USMLE Official 2018 Step 1 Experiences and Scores Thread

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May I ask how many weeks long was your dedicated study period? Also was NBME 13 taken as a baseline before your dedicated study began? thanks!

We have about 8 weeks between our last block exam and the start of clinical rotations. Some people take the test after only part of that time, but I decided to pretty much take the whole time. I took NBME 13 after a couple days of studying and familiarizing myself with resources, so yeah, it was more or less a baseline.
 
Dude...don't even get me started on that question. I did a bunch of cell bio/genetics in undergrad and never EVER heard of that.

I've gotten two questions on internal ribosome entry sites! I'll never forget it now though. Which is good cuz obvs I'm going to use that knowledge every day as a physician.
 
Does anyone know if I can buy an NBME and do the blocks whenever I want? Or do I have to do it all in one sitting? I'm planning on buying some of the older NBMEs just for access to the questions for practice, but I dont want to do 200 questions at once.
 
great job!

by any chance do you remember what percentages you had for your NBME.. for example how many questions did you get wrong to get a 225 vs 232? Thank you!

NBME 13 - 196 --> missed 51 (74.5%)
NBME 15 - 209 --> missed 44 (78%)
NBME 16 - 225 --> missed 34 (83%)
NBME 17 - 223 --> missed 31 (84.5%)
NBME 18 - 232 --> missed 35 (82.5%)
NBME 19 - 225 --> missed 28 (86%)

So the curves aren't that consistent (especially between 18 and 19...). Hope this helps!
 
Does anyone know if I can buy an NBME and do the blocks whenever I want? Or do I have to do it all in one sitting? I'm planning on buying some of the older NBMEs just for access to the questions for practice, but I dont want to do 200 questions at once.

When you buy them, you can either choose standard timing or self-paced. So just choose self-paced.
 
Dumb question but standard pace still has breaks right?

Not a dumb question because no they do not. As soon as you end one block it takes you right to the next block. I usually have 20-30 mins left at the end of each block so I just use that as my break.
 
Don't know if anyone will know the answer to this, but if I want to take the free 120 at Prometric, are my only options the dates that show up as having available slots for step 1?
 
Question for those that have taken the test recently. Were there times where you felt they tested multiple times on the same fact? I.e. multiple questions where the answer is Langerhans cell histiocytosis or some other rare disease?

Lol, actually yes, now that you mention it, I definitely had--I wouldn't say repeats--but almost the exact same question. Never in the same block but almost back to back blocks.
 
Lol, actually yes, now that you mention it, I definitely had--I wouldn't say repeats--but almost the exact same question. Never in the same block but almost back to back blocks.

Did you feel the exam was testing minutiae or your overall understanding of topics?

This goes also to anyone that's taken the test, would love to hear some insight on this. 🙂
 
I just finished watching up the Female Repro chapter on Pathoma and when he's discussing the hydatidiform moles Sattar says "As with most things in life, it's Dad's fault" :laugh::laugh::laugh::laugh::laugh:
 
Did you feel the exam was testing minutiae or your overall understanding of topics?

This goes also to anyone that's taken the test, would love to hear some insight on this. 🙂

There was definitely some minutiae. But I think overall the test tips toward broader understanding. Most of it was stuff you would see in UWorld but maybe a little more complicated. And then here and there were some truly weird ones. I definitely remember several times being given a disease and then asking something about it that I'd never thought about before.

Some examples to compare are some oddball questions from UWorld. Like that one from UWSA2 (spoilers) that shows you tingible body macrophages in Burkitt lymphoma and asks what process is going on. And Dr. Sattar never said what they actually signify, FA never mentions it, and the regular 2500 question UWorld Qbank doesn't mention it. All you know is that Burkitt lymphoma (and normal lymph nodes) just have things called tingible body macrophages. And half of the choices are stuff you've probably never heard of. But you see apoptosis and you're like, Welp. I guess that makes sense.

Or that one UWorld question that asked about holoprosencephaly and had a bunch of weird choices that you could classify the disease as, and none of them really seem like they fit, but the answer was field defect.

I don't mean to say it was all like that. Probably 30/40 questions per block were okay and resembled UWorld style questions, but maybe a little harder/more ambiguous. Those oddballs, though... Had a few every block.
 
There was definitely some minutiae. But I think overall the test tips toward broader understanding. Most of it was stuff you would see in UWorld but maybe a little more complicated. And then here and there were some truly weird ones. I definitely remember several times being given a disease and then asking something about it that I'd never thought about before.

Some examples to compare are some oddball questions from UWorld. Like that one from UWSA2 (spoilers) that shows you tingible body macrophages in Burkitt lymphoma and asks what process is going on. And Dr. Sattar never said what they actually signify, FA never mentions it, and the regular 2500 question UWorld Qbank doesn't mention it. All you know is that Burkitt lymphoma (and normal lymph nodes) just have things called tingible body macrophages. And half of the choices are stuff you've probably never heard of. But you see apoptosis and you're like, Welp. I guess that makes sense.

Or that one UWorld question that asked about holoprosencephaly and had a bunch of weird choices that you could classify the disease as, and none of them really seem like they fit, but the answer was field defect.

I don't mean to say it was all like that. Probably 30/40 questions per block were okay and resembled UWorld style questions, but maybe a little harder/more ambiguous. Those oddballs, though... Had a few every block.

I see what you're saying, makes sense. I guess as I'm about half way through dedicated I'm trying to assess if I should really start to try and memorize more minutiae or just spend more time reading UWorld. I could anki more and more but I will never honestly have all of FA down, so I would have to be selective with what I decide to anki, but that's where I'm coming from. Looking into how I should approach the following weeks, more granular and trying to memorize every little detail, or make sure that all my ground is covered well enough. I feel like I developed better test taking skills where I can use my knowledge of the topic better to answer questions, thanks to UWorld of course, but a good amount of minutiae I really still have yet to get down. Any thoughts? Would appreciate some insight.
 
I see what you're saying, makes sense. I guess as I'm about half way through dedicated I'm trying to assess if I should really start to try and memorize more minutiae or just spend more time reading UWorld. I could anki more and more but I will never honestly have all of FA down, so I would have to be selective with what I decide to anki, but that's where I'm coming from. Looking into how I should approach the following weeks, more granular and trying to memorize every little detail, or make sure that all my ground is covered well enough. I feel like I developed better test taking skills where I can use my knowledge of the topic better to answer questions, thanks to UWorld of course, but a good amount of minutiae I really still have yet to get down. Any thoughts? Would appreciate some insight.

Hmm, that's hard to say. I don't want to discourage you from learning minutiae... as it does show up. But it's easy to lose a lot of time trying to learn the small stuff, and honestly if I were hard pressed to give a number, I'd say it was 70:30 in favor of knowing larger picture concepts. I think it will largely depend on what your target score is, what your practice scores are, and what kinds of questions you find yourself missing in UWorld. If you're scoring in the 240's, you're probably fine with big picture and maybe could spend more time on little stuff. It's really hard to say because your test will be different from mine, so I don't really know whether you'll get lots of big picture questions like I did or more nitpicky stuff.
 
So, officially 1 week out from my Step and I don't know how else to best raise my score during this home stretch.

UWSA 1 (5/14): 123/160 = 76.9%, 251
UWSA 2 (5/16): 113/160 = 70.6%, 232
NBME 13 (5/18): 159/200 = 79.5%, 209
NBME 15 (5/20): 174/200 = 87%, 236
NBME 16 (5/22): 164/200 = 82%, 223
NBME 17 (yesterday): 173/200 = 86.5%, 230

I'm still going to dream and hope that a miracle happens on test day and I somehow land a 250+, but I feel like for every new section I improve in, my scores in some other section drop. NBME 17 was probably my best overall in terms of the number of * that showed up on the right hand side, but I'm barely a 230. As I'm going through and reviewing, I'm finding that 3/4 of the ones I'm getting wrong I have no idea how to prepare for because the way the answer choices or the question was worded have no meaning to me. Like it's the kind of feeling where you could know everything back and forth about a disease, but simply because of wording, it means nothing to you. Is this something that can be worked on? I've done at this point close to 10,000 practice questions over the last 6-7 months so I'm feeling pretty stumped.
 
Okay so I just found out about this "delay in score reporting"... is this for real?? United States Medical Licensing Examination | Announcements Anyone who took step 1 between May 4th and early June will have to wait until July 11th to receive their scores?

I'm taking it next week and I'm going to lose my mind if I have to wait 6 weeks to get my score back.
Yes, that is accurate. I feel really bad for the people who took it on May 5th and have to wait more than 2 months
 
Yes, that is accurate. I feel really bad for the people who took it on May 5th and have to wait more than 2 months
For real... I just don't understand what takes so long to begin with. It's a freaking multiple choice exam... I get taking a week or two to throw out certain questions and set up the curve, but I've never understood why it would take 3-4 weeks for this. And now multiple MONTHS? Totally insane, especially considering how much we pay to take the damn thing.
 
Just took NBME 17, not sure how to feel about it.

NBME 13: 234
CBSE: 248
UWSA1: 258
UWSA2: 256
NBME 15: 261
NBME 16: 263
NBME 17: 257

Not that I'm not happy with a 257...I'm just not sure if this represents a decrease in my score, or just a random variation. I did only get 1 more question wrong than on NBME 15/16 (got 10 wrong on both 15 and 16, 11 wrong on 17), but at the same time a 6 point decrease seems significant. I don't know. This does not help me in deciding whether or not to move my exam up. Thoughts?
 
Just took NBME 17, not sure how to feel about it.

NBME 13: 234
CBSE: 248
UWSA1: 258
UWSA2: 256
NBME 15: 261
NBME 16: 263
NBME 17: 257

Not that I'm not happy with a 257...I'm just not sure if this represents a decrease in my score, or just a random variation. I did only get 1 more question wrong than on NBME 15/16 (got 10 wrong on both 15 and 16, 11 wrong on 17), but at the same time a 6 point decrease seems significant. I don't know. This does not help me in deciding whether or not to move my exam up. Thoughts?
Honestly any score 255+ probably comes down to variance more than anything. Those scores are good enough for any specialty, I say go for it and move it up.
 
Honestly any score 255+ probably comes down to variance more than anything. Those scores are good enough for any specialty, I say go for it and move it up.

Yeah and I'm not gunning for a competitive specialty at all, I'll probably do FM or peds. I just want to score well for two reasons. One, because for personal/family reasons it is very important to me that I'm able to get a residency spot in a competitive city. And two, I think I just need to prove to myself that I can score well haha.
 
Just took NBME 17, not sure how to feel about it.

NBME 13: 234
CBSE: 248
UWSA1: 258
UWSA2: 256
NBME 15: 261
NBME 16: 263
NBME 17: 257

Not that I'm not happy with a 257...I'm just not sure if this represents a decrease in my score, or just a random variation. I did only get 1 more question wrong than on NBME 15/16 (got 10 wrong on both 15 and 16, 11 wrong on 17), but at the same time a 6 point decrease seems significant. I don't know. This does not help me in deciding whether or not to move my exam up. Thoughts?


Wow those scores are amazing! Would you mind briefly sharing your resources and how long you have been preparing for? Thank you!
 
Wow those scores are amazing! Would you mind briefly sharing your resources and how long you have been preparing for? Thank you!

Thanks 🙂
I started preparing back in mid-January (thinking about it now, I have literally only taken one day off from step studying in over 5 months, and even that one day was involuntary haha). From January to mid-April I completed Rx. I did 30 questions/day, which took me about 3-4 hrs/day on average. I don't think Rx gets enough credit, I really think it's superior to Kaplan. I read every single explanation and every First Aid page (Rx gives you screenshots of relevant FA pages with every question). It did get repetitive, I think I read the FA about macrocytic anemias at least 20 times), but I think doing that was largely the reason for my success so far. I've done about 1000 Kaplan problems, about 500 of those were done throughout M2 as study for my EOB exams. The other 500 have been scattered throughout the last few months when I had spare time. I'll probably be working through a bit more of Kaplan in the next two weeks (or one week, if I decide to move my exam), but I have no strong desire to finish it.

In mid-April after I completed Rx, we started our multisystems course, which is also when I took my first practice exams (NBME 13 and CBSE). That's also when I started UWorld, which I completed a few days ago. I don't plan on doing a second pass of UWorld, because my greatest strength is my ability to memorize, so I know that I will get many questions correct only because I remember the answer from my first pass.

I watched all of Pathoma along with classes during M1/M2. I have watched a few of the chapters again during dedicated, mostly the first three chapters and then 2 or 3 of the organ system chapters. At this point I feel like I'm not learning anything new from Pathoma so I probably won't use it anymore (it's a fantastic resource though). I watched a few sketchy micro videos during the last two years for classes, but I haven't used it at all during dedicated and I don't really feel the need to. I think it's a great resource for people who struggling with memorizing facts, though.

So I guess I have mostly been able to achieve those scores through practice questions. I was a bit nervous about relying so heavily on practice questions because it always seems like everyone else is using 500 different resources, some of which I had never even heard of until a few weeks ago (DIT, boards and beyond, Goljan). But so far I'm glad that I trusted my intuition and decided to stick with practice questions. For reference, I am a solidly average student compared to the rest of my class, and I had to work pretty damn hard to stay above average.

EDIT: oh! almost forgot. I also used the Rx videos for biochem and immunology. Basic science tends to be my weakest area, and I found those videos enormously helpful. I actually enjoy biochem questions now!
 
Just took NBME 17, not sure how to feel about it.

NBME 13: 234
CBSE: 248
UWSA1: 258
UWSA2: 256
NBME 15: 261
NBME 16: 263
NBME 17: 257

Not that I'm not happy with a 257...I'm just not sure if this represents a decrease in my score, or just a random variation. I did only get 1 more question wrong than on NBME 15/16 (got 10 wrong on both 15 and 16, 11 wrong on 17), but at the same time a 6 point decrease seems significant. I don't know. This does not help me in deciding whether or not to move my exam up. Thoughts?

I would say it's just random variation. I Scored 257 on 18 and 263 on 17, and 255 on 19. I think once you get passed 250 variation of +/-5 seems normal.


What did you guys think of the free 120?
I just took it and got 89%. I changed two of my answers on the first block like a dummy, but damn. I hope I feel more confident going into the real thing.
 
I would say it's just random variation. I Scored 257 on 18 and 263 on 17, and 255 on 19. I think once you get passed 250 variation of +/-5 seems normal.

I have a feeling that, like you, I'm probably going to score lower on 18 (taking tomorrow) and 19. I don't really care about 19, I'm pretty much going to ignore my score because I don't want it to ruin my confidence. But it sounds like most people also score lower on 18 than 17, so I'm gonna be sad if my score drops even further.
 
Just took NBME 17, not sure how to feel about it.

NBME 13: 234
CBSE: 248
UWSA1: 258
UWSA2: 256
NBME 15: 261
NBME 16: 263
NBME 17: 257

Not that I'm not happy with a 257...I'm just not sure if this represents a decrease in my score, or just a random variation. I did only get 1 more question wrong than on NBME 15/16 (got 10 wrong on both 15 and 16, 11 wrong on 17), but at the same time a 6 point decrease seems significant. I don't know. This does not help me in deciding whether or not to move my exam up. Thoughts?

Good work! I think that's normal variation. As has been said previously, the NBME's have weird variations in scoring inherently, not to mention different exams cover different topics so eventually you'll get an exam that has less of your strong topics on it. If you had dropped down to 250 then maybe there would be a reason for concern, but 257 is still pretty on par with your other exams.

Also I calculated the curve on NBME 17 and after 255, each question is literally 2 points.

BTW congrats on your progress! I think I remember you posting before that you would have been shooting for a 240+ and I'm thrilled that you're looking like you'll end up in the high 250s/low 260s.
 
Good work! I think that's normal variation. As has been said previously, the NBME's have weird variations in scoring inherently, not to mention different exams cover different topics so eventually you'll get an exam that has less of your strong topics on it. If you dropped down to 250 then I would start worrying.

Also I calculated the curve on NBME 17 and after 255, each question is literally 2 points.

BTW congrats on your progress! I think I remember you posting before that you would have been shooting for a 240+ and I'm thrilled that you're looking like you'll end up in the high 250s/low 260s.

Thanks! Haha I told my advisor I would have been content with a 230+ and she was like "no that's way too low, I think we can get you to a 270" and I was like OK lady I appreciate your faith in me but that's taking things way too far LOL.
 
Thanks! Haha I told my advisor I would have been content with a 230+ and she was like "no that's way too low, I think we can get you to a 270" and I was like OK lady I appreciate your faith in me but that's taking things way too far LOL.
I think a 260 is still really likely for you. Perhaps the fact that you seem to have plateaued after your stellar rise indicates that you should move your test up.
 
I think a 260 is still really likely for you. Perhaps the fact that you seem to have plateaued after your stellar rise indicates that you should move your test up.

That is a very good point. At this point unless I score sub-250 on 18 tomorrow I will likely move it up. The fact that I just spent two hours shopping and enjoying the nice weather like a normal person has definitely swayed my opinion too. It would be awesome to have a few days to chill out and do nothing.
 
If you feel confident definitely move it up. I really feel moving up 2 weeks was the best thing. Even tho i don’t have my score yet I’m pretty sure I would’ve lost points if I didn’t.

Haha the thing is, I feel confident about none of this! I don't feel confident about taking it next Saturday, but I don't feel confident about taking it on my scheduled date either! I'm a nervous wreck. I'm trying to separate nerves and insecurity (which are telling me to take every day available to me to study) from logic (knowing that the best thing for me to do is probably to move it up).

I am definitely making a decision tomorrow immediately after I take 18. if I score a 250 or higher, I will reschedule. If I score lower than a 250, I will not reschedule. At this point anxiety about whether or not to change the test is causing me to waste so much time and honestly probably taking years off my life lol, so I just need to make a final decision as soon as possible.
 
Just took NBME 17, not sure how to feel about it.

NBME 13: 234
CBSE: 248
UWSA1: 258
UWSA2: 256
NBME 15: 261
NBME 16: 263
NBME 17: 257

Not that I'm not happy with a 257...I'm just not sure if this represents a decrease in my score, or just a random variation. I did only get 1 more question wrong than on NBME 15/16 (got 10 wrong on both 15 and 16, 11 wrong on 17), but at the same time a 6 point decrease seems significant. I don't know. This does not help me in deciding whether or not to move my exam up. Thoughts?

Nice! Your scores look really consistent. It's also good to see you outdid UWSA1 on two other tests and pretty much matched it on UWSA2/NBME17, as I'm hoping that's the case for me too. What did you think about NBME 17?
 
Long time lurker 1st time poster. My goal score is 250, I started dedicated off strong but my practice test have not been improving. I use Uworld, first aid, pathoma and anki. I feel like i am stuck in mud and my wheels are just spinning around. I thought that by week 3 I would see improvement but there is none. Does anyone have any tips to break out of the 240s?

CBSE: 240-245
UWSA1: 262 (1 weeks into dedicated)
NBME 13: 244 (2 weeks into dedicated)
NBME 15: 242 (yesterday)
 
Nice! Your scores look really consistent. It's also good to see you outdid UWSA1 on two other tests and pretty much matched it on UWSA2/NBME17, as I'm hoping that's the case for me too. What did you think about NBME 17?

It definitely felt different than the earlier ones. I would say in terms of difficulty it was most similar to 16. And I would say 16 and 17 were more difficult than 15.
 
Question. Why does First Aid say that LMWH inhibits factor IIa? Sketchy and wikipedia made it sound like LMWH only acts on Xa, not IIa.
 
It definitely felt different than the earlier ones. I would say in terms of difficulty it was most similar to 16. And I would say 16 and 17 were more difficult than 15.

Ah ok, thanks! Also, I believe that the pentasaccharide sequence of unfractionated heparin is long enough to allow for inhibition of both thrombin and Factor 10 while the structure of LMWHs allow them to mostly inactivate Factor 10a. Maybe there's some activity retained against thrombin, and that's what it's referring to?
 
Ah ok, thanks! Also, I believe that the pentasaccharide sequence of unfractionated heparin is long enough to allow for inhibition of both thrombin and Factor 10 while the structure of LMWHs allow them to mostly inactivate Factor 10a. Maybe there's some activity retained against thrombin, and that's what it's referring to?

Yeah I think you're probably right! Thanks!
 
Looking for some advice. Got about 2 weeks till exam and just finished Uworld. have about 800 wrongs and wanted to do a second pass. Should I redo wrongs and then do second pass so I dont miss out on concepts I got wrong?

Also Ive taken 18,19,15 so far. I planned on doing the free 120 soon and then USWA2 the week (hopefully for some confidence boost going into the exam)

any advice for last 2 weeks would be appreciated!
 
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