USMLE Official 2018 Step 1 Experiences and Scores Thread

Awesome progress!!

 

For those who have taken their exams on Mondays, how long has it taken to get the score back? 16 days or 23 days?

 

Made an account just to share this because I obsessed over the score reports and wanted to give back. Found out my score 4/11, took 3/20

3 months out: CBSE: 170
6 wks out: NBME 15: 205 (pre-uworld)
4 wks out: NBME 16: 234 (post-uworld)
3 wks out: NBME 17: 234
3 wks out: UWSA1: 256
2 wks out: NBME 18: 246
1 wk out: UWSA2: 245

uworld first pass: 69%
uworld second pass: 91%

Felt ok leaving. Remembered 20ish wrongs.

Prep was just UFAP. USMD school

Score: 250 - 255

 

Awesome progress! You give me hope

 

Awesome progress and score. Did you find that your second pass of UWorld made the difference between 2-3 weeks out?

 

@Lannister How are the NBMEs in relation to Rx and UW questions (I know you haven't done UW yet but what about RX)? I should probably do one soon to gauge where I'm at. Test is in a little under 8 weeks.

Also, great to see all the improvements that everyone is making. Keep up the good work guys!!

 

Just wanted to post my progress so far and ask some advice from y'all:
Test date: 6/15
Class ends: early may
Uworld: 71% (doing mixed material starting january with material covered, still havent added in Endocine/OBGYN/Derm yet)- 1700Q's
Kaplan: 70%-Doing by system to try and uncover gaps a little early in each block-1200Q's
Goal score: 240+

The problem I'm starting to run into is that my Uworld 40-blocks have essentially plateaued in the 70's. Besides heme/onc, psych and MSK anatomy (haven't seen it since mid M1), the questions I miss are not really concentrated anywhere (ususally just forgot a random fact about a disease, but was able to get to 50/50 most of the time). What do you guys suggest in terms of trying to proceed from here? Should I just keep chugging along and fill in those random gaps as they come in Uworld? Or should I be going back to First Aid and review the systems slowely over the next few weeks? I have 3 weeks of class left and have done well enough on the past exams to kinda drop the ball on the inhouse exam.

 

I would say that NBME 13 was definitely harder than Rx but more or less consistent with UWorld (I've done about 200 UWorld questions via a review class, so my impression of UWorld is only based on those 200 questions). I think Rx does a really good job of teaching you the material, but the questions in Rx are usually very straightforward and I find that it's almost always very obvious what they're asking of you, whereas the NBME questions were a little more vague.

 

Done with Rx, wooo. Just bought UWorld, here we go.

Side note, my last set of questions on Rx was stupidly hard, a ton of trick questions that <40% got right. A small part of me is convinced that they saved all the hard questions for last so I would renew my subscription haha.

 

I think like a week or two ago I was in the middle of a nice run of like, high 70s/low 80s on Rx (sets of 40 questions) and then I got a random ridiculously hard block where I flagged like 15-20 and got a 45%. It was painful. It's amazing how one block like that can make you feel so bad about where you stand even though it's just 40 questions haha.

 

I know! Whenever that happens to me I get all pissed off and don't even want to review the questions, even though that's like the worst thing you can do after doing poorly on a block!

 

I'm almost half done with UW and microbio and pharm are two of my worst subjects. I'm considering doing Rx for spot-checking these two subjects after I finish UWorld. How did you feel Rx covered microbio and pharm?

 

So I had absolutely no foundation for microbio. My school really doesn't teach us micro unfortunately, so going into Rx I knew absolutely nothing. By the end of Rx my % correct for micro was in the mid 80s, and I feel very good about micro. So I would say that's probably a good sign that Rx covers micro pretty well.

I think it does a fine job with pharm too. Rx is definitely the best qbank for memorizing facts, and I think pharm requires a lot of memorization.

 

To follow up on what I posted before: I thought permit disappearing means when you click your permit it says "permit no longer available." That's what I was seeing before. This week is the 3rd Wednesday and now there is no link for my permit. The permit thing still stands

 

mines gone too!

 

@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.

 

Progress through dedicated, just moved test up to this week from next:

UWorld % - 77 first pass, 95 second pass
CBSE - 245 (6 weeks)
NBME15 - 250 (5 weeks)
NBME16 - 257 (4 weeks)
NBME17 - 263 (3 weeks)
NBME18 - 257 (2 weeks)
UWSA2 - 266 (1 week)

Hope they weren't all flukes!

 

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

 

Nah

 

Why not?

 

Because I'm confident with my trend of scores. Because NBME 13 is older, because NBME 19 underpredicts and I don't need to bruise my confidence this close, and because I don't have enough time - I only moved my exam up 3 days.

 

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?

 

Heard it over predicted and I really only had time to hit 5 practice tests. Took UWSA2 today and NBME18 last week, wanted the most predictive tests last.

 

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

 

Zanki/Sketchy/Pathoma/Boards and Beyond/FA + class material first two years. Full pass of UWorld second year keeping an anki deck of wrongs. 5 weeks dedicated: second pass of Uworld, used boards and beyond to review alongside of FA (1 pass), almost full pass of pathoma, some sketchy, hitting weak subjects in anki

 

210! Nice! I did a retired nbme recently and got a similar score.

As a filthy DO can someone gently tell me precisely what a CBSE is? Is it retired step 1 Qs like the nbmes? Or, is it an entire seperate set of questions written by the nbme?

Neither?

Edit-- grammar.

 

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.

 

Thanks friend

 

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

 

Great scores this far out! Not really sure if there is a one-size-fit-all for how much improvement you should expect. A good friend went from 195-235 in 5 weeks last year. But, obviously that is much easier than a 240-280, if we compare relatively. I think a 250 or more is totally doable. I would be aiming for a 260 if I were you. But, then again, I'm not a destroyer like all of you peeps .

Which Comsae did you take btw?

 

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.