feel overwhelmed in this department.
Anatomy: Another glaring weakness (for most people I think). Thought it was well represented on my test, but nothing outrageous. Had a few questions where I really had to just make an educated guess and move on because I had no idea. Freaking hand and foot ligaments. Also, I didn't get very many CTs or imaging.
Organ Specific: Felt like it was all well balanced with the exception of Psychiatry which I probably only had 3 questions on for the whole test. The heart sound questions were very straightforward.
I have counted 8 questions that I have missed for sure (2 of which where I knew the right answer, but I just talked myself out of it).
I was surprised at how many "next step in management" questions I had, as well as general physical diagnosis. I did not have problems with time, (mainly because I was expecting it and was mindful of moving quickly). The question stems are consistently longer than UWorld and NBMEs, but I think that can be attributed to the random fluff they throw into most questions. I can see how one could have problems with time if they get hung up on all the detail each question presents. The shorter 2 sentence questions tended to be the harder questions.
Overall, I have very little idea as to how I am going to score on this thing. My goal coming into my dedicated study period was 240 and that hasn't changed. I feel that it is certainly possible I could get that, but I also feel like it's possible for me to get something like a 220, I really don't know. I felt like I made educated guesses on most of the test, but that is nothing different from when I do a block of UWorld or UWSA2, and I did okay on those.
I will find out on July 9th and let everyone know then.
Actual Score:
250
So this was 10 points above my NBME 11-16 average. Above includes information on my NBME scores and my exam experience. Now for how I studied:
Before dedicated study time: Used First Aid throughout my curriculum (system-based). When it came to my dedicated study period, I had already been through first aid once. I also got through USMLERx Qbank before the dedicated study time. I started doing UWorld beginning second semester of MS2 on organ-specific/timed with the hopes of getting through two passes.
What I would have done differently: Save UWorld for dedicated study time. Ideally, you want to do UWorld on all-random/timed when you are comfortable with all disciplines. Also, I wish I would have studied better/harder for anatomy. There is just so much that you can not and will not study for in this subject that will show up on your test. The only way you can get these right is if you can recall something from year 1. To study specifically for these questions is a waste of time as the subject is just too broad.
Dedicated study time (6 Weeks):
Materials: DIT + First Aid + UWorld + Pathoma
DIT: For the first 4 weeks I spent my mornings watching 8 videos of DIT a day and completing their workbook. I consider this just a pass through First Aid and not much more. Of the four resources I posted, this is EASILY the least valuable and not essential. However, I did find DIT useful in that it broke up the monotony of studying. I would watch videos in the morning, do questions in the afternoon, and read FA at night. Variety was what kept me moving forward, and I think this is important in studying: hearing the same thing, over and over again, from different sources.
First Aid: Obviously essential in studying for Step1. However I've seen a couple students using Kaplan MedEssentials, but 95% use FA. The key to this book for me was just reading it as many times as I could. I annotated important concepts from UWorld into the pertinent sections in First Aid. If you include DIT as a pass thru FA, I got through the book four times. Each time, you want to add a layer of detail. First pass through FA is just to gain familiarity with the material. Each subsequent pass, you want to make note of what you did not know from the previous pass, and keep adding onto your knowledge. This is a very difficult book to LEARN from, but practice makes perfect. It's often what is in between the lines that helps you answer the question. However, First Aid alone can get you very far. Each subsequent pass also goes a bit faster I noticed. The book took me like 4+ months to get through the first time. 1 month the second time. 1 week the next time.
UWorld: The #1 resource in my opinion. Also the most frustrating. This was a constant struggle to determine how much time I should actually spend reviewing my answers, and it's about finding that balance. Obviously, the less questions you miss, the less time it will take you to review. I found that there was MORE I wanted to do in the day than to spend 5-6 hours reviewing my questions in UWorld, so I would simply read the Educational Objective on questions and concepts I knew I had down. I would read fully all the ones I got wrong, and toward the end of my studies (last 2 weeks), I was annotating very sparingly. I would recommend saving UWorld for your dedicated study time as there is a certain rhythm and groove you develop from doing 46 question blocks on all-random/timed on a regular basis (like twice daily). However, I am not entirely against doing UWorld by organ-specific and using it purely as a learning resource. For me, I didn't want to waste this valuable resource simply because I was not comfortable with a specific subject yet. Toward the end of my dedicated study time when I felt relatively comfortable with everything, I started to appreciate the value of all-random/timed mode.
Pathoma: In my last week of study, I had completed UWorld and DIT. I was quite burned out, and had NO motivation to continue redoing my missed UWorld questions. So I needed a spark. I also had very little interest in purely reading FA. Pathoma was what saved me, and possibly what gave me that extra 10 points from my last NBME to actual Step 1. Dr. Sattar was yet another voice telling me many things I already knew, and surprisingly many things I did not know (which was kind of unsettling within one week before my test). The fact there was so much active LEARNING still occurring this close to my test is what kept my motivated and finishing strong in this last week of studying. I watched all of Pathoma on 1.5 speed in my final week.
Key to success: Confidence is very important in this exam. For me, it was easier to trust my instincts on the real test than on practice tests because I realized I had no choice at that point. If I came across something that made me thing "hmm I think I remember the PCT being most susceptible to ischemia" that thought became "the PCT is most susceptible to ischemia. Period." There was no room for doubt. Even if what I was thinking was absolutely WRONG, I was stubborn about my wrongness. And the key is to be stubborn. Also, I think the last 2 weeks are the most important in the dedicated study period. It's about seeing as much as you can as fast as you can to keep it all fresh. This is a rare instance in which quantity outweighs quality. It's all about keeping those synapses dusted off for the big day, so
try to get through an entire pass of First Aid during the last week of your studies. And cover your weaknesses again 2 days and the day before your test.
