The KING of all lurkers here just took the test yesterday… as you can see this is literally my first post and like a typical lurker im making this post because it was helpful reading all of these posts during dedicated and wanted to switch it up add my 2cents. Profile: US med student, top 50 school, slightly above average student Resources: (UFAPer supplemented with Sketchy Micro and Pharm, BnB and Goljan audio)
The unyielding beast that is the USMLE Step 1 was without a doubt it was the HARDEST exam I’ve ever taken in my life (would anyone who took it recently agree?), and I think part of the reason I feel sick right now is because I was aiming for a 245+ and I felt the margin of error on the NBME’s was so low that in order to do well I had to have a stellar day and land most of my 50/50’s. So now I’m sitting in my room staring at a wall praying that other med students would have found my test just as difficult HA. It’s tough knowing many questions I definitely know I got wrong already that were some EASY softball qs and 50/50’s, nevermind the difficult questions. It’s a sick feeling to prepare for something for pretty much two years and feel like you didn’t give it your best effort on the day and have to now rely on some sort of curve, I wish this upon no one lol, but hopefully I did well enough to not be completely ashamed of myself.
Don’t get me wrong, the first thing I will say specifically about the test is there are a TON of gimmes (maybe 50%) if you studied UFAP even through one pass like I imagine any medical student would, you will get most, if not, all of these correct. Don’t be like me and panic during the test miss some of these lol. Then, I would say like maybe an additional 25-30% was in UFAP but were a specific one line detail almost as if the examiners were to say “did you read this one obscure fact in FA that never showed up in UW? Or did you understand the reasoning behind this one concept in UW?” I even saw a concept tested from Pathoma that was in no other resource 😳 (these type q’s is what I imagine would separate a 220 from 240), then, maybe another 5-10% were not in any of the major resources but you could probably make an intelligent guess based on answer choices (this is what I think would probably separate 250 from 260 idk), and the rest were complete WTF questions from outerspace - for me these came from embryology, micro, immuno, things that would never in a million years show up in UFAP, but that you hopefully picked up in an upper level undergrad science course, research experience, additional supplementary resource or just by being genius- Therefore I would say the beast is unlike any NBME of UWSA in that the range of difficulty is insane (think from the easiest NBME question to the hardest UWSA question)
EXTRA random things I noticed:
1. A good portion of things you consider high yield will not be on the test---I remember during MS1 one of my professors GUARANTEED a certain concept on the test, didn’t even come CLOSE to showing up on the real---the questions are more skewed that you would think, with many repeat concepts. Flipping through FA after the test was frustrating for me because A LOT of concepts I knew cold and were ‘high yield’ did not show up, though with that being said there were a couple lower yield concept on pages in FA or UW questions that I had a sneaking suspicion would show up were staring right back at me in the first couple of blocks.
2. Keep in mind is that the method by which they ask the more difficult questions is unlike anything you would have ever seen or imagined. They have an uncanny skill of taking a concept you think you know backwards and forwards, and putting it in the 5th dimension (like that one scene in intrastellar lol). So know what you already know COLD and know that you know it COLD you don’t want to be second guessing yourself a basic concept on the test.
3. The test is picture HEAVY (CT’s MRI, gross specimens, rashes,) –almost 10% of mine I would say—most of which are not in FA, I would listen to Dr Ryan on BnB and he would say “after this video you should go and google pictures of this” and never do it thinking his pictures combined with FA were enough LOL. Even if you haven’t been doing this at least know how something is described in a picture so when it shows up on the real thing you can make a strong guess.
4. I got surprisingly a lot of : “What’s the next best step in management of this patient” type questions in true vague Step 2- esque fashion which brings me to my last thought that I had coming out of the exam…
I feel strongly that 20 years from now, most US medical schools will require their students to spend a year, or perhaps a semester doing actual clinical rotations BEFORE they sit for Step 1 and Step 2. There are already schools that already do this a good example is Baylor, where they rotate for about a year and a half then take Step 1 and 2 back to back. Go look at their school’s Step 1 average last year…its ridiculously high (the highest) and is most likely significant correlated (with a few effect modifiers lol) with the fact that they have more clinical experience than the average student before taking Step. Which now after taking the exam, I realize that a mere semester (even half a semester) in clinicals in addition to UFAP would easily have boosted my score. I also feel like the test writers are catching on to the fact that MS 1 & 2’s are getting more clinical more experience and are starting to blur the lines between licensing exams.
I’ll finish with my stats:
CBSE 203
NBME 13 215
NBME 15 225
NBME 16 240
NBME 17 236
UWSA 1 251
NBME 18 236
NBME 19 236
UWSA 2 249
Free 120: 86%
Will try my best to answer questions you all may have, but I l have to revise a journal paper and get ready for clincals that start in a couple of weeks Good luck to you all. As cliché as this last part will sound, remember you are more than just a score, keep the fire burning not only for a good score, but to become an excellent clinician and improve the lives of your future patients!
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