USMLE Official 2019 Step 1 Experiences and Scores Thread

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Took NBME 19. Did worse on 19 with three digit score 😕. However, I missed less questions on 19 than 18. The curve on 19 is brutal.
 
I took my first NBME, which is 16. My endurance is so bad... I don't know how Im supposed to get it up in a month and a half.

Endurance is one of my biggest pitfalls currently. I just started my second UW pass and I've been trying to do 3 blocks a day on days I'm not doing an NBME. I was previously doing two blocks/day. I think the only way to bump up endurance is to do multiple blocks back to back when you do your daily questions.
 
I'm curious to hear yall's feedback on my dedicated anki/zanki strategy. I haven't really heard of other people doing this, but it seems like a good idea to me. I'm currently 8 weeks out from step, with ~1000 scheduled reviews/day, which is totally ridiculous and massively cuts into my QBank time. Thus, here is my plan for the next 8 weeks:
  • Sorted learned cards into two decks: interval>30, and interval <=30
  • Capped ivl>30 cards to 100 reviews/day
  • No cap on reviews for cards with interval<=30
  • Adding an Rx question regimen on top of UW/Kaplan

For the past 2 years I've pretty much just done nothing but Zanki all day every day. This plan will quickly cut my daily reviews to like <200/day, which feels scary but exciting! I think adding a lot of Rx questions on top of UW/Kaplan will do a good job of making sure I keep refreshing that FA info regularly, and be more helpful than seeing some Zanki card for the 12th time.

Somewhat disappointed in my Rx average of 68% so far, and I've dropped to 78% average on Kaplan. Still 2 more weeks of class until dedicated starts and I can really start hitting the QBanks hard. Tentatively hoping to average 120 questions/day split between Rx/Kaplan/UW once dedicated hits...
 
I'm curious to hear yall's feedback on my dedicated anki/zanki strategy. I haven't really heard of other people doing this, but it seems like a good idea to me. I'm currently 8 weeks out from step, with ~1000 scheduled reviews/day, which is totally ridiculous and massively cuts into my QBank time. Thus, here is my plan for the next 8 weeks:
  • Sorted learned cards into two decks: interval>30, and interval <=30
  • Capped ivl>30 cards to 100 reviews/day
  • No cap on reviews for cards with interval<=30
  • Adding an Rx question regimen on top of UW/Kaplan
For the past 2 years I've pretty much just done nothing but Zanki all day every day. This plan will quickly cut my daily reviews to like <200/day, which feels scary but exciting! I think adding a lot of Rx questions on top of UW/Kaplan will do a good job of making sure I keep refreshing that FA info regularly, and be more helpful than seeing some Zanki card for the 12th time.

Somewhat disappointed in my Rx average of 68% so far, and I've dropped to 78% average on Kaplan. Still 2 more weeks of class until dedicated starts and I can really start hitting the QBanks hard. Tentatively hoping to average 120 questions/day split between Rx/Kaplan/UW once dedicated hits...
Only tangentially related: how many cards of zanki+lol (or whatever) have you seen and how many cards have you matured?
 
I think adding a lot of Rx questions on top of UW/Kaplan will do a good job of making sure I keep refreshing that FA info regularly, and be more helpful than seeing some Zanki card for the 12th time.

Honestly I would watch BnB instead of doing Rx. He made those videos with FA as the template but goes into more depth than what is there, and then connects stuff in a way you won't find in the Rx questions. I never thought I'd say this but honestly doing BnB this first week of dedicated and not doing Zanki or anything like that has actually been eye opening. I think Zanki hammered in all the knowledge, and now BnB is tying it all together. It's also a way to review a lot more information than by doing 10k reviews a day.
Somewhat disappointed in my Rx average of 68% so far

Don't be, I hate Rx. My average is like 64 or something like that. My UWorld percentage is at least 10 points higher. Rx is simply a "did you memorize this little minutia piece from page 256 of FA" Q-bank instead of actually applying your knowledge to reason through the presentation.
 
Only tangentially related: how many cards of zanki+lol (or whatever) have you seen and how many cards have you matured?

Just under 38,000 cards learned, 35k of those are matured. A lot of those are cards where I added clozes, or things I made from QBanks or class material. Average interval is 6 months, so the daily mature reviews on the Forecast are actually only around 300/day. 88% accuracy on matures. Still have ~1000 zanki cards left until I've finished it - will get through them over the next week or so hopefully.

In retrospect, I think I mis-calibrated my card-making somewhat. This is probably way too many cards, too much minutiae. It would have been better to make fewer cards and do more Rx/Kaplan during the year. My Obsessive Compulsiveness compelled me to try to memorize every factoid and probably spend my time sub-optimally. Ah well.

Honestly I would watch BnB instead of doing Rx. He made those videos with FA as the template but goes into more depth than what is there, and then connects stuff in a way you won't find in the Rx questions. I never thought I'd say this but honestly doing BnB this first week of dedicated and not doing Zanki or anything like that has actually been eye opening. I think Zanki hammered in all the knowledge, and now BnB is tying it all together. It's also a way to review a lot more information than by doing 10k reviews a day.

I wonder, might be worthwhile... As a Zanki disciple I sort of built my knowledge by memorizing the details first, and drawing connections / understanding the big picture later. Rx has been valuable so far in helping me learn the big picture better, maybe BnB would do the same.
 
So those who have taken any of the new NBMEs, what are your thoughts on them and how do they compare to the old ones in terms of difficulty, curve, concepts being asked?
 
242 on 16 today. I went ahead and missed the repeats I missed on 20/21, but that exam was so much more straightforward than the new ones. I’ve got 2.5 weeks before my exam. Chances I can get close to a 250?

You'll definitely hit 250+, keep grinding. I'm about to be starting dedicated next week!
 
242 on 16 today. I went ahead and missed the repeats I missed on 20/21, but that exam was so much more straightforward than the new ones. I’ve got 2.5 weeks before my exam. Chances I can get close to a 250?

I got my bet on you hittin 256, you can send my "guessed your step score correctly" pizza to the lib
 
inb4 step becomes a reasoning test based on simple phys/pathophys principles and your score is = IQ + 100

For real though, from what I've read and heard it seems that the test has changed from largely a memorization+application test into a "do you understand this esoteric language" test, with tons of up/down arrows, and making you figure things out that there's no way you could have studied for them...

any comments?
 
inb4 step becomes a reasoning test based on simple phys/pathophys principles and your score is = IQ + 100

For real though, from what I've read and heard it seems that the test has changed from largely a memorization+application test into a "do you understand this esoteric language" test, with tons of up/down arrows, and making you figure things out that there's no way you could have studied for them...

any comments?

I hate the up/down arrow q's 😱😱

But no seriously, this is I think one underlying reason why there is a discussion about making step 1 p/f. Which has been discussed at length in 1023043 other posts on this forum. But I will say, each year it seems as if the scores go up, we memorize more and more. And the NBME has to figure out a way to make it more challenging. Up/down arrows are one way lol
 
More biostats and ethics are another method. I've heard that over the past few years biostats and ethics have gained the highest % of increase in total q's on the exam.

That’s good for me because those are my best subjects lol
 
Just finished my last final big final of 2nd year. Dedicated starts on Monday but there will still be some school stuff to do throughout the next couple of weeks. I figured I would put an update post to see where I'm at.

Zanki - Really fell off with the reviews this semester. During each course I completed the relevant cards but I did not keep up with the reviews after the class was over. Out of 38k cards, I have 12.8k (34%) matured, 16k (42%) young+learning, and I haven't seen 7k (19%). A good 5% are suspended/dead cards. I will just be picking up where I left off during dedicated and if I don't feel comfortable with a card, I'll reset it.

Sketchy Micro - through all of it

Sketchy Pharm - though all of it

Sketchy Path - I use it for some stuff. I find this resource to be crazily underrated. Am considering going through all of it in dedicated.

Qbanks - overall I have done ~5900 qbank questions since start of 2nd year.

UWorld - I did questions throughout the this semester on tutor random, including subjects I had already seen at that point. When I finished a class, I added those questions into rotation. The only questions I didn't do was Psych. I completed 93.6% of the bank at 70% correct. I will be resetting on Monday.

UsmleRx - I hate this qbank and only do it when I am bored and I honestly don't really pay much attention while doing it anymore. I've done 1400 questions at 68% correct.

Truelearn - USMLE bank - ~1k questions done at 73% correct. COMLEX bank - ~850 questions done at 76% correct.

I'm taking the weekend off and will be hitting the ground running on Monday. Good luck to everyone in dedicated and those about to start!! We got this!
 
inb4 step becomes a reasoning test based on simple phys/pathophys principles and your score is = IQ + 100

For real though, from what I've read and heard it seems that the test has changed from largely a memorization+application test into a "do you understand this esoteric language" test, with tons of up/down arrows, and making you figure things out that there's no way you could have studied for them...

any comments?
Nothing 5K questions or 200K anki cards cant fix.

Everytime i do an NBME exam , it is like they either test a simple concept in an ass backwards way. Or they use language to obfuscate a simple concept. or they test a level beyond what you would have memorized, or a topic that is adjacent to canon of UFAP.

IMO, The purpose seems to drive everyone to the middle, if you studied hard you are going to get a 230 at least. The rest is going to be up to application and going beyond the canon.
 
Never came back here to provide an update to ya'll after my exam at the end of march. I initially was freaking out because I borderline passed nbme 19 (the one with the crazy hard curve) a week out from test day and couldn't do any of the new NBMEs because I couldn't postpone the test any further. Was worried the test would be really different from the old NBMEs if they were being discontinued etc.

My score came back like 2 weeks ago. I did better than any of my NBMEs and over 20 points better than 19. While my score isn't good relative to the SDN community, I was relatively pleased with it compared to how far I had come all things considered. My baseline before dedicated was well below passing standards.

How I felt after the test: It felt like doing any other NBME. Questions were very similar. Topics were the same from uworld and nbmes. Nothing really surprised me. Of course I got questions I didn't know, just guessed and moved on. I honestly felt like step 1 was one of the most fair tests I've ever taken. I never even practiced doing a full 8 hours. The longest I had ever practiced for stamina was an NBME plus 1 uworld block back to back. Never did the free 120. Made sure to take a bathroom break after every block. Cant do back to back blocks without a small break. Used the full hour of break time given just to get up and snack and pee.

My advice: Biggest thing for me was focusing on uworld and first aid. Kept my study simple. My scores jumped significantly when I started doing uworld on semi random systems and timed myself. While I never mimicked a full length test day, just getting into the habit of 60 min blocks made my pacing on test day fine and I never really had fatigue issues.

My first pass of uworld was system by system and on tutor. Then I did a few hundred incorrects, restarted it got through about 1000 questions on a second pass doing multiple systems of mostly higher yield stuff and things I wasn't good at so cards, neuro, renal, resp etc. Stuff that comes up a lot more. Didn't focus on ID questions, psych, or repro because I had a good handle on those topics/ lower yield.

Uworld is designed to teach. The bank is like a textbook. I spent the same amount of time on reading explanations for questions I got right and knew vs the ones I got wrong because I wanted the repetition. Did a block a day and re-read a chapter of first aid. Did all the NBMEs twice to make sure I was super familiar with the format and NBME style. Spent about 3-4 hours reviewing a single block of uworld each day.

Never did any BB didn't really like it, did pathoma throughout med school but didn't focus on it during dedicated, did sketchy micro once and most of pharm once but didn't really remember the sketches that well esp the pharm sketches are super long and convoluted. Maybe I just don't learn from sketchy but my friends swore by it. The new quiz function on sketchy seems pretty sweet tho. Honestly I just learned most of my pharm through doing uworld questions.

summary: first aid and Uworld. Not finishing a full second pass of Uworld is my only regret.
 
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Everytime i do an NBME exam , it is like they either test a simple concept in an ass backwards way. Or they use language to obfuscate a simple concept. or they test a level beyond what you would have memorized, or a topic that is adjacent to canon of UFAP.

This concept is also seen in UWorld percentages. There are enough questions in there that all people who have studied hard are capable of getting, but they throw in enough questions where less than half of people get them so that to bump your percentage above the median you have to get a few of those. These questions are almost invariably still found in FA but not as FA has it, you have to go backwards or reason through a clear physiological pathway to get to the answer.

And then just for funsies they throw in a question they know isn't found in FA or any board review source as to delineate the super high scorers, like that procalcitonin is an APR that is increased in bacterial disease and decreased in viral disease 🙄 Yeah I didn't get that question right lol. Had literally never heard of it before.
 
Hi guys, I’m new to this thread. I just have one question. I’m not sure why it’s taking me 5 hours to review a block of uworld. It used to take me 8-10 hours but if I try to do it really fast, it takes me 5 hours (including doing the questions). I don’t know how everyone is able to review a block for 2-3 hours. Do you guys not read everything thoroughly if you get the question right? For me, I always find something that I didn’t know when I read through the explanations. Maybe I should focus on the big picture and skim through as long as I know the educational objective?

I need some advice because I’m way behind my schedule.
 
Hi guys, I’m new to this thread. I just have one question. I’m not sure why it’s taking me 5 hours to review a block of uworld. It used to take me 8-10 hours but if I try to do it really fast, it takes me 5 hours (including doing the questions). I don’t know how everyone is able to review a block for 2-3 hours. Do you guys not read everything thoroughly if you get the question right? For me, I always find something that I didn’t know when I read through the explanations. Maybe I should focus on the big picture and skim through as long as I know the educational objective?

I need some advice because I’m way behind my schedule.

Everyone is different. I know plenty of people that spend hours reviewing a single block and others that can do 3-4 blocks a day. Its not important how fast you review it but rather that you are learning from each question and understanding it thoroughly. You're not getting the most out of the bank if you just skim through it.
 
This concept is also seen in UWorld percentages. There are enough questions in there that all people who have studied hard are capable of getting, but they throw in enough questions where less than half of people get them so that to bump your percentage above the median you have to get a few of those. These questions are almost invariably still found in FA but not as FA has it, you have to go backwards or reason through a clear physiological pathway to get to the answer.

And then just for funsies they throw in a question they know isn't found in FA or any board review source as to delineate the super high scorers, like that procalcitonin is an APR that is increased in bacterial disease and decreased in viral disease 🙄 Yeah I didn't get that question right lol. Had literally never heard of it before.

Yea I remember that question. It's one of the newer ones and it's not in first aid. The only reason I got it right is because I took step 1 after 3rd year so I had been familiar with procal from being on the wards (its used sometimes to differentiate between bacterial and viral pneumonia and response to treatment). I would imagine its not really something taught in basic sciences.
 
Anyone have a quick reference for how to effectively create a filtered deck for zanki? Trying to cut back on time spent on zanki during these last two months
 
Anyone have a quick reference for how to effectively create a filtered deck for zanki? Trying to cut back on time spent on zanki during these last two months
Just limit the number of reviews by deck.



Does anyone know what the "general principles" bar on NBME reports means or what it contains?
 
Just limit the number of reviews by deck.



Does anyone know what the "general principles" bar on NBME reports means or what it contains?

Limiting the # of reviews would be a way to limit how much time I'm spending on zanki but I'm looking for more of a focused way of studying my zanki cards, the ones I need to study. If that makes sense. It seems like there are many ways of creating filtered decks to focus/hone in on weak points. Ie, set a filtered deck to "most lapses" and it'll pull cards that you have lapsed a review card. I was curious if anyone on here had more experience with creating really good filtered decks.

If you click that tab after you take an NBME you can go through the q's marked as "general principles". IMO it seems to be all the MCAT-style stuff, which is basically the first three subections of the biochemistry chapter of FA (Molecular, Cellular, Genetics principles). Its a brutal section for me lmao
 
Limiting the # of reviews would be a way to limit how much time I'm spending on zanki but I'm looking for more of a focused way of studying my zanki cards, the ones I need to study. If that makes sense. It seems like there are many ways of creating filtered decks to focus/hone in on weak points. Ie, set a filtered deck to "most lapses" and it'll pull cards that you have lapsed a review card. I was curious if anyone on here had more experience with creating really good filtered decks.

If you click that tab after you take an NBME you can go through the q's marked as "general principles". IMO it seems to be all the MCAT-style stuff, which is basically the first three subections of the biochemistry chapter of FA (Molecular, Cellular, Genetics principles). Its a brutal section for me lmao
There are probably much more efficient ways to do it, but I have done this after my NBMEs. I have a “past” deck of everything I’ve covered prededicated that I no longer touch. I do uworld questions throughout the week, and if I miss any questions from info in that deck, I pull it into a “uworld/NBME” deck I’ve made of all of my misses and reset it so I start seeing it again. I make new cards off of my misses that aren’t in zanki and put them in that deck as well. I took a few NBMEs to find consistent weaknesses (psych/Neuro and endocrine for me). I then pulled the tags that I struggle with (endocrine path or physiology for example) and I move everything into a separate deck and hit that hard for the week leading up to my next NBME (plus that uworld deck). Then I adjust it based on those results (typically it’s the same 2-4 subjects though for me). It’s cut my anki time down drastically.
 
Limiting the # of reviews would be a way to limit how much time I'm spending on zanki but I'm looking for more of a focused way of studying my zanki cards, the ones I need to study. If that makes sense. It seems like there are many ways of creating filtered decks to focus/hone in on weak points. Ie, set a filtered deck to "most lapses" and it'll pull cards that you have lapsed a review card. I was curious if anyone on here had more experience with creating really good filtered decks.

If you click that tab after you take an NBME you can go through the q's marked as "general principles". IMO it seems to be all the MCAT-style stuff, which is basically the first three subections of the biochemistry chapter of FA (Molecular, Cellular, Genetics principles). Its a brutal section for me lmao

What!?! I didn’t see any way to get more info after my NBME except the bands. Guess I need to click around more. I never saw the questions again, answers, or any breakdown of what made up the bands.
 
232 on 20 :barf:

I got a 248 on Form 18 three weeks ago and then I took Form 20 yesterday...scored a 228. I don't know if that means I should change my study style or that I'm burnt out. But so many of the question stems seemed so vague. To get to the correct answer I needed to make at least two assumptions.
 
I got a 248 on Form 18 three weeks ago and then I took Form 20 yesterday...scored a 228. I don't know if that means I should change my study style or that I'm burnt out. But so many of the question stems seemed so vague. To get to the correct answer I needed to make at least two assumptions.

crap im taking 20 in a couple days... Was hoping to use it as an indicator of some improvement.. Did anyone else have this drastic of a score difference between 20 and older NBMEs
 
crap im taking 20 in a couple days... Was hoping to use it as an indicator of some improvement.. Did anyone else have this drastic of a score difference between 20 and older NBMEs

I was hoping for the same thing too, but take it with a grain of salt. You might be more comfortable with answering these questions or have more knowledge in the topics on the exam. Don't let these posts change your mindset when you go into the test. Fingers crossed for you!
 
I got a 248 on Form 18 three weeks ago and then I took Form 20 yesterday...scored a 228. I don't know if that means I should change my study style or that I'm burnt out. But so many of the question stems seemed so vague. To get to the correct answer I needed to make at least two assumptions.
I’m convinced the only way to do reasonably well on 20 is if you’ve done the old forms and see all of the repeats. It’s been as much of an outlier as UW1 for me (obviously opposite direction). Averaging those two out though has basically been my NBME average haha
 
crap im taking 20 in a couple days... Was hoping to use it as an indicator of some improvement.. Did anyone else have this drastic of a score difference between 20 and older NBMEs

Dropped 12 points from my prior NBME (17), even though I'm pretty sure I was better prepared. I think it's okay to take as long as you know that it might be kind of rough - plus, whatever you take the week after will give you a double boost.
 
Well that was heavily disappointing. Just got a 228 on NBME 17. 5 weeks of dedicated left. I hope my NBME performances start to reflect to my UW percentages 🙄 Should be done with my first pass of BnB/Sketchy in 2 weeks and stuff I'm missing is stuff I haven't covered in a long time, so I'm banking on those weaknesses fixing themselves as I get through those topics.
 
Well that was heavily disappointing. Just got a 228 on NBME 17. 5 weeks of dedicated left. I hope my NBME performances start to reflect to my UW percentages 🙄 Should be done with my first pass of BnB/Sketchy in 2 weeks and stuff I'm missing is stuff I haven't covered in a long time, so I'm banking on those weaknesses fixing themselves as I get through those topics.
Yeah, my uworld percentage is close to 80 now with 1/2 done and im still stuck in the 230-245 range on the NBMEs. Maybe the cake is a lie.
who knows?
 
I applaud you all for crushing uw so easily on your first pass. I finished it my first time through at a 55%
Thanks. Its random tutor. And eveyrone uses it differently. Using it during the year is very different then opening it for the first time in dedicated(which is what I am doing). As long as you learn from it thats all that matters. But zanki really sets you up to answer some of those questions. Uworld percentages wont matter tho if it doesnt correlate with the real thing.

What I have found is uworld simultaneously rewards and punishes overthinking. I could think five steps for a question and get it right, and the very next question I might get wrong for thinking that far into the weeds.
 
Yeah, my uworld percentage is close to 80 now with 1/2 done and im still stuck in the 230-245 range on the NBMEs. Maybe the cake is a lie.
who knows?
Upperclassmen at my school have constantly reminded us going into dedicated that the NBMEs are still throwaway/retired/old questions from the exam and even though they are predictive on average, they don’t really simulate the same thought process/question format of the real deal like UWSA and UWorld do

I think the heterogeneity of how people use uworld results in its % score being a worse predictor (vs NBMEs where largely everyone takes them with the same constraints).
 
Upperclassmen at my school have constantly reminded us going into dedicated that the NBMEs are still throwaway/retired/old questions from the exam and even though they are predictive on average, they don’t really simulate the same thought process/question format of the real deal like UWSA and UWorld do

I think the heterogeneity of how people use uworld results in its % score being a worse predictor (vs NBMEs where largely everyone takes them with the same constraints).
I hope so. I would love a score in my uworld range and not my NBME average. Uworld is definitely more tricker than NBME which I felt is just testing content memory for the most part.
 
I hope so. I would love a score in my uworld range and not my NBME average. Uworld is definitely more tricker than NBME which I felt is just testing content memory for the most part.

Agreed. So many NBME questions are basically one liners that are straight memorization. I finished my last block with like 35 minutes left. I'm scheduled to take one of the new ones next so we'll see if they are any different.
 
So with this progression:

NBME16 (1.5 months ago): 252
NBME20 (3 weeks ago): 244
UWSA1 (1 week ago): 273
NBME18 (Yesterday): 257

I'm scheduled for about four weeks from now.
Would I be stupid to move it up to two weeks from now? Goal is 255+. I could get greedy and say I want 260, but that probably just depends on the form I get. I'm only 10ish days into dedicated. Looking at my mistakes on 18, it seems like there weren't huge knowledge gaps, and I got like 4 gimme ethics-type questions wrong.

I just need to know if I'm good to switch it to Threat Level Midnight.
 
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