USMLE Official 2018 Step 1 Experiences and Scores Thread

[Foot Fetish]

I've always wanted to start one of these...So here we go!

My stats:

M2
Test time: June 2018
Goal score: 270

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[pbrocks15]

My turn to quit lurking. I only looked at this thread after actually taking Step because, yunno, if I wasn't studying during dedicated I was trying to do stuff that didn't have to do with the exam.

Let my results be an inspiration to those of you who struggled with NBMEs.

CBSE (school administered ~8 weeks out): 165 lol
NBME 13: ~210 (3 weeks into dedicated, hadn't really finished first pass yet)
NBME 17: ~220
UWorld SA1: 254 (end of week five)
NBME 15: ~220
NBME 17: ~250 (mid week seven, to decide if I would push my test back)
Actual score: ~255

Basically I went into dedicated having been one of those who didn't do any pre-studying during M1 and M2. There was a strong foundation of the basics set in place by my curriculum but I had a lot of gaps to fill (particularly with respect to micro and pharm, for which I used Sketchy, Zanki, and Pepper). I studied about eight hours a day--Zanki in the morning, UWorld in the afternoon, watched Pathoma videos on the treadmill. Every time I took an NBME I got worried that I wasn't doing it right, but realistically, my actual test didn't feel very NBME-y anyway so I guess that didn't matter. I probably could have gotten a better score if I started doing sketchy and/or a little review of first year material prior to dedicated, but I also think that if you did well in your curriculum first and second year and you can really hammer in some work during your dedicated, anything is possible. GL to everyone.

Congrats on the score! That's a solid dedicated period you had. In what way did you formulate how you used anki? Did you just do all the cards that morning if that day was "GI" for example? And then maybe keep up or scrap the reviews?

 

[The Knife & Gun Club]

Anyone else feel like they learn about a new rare genetic disease that causes recurrent _______ infections like every single day?

 

[pbrocks15]

Anyone else feel like they learn about a new rare genetic disease that causes recurrent _______ infections like every single day?

Hahaha I actually laughed out loud.

 

[hueso]

Congrats on the score! That's a solid dedicated period you had. In what way did you formulate how you used anki? Did you just do all the cards that morning if that day was "GI" for example? And then maybe keep up or scrap the reviews?

Essentially exactly that. I basically replaced "reading first aid" with Zanki (at least for first pass). Once I got through all of Zanki (minus pharm) I did a little review for every system every day. The Sketchy micro deck I used took me ~3 mornings to get through and then I did 100 reviews a day of that. I definitely didn't use Anki the way a lot of people do, because during first pass I was kind of using it as my main resource and taking notes on it sometimes; likewise, when I did the Zanki biochem deck I wrote out all the pathways as I went and annotated them with relevant diseases/regulatory steps/etc.

 

[pbrocks15]

Essentially exactly that. I basically replaced "reading first aid" with Zanki (at least for first pass). Once I got through all of Zanki (minus pharm) I did a little review for every system every day. The Sketchy micro deck I used took me ~3 mornings to get through and then I did 100 reviews a day of that. I definitely didn't use Anki the way a lot of people do, because during first pass I was kind of using it as my main resource and taking notes on it sometimes; likewise, when I did the Zanki biochem deck I wrote out all the pathways as I went and annotated them with relevant diseases/regulatory steps/etc.

I've actually been considering this because I've been really not into reading FA recently and I loved Zanki during my systems. How long did you usually do it each morning? I'm also going through the Pepper deck for Pharm and Micro, I'm an overall huge anki fan.

 

[Lannister]

Does anyone know how exactly you distinguish group B strep meningitis from other causes of meningitis (e. coli, listeria) in newborns, based on timeline alone? A few months ago I swear I had a question where the newborn baby had meningitis and I put group B strep because that's the most common. But the answer was e. coli, and the explanation said that you see group B strep like immediately after birth (like within hours) and then again about three weeks later. But just now I got a Kaplan question with a 1 week old, and the answer was group B strep! Maybe I'm misremember the original question, idk. But is there like a cutoff for when e. coli becomes more likely than group B strep?

 

[pbrocks15]

Does anyone know if Pathology is more high yield overall than physiology? I know they're intertwined but just curious what the thoughts are out there for those who've taken it recently or have heard.

 

[The.Supinator]

So looking for input on progress and how these scores are possible? is the jump realistic or should I take another NBME, i'm taking an nbme in two weeks, so far halfway through u world.
January-march Kaplan and Rx q bank

April 18th NBME 15 - 205

April 25th CBSE exam - 215 (30%uworld finished)

UWSA1--245 (48% uworld finished)

 

[takeurmeds02]

Anyone else feel like they learn about a new rare genetic disease that causes recurrent _______ infections like every single day?

You'll start to recognize the buzzwords but they all essentially cause the same ****

 

[pbrocks15]

So looking for input on progress and how these scores are possible? is the jump realistic or should I take another NBME, i'm taking an nbme in two weeks, so far halfway through u world.
January-march Kaplan and Rx q bank

April 18th NBME 15 - 205

April 25th CBSE exam - 215 (30%uworld finished)

UWSA1--245 (48% uworld finished)

The UWorld assessment are universal for their forgiving curve. I think taking another NBME in a week would be helpful!

EDIT: like someone mentioned before, I would take a look at the percentile you fall in over the scores perhaps for the UWorld assessments.

 

[hueso]

I've actually been considering this because I've been really not into reading FA recently and I loved Zanki during my systems. How long did you usually do it each morning? I'm also going through the Pepper deck for Pharm and Micro, I'm an overall huge anki fan.

Yeah, I realized before dedicated that reading first aid (at least for first pass) was not going to work for me. I usually spent between four and five hours in the morning doing Anki stuff, took a few hours for lunch and nap and whatever, went back and hit the UWorld for a couple hours, gymmed, dinner, maybe some more UWorld or whatever, then bed ~10.

 

[Lannister]

EDIT: like someone mentioned before, I would take a look at the percentile you fall in over the scores perhaps for the UWorld assessments.

Sorry I must have missed the post you're referring to, but why is it better to go by the UWSA percentile rather than the three-digit score?

 

[pbrocks15]

Sorry I must have missed the post you're referring to, but why is it better to go by the UWSA percentile rather than the three-digit score?

I think someone was mentioning how its more predictive of where you're at compared to the score because a 230 was apparently like the 22nd percentile, something of that sort. I think that might be better to use when comparing it with your NBMEs since the score itself is inflated. So I guess overall, use both but when comparing it to your performance maybe using the percentile might be a little better.

Yeah, I realized before dedicated that reading first aid (at least for first pass) was not going to work for me. I usually spent between four and five hours in the morning doing Anki stuff, took a few hours for lunch and nap and whatever, went back and hit the UWorld for a couple hours, gymmed, dinner, maybe some more UWorld or whatever, then bed ~10.

Thanks for the input! Still early in dedicated and I have a basis to my day, just thinking of how to better work in the FA material, I might go with some Zanki in the next few days and see how it works. Thanks!

 

[The.Supinator]

The UWorld assessment are universal for their forgiving curve. I think taking another NBME in a week would be helpful!

EDIT: like someone mentioned before, I would take a look at the percentile you fall in over the scores perhaps for the UWorld assessments.

Thanks haha yeah that was me, I was talking about percentiles being more important, for me it was 65th percentile, regardless your totally right, another NBME would be better.

 

[pbrocks15]

Thanks haha yeah that was me, I was talking about percentiles being more important, for me it was 65th percentile, regardless your totally right, another NBME would be better.

So, I just quoted you, about something you said to suggest something to you...haha that's amazing. Nice though! That's really good, so it shows your improving. Another NBME it is, I figure you're early on and are probably taking one again anyways.

 

[The.Supinator]

So, I just quoted you, about something you said to suggest something to you...haha that's amazing. Nice though! That's really good, so it shows your improving. Another NBME it is, I figure you're early on and are probably taking one again anyways.

Thanks man, when are you planning on taking step? if there really was true improvement I would credit anki and sketchy

 

[orangetea]

just analyzed the "why" behind questions I am getting wrong in NBME

out of 14 for example 6 were -careless mistakes (didn't read carefully, quick to answer, etc) and the rest were gaps.

I wouldn't say I have ADD but when I am taking NBME I tend to want to just answer and move on.. (timing has never been an issue even with uworld, usually have 15-20min left). Does this fall under "bad test taking habits?"

Anyone have any insight on how to avoid such mistakes because clearly they are taking up about half of my wrongs at this point.

 

[PleaseCallMeDoc]

To the people not getting 240's on their CBSEs, hang in there!

CBSE: 190 (2 months out)
NBME19: 198 (5 weeks out)
UWSA1: 245 (4weeks out)
NBME16: 234 (3 weeks out)
UWSA2: 241 (1 week out)
Free 117%: 87% (1 week out)

Final score: 239!

-Felt good coming out. Seems like UWSA2 predicts another one accurately again!

Overall, very happy to move up 49 points in 2 months. I knew coming into dedicated I did not want to do a surgical subspecialty / derm and am very pleased.

 

[pbrocks15]

Thanks man, when are you planning on taking step? if there really was true improvement I would credit anki and sketchy

Taking it mid June. I'm taking an NBME next week to see where I sit. I do mostly sketchy and Anki so my credit to then as well haha do you use Zanki?

 

[orangetea]

To the people not getting 240's on their CBSEs, hang in there!

CBSE: 190 (2 months out)
NBME19: 198 (5 weeks out)
UWSA1: 245 (4weeks out)
NBME16: 234 (3 weeks out)
UWSA2: 241 (1 week out)
Free 117%: 87% (1 week out)

Final score: 239!

-Felt good coming out. Seems like UWSA2 predicts another one accurately again!

Overall, very happy to move up 49 points in 2 months. I knew coming into dedicated I did not want to do a surgical subspecialty / derm and am very pleased.

what do you think helped increase you from a 198 to 245 (granted they are different exams)but it clearly shows you knew your stuff

 

[PleaseCallMeDoc]

what do you think helped increase you from a 198 to 245 (granted they are different exams)but it clearly shows you knew your stuff

Hey man! Well NBME 19 underpredicts and UWSA1 overpredicts. I probably sat at a 215-220 at that time. I went through a lot of UW and pathoma during this time. Also, I started to realize how much of STEP is test taking and I changed my approach to answering questions (this "skill" came from answering hundreds of UW questions that week. I maybe did 20% of UW before that week)

 

[The.Supinator]

Taking it mid June. I'm taking an NBME next week to see where I sit. I do mostly sketchy and Anki so my credit to then as well haha do you use Zanki?

Nice, your almost there, june 30th is game day for me, just pepper everything and my incorrects, as in uworld, sketchy micro and pharm pepper. Zanki seems intense no?

 

[pbrocks15]

just analyzed the "why" behind questions I am getting wrong in NBME

out of 14 for example 6 were -careless mistakes (didn't read carefully, quick to answer, etc) and the rest were gaps.

I wouldn't say I have ADD but when I am taking NBME I tend to want to just answer and move on.. (timing has never been an issue even with uworld, usually have 15-20min left). Does this fall under "bad test taking habits?"

Anyone have any insight on how to avoid such mistakes because clearly they are taking up about half of my wrongs at this point.

I don't have much insight but I can say that I do this too. From the people I've asked, its a test taking habit that we need to learn to break. Its the main cause of my silly mistakes and I was told to take each question as its own and own that question then move on. Don't worry about the rest of the exam, just treat that one question as if it was just you doing one question and not taking a full exam (but of course be cognizant of time and I'm similar to you where time was never an issue). I've been trying to slow down and I've started to do better. Trust your gut and don't over think, but really focus on each question one by one. My 2c.

 

[pbrocks15]

Nice, your almost there, june 30th is game day for me, just pepper everything and my incorrects, as in uworld, sketchy micro and pharm pepper. Zanki seems intense no?

It is too much, I don't do it yet, but honestly I'm considering adding in tags of things I'm having a tough time remembering into my UWorld deck. I guess we'll see if that works or not. You have some time too, you'll do great with that method.

 

[NotYou20]

Took uwsa1 yesterday.
4/15: (start of dedicated) nbme 13 242
5/06: nbme 15 234 (minor freak out)
5/11: nbme 18 248
5/17 uwsa1 262

Feeling a lot better. I'd be thrilled with 250 and that seems achievable. On nbme 15 I basically nit picked my way to wrong answers the whole test. I'm sure it got me a question or 2 right but like ten wrong. On top of that I went with my gut even when my reasoning led me to another, correct, answer. So since Then I've been going for the more simple straightforward answers.

@orangetea I had a similar problem. First since I know I have plenty of time after each when I first try to prove the answer wrong. Quick reread the stem and the question to see if I missed something. Then go through my logic again and check if it makes sense at a very basic level. Like if I put an answer that implies insulin is driving catabolism I better be damn sure I know why that's the exception to the rule. If not go through the whole question again. I do this for every question.

On questions where I'm between two answers I have a bad habit of picking everything apart and talking myself out of right answers because there's something that basically isn't how I would word it. On these I ask myself if it's a reasonable distinction. Usually it's not. All of this has limited those dumb mistakes and those are what I'm afraid of making on the real deal. Hopefully something in here works for you!

 

[Mikeyyd34]

Yeah I think this is the right attitude. Depending on the specialty, step 1 isn't going to be worth the time and effort. If you're going for academic neurosurg or plastics or whatever, and you come from a mid-tier school, I can see doing what you have to do to give yourself every chance at a high score, but understand that this is not the MCAT. The test will be minimally like the practice exams.

Having just taken the exam, I can tell you 100% that it is random enough and weird enough that there are no guarantees, especially in the > 250 range. I got some questions on things I thought were completely overkill to study because they weren't in UFAP at all. I got questions on low-yield FA topics. Most importantly though, I got tons and tons of vague, obscure questions that were unclear and nearly impossible to answer. I was scoring 260+ on NBMEs and UWSAs towards the end and I marked 15-20 per section on the real deal. This was not so different from my UW blocks as I flag liberally, but the difference is that when I flagged stuff on the real thing, I really didn't know. All I can say is that I almost wish I just took it at baseline, prior to the pool change, with class knowledge still in my head. I was constantly trying to pull things from the back of my mind, including stuff from M1 and even prior.

Also, people who take this after a clinical year have a massive, massive advantage.

I think PDs must know how random it is. I had a few topics that were among my lowest in UW pop up over and over, while many other huge topics were massively underrepresented. I think I had 2 cardio and immuno questions on the whole thing. A friend of mine took it sitting right next to me and said she basically took an immuno exam combined with obscure anatomy.

This test wasn't designed originally to be scored linearly. Obviously accuracy isn't their 1st priority or you wouldn't have people on here getting a 240 and a 265 on the same test 4 days out both getting a 255. The base of knowledge they are pulling from isn't UFAP. UFAP is just the highest yield. The NBME sees nothing as "off limits." So UFAP just introduces you to the highest yield stuff, and on test day you get your socks blown off trying to pick between 5 study types you've never heard of on an obscure biostats question. There are experimental questions, but there were too many weird questions for them all to be experimental, and even if they throw those away, you're looking at a very small # of questions to accurately assess someone's overall understanding of the principles of medicine.

I've also heard from IM PDs are the top of the top (e.g. MGH, JHH), that the score only helps if they see you as a particular type of person. Obviously they fill their spots with geniuses, but they want a well-rounded class. You need a 260+ if you're scoring a spot in that class by virtue of your sheer brilliance and scientific acumen. 240+ is fine if they see you as a future leader and you have some serious accomplishments on your resume.

Tried messaging you but it won't let me. My step experience felt exactly the same. Can you let me know when you get your score back and how that turns out? I fell in that pooling period so I might not get mine back for over 6 weeks. Trying to trust my NBME and Uworld scores but at least with those, I felt the questions were fair and representative.

 

[bom602]

For those of you who received your scores two days ago, when did you sit for the exam? I'm trying to understand if I should expect my scores next Wednesday since I took the exam on May 1, a Tuesday.

 

[takeurmeds02]

For those of you who received your scores two days ago, when did you sit for the exam? I'm trying to understand if I should expect my scores next Wednesday since I took the exam on May 1, a Tuesday.

4th wednesday after your test so likely next week..

For others:
"Posted: January 24, 2018
Most score reporting of Step 1 results occurs within four weeks of testing. However, because of necessary modifications to the test item pool, there will be a delay in reporting for some examinees who test beginning the week of May 7, 2018. The target date for reporting Step 1 scores for most examinees testing the week of May 7 through early June will be Wednesday, July 11, 2018."

 

[Lannister]

For those of you who received your scores two days ago, when did you sit for the exam? I'm trying to understand if I should expect my scores next Wednesday since I took the exam on May 1, a Tuesday.

4th wednesday after your test so likely next week..

edit: actually wait, I think if you took after april, you might have fallen into the cohort that won't get there's back until like june or something like that. check umsle's website.

'

Anyone who tested on or after May 7th won't receive their score until July 11th, so you should be good to go for next week @bom602.

 

[The Knife & Gun Club]

Update - one month out from the test. Would love some insight. Or just someone to tell me I’m not an idiot...

NBME 13: 200 - 12 weeks out, baseline before any studying

CBSE: 213 - 8 weeks out (studying with classes for 1 month)

NBME 15: 217 - 8 weeks out (back to back with CBSE)

NBME 16: 221 - 4 weeks out (today)

This most recent NBME really has me all freaked out. I’ve been in dedicated for a week and objectively have gained virtually no ground from a month ago.


My strategy has mostly been based around UWorld. I take 2 blocks a day and spend about 2 hours after each UW block reviewing in depth and making anki cards. I spends about 2 hours a day reviewing anki, split 50/50 between cards I make from UW and the pepper deck for sketchy micro + pharm. I’ve also done a good amount of pathoma and use FA consistently but don’t really “read it.”

Would love any input you all have on where I can improve.

Also, I’ve been living in my family’s Everglades fishing cabin for 8 days now and have already seen 3 alligators, so that’s a win, I guess.

Ok took UWSA #1 for a confidence boost...Did well but its such a screwy test I cant help but feel like its not truly representative of anything. In any case even if it overshot by 20 points I'd still be up 9 from a week ago.

Anyway:
NBME 13: 200 - 12 weeks out, baseline before any studying

CBSE: 213 - 8 weeks out (studying with classes for 1 month)

NBME 15: 217 - 8 weeks out (back to back with CBSE)

NBME 16: 221 - 4 weeks out (1 week into dedicated)

UW SIM 1: 249 - 3 weeks out (2 weeks into dedicated)

Now off to my brothers college graduation so I can be drunk for 2 days.

 

[Krabbeman]

I took it on may 4th... So I shouldn't expect to get them next Wednesday?

sucks...

But both my friends (granted N=2) who took it on the 28th got their scores this Wednesday, which is only 3 Wednesdays.

Somebody said on here that Friday/Saturday exams are more likely to be 3 Wednesdays, and earlier in the week exams are more likely to be 4. Is this true at all?

 

[Mikeyyd34]

'

Anyone who tested on or after May 7th won't receive their score until July 11th, so you should be good to go for next week @bom602.

That wasn't my interpretation of reading the announcement. If you read the whole thing, it says they "may" take up to 6 weeks to get back based on the size of the testing center and im sure a few other variables. Therefore the target is July 11th, meaning you won't get it any later than this, but you could very well get it before then. I think they were warning people that need a score release along the normal time frame i.e 3 weeks, that they might not receive it because of the change in forms.

 

[Lannister]

That wasn't my interpretation of reading the announcement. If you read the whole thing, it says they "may" take up to 6 weeks to get back based on the size of the testing center and im sure a few other variables. Therefore the target is July 11th, meaning you won't get it any later than this, but you could very well get it before then. I think they were warning people that need a score release along the normal time frame i.e 3 weeks, that they might not receive it because of the change in forms.

You are definitely correct!

I think mentally I'm just going to have to tell myself that my score isn't coming until the 11th. Otherwise I'm gonna get all stressed out for no reason, hoping my score will come earlier than expect haha.

 

[Mikeyyd34]

You are definitely correct!

I think mentally I'm just going to have to tell myself that my score isn't coming until the 11th. Otherwise I'm gonna get all stressed out for no reason, hoping my score will come earlier than expect haha.

haha. Im going to be checking and then if I see that is available, I'm not sure Ill be able to bring myself to do it. Honestly will probably have my GF tell me. Or just watch her face and ill know how it is lol. I felt good going into, but absolute **** afterward

 

[Lannister]

haha. Im going to be checking and then if I see that is available, I'm not sure Ill be able to bring myself to do it. Honestly will probably have my GF tell me. Or just watch her face and ill know how it is lol. I felt good going into, but absolute **** afterward

I admire your self control. The second I know my score has been posted I'm gonna run to the bathroom and check, there's no way I could wait until I got home. It's a bummer that this delay is happening, I would have gotten my score during the last week of June, before M3 starts. But now I'm going to get it during my IM rotation so I'm gonna have to be able to hold it together if I do poorly.

 

[mikil100]

What would be the best NBME to take if I've already done 13, 19, and 18? I'm assuming 17 but just want to be sure before I drop some more money on this already expensive exam.... This will probably be my last practice test before the real thing other than the free 120.

 

[pbrocks15]

I admire your self control. The second I know my score has been posted I'm gonna run to the bathroom and check, there's no way I could wait until I got home. It's a bummer that this delay is happening, I would have gotten my score during the last week of June, before M3 starts. But now I'm going to get it during my IM rotation so I'm gonna have to be able to hold it together if I do poorly.

I'm just like you. I'll literally have to excuse myself even if we're rounding lol.

What would be the best NBME to take if I've already done 13, 19, and 18? I'm assuming 17 but just want to be sure before I drop some more money on this already expensive exam.... This will probably be my last practice test before the real thing other than the free 120.

I would agree with you! The most recents are most closely like the exam from what I've heard. USWA2 seems to be the best predictor but it won't prepare you probably for the format as well as the others would.

 

[Lannister]

I'm just like you. I'll literally have to excuse myself even if we're rounding lol.

I'll just tell everyone I feel like I'm going to vomit...which will probably not be a lie.

 

[Squamous Eddie]

Took it today, I guess this is the "new" Step 1. To sum: It was horrible. Wall of text/rant incoming. I'm going to refrain from saying anything specific of course and stick to generalities.

I'd say about 50% of it was roughly, kinda straightforward, as long as you had studied. There were a few give-me's here and there but those were in the minority. Often times, the freebies were preceded by extraordinarily long question stems, so you paid the price of time in exchange for an easy question. There were very, very few buzzwords, but I expected that much going in. Oh, I remember chuckling because they actually used the words "malar rash" for SLE. Yeah, I think that was it. Also, from talking to my dad (who is a physician as well), one of the questions described a disease that apparently has a super classic demographic that I've never heard of in my life. The disease is in FA and I knew it, but this classic demographic isn't in it or any of the review sources, and the actual patient's presentation was pretty different.

A few times every block, I would come across a question where I'd think, "Alright here we go, EZ mode", where I thought I knew almost every detail of the disease from studying Zanki/FA/UWorld/Pathoma/Sketchy obsessively throughout the year. Then I'd find that they wanted me to answer some random aspect of the disease that you wouldn't find in any of the main review sources, or was a tiny detail that was (in one example) literally one word from FA. It's absolutely crushing to come across questions like this; they feel like points slipping right through your fingers.

Then of course there was stuff that no reasonable MS2 would expect to know. I actually thought that people were exaggerating when they said stuff like that; surely we'd be at least roughly familiar with it. Nope. No matter how much you've studied there will be something you would never in a million years get without guessing. Half the time you can't even PoE it because there's still like 6 choices.

Other times they actually deliberately mislead you. Not only did it seem like every question stem was exquisitely long, but many times, the patient had symptoms that clearly included another disease in the differential, and was distinguished by a very small detail. Or they included details in the stem that truly had nothing to do with what they were asking you for, and only served to distract your thoughts. Sometimes there just didn't seem like there really was a good answer at all.

I think the worst part was how much anatomy I had on mine. It was the one topic I was dreading, because our MS1 anatomy course is agreed to be the weakest part of our curriculum at my school. I'd say 4-5 questions per block were anatomy for me; some were easy, some were obscure. I learned all the anatomy from FA and UWorld, and only half of it showed up.

My practice scores were pretty good, and around what I wanted.
UWorld average: 87% first pass
NBME 16 (taken 1 week from exam): 255
NBME 18 (taken Wednesday): 257
NBME free 120: 93% (took right after NBME 18 to simulate a full test day)
UWSA 2 (taken yesterday): 266

But I've walked out of it feeling like I barely scraped 220. I don't think I've ever felt this disappointed in myself. I second guessed myself a lot of times, and changed answers that turned out to be right the first time. I've counted like ~8-10 questions already that I know I got wrong. I'm trying to resist thinking of more and looking them up, too. And the worst thing is I don't get my score for 2 months, so there's nothing to do but mope around for a few days and then start preparing for third year.

Anyway. Just wanted to get that off my chest/give some more insight into this horrible process that is Step 1.

 

[Foot Fetish]

Took it today, I guess this is the "new" Step 1. To sum: It was horrible. Wall of text/rant incoming. I'm going to refrain from saying anything specific of course and stick to generalities.

I'd say about 50% of it was roughly, kinda straightforward, as long as you had studied. There were a few give-me's here and there but those were in the minority. Often times, the freebies were preceded by extraordinarily long question stems, so you paid the price of time in exchange for an easy question. There were very, very few buzzwords, but I expected that much going in. Oh, I remember chuckling because they actually used the words "malar rash" for SLE. Yeah, I think that was it. Also, from talking to my dad (who is a physician as well), one of the questions described a disease that apparently has a super classic demographic that I've never heard of in my life. The disease is in FA and I knew it, but this classic demographic isn't in it or any of the review sources, and the actual patient's presentation was pretty different.

A few times every block, I would come across a question where I'd think, "Alright here we go, EZ mode", where I thought I knew almost every detail of the disease from studying Zanki/FA/UWorld/Pathoma/Sketchy obsessively throughout the year. Then I'd find that they wanted me to answer some random aspect of the disease that you wouldn't find in any of the main review sources, or was a tiny detail that was (in one example) literally one word from FA. It's absolutely crushing to come across questions like this; they feel like points slipping right through your fingers.

Then of course there was stuff that no reasonable MS2 would expect to know. I actually thought that people were exaggerating when they said stuff like that; surely we'd be at least roughly familiar with it. Nope. No matter how much you've studied there will be something you would never in a million years get without guessing. Half the time you can't even PoE it because there's still like 6 choices.

Other times they actually deliberately mislead you. Not only did it seem like every question stem was exquisitely long, but many times, the patient had symptoms that clearly included another disease in the differential, and was distinguished by a very small detail. Or they included details in the stem that truly had nothing to do with what they were asking you for, and only served to distract your thoughts. Sometimes there just didn't seem like there really was a good answer at all.

I think the worst part was how much anatomy I had on mine. It was the one topic I was dreading, because our MS1 anatomy course is agreed to be the weakest part of our curriculum at my school. I'd say 4-5 questions per block were anatomy for me; some were easy, some were obscure. I learned all the anatomy from FA and UWorld, and only half of it showed up.

My practice scores were pretty good, and around what I wanted.
UWorld average: 87% first pass
NBME 16 (taken 1 week from exam): 255
NBME 18 (taken Wednesday): 257
NBME free 120: 93% (took right after NBME 18 to simulate a full test day)
UWSA 2 (taken yesterday): 266

But I've walked out of it feeling like I barely scraped 220. I don't think I've ever felt this disappointed in myself. I second guessed myself a lot of times, and changed answers that turned out to be right the first time. I've counted like ~8-10 questions already that I know I got wrong. I'm trying to resist thinking of more and looking them up, too. And the worst thing is I don't get my score for 2 months, so there's nothing to do but mope around for a few days and then start preparing for third year.

Anyway. Just wanted to get that off my chest/give some more insight into this horrible process that is Step 1.

Thank you for the write up. Don't be so hard on yourself, man -- feeling terrible after Step 1 is the norm, and you will most likely end up right around your UWSA2 score.

I have a couple questions.

The questions you mentioned that no M2 would reasonably be expected to know - were those like Step 2 style "next step" questions?

And for anatomy, without giving away anything too specific, what sorts of questions were the ones not covered in UFAP? Were they pure gross anatomy , e.g. naming an obscure ligament of the foot based on a picture, or were they clinically-oriented, e.g. "what structure may be damaged in this random neck surgery you never heard of" ?

Looking back on your preparation, aside from an extremely meticulous reading of FA, which you already mentioned might have been useful, what could you have done differently to prepare for these obscure questions? Would a Step 2 resource have helped? Or perhaps a supplemental anatomy review book? ...Or are these esoteric questions actually that random that no single review book would be worth the time and effort?

Thank you. And congrats on finishing. Based on your scores and level of preparation, I'm sure you did better than you think.

 

[ERDOC555]

Took it today, I guess this is the "new" Step 1. To sum: It was horrible. Wall of text/rant incoming. I'm going to refrain from saying anything specific of course and stick to generalities.

I'd say about 50% of it was roughly, kinda straightforward, as long as you had studied. There were a few give-me's here and there but those were in the minority. Often times, the freebies were preceded by extraordinarily long question stems, so you paid the price of time in exchange for an easy question. There were very, very few buzzwords, but I expected that much going in. Oh, I remember chuckling because they actually used the words "malar rash" for SLE. Yeah, I think that was it. Also, from talking to my dad (who is a physician as well), one of the questions described a disease that apparently has a super classic demographic that I've never heard of in my life. The disease is in FA and I knew it, but this classic demographic isn't in it or any of the review sources, and the actual patient's presentation was pretty different.

A few times every block, I would come across a question where I'd think, "Alright here we go, EZ mode", where I thought I knew almost every detail of the disease from studying Zanki/FA/UWorld/Pathoma/Sketchy obsessively throughout the year. Then I'd find that they wanted me to answer some random aspect of the disease that you wouldn't find in any of the main review sources, or was a tiny detail that was (in one example) literally one word from FA. It's absolutely crushing to come across questions like this; they feel like points slipping right through your fingers.

Then of course there was stuff that no reasonable MS2 would expect to know. I actually thought that people were exaggerating when they said stuff like that; surely we'd be at least roughly familiar with it. Nope. No matter how much you've studied there will be something you would never in a million years get without guessing. Half the time you can't even PoE it because there's still like 6 choices.

Other times they actually deliberately mislead you. Not only did it seem like every question stem was exquisitely long, but many times, the patient had symptoms that clearly included another disease in the differential, and was distinguished by a very small detail. Or they included details in the stem that truly had nothing to do with what they were asking you for, and only served to distract your thoughts. Sometimes there just didn't seem like there really was a good answer at all.

I think the worst part was how much anatomy I had on mine. It was the one topic I was dreading, because our MS1 anatomy course is agreed to be the weakest part of our curriculum at my school. I'd say 4-5 questions per block were anatomy for me; some were easy, some were obscure. I learned all the anatomy from FA and UWorld, and only half of it showed up.

My practice scores were pretty good, and around what I wanted.
UWorld average: 87% first pass
NBME 16 (taken 1 week from exam): 255
NBME 18 (taken Wednesday): 257
NBME free 120: 93% (took right after NBME 18 to simulate a full test day)
UWSA 2 (taken yesterday): 266

But I've walked out of it feeling like I barely scraped 220. I don't think I've ever felt this disappointed in myself. I second guessed myself a lot of times, and changed answers that turned out to be right the first time. I've counted like ~8-10 questions already that I know I got wrong. I'm trying to resist thinking of more and looking them up, too. And the worst thing is I don't get my score for 2 months, so there's nothing to do but mope around for a few days and then start preparing for third year.

Anyway. Just wanted to get that off my chest/give some more insight into this horrible process that is Step 1.

Wow, this is absolutely terrifying to read. I was hoping you were going to end your post saying that your practices tests were 240s and U-World 70s, so at least I could chock some of it up to not being prepared enough for the material. But realistically you're someone whose score should be in the 260s and to hear that the test was so perplexing/challenging for someone with your scores is very nerve wracking.

Regardless, congratulations on finishing it up and I know at worst you'll get a 250 and I'm sure that with however they curve/equalize exams, you'll probably end up somewhere around a 260+. If I've learned anything from this thread, it's that NBMEs and UW are really accurate predictors. Looking forward to hearing what you eventually get! Thanks for the write-up

 

[Squamous Eddie]

Tank you for the write up. Don't be so hard on yourself, man -- feeling terrible after Step 1 is the norm, and you will most likely end up right around your UWSA2 score.

I have a couple questions.

The questions you mentioned that no M2 would reasonably be expected to know - were those like Step 2 style "next step" questions?

And for anatomy, without giving away anything too specific, what sorts of questions were the ones not covered in UFAP? Were they pure gross anatomy , e.g. naming an obscure ligament of the foot based on a picture, or were they clinically-oriented, e.g. "what structure may be damaged in this random neck surgery you never heard of" ?

Looking back on your preparation, aside from an extremely meticulous reading of FA, which you already mentioned might have been useful, what could you have done differently to prepare for these obscure questions? Would a Step 2 resource have helped? Or perhaps a supplemental anatomy review book? ...Or are these esoteric questions actually that random that no single review book would be worth the time and effort?

Thank you. And congrats on finishing. Based on your scores and level of preparation, I'm sure you did better than you think.

Sure.

So, for those "unreasonable" knowledge type questions, it varies. For next best step type questions, I think I actually only had 2-ish on my test, and I would say while it seems more like MS3-oriented stuff, it is stuff you probably learned throughout the year as long as you didn't totally blow off lectures. One of them is in FA. And the other I remember learning from lecture, but felt is kind of a no-brainer anyway. (I say that, hoping it was the right answer lol.) I think they really aren't question types I would agonize over learning Step 2 material for. They made a very small minority of my test.

An actual "unreasonable" question that comes to mind, you could only come to the right answer by eliminating every other answer. I guarantee 99% of MS2s have not heard of (what I believe was) the correct answer, unless maybe they have direct personal experience with it. So in a way, I guess it wasn't totally unreasonable... But it feels wrong to me. I should never have to come to the answer by elimination. And I personally am a proponent of, if you don't recognize it, think twice or thrice before picking it.
Unfortunately I can't remember any else right now, my brain is kind of fried. But I will say these types of questions are also in the minority, so don't fret too much. They will show up, but they won't make or break your score.

Regarding anatomy, no, I think only 2 times was I just straight up shown a picture and asked to name what it was. Those were pretty reasonable, too, and I knew it right away. Most of the time it's just like it is in UWorld, knowing relationships of structures to one another or their functions.

To be honest, I truly can't say what would have prepared me better for the anatomy. I read several times that UWorld and FA anatomy is sufficient, so while I considered reading through BRS Anatomy, I decided against it. Flipping through the book now, it doesn't mention 2 of the questions I had. So I think my conclusion for the anatomy issue is: There is no good way to study it. Do learn whatever is in First Aid and UWorld, don't agonize about anything else. Barring doing a long refresher in anatomy (which btw I don't think is worth it, even after today), you're just going to have to cruise with whatever you remember from MS1 and hope it's enough.

Wow, this is absolutely terrifying to read. I was hoping you were going to end your post saying that your practices tests were 240s and U-World 70s, so at least I could chock some of it up to not being prepared enough for the material. But realistically you're someone whose score should be in the 260s and to hear that the test was so perplexing/challenging for someone with your scores is very nerve wracking.

Regardless, congratulations on finishing it up and I know at worst you'll get a 250 and I'm sure that with however they curve/equalize exams, you'll probably end up somewhere around a 260+. If I've learned anything from this thread, it's that NBMEs and UW are really accurate predictors. Looking forward to hearing what you eventually get! Thanks for the write-up

From your username, I take it you want to go into Derm? Yeah, same here... Or at least, I did. RIP.

Jokes aside, after reading other people's experiences on how they ended up missing like 20 questions and still got like 250's, I've calmed down a little... Still keeping my expectations low so I don't disappoint myself in July. It's just hard not to feel like my practice scores must have all been a fluke or something. Every time I'd get a good score I'd think, yeah but I got lucky that this set of questions had a lot of stuff that I knew, what if I get a test with topics I don't know as well? Maybe the day finally came that my luck ran out. We'll see in July.

 

[Lannister]

Took it today, I guess this is the "new" Step 1. To sum: It was horrible. Wall of text/rant incoming. I'm going to refrain from saying anything specific of course and stick to generalities.

I'd say about 50% of it was roughly, kinda straightforward, as long as you had studied. There were a few give-me's here and there but those were in the minority. Often times, the freebies were preceded by extraordinarily long question stems, so you paid the price of time in exchange for an easy question. There were very, very few buzzwords, but I expected that much going in. Oh, I remember chuckling because they actually used the words "malar rash" for SLE. Yeah, I think that was it. Also, from talking to my dad (who is a physician as well), one of the questions described a disease that apparently has a super classic demographic that I've never heard of in my life. The disease is in FA and I knew it, but this classic demographic isn't in it or any of the review sources, and the actual patient's presentation was pretty different.

A few times every block, I would come across a question where I'd think, "Alright here we go, EZ mode", where I thought I knew almost every detail of the disease from studying Zanki/FA/UWorld/Pathoma/Sketchy obsessively throughout the year. Then I'd find that they wanted me to answer some random aspect of the disease that you wouldn't find in any of the main review sources, or was a tiny detail that was (in one example) literally one word from FA. It's absolutely crushing to come across questions like this; they feel like points slipping right through your fingers.

Then of course there was stuff that no reasonable MS2 would expect to know. I actually thought that people were exaggerating when they said stuff like that; surely we'd be at least roughly familiar with it. Nope. No matter how much you've studied there will be something you would never in a million years get without guessing. Half the time you can't even PoE it because there's still like 6 choices.

Other times they actually deliberately mislead you. Not only did it seem like every question stem was exquisitely long, but many times, the patient had symptoms that clearly included another disease in the differential, and was distinguished by a very small detail. Or they included details in the stem that truly had nothing to do with what they were asking you for, and only served to distract your thoughts. Sometimes there just didn't seem like there really was a good answer at all.

I think the worst part was how much anatomy I had on mine. It was the one topic I was dreading, because our MS1 anatomy course is agreed to be the weakest part of our curriculum at my school. I'd say 4-5 questions per block were anatomy for me; some were easy, some were obscure. I learned all the anatomy from FA and UWorld, and only half of it showed up.

My practice scores were pretty good, and around what I wanted.
UWorld average: 87% first pass
NBME 16 (taken 1 week from exam): 255
NBME 18 (taken Wednesday): 257
NBME free 120: 93% (took right after NBME 18 to simulate a full test day)
UWSA 2 (taken yesterday): 266

But I've walked out of it feeling like I barely scraped 220. I don't think I've ever felt this disappointed in myself. I second guessed myself a lot of times, and changed answers that turned out to be right the first time. I've counted like ~8-10 questions already that I know I got wrong. I'm trying to resist thinking of more and looking them up, too. And the worst thing is I don't get my score for 2 months, so there's nothing to do but mope around for a few days and then start preparing for third year.

Anyway. Just wanted to get that off my chest/give some more insight into this horrible process that is Step 1.

Oh God, reading this was not the best way to start my morning. Officially freaking out now. I am absolutely awful at anatomy and now I feel like I should study it more but I don't even know how. I'm just terrible at being able to visualize where structures are in relation to one another.

Anyways, sorry you feel cruddy about it I really hope to see you posting that you got a 255+ in a few weeks!

 

[afib123]

Yup , this post shows the toughest thing abut step 1. Not getting the scores that you should based on practice tests. 260 should have been a guarantee for me based on my practice tests, but ended up getting a 253. It sucks, but 253 is well above the average for neurosurgery which is what I want to do, so it all works out

 

[NoReservation]

Took Step yesterday, felt like NBME questions with the length and detail of Uworld questions; probably one of the hardest exams I've ever taken and didn't expect to see so much low yield on there. Averaged 240s-250s on all NBMEs and 260s on my UWSAs and while I felt pretty confident on the majority of NBMES/UWSAs, I marked at least 20% of questions on all my actual step blocks. Pretty sure I dropped the ball hardcore.

 

[Mikeyyd34]

Took it today, I guess this is the "new" Step 1. To sum: It was horrible. Wall of text/rant incoming. I'm going to refrain from saying anything specific of course and stick to generalities.

I'd say about 50% of it was roughly, kinda straightforward, as long as you had studied. There were a few give-me's here and there but those were in the minority. Often times, the freebies were preceded by extraordinarily long question stems, so you paid the price of time in exchange for an easy question. There were very, very few buzzwords, but I expected that much going in. Oh, I remember chuckling because they actually used the words "malar rash" for SLE. Yeah, I think that was it. Also, from talking to my dad (who is a physician as well), one of the questions described a disease that apparently has a super classic demographic that I've never heard of in my life. The disease is in FA and I knew it, but this classic demographic isn't in it or any of the review sources, and the actual patient's presentation was pretty different.

Yo that one was dermatomyositis......
lol jk I have no idea

 

[theonlytycrane]

Yo that one was dermatomyositis......
lol jk I have no idea

"Dermatomyositis may present with a malar rash that is similar to SLE"

Bruh you're giving people heart palpitations...

 

[Analfissure]

How important is it to take NBME's? I have three weeks out from my test and was doing a practice test every week since dedicated started but am not sure if its worth the $60 and time commitment. Here are my scores so far:

NBME 15: 250 (6 weeks out from Step 1)
UWA 1: 271 (5 weeks out from Step 1)
NBME 16: 248 (4 weeks out from Step 1)
Uworld first pass 80%

Like i said I'm three weeks out... I was planning on doing UWA2 and the NBME's free 120. Would it be beneficial to try and take at least 1/2 more NBME?

All advice is appreciated

 

[pbrocks15]

How important is it to take NBME's? I have three weeks out from my test and was doing a practice test every week since dedicated started but am not sure if its worth the $60 and time commitment. Here are my scores so far:

NBME 15: 250 (6 weeks out from Step 1)
UWA 1: 271 (5 weeks out from Step 1)
NBME 16: 248 (4 weeks out from Step 1)
Uworld first pass 80%

Like i said I'm three weeks out... I was planning on doing UWA2 and the NBME's free 120. Would it be beneficial to try and take at least 1/2 more NBME?

All advice is appreciated

Heard that it was important and that a few questions might show up on your test. You're scoring really well, so I'm sure the knowledge is there, but from what I've heard just getting the practice in and seeing more NBME style questions in helpful.

 

[mikil100]

How important is it to take NBME's? I have three weeks out from my test and was doing a practice test every week since dedicated started but am not sure if its worth the $60 and time commitment. Here are my scores so far:

NBME 15: 250 (6 weeks out from Step 1)
UWA 1: 271 (5 weeks out from Step 1)
NBME 16: 248 (4 weeks out from Step 1)
Uworld first pass 80%

Like i said I'm three weeks out... I was planning on doing UWA2 and the NBME's free 120. Would it be beneficial to try and take at least 1/2 more NBME?

All advice is appreciated

I would try to do at least NBME18. Ideally you would do 18+/- 19 (or 17, Idk, haven't taken it yet). I felt like 18 was very challenging compared to UWSA's and NBME19 and NBME13.