USMLE Official 2019 Step 1 Experiences and Scores Thread

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libertyyne

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Lets get this started.
M2. Mid Tier everything.
Entertaining some surgical sub-specialties.

Goal 270
Happy with 245

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@Gurby

Are you doing Zanki pharm or Pepper or something different? I think I'm going with Pepper micro and Zanki pharm. Was just wondering about your approach to bugs / drugs?

I'm honestly not really sure what I'm using... I'm doing the regular Zanki pharm/micro, and then I downloaded at least 1 more deck last year (maybe Pepper and/or Torky, not sure). I have like 4k pharm cards and 6k micro cards. It's a giant mess and I probably won't get through all of them.

Right now my approach is to do qbank questions, then when I hit a bug/drug I don't know I search and move all the relevant cards to my "sorted out to learn" subdeck. I'll also sometimes hit wikipedia and/or copy/paste from Kaplan explanations to make some of my own cards. This is definitely the biggest drain on my time - it seems like there is an endless list of bugs and drugs with long complicated names to keep track of.

For all the debate over which Anki deck is best, more and more I'm feeling like in the end it doesn't really matter. I can't imagine having large knowledge holes if you go through all of Rx+Kaplan+UW+NBME's and are thorough about adding cards when you encounter new material.
 
I'm very interested to see what our NBME will be like this time around.

At my school, they also pick questions that are only covered in lecture for the NBME, and the local exams are pretty much all minutiae, with Zanki helping to maybe pass, but certainly not to excel.

We only had one last NBME last year which I was ~1.75 SD above mean. I'm guessing that number will also trend downwards for me on this upcoming one, to more about 1 SD, because SO MANY people are doing board prep resources now, especially Zanki.

It makes me think that the high 250s and low 260s of last year with Zanki will now be the high 240s and low 250s of this year with Zanki, if they scale it back so we have the same average of 229/230. That or we get those same high board scores but the percentiles are much lower.
 
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I have also recently switched from being >2SD above average to more like >1SD above average on NBME subject exams. However, my overall scores on the exams have gotten higher and I still score within two-three points of the highest scorer. My classmates have all stepped up their boards prep with pathoma, sketchy, and first aid so the average has been brought up a decent amount. It's not really possible to score over 2 standard deviations better than my classmates unless I get close to a perfect score. A similar thing might be happening in your class?

At least for my school, the professors have selected the questions for the NBME exams prior to the course even starting. Therefore, they will highlight and emphasize their teaching points during lecture to those questions that they have selected for the final. Lecture-goers will probably have a slightly inflated score because of this.
Our NBME's are nationally scored, so the people I am competiting against is the same. Our NBME's are standard and not selected by professors. Which is why it is even weirder. My score in the class is the same ( which just goes to show how poorly on average my class is doing compared to the nation.
 
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5k Zanki cards matured (I reset my progress over the summer), with most of the cards being path. Doing 1000 reviews a day is pretty draining, but still pushing onwards. Also have been doing drastically above average in my path exams, so I hope that is a plus! Also ~200 questions done for Rx and ~ 60 done for Kaplan. Will buy Uworld prob over Xmas break.
 
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Hopping on this train! Taking the test sometime in mid-April! I go to a UC (cali) school!

Shoot for the stars goal: 260
Will be happy with: 240

Good luck to everyone!
 
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5k Zanki cards matured (I reset my progress over the summer), with most of the cards being path. Doing 1000 reviews a day is pretty draining, but still pushing onwards. Also have been doing drastically above average in my path exams, so I hope that is a plus! Also ~200 questions done for Rx and ~ 60 done for Kaplan. Will buy Uworld prob over Xmas break.

How do the Rx questions feel compared to Kaplan?
 
How do the Rx questions feel compared to Kaplan?

Much more simple but also high yield. I just wish the question blocks were divided up better, like how they divide First Aid up.
 
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Much more simple but also high yield. I just wish the question blocks were divided up better, like how they divide First Aid up.
Does the Kaplan bank organize its questions better, where I can better narrow in on a subtopic, even if they're aren't many questions related to it?
 
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Just a heads up to the do Bros here

To save you some time don’t waste time or money on combank or comquest except for a few omm questions.


They are grossly inferior and error ridden. We had to use combank for mandantory quizzes in second year and it was a waste of time.

Bought comquest for comats and wow it’s almost as terrrible as combank. Literally every 5 questions I have to comment on a question and wonder if they even have real physicians writing these questions. Glad I didn’t waste money on it during step 1 season. Wish I could get a refund lol

Uworld plus or minus rx al the way
 
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Just a heads up to the do Bros here

To save you some time don’t waste time or money on combank or comquest except for a few omm questions.


They are grossly inferior and error ridden. We had to use combank for mandantory quizzes in second year and it was a waste of time.

Bought quest for comats and wow it’s almost as terrrible as combank. Glad I didn’t waste money on it during step 1 season.

Uworld plus or minus rx al the way

Did you use Comquest?
 
Did you use Comquest?


No. But am using for comats and it’s pretty error filled. Not to extent of bank but it does not agree with UpToDate or NLM on a lot of things or uworld, etc.
Plus they don’t source anything so literally banging head on wall here studying for comats haha


Somehow I doubt their level one product is much better
 
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100% disagree. Loved comquest for both level 1 and my shelfs so far. Got around a 600 and have honored each shelf exam. In fact, I thought comquest was a better use of my time for level 1 than uworld.

You must be missing out on these errors. I’ve honored all mine so far also but it isn’t due to comquest lol. Everyone I know in the 750+ club including myself said uworld was the most helpful on comlex (and of course step)
 
:rolleyes: O i totally am. You do know uworld has errors too, right? Lol. I've found quite a handful that directly disagree with uptodate. Mostly about kidney/ abdominal imaging and abx. But, you're right, how could a pleb like me match up to the 75o club. I forgot sdn is mainly for the elite circle jerks: my apologies.

It’s not elitist to say a question bank isn’t great
There is also a different between disagreeing and pants on fire wow wrong questions.
The DO question banks are at the fake news level

People want to know how to make the most of their time and ask which banks to use soooo.


More than one way to skin a cat but I’d rather not skin mine with the dull rocks called combank and comquest
 
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It is elitist to blindly accept errors in one, while diminishing said errors, while ignoring errors in the other, so much so to build a strawman on something the opponent never even said. Sounds kinda like psychosis to me. At any rate, I disagree about comquest but apparently you only consider those with a 750+ to be worthy of your two-sided brainwaves (see first sentence for understanding). I'll bow out, o great one :bow:

I found like one or two out of 2500qs on uworld and They were equivocal. Do you work for comquest you seem pretty salty about somebody dissing them lol
 
They sell us a lie by saying we need to prep for comlex with comlex specific stuff lolz
I mean who actually believes anything the NBOME/AOA/admin would say anyways? Naive people and people living under a rock? Who gives a **** what you get on the Comlex anyways.

But enough about that test. This is the USMLE thread, after all.
 
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I mean who actually believes anything the NBOME/AOA/admin would say anyways? Naive people and people living under a rock? Who gives a **** what you get on the Comlex anyways.

But enough about that test. This is the USMLE thread, after all.

Haha good point. Still waiting on that 2019 comlex thread to pop up a week before deadline since everyone forgets about it until then
 
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So I'm averaging about 1k reviews+news per day, set to 150 news per day. Its definitely causing me to fall behind in classes lol, any suggestions on what to do to free up some more time while chipping through zanki? Considering setting a max review or just lowering my new cards to 100 or so on class heavy weeks. I feel I'm just not efficient enough at the moment, can never seem to finish the cards, practice qs, and classwork I want done each day. Hoping I get get faster at cards/reviewing qbanks because this just doesnt feel sustainable with classwork, at least with how well I want to be doing in class.

Hope everything is going well for y'all, we got this :horns:
 
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So I'm averaging about 1k reviews+news per day, set to 150 news per day. Its definitely causing me to fall behind in classes lol, any suggestions on what to do to free up some more time while chipping through zanki? Considering setting a max review or just lowering my new cards to 100 or so on class heavy weeks. I feel I'm just not efficient enough at the moment, can never seem to finish the cards, practice qs, and classwork I want done each day. Hoping I get get faster at cards/reviewing qbanks because this just doesnt feel sustainable with classwork, at least with how well I want to be doing in class.

Hope everything is going well for y'all, we got this :horns:
One thing I would recommend is varying your number of news each day based on your workload for the day. Some days I can do 300 new cards and some days I can only do 75 or something. Prioritize unlocking new cards on current class material (duh) and absolutely do not sacrifice doing your reviews. Get up in the morning and do reviews to start your day. Get them done. That is the whole point of anki. If you absolutely feel like you need to prioritize other things to Zanki for whatever reason, make sure you do cards on the things you are weakest in (duh) over trying to complete the cardiac embyology deck for example. Obviously doing all this without doing questions is pointless and you will have to figure out how to do more questions and less anki. I would consider adding that focus add-on some people use. Perhaps you are taking way too long on each card.
 
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One thing I would recommend is varying your number of news each day based on your workload for the day. Some days I can do 300 new cards and some days I can only do 75 or something. Prioritize unlocking new cards on current class material (duh) and absolutely do not sacrifice doing your reviews. Get up in the morning and do reviews to start your day. Get them done. That is the whole point of anki. If you absolutely feel like you need to prioritize other things to Zanki for whatever reason, make sure you do cards on the things you are weakest in (duh) over trying to complete the cardiac embyology deck for example. Obviously doing all this without doing questions is pointless and you will have to figure out how to do more questions and less anki. I would consider adding that focus add-on some people use. Perhaps you are taking way too long on each card.

Hmm thats a good idea, ill try and be more flexible with my new count and look into the focus add on. Some days i can fly through cards, other days definitely takes a little while longer per card which ends up making a big difference. Hoping if I just keep at it my attention span will get better over time lol
 
Hmm thats a good idea, ill try and be more flexible with my new count and look into the focus add on. Some days i can fly through cards, other days definitely takes a little while longer per card which ends up making a big difference. Hoping if I just keep at it my attention span will get better over time lol
Are you taking breaks? Some days I absolutely have to do the cards pomodoro style and other days I can do 500 cards without looking up from the screen. Sometimes I will do 200 reviews and then switch from pc to phone or vice versa just to change something up.
 
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Sometimes I take breaks too frequently, other times not at all. It would probably be beneficial for me to pick up something similar to pomodoro, what timing does you typically use for work/break?
 
Sometimes I take breaks too frequently, other times not at all. It would probably be beneficial for me to pick up something similar to pomodoro, what timing does you typically use for work/break?

I haven't ever used flashcards, so I don't know if this works out the same with flashcards as it does with regular studying, but I'm an avid Pomodoro user. I started with 25/5 but I found out I was starting and stopping too frequently for my liking. Switched to 50/10 and now I swear by it. It's really helpful to add a longer break, let's say 30-45 mins every 4 Pomodoros. I 've been on my "dedicated" for 8 weeks now and I'm cranking out 10 and 11 hour studying days easily on a daily basis. I 've also used this for the last 2 years in med school and it actually had a significant positive impact on my grades. This comes from a guy who used to study 2-3 hours continuously until feeling cloudy af, then taking hour/2 hour long breaks and barely managing to get 6-7 hours in a good day back in the early days of med school.
 
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I haven't ever used flashcards, so I don't know if this works out the same with flashcards as it does with regular studying, but I'm an avid Pomodoro user. I started with 25/5 but I found out I was starting and stopping too frequently for my liking. Switched to 50/10 and now I swear by it. It's really helpful to add a longer break, let's say 30-45 mins every 4 Pomodoros. I 've been on my "dedicated" for 8 weeks now and I'm cranking out 10 and 11 hour studying days easily on a daily basis. I 've also used this for the last 2 years in med school and it actually had a significant positive impact on my grades. This comes from a guy who used to study 2-3 hours continuously until feeling cloudy af, then taking hour/2 hour long breaks and barely managing to get 6-7 hours in a good day back in the early days of med school.
judging by your name , are you sure it wasnt just a b12 deficiency?
 
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Which schools actually use only NBME, by the way? Curious.


I'll be joining you the moment we get through neuro, it's heavily PhD based and I'll fail if I am not substituting my cards with heavy doses of lectures lol. The rest of the semester slows down a bit and I'll be jumping head first into the full time Zanki life.

Had to take a break from the real s**t (qbanks/anki) during both Neuro and GI. It was depressing.
 
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Sometimes I take breaks too frequently, other times not at all. It would probably be beneficial for me to pick up something similar to pomodoro, what timing does you typically use for work/break?
I'm a 5 minute break every 45-50 min guy when I know I need to do pomodoro that day. Get up. Don't get on the computer or whatever for your break. That just isn't a real get your body moving and refreshed break.
 
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Which schools actually use only NBME, by the way? Curious.




Had to take a break from the real s**t (qbanks/anki) during both Neuro and GI. It was depressing.
my school uses both. The class below us only use NBME. Plenty of schools have transitioned this way. There is a school out there that straight up just uses CBSSE every quarter and only does quizes besides that from the start.
 
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my school uses both. The class below us only use NBME. Plenty of schools have transitioned this way. There is a school out there that straight up just uses CBSSE every quarter and only does quizes besides that from the start.

Damn, makes me even more jaded.
 
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Damn, makes me even more jaded.
Most of the NBME's were first maybe second order and a reasoning question or two. The Pharm one tho, After i finished, I was touched by how beautifully the questions were written. Straight up third order all day requiring integration from path, phys, antomy, micro , and biochem. It is what I imagine step 1 will be like.
 
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We finally got the results of our last NBME back, and it's worse than expected with cherry-picked questions by faculty (direct fact-based recall, maybe 10% single-step of logic, only 1-2 questions that were head-scratchers). The test was so bad (in that everyone crushed it) that we couldn't even get a second standard deviation out of it, or our class grades.

I have no idea how prepared I am thus far for step, only that I'm doing well in classes. My best estimate at this point is my confidence when reviewing FA and my Rx % correct.

Anyone else feeling in the dark? Or have suggestions on how to self-evaluate?

I was hoping to delay using UWorld until later, and official NBMEs certainly, because we haven't yet covered all the material
 
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Damn, makes me even more jaded.
Yeah, my questions are like "remember that fuzzy caption on slide 54 that I skipped after talking for 30 minutes on this one particularly important point that absolutely won't be tested on? Yeah, so what page is this referenced in the JAMA article I linked?"

I can only imagine how easy school would be with real exams and not PhD bull****. At least my physician instructors write questions that aren't absolutely garbage even if they still aren't super well-written. It's stupid that Q-banks have easier questions than my school exams.
 
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Yeah, my questions are like "remember that fuzzy caption on slide 54 that I skipped after talking for 30 minutes on this one particularly important point that absolutely won't be tested on? Yeah, so what page is this referenced in the JAMA article I linked?"

I can only imagine how easy school would be with real exams and not PhD bull****. At least my physician instructors write questions that aren't absolutely garbage even if they still aren't super well-written. It's stupid that Q-banks have easier questions than my school exams.

Hahahaha that’s how our first year exams were. So far, second year exams have been MUCH better.
 
Does the Kaplan bank organize its questions better, where I can better narrow in on a subtopic, even if they're aren't many questions related to it?

I would say so. When I separate Rx questions by organ system, it still gives me the occasional random WTF did this come from question, half the time being something my curriculum hasn't covered yet. Of course Kaplan is also guilty of this, but to a much less degree. When I separate Kaplan Q's by organ system, I more or less feel most of the questions are well separated.

With that said, Rx is still better content-wise and I would prioritize those. But Kaplan has a better interface and the questions can be quite challenging, if you're up to the task.
 
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my school uses both. The class below us only use NBME. Plenty of schools have transitioned this way. There is a school out there that straight up just uses CBSSE every quarter and only does quizes besides that from the start.
Why do you think schools don't just use nbme questions? What is the point of the faculty developed questions if they aren't helpful in developing the higher order reasoning that step desires?
 
Why do you think schools don't just use nbme questions? What is the point of the faculty developed questions if they aren't helpful in developing the higher order reasoning that step desires?
they are expensive. It encourages students to only focus on board studying vs studying extra stuff in the curriculum. Students dont learn what they got wrong.

Faculty questions dont have to be bad, and in fact are written by comittees of faculty members and course directors at our school. My school's questions have probably been the same for the past 30 years. You have to learn the basics before you can do higher order questions , and the faculty questions are often designed to randomly test the depth of your knowledge. I am convinced my schools exams are created to generate curves where a 70 is possible by good understanding alone.
 
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they are expensive. It encourages students to only focus on board studying vs studying extra stuff in the curriculum. Students dont learn what they got wrong.

Faculty questions dont have to be bad, and in fact are written by comittees of faculty members and course directors at our school. My school's questions have probably been the same for the past 30 years. You have to learn the basics before you can do higher order questions , and the faculty questions are often designed to randomly test the depth of your knowledge. I am convinced my schools exams are created to generate curves where a 70 is possible by good understanding alone.

My school also has faculty-written exams and my theory is that they know students will use board materials and that will prepare them for at least 60-70% of Step 1, period, so the faculty tries to prepare us for the rest of the exam. So we get lectures and many questions focused on diagnostic and treatment approaches, "next best step," followup, etc and current clinical practices that you can't find in board materials along with random questions on knowledge depth like yours.
 
Does anyone have experience using a β-blocker for performance anxiety on test day? I'm seriously considering trying it.

Edit: wording.
 
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Does anyone have experience using a β-blocker for performance anxiety on test day? I'm seriously considering trying it.

Edit: wording.

arent there memory issues with that?

upload_2018-10-15_15-3-37.jpeg
 
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arent there memory issues with that?

I would think any memory issues would be much less significant than the effects of anxiety on someone who is anxious enough to be thinking about taking beta blockers for a test. They are widely used in the classical music/audition scene to great effect for many people.

I imagine you might want to study while on BB's too, to preserve that state-dependent memory?

Worth talking to the school's education department sooner rather than later if you're seriously considering this.
 
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I would think any memory issues would be much less significant than the effects of anxiety on someone who is anxious enough to be thinking about taking beta blockers for a test. They are widely used in the classical music/audition scene to great effect for many people.

I imagine you might want to study while on BB's too, to preserve that state-dependent memory?

Worth talking to the school's education department sooner rather than later if you're seriously considering this.
I suppose the reason I brought that up was one of the well known side effects of beta blockers. That being said, I personally would require a lot of evidence of efficacy in this context or lots of personal trials of the medication in the context of exams before even thinking about using it in such a manner. I do understand that they might be great for performance in other contexts that are dependent on muscle memory compared to the cerebral nature of taking a step exam. That being said, I think the appropriate first line would be cognitive behavioral therapy and other psychoeducation, mindfulness training etc , which is less chemically dependent and more focused on training. I say this with the personal experience of having terrible anxiety during the mcat where my first section was 4 points below my average on other sections. But iwould take everything I say with a grain of salt considering I am merely an m2.
 
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How important do you guys think it is to know how to calculate metabolic disturbances in acid-base disorders? Have any of you encountered a test/Qbank question that needed it? Winters formula is necessary, for sure, but I don't know if the compensation formulas for respiratory acidosis/alkalosis, acute/chronic, metabolic alkalosis, delta-delta, blah blah blah are worth knowing.
 
How important do you guys think it is to know how to calculate metabolic disturbances in acid-base disorders? Have any of you encountered a test/Qbank question that needed it? Winters formula is necessary, for sure, but I don't know if the compensation formulas for respiratory acidosis/alkalosis, acute/chronic, metabolic alkalosis, delta-delta, blah blah blah are worth knowing.

Delta-Delta is worth knowing. As for the other ones nah. Winter formula is all I’ve needed for the Q Banks.
 
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NON US IMG, 4 MONTHS OUT
GOAL 250+
NBME 13 10/20: 153 ( How on earth can i achieve an 100 point increase:( )
taking another test a month from now, lets see what that brings.
Good luck everyone.

MATERIALS: BB, UWORLD, FA, PATHOMA, SKETCHY MICRO.
 
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Hey guys, Having a beast of a time memorizing cytokines, and the intracellular signaling molecues Ras, MTOR, Kinases, and genes associated with it. Any suggestions? I know them for a few hours and then when I hit those cards again I am like a lost puppy.

Any good videos explaining them that can help? or resources? flow charts etc?
 
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Hey guys, Having a beast of a time memorizing cytokines, and the intracellular signaling molecues Ras, MTOR, Kinases, and genes associated with it. Any suggestions? I know them for a few hours and then when I hit those cards again I am like a lost puppy.

Any good videos explaining them that can help? or resources? flow charts etc?


I drew them up on a few sheets of paper and put them on the wall above my desk. I stared at them a little bit every day and eventually (weeks/months later) they finally stuck. did this for the insulin/glucagon pathway too
 
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