My $0.2 on Step 1 (got score back a couple weeks ago >250).
Really hope this isn’t the case, because physiology is like the main thing keeping my test scores up
I honestly do think this will pay off. I hammered phys because those questions are very "thinking heavy" questions and would stress me out because they're not memorizable facts. I think it payed off in a big way, because whenever I was trying to memorize something path related, I would bring it back to phys, and then the whole concept would be stuck in my head in a very grounded, long term, way. For example, learning WHY certain murmurs increase/decrease with specific maneuvers. Then, if you see a question on heart murmurs 2 weeks later, you won't be trying to remember which words go together or which way the arrow goes on the chart, because you'll be able to re-think through the phys and pathological process, which is 100% more reliable. Eventually, as you keep repeating these same pathways, you skip the middle thinking step and the answer becomes intuitive.
Being strong in phys will also give you the best possible ammunition for educated guessing on pretty much any tough question. If you know how the body works and it makes sense to you, you can usually piece together the correct answer or at least eliminate a LOT of nonsensical ones.
Other thoughts:
1) High yield is nonsense. There is gonna be SO MUCH that you spent time on that doesn't even show up on the test tangentially, or the questions or so easy that you click and immediately forget them. So you will spend so many hours on all the minute tiny details of rheumatic fever, and then get a question you could have answered in your sleep. And then, you will have at least one page of FA that you blew off because it was tedious and "low yield" that shows up about 5 times. It is what it is. It may mess with your bars, but probably won't mess too much with your score.
It's not at all like a test at the end of a block in med school, where the teachers test you on the most important concepts and you have a general idea of what needs to be asked to pass cardio. Step 1 can ask you 0 questions about hepatitis or penicillin and 3 questions about erlichiosis. I mostly got cranky waiting for my score to come back because I couldn't stop thinking about everything that HADN'T been tested!!!
2) The test itself weirdly feels like doing a bunch of random blocks on UW. By the end of the first block, my heart had calmed down and I felt like I was just doing my thing. Lie to yourself a little bit, and try to not harp on the fact that this is THE TEST.
3) I fully expected more insane, obscure, I-can't-believe-they-asked-that questions. Instead, I got questions that I recognized from my M1 courses, but definitely didn't know (a good chunk of anatomy ones). The good news was that I had some frame of reference to answer the question. The bad news was that those questions made me feel frustrated in the moment, like there was some studying I could have or should have done differently.
Ideally, I could have gone through a bunch of old powerpoints and pulled out some random-not-in-FA-or-UWorld-or-Goljan facts. Realistically, that was never gonna happen. I still did well.
4) You're gonna remember questions, but you're going to disproportionately remember the ones you didn't understand or got wrong. You will randomly flash back to questions and freak out because what if you misunderstood that concept or got confused during the test???? Odds are you're just not remembering the question completely, and you were definitely more likely to get a right answer in a focused testing environment than while trying to fall asleep 2 weeks later. Let it go, resist the urge to look things up.
Don't look things up during the exam either, because you could be misremembering a question and either freak yourself out or reinforcing incorrect thinking.
5) The whole thing is weird because you celebrate before you get your results back, and then you get your results back and you want to ACTUALLy celebrate but life goes on like nothing happened. Try to relax as much as you can directly after the test, because if you wait to de-stress until after you get your score, the world will already have moved on and you'll be on the wards.
6) My NBMEs were totally accurate. I outscored my highest by a small margin. A happy and semi-expected outcome.
