USMLE Official 2018 Step 1 Experiences and Scores Thread

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Thanks for your suggestion! Our Pharm lectures are reaaaally bad and I also don't learn best from watching and reviewing lecture material. I guess my question is more how would you organize the material in the FA reproductive pharm section into Anki cards?

@Foot Fetish or anyone else who used Zanki, I haven't downloaded it (making my own Anki cards) — are there Reproductive pharm cards in the deck?
I didn't use Anki - I'm an Osmosis fan.
 
Alright here's my write-up, as promised.

Me: average student (2nd quartile, don't know exact ranking but I'm usually within 5% of the average so probably lower down in second quartile), mid-tier school with an average step in the 240s.

Step 1: 261
NBME 13: 234
CBSE: 248
UWSA1: 258
UWSA2: 256
NBME 15: 263
NBME 16: 261
NBME 17: 257
NBME 18: 255
NBME 19: 255
Free 120: 87% - 248

UWorld: 86%
Rx: 84%
Kaplan (~50% complete): 84%

Spring semester of M2: I started studying in January. I did Rx, 30 problems/day. I read every word of every answer explanation and every associated First Aid page. It took me an average of 3 hours/day. I honestly think this was the biggest factor in my success. It got repetitive after a while, like I read the FA page about macrocytic anemia about 50 times. But by the time I was done with Rx, I had probably 90% of First Aid down cold. I did take notes when working through Rx, but never looked at them again after writing them haha. I think just the process of writing helped me remember stuff better.

I did some of Kaplan during first semester of M2 to study for EOB exams, and sporadically throughout the spring semester and dedicated. I think Rx is infinitely better than Kaplan. Kaplan has so many completely irrelevant questions that I couldn't even find the answer to with google. Rx focuses on higher yield stuff. I think it's especially good if you struggle with memorizing stuff, because it forces you to nail down First Aid. Rx also has short videos, which I used whenever I found a topic I struggled with (mostly biochem, which ended up being my best section on the real deal despite being probably my worst block of M1/M2).

I followed along with my classes in Pathoma.

Multisystems course: my school has a 3-week multisystems course right before dedicated. At this point I started UWorld and was studying around 5-6 hours a day. The beginning of MS was when I took the CBSE and NBME 13. I didn't take any notes on UWorld but I did make my own Anki cards. By the time I started UWorld I felt like I had a good grasp on the high-yield concepts, and was more focusing on nailing down lower yield details.

Dedicated: I took 3.5 weeks of dedicated (school offered 6.5). I finished UWorld about 2 weeks into dedicated. Knew I was not going to do it again because my first pass percentage was already pretty good, and I would probably just answer the questions based on memorization from my first pass. As I was finishing up UWorld, I also watched the cardio and pulmonology chapters of Physeo, which I found very helpful. I re-watched chapters 1-3 of pathoma, which I found extremely high yield. I watched a few other chapters of pathoma again just to feel like I was being productive but that was mostly a waste of time since I had already been through pathoma once during classes.

My last week and a half or so was mostly NBMEs and days off. I took a LOT of NBMEs in that time, which wasn't my original plan, but I felt like I was ready to move my test up at that point and wanted to get them all done.

I took the last day off before the test. This is a must, in my opinion.

The test: Won't say too much because everyone has a different experience, but I walked out feeling pretty decent about it. It was just slightly harder than the free 120. I didn't look up answers so no idea how many I got wrong.

I never used DIT, B&B, or any pre-made Anki decks. I watched a few Sketchy micro videos (staph, strep, neisseria), which were only slightly helpful. I think Sketchy pharm is a total waste of time but I know some people swear by it.

Will be beginning M2 year in two-ish weeks and was curious what your thoughts would be about only using Rx and UWorld while leaving out Kaplan? I was planning on doing all three banks but your post suggests that Kaplan wasn’t too helpful and I wouldn’t want to waste my time slaving away at it if it wasn’t very useful.
 
Lmao good God some of these scores. Can you all please apply to plastic surgery and IR and leave me and my 236 alone in whatever field I apply to? But seriously, congratulations.

Important to remember that a lot of people in this thread are IMGs who operate on a totally different score scale than US grads (cant recall if you're MD or DO, but it doesn't really matter). You can confidently match virtually every speciality in the book except the surgical subs with a anything over a 230.
 
Will be beginning M2 year in two-ish weeks and was curious what your thoughts would be about only using Rx and UWorld while leaving out Kaplan? I was planning on doing all three banks but your post suggests that Kaplan wasn’t too helpful and I wouldn’t want to waste my time slaving away at it if it wasn’t very useful.

That's a good combo. Rx before UW will help. IMO, Kaplan is losing the battle of the qbanks.
 
Important to remember that a lot of people in this thread are IMGs who operate on a totally different score scale than US grads (cant recall if you're MD or DO, but it doesn't really matter). You can confidently match virtually every speciality in the book except the surgical subs with a anything over a 230.

I'd go as far as to say that as low as a 210/215 allows US MDs to feel pretty good about any specialty outside of the elite tier and maybe gensurg/radiology.

Make that a 220 and Gen Surg and Rads are probably great odds.

Bottom line, even a 210 leaves you with almost all options still on the table except the crazy specialties (plastic,ortho,derm, etc) you'll just have to apply broadly and be flexible on location.
 
High MCAT = High Step1 is not a fallacy. Doing well on the MCAT correlates to higher USMLE scores. There is an NCBI study published you should take a look at comparing the 2, which is why the MCAT is weighed so heavily in med school admissions.


However, mediocre MCAT scores do not rule out high Step 1 scores. The idea that poor MCAT = poor USMLE is the fallacy.

"Each of the MCAT component scores was significantly associated with USMLE Step 1 and Step 2 CK scores, although the effect size was small. Being in the top or bottom scoring range of the MCAT exam was predictive of being in the top or bottom scoring range of the USMLE exams, although the strengths of the associations were weak to moderate. These results indicate that MCAT scores are predictive of student performance on the USMLE exams, but, given the small effect sizes, should be considered as part of the holistic view of the student."


Do MCAT scores predict USMLE scores? An analysis on 5 years of medical student data


In an older study too, correlation was like .4 overall and like .6 for bio section, if I'm remembering correctly. it's weak to moderately predictive. Something like an LSAT MCAT would correlate much better. MCAT is much more of a thinking test. But I've had this argument a 100 times.

harvard with an mcat average at 36 had a usmle average in 230s. UCSF had average mcat of 35 and average in the 220s. Baylor 34 and the higest average in the nation at mid 240s. My school average MCAT is a 32 and average at pretty much 230.

Teach to the test and students will do better on average. One can overcome their school not doing this and get in the 260s. Carib students and DO kids who sometimes failed to break a 30 on amultiple attempts sometimes also get 260s and 270s. It happens more than you'd think. This is at baseline an effort and dedication test. Other things matter and make life easier but only slightly.

Also, these scores are an arbitrary screen. You can train a dedicated 220 scorer to be a great neurosurgeon. They are used as an artificial barrier to preclude people because training funding for residency is limited by Congress and lobbying of certain groups keeps spots low. STEP1 is seen as a highly imperfect yet the most objective of all markers currently in use. Given our current system, it is better there than not. Otherwise prestige would rule more and we would trend more and more towards how something like law works, where top schools have a monopoly on graduate placements into the most lucrative and prestigious jobs.

Frankly medicine is much more of a field of effort, dedication, and grit than deep thought, outside of niches of highly specialized people routinely doing weird/hard cases, research, and medical device innovation.

Here is a table of MCAT and USMLE scores by specialty

Data and Analysis - AAMC

The highest average MCAT was neurosurgery with an average of a 33. That's not much above the mean of matriculating US MD students. The USMLE is a licensing test, not an aptitude test. It is designed to test knowledge and not to be g loaded heavy. If you can get into a US MD school on your own merits, you can crush this test.
 
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Will be beginning M2 year in two-ish weeks and was curious what your thoughts would be about only using Rx and UWorld while leaving out Kaplan? I was planning on doing all three banks but your post suggests that Kaplan wasn’t too helpful and I wouldn’t want to waste my time slaving away at it if it wasn’t very useful.

I think you're totally fine leaving out Kaplan. If you have the time and you run out of other questions, do it. But otherwise don't worry about it.
 
So I'll be honest, I tended to avoid SDN like the plague the entirety of my second year because this is a very....skewed sample of the med student population. But, I figure it might be useful to get some feedback on what my score means for me.

STEP 1 = 246

NBME 16 = 225
NBME 17 = 228
NBME 18 = 235
NBME 19 = 236
UWSA 1 = 249
UWSA 2 = 249

So overall, I'd pretty ****ing pumped about my score. I was expecting somewhere in the mid 230s based on my NBMEs, hoping for a 240 as a reach. Cannot believe I managed to do this.

Quick summary for the year:

Unlike many people in my class, I actually tried to do well in school. I maintain relatively high grades and I would attribute part of my score to this. I certainly felt more comfortable entering dedicated than some of my peers that had substituted class with BEB, Pathoma, DIT, etc. Anecdotal of course, but going to class and trying to do well helped me learn the material well. Having the "just pass" attitude wouldn't have worked for me. That being said, I know people that blew STEP 1 out of the water without trying at all during the school year. So your mileage will vary.

During the year I completed about 60% of UWorld before entering dedicated, at which point I reset and finished a second pass, and then a third pass with my incorrects. I'd say this was one of the most important things because STEP 1 does not give buzzwords and has vague question stems compared to the NBMEs (imo). I had exactly 6 weeks of dedicated, so I scheduled out all the practice exams and UW questions within this time-frame. Can't honestly say I stuck to it everyday, but general idea was 3 blocks of 40qs in the morning, afternoon was review, and then finish the night with Anki.

Pathoma was essential during the year, but I can't say I looked at it much during dedicated. I took notes on Sketchy Micro during the year so this was also pretty well ingrained in my noggin for dedicated. I rewatched a majority Sketchy Pharm though, and this was golden. There were a ton of questions about side-effects and anti-microbial resistance that I absolutely would not have gotten without Sketchy Pharm.

Sketchy Path is trash, don't use it.

I also tried using Zanki, and it helped decently. If I had to changed something, I would probably have been a little more consistent with it during the year.
 
"Each of the MCAT component scores was significantly associated with USMLE Step 1 and Step 2 CK scores, although the effect size was small. Being in the top or bottom scoring range of the MCAT exam was predictive of being in the top or bottom scoring range of the USMLE exams, although the strengths of the associations were weak to moderate. These results indicate that MCAT scores are predictive of student performance on the USMLE exams, but, given the small effect sizes, should be considered as part of the holistic view of the student."


Do MCAT scores predict USMLE scores? An analysis on 5 years of medical student data


somewhat wrong. In an older study too, correlation was like .4 overall and like .6 for bio section, if I'm remembering correctly. it's weak to moderately predictive. Something like an LSAT MCAT would correlate much better. MCAT is much more of a thinking test. But I've had this argument a 100 times.

harvard with an mcat average at 36 had a usmle average in 230s. UCSF had average mcat of 35 and average in the 220s. Baylor 34 and the higest average in the nation at mid 240s. My school average MCAT is a 32 and average at pretty much 230.

Teach to the test and students will do better on average. One can overcome their school not doing this and get in the 260s. Carib students and DO kids who sometimes failed to break a 30 on amultiple attempts sometimes also get 260s and 270s. It happens more than you'd think. This is at baseline an effort and dedication test. Other things matter and make life easier but only slightly.

Also, these scores are an arbitrary screen. You can train a dedicated 220 scorer to be a great neurosurgeon. They are used as an artificial barrier to preclude people because training funding for residency is limited by Congress and lobbying of certain groups keeps spots low. STEP1 is seen as a highly imperfect yet the most objective of all markers currently in use. Given our current system, it is better there than not. Otherwise prestige would rule more and we would trend more and more towards how something like law works, where top schools have a monopoly on graduate placements into the most lucrative and prestigious jobs.

Frankly medicine is much more of a field of effort, dedication, and grit than deep thought, outside of niches of highly specialized people routinely doing weird/hard cases, research, and medical device innovation.

Here is a table of MCAT and USMLE scores by specialty

Data and Analysis - AAMC

The highest average MCAT was neurosurgery with an average of a 33. That's not much above the mean of matriculating US MD students. The USMLE is a licensing test, not an aptitude test. It is designed to test knowledge and not to be g loaded heavy. If you can get into a US MD school on your own merits, you can crush this test.
what are they feeding the baylor kids, and may i please have some?
 
So I'll be honest, I tended to avoid SDN like the plague the entirety of my second year because this is a very....skewed sample of the med student population. But, I figure it might be useful to get some feedback on what my score means for me.

STEP 1 = 246

NBME 16 = 225
NBME 17 = 228
NBME 18 = 235
NBME 19 = 236
UWSA 1 = 249
UWSA 2 = 249

So overall, I'd pretty ****ing pumped about my score. I was expecting somewhere in the mid 230s based on my NBMEs, hoping for a 240 as a reach. Cannot believe I managed to do this.

Quick summary for the year:

Unlike many people in my class, I actually tried to do well in school. I maintain relatively high grades and I would attribute part of my score to this. I certainly felt more comfortable entering dedicated than some of my peers that had substituted class with BEB, Pathoma, DIT, etc. Anecdotal of course, but going to class and trying to do well helped me learn the material well. Having the "just pass" attitude wouldn't have worked for me. That being said, I know people that blew STEP 1 out of the water without trying at all during the school year. So your mileage will vary.

During the year I completed about 60% of UWorld before entering dedicated, at which point I reset and finished a second pass, and then a third pass with my incorrects. I'd say this was one of the most important things because STEP 1 does not give buzzwords and has vague question stems compared to the NBMEs (imo). I had exactly 6 weeks of dedicated, so I scheduled out all the practice exams and UW questions within this time-frame. Can't honestly say I stuck to it everyday, but general idea was 3 blocks of 40qs in the morning, afternoon was review, and then finish the night with Anki.

Pathoma was essential during the year, but I can't say I looked at it much during dedicated. I took notes on Sketchy Micro during the year so this was also pretty well ingrained in my noggin for dedicated. I rewatched a majority Sketchy Pharm though, and this was golden. There were a ton of questions about side-effects and anti-microbial resistance that I absolutely would not have gotten without Sketchy Pharm.

Sketchy Path is trash, don't use it.

I also tried using Zanki, and it helped decently. If I had to changed something, I would probably have been a little more consistent with it during the year.

Congrats on your accomplishment!

How would you say you felt after your exam? Do you remember how many questions you potentially got wrong?

I ask because our scores and mentality are pretty similar. I too did not align with the just pass approach.

Thanks and congrats again
 
How would you say you felt after your exam?
Pretty meh, to be honest. I felt like there were some I definitely knew, a good number where I felt like I was guessing, and some where I couldn't even recognize the words in the question stem. I came out feeling like I probably got what I was getting on my NBMEs. I made the mistake of looking things up on my phone afterwards though, which cratered my confidence for a bit.

Do you remember how many questions you potentially got wrong?
Nope. One thing I noted was that most questions were a lot more vague than anything I did in practice. There was no obvious answer and it took a lot more thinking, and there was a lot more stuff to dig through, so I felt ambiguous about a majority of the questions I'd say.
Thanks and congrats again
Same to you!
 
Thats an amazing jump! Congrats!! Mind sharing your study resources and study schedule? Thank you!!

Thank you!! I started doing about 20 UWorld questions a day starting around February until dedicated. I got through about 60% of UWorld before dedicated started and reset the QBank the day I started dedicated. Dedicated was 4.5 weeks. My schedule was based on organ system with 2-3 days per subject.

Typical study day (tentative):
7:30am: 40 UWorld questions, random
10:00am-3pm: subject study/lunch break
3pm 20 UWorld questions, subject specific
4pm: 40 UWorld questions, random
6pm-8pm: dinner/break/TV time
8pm-10pm: finish subject studying, ANKI, hand-made flashcards

I annotated First Aid with any information on UWorld questions I was unsure about. For subject study, I relied on First Aid, sketchy micro, and pathoma. I did pathoma throughout the year so I did not rewatch all of the Pathoma videos during dedicated - only the ones I was weak on. I watched some DIT videos on subjects I was particularly weak on, and I listened to some of the Goljan lectures while I did laundry or dishes.

Saturday was my practice test day each week, so I would use the rest of the day as a half day off. If I ever felt tired or didn’t want to study anymore I would make sure to take breaks/end my studies early. I still exercised 3-4 times a week in the morning or afternoon and I continued to go to church on Sundays. I didn’t let my life stop or let myself get too stressed out. And I prayed A LOT.
 
4/2/18 UWSA1 - 237
5/1/18 UWSA2 - 228
5/7/18 NBME 13 - 213
5/17/18 NBME 16 - 211
5/21/18 NBME 15 - 225
5/28/18 NBME 17 - 238
6/1/18 Free 120 - 80%
6/4/18 NBME 18 - 240
6/11/18 NBME 19 - 225
6/15/18 Actual USMLE: 235

Me: Had a 30 on the MCAT. Bottom quarter of my class at a DO school...3.0 GPA in first 2 years. Worked my ass off second year though. Don't want sx or anything super competitive so my 235 should be fine.
Study material: UFAP, Skethcy Micro, Little bit of sketchy pharm, select B&B, Medquest biostats course, Kaplan Q bank, USMLE RX, COMBANK
Dedicated: 6 weeks
What I wish I had done differently: Used FA more than I did and earlier than I did. Spent more time on Neuro (neuro was my only bad section on the exam, probably would have had a 240 if I had focused more on neuro).
What I did right: Started UWORLD early (during second year). Between all Q banks and doing U world twice and practice exams I probably did over 15,000 questions. This test is largely about pattern recognition.
 
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I have 3.5 months to my exam (i'm allowed to push it back - IMG here but i prefer not to) Baseline nbme: 140. Strategy UFAP+Sketchy. Is it even remotely possible to get a 250 in 3.5 months? :/ I want at least a 245, but a 250 would be my dream come true!! Has anyone been able to pull what i want to off? TIA for your feedback/help/suggestions!
 
I have 3.5 months to my exam (i'm allowed to push it back - IMG here but i prefer not to) Baseline nbme: 140. Strategy UFAP+Sketchy. Is it even remotely possible to get a 250 in 3.5 months? :/ I want at least a 245, but a 250 would be my dream come true!! Has anyone been able to pull what i want to off? TIA for your feedback/help/suggestions!

Depends on how busy you are in the 3.5 months, but based on the 140 baseline I don't think a 250 is possible. I think a 230 is extremely doable and a 240 is definitely possible but tough. If you had a 210-220 baseline I would bet on you hitting 250.
 
Geez, these comments about Kaplan qbank and starting Uworld early make me feel like I really screwed up. I completed Rx and Kaplan banks a while ago when I was relatively free but since then I've had a ton of classwork and exams so I've done minimal Step 1 study and only 200 UWorld questions since then so I've forgotten a lot of basic HY stuff. My dedicated begins next week and I wish I'd done more UWorld.
 
I have 3.5 months to my exam (i'm allowed to push it back - IMG here but i prefer not to) Baseline nbme: 140. Strategy UFAP+Sketchy. Is it even remotely possible to get a 250 in 3.5 months? :/ I want at least a 245, but a 250 would be my dream come true!! Has anyone been able to pull what i want to off? TIA for your feedback/help/suggestions!

Geez, these comments about Kaplan qbank and starting Uworld early make me feel like I really screwed up. I completed Rx and Kaplan banks a while ago when I was relatively free but since then I've had a ton of classwork and exams so I've done minimal Step 1 study and only 200 UWorld questions since then so I've forgotten a lot of basic HY stuff. My dedicated begins next week and I wish I'd done more UWorld.

You're fine. Most med students who score well didn't start uworld till dedicated. SDN just attracts OCD neurotic types, myself included.
 
Geez, these comments about Kaplan qbank and starting Uworld early make me feel like I really screwed up. I completed Rx and Kaplan banks a while ago when I was relatively free but since then I've had a ton of classwork and exams so I've done minimal Step 1 study and only 200 UWorld questions since then so I've forgotten a lot of basic HY stuff. My dedicated begins next week and I wish I'd done more UWorld.

Don't worry about it. Different things work for different people, just do what works for you.
 
UW%: 85.6% (timed, random)

UWSA1: 271
UWSA2: 262

NBME 17: 269
NBME 18: 263
NBME 19: 257

Free120: 92.5%

REAL DEAL: 266

(June 11th test date)

Overall the test is just like the NBMEs and NOT like uworld like most people say. About 10-15% of uworld questions are poor questions in that you can know what's going on super well but they trick you. On the real exam they NEVER try and trick you. The real thing was most like the free120, very fair exam.
 
posting b/c hopefully someone can benefit as i did from posts like this during my dedicated study period:

started studying pretty early (4 months out) w/ UFAP along with classes ---- had a 3 week dedicated period

NBME 15 (8 wks out) = 221
UWSA 1 = 237 ( 7 weeks out)
NBME 16 & 18 ~225ish (1 month, 3 weeks)
UWSA 2 = 237 ( 4 weeks out)
FINAL NBME (sorry I cant remember which, 2 weeks out) = low 240s

USMLE Step 1 = 245-255 <--- im interested in a fairly competitive surgical subspecialty, hopefully this can help get me to where im going

if ur reading this thinking "damn, another score that is better than my 2XX (this is how I feel every time i see someone scored a 260), just keep in mind it is an honor and privilege to sit for this exam. we are not suffering in truth, but in relation to others. i believe that is called envy.


if u havent taken step 1 yet...
unsolicited advice/things i wish i had done differently:
-always remember why u are studying for this exam --> behind every clinic vignette is a real patient we may encounter
-focus more on studying & less on stressing about practice test scores
- have confidence in ur abilities --> i know it's cliche, but this is not a test where u can afford to second guess urself
-find weaknesses & focus on them (i believe the reason i hit a plateau is because i didnt address weaknesses early)
-the final 2 weeks you MUST hit ur stride (again, these 2 weeks i focused on my weakness & think it allowed me to jump up nicely)
-when u get to the exam, take a few deep breaths and answer the questions one at a time. stay cool, calm, and collected. u owe it to urself. at this point u have put urself in the best possible position to do well on the exam



now i will stand atop my digital soapbox:
-there will always be another step 1. literally, Step 2 is now less than a year away for me. on our journey through life we will encounter many obstacles - do not let them change who u are as a brother/wife/friend/etc.
-if u do "well" (whatever the f that means, so subjective at this point) on step 1, great. take 1 night to celebrate how u wish and move on. do not congratulate urself too much. stay humble & hungry. we chose this profession for reasons other than glory. that should be obvious at this point.
-if u didnt/dont do well, dont waste time beating urself up. we are human. focus on the wards & step 2. overcoming adversity & improvement is viewed very positively by program directors. also, believe it or not, ur step 1 score does not define u as a person, does not represent ur intellect, and does not determine the kind of doctor u will become. it also will not be part of the epitaph written on ur tombstone (unless u are a sad sad person and want it to be i guess).
-remember, there is life outside medicine. and quite a bit of it actually. so enjoy it.




PM if u have specific questions
 
Okay, I got a lot out of this thread and I took a bit of a “less traditional” approach to Step 1/M2 year than some, so I wanted to write this up.


Overview:

Target Score: 240
Five weeks dedicated time

NBME 13 - pre study: 208
NBME 17 - end week 1: 213
NBME 16 - end week 2: 221
UW1 - end week 3: 241
NBME 15 - mid week 4: 250
NBME 18 - end week 4: 236
UW2 - mid week 5: 249
NBME 19 - end week 5 (2 days before exam): 234

Real Deal: 252

Study techniques:

During the year:

I used Boards and Beyond throughout M2 to teach me things because I hate reading textbooks. NO Robbins or anything else aside from Wikipedia. I studied in two small study groups all year going through First Aid to learn the material for in-house exams. I am part of the minority of people who hate sketchy and thus I barely used my subscription at all. I started doing UWorld in mid-march, about 3 months ahead of the test. Didn’t reset, just did my incorrects once I finished the bank midway through Dedicated.

Dedicated:

I used UWorld and Pathoma almost exclusively, while reading and annotating First Aid, combing it for finer points I missed. I did 4 blocks of mixed timed UWorld every day of dedicated along with 3-6 hours of Pathoma, taking handwritten notes. Two organ systems per day pathoma with accompanying First Aid was as much as I could do per day. I took an NBME every Saturday and UWSAs mid-week in my last two weeks. The rest of the Saturday I took off and did nothing. I stopped work every day by 9:00. No anki, I tried to use it but too many cards and too scattered.

Test Day:

The day before was very stressful, slept about 5 hours after stressing all day. Test day was some kind of weird calm, I wasn’t nervous whatsoever. I was surprised by the faster pace of the test but I still had about 7-10 minutes left at the end of each section except for one, which I banked for extra breaktime. I originally planned to do 3/2/2 blocks, but after the third in a row I got so bored that I took a break after each block. Finished with about 45 minutes remaining on the break timer despite frequent breaks — no reviewing sections or flagging questions, just one at a time in a row until they were done.

I left feeling like it went pretty okay, not sure if I scored 200 or 260 but sure I passed and delighted it was finished.

When I got my score I was in disbelief (still am), as I hadn’t ever hit a score that high and I was expecting something in the 230s as my NBMEs predicted.

This test is not that bad, it’s long and there’s a lot of content, but it’s not some mythically hard impossible challenge. My best advice to the future readers of this is to rust your preparation and stick to methods that work for you, regardless of what anyone else is doing.
 
Looking at peoples' score progressions, I think I must have really choked on test day and not realized it. I'm seeing tons of people who had NBME scores in the 210s, 20s, 30s end up with a final score in the 250s. And people who averaged in the 250s on NBMEs seem to be getting 260s on the real deal. It is very clear that NBME underpredicts, so the fact that I scored exactly at my average must mean I really messed up. The weird thing is that it didn't feel that way when I got out the test. Now I'm starting to wonder if I accidentally omitted questions or accidentally clicked the wrong choice. Now that I think about it, I distinctly remember one marked question where I went back to review it, and the selected answer choice was something other than what I remembered choosing. I fixed that one, but maybe there were others that I didn't catch.

These are probably just the rationalizations of a sore loser, but still...I am tempted to pay the $50 for a score recheck. I know on their website it says that this has never resulted in an actual score change, but their website also says that they never recycle questions from old forms, which was patently false.
 
Looking at peoples' score progressions, I think I must have really choked on test day and not realized it. I'm seeing tons of people who had NBME scores in the 210s, 20s, 30s end up with a final score in the 250s. And people who averaged in the 250s on NBMEs seem to be getting 260s on the real deal. It is very clear that NBME underpredicts, so the fact that I scored exactly at my average must mean I really messed up. The weird thing is that it didn't feel that way when I got out the test. Now I'm starting to wonder if I accidentally omitted questions or accidentally clicked the wrong choice. Now that I think about it, I distinctly remember one marked question where I went back to review it, and the selected answer choice was something other than what I remembered choosing. I fixed that one, but maybe there were others that I didn't catch.

These are probably just the rationalizations of a sore loser, but still...I am tempted to pay the $50 for a score recheck. I know on their website it says that this has never resulted in an actual score change, but their website also says that they never recycle questions from old forms, which was patently false.

Having read through this whole thread I was fairly surprised to see that you did not break 260, but a 257 is still an extremely high score, and will certainly set you up well for dermatology.

I think it is possible that you under-performed on test day, and even if you didn't, that this score is possible simply from the variability of the test itself.

Based on the randomized set of questions that you got vs others, it is possible that your score (if a previous poster was correct) could have actually been a 270 based on the 13 point variation.

Then again, based on NBMEs, in the 250s makes sense for your test history. There are only recent posters sharing where they peaked at test time, and this also may be due to how their dedicated is when they completed most of their questions and were truly peaking, whereas you did many questions early and may have peaked early.

It is difficult to say what truly happened, but I think that you should lay to rest step 1 and accept a phenomenal score!

This score will not hold you back from residency, and the ultimate goal is to match and do well there. Put your efforts now into doing well on the next thing.

Truly congratulations, enjoy time off or settle into rotations, and keep doing your research
 
I used this forum quite a bit during the past year, so I’m paying it forward!

NBME 13: 217 - 2 weeks before dedicated
UWS1: 251 - beginning of dedicated
NBME 17: 232
NBME 18: 236
NBME 16: 234
UWS2: 249 - week before step 1
Step 1: 247

Overall I am absolutely thrilled with my score.

Throughout M2:
I used Boards and Beyond religiously throughout M1 and M2, and made it my mission to get through it completely during M2. I hate reading textbooks and Dr. Ryan does a great job of explaining complicated topics. I went through Pathoma once at 1.5x, watched Sketchy Micro and Pharm once through and then kept them fresh with Zanki decks. Did Anki Brosencephalon for Pathoma daily to keep pathology fresh in my head. I finished UWorld in early March, so I used USMLE Rx questions to start getting used to 40 question blocks. I think that made a huge difference in my performance on Step: I got completely through it in about a month and a half, and since those questions are so focused on the nitty gritty details in First Aid, I got a great review of all of First Aid before I even entered my dedicated study period.

Dedicated:
I used primarily UWorld and Boards and Beyond during my dedicated to make sure I was reviewing on topics that were difficult for me and building 40 question block endurance. My question blocks were random and took place in the morning and then I spent about 2-3 days reviewing each organ system in the afternoons. I started studying at 7am and very rarely studied past 7pm. I kept up with my daily Anki cards, especially my Zanki pharm which I found extremely helpful during the actual test. My last week of dedicated I spent finishing up UWorld, and watching YouTube videos from Dirty USMLE on topics that were detail-oriented. These were awesome videos because they have great memory tricks but also kept me laughing and kept my spirits high leading up to step.

Test day I felt strangely calm and just made sure I kept a good head on my shoulders! I did 2 sections at a time with breaks in between, which was how I had been doing blocks during dedicated and I think that did a lot to keep me motivated. Of course I walked out feeling like I had been hit by a truck, but I am beyond happy with my score and I think I did as much as I possibly could to be prepared for Step, and that’s all we can really ask for!
 
Test day I felt strangely calm and just made sure I kept a good head on my shoulders! I did 2 sections at a time with breaks in between, which was how I had been doing blocks during dedicated and I think that did a lot to keep me motivated. Of course I walked out feeling like I had been hit by a truck, but I am beyond happy with my score and I think I did as much as I possibly could to be prepared for Step, and that’s all we can really ask for!

Job well done! Must be a nice feeling to finally be over with step 1. After the test could you recall making a number of silly mistakes?
 
Job well done! Must be a nice feeling to finally be over with step 1. After the test could you recall making a number of silly mistakes?
Thank you! It does feel wonderful to done. I remembered a few questions that I definitely got wrong throughout the week after step, but it was mostly on topics that I had struggled with since day one. Nothing like where I read the question too fast or missed a crucial part of a question stem
 
Looking at peoples' score progressions, I think I must have really choked on test day and not realized it. I'm seeing tons of people who had NBME scores in the 210s, 20s, 30s end up with a final score in the 250s. And people who averaged in the 250s on NBMEs seem to be getting 260s on the real deal. It is very clear that NBME underpredicts, so the fact that I scored exactly at my average must mean I really messed up. The weird thing is that it didn't feel that way when I got out the test. Now I'm starting to wonder if I accidentally omitted questions or accidentally clicked the wrong choice. Now that I think about it, I distinctly remember one marked question where I went back to review it, and the selected answer choice was something other than what I remembered choosing. I fixed that one, but maybe there were others that I didn't catch.

These are probably just the rationalizations of a sore loser, but still...I am tempted to pay the $50 for a score recheck. I know on their website it says that this has never resulted in an actual score change, but their website also says that they never recycle questions from old forms, which was patently false.

I can't remember or not but I'm pretty sure we've gone back in forth with replies to each other ITT. I haven't posted or done a write up yet but scores were
NBME 15: 255 - 4/7
NBME 16: 255 -4/13
NBME 17: 259 -4/21
NBME 18: 252 -5/4
NBME 19: 252- 5/13
UWorld SA 1: 266
Uworld SA 2: 254

Step Score: 254-5/16

As others have eluded to, I think its just luck of the draw whether you hang around/within your averages or significantly outperform them. The knowledge required was there for me over a month out. I refined and focused on things over the next month and was able to maintain it. Unfortunately test day, I had no exaggeration, 6 biostats questions on my very first block. What a major loop that through me for and go figure, when you look at my performance bars, biostats was my only non high performance category. In addition, I had probably close to 10 dermatology questions which I probably missed half of those. Had I gotten lucky like my friend who had virtually no biostats and almost no dermatology, I think my score would be dramatically different. I probably wouldn't have done anything different. I would have continued to bank on minimal dermatology and the questions asked either having to do with a childhood rash or bullous pemphigoid or any of the other high yield stuff that showed up throughout U world and NBMEs. And for biostats, I would have thought review FA content, Boards and Beyond, and U world questions would be sufficient, but it obviously wasn't. Biostats was never a poor category for me on any assessment. So I guess at the end of the day, it sucks I didn't get lucky, but Im also glad I didn't dramatically underperform. Realistically, what is a middle to high 250s score going to keep you out of residency wise that a 260 would get? The score gets you an interview and your foot in the door. The rest from there is up to you.
 
Thank you! It does feel wonderful to done. I remembered a few questions that I definitely got wrong throughout the week after step, but it was mostly on topics that I had struggled with since day one. Nothing like where I read the question too fast or missed a crucial part of a question stem

That’s awesome. I was asking because I remember missing about 10 easy recall questions. Just curious to see how much that would hurt. Thank you
 
Hey! Congrats on the awesome score!! I am in your boat and would love to hear what resources you used and how you studied. Thanks a lot!!

Sorry for taking so long, but I'm still getting used to checking this!

Want to start off by saying that I completely changed my studying in the middle of it, so my exact schedule might not be that helpful to go off of. I'll start first with the lessons I learned and then give you my schedule below, and you can decide what to take from it!

  1. If I could give one piece of advice based on my experience is that ACTIVE RECALL AND REPETITION ARE KEY. The game changer for me was starting Zanki (subject) and pepper (micro and pharm) decks and making my own flashcards on things that I repeatedly got wrong.

  2. Doing mixed sets right away made it hard for me to fully understand each subject. By the time I finished UWorld, I still had a lot of gaps in my knowledge (especially in physiology since I never really learned it in the first place). If I could go back, I would focus on each subject one at a time.

  3. There are A LOT of small factoids sprinkled throughout FA that you would never come across if you don't read it cover to cover. Zanki covers almost all of these and more, so if I could go back, I still wouldn't read FA, but that might be something to keep in mind.
First 3 weeks:

- UWorld: in the morning, 2 mixed sets, timed. Started with only micro and each time I watched the BB videos for a subject, I would add the subj into my sets. I went over every question and read the section in FA about it, annotating notes from UWorld into FA

- Boards and Beyond: in the afternoons, watched videos from a single subject and took notes in a word doc. I gave each subj 2-3 days for review (not sure if this was the best use of my time, but I'll never know)

- Pathoma: I had already watched/annotated everything during my first two years (possibly one of the best decisions I made), so for every UWorld question, I would cross reference pathoma and annotate it into FA

- Sketchy pharm: I bought the book from etsy and watched the videos/took notes of the drugs that went with the subject I was reviewing that day

- Sketchy micro: I had already watched most of them during my coursework and written out everything, so I just made myself rewatch the video each time I got a bug question in UWorld.

Weeks 4-8:

- UWorld: Mixed, timed. 2-3 sets each day. I got through all of it by the end of the 8 weeks.

- Continued with sketchy pharm and micro review whenever I got a question on either of them

Here's where I decided to change up my studying. I feel like my work in the first two months gave me a strong basic foundation and got me to a solid score in the 220s. But to really push me into the above average scoring range, I needed nail down the small details that generally aren't considered "high yield"

- Zanki: I went through each deck subject by subject. 700 new cards a day

- Pepper micro and pharm: 100 new cards a day each

- Personal Anki deck: 50 new cards a day

- Any cards that were due that day

- UWorld: incorrects only, read the explanations only for those I got wrong again

This last month of studying is what I really felt helped to get me to the 240s from 220s. If I could go back, I would definitely have started with these earlier on! Let me know if you have any questions!
 
Okay, I got a lot out of this thread and I took a bit of a “less traditional” approach to Step 1/M2 year than some, so I wanted to write this up.


Overview:

Target Score: 240
Five weeks dedicated time

NBME 13 - pre study: 208
NBME 17 - end week 1: 213
NBME 16 - end week 2: 221
UW1 - end week 3: 241
NBME 15 - mid week 4: 250
NBME 18 - end week 4: 236
UW2 - mid week 5: 249
NBME 19 - end week 5 (2 days before exam): 234

Real Deal: 252

Study techniques:

During the year:

I used Boards and Beyond throughout M2 to teach me things because I hate reading textbooks. NO Robbins or anything else aside from Wikipedia. I studied in two small study groups all year going through First Aid to learn the material for in-house exams. I am part of the minority of people who hate sketchy and thus I barely used my subscription at all. I started doing UWorld in mid-march, about 3 months ahead of the test. Didn’t reset, just did my incorrects once I finished the bank midway through Dedicated.

Dedicated:

I used UWorld and Pathoma almost exclusively, while reading and annotating First Aid, combing it for finer points I missed. I did 4 blocks of mixed timed UWorld every day of dedicated along with 3-6 hours of Pathoma, taking handwritten notes. Two organ systems per day pathoma with accompanying First Aid was as much as I could do per day. I took an NBME every Saturday and UWSAs mid-week in my last two weeks. The rest of the Saturday I took off and did nothing. I stopped work every day by 9:00. No anki, I tried to use it but too many cards and too scattered.

Test Day:

The day before was very stressful, slept about 5 hours after stressing all day. Test day was some kind of weird calm, I wasn’t nervous whatsoever. I was surprised by the faster pace of the test but I still had about 7-10 minutes left at the end of each section except for one, which I banked for extra breaktime. I originally planned to do 3/2/2 blocks, but after the third in a row I got so bored that I took a break after each block. Finished with about 45 minutes remaining on the break timer despite frequent breaks — no reviewing sections or flagging questions, just one at a time in a row until they were done.

I left feeling like it went pretty okay, not sure if I scored 200 or 260 but sure I passed and delighted it was finished.

When I got my score I was in disbelief (still am), as I hadn’t ever hit a score that high and I was expecting something in the 230s as my NBMEs predicted.

This test is not that bad, it’s long and there’s a lot of content, but it’s not some mythically hard impossible challenge. My best advice to the future readers of this is to rust your preparation and stick to methods that work for you, regardless of what anyone else is doing.


Thanks so much for the write up! What did you use rather than sketchy? I also am not a fan of sketchy but am using it just to cover my bases. Also, how good do you think Boards and Beyond as a source for building a foundation before dedicated? I have 1.5 months before dedicated and am considering doing B and B to improve by ****ty foundation. Thank you!!
 
Thanks so much for the write up! What did you use rather than sketchy? I also am not a fan of sketchy but am using it just to cover my bases. Also, how good do you think Boards and Beyond as a source for building a foundation before dedicated? I have 1.5 months before dedicated and am considering doing B and B to improve by ****ty foundation. Thank you!!

I used sketchy a little bit but really practice questions are where it is. They don’t ask you fine details about obscure things, they ask broad things about different bugs or often they ask about treatment or mechanism of appropriate drug. I thought UWorld was excellent prep for this as well as pharm. I used sketchy during the year a little just to hear someone tell me the facts, I didn’t look at the pictures or memorize them. Just took notes.

Boards and Beyond was my foundation, and it was exceptionally good in my opinion and has been practical so far on my first rotation. If you have the time to watch it it’s totally worth it. I used Pathoma for videos during dedicated because it was faster and broader. I’d say if you’re time crunched use Pathoma but if you have time B+B is better.
 
Looking at peoples' score progressions, I think I must have really choked on test day and not realized it. I'm seeing tons of people who had NBME scores in the 210s, 20s, 30s end up with a final score in the 250s. And people who averaged in the 250s on NBMEs seem to be getting 260s on the real deal. It is very clear that NBME underpredicts, so the fact that I scored exactly at my average must mean I really messed up. The weird thing is that it didn't feel that way when I got out the test. Now I'm starting to wonder if I accidentally omitted questions or accidentally clicked the wrong choice. Now that I think about it, I distinctly remember one marked question where I went back to review it, and the selected answer choice was something other than what I remembered choosing. I fixed that one, but maybe there were others that I didn't catch.

These are probably just the rationalizations of a sore loser, but still...I am tempted to pay the $50 for a score recheck. I know on their website it says that this has never resulted in an actual score change, but their website also says that they never recycle questions from old forms, which was patently false.
Broo you worked too hard not to go for a re-score, I would totally do it! Living with some doubt or 50 bucks...whats more important? FYI I do have a conflict of interest because it does freak me the hell out when people match their NBMES or don't outperform them..
 
Looking at peoples' score progressions, I think I must have really choked on test day and not realized it. I'm seeing tons of people who had NBME scores in the 210s, 20s, 30s end up with a final score in the 250s. And people who averaged in the 250s on NBMEs seem to be getting 260s on the real deal. It is very clear that NBME underpredicts
Without a representative sample of NBMEs and actual Step 1 scores, you're hard pressed to legitimately support the claim the NBME underpredicts; I'm not saying it's not possible. It just appears that way from data that are readily available on an online forum of overachievers. You're also likely going to see selection bias. It's reasonable to assume people who fare worse or score well below their average won't report this as readily as people who over perform or just do well. Again, it is possible that the NBMEs underpredict, but there are more simple and reasonable explanations that should absolutely be considered first.

so the fact that I scored exactly at my average must mean I really messed up.
No, it doesn't necessarily mean that.

These are probably just the rationalizations of a sore loser, but still...I am tempted to pay the $50 for a score recheck. I know on their website it says that this has never resulted in an actual score change, but their website also says that they never recycle questions from old forms, which was patently false.
I think you are correct that this is mostly rationalization for what you perceive to be a failure; you did well in absolute terms and relative to your peers. If you are disappointed with your performance because of the effort you put in, ask yourself if your performance will hurt your goals and if it was objectively bad. I think the answer to both of those it in the negative. Additionally, you worked hard, so that's what matters at the end of the day. Lazy people scoring high is less respectable because they aren't willing to work. You're going to be just fine.
 
Okay, I got a lot out of this thread and I took a bit of a “less traditional” approach to Step 1/M2 year than some, so I wanted to write this up.


Overview:

Target Score: 240
Five weeks dedicated time

NBME 13 - pre study: 208
NBME 17 - end week 1: 213
NBME 16 - end week 2: 221
UW1 - end week 3: 241
NBME 15 - mid week 4: 250
NBME 18 - end week 4: 236
UW2 - mid week 5: 249
NBME 19 - end week 5 (2 days before exam): 234

Real Deal: 252

Study techniques:

During the year:

I used Boards and Beyond throughout M2 to teach me things because I hate reading textbooks. NO Robbins or anything else aside from Wikipedia. I studied in two small study groups all year going through First Aid to learn the material for in-house exams. I am part of the minority of people who hate sketchy and thus I barely used my subscription at all. I started doing UWorld in mid-march, about 3 months ahead of the test. Didn’t reset, just did my incorrects once I finished the bank midway through Dedicated.

Dedicated:

I used UWorld and Pathoma almost exclusively, while reading and annotating First Aid, combing it for finer points I missed. I did 4 blocks of mixed timed UWorld every day of dedicated along with 3-6 hours of Pathoma, taking handwritten notes. Two organ systems per day pathoma with accompanying First Aid was as much as I could do per day. I took an NBME every Saturday and UWSAs mid-week in my last two weeks. The rest of the Saturday I took off and did nothing. I stopped work every day by 9:00. No anki, I tried to use it but too many cards and too scattered.

Test Day:

The day before was very stressful, slept about 5 hours after stressing all day. Test day was some kind of weird calm, I wasn’t nervous whatsoever. I was surprised by the faster pace of the test but I still had about 7-10 minutes left at the end of each section except for one, which I banked for extra breaktime. I originally planned to do 3/2/2 blocks, but after the third in a row I got so bored that I took a break after each block. Finished with about 45 minutes remaining on the break timer despite frequent breaks — no reviewing sections or flagging questions, just one at a time in a row until they were done.

I left feeling like it went pretty okay, not sure if I scored 200 or 260 but sure I passed and delighted it was finished.

When I got my score I was in disbelief (still am), as I hadn’t ever hit a score that high and I was expecting something in the 230s as my NBMEs predicted.

This test is not that bad, it’s long and there’s a lot of content, but it’s not some mythically hard impossible challenge. My best advice to the future readers of this is to rust your preparation and stick to methods that work for you, regardless of what anyone else is doing.
Curious why you decided to take 19 2 days before the real deal.
 
I know nobody knows for sure, but does anyone have an educated guess about whether scores will be posted this Wednesday or next for someone who took it on June 27th (a Wednesday)?
 
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