Official 2015 Step 1 Experiences and Scores Thread

KushWeedNuggetsStankyLeg · Oct 23, 2014

M2 here. Starting today, I am just going to be reviewing for Step 1 which I am taking next May, and nothing else. Here is my plan:

Oct 23-Dec 31: Memorize FA2014, Watch all of Pathoma
Jan 1-Jan 31: FA2015, Pathoma (pass 2), Kaplan QBank
Feb 1-Feb 28: FA2015 (pass 2), Pathoma (pass 3), USMLERX
March 1- March 31: FA2015 (pass 3), Pathoma (pass 4): UWorld
April 1- Mid May: FA2015 (pass 4), Pathoma (selective topics), UWorld (pass 2), all practice tests

Goal: High number

NekoBeats · Jan 14, 2015

Do the receptors in the aortic arch respond only to increases in BP or both decreases and increases in BP? In FA2014 on pg. 280, it says that they only respond to increased BP. But in FA2015 on pg. 286, it says that they respond to both decreases and increases in BP. Not sure what to believe lol

Transposony · Jan 14, 2015

NekoBeats said:
Do the receptors in the aortic arch respond only to increases in BP or both decreases and increases in BP? In FA2014 on pg. 280, it says that they only respond to increased BP. But in FA2015 on pg. 286, it says that they respond to both decreases and increases in BP. Not sure what to believe lol

That's because the dominant innervation to heart is parasympathetic (as compared to periphery where it is sympathetic).
IOW these baroreceptors are firing at rest (basal tone).
Therefore, where BP is low they fire less thereby raising the BP (essential for control of postural hypotension).

NekoBeats · Jan 15, 2015

mnhockeyfan said:
I always thought the aortic arch response was just to increases in BP...

Yeah that's what I thought.. :shrug:

Transposony said:
That's because the dominant innervation to heart is parasympathetic (as compared to periphery where it is sympathetic).
IOW these baroreceptors are firing at rest (basal tone).
Therefore, where BP is low they fire less thereby raising the BP (essential for control of postural hypotension).

So you're saying that the baroreceptors in the aortic arch do respond to low BP?

USMLE Secrets also says that the baroreceptors in the aortic arch only respond to increases in blood pressure.

seminoma · Jan 15, 2015

NekoBeats said:
Do the receptors in the aortic arch respond only to increases in BP or both decreases and increases in BP? In FA2014 on pg. 280, it says that they only respond to increased BP. But in FA2015 on pg. 286, it says that they respond to both decreases and increases in BP. Not sure what to believe lol

Might be errata. Costanzo and Rhoades/Bell both say increase in BP only.

Edit: Actually, FA 15 doesn't say that the aortic body responds to both. It says that the nucleus solitarius responds to both. I think the point they're trying to get across is that the signals being transmitted go to one place regardless of if they are signaling increased BP or decreased BP.

Edit 2: Actually I am not sure now that I look at how things are written in FA 2014...

Edit 3: I can't find anything published after FA 14 that says aortic arch responds to decreased BP only.. So maybe it's not errata?

Aortic arch transmits via vagus nerve to solitary nucleus of medulla (responds to and in BP).

Transposony · Jan 15, 2015

NekoBeats said:
So you're saying that the baroreceptors in the aortic arch do respond to low BP?

Yes, that's exactly what I am saying.

seminoma · Jan 15, 2015

Transposony said:
Yes, that's exactly what I am saying.

This seems to contradict every textbook I can remember looking in.. Robbins, Costanzo, Rhoades/Bell, Katzung, and I think maybe Goljan. Where did you learn that it can do both? Your prior post about normal physio makes sense, but I have always been taught that the aortic arch signals only for increases in BP.

Transposony · Jan 15, 2015

seminoma said:
This seems to contradict every textbook I can remember looking in.. Robbins, Costanzo, Rhoades/Bell, Katzung, and I think maybe Goljan. Where did you learn that it can do both? Your prior post about normal physio makes sense, but I have always been taught that the aortic arch signals only for increases in BP.

KLN Pharmacology Page 40-41.

Also explained very well in Sherwood’s Human Physiology as well as Guyton's Textbook of Physiology.

http://cvphysiology.com/Blood Pressure/BP012.htm

http://highered.mheducation.com/sit...eceptor_reflex_control_of_blood_pressure.html

http://www.medscape.com/viewarticle/409506_2

mcloaf · Jan 15, 2015

From Costanzo Physiology 5th Ed: "The carotid sinus baroreceptors are responsive to increases or decreases in arterial pressure, whereas the aortic arch baroreceptors are primarily responsive to increases in arterial pressure." I guess the word "primarily" is key here, implying that they can actually respond to lower pressure even if it's a less robust response than in the case of increased pressure.

NekoBeats · Jan 15, 2015

Transposony said:
KLN Pharmacology Page 40-41.

Also explained very well in Sherwood’s Human Physiology as well as Guyton's Textbook of Physiology.

http://cvphysiology.com/Blood Pressure/BP012.htm

http://highered.mheducation.com/sit...eceptor_reflex_control_of_blood_pressure.html

http://www.medscape.com/viewarticle/409506_2

mcloaf said:
From Costanzo Physiology 5th Ed: "The carotid sinus baroreceptors are responsive to increases or decreases in arterial pressure, whereas the aortic arch baroreceptors are primarily responsive to increases in arterial pressure." I guess the word "primarily" is key here, implying that they can actually respond to lower pressure even if it's a less robust response than in the case of increased pressure.

Ah, I see. I'll keep that in the back of the mind just in case.

Thanks for the input guys. I appreciate it!

Macaroon_Berry · Jan 15, 2015

seminoma said:
This seems to contradict every textbook I can remember looking in.. Robbins, Costanzo, Rhoades/Bell, Katzung, and I think maybe Goljan. Where did you learn that it can do both? Your prior post about normal physio makes sense, but I have always been taught that the aortic arch signals only for increases in BP.

From the Kaplan vids, what I understood was that: an increase in BP will increase the firing from the aortic arch which will be sensed as high BP, but a decrease in BP will result in *no* firing coming from the aortic arch which will be sensed as low BP. So what I think is true is that the aortic arch only fires and thus responds to high BP, when there's low BP, its lack of response is how we sense we have lower BP.

vashka · Jan 16, 2015

Hey, can anyone tell me how many questions there currently are in UWorld? Trying to figure how much time I need to complete it. Thanks

FA2014 · Jan 16, 2015

We come here to check student's experience of step 1 exam and get advice as we are coming near our exam date, but instead we see people asking questions that should be in separate thread. So annoying! Can you guys pleaseeeee ask questions on separate thread and leave this thread for experiences related questions only? You guys can have all the space you want there. Please.....

Transposony · Jan 16, 2015

FA2014 said:
We come here to check student's experience of step 1 exam and get advice as we are coming near our exam date, but instead we see people asking questions that should be in separate thread. So annoying! Can you guys pleaseeeee ask questions on separate thread and leave this thread for experiences related questions only? You guys can have all the space you want there. Please.....

That's exactly the reason I started these two threads.
Step 1 Planning and Strategy Thread
Step 1 High Yield Concepts Thread
But I guess people are creatures of habit.

faisal 2000 · Jan 16, 2015

Transposony said:
Step 1 High Yield Concepts Thread

syoung · Jan 16, 2015

edit.

NekoBeats · Jan 17, 2015

FA2014 said:
We come here to check student's experience of step 1 exam and get advice as we are coming near our exam date, but instead we see people asking questions that should be in separate thread. So annoying! Can you guys pleaseeeee ask questions on separate thread and leave this thread for experiences related questions only? You guys can have all the space you want there. Please.....

Sorry, this is the only thread I'm subscribed to on SDN so I don't check the main Step 1 page (read: didn't know there were topic specific threads). Didn't meant to annoy anyone.

Thanks again to those who helped to clarify my question.

aspiringdoc09 · Jan 19, 2015

It's official! Test on May 14th.

manno · Jan 19, 2015

My strategy for now is to focus more on class work. My test date is July 24

NoLollipops4U · Jan 19, 2015

manno said:
My strategy for now is to focus more on class work. My test date is July 24

This is something that many students overlook (including myself in MS2). Classes are more important, at least for the first half of the semester. I'm not sure about other schools, but at my school they taught well beyond First Aid.....with FA only helping for 1/5 of each system taught by the school. It sucked because A) we never saw the material taught by profs again B) couldn't study first aid, since it barely covered anything for our systems

I hate to say it but I wish US MD/DO schools taught like Caribbean students.......one giant board prep course. Why? Well I literally don't remember a single obscure management algorithm we had to memorize or any small details about pathways. The only things I remember from M1/M2 was what we learned for boards and a physical exam/bare differential.

Anyways, good strategy!

manno · Jan 19, 2015

NoLollipops4U said:
This is something that many students overlook (including myself in MS2). Classes are more important, at least for the first half of the semester. I'm not sure about other schools, but at my school they taught well beyond First Aid.....with FA only helping for 1/5 of each system taught by the school. It sucked because A) we never saw the material taught by profs again B) couldn't study first aid, since it barely covered anything for our systems

I hate to say it but I wish US MD/DO schools taught like Caribbean students.......one giant board prep course. Why? Well I literally don't remember a single obscure management algorithm we had to memorize or any small details about pathways. The only things I remember from M1/M2 was what we learned for boards and a physical exam/bare differential.

Anyways, good strategy!

You know med school prepares us for clinical rotations, boards, and probably general knowledge. That is why First Aid, Pathoma, and other board review resources are not enough to do well on class work.

aspiringdoc09 · Jan 19, 2015

NoLollipops4U said:
This is something that many students overlook (including myself in MS2). Classes are more important, at least for the first half of the semester. I'm not sure about other schools, but at my school they taught well beyond First Aid.....with FA only helping for 1/5 of each system taught by the school. It sucked because A) we never saw the material taught by profs again B) couldn't study first aid, since it barely covered anything for our systems

I hate to say it but I wish US MD/DO schools taught like Caribbean students.......one giant board prep course. Why? Well I literally don't remember a single obscure management algorithm we had to memorize or any small details about pathways. The only things I remember from M1/M2 was what we learned for boards and a physical exam/bare differential.

Anyways, good strategy!

manno said:
You know med school prepares us for clinical rotations, boards, and probably general knowledge. That is why First Aid, Pathoma, and other board review resources are not enough to do well on class work.

My school definitely doesn't teach to the exam. They try to prepare us overall for shelf exams and general knowledge. I would fail if I tried to just study for STEP and apply it to classes. There is way too much detail for that suicide mission. I just decided to follow along in my FA with classes as we cover subjects while reviewing first year stuff. That's why I started early. I won't risk failing multiple classes for a 1-day exam.

seminoma · Jan 19, 2015

Can anyone who has purchased the hardcopy of FA 2015 provide some input as to the quality of paper and content? I am 100% sticking with FA14 for the stuff I've covered so far in school, but I'm considering buying FA 15 and using it for the organ systems we cover from here until the end of the year. I have my FA unbound so I can just mix and match FA14/FA15.

Macaroon_Berry · Jan 20, 2015

seminoma said:
Can anyone who has purchased the hardcopy of FA 2015 provide some input as to the quality of paper and content? I am 100% sticking with FA14 for the stuff I've covered so far in school, but I'm considering buying FA 15 and using it for the organ systems we cover from here until the end of the year. I have my FA unbound so I can just mix and match FA14/FA15.

I have FA 2015 - the paper quality is perfectly fine. I have no idea why people are complaining about it either.

syma · Jan 20, 2015

My FA 2015 is being shipped. So ready to start that. Rotations start in March.
Ready to start this now. Need to book my date and commit to it.

NoLollipops4U · Jan 20, 2015

syma said:
My FA 2015 is being shipped. So ready to start that. Rotations start in March.
Ready to start this now. Need to book my date and commit to it.

Not trying to throw this thread off topic, but i'm curious....if your rotations start in March, how does that work with timing of the transition between 3rd/4th year when you schedule your aways etc? If you started in March, do 12 months of rotations (including vacation)....you end up in March again....and then have a few months off before starting 4th year? Or does your 4th year just end really early?

syma · Jan 20, 2015

NoLollipops4U said:
Not trying to throw this thread off topic, but i'm curious....if your rotations start in March, how does that work with timing of the transition between 3rd/4th year when you schedule your aways etc? If you started in March, do 12 months of rotations (including vacation)....you end up in March again....and then have a few months off before starting 4th year? Or does your 4th year just end really early?

I'm a UK ( accelerated) student. So we have 1.5years pre clinicals, 1 year junior rotations, 1 year senior rotations, then 8 week elective.
So still technically MS2.

Faol · Jan 20, 2015

seminoma said:
Can anyone who has purchased the hardcopy of FA 2015 provide some input as to the quality of paper and content? I am 100% sticking with FA14 for the stuff I've covered so far in school, but I'm considering buying FA 15 and using it for the organ systems we cover from here until the end of the year. I have my FA unbound so I can just mix and match FA14/FA15.

Just finished a read through of 15. Paper quality is fine and I feel like this is my favorite edition so far (had 13 and 14).

ALUCSD18 · Jan 20, 2015

Faol said:
Just finished a read through of 15. Paper quality is fine and I feel like this is my favorite edition so far (had 13 and 14).

What makes it your favorite edition? Thanks

Dr Dazzle · Jan 20, 2015

Faol said:
Just finished a read through of 15. Paper quality is fine and I feel like this is my favorite edition so far (had 13 and 14).

Curious to know what key differences you've seen between them

PL198 · Jan 20, 2015

yeah I feel like 15 is more succinct and refined for some reason. it just seems like an overall step up IMO

Faol · Jan 20, 2015

A lot of it was cosmetic. I felt like they did a very good job on color and clarifying certain diagrams (specifically sinuses and circle of Willis). As mentioned above, it felt like they cut out fluff and removed a few more obscure disorders. Also the number of diagrams for nerve lesions and total number of pictures seemed higher than 14. So content wise I didn't notice too much, just looked significantly better with better color, diagrams, and more pictures.

ALUCSD18 · Jan 20, 2015

Thanks for the response. Are you sticking with the UFAP method for Step 1, or are you adding stuff too?

Faol · Jan 20, 2015

ALUCSD18 said:
Thanks for the response. Are you sticking with the UFAP method for Step 1, or are you adding stuff too?

I didn't actually know about that until you posted it but it's pretty close. I wanted to go through it once, just reading, so I had at least seen most of the material once recently. (My school does organ system blocks so I haven't seen a lot of stuff in over a year). I have about 1700 questions left in USMLErx so I'm planning on finishing those up, then focusing on completing Uworld. I did one random block in Uworld about 2 weeks ago and got wrecked, which is why I decided to reread FA and finish Rx to establish a foundation.

NoLollipops4U · Jan 20, 2015

Can anyone please explain how you understand the branch angles of fungi?! I understand the basic phrasing of Candida = 20 degrees, Aspergillus = 45 degrees, and Mucor = wide angles...........but how do you know what way to form the angle when looking at a picture?

Take candida for example. It says 20 degrees right........well if you look at the angle from the opposite side its now 160 degrees and could be "wide"

Anyone input would be greatly appreciated. I just got a UWorld question wrong where you needed to get the image to make diagnosis. Most people used the clinical vignette and got the wrong answer (only 30% got it right) because the image is just horrible and looks to be wide branched when in reality its supposed to be "45 degrees"

Mr. Mojo Risin · Jan 20, 2015

NoLollipops4U said:
Can anyone please explain how you understand the branch angles of fungi?! I understand the basic phrasing of Candida = 20 degrees, Aspergillus = 45 degrees, and Mucor = wide angles...........but how do you know what way to form the angle when looking at a picture?

Take candida for example. It says 20 degrees right........well if you look at the angle from the opposite side its now 160 degrees and could be "wide"

Anyone input would be greatly appreciated. I just got a UWorld question wrong where you needed to get the image to make diagnosis. Most people used the clinical vignette and got the wrong answer (only 30% got it right) because the image is just horrible and looks to be wide branched when in reality its supposed to be "45 degrees"

seminoma · Jan 20, 2015

Ordered FA15 today. I've been annotating Kaplan qbank into my FA14, but I think I'm going to reserve FA 15 for UWorld and just start making a separate document for Kaplan/Rx.

PL198 · Jan 20, 2015

seminoma said:
Ordered FA15 today. I've been annotating Kaplan qbank into my FA14, but I think I'm going to reserve FA 15 for UWorld and just start making a separate document for Kaplan/Rx.

I had no idea what your username referenced until like a week ago. So sad but true

I also had no idea of the connection between wednesday and hump day until I was like 18, I just thought it was an usually humpy day for some reason

razazz · Jan 20, 2015

3 weeks from my exam , done nbme 13 with score 228 , i am really nervous and i don`t know if this score can be boosted to 250 + in three weeks ?

seminoma · Jan 20, 2015

razazz said:
3 weeks from my exam , done nbme 13 with score 228 , i am really nervous and i don`t know if this score can be boosted to 250 + in three weeks ?

Keep pushing! I know someone who went from 219 to 257 in 6 weeks. You can do it!

razazz · Jan 20, 2015

seminoma said:
Keep pushing! I know someone who went from 219 to 257 in 6 weeks. You can do it!

what is the last few weeks mainly about ? do more questions or do more revisions or what ? it `s just like trying to catch up the water in the ocean , it never ends 🙁

seminoma · Jan 20, 2015

razazz said:
what is the last few weeks mainly about ? do more questions or do more revisions or what ? it `s just like trying to catch up the water in the ocean , it never ends 🙁

Don't know.. haven't taken the test myself, but I've been told that in the last 3 weeks you still have time to strengthen the things you're weakest in.

NoLollipops4U · Jan 20, 2015

razazz said:
what is the last few weeks mainly about ? do more questions or do more revisions or what ? it `s just like trying to catch up the water in the ocean , it never ends 🙁

If it were me personally, I would spend a lot of time reviewing Micro, Pharm, Biochem, and Embryology since most of that is pure memorization. Also, don't forget the rapid reviews section at the end of First Aid!!

These topics are very high yield too: Vasculitis, Brain cancers, Ovarian cancers, Breast cancers, Ego defenses, Vitamins, diagnosing disorders of sex hormones, Cardio/Psych/Neuro pharm, Weber/wallenburg syndromes, and murmurs. These are more or less the "5 star" high yields from DIT (meaning every single student will have questions on these topics)

Transposony · Jan 21, 2015

NoLollipops4U said:
Can anyone please explain how you understand the branch angles of fungi?! I understand the basic phrasing of Candida = 20 degrees, Aspergillus = 45 degrees, and Mucor = wide angles...........but how do you know what way to form the angle when looking at a picture?

It's in relation to the long axis.
Just think it as branches coming off a tree, the long axis being the tree trunk.

blueforest · Jan 21, 2015

Hello everyone , I would just like some advice. I just received my score from one of the basic science exams created by the NBME, and it was a 190 after having read First Aid cover to cover one time, finishing Kaplan QBank, and doing some offline uworld. What am I doing wrong? I seem to have trouble answering those questions where it's like "What could I have read to prepare me for this quesiton?" ...and where the answer choices all seem so very similar to each other where it's almost impossible to answer the question by process of elimination. I seemed to be doing absolutely fine on uworld (only did a few questions), Kaplan was just annoying and I don't recommend it. I am well aware of all the resources, I have been using them throughout medical school.

Very very discouraged at the moment, I want to write Step 1 this summer. Also, I'm an IMG.

addy · Jan 21, 2015

US Allo MDs:

What're your thoughts on trying to do all three question banks (UWorld + Rx + Kaplan) during dedicated period if, prior to dedicated you have had one full run though of FA, UWorld, Pathoma?

I have 6 weeks to study so I was thinking that for 20 days, I'd tear through Rx to make sure I have all of FA down, and then do Kaplan. If it ends up looking like it's going to take me more than 21 days, I'll just cut my losses and spend the rest of my 3 weeks on doing another thorough run through of UWorld and Pathoma with another run of UWorld incorrects only.

Thoughts? Has anyone tried doing all three banks during dedicated?

Transposony · Jan 21, 2015

blueforest said:
I am well aware of all the resources, I have been using them throughout medical school.

What are those resources you have been using?

BTW there is a dedicated thread for this purpose where you might find other's input helpful.

blueforest · Jan 21, 2015

Transposony said:
What are those resources you have been using?

BTW there is a dedicated thread for this purpose where you might find other's input helpful.

First Aid 2014, Pathoma videos (watched them at least 3 times since last year), DIT 2013 (completed in late summer/early fall of 2014), Kaplan Live Prep course was offered at my medical school this past summer, Kaplan Qbank+Videos+Lecture Notes, Uworld offline, NBME Subject Exams at my school

I will buy USMLE Rx and UW before I start the real deal... whenever that will be.
I feel like my major problem is just answering test questions correctly, maybe I need more practice or I am just coming to a conclusion that I may be one of those "poor standardized test takers." Every time I walk out of an exam I can instantly remember at least 5 questions where I chose the worst answer out of all them, only to realize the correct one when it's too late. Is there any hope? I think I just need to go over all of the Kaplan lecture notes to get this information into my head, seems like i'm lacking basic concepts.

Transposony · Jan 21, 2015

blueforest said:
First Aid 2014, Pathoma videos (watched them at least 3 times since last year), DIT 2013 (completed in late summer/early fall of 2014), Kaplan Live Prep course was offered at my medical school this past summer, Kaplan Qbank+Videos+Lecture Notes, Uworld offline, NBME Subject Exams at my school

I will buy USMLE Rx and UW before I start the real deal... whenever that will be.
I feel like my major problem is just answering test questions correctly, maybe I need more practice or I am just coming to a conclusion that I may be one of those "poor standardized test takers." Every time I walk out of an exam I can instantly remember at least 5 questions where I chose the worst answer out of all them, only to realize the correct one when it's too late. Is there any hope? I think I just need to go over all of the Kaplan lecture notes to get this information into my head, seems like i'm lacking basic concepts.

I, too, am a "poor standardized test takers." I compensate loss of those 10-15 points by over-preparing for the test.
Therefore, I doubt that's your problem. You need to analyze this NBME in depth (preferably with a senior colleague/faculty) to figure out your weaknesses.
Also, it might be a good idea to have a study partner to discuss and clarify concepts.

NoLollipops4U · Jan 21, 2015

addy said:
US Allo MDs:

What're your thoughts on trying to do all three question banks (UWorld + Rx + Kaplan) during dedicated period if, prior to dedicated you have had one full run though of FA, UWorld, Pathoma?

I have 6 weeks to study so I was thinking that for 20 days, I'd tear through Rx to make sure I have all of FA down, and then do Kaplan. If it ends up looking like it's going to take me more than 21 days, I'll just cut my losses and spend the rest of my 3 weeks on doing another thorough run through of UWorld and Pathoma with another run of UWorld incorrects only.

Thoughts? Has anyone tried doing all three banks during dedicated?

Maybe it's just me, but doing 3 question banks in 6 weeks is REALLY intense (even if you are just redoing UW incorrects only). I think Kaplan is overkill from what I have read about it. My school gave it to us and I found the questions to be way too detailed.

My recommendation as someone done Rx and 20% done UW....
1) Do Rx before dedicated study time - It's a solid overview of FA and slightly "worse" than UW
2) Do UW TWICE (including corrects) during dedicated time. It's the most similar to the actual exam
3) Make sure to do 1-2 NBME exams during dedicated (or 1 at the start to see where you stand), since they are actual exams and can closely predict score

addy · Jan 21, 2015

NoLollipops4U said:
Maybe it's just me, but doing 3 question banks in 6 weeks is REALLY intense (even if you are just redoing UW incorrects only). I think Kaplan is overkill from what I have read about it. My school gave it to us and I found the questions to be way too detailed.

My recommendation as someone done Rx and 20% done UW....
1) Do Rx before dedicated study time - It's a solid overview of FA and slightly "worse" than UW
2) Do UW TWICE (including corrects) during dedicated time. It's the most similar to the actual exam
3) Make sure to do 1-2 NBME exams during dedicated (or 1 at the start to see where you stand), since they are actual exams and can closely predict score

Unfortunately my test date is in mid-March so there's no way of knocking out those banks before dedicated since my dedicated period starts in a week or so 🙁

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