Serious Question: Why doesn't everyone do well on Step 1?

[stickgirl390]

2021 EDIT: I made this post prior to taking step 1. Having taken the beast of a test at this point, I take back all my comments/questions. Preparing for and taking the test is an experience that can’t be understood until you actually do it yourself.

I've seen a lot of threads about how to score 250+ on Step 1. Pretty much everyone says maturing Zanki and completing UWorld before dedicated does the trick, and there has even been formal research done that supports this.

My question is, if the formula for success is so black and white, how come everyone doesn't score 250+? What are the reasons students do poorly, or simply "average" on Step?

EDIT:

I didn’t mean for this thread to be about Zanki specifically. There are multiple threads about what to do when preparing for step. I was hoping we could make a thread about common pit-falls students make when preparing for Step that ends up hurting them. Ex: not doing enough practice full lengths, etc.

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[paradoxic_toxic]

Some people just suck at taking standardized tests.

 

[Type2Fiber]

I've seen a lot of threads about how to score 250+ on Step 1. Pretty much everyone says maturing Zanki and completing UWorld before dedicated does the trick, and there has even been formal research done that supports this.

My question is, if the formula for success is so black and white, how come everyone doesn't score 250+? What are the reasons students do poorly, or simply "average" on Step?

Why doesn't everyone bench press 400 pounds?

 

[Mass Effect]

Because Step 1 isn't truly a standardized test of knowledge everyone attains in MS 1 and MS 2. If it was, testing companies wouldn't be filthy rich on the backs of medical students paying with loan money to learn "tricks" to ace the exam and people wouldn't need 8 weeks of "dedicated time" in order to master and re-master UWorld and 10 other q-banks.

The standardized testing business is out of control in this country and I'm not talking about just medical education.

 

[stickgirl390]

Some people just suck at taking standardized tests.

So someone could mature zanki, complete 3,000+ practice questions, and still only pull 210 simply because they "suck at taking tests"?

I meant more like, do students not take preparing seriously? Are there that many people that wait until dedicated to prepare?

 

[CyrusHabs7695]

Also SDN population isn't the norm. If you think your entire class is maturing Zanki + hitting uWorld 1.5-2x you would be wrong

 

[stickgirl390]

Because Step 1 isn't truly a standardized test of knowledge everyone attains in MS 1 and MS 2.

Can you elaborate on this part?

 

[bahdahboom]

I've seen a lot of threads about how to score 250+ on Step 1. Pretty much everyone says maturing Zanki and completing UWorld before dedicated does the trick, and there has even been formal research done that supports this.

My question is, if the formula for success is so black and white, how come everyone doesn't score 250+? What are the reasons students do poorly, or simply "average" on Step?

Lol um by nature of the definition of a standarized exam... everyone cannot "do well." The score stratifies according to performance. Even if everyone scored within a few percentage points of each other, the highest scorers would still get the 250+.

 

[stickgirl390]

Also SDN population isn't the norm. If you think your entire class is maturing Zanki + hitting uWorld 1.5-2x you would be wrong

I agree with this and know it to be the case. My question is, why? It's a career deciding exam; why isn't everyone treating it as such?

 

[Chelsea FC]

I've seen a lot of threads about how to score 250+ on Step 1. Pretty much everyone says maturing Zanki and completing UWorld before dedicated does the trick, and there has even been formal research done that supports this.

My question is, if the formula for success is so black and white, how come everyone doesn't score 250+? What are the reasons students do poorly, or simply "average" on Step?

Zanki is a hard, long soul sucking process that most people dont keep up with. It's not easy to do much less to do it so well to mature it all. Nobody wants to do 1000 cards on Thanksgiving. Nobody wants to be doing cards the morning of Christmas the day of your best friends wedding. Zanki sucks and noone really enjoys doing it.

 

[slowthai]

I agree with this and know it to be the case. My question is, why? It's a career deciding exam; why isn't everyone treating it as such?

Everyone has different goals. Some people might want family medicine in the Appalachian mountains. Some might want derm at Harvard.

 

[stickgirl390]

Thanks for the responses everyone.

 

[ExplodingUlcers]

I agree with this and know it to be the case. My question is, why? It's a career deciding exam; why isn't everyone treating it as such?

A lot of people at my school don't use it due to a combination of factors. Some simply don't find the whole cloze deletion effective while with others it stems from the anxiety that you won't be covering everything in class or covering too much material that won't be tested in the immediate short term.

After doing Zanki for a while now, I can sympathize with the second point. Committing to Zanki requires you to take charge of your own education and not become reliant on the school's curriculum. If you see a card that you don't recognize from class, do you suspend it or put in the time to learn where it fits in your medical knowledge eventhough it wasn't covered on top of staying on top of passing?

However, why people don't believe in Anki and the power of spaced repetition is still beyond me. Even the people who only focused on lectures and killed it on step 1 made their own Anki cards and were huge proponents of it.

Sent from my SM-G955U using SDN mobile

 

[AnatomyGrey12]

Not everyone does those things. I would say the average medical student actually doesn't do those things.

 

[slowthai]

Not everyone does those things. I would say the average medical student actually doesn't do those things.

Yeah, I think we overestimate the amount of people that are on Zanki, let alone the amount of people that actually use it correctly.

 

[CyrusHabs7695]

Yeah, I think we overestimate the amount of people that are on Zanki, let alone the amount of people that actually use it correctly.

Way over-estimate. Of the small amount of people who actually use it, like 1% actually use it correctly. Most people will finish a module then just suspend those cards, which defeats the entire point of it lol

 

[Chelsea FC]

Yeah, I think we overestimate the amount of people that are on Zanki, let alone the amount of people that actually use it correctly.

I feel alot of people use zanki, because people who do talk about it alot and then people feel pressured into doing it. But very very few keep up with it and stuck it out.

 

[Goro]

I've seen a lot of threads about how to score 250+ on Step 1. Pretty much everyone says maturing Zanki and completing UWorld before dedicated does the trick, and there has even been formal research done that supports this.

My question is, if the formula for success is so black and white, how come everyone doesn't score 250+? What are the reasons students do poorly, or simply "average" on Step?

Did you ever take statistics???

Look up "bell shaped curve".

Med students are very bright, but they're not all MENSA material.

It's a career deciding exam; why isn't everyone treating it as such?

Why would you think that they're not???

 

[ak427]

Piggybacking off this, what percentage of students in your class do you think are using Zanki? I’d wager mine is pretty high as an M1, but going to drop significantly as the reviews pile up

 

[AnatomyGrey12]

Piggybacking off this, what percentage of students in your class do you think are using Zanki? I’d wager mine is pretty high as an M1, but going to drop significantly as the reviews pile up

Many start, few finish.

 

[Cranjis McBasketball]

Piggybacking off this, what percentage of students in your class do you think are using Zanki? I’d wager mine is pretty high as an M1, but going to drop significantly as the reviews pile up

Basically everyone in my class uses the anki app. Half probably use Zanki cards for the block we are in, but I could probably count on one hand how many people keep up with all their cards every single day and are on pace to mature most of them by dedicated. Most of my classmates just suspend the cards after the block. For reference I am a 2nd year

 

[libertyyne]

Way over-estimate. Of the small amount of people who actually use it, like 1% actually use it correctly. Most people will finish a module then just suspend those cards, which defeats the entire point of it lol

You don't need to use it correctly to score 250+. Just need to use it .


A few observations for OP.
1. people have different goals. Some people want a 230 and want to move on with their life, trying to replace the trauma of preclinical with the trauma of clinical years.
2. Some people don't realize how important step one is. I had a classmate tell me the other day they were interested in neurosurgery with a 210.
3. Maturing zanki and doing so many questions is not an easy effort, and it is a marathon, that not everyone is willing to get on board with.
4. The evidence for zanki doesn't really exist, the evidence does say that doing more unique questions and higher number of flashcards does increase score.
5. Even with maturing zanki and doing those things people can have bad test days. A friend of mine ended up with a 240 after busting his behind.
6. A very small amount of people actually put in the effort required to get 250 + you can identify these people by looking into their eyes and seeing the life draining over the span of preclinical even before the start of dedicated.
7 . Not everyone likes anki or can even stand it. I recently converted 3-4 people to it in m3!!!

 

[Lawpy]

Yeah, I think we overestimate the amount of people that are on Zanki, let alone the amount of people that actually use it correctly.

I feel alot of people use zanki, because people who do talk about it alot and then people feel pressured into doing it. But very very few keep up with it and stuck it out.

It still feels like Zanki is a bit overrated on here even though it's a good tool. Some people learn far more by doing a lot of practice questions and thus crush Steps without using Zanki.

 

[slowthai]

It still feels like Zanki is a bit overrated on here even though it's a good tool. Some people learn far more by doing a lot of practice questions and thus crush Steps without using Zanki.

I don't think it's overrated at all, provided you have the focus and discipline to use it properly. I know I'm not talented enough to do extremely well on step without Zanki, lol.

I believe doing both Zanki and loads of questions is a winning formula. That's what I'm doing/plan to do.

 

[slowthai]

You don't need to use it correctly to score 250+. Just need to use it .

Can you expand on this?

 

[libertyyne]

Can you expand on this?

The purpose of anki is to remember stuff . Not to mature a deck. If you can abuse anki to remember the stuff you need to, not maturing anki is not a deal breaker.
I used anki during classes, made my own cards and went through 3-5 passes of zanki in the block. I wouldn't look at the cards again till breaks or dedicated. It's much easier to learn them the second time around . I would even only focus on decks where I was weak in dedicated.

 

[slowthai]

The purpose of anki is to remember stuff . Not to mature a deck. If you can abuse anki to remember the stuff you need to, not maturing anki is not a deal breaker.
I used anki during classes, made my own cards and went through 3-5 passes of zanki in the block. I wouldn't look at the cards again till breaks or dedicated. It's much easier to learn them the second time around . I would even only focus on decks where I was weak in dedicated.

I think I see what you mean. So you didn't keep up with your earlier cards? You just pounded whatever content you were on in your curriculum and then revisited your old ones prn?

Also, I definitely don't think the whole deck has to be matured. It's about finishing the deck more than anything. You don't have to mature a deck to actually know all of the cards.

 

[mvenus929]

In addition to what others have said... there is something to be said about knowing the answer to a flashcard and being able to apply that information to a test question. It's been a long time since I took step 1, but in my specialty, we have very specific 'learning objectives' that are tested on the in-training exams and board exam. I 'know' the answers to many of these learning objectives, but the way questions are worded or how they are presented doesn't necessarily reflect 'knowing' that material.

Also, some people want lives outside of medicine and that is more important than scoring 250+ on Step 1. Which is how it should be.

 

[libertyyne]

I think I see what you mean. So you didn't keep up with your earlier cards? You just pounded whatever content you were on in your curriculum and then revisited your old ones prn?

Also, I definitely don't think the whole deck has to be matured. It's about finishing the deck more than anything. You don't have to mature a deck to actually know all of the cards.

Yes that's essentially what I did.
My motto during preclinical was a thousand cards a day keeps the primary care away.

It's the same argument about uworld percentages etc. No one gives a **** if you matured zanki or if you got 90% of uworld first pass or if you did 10k questions, if that doesn't translate to you learning the material. These are learning tools , use them to learn stuff and and reassess how things are working for you. Maybe you have a terrible memory tx more zanki. Maybe you have a terrible conceptual understanding tx is more boards and beyond. Or maybe you have a terrible time integrating tx is more uworld.

 

[slowthai]

My motto during preclinical was a thousand cards a day keeps the primary care away.

This is gold. I'm going to frame it above my desk

 

[FindersFee5]

I've seen a lot of threads about how to score 250+ on Step 1. Pretty much everyone says maturing Zanki and completing UWorld before dedicated does the trick, and there has even been formal research done that supports this.

My question is, if the formula for success is so black and white, how come everyone doesn't score 250+? What are the reasons students do poorly, or simply "average" on Step?

Because the questions are hard, the margin of error is thin, and not everybody brings the same skills to the table. I averaged over 90% on UWorld and I still had 8 - 15 questions every block that I was legitimately unsure about.

Honestly, I think this is kind of a disrespectful question for somebody who hasn't even taken a single practice test to ask. If you'd taken practice tests or the real thing and scored 250+, then it would still be kinda dickish, but at least you'd have the scores to back it up.

You don't need to use it correctly to score 250+. Just need to use it .

While not everybody needs to use these resources exactly as prescribed, I think there are many more people who use it off-label poorly than those who use it well. I knew a good number of people who would kind of skim through UWorld questions, used Zanki for passive rather than active review, basically lying to themselves about their knowledge and where their gaps were. That's more harmful than using less high-yield resources more honestly.

 

[Goro]

There seems to be a pervasive idea on SDN that the people who do average/below average are just lazy or something...I don't think that's the case. The reality is that as someone said above, Step 1 is scored on a bell curve. The intent is to stratify a group of very smart and hard working people, and some of them are going to end up on the back end of that curve. Maybe those folks just have less innate ability to memorize, or our brains are less multiple choice question oriented, or just didn't have as good of study skills. And I'm sure there are some people out there who just don't take the exam seriously, but I think that's the minority based on what I've seen of my peers.

And I'm sure you guys above didn't mean it this way, but it's a bit insulting to presume that if you want to go into FM or other non-competitive specialties, you don't work as hard in med school...even though I knew pretty early on I wanted to do FM/primary care, I still worked my butt off for classes, Step 1, and rotations. Not because I wanted to get a certain score or grade, but because I wanted to become a good physician.

There are definitely SDNers who perceive Board scores as an affirmation of their person and value as a human being.

 

[OrgoCoop]

There are definitely SDNers who perceive Board scores as an affirmation of their person and value as a human being.

Whose fault is it that people become neurotic about test scores though? 😉

 

[Neopolymath]

The amount of people who think they are working hard in med school versus people who actually are is shocking. It's honestly probably as bad as your average office worker's perspective which is comical.

The average medical student half-assed UWorld and completely uses Anki wrong. Any average intelligence person who does those things correctly is 240+ no questions through brute force.

Basically, everybody wanna be a bodybuilder but nobody wanna lift no heavy ass weights.

 

[Cath Up]

It still feels like Zanki is a bit overrated on here even though it's a good tool. Some people learn far more by doing a lot of practice questions and thus crush Steps without using Zanki.

How dare u

 

[Ho0v-man]

Probably because it’s super hard and adds several hours of studying per day every day to a day of studying that at baseline is already unreasonable to expect of a typical human without Zanki. The typical folks in my class either tried it for <2 weeks and went crazy or just kept up for the block and never reviewed it again. I’d be surprised if 10% kept up with reviews.

Not only is it time consuming, but once your reviews start getting pretty high, your grades can actually suffer a little bc you’re so focused on Zanki>class material. It’s kind of disheartening knowing that if you weren’t doing cards for a couple hours every day and instead looking at class powerpoints you’d be crushing it OR just not doing anything and actually experiencing some semblance of happiness.

Also, some students are just arrogant. They think they just crack open FA at the beginning of dedicated and pass through uworld and hit 240+ (and some can!). It seems outlandish to the step maniacs on this site but this line of thinking is surprisingly prevale

You don't need to use it correctly to score 250+. Just need to use it .


A few observations for OP.
1. people have different goals. Some people want a 230 and want to move on with their life, trying to replace the trauma of preclinical with the trauma of clinical years.
2. Some people don't realize how important step one is. I had a classmate tell me the other day they were interested in neurosurgery with a 210.
3. Maturing zanki and doing so many questions is not an easy effort, and it is a marathon, that not everyone is willing to get on board with.
4. The evidence for zanki doesn't really exist, the evidence does say that doing more unique questions and higher number of flashcards does increase score.
5. Even with maturing zanki and doing those things people can have bad test days. A friend of mine ended up with a 240 after busting his behind.
6. A very small amount of people actually put in the effort required to get 250 + you can identify these people by looking into their eyes and seeing the life draining over the span of preclinical even before the start of dedicated.
7 . Not everyone likes anki or can even stand it. I recently converted 3-4 people to it in m3!!!

I felt this so much...

 

[Goro]

Whose fault is it that people become neurotic about test scores though? 😉

Tiger parents

 

[order66.exe]

I've seen a lot of threads about how to score 250+ on Step 1. Pretty much everyone says maturing Zanki and completing UWorld before dedicated does the trick, and there has even been formal research done that supports this.

My question is, if the formula for success is so black and white, how come everyone doesn't score 250+? What are the reasons students do poorly, or simply "average" on Step?

Maturing Zanki is by far the most difficult thing I've done in medical school. The demoralizing feeling of waking up to see 1000+ reviews day after day...

 

[managedcarefin]

This is not meant to be offensive but it'll come off as such because this is the internet but I digress.

This is the type of question you ask when you have 0 life experiences. The reason why everyone doesn't do well on a test is because everyone is different. Life doesn't work the same way for everyone, and you can't make these assumptions based on some forums on the internet full of type A neurotic people. The average med student isn't nearly as bright as the average person thinks they are. Go talk to some people in your class you'll realize people have different goals and because of that they are looking for different things from step 1.

 

[bananafish94]

I did everything you're "supposed" to do for Step 1 and scored only a bit above the 50th percentile. I have absolutely no regrets because there's literally not another ounce of effort I could have spared. I did Zanki (at least the version that existed when I was taking it), UWorld twice, took all of dedicated, etc. I knew people who waltzed into the diagnostic exam and scored 250s just from their regular pre-clinical studying, and I also know people who slaved over every available study tool for years and got 200s. If you think there's a one-size-fits-all approach to this test and that some pluck and elbow grease is the difference between getting a 210 and 250, I have a bridge to sell you.

For what it's worth, I charted my own path on Step 2 CK and tried to just focus on what was right for me and scored well over the 90th percentile. I truly believe you need to pay very close attention to how you learn best and adjust accordingly rather than blindly following guides from people who got high scores. LeBron James's advice on how to get good at basketball would be worthless to me as someone who is unathletic and isn't 6'9''.

Finally, and this is something that I believe is very important to emphasize, Step 1 is a means to an end. The end is graduating medical school and becoming a doctor. It is not Step 1. It is of course a very important exam and I wish everyone could get the score they need to keep the doors they want open. But you don't go to medical school to take Step 1. Oh, and the bizarre views expressed here about primary care are ridiculous and embarrassing.

 

[stickgirl390]

It is very apparent that I made my query unclear:

I didn’t mean for this thread to be about Zanki specifically. There are multiple threads about what to do when preparing for step. I was hoping we could make a thread about common pit-falls students make when preparing for Step that ends up hurting them. Ex: not doing enough practice full lengths, etc.

I’ll add this to the original post.

@Goro in response to your comment “what makes you think students aren’t taking it seriously?” This is just my n=1 observance of my classmates. I have many of them approach me in class asking when I plan to start studying for step, and they look at me like I’m crazy when I say I started 3 months ago. So I’m wondering if I’m doing over kill, or if they are behind, or neither, or both?

 

[Goro]

It is very apparent that I made my query unclear:

I didn’t mean for this thread to be about Zanki specifically. There are multiple threads about what to do when preparing for step. I was hoping we could make a thread about common pit-falls students make when preparing for Step that ends up hurting them. Ex: not doing enough practice full lengths, etc.

I’ll add this to the original post.

@Goro in response to your comment “what makes you think students aren’t taking it seriously?” This is just my n=1 observance of my classmates. I have many of them approach me in class asking when I plan to start studying for step, and they look at me like I’m crazy when I say I started 3 months ago. So I’m wondering if I’m doing over kill, or if they are behind, or neither, or both?

If you're an M1, then you are indeed crazy for starting Boards prep that early. Even for M2, that's still early. Xmas of M2 is a good time to start.

 

[managedcarefin]

It is very apparent that I made my query unclear:

I didn’t mean for this thread to be about Zanki specifically. There are multiple threads about what to do when preparing for step. I was hoping we could make a thread about common pit-falls students make when preparing for Step that ends up hurting them. Ex: not doing enough practice full lengths, etc.

I’ll add this to the original post.

@Goro in response to your comment “what makes you think students aren’t taking it seriously?” This is just my n=1 observance of my classmates. I have many of them approach me in class asking when I plan to start studying for step, and they look at me like I’m crazy when I say I started 3 months ago. So I’m wondering if I’m doing over kill, or if they are behind, or neither, or both?

Why does this matter? Again, think about this in context of life. You aren't competing against anyone in life besides yourself. It doesn't matter what other people are doing, it matters what makes you happy. If you think you are doing enough for yourself then that's all that matters.

 

[operaman]

A few thoughts:

1) not all medical students are smart. Quite a few are working at their maximum and just barely passing. These people are not destined for 240 land. These people are not doing 1000 anki reviews a day. We all like to believe the myth that we can do whatever we want if we work hard enough, but that’s simply not true.

2) not everyone needs to do well. I had many classmates who knew from day 1 they wanted to do primary care and move back to their small hometown. These folks didn’t have to do much more than get an average score and they knew it. They tended to be rather happy contented people as students and seem pretty darn happy now as attendings.

3) not everyone really works hard consistently. This was mentioned above but bears repeating. We have incredible tools available for step prep now but you still have to use them right, otherwise it’s like buying a Fancy gym membership but not actually going to the gym. “Right” is defined as whatever way makes you learn the info such that you can put it to use on test day. But yeah even now I see people carrying around their FA and I hope they’re actually reading it as often as they’re carrying it!

Overall I think #1 drives most of the variation in scores. Step 1 is actually not designed to stratify people like the MCAT is. It was designed and remains a test of minimum competence. It actually does a terrible job discriminating performance. The USMLE bulletin states that 2 scores must differ by more than 16 points in order to be different to a level of p<0.05. Sixteen! That’s how inaccurate their scaling is. A 240 and a 255 or 225 are statistically no different though obviously we treat them as such.

 

[Schwifty]

So someone could mature zanki, complete 3,000+ practice questions, and still only pull 210 simply because they "suck at taking tests"?

I meant more like, do students not take preparing seriously? Are there that many people that wait until dedicated to prepare?

With my test taking abilities, this will probably end up being me. I'll come back in 2 years and let y'all know how I did

 

[Cornfed101]

Oh, and the bizarre views expressed here about primary care are ridiculous and embarrassing.

Very true, my cousin is interviewing for IM (with little intention of subspecializing) and he got a 250+ on step 1. Primary care is not a death sentence. A lot of people prefer it!

 

[BigRedBeta]

1) As others have pointed out, the scores are curved. And while average score has trended up over the last decade, it's only because there is "memory" built into the conversion factor so that a score from 2014 means roughly the same as a score in 2019. If they were to isolate years you might run into situations where the raw scores from one year to the next would fluctuate wildly but the scaled score wouldn't and that would make comparisons for programs more difficult.

2) While it's likely changed in 2019, a decade ago when I was a med student, plenty of schools were actively discouraging specifically studying for step 1 over the courses they were teaching. Some institutions may still have that mindset (perhaps rightfully so based on their internal data). If they have significant correlation between the highest ranked students and Step 1 scores, they may feel appropriate in saying "do well in our courses and you'll do well on Step 1"

3) I'll flat out disagree that the Step 1 is truly career defining for the majority of med students. Sure if you are going Derm (217 US senior applicants in 2019), Ortho (830), Rads (595 for PGY1 spots and 925 for PGY2 spots - likely significant overlap between the two), or ENT (398), then doing poorly on Step 1 likely changes your direction. But for pretty much everybody else, you're probably only talking about changes in tiers of residency programs....something that is significantly harder to delineate as "career defining". Yes prestige can matter for getting fellowships, but you really have to understand what the outcomes from fellowships really are. There was a good thread in the IM-Cardiology forum maybe a year ago that really hammered the point that the so called top programs are looking to produce researchers, and many others chimed in that lower tier places actually produce better clinicians. This is a paradigm that is repeated throughout medical training in nearly every field. If an academic career is not for you, then there are many, many, many residency programs out there that will absolutely get you to where you want to be at the end. Even if you do want to be in academics, there probably are still many, many, programs that will get you to that spot...your academic attending landing spot might just be Little Rock instead of Chicago. But if you just want to be a good doctor that takes good care of patients and makes a reasonable salary, Step 1 really isn't going to change your direction that much.

4) While SDN makes it seem like it never happens, there are lots of very high scorers who go on to do "mundane" (by SDN standards) training pathways for which their high score doesn't really provide any tangible benefit. That's because the choice of specialty and residency programs for any individual is based on so much more than just your step 1 score. The person I know who scored the highest on Step 1 went to her home state public medical school (not highly ranked), stayed there for residency in a non-competitive field because her family/husband were well established there and the program was good in her desired subspecialty. She went on to get fellowship interviews at all of the top locations in her desired field but ultimately elected to stay at her home program because she realized she would get more case volume with fewer fellows to compete with. She is doing exactly what her end goal was from the time she was a second year med student. But her training path would have ultimately been the same had she not scored >260 and instead had scored 217 or probably even 200. That's just one anecdote among dozens that I have.

 

[sloop]

I've seen a lot of threads about how to score 250+ on Step 1. Pretty much everyone says maturing Zanki and completing UWorld before dedicated does the trick, and there has even been formal research done that supports this.

My question is, if the formula for success is so black and white, how come everyone doesn't score 250+? What are the reasons students do poorly, or simply "average" on Step?

EDIT:

I didn’t mean for this thread to be about Zanki specifically. There are multiple threads about what to do when preparing for step. I was hoping we could make a thread about common pit-falls students make when preparing for Step that ends up hurting them. Ex: not doing enough practice full lengths, etc.

The same two reasons that mostly determine success on the majority of tasks: intelligence and temperament.

Of course there are potentially many factors that can affect test performance. That said, as you point out, people tend to use the same resources to prepare for these exams. They also tend to take them under pretty similar conditions (Step 3 might be the exception to this, as residents have a lot of variability in terms of their responsibilities and ability to set aside time to study). External factors can also play a role, such as a death in the family close to the exam, but most students would postpone if something major happened that might affect their performance.

Since most medical students get at least some dedicated study time, use the same resources, and avoid taking the exam during times when there are significant uncontrollable factors that would impact performance, it is obvious that innate factors are going to predominate.

 

[bahdahboom]

I've seen a lot of threads about how to score 250+ on Step 1. Pretty much everyone says maturing Zanki and completing UWorld before dedicated does the trick, and there has even been formal research done that supports this.

My question is, if the formula for success is so black and white, how come everyone doesn't score 250+? What are the reasons students do poorly, or simply "average" on Step?

EDIT:

I didn’t mean for this thread to be about Zanki specifically. There are multiple threads about what to do when preparing for step. I was hoping we could make a thread about common pit-falls students make when preparing for Step that ends up hurting them. Ex: not doing enough practice full lengths, etc.

Another perspective for you..

The reason why I never got even close to a 250 and didn't realistically try for anything that high was that I realized my daily contentment, peace of mind, and loyalty to my outside endeavors were more of a priority to me than putting in the necessary work to score very well. As someone said earlier, of course there are many students who put in the work to score high. But then you look in their eyes, and you KNOW they dedicate ALL (not some or most, but ALL) of their waking hours to STEP studying, most look dead and unhappy. For me, that would no doubt spiral me into a state of depression. Even when I was studying for 8 hours daily, I had to do constant mental checks, and I STILL ended up going into a depression.

Medical school taught me not only is my sanity and emotional well-being the MOST important thing to me, it is equally very fragile.

 

[alprazoslam]

Another perspective for you..

The reason why I never got even close to a 250 and didn't realistically try for anything that high was that I realized my daily contentment, peace of mind, and loyalty to my outside endeavors were more of a priority to me than putting in the necessary work to score very well. As someone said earlier, of course there are many students who put in the work to score high. But then you look in their eyes, and you KNOW they dedicate ALL (not some or most, but ALL) of their waking hours to STEP studying, most look dead and unhappy. For me, that would no doubt spiral me into a state of depression. Even when I was studying for 8 hours daily, I had to do constant mental checks, and I STILL ended up going into a depression.

Medical school taught me not only is my sanity and emotional well-being the MOST important thing to me, it is equally very fragile.

You can score high and still have time to live life. The people in my class who scored 260 plus still had lives we just managed time and energy better. The whole “oh I didn’t try hard” thing is just bs that people say making it sound like they could have done better if they actually tried. Even if you don’t want a competitive specialty it’s worth doing well. It’s much better not having to interview at 100 programs and going to maybe 8-10 knowing you will probably get too 3 because you worked hard for boards and clinicals. Also if you didn’t try as hard as you could realistically that’s just dumb since u might discover that you like something competitive later on. Doing well on step saved me thousands on applications and interviews. I applied to 1/8th the amt of programs as some of my friends got just as many invites and only had to go to places I REALLY WANT to go to. Plus the knowledge gained helps out for the rest of your career (depending on field)