USMLE Official 2020 Step 1 Experiences and Scores Thread

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Anyone know the difference between global payment and bundled payment? The description in FA 2020 makes them seem awfully similar. Google seems to suggest global payment is more or less capitation (or rather, capitation is the most common way global payments are implemented).

I’m not so sure about global payment, but I like to think of the PRK eye surgery I had. I paid the surgeon $$$ out of pocket and every follow up, drug, etc was paid for with that one payment.
 
I’m not so sure about global payment, but I like to think of the PRK eye surgery I had. I paid the surgeon $$$ out of pocket and every follow up, drug, etc was paid for with that one payment.

That fits my understanding of what a bundled payment is, ie, a fixed payment for a single episode of care (in your case, the PRK eye surgery).

Global payment's description in FA2020 doesn't clearly separate it form bundled payment, so I googled. What it seems to be is a payment method for a large no. of patients (such as an organization paying for its employees). The most common type of global payment is capitation.

Want to make sure this is correct before I commit it to memory.
 
Took nbme 22 today and that was a very stressful experience to say the least. 20 and 21 did not give me this much anxiety during the exam

My friend took NBMEs 20 & 22. He did pretty will (250s), but he says there were a bunch of questions and options that he had never heard of before and he wouldn't have gotten them right even if he studied a million years.

How do people go about this? Lets say option D of some question on an NBME mentions a condition that you haven't read anywhere. Are we supposed to read these from somewhere? Or work on the idea that knowing FA and UW well should be enough to rule out or in such choices by the process of elimination?
 
TFW you finish your 40th question thinking you just killed the block but you actually end up bombing it and you have to force yourself to mumble "UW is for learning, UW is for learning, UW is for learning" #feelsbadman

Lol just happened to me, thought I was going to see a solid 80% or something when I pressed submit, instead I see a sweet 63% starring me back in the face
 
Looking for some opinions... Keep in mind my goal score is a 250+ and my test date is currently July 17th

What I have done to date:
1) All of UWorld 1x pass with a ~77% average (83rd percentile)
2) About 3/5 of Amboss (84th percentile)
3) A little over half of Kaplan but I don't like it
4) About 2/3 or so of Rx
4) NBME 18, 19, 20, and 24

Since I've done a ton of questions already I realize I don't have enough left to make it through until my test date if I keep up at the pace I've been at. Because of this, I want to start doing content review to keep the info fresh. Also, since I have been so deep in questions for so long, I want to take a step back and brush up on the basics. I'm a bit odd in the way that I have never read FA, never watched BnB, and just started watching Pathoma this week for the first time. Most of my learning during preclinical has been via lectures and textbooks. I am about half way through the Pathoma videos and was planning on giving FA a full pass afterwards but the thought of reading FA is honestly making me sick lol. I've been trying to think of alternatives to get a comprehensive content review and was thinking maybe BnB. My only concern is that BnB is 120 hours of videos. I was planning on watching at 1.5x speed, which would equate to 80 hours. Additionally, BnB has questions (idk if there of good quality though?).

TLDR: For content review should I either: 1) Do a full read of FA; 2) Buy BnB and do a full pass at 1.5x speed; 3) Something else (NO ANKI though)
 
Looking for some opinions... Keep in mind my goal score is a 250+ and my test date is currently July 17th

What I have done to date:
1) All of UWorld 1x pass with a ~77% average (83rd percentile)
2) About 3/5 of Amboss (84th percentile)
3) A little over half of Kaplan but I don't like it
4) About 2/3 or so of Rx
4) NBME 18, 19, 20, and 24

Since I've done a ton of questions already I realize I don't have enough left to make it through until my test date if I keep up at the pace I've been at. Because of this, I want to start doing content review to keep the info fresh. Also, since I have been so deep in questions for so long, I want to take a step back and brush up on the basics. I'm a bit odd in the way that I have never read FA, never watched BnB, and just started watching Pathoma this week for the first time. Most of my learning during preclinical has been via lectures and textbooks. I am about half way through the Pathoma videos and was planning on giving FA a full pass afterwards but the thought of reading FA is honestly making me sick lol. I've been trying to think of alternatives to get a comprehensive content review and was thinking maybe BnB. My only concern is that BnB is 120 hours of videos. I was planning on watching at 1.5x speed, which would equate to 80 hours. Additionally, BnB has questions (idk if there of good quality though?).

TLDR: For content review should I either: 1) Do a full read of FA; 2) Buy BnB and do a full pass at 1.5x speed; 3) Something else (NO ANKI though)

If you watch a B&B video, you will see that he is covering everything that is in first aid for that topic. So you could essentially watch the videos and go through FA at the same time. Literally if you watch the videos and have FA open with it, you can see him going through all the main points
 
I haven't done it myself (ignorance is bliss), but apparently you can call your center and ask them to look at the roster for that day to find out if you're even or odd. Again, whether this even/odd thing is already completed or even a real thing is still a question.
Some centers will not tell you your seat number though
 
Looking for some opinions... Keep in mind my goal score is a 250+ and my test date is currently July 17th

What I have done to date:
1) All of UWorld 1x pass with a ~77% average (83rd percentile)
2) About 3/5 of Amboss (84th percentile)
3) A little over half of Kaplan but I don't like it
4) About 2/3 or so of Rx
4) NBME 18, 19, 20, and 24

Since I've done a ton of questions already I realize I don't have enough left to make it through until my test date if I keep up at the pace I've been at. Because of this, I want to start doing content review to keep the info fresh. Also, since I have been so deep in questions for so long, I want to take a step back and brush up on the basics. I'm a bit odd in the way that I have never read FA, never watched BnB, and just started watching Pathoma this week for the first time. Most of my learning during preclinical has been via lectures and textbooks. I am about half way through the Pathoma videos and was planning on giving FA a full pass afterwards but the thought of reading FA is honestly making me sick lol. I've been trying to think of alternatives to get a comprehensive content review and was thinking maybe BnB. My only concern is that BnB is 120 hours of videos. I was planning on watching at 1.5x speed, which would equate to 80 hours. Additionally, BnB has questions (idk if there of good quality though?).

TLDR: For content review should I either: 1) Do a full read of FA; 2) Buy BnB and do a full pass at 1.5x speed; 3) Something else (NO ANKI though)
So i have read several articles on going back to basics and doing so for longer than 2-3 weeks can cause your scores to drop. I would not stop doing questions for sake of content review. Keep up the questions-they are king. My test is July 14 shooting for 250+ as well and what im doing is 60 questions per day 5 days per week then one day per week doing content review only with no questions. this way i dont stop with questions and I get content review on my weaknesses weekly. I will do this until late may and then ramp up to 100 questions per day 6 days per week for 6-7 weeks. My advice is to find ur weaknesses on UW (the percentiles for each subject on the breakdown) and hit those. No need to rip all BnB just ur weak subjects. Deliberate practice on ur weaknesses until ur test date plus more questions youll pop a 270 man. Also what percent did u start UW at? Im half way thru with 75%ile but my goal is 83-85%ile which is what youre at. Is it possible to climb to that by time I finish u think?
 
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Looking for some opinions... Keep in mind my goal score is a 250+ and my test date is currently July 17th

What I have done to date:
1) All of UWorld 1x pass with a ~77% average (83rd percentile)
2) About 3/5 of Amboss (84th percentile)
3) A little over half of Kaplan but I don't like it
4) About 2/3 or so of Rx
4) NBME 18, 19, 20, and 24

Since I've done a ton of questions already I realize I don't have enough left to make it through until my test date if I keep up at the pace I've been at. Because of this, I want to start doing content review to keep the info fresh. Also, since I have been so deep in questions for so long, I want to take a step back and brush up on the basics. I'm a bit odd in the way that I have never read FA, never watched BnB, and just started watching Pathoma this week for the first time. Most of my learning during preclinical has been via lectures and textbooks. I am about half way through the Pathoma videos and was planning on giving FA a full pass afterwards but the thought of reading FA is honestly making me sick lol. I've been trying to think of alternatives to get a comprehensive content review and was thinking maybe BnB. My only concern is that BnB is 120 hours of videos. I was planning on watching at 1.5x speed, which would equate to 80 hours. Additionally, BnB has questions (idk if there of good quality though?).

TLDR: For content review should I either: 1) Do a full read of FA; 2) Buy BnB and do a full pass at 1.5x speed; 3) Something else (NO ANKI though)
How did you do the NBMEs?
 
So i have read several articles on going back to basics and doing so for longer than 2-3 weeks can cause your scores to drop. I would not stop doing questions for sake of content review. Keep up the questions-they are king. My test is July 14 shooting for 250+ as well and what im doing is 60 questions per day 5 days per week then one day per week doing content review only with no questions. this way i dont stop with questions and I get content review on my weaknesses weekly. I will do this until late may and then ramp up to 100 questions per day 6 days per week for 6-7 weeks. My advice is to find ur weaknesses on UW (the percentiles for each subject on the breakdown) and hit those. No need to rip all BnB just ur weak subjects. Deliberate practice on ur weaknesses until ur test date plus more questions youll pop a 270 man. Also what percent did u start UW at? Im half way thru with 75%ile but my goal is 83-85%ile which is what youre at. Is it possible to climb to that by time I finish u think?

Thanks man! That's interesting and definitely some good advice. I think then I'll start doing about 40-50q a day with a mix of BnB for the next month or so and then go back to mostly just the qbanks until my test date after that. For Uworld I don't quite remember the percentiles, but as for percent correct, after looking at my 'Graphs', it seems I started off in the high 60's, went up to about 73% after around 600qs and slowly crept up to 77% over the rest.

Also, did you do any of the questions for BnB? Are they complete crap or at least half-way decent?
 
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Thanks man! That's interesting and definitely some good advice. I think then I'll start doing about 40-50q a day with a mix of BnB for the next month or so and then go back to mostly just the qbanks until my test date after that. For Uworld I don't quite remember the percentiles, but as for percent correct, after looking at my 'Graphs', it seems I started off in the high 60's, went up to about 73% after around 600qs and slowly crept up to 77% over the rest.

Also, did you do any of the questions for BnB? Are they complete crap or at least half-way decent?
The BnB questions are ok but I wouldn't use them in place of actual Step 1 qbank questions. They aren't your typical qbank questions they are basically just to see if you got anything out of Dr. Ryans lecture. They are hard but they aren't vignette qbank style
 
looking for honest evaluation of where im at so far: 610 questions into UWORLD sitting at 71% correct, haven't done NBME yet (first one Sunday) or UWORLD practice tests yet. 5 weeks from test day
Bro u still got 2000+ UW questions to go yet. No doubt youll rip 240+ on real deal. You also still have 5 weeks thats a ton of time. Keep grindin brother
 
looking for honest evaluation of where im at so far: 610 questions into UWORLD sitting at 71% correct, haven't done NBME yet (first one Sunday) or UWORLD practice tests yet. 5 weeks from test day
i would highly suggest u finish uworld in like 2-2.5 weeks so u have the rest of the time for other exams+going over your weak areas.
 
Checking back in.

With the unknown of everything, my study schedule has flown out the door haha. Took off several days and honestly only did my anki cards. So I count that as a win.

Getting back on the horse tomorrow. Making a new schedule today.

Originally, I was planning on doing UW 3x. Will decide next week if this will still happen. I'm hesitant to totally redo my schedule because i'm holding out for a Sub-I in july that may be canceled (it is in philly which from my understanding is a borderline hotspot). The school still hasn't decided if its going to allow auditioners for july.
 
Checking back in.

With the unknown of everything, my study schedule has flown out the door haha. Took off several days and honestly only did my anki cards. So I count that as a win.

Getting back on the horse tomorrow. Making a new schedule today.

Originally, I was planning on doing UW 3x. Will decide next week if this will still happen. I'm hesitant to totally redo my schedule because i'm holding out for a Sub-I in july that may be canceled (it is in philly which from my understanding is a borderline hotspot). The school still hasn't decided if its going to allow auditioners for july.
Yo man I think doing UW 3x is honestly time you could be spending doing questions youve never seen before! Just my 2 cents- There are studies with strong evidence supporting the fact that new questions are superior to repeating questions. UW even 2x isn't as good as doing UW 1x plus Kaplan/Amboss 1x. People that do UW more than 2x end up coming out of the actual thing saying "omg it was nothing like the exam" because they were so used to doing the same questions they had seen 100x despite UW actually being the closest to the real thing than anything else (their brain just wasn't used to change). The more you simulate the unknown the better off you will be imho. Think of it as if you are an NBA player practicing for the NBA finals all year-you are going to have a lot of unexpected things come up during gameplay, so if you practice like prepping for these unexpected occurrences you are going to be able to handle them much better than others. This is what Michael Jordan did and why his teammates (and opponents) said was part of why he was so damn good. They all used to make fun of him for going "playoff game hard" in practice and he told them years down the line he practiced this way so that during the game he was always ready for the unknown and was able to outperform anyone under pressure. If it was me I would think about doing another bank on top of UW instead. If not no worries lol just figured id share
 
Hey guys!

My exam is scheduled for the 21 of july. Here in Greece prometric opened 4 days ago and there are many available dates for the exam since like 50 med students take step 1 each year. With that in mind I don't think I'm gonna have to reschedule.

When do you think is a good time to start taking the NBMEs? I have 500qs left in UW (69% average) and 600 in Rx.

Which NMBE do you suggest as a baseline?
 
Hey guys!

My exam is scheduled for the 21 of july. Here in Greece prometric opened 4 days ago and there are many available dates for the exam since like 50 med students take step 1 each year. With that in mind I don't think I'm gonna have to reschedule.

When do you think is a good time to start taking the NBMEs? I have 500qs left in UW (69% average) and 600 in Rx.

Which NMBE do you suggest as a baseline?
Id take one within the next 2 weeks to get a baseline. I took NBME 21 as a baseline just because it is hard but also not as hard or unfair as NBME 20 lol. The new NBMEs (20-24) are insanely underpredictive but they kind of light a fire under your ass. Leave NBME 16 for closer to test day since its very predictive. Honestly you are good with any of them really other than 20 (crapshoot) and 16 (too good to do this far out)
 
Id take one within the next 2 weeks to get a baseline. I took NBME 21 as a baseline just because it is hard but also not as hard or unfair as NBME 20 lol. The new NBMEs (20-24) are insanely underpredictive but they kind of light a fire under your ass. Leave NBME 16 for closer to test day since its very predictive. Honestly you are good with any of them really other than 20 (crapshoot) and 16 (too good to do this far out)

I think you mean NBME 18 right? (not 16)
 
Whats a 'good' percentage to see after you do a block of UWorld questions? I review all the questions regardless, but im curious as to what percentage correct on a block is like 'hey I did good on that one' is mid 70s good orrrrr
 
Whats a 'good' percentage to see after you do a block of UWorld questions? I review all the questions regardless, but im curious as to what percentage correct on a block is like 'hey I did good on that one' is mid 70s good orrrrr

My goal is always an 80. But I’m satisfied with mid to upper 70’s and very happy if I get above an 80. In the grand scheme things of though, mid 70s is very good if you consistently scoring in that range
 
Whats a 'good' percentage to see after you do a block of UWorld questions? I review all the questions regardless, but im curious as to what percentage correct on a block is like 'hey I did good on that one' is mid 70s good orrrrr
Mid 70s is solid man. If you are consistently hitting mid 70s I agree with @NotSoObvious its really good
 
Yo man I think doing UW 3x is honestly time you could be spending doing questions youve never seen before! Just my 2 cents- There are studies with strong evidence supporting the fact that new questions are superior to repeating questions. UW even 2x isn't as good as doing UW 1x plus Kaplan/Amboss 1x. People that do UW more than 2x end up coming out of the actual thing saying "omg it was nothing like the exam" because they were so used to doing the same questions they had seen 100x despite UW actually being the closest to the real thing than anything else (their brain just wasn't used to change). The more you simulate the unknown the better off you will be imho. Think of it as if you are an NBA player practicing for the NBA finals all year-you are going to have a lot of unexpected things come up during gameplay, so if you practice like prepping for these unexpected occurrences you are going to be able to handle them much better than others. This is what Michael Jordan did and why his teammates (and opponents) said was part of why he was so damn good. They all used to make fun of him for going "playoff game hard" in practice and he told them years down the line he practiced this way so that during the game he was always ready for the unknown and was able to outperform anyone under pressure. If it was me I would think about doing another bank on top of UW instead. If not no worries lol just figured id share
Just realized i'm on the step 1 forum and i'm taking step 2 haha.
Thanks for the insight though!
 
Reporting back in for those of us that aren't >10% above average % correct!

65% first pass UWorld, took a week of Anki/other content. Now going to start my 1000 incorrects today.
NBME 18 in the last week was 223. What a tough exam!
Step and COMLEX are late June.

Good stufff, with that much time left before the real deal you are in good shape Id think
 
15-20 i heard

Seems to be the consensus on all the new NBMEs. Saw a post on Reddit today from someone who took it this week and they said it was harder than UWorld but easier than the new NBMEs. Apparently the question stems were like UWorld but the answer choices could be a bit weird like the NBMEs. They also apparently had a lot of micro and pharm on their form.
 
Seems to be the consensus on all the new NBMEs. Saw a post on Reddit today from someone who took it this week and they said it was harder than UWorld but easier than the new NBMEs. Apparently the question stems were like UWorld but the answer choices could be a bit weird like the NBMEs. They also apparently had a lot of micro and pharm on their form.
Damn dude harder than UW? Ive heard a lot of people say it was easier or just as hard but never harder and not a single person said as hard as NBMEs. If its harder than UW i'll most likely have a panic attack lol
 
Damn dude harder than UW? Ive heard a lot of people say it was easier or just as hard but never harder and not a single person said as hard as NBMEs. If its harder than UW i'll most likely have a panic attack lol

It's just one person's opinion but I've seen several people say that they thought it was a mix between UWorld and the new NBMEs, leaning slightly more towards UWorld. This person said the question stems were very UWorld-like but the answer choices could be tricky like the NBMEs. They also said there was a lot of basic First Aid recall too and it was more straightforward than they were expecting.
 
They also said there was a lot of basic First Aid recall too and it was more straightforward than they were expecting.
+1. The "hard" questions for me were all extremely straightforward flashcard factoids that I simply didnt know, like "which CYP subfamily metabolizes Drug X"

Not nearly as much of that in uworld, but it's all over the real deal
 
+1. The "hard" questions for me were all extremely straightforward flashcard factoids that I simply didnt know, like "which CYP subfamily metabolizes Drug X"

Not nearly as much of that in uworld, but it's all over the real deal
You did say several posts back you thought overall real thing was slightly easier than UW right?
 
You did say several posts back you thought overall real thing was slightly easier than UW right?
I think I called it "more straightforward" because it was actually harder for me, lots of factoids I simply hadn't memorized. But for friends who had committed Zanki to memory, it was a breeze. Every single one of them scored 260-270.
 
I think I called it "more straightforward" because it was actually harder for me, lots of factoids I simply hadn't memorized. But for friends who had committed Zanki to memory, it was a breeze. Every single one of them scored 260-270.
Damn that sounds nothing like Step to me lol Step is no longer the factoid exam it once was in the 2000s. I guess thats one exam on one day but thats Interesting
 
Damn that sounds nothing like Step to me lol Step is no longer the factoid exam it once was in the 2000s. I guess thats one exam on one day but thats Interesting
By design, the vast majority of questions are a slam dunk that any American physician who is safe to practice medicine should be able to get right to be licensed. Remember, our absolutely bottom of the barrel scores who barely passed are still getting ~70% right.

The other ~30% is what actually differentiates people across the entire 195-270 interval, and so those handful of 1-2 factoid questions per block become a distinguishing feature of high scorers.

That's why Anki will never ever be needed for a solid Pass, but has become de facto required for 260+
 
+1. The "hard" questions for me were all extremely straightforward flashcard factoids that I simply didnt know, like "which CYP subfamily metabolizes Drug X"

Not nearly as much of that in uworld, but it's all over the real deal

When youre sitting here reading this and cant even think of another CYP subfamily other than P450

Screen Shot 2020-05-02 at 7.18.33 PM.png
 
By design, the vast majority of questions are a slam dunk that any American physician who is safe to practice medicine should be able to get right to be licensed. Remember, our absolutely bottom of the barrel scores who barely passed are still getting ~70% right.

The other ~30% is what actually differentiates people across the entire 195-270 interval, and so those handful of 1-2 factoid questions per block become a distinguishing feature of high scorers.

That's why Anki will never ever be needed for a solid Pass, but has become de facto required for 260+

Do you mean like carbamazepine is cyp3a4 indeucer ans warfarin is metabolized by cyp2c9 type of stuff?
 
By design, the vast majority of questions are a slam dunk that any American physician who is safe to practice medicine should be able to get right to be licensed. Remember, our absolutely bottom of the barrel scores who barely passed are still getting ~70% right.

The other ~30% is what actually differentiates people across the entire 195-270 interval, and so those handful of 1-2 factoid questions per block become a distinguishing feature of high scorers.

That's why Anki will never ever be needed for a solid Pass, but has become de facto required for 260+
I personally think number of questions done and reviewed is superior to anki. Every single high scorer I personally know never touched anki but did do at least 7000 unique questions by the time they took the exam. Some did 10K. My step 1 tutor personally did 7500 himself and he swears by this theory. Its not that anki is bad its that its not required to get a high score
 
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