Took this biatch last week. Just a brief rundown of my thoughts here because overall my experience was identical to what you read in last year's level 1 thread. Lots o' micro, pharm, neuro/anatomy/omm and a surprising amount of the common CV and pulm stuff like asthma and CHF.
To sum it up I walked out of the testing center pretty pissed off because a) I felt like the exam in no way tested my understanding of the first two years of medical school and b) most of the wtf type questions were a straight forward vignette with answer options that were like word games...I felt like I was choosing the least incorrect answer rather than the most correct. It was really weird beyond the level that I saw on COMSAE's.
Now, let me back up a bit and say that I tend to dwell on the few questions I got wrong and forget about the easy ones. I spent the last 2 years thinking I failed every test because all I could think about were the 15 tough questions on the test. Then come to find out that I got the other 85 easy--moderately difficult questions right.
My thoughts by subject:
1. Micro: these were mostly first order name the bug based off most common or other ID characteristics we love like thayer-martin agar, lysed RBCs etc.. When it was dysentery, only one option would be a crampy, bloody diarrhea while the other 4 options were watery diarhea pathogens. If you know your basics and buzzwords, micro is easy points.
2.Neuro/anatomy/omm: I lump these together because sometimes I wasnt' sure what subject the question was. Neuro was tons what artery causing the stroke symptoms. Anatomy/neuro was your standard peripheral nerves innervation etc. OMM seemed straight forward. There were a few odd ball questions but the bulk were exactly what you probably saw on your school's exams.
3. Pharm: I studied the hell out of pharm because I'm a nerd so this is hard for me to judge the difficulty. Either first order class of drug for disease X or MOA for drug Y. The rest were side effx and toxicities. I thought they were easy when I would pick up on the classic side effect or toxicity. If you know these, the questions are as simple as spironolactone is a K-sparing is putting someone at risk for hyperK, for example. If you don't pick up what they're hinting at then it's just a guess and move on.
4. The rest seemed like it was mostly type of pathophysiology questions. In reality most of these were as straight forward regarding starling forces or Like, e.g., a 3 paragraph clinical presentation and history of a patient and then it would ask what is causing symptom X. Then, none of the answer choices would make sense and you would spend 45 seconds decoding them to choose which one in a round-about way would maybe indirectly lead to the symptom X.
One last tip I can think of right now: Most of the questions are very short 2-3 sentences, but when you get the occasional longer pt presentation, don't get lured in to sifting through every word trying to figure it out along the way. Jump to the bottom and look at the actual question. This is a made up example to preserve test confidentiality, but I had several that were of similar style. Example: a 500 word H&P on a burn victim with all of his lab values and comorbidities then the real question at the end was what is the most likely pathogen infecting his burn wounds.
And finally, the reason I say I didn't feel like it reflected my understanding of medicine was because I spent 2 years learning from sources like pathoma, first aid, comlex-style Q banks and NONE of these will prepare you for their crappily-worded answer choices. Now, the bulk of the test was textbook, board-review type of questions, but those wtf questions are so frustrating they'll make you want to build a time machine, go back in time, and burn your AACOMAS app and only apply MD.
/end rant.
We will all pass and be doctors. I just wanted to share my thoughts.
Thank you and godspeed for all those upcoming comlexes!
