USMLE Official 2018 Step 1 Experiences and Scores Thread

[Foot Fetish]

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

My stats:

M2
Test time: June 2018
Goal score: 270

 

[docksan]

Sure. If you’re an MD/Phd in a top 20 school. You can pretend that its not hard but it is.


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Mmkay. You do you.

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[ERDOC555]

What step score threshold will allow you to do any speciality? I know the number has shifted over the years.

A 250 will not rule you out of any specialty, buy I agree with the earlier post on this thread that 255+ (which is about Top 10% on Step 1) is ideal for any specialty especially if you're coming from a school without a top reputation. There are always exceptions, for example, a 248 from Harvard will open more doors than a 253 from Wyoming (not a real med school, as not to offend anyone).

 

[ERDOC555]

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

52/68 people with a USMLE of 240-250 matched NS in 2016

was 50/56 for 250-260

Seems like your odds are decent for NS with a 24x....

This data grossly underestimates trends. Many people can opt out of the data and it doesn't include people who aren't ranked. More people apply to each specialty than show up in the final data from charting outcomes. True match rates are lower for competitive specialties than that data would have you believe. You can't just look at that data and say "my step score is 2XX my odds are X" The crappier the step score the more those people need to do, ie. research years, pubs, nepotism, top school, PhD, etc.

You can't look at that data and actually say that those with a 201 to 210 have a 50% chance of matching dermatology. That's absolutely absurd. For every 1 person applying with a 210 there were likely 5 who foolishly applied with that score and didn't even get 1 interview and thus don't show up on the data.

 

[yungmoney2021]

Sure. If you’re an MD/Phd in a top 20 school. You can pretend that its not hard but it is.


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Yeah...because clearly 50+ of those neurosurgeons were MD/PhD's from top 20 schools. Quit spreading garbage

 

[sharkbyte]

UWSA 2: 243

Feel like I'm really slowing down and hitting a wall. Test is this Friday, and I really don't feel like studying that much but part of me feels like I should really push these next 6 days. I'm continuing to make silly mistakes, getting questions wrong that 70%+ of people are getting right. Not recognizing some really easy principles. I don't know what it is but I feel pretty good about UW Qbank but the two UWSAs have really felt uncomfortable for me. I still have NBME 19 left; might also buy NBME 16 too. I'm really dreading reviewing these questions; might just break them up one section a day.

 

[HybridEarth]

Free 120 spoiler:

"A 26-year-old woman is brought to the emergency department 3 hours after ingesting approximately 50 tablets of aspirin in a

suicide attempt. She is nauseated, confused, and sleepy. Her pulse is 130/min, respirations are 30/min, and blood pressure is

100/60 mm Hg. Which of the following sets of laboratory values is most likely on evaluation of blood obtained before

treatment?"

I went with the answer being she is in a respiratory alkalosis (given the time frame of 3 hours). UWorld says respiratory alkalosis occurs until 12 hours, then the acidosis kicks in. A textbook I looked into said the same thing... why is the answer acidosis?

 

[Lannister]

UWSA 2: 243

Feel like I'm really slowing down and hitting a wall. Test is this Friday, and I really don't feel like studying that much but part of me feels like I should really push these next 6 days. I'm continuing to make silly mistakes, getting questions wrong that 70%+ of people are getting right. Not recognizing some really easy principles. I don't know what it is but I feel pretty good about UW Qbank but the two UWSAs have really felt uncomfortable for me. I still have NBME 19 left; might also buy NBME 16 too. I'm really dreading reviewing these questions; might just break them up one section a day.

You got this, the next few days are going to fly by! I know it feels like you have to be super productive since your time is limited, but I would say don't be afraid to take a day off if you need it. Better to take a day off and then have four productive days than waste five days cuz you're totally burnt out. Also I think it's normal to have a hard time studying the last few days, happened to me too.

 

[HybridEarth]

UWSA 2: 243

Feel like I'm really slowing down and hitting a wall. Test is this Friday, and I really don't feel like studying that much but part of me feels like I should really push these next 6 days. I'm continuing to make silly mistakes, getting questions wrong that 70%+ of people are getting right. Not recognizing some really easy principles. I don't know what it is but I feel pretty good about UW Qbank but the two UWSAs have really felt uncomfortable for me. I still have NBME 19 left; might also buy NBME 16 too. I'm really dreading reviewing these questions; might just break them up one section a day.

I bought a few of the NBMEs just to do 1 or 2 a block a day for practice, I don't regret it! It's nice seeing as many of their-style questions as possible (I hope). Also I have felt pretty burnt out for two weeks now... best thing I did was take a day or two off just messing around, came back and did my best on NBME 19 (highest of all my NBMEs). Not saying take the next week off or anything... but give yourself some free time too!

 

[LongDucDong]

I went with the answer being she is in a respiratory alkalosis (given the time frame of 3 hours). UWorld says respiratory alkalosis occurs until 12 hours, then the acidosis kicks in. A textbook I looked into said the same thing... why is the answer acidosis?

I thought the same as you and got it wrong... so, naturally, I think its a garbage question. It does essentially directly contradict UWorld, though, so I wasn't sure what to do with it either..

 

[831929]

Free 120 spoiler:

"A 26-year-old woman is brought to the emergency department 3 hours after ingesting approximately 50 tablets of aspirin in a

suicide attempt. She is nauseated, confused, and sleepy. Her pulse is 130/min, respirations are 30/min, and blood pressure is

100/60 mm Hg. Which of the following sets of laboratory values is most likely on evaluation of blood obtained before

treatment?"

I went with the answer being she is in a respiratory alkalosis (given the time frame of 3 hours). UWorld says respiratory alkalosis occurs until 12 hours, then the acidosis kicks in. A textbook I looked into said the same thing... why is the answer acidosis?

the respiratory alk (im guessing you're referring to answer choice C) would make sense because it also mentions that the serum bicarb is going up. That is not a compensating mechanism nor do you get metabolic alk with aspirin. That was a tricky question. You had to eliminate things based on what compensations would add up which then leads you to pick that metabolic acidosis has already set in. At least that is what I think it was trying to get at haha.

 

[Azete]

Free 120 spoiler:

"A 26-year-old woman is brought to the emergency department 3 hours after ingesting approximately 50 tablets of aspirin in a

suicide attempt. She is nauseated, confused, and sleepy. Her pulse is 130/min, respirations are 30/min, and blood pressure is

100/60 mm Hg. Which of the following sets of laboratory values is most likely on evaluation of blood obtained before

treatment?"

I went with the answer being she is in a respiratory alkalosis (given the time frame of 3 hours). UWorld says respiratory alkalosis occurs until 12 hours, then the acidosis kicks in. A textbook I looked into said the same thing... why is the answer acidosis?

If you look at the answer choices, the only options with increased pH also have increased bicarb. It’s true resp alk occurs in acute aspirin toxicity, but there is no mechanism for bicarb to increase in this situation.

I actually found a lot of this sort’ve thing on the real deal; the answer choices didn’t have what I was looking for, but there was only one that was even possible so you had to eliminate the rest and uncomfortably go with it.

 

[Money Moniker]

Anyone else feel like Uworld is unrealistically easy due to the fact every wrong answer choice is used to "educate" you in the explanation, and thus has to correspond to a real disease? Even when I read the vignette and have no idea what disease they're portraying, I can almost always get the question right by easily recognizing which disease the wrong answer choices are referring to that cannot possibly be the correct answer and just choosing the one that doesn't ring a bell.

For example, vignette gives you clinical presentation of ataxia telangectasia and asks about pathological changes that would be present. Even if you don't recognize that they're talking about ataxia-tel, the fact that all the wrong answer choices are clear representations of AD, parkinsons, lewy body demential etc allows you to get the question correct by POE since you know none of those diseases fit the vignette. I feel like on the real thing, they would give you at least one completely nonsensical wrong answer that you couldn't eliminate solely by knowing which disease the answer ISN'T.

 

[HybridEarth]

If you look at the answer choices, the only options with increased pH also have increased bicarb. It’s true resp alk occurs in acute aspirin toxicity, but there is no mechanism for bicarb to increase in this situation.

I actually found a lot of this sort’ve thing on the real deal; the answer choices didn’t have what I was looking for, but there was only one that was even possible so you had to eliminate the rest and uncomfortably go with it.

Ahh I see, excellent point about the bicarb. Admittedly I didn't even look at that, so that's where I went wrong. Great thinking. Thanks!

 

[Tommytom]

Hey guys I'm just curious as to if the NBME/CBSSA 3 digit step one score is accurate.... I took NBME 15 form got a 68.5% correct and that equates to a 184? And like a 75% is barely passing? Surely that isn't the case on the real test.. thoughts?

 

[sharkbyte]

Anyone else feel like Uworld is unrealistically easy due to the fact every wrong answer choice is used to "educate" you in the explanation, and thus has to correspond to a real disease? Even when I read the vignette and have no idea what disease they're portraying, I can almost always get the question right by easily recognizing which disease the wrong answer choices are referring to that cannot possibly be the correct answer and just choosing the one that doesn't ring a bell.

For example, vignette gives you clinical presentation of ataxia telangectasia and asks about pathological changes that would be present. Even if you don't recognize that they're talking about ataxia-tel, the fact that all the wrong answer choices are clear representations of AD, parkinsons, lewy body demential etc allows you to get the question correct by POE since you know none of those diseases fit the vignette. I feel like on the real thing, they would give you at least one completely nonsensical wrong answer that you couldn't eliminate solely by knowing which disease the answer ISN'T.

I agree for the most part, but I feel like UW also balances that out a little bit with the really tough questions that ~20-50% of people are getting right. Where the question stem leads you to an answer that sounds good but it's actually a different answer that required more thought and content connections. I'm at the end of UW now and I feel like I'm answering the majority of questions based on quick recognition and POE but there are still some really hard questions that I repeatedly get wrong and always will. Maybe that's just me though lol

 

[sharkbyte]

Does anyone know if that one UW % and Kaplan% score correlation chart floating around is accurate? I have a feeling it's outdated, it says that a 70% on the UW Qbank is equivalent to a 250 but I got a 76% on UWSA2 and that was just a 243.

 

[sharkbyte]

It's talking about your % on uworld, not the uwsa exams.

Right. But I'm at a 76% on the UW Qbank and I've been in the low-mid 240s on both the UWSAs and NBMEs. Maybe it's just me and my dumb mistakes lol

 

[docksan]

Right. But I'm at a 76% on the UW Qbank and I've been in the low-mid 240s on both the UWSAs and NBMEs. Maybe it's just me and my dumb mistakes lol

General rule is 2.33*bank% + (70-80).

The self assessments and nbmes have ranges too, and your raw could vary by 3-5 points. That would make sense that on the low end of deviation you're hitting mid 240s.

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[sharkbyte]

General rule is 2.33*bank% + (70-80).

The self assessments and nbmes have ranges too, and your raw could vary by 3-5 points. That would make sense that on the low end of deviation you're hitting mid 240s.

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Yeah that would seem to make sense. I just don't know why on UW I am consistently getting a good # of the easier questions wrong. I do quite well on the moderate to hard ones but I always end up messing up questions that 65% or 70%+ get right. Obviously it's idealistic to assume I'd get all of these right but it's just frustrating when I don't think about something or something doesn't pop up in my head that the majority of other students were able to figure out. I think it might be fatigue/slowing down/overthinking. I'm hopeful it doesn't hurt me too much on the test day.

 

[ciestar]

UWSA1: 232
I am getting nervous. Only other thing I have to compare to is a 198 on NBME 15.

Exam is the 11th so I have 7 more days to prep. Next NBME will PROBABLY be monday or tuesday.

I am not sure if I am in okay shape or not. Should I postpone? I’d be very happy with a 232 (and I know this is an inflanted score)

 

[docksan]

Just keep doing what you're doing, add details, do some nbmes. You can't change test day.

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[docksan]

UWSA1: 232
I am getting nervous. Only other thing I have to compare to is a 198 on NBME 15.

Exam is the 11th so I have 7 more days to prep. Next NBME will PROBABLY be monday or tuesday.

I am not sure if I am in okay shape or not. Should I postpone? I’d be very happy with a 232 (and I know this is an inflanted score)

I would check the difference in content mastery between the two. A difference that broad can be a red flag this close. When did you take the nbme? How far out? What's your bank percentage?

You might want to take that second practice sooner and consider pushing your test out if you're worried.

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[ciestar]

I would check the difference in content mastery between the two. A difference that broad can be a red flag this close. When did you take the nbme? How far out? What's your bank percentage?

You might want to take that second practice sooner and consider pushing your test out if you're worried.

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A month ago! I should have mentioned that.
UWorld is a 68%

 

[Tommytom]

A month ago! I should have mentioned that.
UWorld is a 68%

What % correct did you get on UWSA1 for a232?

 

[ciestar]

What % correct did you get on UWSA1 for a232?

65.75%

 

[ciestar]

Um ya I think you're gonna be ok. Everyone I know has gone up 25-40 points in a month...I'd take another nbme if I were you. Probably low 220s based on my mental uworld to nbme conversion 😉

Any thoughts on which NBME? My school requires I take a second one so I will be soon.

Id be fine with a score in the 220s.

 

[pbrocks15]

Is anyone doing the Pepper Micro/Pharm Deck? I'm essentially done with Micro and I'm about 75% done with pharm, but recently pharm has been taking me at least two hours to complete a day. Is this normal? I know I'm not the fastest out there but is this worth it? Should I just do the reviews now and not add more? I would hate to do this because I wanna be complete, but idk if the time commitment is worth it (Exam is in 3 weeks).

 

[The.Supinator]

When you get ready to pull an all nighter doing uworld questions and mid review on a set of 40...... uworld decides to close! thanks uworld! thanks! I totally forgot it was going to be out tonight smh!

 

[ciestar]

When you get ready to pull an all nighter doing uworld questions and mid review on a set of 40...... uworld decides to close! thanks uworld! thanks! I totally forgot it was going to be out tonight smh!

I forgot too! Guess it is time to get cozy with Sketchy or Pathoma.

 

[The.Supinator]

I forgot too! Guess it is time to get cozy with Sketchy or Pathoma.

lol I am hitting that pepper deck hard now

 

[EbolaOnMyMind]

I feel ya, something about may 7th tests looks like all the test takers are underperforming from that day. I thought UWSA2, which i took 4 days pre-exam (i got a 245) would most accurately predict my score but I ended up getting my NBME/UWSA average (low 230s). I guess the hype over UWSAs being worthy predictors was overdone.

my anecdotal evidence on the 7th says that people have been exceeding their NBME averages, actually. Everyone at my program has been doing better than they thought they would, or at least on their average.

What step score threshold will allow you to do any speciality? I know the number has shifted over the years.

If you look at the MATCH data from previous years, the average Step 1 score for the competitive specialties hover around mid-high 240s (except for, I think, Plastics, ENT and Derm (which hover around 250). I've always been told that breaking a 250 makes you competitive for any specialty assuming you have research activity and a good statement/LOR. So I'd say 250+.

My confidence is in tatters, just got a 244 on NBME 18 (total avg is now 247). Was really hoping to break 250+ and was confident at start of dedicated, but I definitely feel like I've regressed the past 2 weeks. What should I do the next 4-5 days?

My NBME average was a 245.2 and I got a 252. NBMEs are generally known to under-estimate your score. You are definitely in the range where you can break a 250.

 

[EbolaOnMyMind]

When we can't print the permit on the ECFMG site does that mean our result will come out this week?

when did you take yours?

 

[docksan]

When we can't print the permit on the ECFMG site does that mean our result will come out this week?

I was under the impression it meant your score had been finalized, and I think it physically has to disappear... Not just give you an error when you click.

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[docksan]

It's a brutal wait for sure, but I know classmates that took it a week or two before me that either have their scores or no longer have their permit.

I took mine 18/5, for reference.

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[orangetea]

do a uworld question get it right
same one appears on NBME get it wrong

how do I prevent this stupidness

 

[Elessar]

.

 

[831929]

Hey guys wanted to share and ask opinion on whether there is a chance I can get 238-240 range on the real deal
NBME 19 - 190s (prededicated)
NBME 18 - 205 (first pass ~3 weeks)
NBME 15 - 236 (2nd pass ~ 1.5 weeks)
USWA2 today - 245 (half third pass ~1 week)

I have just a few days left to review.
Was going to finish sketchy pharm and do zanki for weak subjects
Any advice...words of encouragement?

 

[pbrocks15]

Need some help here as well.

Was thinking of going through a second pass of FA. I'm considering making it quicker and instead of slowly reading each chapter, just quickly reviewing it in about an hour and then doing the questions on it from Rx/Kaplan? I'm not sure how beneficial a second pass will be for me.

 

[pbrocks15]

Hey guys wanted to share and ask opinion on whether there is a chance I can get 238-240 range on the real deal
NBME 19 - 190s (prededicated)
NBME 18 - 205 (first pass ~3 weeks)
NBME 15 - 236 (2nd pass ~ 1.5 weeks)
USWA2 today - 245 (half third pass ~1 week)

I have just a few days left to review.
Was going to finish sketchy pharm and do zanki for weak subjects
Any advice...words of encouragement?

My 2c...Your progress is awesome. I think you're definitely heading in the right direction, so everything your doing seems to be working well for you and that should give you some confidence coming into test day. UWSA2 is said to be pretty predictable as you might know so that adds a little more confidence. I think you're on the right path and headed towards a 240! Not sure what's best before the exam since I haven't taken it yet, but I would just do as you said.

Best of luck!!

 

[831929]

My 2c...Your progress is awesome. I think you're definitely heading in the right direction, so everything your doing seems to be working well for you and that should give you some confidence coming into test day. UWSA2 is said to be pretty predictable as you might know so that adds a little more confidence. I think you're on the right path and headed towards a 240! Not sure what's best before the exam since I haven't taken it yet, but I would just do as you said.

Best of luck!!

Thanks man!! Yeah I guess at this point there isnt probably too much one can do but cram in a few high yield things.

In regards to your FA second pass, idk if you used zanki during the year, but I never kept up with the cards and just redid them during dedicated after first pass. I would do a system a day and just push the cards I knew well out 20+ days and keep ones I didnt know for third pass. Its a less passive way than just reading first aid but pretty time consuming.

 

[sharkbyte]

NBME 16: 252! I think I'm much more comfortable with the NBME style questions than UW. For better or worse

 

[831929]

Congrats on the upward movement! When you say 2nd pass are you referencing FA or something else?

Thank you! That second nbme really had me doubting a lot of things in life haha. I didnt really use FA too much. I watched all of BandB and Pathoma for first pass and then second pass I did zanki.

 

[pbrocks15]

Thanks man!! Yeah I guess at this point there isnt probably too much one can do but cram in a few high yield things.

In regards to your FA second pass, idk if you used zanki during the year, but I never kept up with the cards and just redid them during dedicated after first pass. I would do a system a day and just push the cards I knew well out 20+ days and keep ones I didnt know for third pass. Its a less passive way than just reading first aid but pretty time consuming.

I was really thinking of doing that but I didn't and I moderately regret it now (not entirely bc I somewhat like the big picture from just reading, so a mix of both is ideal). I think that is a great idea though for something now and I'm considering it! I might give it a shot tomorrow and see how it goes.

 

[831929]

A 30 point jump in 1.5 weeks is great 🙂. I think you will do fantastic on your exam!

I see now, thank you for the clarification.

Thanks!! 😀

 

[Squamous Eddie]

It's a brutal wait for sure, but I know classmates that took it a week or two before me that either have their scores or no longer have their permit.

I took mine 18/5, for reference.

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Oh shoot, I took mine the same day, as well. I thought scores weren't supposed to be even close to coming out until July 11th?

 

[docksan]

Me too, but that's what I've been experiencing.

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[orangetea]

How cool would it be..
if uworld made a text book with ALL of their questions by organ with the explanation..
oh and in color.


when I grow up I wanna be a doctor so I can eventually work for uworld and make that into reality.

 

[HybridEarth]

Just did NBME 17 today... got a 261. Up from 248 on NBME 19. Bit surprised to be honest because I felt that this exam was much harder than NBME 19, and I'm also extremely burnt out and panicking because there is so much stuff in First Aid I (think?) I don't know. Exam is Saturday. Not sure what to do this week.

 

[sharkbyte]

Just did NBME 17 today... got a 261. Up from 248 on NBME 19. Bit surprised to be honest because I felt that this exam was much harder than NBME 19, and I'm also extremely burnt out and panicking because there is so much stuff in First Aid I (think?) I don't know. Exam is Saturday. Not sure what to do this week.

Great job! Feel the same way as you, I have my exam Friday and I just have NBME 19 left to take. Probably going to take it Tuesday or so. I think I'm going to write down a list of everything I want to review over the next 4-5 days that I feel like I'm weak on.

 

[HybridEarth]

Great job! Feel the same way as you, I have my exam Friday and I just have NBME 19 left to take. Probably going to take it Tuesday or so. I think I'm going to write down a list of everything I want to review over the next 4-5 days that I feel like I'm weak on.

Good stuff, hopefully we can kill it this week. Do you think it would be a bad idea for me to skim through all of first aid 1 more time this week? Just to cram in any last minute small details into my brain... or should I spend time actually learning the biochemistry (I feel like I've been getting no biochem questions... thankfully because I don't know any of it lol)