USMLE Official 2018 Step 1 Experiences and Scores Thread

That's an extreme example but I've definitely seen UWorld questions where they try to blur the lines pretty heavily between MDD vs. Schizoaffective vs. Schizophrenia vs. Schizophreniform, GAD vs. Adjustment Disorder, Conduct Disorder vs. ODD vs. Antisocial, everything vs. normal reactions to stressors, etc. In my experience psych is the subject where I least trust my "gut" answer choice and have to know the nitty-gritty definitions cold.

 

Thanks.
Definitely not

 

Thank you,
No I wrote them separately and I think this is the better way. Cause you don't need to go over those notes as much as doing FA.

 

Hola Muchachos!

Does anyone have a say regarding UWSA 1 accuracy ?

Scored 256 today, NBMEs have been mid 230s

Test is on the 16th

Thanks!

 

Late replying; I get up early in the lead up to exams, so I know I'll get a lie in the night before an exam if I need to. Got up hella early though

 

UWSA's usually overpredict, but I'd say you're 240's with that kinda score on them. I found there was a big leap from mid 230's to mid-to-high 240's a few days before exams, might be that. If you do another NBME I'm sure your score will be up

 

Our school advisors tell us to subtract 20 from UWSA 1, but they said that UWSA 2 was pretty accurate. I do hope they are wrong.

 

Taking it 3 weeks from today (I'm week 4 into a 7 week dedicated) and noticed that my last 5-7 UW blocks have dropped 15+ points by average. I tried to chalk it up to a bad section or two, but then when it kept happening the major anxiety set in. Does this mean I'm forgetting things/regressing or that I'm burning out? Is this normal for your scores to decrease like this?

 

I had some periods of decrease like that and I chalked it up to burnout. Comes and goes for me...one week out and my main goal for the weeks is to feel strong on test day. Keep moving forward and don't sweat Uworld averages...its all about test day.

 

UWSA 1 overpredicts for sure. It overpredicted mine by 10 points. UWSA 2 was my best predictor - 1 point off.

 

Sahell -- you have an excellent score

When going over practice tests I find countless easy errors

I'm planning on taking at least the day before my test off, maybe even a half-day the day before that.

Did you see easy mistakes due to burnout when taking your tests?

I'm hoping a recharge will ameliorate these easy errors.

Thanks!

 

Be careful with this, I'm pretty sure there was a UWorld question or a question from one of the big 3 qbanks or Boards and Beyond that said you might not get 5 SIGECAPS, so don't bother counting. If there is anhedonia and it sounds likes depression for more than 2weeks, it's MDD.

@Lannister UWorld is good at hammering the tiny differences between all the psych stuff. I'm crap at it too, so Im going to do some blocks of just pysch the last week of dedicated. The NBMEs havent had too many psych questions and they have been more clear than qbanks questions for me at least

 

Completely disagree regarding not counting SIGECAPS criteria. You MUST count the criteria for all MDD questions. Very often the answer will be adjustment disorder if not all 5 criteria are met. Whoever wrote that explanation probably was not counting the criteria correctly. If you don't count, you WILL lose points.

 

Hi guys! I plan on taking step 1 end of April. Going through my second run of uworld atm and scoring from 65% to 90%. My scores are all over the place and I still have 1400 questions to go. I am also making anki cards of the questions I am missing or random facts I need to know. I am doing around 2 blocks a day. I plan on taking nbme 15 at the end of my uworld pass. I am concerned about my uworld score. Should I just still take it as a learning tool and asses myslef at the end based on my score in the NBME? Confused.

 

You've got a lot of time

Probably wouldn't hurt to blend in a lesser bank (Kaplan or rx) with your daily UW

The UW scores go up and down but eventually settle after you've done an ass load of questions

 

Hey UPro

I haven't seen this in any of this banks

Was this your experience on test day?

 

The point is that you shouldn't get so hung up on finding all 5 criteria or freaking out if you can't find 5. I've been told that there aren't necessarily always 5 criteria mentioned/or they describe a criteria in such a vague way that you may miss it, so don't get too stuck on that if the presentation clearly seems like MDD. And it's absolutely not true to say that if you don't count, you will lose points. I don't count and have no trouble with depression questions. People have different ways of thinking through things.

I'm not saying that people shouldn't count, it's just a heads up that if you don't count 5 and there is anhedonia and it seems like MDD is the most correct answer, don't get caught up in SIGECAPS (which is the kind of scenario Bananafish was talking about).

Adjustment disorder falls more under an anxiety category and you will have anxiety mixed with depressive symptoms and the NBME would make it obvious that it is following a stressful event. In a patient on a test like the NBME who just had a stressful non-traumatic event, I would personally start with assumption that it is adjustment disorder and look for reasons to rule it out.

Maybe this advice only works for people who have certain methods for answering questions. People can develop their own style while doing qbanks- just wanted to put out a piece of info that helped me

 

A lot of people advise taking a day off but that's not my style. I'd go crazy thinking about how much time I was wasting and the fear of missing out a question because I didn't revise it the day before. So a day off wouldn't be relaxing for me. I did feel like I was starting to burning out in the last week or so but that didn't affect my performance. I had once done 9 blocks after only 4 hours sleep to prepare for all eventualities. My method was stupid mistakes was to reread the question slowly if I felt something was off and possibly mark it and come back to it at the end.

Totally agree. I never learnt how many criteria were required and I even got 2 depression questions on my test. Look to r/o other options like mood Sx for schizoaffective. I've never seen adjusmtent disorder as an answer - the criteria are too prohibitive and they would have to give you the timing of onset and resolution, so it becomes an easy question.

 

This is based off of my experience, that of my 18 other tutors, and that of our students. It’s easy to think you KNOW how the NBME tests things based on your own anecdotal experience, but I wouldn’t stake something this important on an n of 1. I very often see people applying SIGECAPS incorrectly, and this misleads people into thinking MDD can be the answer without 5/9 criteria being met.

 

I think if the point of the question is for you to discriminate between MDD and something else, then maybe they want you to count SIGECAPS. But to say its NOT depression, unless the stem specifically gives you 5 SIGECAPS...I don't think that's good test taking. Sometimes they want you to go with what is most likely, without giving you every diagnostic criteria. If someone has a malar rash...probably Lupus, even though the criteria for diagnosis requires a lot more than that. I think that's what others posters are getting at.

 

Be very careful about malar rash for SLE, I’ve been told in the real world it’s true, but it’s about 50/50 on step. Could be dermatomyositis


Sent from my iPhone using SDN mobile app

 

The issue here is that you're applying how a diagnosis is made for other diseases to major depression. In psychiatry, you make diagnoses based on meeting DSM criteria. I haven't come across an NBME question where the answer was MDD and 5 criteria weren't met (the only exception being if the all other diagnoses were very far out, such that it was obvious the answer was MDD).

The problem is it can be hard for some people to properly recognize the criteria. For those people, yes, you may need to just go with your gut essentially, but it isn't wise to tell people to not be stringent about counting for 5 SIGECAPS if they haven't had issues recognizing them.

The point of me giving advice is to help you score higher, of course you are free to take it or leave it

 

My exam is on Tuesday, and I still have quite a bit of studying left. Unfortunately, Im 95% sure that my heart rate is through the roof as I can hear it, and I can feel my chest tightening . Ive been performing the carotid message and valsalva to slow down my heart rate lol. I cant wait for this stupid test to be done.

 

Sorry to ask this because I know the info is out there but I just did some digging and couldn’t find it-

Could someone comment on how the score release works? I know it’s always on a Wednesday but I feel like I heard that the Monday before it comes out you can see that your permit is down on the NBME site or something. Is that true?

I think my score is either getting released this Wednesday or next and would be great if there’s actually a way to know tomorrow if it’s time to brace myself or not, haha.

 

Based on my understanding, a 2/26 test date should be next Wednesday (3/21), and I’ll be the one after that. We took early in the week tests which sucks cause our wait is longer haha. Hang in there and good luck!

*Edited to clarify (someone please correct me if I’m wrong): scores are released on the 3rd Wednesday from your test date. If you take the test on a Saturday-Tuesday, your “first” Wednesday will be the Wednesday of the following week, not the Wednesday of the week you took it. If you take it on a Thursday/ Friday your “first” Wednesday is the following week as you’d expect. This is why some people wait “longer”. Also, supposedly your test permit will disappear on the Monday of the week your scores are to be released

Hope this helps people waiting or planning.

 

Thanks man you too! This wait sucks haha

I’m pretty much expecting it to be 3/21, though I’ve heard that sometimes it’s quicker in the beginning of the year (as there’s less test takers generally). N=2 but a couple of my classmates took it 2/17 (a Saturday) and got there’s this past Wednesday (the 3rd wed) which had me questioning things a little.

 

Man I would absolutely love to have mine the 21st. I’ll be with my family, so I would love a chance for that to be true haha. I’m no expert on this so hopefully someone else can chime in. The wait is absolutely the worst thing ever, but you're a week ahead of me and not alone!

 

Yea I totally feel you, the 14th I’ll be with my wife.. the 21st I’ll be doing a CPR class with my classmates- you can guess where I’d rather get my score haha.
Here’s hoping!

 

What have been student's experiences in terms of NBME score increases week to week? I know it varies from student to student, but is it reasonable to be able to go up 5-6 points in one week if you're currently scoring a 235-245 on NBMEs?

 

Well there’s of course the idea of regression towards the mean at the insanely high scores (265+), but know of a couple people personally who were 240 range a week out and ended up 250+, but of course I’m sure there’s plenty of examples of the opposite or of people getting exactly their overall averages.

It’s hard to know what to do with some of this info IMO. For me, I was getting like 225-232 on my NBMEs while I was doing UWorld and always felt like it should be higher (I finished UWorld with a 70 something average). Then after finishing UWorld I did another one and was 259 (a week after a 225) then 266 on UWSA a few days later (and 2days out). So it remains to be seen once I get my score but TLDR for me it was definitely possible to jump a ton in a week (on practice tests anyway).

I would imagine if you’ve already UFAP’d your brains out and are getting consistent scores you’ll see diminishing returns on your score, but otherwise I think it’s hard to put on a ceiling on anything until you’ve hit the high yields thoroughly and addressed weaknesses.

 

Curious if anyone has any predictions for actual score given the following:

UWSA1: 258
Form 19: 240
Form 17: 261

If you have experiences with these practice exams and ideas on typical biases for them, please let me know. Thanks!

 

UPDATE: Just took the USWA 2 and got a 220. Unfortunately Im an IMG and Im interested in the surgical specialties, so I delayed the exam by 25 days. I figure getting a better step 1 score outweighs being a few weeks late into clinicals (I checked and made sure that I would still graduate on time). My goal is to go over FA once, uworld once, Kap qbank once and Rx once. I'll retake the UWSA 2 in a few weeks to see if my marks change (obviously that means I wont be reviewing the answers for UWSA 2 . Anyone wishes to comment? I could use all the help I can get.
P.S. I will not be doing a single NBME as that would just cause me unnecessary anxiety. I already complete blocks with 15 minutes left to spare, and the fact that I'll be revising 3 qbanks (7500 questions) makes the NBME an unnecessary, and expensive burden.

 

If you look on page 5 there’s a link to all of the correlations for every assessment from Reddit.

 

Update: out of curiosity, I went and checked and my permit is no longer available (link is still there, but when I click it it says it’s not available anymore); that may no longer be a reliable predictor of score reporting. That being said, the fact your two classmates got their scores back early still has me really intrigued. Not sure what to make of it. The people who run this test really know how to mess with people’s heads haha

Keep me updated this Wednesday

 

Will do! I actually checked last night as well and my link is still available but also get the Application Error message thing when I try to click it.

 

How well are we required to know coronary angiography, considering the multitude of views?

 

Had zero questions on it. Only Angiogram I had was pretty basic (external carotid or something) and you could have probably gotten it from the question stem. I suspect the same would be true for coronary.

 

There are PLENTY of medical diseases diagnosed based on specific criteria..SLE is one of them. I agree that you should know/memorize SIGECAPS. But you should only try counting them if absolutely necessary. You should feel comfortable assuming its MDD without 5 SIGECAPS because not every MDD question is about distinguishing between two similar psych diseases. There are no absolutes here.

 

At step 1 level, there will probably be more clues than just the image. They would probably give the leads with ST elevations, you could use bradycardia vs tachycardia during the MI to guess at which artery is occluded, they could say the "the distal anterior LV shows ischemia," etc.

 

Redoing a test is pointless. Even if you dont review the answers, when you study, the things you missed will pop out to you like "oh yeah" and then you'll remember it. Take NBMEs. The hardest part of step is that some questions are very vague and you need to be able to piece together what they want.

Less can also sometimes be more. Kaplan, RX, UWorld, and FA in 25 days is too much. If you were already at a 250 range, maybe you'd be able to get through that stuff fast enough (at 250 level, you are just hammering details, at 220 you want to work on perfecting your understanding). With a 220, it would be better for you to take the time to really understand the things you get wrong.

 

Disclaimer: still haven’t gotten my score back.

I second Pepe18 all around, and just wanted to echo him/her. I really enjoyed doing questions because content review was much more difficult and required a lot more effort, but it’s the hard stuff that makes you better. At 220 there’s a lot in the Uworld explanations you don’t know (and maybe more importantly don’t understand). Getting good at doing questions is also no doubt a part of being prepared, but you definitely have some gaps in your knowledge and understanding that require content review. The good news is that you have plenty of time to fill those gaps! Like Pepe said, focus on knowing your basic resources perfectly then if you feel comfortable you can go for lower yield stuff.

Also, if you can afford it, take some NBMEs. Fear shouldn’t be a motivator. Think about all you can gain, not what you have to lose! They are only practice, so you can always tell yourself you’ll be more ready on exam day and they tend to under-predict.

Good luck!

 

Is there a difference in study strategy based on how well you are scoring on NBMEs with all of dedicated ahead of you? I am starting my 5 weeks of dedicated and I've hit 240/250s on CBSE and NBME15. I've completed UWorld and I don't know how to target my focus for 5 weeks. My plan was to do basic UFAP with multiple passes of FA and anki the fine details.

 

Does anyone have a problem with reviewing Rx questions where it will show that the number of people who answered each answer choice for a question is 0%? This has happened on 3-4 questions on my last set of 40 questions that I did. Is this just some glitch with the Rx program?

 

Happens on about 20% of questions for me. I let them know about it last week, said they're working on it.

 

Congrats on being there at this point!

There’s a pretty good correlation between number of questions done and score apparently so if you haven’t done them I’d be hitting RX and Kaplan.
Definitely work FA and pathoma hard to and do your anki cards but don’t get out of the habit of doing questions (you could redo UWorld but I think the more fresh questions you see the better).

 

Hmm I'll consider that, was definitely planning to re-hit UWorld for a second pass. Thanks!

 

I'm wondering if it's just me, but has anyone else basically gone from Rx/Kaplan to UWorld and just had your confidence completely crushed? I finished Rx (74%), Kaplan (68%), Kaplan Sim 1 (74%) and Sim 2 (80%), but after doing a little less than 100 UWorld questions, I'm 7% below average . Sample size is of course really small, but man, UWorld definitely has a way of making me feel like poop.

 

The link itself should disappear if your eligibiltiy period is still valid. Mine disappeared late on monday and I got my score back that Wednesday.

Don't count on it. I got a bunch - around 5 vague image questions with no other hints and very brief clinical stems overall.

I would see 114% choosing an answer choice.

 

For coarctation of the aorta, are preductal and postductal distinctions obsolete? UW, uptodate, emedicine seem to suggest so. All 3 seem to explain symptoms based on the severity of the coarctation, as opposed to the anatomic point of narrowing. Emedicine clearly says pre and post are a thing of the past, since most coarctations have been discovered to be juxtaductal (ie at the point where the DA inserts into the aorta). UW seemed to say the same thing afaik.

 

Since I wanted this thread to be about scores I'll post mine!

Official step 1: 255!
Uworld first pass 76%
Nbme 18 (5 days out): 263
Nbme 17: 260
Uwsa1: 260
I took some others but I did 44 days or so of dedicated study time.