Hey all, I took the beastie on 6/26. I'll do the long writeup when I get results, but thought I share some of my inital thoughts on the test:
Overall, I think what people have been saying on increased difficulty is true, at least in comparison to the NBME's/UWSA. I felt mine was very similar to NBME 16, except I felt like there were even more questions with long stems and extraneous information. On NBME's/UWSA i usually had 10-13ish minutes left to review blocks. The real thing I was closer to 5-9 minutes left per block, this made me skittish, as sometimes I had one or two unanswered questions in the marked; I had to guess on a couple of these due to the time factor. In retrospect, I should have spent more time getting used to skimming vital signs/pulmonary sx, generally extra info when doing practice blocks.
I must have marked 10 of my first 15 questions, just the exhilaration of starting the test made me question like everyone of my answers.
In general, they have made the test hard in two ways in my opinion:
1) Longer stems - Being an average-speed reader, i was pressed for time; skimming/speed reading is an important skill to have.
2) asking questions in different ways than we have previously seen. Again, these guys know what Uworld and other question banks have been churning out. They are really testing to see if we are just answering by pattern recognition, or if we really understand the underlying concept.
Biochem - lots of big picture biochem for me. I know Uworld does a great job of getting you used to biochem questions, but for my test it was especially important to be able to visualize the general flow of pathways in your head. Like, really know which way FA's/AA's/glucose metabolism goes, not in just regular fasting or fed states, but they would love to incorporate them in galactose/fructose disorders, glycogen storage disorders, lipid disorders. In this, they really make you think that extra step.
Pharm - very fair. all drugs answers except 1 or 2, I had seen in FA/Uworld. In fact i think FA alone would have covered ~99% of the drugs on my form. Mostly MOA's and SE. They liked SANS/PANS a lot, the manipulation of selective alpha/beta receptors and then adding epinephrine...KNOW THESE COLD, i had like 3-4 questions in that format, and at least 10 more on just autonomics.
Micro - i felt my test was VERY MICRO HEAVY. maybe an exaggeration, but it felt like i had at least 10 micro questions on each block. Lot of "most common" infections in certain settings (hospital, dialysis, catheter, etc); a couple times they mixed several comorbid factors, and you kinda have to feel your way through and guess the most likely pathogen without any other clues. For this, i think FA fell a bit short. Overall though, all bugs mentioned were somewhere in FA. (edit: i did see a couple weird bug answers like aeromonas, prevotella, but they just seemed like distractor answers)
Behavioral Sci - all over the place. some SUPER DUPER common sense questions, some ambiguous ones where all concepts that you learned from qbanks seem to still point towards 2 correct answers. Behavioral might have been my weakest subject going in, so i read Khan's 100 cases a few days out, i think it got me a point or two. Conrad fischer's cases seem a bit outdated to me, but i did that also just to get more comfortable with the subject.
when in doubt, ALWAYS lean towards answering normal development/reassurance lol.
Physio - decently represented. Mostly stuff you'd have come across in Uworld, physio/pathophys is were Uworld really shines IMO. Fluid/electrolytes/osmolality questions were especially tough though. Again, they wouldnt just ask up/down arrows on electrolytes of classic DKA, b/c everyone knows those by memory. They would ask it for some drug that you hadn't specifically thought about the fluid/electrolyte changes for before, but you could kinda of figure it out if you understood the renal physio well. Cardiovascular/respiratory physio/pathophys seemed like gimmes if you did your uworld.
Anatomy - few brain sections, no brainstem sections (disappointing, neuro is my strength). but holy crap the pelvic anatomy....I had a least a question relating to this on each block....ugh my ultimate weakness. Kegel exercises showed up (thanks SDN)
🙂. Different kinds of urinary incontinence, birthing muscles were fair game
🙁. Luckily, no muscle insertions (i didnt do too hot during anatomy classes)
I guess dont have much to say about other subjects because they didn't really stick out too much. Path was of course all over the place and integrated. I might not have had any straight up histo, or it was just really easy like recognized where is protein surfactant stored in an electron microscrope pic (not the actual Q.) Immuno was pretty heavy, but I think if you did and understood Uworld +/- kaplan qbank, that had everything you needed to answer all the questions. Too be honest, there were fewer patho images than i expected; no renal biopsies, though i suppose that varies from form to form.
3 EKG's, 3 Heart sounds. Not too bad, but most of they I would say you needed to multimedia to give you the answer. I think only 2 of them I could have answered without looking at EKG/auscultation.
Experiment questions were very similar to those on NBME. I had a question that was the exact same format as that one SF/NY virus question on NBME (15 i think?), they just switched the variables around. So doing practice NBME's for these help, but only to an extend. These still felt like IQ questions; asking if you can see the pattern they want you to see.
Whoever was talking about that question with a guy breaking the world record for banana eating, I got the same question
Safety science - still not sure what that is. Though i got a question on Medicare/medicaid, and another 1-2 on disinfectants. these were covered in FA/Uworld
Maybe 3 questions total were it seemed like totally too specific minutiae (had one on which p450 enzyme does X inhibit), just guess, laugh it off, and move on. The main problem is not the minutiae; again it's mastering the information that you do have, and applying it in a timely fashion, while these test makers are simultaneously throwing all this extra stuff in the stem to see if they can get you to mess up.
My feeling on the coverage of FA/uworld/pathoma - I believe this test required a deeper level of knowledge than before to answer questions correctly; however the scope of it has not changed much i think. If one knows first aid TO MASTERY, i think they could correctly answer 80% of the exam. I did FA 7x, Uworld once, RX once, 60% of Kaplan qbank. I feel these resources covered >95% of the total contents of the test (if it weren't for wonky anatomy questions, I think this number would be closer to high nineties%). I'm not saying they asked about that exact topic, but MASTERY of the aforementioned resources should enough to logic your way through 95% of the exam(not saying i did that well, I definitely made waaaaayyy too many dumb mistakes). The minutiae are exactly what they sound like, minutiae.
My forms were:
NBME 6 (8 months out): 208
NBME 11(5 months): 221
NBME 12(4 months):228
NBME 13(3 months): 243
UWSA 1 (6 weeks):258
UWSA 2 (5 weeks):265
NBME 15 (4 weeks):245
NBME 16(2 weeks):254
NBME 7 (4 days):254
Free 150(3 days):93%
Of course it felt harder than the practice forms. but like everyone says, you just gotta trust you work you put in, and believe in that curve. If it was hard for you, it was probably hard for everyone else.
