Cross-post from /r/medicalschool:
Got my score today, 264.
Whatever you do, trust your statistics. I was scoring in the low 260s range in the last 4 NBMEs I took, and NBME 18 was exactly 264, where I landed in the final one.
Here is my progression:
CBSSA (school administered practice): 245
NBME 12 (done as baseline 2 weeks before dedicated, before I had to take a break for school exams): 249
NBME 13 (done right at start of dedicated): 249
NBME 15 (end of week 1): 262
NBME 16 (end of week 2): 262
NBME 17 (end of week 3): 260
UWSA 2 (end of week 4): 263
UWSA 1 (day after UWSA 2): 264
NBME 18 (middle of week 5, a few days before my test): 264
Real deal: 264
Method used: UFAPS.
I decided to disregard everyone's advice (and I urge you do to the same), and do my own thing. I didn't set up a schedule of what subjects to cover on which day. My only goal was to get through UWorld as quickly as possible.
I used Rx throughout the year on untimed mode starting in August, keeping up with school material. In January, right after coming back from winter break, I switched to tutor mode so that I could pound through the rest of Rx. Goljan in one of his talks (around the 14:00 mark) mentions how it is useful to do tutor to go through many questions, so I heeded his advice. I finished around half of Rx in about 2-3 weeks. Since coming back from winter break, I also started listening to Goljan recorded lectures in the gym (I barely went) and while driving. I think I went through them at least 1x, some lectures maybe 2-3 times.
After winter break, I barely dedicated time to studying for class, choosing just to cram a few days before the exam. Rather, I focused all my efforts to study for boards.
Right after finishing Rx, I embarked on UWorld. I did UWorld only timed and random. In my opinion, this is the way to do it. Because of this, timing myself and thinking on the fly became second nature early on, rather than things to add on later. I would shoot for 3 blocks per day, every day, 6 days a week, until I was done. It took me a long time to go through UWorld (see below) so I finished it with only 2 weeks to spare at the end of my dedicated.
I went through UWorld extremely thoroughly. For every single question I got wrong or guessed on, I would read up on it (UWorld explanations, Goljan, Big Robbins, Wikipedia, FA, Moore's anatomy, Lippincott's Biochem, etc), and then write a passage about it in a Google Doc as if I were writing a textbook. I would add images as appropriate. I would spend a lot of time making my own diagnostic flow charts. I paid for a one month subscription to Lucidchart to make these more easily and make them more neat. This was very helpful for organizing my thoughts and creating a fast way for me to arrive at a diagnosis within a certain disease. I had a chart for the lysosomal storage disorders, trisomies, psych diagnoses, you name it. By the end of UWorld, I had written my own version of First Aid, which ended up being around 500 pages. It was tailored to things that I didn't know the first time around. Making this monster of a study guide took ages and ate up the majority of my dedicated, but it was extremely worth it because it forced me to really understand every single question that I got wrong.
By the end, I had used Rx x 1.3 at 74%, UWorld x 1.3 at 87% (2nd time at 99%: having really gone over the questions carefully paid off). I chose not to do UWorld twice in favor of reading more Goljan, and watching Pathoma several extra times, and reviewing Sketchy parasites, as that was my weakest section in micro.
In the last 2 weeks, I read sections of Big Robbins about obgyn and neuro pathology, which I felt like I needed more practice in. I also went through about ~500 MC questions in Firecracker (the cases that they offer) - these were honestly not great compared to UWorld or Rx (very lackluster explanations and lots of blatant errors), but it was useful to do them rapid fire to tune my intuition. I also did a quick read of Goljan's review of pathology (and then spent some time regretting I didn't start this book earlier with my classes). I also did the 100 free Kaplan questions (trial of their Qbank).
Throughout the process, I barely used FA (really just as a reference). In the final few days, I closely read the micro section, and then did the Rapid Review section at the end.
For those who haven't taken, good luck. My advice: 1. Don't listen to what others say. Do what works for you. I had no schedule and barely used FA. 2. Trust the NBMEs. If you have been consistently scoring in your target range, trust your preparation and go kill this exam.
