Apologies in advance for the long post. I'm a long-time lurker and this is my first post ever. I decided to post because I just took the exam on Monday June 13 and I wanted to share my experiences because some of the recent comments have really helped me...recover. Lol. So I wanted to make my contribution so that others can be comforted by my experience and know that they're not alone in feeling awful after the exam.
As background: I did very well in my classes all year and had been scoring highly on UWorld, NBMEs, etc. Finished UWorld (first and only pass) with an 86% random. My most recent NBMEs and UWSAs were in the range of 260-275. I therefore felt decently confident in my abilities to get a score that would make it reasonable for me to match into the specialty I am currently interested in (one of the most competitive ones). I felt that even if I "dropped" a little bit on the day of the exam, I could still pull out >245 (which would itself be a significant drop from my NBMEs predicted).
I had a terrible exam experience. The night before my exam, I had a massive fight with my significant other. That plus the impending exam made it so that I didn't sleep a wink the night before. When people generally say they "didn't get any sleep the night before," they generally mean like one or two hours. No. I literally did not get a single second of sleep.
The morning of, I was obviously freaked out. How in the world was I going to take STEP FREAKING ONE on an all nighter? I considered canceling my exam, but in the end decided I had to take the exam for the following reasons. 1) I had to take my exam before the start of third year, which is very soon, so there was not a huge window of time in which it would have been even possible to reschedule. 2) Even if I wanted to reschedule, it would have likely been a struggle to find one in a location at the last minute that I could get to easily and that process would have just made my life even more complicated. 3) The morning of, I searched frantically on SDN whether anyone else had ever taken the exam on no sleep and whether they felt it significantly impacted their abilities. I saw quite a few posts with stories about similar experiences and almost everyone said that they didn't feel tired during the exam because of the adrenaline even though they got no sleep. 4) I realized that I indeed didn't feel tired at all (I was wide awake) and that I should just got ahead and take it because any other option would just make my life so complicated and also I had no guarantees that it wouldn't happen again. Like, even if I were lucky enough to reschedule it for the following day, what if the same thing happened again? I think that when you pull an isolated all nighter you can feel OKAY the following day but two days in a row is not the same...
The exam itself was so demoralizing. When people say that they found Step 1 easier than UWorld, etc., I can't for the life of me begin to comprehend how. My test was a good 3-4x harder than any NBME I ever did, way harder than UWorld in general, and just had soooooo much stuff I straight up had no clue about. For reference, given my NBME and UWorld scores, I wasn't missing very many questions on those, and even the questions I missed, almost all of them were things that I've at least seen before and I just didn't fully understand the topic and had more to learn. On the real thing, however, there were countless questions where I was just like...what???? I think on each section I marked 10-20 questions and I'm sure I missed a large percentage of them. When I think about how harsh the curve is on NBMEs, I am just gutted by my performance. I easily could have missed 50 questions.
When I got out of the exam, I cried in the parking lot for half an hour. It feels super unreal that Step is actually over with after working so hard for months and knowing that I potentially undid all of my hard work because I just couldn't perform. I know there are so many stories on SDN of feeling devastated walking out of the exam and then they end up score like >260 lol. But that isn't going to be me, I know. I am super disappointed in myself. No, it's not the end of the world if you don't end up with the score you want. However, it's always sad when you don't live up to what you have in your capabilities. That's how I feel right now. So if there's even more people out there feeling like this...YOU'RE NOT ALONE!!!
As for the question of whether my lack of sleep/emotional state affected me...I am going to say probably a little, but maybe not. I just wasn't at the top of my game and even though physically I was okay, mentally I was not. It could have potentially affected my performance a bit, but it also could not have made that much of a difference at all. I'm not sure. What I would corroborate is that you shouldn't be scared that you will fall asleep during the exam or something if you don't get any sleep the night before haha. Physically, I was actually SO wired from the adrenaline that I didn't feel drowsy even in the slightest.
This month flew by so fast. After feeling so incredibly miserable after the exam, I thought I would spend the entire month worrying about it. In reality, within a few days I was happy/non-anxious again. In retrospect, a lot of my worry/anxiety about performing terribly on my exam was due to the circumstances surrounding it (complete lack of sleep, BAD BAD BAD fight with my SO), which you can read about in my previous post. I'm saying that in defense of my neuroticism
😛. That being said, however, I still maintain 100% that the exam felt much, much harder than NBMES, Uworld, etc. But anyways, it is over. I am very thankful for the other people who posted about their experiences with the exam, because it helped me so much to know that I wasn't the only one who felt like I catastrophically under-performed. I made a promise to myself that I would post my score regardless of what it was so that it could be helpful for others in trying to relate to my experience.
For reference:
Uworld (first pass, random): 86% random
NBMEs and UWSAs: 260-275
Real score:
265-270.
I am beyond ecstatic. Obviously, with how I felt after the exam, I can't have hoped for a better score. So many people say it, but it's hard to do it yourself when you are worried....trust your NBMEs! You are not going to catastrophically drop from your practice scores by like >20 points! You might drop a little but the cases where people drop significantly are rare. I am in awe of how perfectly the NBMEs predicted my score, despite how terribly I felt I performed.
I have a lot of advice with regards to studying and the whole experience, but a lot of it has been said by other people. I will just go with a few bits I would personally would like to emphasize.
1) STUDY FOR CLASSES: My belief is that consistently studying for classes is the #1 most important thing you can do for yourself in preparation for Step 1, even if you believe that your school doesn't "teach to the boards" (I don't think mine particularly do or don't). There is not much you can do during dedicated period, in my mind, that will compensate for a lack of a good foundation from your first two years. In fact, I did not start studying for Step 1 until the end of January this year. Before that, my focus was on classes. I did not go crazy studying for classes (I still had a healthy social life with lots of extracurriculars). I made sure to just put in consistent work from the beginning of med school (aka trying to make sure I was caught up with reviewing lectures, never letting myself get behind by more than a day or so). This made my life so much easier when it came to Step 1 because I still was able to maintain a healthy lifestyle for myself as the exam approached. I still exercised, got enough sleep, etc. because I had set the solid foundation for myself earlier on so that I didn't need to make my life so miserable in the month before Step 1. On the flip side, I have friends who slacked off first year and then MASSIVELY turned it up second year so that they were studying way harder than me...but it was almost too late. Their lives around dedicated period were just...awful. Some people would come into school to study at 8 am and then not leave until like 2 a.m. What I'm trying to say is that if you put in good consistent work, you won't need to scramble so hard towards the end in an effort to catch up. At certain point, you just can't catch up. No amount of 18 hour studying days will entirely compensate for slacking off for the first 1.5 years of med school.
2) There is no magical resource that will guarantee you a good score. I actually only went through First Aid a single time and didn't like it very much. I thought that Sketchy Medical was clutch for the topics it covered (although I'm not sure it actually helped me in terms of the exam because of the particular pharm/micro questions I received). Pathoma's great. But the moral of the story is that there are going to be people who score highly with all different combinations of resources. Obviously there are a ton of people who think that First Aid is the be-all-end-all of Step resources. I would always have to fight the urge to feel a little bit anxious at the fact that I was barely using First Aid while others were doing a million passes. Just find the resources you like early on and stick with them. Don't feel compelled to buy a dozen different books, website subscriptions, etc. because someone somewhere said "OMG I couldn't have done Step 1 without this." Everyone who did well on Step 1 only did it once so of course they are going to think that the resources they used were key to their success -- they don't know what they would have gotten had they done things differently. On that note, try to not let what other people are doing make you anxious in general. Everyone is different.
