USMLE Official 2018 Step 1 Experiences and Scores Thread

@sahell

NBME 4, block 4, question 27

Its about a 22 year old with severe chest pain radiating to the back & CT scan confirms aortic dissection. Question is which of the proteins is most likely defective. Both fibrillin and elastin were options. I chose elastin, since the only feature they'd given was aortic dissection, so it seemed more appropriate than fibrillin. The few online discussions disagree with me, but I'm still unsure. What is your take on this?



NBME 5, block 3, question 47

This is the one with 3 graphs and how elderly maintain CO. Online disagreement between LV dilation vs LV hypertrophy.



NBME 5, block 4, question 28

This is the one about the mechanism behind hirsutism in post menopausal women. I remembered reading (in FA I think) that increased androgens are behind this. Most online searches echo increased testosterone as the cause (I think this includes uptodate), but some do mention an increased T:E ratio as well as decreased SHBG due to lower E. The testosterone values they've given are in the normal range, so perhaps T:E ratio is the answer? Confused!



NBME 5, block 4, question 35

Patient with gastrinoma, hyperstimulation of which cell is the cause behind the development of a duodenal ulcer?
Both ECL and parietal cells could be the answer, it just depends on what they want the answer to be. How did you go about deciding this?

 

Thanks. Micro and pharm aren't strong points at my school and I hate memorizing and reading FA, so I think I'll give Rx a try and hopefully hammer in some minutiae a couple weeks out from the big dance.

 

I think: Fibrillin-1 deficiency is indicative of Marfan's, in which patients are 250x more likely to have an aortic dissection than a healthy individual. Not sure what the rest of the stem says, but young age (22 y/o) is also a tip off of Marfan's, as elastin becomes weaker with increasing age.

 

22 year old with an aortic dissection is Marfans until proven otherwise in my mind.

The defect in Marfans is loss of Fibrillin, which crosslinks elastin and makes it stronger.

At least thats my take on it.

 

Plan on doing the final two NBMES - 13 and 19?

 

Why not?

 

Curiosity got the better of me and I took NBME 19...offline though because I didn't want to be demoralized with a score.
But then I only missed 12 questions so I got curious about scoring. My best estimates from previous posts put that at a 250-255. Any insight?

Was pretty happy with this performance, especially since people tend to outscore this exam by at least a little!

 

You're definitely going to beat 255 but I sense a 260 in your future! What are your plans for your last days of studying?

 

So I got a 210 on my CBSE, 9 weeks out. Not too bad, I guess? I'll take it

 

Great score!
How did you find NBME 19 in comparison to NBME 17 (or any other NBME)? Was it easier/harder/more vague/more twisted/any-adjective-that-describes-it?
Thanks

 

Thanks for the optimism
I'm just doing 40-80 Uworld incorrects a day to stay fresh and reading up on topics related to any questions I get wrong.
Beyond that, I'm going through some flashcards for the memorization heavy topics I'm weak on (biochem, neuro and antibiotic pharm).

 

Overall, I'd say it was...easier?
With the caveat also being that this is the most knowledge I've ever had. I took NBME 17 ~3 weeks ago I believe, so that felt harder, but it was probably partially because I knew less. But even with 18 that I took more recently, 19 still felt easier, which is why I think the curve is so tough. Like always, there were a couple questions that I wouldn't have gotten right no matter what, but I just feel like that's to be expected for most people in most testing situations.

 

Any reason why you went straight to UWSA2 as opposed to going through UWSA1 first?

 

What other resources did you use? How much time are you taking for dedicated in total?

 

It's 200 NBME questions that only schools can purchase to administer to students (to see how well their curriculum prepares you for step 1...?) Unsure if it's retired step 1 questions specifically, but it has the same vibe to it as the NBMEs at least.

 

DO student here, about 6 weeks out. Dedicated starts in 2 weeks. Took NBME 13 and a COMSAE recently. Got a 240 and 680 respectively. 240 was my goal at the beginning of the year, so hitting it already is great. I'd like to get 250 now. How much improvement is realistic to expect at this point?

I went through pathoma with class and did some of bros deck (8000 cards now), mostly path and pharm. Also have been though most of sketchy. I've done most of rx and about 500 Uworld questions, random. Percentages have been steadily 75-80%.

 

What's your take on Boards and Beyond? Do you think his videos are good for all subjects, or are there certain organ systems or subjects in general that he's really good for? Also, did you feel like his videos directly helped in getting UW/NBME questions correct? Thanks for the help.

 

Hey guys, hopefully expecting scores this week...have such a horrible feeling I failed...anxiety is through the roof! I made a list of about 60 questions I may have missed but I only know 15 that I missed for sure...can't remember most of the test...I know people have similar experiences but I really feel hopeless

 

looking for advice.

I had 7 weeks of dedicated, during my M2 I had all but about 800Qs of Rx and Kaplan finished. So in the first 2 weeks I read through FA one time, completed the 800Qs from Rx and Kaplan I had left, and took a practice exam.

Rx:83%
Kaplan:84%
5 weeks out 1st practice exam-NBME 13: 232

over The last 2.5 weeks I've bought and gone though UWORLD. about 85% done with the bank, all mixed, and I'm averaging 84% right now. I usually score like 82-85% on any given block, with some random 90s and 70s mixed in.

I'm due to finish by the end of the week, and I'll have 2 weeks remaining.

Any suggestions on the best things to do in those last 2 weeks to maximize my score?

suggestions desperately welcome

 

I haven’t taken the test yet, but it may be a good idea to slow down on Uworld and start working through the NBMEs. Taking an reviewing a while NBME easily takes a whole day, and you’ve got 5 more available (not counting those off line). Plus the 2 Uworld Full lengths. Or you could re-do your wrongs in Uworld if your worried about retention.

 

It's an NBME exam administered by the school that is mandatory for us to take after we complete all our M2 organ systems. It's 4 blocks of 50 questions each, so 200 overall. I think the main goal of it is to give you a diagnostic score that tells you where you stand right after you finish your curriculum, and also is supposed to evaluate how well your school's curriculum prepares you for Step 1. For the majority of people it's a pretty meaningless test because people haven't started Step studying, so most people don't do well on it. The nice thing is that you get a score report back that shows you your performance on all the subjects and organ systems relative to the average. For example, I did really well on pharm, renal, and GI and have a TON of work to do on cardio.

 

Those are some pretty insane qbank completion averages if you're doing them all random/timed. With 2 weeks to go, I'd highly recommend buying all of the NBMEs and spending your last 2 weeks on them. Considering your qbank scores and your NBME 13 score, all you need to kill the real deal is time spent adjusting to true USMLE questions which will come from the NBMEs. Congrats on your killer work!

 

I used kaplan and rx as learning tools through M2-so theyre not random. But uworld is. I have a question for you-why do nbmes if they dont give the answers? Thats the only reason ive been avoiding them since after taking nbme 13 i felt like i learned nothing and just got my soul crushed (i didnt know they under predict) Is there somewhere i can get them? The answers i mean

 

There are NBME explanations floating around - not in a nice neat format like we would like, but a quick google search will probably turn up some. A significant benefit though comes from simply allowing yourself to get accustomed to how the true USMLE questions are written. I'm sure you've probably noticed that going from Rx to Kaplan and from Kaplan to UWorld each qbank was slightly different in how cases were presented. For me personally, it took me about 200-300 in order to get use to the transition and after I got accustomed to the style, I made less stupid mistakes.

 

Absolutely, when I started uworld I was expecting to crush because I had a higher Kaplan avg. but my first couple were low 70s. After a hundred or so I got into the 80s like I was doing in Kaplan. When I took that nbme 13 I got hammered because I hadn’t touched uworld yet, and uworld I think is closer to the nbmes than Kaplan, even tho it’s still pretty different. Do you think nbmes>than second pass of uworld?

 

My responses in the quote

 

Whether or not to do UWorld twice is a huge topic of debate. Looking at people that score in the 260+ range, you'll find people that only did UWorld once and you'll find just as many that did UWorld twice. Most recent research data suggests that per time spent, the best return is to do new questions. Reviewing NBMEs is a lot more time consuming than reviewing qbanks, but the return should still be higher than doing the same qbank twice. The advantage with new questions comes from 1. Being exposed to material that you thought you knew very well in a new way that you might not have seen, 2. Eliminates any bias from question/stem/answer choice recall that would otherwise trick you into thinking you knew something when you really didn't.

But again this is just my analysis of the research that's been presented in this area. I wish I could provide you with a "this is what I did and I got a xxx," but I'll be taking my own Step 1 in a little less than 1.5 months.

 

Damn, my permit link is still there. I guess I will have to be a patient aneurysm and wait another week for my score!

 

Thanks. I think apart from the LV one, I should've gotten the rest right. Irritating to make such mistakes! Although I definitely am able to focus less than I do during online NBMEs.

 

When did you take your test?

 

Thanks! We took form D

 

Like the 2nd- I shouldn't expect it for another week or so lol

 

anybody know what time of day scores come out?

 

Good luck to everyone getting scores today!!!!! Received good news and hope you all do too!!!!!!!!!

 

Did you get them today/did you get an email about it?

 

yeahh i got an email around 4:45 am PST! I'm in California

 

I can now purchase a score transcript from my account, but my score report hasn't been posted yet -_-

 

Congrats! You took it the 30th, right? Not too bad in terms of turn around.

 

Yes I did!! Ahhhh so relieved!!

 

hmm maybe wait a few hours?? it should be up soon!

 

Sorry for one of these posts, but I'm just wondering if I took Step 1 yesterday (Tuesday, 4/17), then when could I expect to see my score? Thanks!

 

Based on what I've witnessed, I would think on the 9th, but I don't know many people who took the exam on a Tuesday. So I'm not sure if it gets rolled into the previous week's "batch" or not, so maybe someone with more experience can comment.

EDIT: upon further research, trend seems to be Thursday through Saturday exams get is the 3rd Wednesday after, whereas Sunday through Wednesday seems to be 4th Wednesday. Obviously there's always exceptions, but the 9th seems like a good bet!

 

Very helpful; thank you so much!

 

My average NBME: 258, UWSA1: 262, UWSA2: 258. Edit: UWorld- 86%

Actual score: 248. My goal was 250, so I'm a little sad that after everything I gave up for this test the few senseless mistakes I made cost me the goal. But I'm glad it's over. Good luck to everyone still studying

 

Hey that is an amazing score! Don't let those two points from your goal get you down. All doors are open for you with that score! Congratulations and go celebrate!

 

Good score!! Congrats!!!

 

Real thing: 258

NBME: 250-260
UWSA 2: 256
UW %: 85% (1x thru)
Knew for sure I missed around 12ish. Felt crummy after.

 

Did anyone who took their test on 3/31 (Saturday) happen to get their scores? I'm drowning in anxiety and I don't even know if the score will come for sure today.

 

I got an email around 10 am that told me my score is coming out at 11am. I think if you didn't get the email, you will get it next week. Sorry you have to continue waiting

 

This is a great score. I would be thrilled! Two points will not mean anything. I know it’s disappointing when you have a goal but in my mind you made that goal because who knows what questions they did or did not throw out. On a different day they could have thrown out what you needed. Celebrate that score. The world is your oyster.