Got my score back today and did well, so sharing strategies for those trying to build their study plan:
Score: 261
UWorld first pass: 84% (fully random, timed, 40 question blocks)
Practice scores (exams are order of completion):
School sponsored NBME (November): 235
NBME 13: 248
NBME 15: 246
NBME 19: 261
NBME 16: 267
UWSA1: 264
Free 120: 93%
NBME 17: 252
NBME 18: 265
UWSA2: 264
(take with grain of salt due to new NBME forms being released and old ones being retired)
Resources: firecracker, UFAP, sketchy, anki, Kaplan QBank
Going into dedicated: had watched all of sketchy micro and pharm and did all of the cards in the Pepper anki decks for those, maintaining them every day during school. Did 120 firecracker flashcards per day, started firecracker at the very beginning of med school (for this I always marked all my past stuff as "current" and actual current school stuff as "urgent" so I'd get a 50/50 split). These two resources are what I thank for getting a good score on my school's NBME without having started dedicated yet. My school is an 18 month curriculum so we do step 1 in January. Did every subject/system specific Kaplan QBank question to prep for each system's final exam during school as well.
Dedicated: got like 6 weeks (including christmas break, so had to spend a good portion of that studying).
First week I watched all of pathoma and annotated while I watched, then did the Duke pathoma anki deck after each chapter. After week 1 I just did uworld, read every explanation, and made an anki card for every question I got wrong.
Starting maybe week 3, took NBME 13 and 15 (they are older and less predictive of the real thing).
4th week, took NBME 19, then 16. Doing uworld blocks after each exam just to make it feel more like true legnth (NBMEs are 200 questions, 4 blocks of 50, real thing has 280). Then I took UWSA 1 (the uworld practice exams have 4 blocks of 40 questions each, more similar to the real thing's 7 blocks of 40). What I did with that one is got up early, went to the school library, and then took the UWSA 1 exam followed by the free 120 (which is a set of 3 blocks of 40 questions each released by USMLE as a tutorial of sorts, but it's the best approximation of what the real questions were like in my opinion). The UWSA1 + free 120 totaled 7 blocks 40Qs each, so it was essentially my full length run through.
5th week, took NBME 17 and 18 on two different days, and finished uworld.
The last week, took UWSA2 monday, spent tuesday reviewing the answers I didn't get to from that on monday and read up on topics I had made a list of that I felt shaky on, Wednesday did some light last minute content review and watched netflix, drove to city where testing center is the night before, went to a restaurant that evening and split a hotel with a classmate, then got up and took step 1.
General thoughts: the buildup is worse than the exam. I felt worse in October about step than I did immediately following the exam. Dedicated is the worst part. Seeing your practice scores fluctuate and getting UWorld blocks where you suddenly take a major score dip when you had been improving previously can be an emotional roller coaster. You just have to keep pushing through - the blocks are random and you never know if they'll happen to hit a bunch of subjects you're weak on in one block, deflating your score. The best advice I heard was to treat UWorld as a learning tool and not to get too hung up on your percent scores from that.
When I know something is on the horizon I start to prepare - I've never been much of a procrastinator, so that's why I started things like FC and anki early and kept them going during school. It helped me a lot because I'm more confident when I've been studying something at a constant baseline, but that kind of strategy might not work for everyone so it's important to know how you learn the best.
About the changes in the NBME practice tests, I think the big thing for me was just sitting down and doing a ton of practice questions, more than actual predictiveness of the exam. Most of the NBMEs have shorter question stems than the real thing, but you can often reason through questions on the actual exam vs. the NBMEs which tend to be more cold recall. I do hope the new forms they're coming out with look and feel more like the real exam - I thought the "4 blocks, 50 questions each" format was dumb when the real test is 40Q x7.
That's what I can come up with now, but if you have questions about other details feel free to PM or ask here too!