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Discussion in 'Step I' started by Foot Fetish, Oct 15, 2017.
According to wikipedia, "each exam is dynamically generated for each test taker"
I agree about the MS3 thing and I wish it was taken into consideration in some way. I had 5-10 questions that I luckily guessed correctly, but were not really preclinical. Like knowing which medical device to use, what is the next step in treatment, and asking what someone receiving a procedure was most at risk for.
For these types of questions, were you at least able to reason to your final answer? Or are these kinds of topics so far out of the realm of pre-clinical that an MS2 has to rely on luck?
Are trisomies more commonly caused by nondisjunction in meiosis I or II? A few weeks ago I had a question that told me meiosis I was more common, and now I just got a question that said nondisjunction in meiosis I is rarer.
I could eliminate at least half the answers using logic and then would normally be down to 2 and take my most educated guess
I think I just realized something crazy. The NBME practice exams give a different question order within each block to each different user.
Can anyone confirm this?
Yes, I went over them with friends and they are not in the same order
For Trisomy 21 the majority is caused by nondisjunction in Meiosis I. I don't know if that applies to all trisomies, though.
Meiosis I would make more sense to me, because you create two gametes with trisomy, vs meiosis II where you just get one with trisomy. But yeah I didn't consider that maybe it varies between trisomies because the original question I got was about trisomy 21 while the most recent one that said meiosis I nondisjunction is rare was about Patau.
27 wrong on 13 and 28 wrong on 15, so 86.5% and 86% respectively
If this is true then for my test n=1 and we all get perfect scores! lol jk wishful thinking!
I keep counting questions I got incorrect. I am at like 14-15 now. Ugh. I do remember like 150 correct answers though. But that's all I remember. These couple weeks can't go fast enough.
Anyone doing old NBMEs? Theres an NBME 5 question about a 75 year old woman who falls and hits the back of her head, and you have to pick between epidural and subdural hematomas. Online answers seem to be split between the two, with supporting evidence for both. I was wondering if anyone here had a definitive answer.
Is the exam 180 questions?
It is 280 questions, I just can't remember them all. Wish I could! Lol
Subdural for sure. She is old (encephalomalacia- small brain= easy tear of bridging veins), and epidural is classically the middle meningeal artery which is below the pterion, and thus would be from a blow to the side of the head, not the back of the head. 100% subdural
This one was frustrating for me too. It's definitely not the clearest vignette.
Age and CT point to SDH. I'm still not exactly sure what a diffuse extra axial H'ge is but the online consensus said SDH.
EDH is also possible - but the mechanism of injury is not classic for EDH, neither do we have the classic lucid interval.
I have always associated herniation with EDH. It's an arterial bleed whereas SDH tends to be a slower venous bleed. I initially chose EDH for this reason.
Unfortunately this was before expanded feedback so your guess is as good as mine, but I'm split 70/30 favoring SDH after reading the online discussions.
Well, tomorrow's the big day - any sage words of wisdom to remain calm and composed during the exam?
You got this bruh
Step 1 this Friday.
6 weeks out - CBSE 230
3 weeks out - Form 17 238
2 weeks out - UWorld sim 1 247
1.5 weeks out form 15 - 232
EDIT: 2 days out - UWorld sim 2 254
UWorld %correct (cold, full random 40's) 62%
Goal score: 230+
Reach score 240
Happy with anything above 230 but a 235 would be tight and 240 would be sick
Wish me luck brevs
Just take a deep breath and know that you might have a few WTH blocks. Just power through, it is not a reflection of your preparedness or intelligence. It happened to all of us. Just keep swimming
240 seems pretty realistic for you tbh. Would be surprised if you scored under a 235 considering your NBME scores.
My SO's and my score both went up on today's NBME. 230 today, still have 2.5 weeks to refine, so I think I'm in a good place. My motto today was "don't do anything stupid" and it seemed to have worked decently well.
Not to sound snarky, but the only way to consistently score in the 260+ range is by expanding your knowledge to such an extent and developing your test-taking skills so that you never get more questions wrong than the number that corresponds to a 260 score on any given test.
Up, up, down, down, left, right, left, right, A, B, start, select. (Right before starting the tutorial of course)
My friend who consistently scores that high never makes “knowledge errors” - he only makes stupid mistakes.
So if you truly know everything very well from first and second year, yes you can make 260+ if you don’t make stupid mistakes. Take a look at your past forms and look at the incorrects. Were they “knowledge errors,” “logic errors,” or stupid mistakes? If all you make is stupid mistakes then yes you can really knock the test out the park by paying attention to what each question is asking and not glazing over stems completely. I noticed on my forms that I make zero stupid mistakes. All my mistakes are knowledge errors typically, with the occasional logic error (incorrect application, or question asked for the opposite, or question asked for something upstream of pathway etc etc).
Knowledge errors are probably more prone to variance day to day (depending on test content), while stupid mistakes can be very well taken care of by just paying attention.
The differences in any score over a 255+, and especially 260+ is really just chance. You're always going to misread or misinterpret a few questions at the least. The wording and distribution of these questions is what makes the difference. I think that the only non-chance factor that contributes at scoring in this range is innate test-taking ability. Once you're scoring in the 250s, I'd say you're getting close to hitting the ceiling of what pure knowledge and memorization can get you.
Depends on what's holding you back. For me it was the esoteric minutiae. I have scored consistently above 260s except for my first one btw.
I thought that only worked to catch Pokemon. Damn!!
I only had a couple of stupid mistakes on my first NBME. Your friend must have studied a lot to know all the minutiae. I'm very jealous.
I humbly disagree. You may misread or misinterpret questions the first time, that's why I reread the stem when something seems off. I would say anything past 270 is getting the minutiae right - requiring hard work and luck, the ratio of the 2 depends on your form. Up till that point I would say know the high and medium yield stuff cold and learn to dissect a question.
I just met with my school's step advisor to hash out a schedule for our multisystems block and dedicated. Apparently I am "very behind" and should be several hundred questions into UWorld by now (test is on June 7th). That was so depressing, I thought I was doing well by almost being done with Rx and also having done some of Kaplan.
I'm in a very similar boat. I'm taking my exam June 8, currently done with ~1300 Rx questions (all medium/hard) and some sporadic Kaplan but haven't done any Kaplan recently. I honestly don't know if that person's advice is good. I would think as long as we finish all of UWorld by the time we take the test we should be good. Once I get done with Rx I plan to do 80 UW questions a day with review, which would theoretically take a month, but I'm accounting for longer than that owing to off days, mandatory school exams/classes/etc that take up most of the day, etc. On those days I'll probably only be able to do 40.
Quick question for advice -- I've done 1300 Rx questions so far set to only Medium and Hard, and I have about 700 of those left to go. Since that should take me roughly 10 days, I want to go through and finish all of them before moving to UW. That would leave something like 400 ish Easy questions that I did not touch. Would you guys recommend I go back and do all of those, or just skip them? It would give my Rx score percentage a nice boost but I don't know if there's much utility to doing those questions.
Honestly, I wouldn't listen to much from your school's step advisor unless that person is an MS3/4 that scored in the 250+ range.
As long as you have a plan to finish U-World before your test I think you're good to go. If you wanted to do a second pass then sure you should finish early.
I'm also pacing myself on U-World
Real question... what is a "step advisor"? I'm at a DO school and if a step advisor is what I think it is, then I couldn't imagine my school having one of those. If I even suggested it to the dean (or a COMLEX advisor equivalent) I would literally get laughed out of his office...
I would echo what others have said. Unless your schools step advisor is actually super wise in this area and have coached others to score in the 250s or so then I wouldn't give much thought either. I trust the advice here more than I would there lol
Some people wear many hats in our school. One person is a step advisor along with many other things. I don't think many schools have a single person dedicated to this.
I would say that Rx can be good for nailing down FA, but I feel like it lacks the minutia and focuses on the same stuff over and over again. My only advice is to be aware that Rx is WAY too easy and nothing like the actual exam. I finished Kaplan, Rx and UW twice and I would say that I wish I had not done Kaplan or Rx and had spent way more time really thoroughly dissecting UW. I think that would have helped me the most.
Speaking of Q banks..
I bought the 1 year uworld subscription hoping to complete it during MS2 and unfortunately I went through about 75 of it but honestly I would just do a block and quickly look through them without really taking time to go through the answer choices.
I reset it and now I am almost done with my "second" pass and this time I really sat down to read through the explanations/make a journal of my wrongs. I feel like this was a legitimate first pass because I felt like I was learning the material.
Now that I am done. Should I go through my wrongs or invest in a 90 day subscription and do it a "third" time ..(I have about 7 weeks left FYI) I really wish I had used it correctly the first time but you live and learn
Would you recommend though adding a little Rx/Kaplan during break to switch things up and get more practice questions out though?
That is all based on personal preference. Looking back I wish I would not have wasted any time with Rx or Kaplan. The only reason I think Rx is useful is if you are not someone who can just sit and memorize first aid. Honestly your best bet is UW and dissecting each question and all of the explanations which will take forever and reading first aid and making sure you understand first aid not just memorizing words. If i could go back and do it differently thats what I would do and it should take you all day if you are doing it correctly. Sorry if this looks weird/has mistakes. I am using a vietnamese keyboard and it doesnt have certain characters.
Thanks for the encouragement guys, I think I'll probably just ignore the advisor's advice and keep on doing what I'm doing.
Today has not been kind to me. On top of that demoralizing chat, I also randomly did super poorly on what should have been an easy stats test, and am still being harassed by my school's vaccination people for supposedly being non-compliant. :'( All this stress is making it hard to study for my End of Block exam on Thursday.
I focused completely on UW during the year but when I did the NBMEs, I found I was getting some of the easy questions that required straight recall wrong and all the hard questions right. So, I switched to kaplan and rx instead of doing UW 2nd time to get all those small things. Hopefully, my mind can still work through the complex UW like questions with my exam in a week . Man , why do their NBMEs have to be so different to what they test on the real exam
I suppose what I was getting at was that - for me anyway - there always seems to be a question or two that I approach from the wrong perspective and will misinterpret no matter how many times I read it. Those questions where after you read the explanation on UWorld, you just think "damn I knew that but that's just not where the question was leading me". Like, you see the question and are certain you know the answer so you don't necessarily second-guess yourself. There's bound to be a couple of those in a 280 question exam - we can't really know the frequency of this since nobody gets to review their exam. Perhaps others don't have this problem.
Regarding really high scores, I suppose in theory you could just study the crap out of everything including the "WTF" questions that seem to really differentiate the 265 from the 270+. But if I had to guess (and I have no evidence for this), I'd wager that the people who get those questions right just guess better due to testing ability, rather than having seen the material from excessively studying the minutiae and getting lucky. I'm sure either is possible.
Is there any consensus about which NBME is the best to take first, before starting dedicated?
I would strongly disagree. I think beyond ~264 is where luck starts coming into play. My evidence for this is all those IMGs you read about who study like crazy for 2 years and score in the 260s. For the vast majority, it's unrealistic because they're not willing to put in the sacrifice it takes to get there. It's the people who study like they're in dedicated for a year straight who could take Step 1 ten times and get 260s on every form. Most students can't even fathom that amount of sacrifice. I know it's an unpopular opinion, but I think it's the truth.
We're all waiting for your 265+ performance! When you take a NBME tell us what you get.
anyone know where in Zanki are the cards for Joint pathoma video? its not in MSK deck
Yes... with the caveat that sometimes it is really difficult to figure out what they are asking due to the poor writing of the questions. So maybe take a few % away from those IMO. I'm sure people will disagree, but I thought they could be more clear in what they were looking for in their actual question. I'm sure a 98% is pushing 280, but I have absolutely nothing to back up that claim lol.
Good luck @Pepe18 !!
I think if you miss 5 questions (98%) on the whole exam you are probably up at like 285-290, uncharted territory. I have scoured these forums trying to find a conversion for percentages for the high-end scores, and it's really all over the place. If I had to make a guess, it seems very very roughly like on the real exam-
95%+ correct -----> 270s
90%+ correct ------>260s
Of course this depends a lot on how hard the form was and if the ones you missed were experimental or whatnot.
I got 220 on NBME 17 one day. Then after one day’s gap, I got exactly 220 again on UWSA1.
Is this even possible? Aren’t UWSAs suppose to overpredict? After having done first pass of UW (which was system based btw), I found UWSA1 extremely hard! Specially since I had been focusing more on NBMEs recently and we all know they’re cakes.