Step 1 Advice (2.5 weeks out)

[suburbanfreckles]

I’m about 2.5 weeks out from step 1. Here’s the list of assessments I’ve taken so far

NBME 29: 49% (168)
NBME 30: 52% (168)
NBME 27: 57% (180)
Uworld: 50% (62% complete)

I have a good understanding of big picture concepts and diagnoses. Struggling with smaller details/biochem/general pathology.

I plan to review Pathoma chapters 1-3 and take at least 2 more NBME practice exams. I was wondering if anyone had any suggestions of resources to use/things to do to reach a passing score in the next few weeks.

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[djiboutiman]

The high yield stuff I've seen a lot of people reference are:

-Mehlman PDFs particularly HY Arrows, Biochemistry, Immunology, and Neuroanatomy
-Dirty Medicine Youtube High Yield Images videos, also heard good things about his Biochemistry section and other sections
-Randy Neil Youtube Communication videos and Statistics if you struggle with that
-The 100 Anatomy Concepts PDF for anatomy
-First Aid Rapid Review
-Of course Pathoma (1-3) too

 

[Rachapkis]

Prerak Juthani has some helpful videos on this topic. Here is a link to one below:

 

[SweetBurger]

Do you have time to push it back?

 

[mrbreakfast]

I think pushing back the test would be the single most high-yield thing to do here.

 

[Dr. Anonymouss]

Thats a tough situation with you being so close to test day, but one a lot of other students find themselves in. If I were you I would just keep grinding everyday trying to work on weak areas because you may see a big improvement in a matter of only 1-2 weeks, but at the same time be realistic. A failing step I score is a lot more detrimental than pushing your test back or taking a year LOA to study more. Our academic counselor told us we shouldn't sit for the test unless we scored above 70% on an NBME one week out from test day. I can't give specifics to back up her claim that this is the magic score, but I think its a fairly reasonable guideline. Talk to the academic specialists at your school, but I personally think your scores are too low right now.

 

[suburbanfreckles]

Do you have time to push it back?

I really wanted to take it before starting clinicals in July. I’m worried I won’t have time to study then. I’m a DO student and I already took COMLEX so there’s really no timeline for when I need to take step or if I even take it at all

 

[suburbanfreckles]

Thats a tough situation with you being so close to test day, but one a lot of other students find themselves in. If I were you I would just keep grinding everyday trying to work on weak areas because you may see a big improvement in a matter of only 1-2 weeks, but at the same time be realistic. A failing step I score is a lot more detrimental than pushing your test back or taking a year LOA to study more. Our academic counselor told us we shouldn't sit for the test unless we scored above 70% on an NBME one week out from test day. I can't give specifics to back up her claim that this is the magic score, but I think its a fairly reasonable guideline. Talk to the academic specialists at your school, but I personally think your scores are too low right now.

I’m a DO student and our advisors are pushing us to not even take step 1. I feel like it’ll help my residency application to have a pass on step 1 and a scored step 2. I won’t sit for step 1 if I’m not at least in the 60s for NBME exams. At this point I feel like I’ll take it in 2.5 weeks or just cancel. Im not sure if I’ll improve trying to study while also on clinical rotations in July.

It’s definitely a tough situation. Not really sure what to do but at this point I’m going to keep trying for it.

 

[Billiam95]

I'm not sure how the prometric rescheduling fees would differ, but I think you could grind uWorld for 2 weeks, take a practice test, then reassess.
I'd recommend doing 1-2 day content review per system (via Pathoma for systems, DirtyMedicine for biochem/genetics, Randy Neil for stats) and do focused uWorld question blocks for the system you are reviewing.

 

[DOVinciRobot]

If you take the test you will fail. Do not take it in 2.5 weeks. I do however highly suggest you study during rotations and pass Step 1. Not having it will be detrimental to your residency application.

Ignore all DO school advisors. They are not to be trusted.

 

[Ho0v-man]

You’ll almost certainly fail if you take it in 2.5 weeks. Push it back and keep studying. You haven’t even finished uworld.

Try to take it on a rotation without a shelf exam. For instance, we had two months of family med and only took the shelf after the second month.

 

[Konigstiger]

So what's generally considered the baseline amount of studying you need to do to pass? Complete all 4000 questions of UWorld? All NBMEs?

Reading threads like these makes me realize I underestimated how much people study just to pass. If I don't end up failing this exam, it's going to be a miracle.

 

[Billiam95]

So what's generally considered the baseline amount of studying you need to do to pass? Complete all 4000 questions of UWorld? All NBMEs?

Reading threads like these makes me realize I underestimated how much people study just to pass. If I don't end up failing this exam, it's going to be a miracle.

A lot of it depends on knowledge baseline coming in to dedicated. At minimum, I'd say 3 practice exams and ~65% of uWorld, but the more uWorld the better IMO.

 

[ChymeofPassion]

So what's generally considered the baseline amount of studying you need to do to pass? Complete all 4000 questions of UWorld? All NBMEs?

Reading threads like these makes me realize I underestimated how much people study just to pass. If I don't end up failing this exam, it's going to be a miracle.

I did (and most of my classmates did) 2 practice NBMEs (school said >65 AVG to test) and did like 40 percent of UWorld with a 60 percent avg. I started UWorld 2 months before my exam. Ez pass. I dont know many people who did >70 percent of UWorld

 

[ujsc]

I’m about 2.5 weeks out from step 1. Here’s the list of assessments I’ve taken so far

NBME 29: 49% (168)
NBME 30: 52% (168)
NBME 27: 57% (180)
Uworld: 50% (62% complete)

I have a good understanding of big picture concepts and diagnoses. Struggling with smaller details/biochem/general pathology.

I plan to review Pathoma chapters 1-3 and take at least 2 more NBME practice exams. I was wondering if anyone had any suggestions of resources to use/things to do to reach a passing score in the next few weeks.

Don't screw up your career by allowing yourself to take this exam when you are no way near ready. Postpone until ready..

 

[Dr. Anonymouss]

I did (and most of my classmates did) 2 practice NBMEs (school said >65 AVG to test) and did like 40 percent of UWorld with a 60 percent avg. I started UWorld 2 months before my exam. Ez pass. I dont know many people who did >70 percent of UWorld

I did 45% of UWORLD with a 68% average and scored 70% on NBME 26 and 80% on NBME 29 and then took the test. So yes doing all of UWORLD isn't necessary. A lot of it has to do with your background going into dedicated and how you are doing on the questions. I was an avid anki user during pre-clinicals and I think that helped so much.

 

[ChymeofPassion]

I did 45% of UWORLD with a 68% average and scored 70% on NBME 26 and 80% on NBME 29 and then took the test. So yes doing all of UWORLD isn't necessary. A lot of it has to do with your background going into dedicated and how you are doing on the questions. I was an avid anki user during pre-clinicals and I think that helped so much.

Yes, that makes a lot of sense. I didnt start anki till January of M2 (and just did the BnB video anki), so the averages make sense.

 

[CyrilFiggis]

I say this not only to OP, but to all current M1/2.

Before it was pass/fail, students studied aggressively for up to 6 month before their test date and some people still only scored in the low 200s. Step 1 is not an easy test. The pass rate was super high because the test was the sole focus of every med student.

You still need to do every UWorld question. You should still take multiple practice tests. And those practice tests vary wildly in terms of representation of actual scores.

To OP specifically, you need 2 months, not 2 weeks more of studying.

 

[suburbanfreckles]

I say this not only to OP, but to all current M1/2.

Before it was pass/fail, students studied aggressively for up to 6 month before their test date and some people still only scored in the low 200s. Step 1 is not an easy test. The pass rate was super high because the test was the sole focus of every med student.

You still need to do every UWorld question. You should still take multiple practice tests. And those practice tests vary wildly in terms of representation of actual scores.

To OP specifically, you need 2 months, not 2 weeks more of studying.

I appreciate this advice and the advice of everyone else that has responded. I’ve been studying for several months now but I did not have a good foundation when I started. I’ll continue to study everyday and take the exam when I’m ready.

 

[hallowmann]

I say this not only to OP, but to all current M1/2.

Before it was pass/fail, students studied aggressively for up to 6 month before their test date and some people still only scored in the low 200s. Step 1 is not an easy test. The pass rate was super high because the test was the sole focus of every med student.

You still need to do every UWorld question. You should still take multiple practice tests. And those practice tests vary wildly in terms of representation of actual scores.

To OP specifically, you need 2 months, not 2 weeks more of studying.

Exactly.

So what's generally considered the baseline amount of studying you need to do to pass? Complete all 4000 questions of UWorld? All NBMEs?

Reading threads like these makes me realize I underestimated how much people study just to pass. If I don't end up failing this exam, it's going to be a miracle.

To put it into perspective, people were studying for months followed by intense studying daily for dedicated.

My specific study plan involved 2-3 months of studying through FA, UWorld and Pathoma during school, then for the 3.5 wks I had of dedicated, I studied for 10-12 hours a day every day. And I really mean 10-12 hrs a day. In other words, I studied for 250-300 hrs in the <4 wks leading to the exam. It was by far longer and more intensely than I had ever studied for literally any other thing in my life before and since. Even then I only did OK/average. My starting scores before dedicated were better than OPs.

I forgot what it was like to see the sun when I wasn't walking to or from the library. I heard Dr. Sattar in my dreams. Everytime something even remotely related to medicine happened around me it was like my mind would jump through an elaborate array of physiology, anatomy, and pathology. It took me a month to be an even remotely social human being again. I'm only slightly embellishing on this btw.

For Step 2, I spent 2 wks at 5-6 hrs a day. For Step 3, 1.5 wks at 3 hrs a day. For first set of specialty boards, like a week doing 2 hrs worth of questions a day, and for the second set, I'll let you know in a few months, but there's no way it'll be as much as Step 1.

 

[Konigstiger]

Yeah... So I did 20% of UWorld and UWSA1 was my only practice exam. Seems I've made a huge mistake in thinking that P/F scores meant I don't have to study that much.

If I somehow pass, at least I now know not to make the same mistake for STEP 2...

 

[Ho0v-man]

Exactly.

To put it into perspective, people were studying for months followed by intense studying daily for dedicated.

My specific study plan involved 2-3 months of studying through FA, UWorld and Pathoma during school, then for the 3.5 wks I had of dedicated, I studied for 10-12 hours a day every day. And I really mean 10-12 hrs a day. In other words, I studied for 250-300 hrs in the <4 wks leading to the exam. It was by far longer and more intensely than I had ever studied for literally any other thing in my life before and since. Even then I only did OK/average. My starting scores before dedicated were better than OPs.

I forgot what it was like to see the sun when I wasn't walking to or from the library. I heard Dr. Sattar in my dreams. Everytime something even remotely related to medicine happened around me it was like my mind would jump through an elaborate array of physiology, anatomy, and pathology. It took me a month to be an even remotely social human being again. I'm only slightly embellishing on this btw.

For Step 2, I spent 2 wks at 5-6 hrs a day. For Step 3, 1.5 wks at 3 hrs a day. For first set of specialty boards, like a week doing 2 hrs worth of questions a day, and for the second set, I'll let you know in a few months, but there's no way it'll be as much as Step 1.

So much this. And then after I took it I was burnt out for two more months. I felt like every time I spoke I just vomited FA everywhere. It was the most intense 6 months of my life.

 

[Z2911BME]

I’m about 2.5 weeks out from step 1. Here’s the list of assessments I’ve taken so far

NBME 29: 49% (168)
NBME 30: 52% (168)
NBME 27: 57% (180)
Uworld: 50% (62% complete)

I have a good understanding of big picture concepts and diagnoses. Struggling with smaller details/biochem/general pathology.

I plan to review Pathoma chapters 1-3 and take at least 2 more NBME practice exams. I was wondering if anyone had any suggestions of resources to use/things to do to reach a passing score in the next few weeks.

If you haven’t passed a single practice exam with 2.5 weeks left the chances of you failing are astronomically higher than the chances of you passing. While the first 3 chapters of Pathoma are high yield, they won’t get you to where you need to be unfortunately. Postpone the exam and try to identify where there is a break in your knowledge and understanding of material AND application of that knowledge and take the test when you’re ready.

 

[psyspy]

I say this not only to OP, but to all current M1/2.

Before it was pass/fail, students studied aggressively for up to 6 month before their test date and some people still only scored in the low 200s. Step 1 is not an easy test. The pass rate was super high because the test was the sole focus of every med student.

You still need to do every UWorld question. You should still take multiple practice tests. And those practice tests vary wildly in terms of representation of actual scores.

To OP specifically, you need 2 months, not 2 weeks more of studying.

I disagree with doing every UW question. I think the practice NBMEs are your best predictor of passing if you can get 70%+. Just from what I’ve seen on the subreddit, the failures all entailed relatively low (consistently sub 63-65%) NBME scores. So much of the test is test taking skills and process of elimination.

Also from what I’ve seen most students, even the 250+ ones, were not aggressively studying for step 1 in addition to their coursework. Sure they probably kept up with board materials throughout the year, but most of the high scorers were still able to make do with the 1-1.5 months dedicated to make their biggest strides in score increase. Lots of people are just that good (and no, not me lol)

 

[DOVinciRobot]

Also from what I’ve seen most students, even the 250+ ones, were not aggressively studying for step 1 in addition to their coursework.

Then you haven’t seen nearly enough 250 scorers.

People not completing UWorld is one of the biggest mistakes they can make regarding Step prep in my opinion. It’s going to be Interesting when these students get to Step 2. Step 2 is not some completely different test, if you don’t know Step 1 content cold you’re going to bomb it.

 

[Ho0v-man]

I disagree with doing every UW question. I think the practice NBMEs are your best predictor of passing if you can get 70%+. Just from what I’ve seen on the subreddit, the failures all entailed relatively low (consistently sub 63-65%) NBME scores. So much of the test is test taking skills and process of elimination.

Also from what I’ve seen most students, even the 250+ ones, were not aggressively studying for step 1 in addition to their coursework. Sure they probably kept up with board materials throughout the year, but most of the high scorers were still able to make do with the 1-1.5 months dedicated to make their biggest strides in score increase. Lots of people are just that good (and no, not me lol)

Bolded is not true

 

[Ho0v-man]

Then you haven’t seen nearly enough 250 scorers.

People not completing UWorld is one of the biggest mistakes they can make regarding Step prep in my opinion. It’s going to be Interesting when these students get to Step 2. Step 2 is not some completely different test, if you don’t know Step 1 content cold you’re going to bomb it.

Beat me to it lol

 

[psyspy]

Then you haven’t seen nearly enough 250 scorers.

People not completing UWorld is one of the biggest mistakes they can make regarding Step prep in my opinion. It’s going to be Interesting when these students get to Step 2. Step 2 is not some completely different test, if you don’t know Step 1 content cold you’re going to bomb it.

Fair, I don’t actually know that many. I’m not among them either

 

[psyspy]

Also as for the OP, seeing that step 2 is still number graded. Wouldn’t it in fact be in his best interest to cancel step 1? Honestly those practice scores are not going to budge in 2.5 w. Not saying he’s guaranteed a high step 2, but wouldn’t he be better off ”chanceing” that rather than this?

 

[voxveritatisetlucis]

Fair, I don’t actually know that many. I’m not among them either

Keep in mind, a lot of people will lie about how much they study. It’s the old “bro, I barely studied and still managed to get a 95” routine.

 

[Isoval]

I think you NEED to push back.

This is insanely concerning for failing Step 1.

 

[DOVinciRobot]

Also as for the OP, seeing that step 2 is still number graded. Wouldn’t it in fact be in his best interest to cancel step 1? Honestly those practice scores are not going to budge in 2.5 w. Not saying he’s guaranteed a high step 2, but wouldn’t he be better off ”chanceing” that rather than this?

Yes they need to cancel and push it back. Their scores indicate they are going to fail.

 

[Billiam95]

I disagree with doing every UW question. I think the practice NBMEs are your best predictor of passing if you can get 70%+. Just from what I’ve seen on the subreddit, the failures all entailed relatively low (consistently sub 63-65%) NBME scores. So much of the test is test taking skills and process of elimination.

Also from what I’ve seen most students, even the 250+ ones, were not aggressively studying for step 1 in addition to their coursework. Sure they probably kept up with board materials throughout the year, but most of the high scorers were still able to make do with the 1-1.5 months dedicated to make their biggest strides in score increase. Lots of people are just that good (and no, not me lol)

Completing uWorld (or coming as close as possible) is the single most important thing to do in dedicated. Studying boards materials and keeping up with the anking cards throughout MS1/2 is, imo, absolutely critical to making the most of uworld and dedicated as a whole.

 

[hallowmann]

Also as for the OP, seeing that step 2 is still number graded. Wouldn’t it in fact be in his best interest to cancel step 1? Honestly those practice scores are not going to budge in 2.5 w. Not saying he’s guaranteed a high step 2, but wouldn’t he be better off ”chanceing” that rather than this?

2.5 wks of true dedicated at that score range can mean a change of 10-20 points if effort is put in specifically to address deficiencies - so I disagree that they won't budge. The problem is at best that puts OP to a practice score of 200, which in my opinion is too close to failing to warrant taking it. The actual test day score often varies by +/- 5-10 pts, so I agree, high risk of failing even with very effective use of the 2.5 wks.

 

[Lawpy]

I’m about 2.5 weeks out from step 1. Here’s the list of assessments I’ve taken so far

NBME 29: 49% (168)
NBME 30: 52% (168)
NBME 27: 57% (180)
Uworld: 50% (62% complete)

I have a good understanding of big picture concepts and diagnoses. Struggling with smaller details/biochem/general pathology.

I plan to review Pathoma chapters 1-3 and take at least 2 more NBME practice exams. I was wondering if anyone had any suggestions of resources to use/things to do to reach a passing score in the next few weeks.

Hopefully you took the advice and postponed the exam. Otherwise you’re pretty much guaranteed to fail

 

[ortnakas]

I’m about 2.5 weeks out from step 1. Here’s the list of assessments I’ve taken so far

NBME 29: 49% (168)
NBME 30: 52% (168)
NBME 27: 57% (180)
Uworld: 50% (62% complete)

I have a good understanding of big picture concepts and diagnoses. Struggling with smaller details/biochem/general pathology.

I plan to review Pathoma chapters 1-3 and take at least 2 more NBME practice exams. I was wondering if anyone had any suggestions of resources to use/things to do to reach a passing score in the next few weeks.

OP, “smaller details/biochem/general pathology” are a LOT of Step 1. And your scores are not yet close to passing. Please follow all the advice here and cancel/postpone.

 

[suburbanfreckles]

Thank you everyone for the feedback! I took NBME form 28 today and scored 63%. I’m also on tract to finish uworld by next week. I realize I’m still in low passing range but I’m glad to see improvement in my score.

I’m curious what everyone’s thoughts are following my NBME score today. I did not officially push back my exam date yet. I wanted to see how I would do this last few weeks but I still have time to reschedule.

 

[suburbanfreckles]

Also as for the OP, seeing that step 2 is still number graded. Wouldn’t it in fact be in his best interest to cancel step 1? Honestly those practice scores are not going to budge in 2.5 w. Not saying he’s guaranteed a high step 2, but wouldn’t he be better off ”chanceing” that rather than this?

I got 63% on NBME 28 today. Still have plenty of more studying to do, but I am improving each week.

I’m not sure if cancelling is the right thing to do. I’ve recieved conflicting advice on this but the majority agree that it would be worth it to get a pass on Step 1 even if it means pushing back my exam into clinical rotations.

 

[Billiam95]

Thank you everyone for the feedback! I took NBME form 28 today and scored 63%. I’m also on tract to finish uworld by next week. I realize I’m still in low passing range but I’m glad to see improvement in my score.

I’m curious what everyone’s thoughts are following my NBME score today. I did not officially push back my exam date yet. I wanted to see how I would do this last few weeks but I still have time to reschedule.

Unfortunately, I think you're still at a high risk of failure. Barometer I've gotten from reddit regarding readiness to take step1 is 2 NBMEs >70% and Free120 >70%.
Congratulations on the improve, though - sounds like you've been working hard.

 

[ChymeofPassion]

I got 63% on NBME 28 today. Still have plenty of more studying to do, but I am improving each week.

I’m not sure if cancelling is the right thing to do. I’ve recieved conflicting advice on this but the majority agree that it would be worth it to get a pass on Step 1 even if it means pushing back my exam into clinical rotations.

Try to get 2 >65 percent (>95 percent chance to pass), that's what my school recommended.

 

[Isoval]

2.5 wks of true dedicated at that score range can mean a change of 10-20 points if effort is put in specifically to address deficiencies - so I disagree that they won't budge. The problem is at best that puts OP to a practice score of 200, which in my opinion is too close to failing to warrant taking it. The actual test day score often varies by +/- 5-10 pts, so I agree, high risk of failing even with very effective use of the 2.5 wks.

My biggest concern is that if they’ve managed to get this far with such low scores in practice, there is nothing at all telling me that their next two to three weeks will be anywhere near that productive.

And like you stated, even if it was, it’s still close to failing.

 

[suburbanfreckles]

My biggest concern is that if they’ve managed to get this far with such low scores in practice, there is nothing at all telling me that their next two to three weeks will be anywhere near that productive.

And like you stated, even if it was, it’s still close to failing.

Hello!

As a DO student my school required me to take a comsae exam (basically DO version of NBME exams) to sit for comlex level 1. The beginning of my dedicated studying was therefore focused on scoring well on comsae and taking level 1. I spent most of the time reviewing MSK, microbiology and osteopathic concepts since these are all high yield for level 1. I already took level 1 and felt it went well even without having a solid foundation in basic science/immunology/biochem.

Step 1 and Level 1 are two very different exams in my opinion and I was focused on preparing myself for Level 1 first. Now that it’s over I’ve been able to shift my focus to topics that are more high yield for Step. I’ve been improving each week (63% on my last NBME) and hope to take it soon, when I’m ready.

 

[candbgirl]

Did you get your Level1 score back?

 

[suburbanfreckles]

Did you get your Level1 score back?

Not yet. I think score releases have been delayed due to p/f

 

[Lawpy]

Step 1 and Level 1 are two very different exams in my opinion and I was focused on preparing myself for Level 1 first.

Well this fits the advice over in DO forums to spend a lot of time with Step 1 prep because Level 1 would be a breeze in comparison. I don’t think anyone who passed Step 1 failed Level 1 but there have been too many instances of people who passed Level 1 either failed Step 1 or skipped it entirely

I would postpone Step 1

 

[hallowmann]

Hello!

As a DO student my school required me to take a comsae exam (basically DO version of NBME exams) to sit for comlex level 1. The beginning of my dedicated studying was therefore focused on scoring well on comsae and taking level 1. I spent most of the time reviewing MSK, microbiology and osteopathic concepts since these are all high yield for level 1. I already took level 1 and felt it went well even without having a solid foundation in basic science/immunology/biochem.

Step 1 and Level 1 are two very different exams in my opinion and I was focused on preparing myself for Level 1 first. Now that it’s over I’ve been able to shift my focus to topics that are more high yield for Step. I’ve been improving each week (63% on my last NBME) and hope to take it soon, when I’m ready.

Ideally you would have been doing general dedicated studying, which would have helped your COMSAE score and not put you behind on studying for step. In general, it's better to treat those tests as practice tests to assess your knowledge and not study solely to pass them.

The typical recommendation is also to take Level 1 shortly after Step 1, because while the content overlaps quite a bit, they are different tests strategically and they ask questions differently, which can make it harder to switch gears. Plus, you can avoid wasting a ton of time on material that is only on the COMLEX.

Well this fits the advice over in DO forums to spend a lot of time with Step 1 prep because Level 1 would be a breeze in comparison. I don’t think anyone who passed Step 1 failed Level 1 but there have been too many instances of people who passed Level 1 either failed Step 1 or skipped it entirely

I would postpone Step 1

People have passed Step 1 and failed Level 1, but I agree the converse is probably more common. Typically it's because they don't study as dedicated for the OMM topics as they should have, and that is like 20-25% of the exam. That said, a lot of that part correlates to anatomy and a general understanding of OMT, which I hope most DOs have after 2 yrs of it in preclinical, so you don't need too much time for this.

 

[suburbanfreckles]

UPDATE:
I passed another NBME, got 70% on the free 120, took the exam and PASSED! I never pushed back my date.

 

[Ho0v-man]

Glad I was wrong. Congrats OP

 

[suburbanfreckles]

Holy **** OP, I'm so proud of you!

What did you end up doing those past two weeks to get such a huge boost?

Uworld! I really think finishing uworld was a game changer for me. I did questions everyday and thoroughly reviewed everything. I was also taking an NBME every week and my score continued to improve. I had a ton of confidence going into the exam after getting 70% on the free 120 and I walked out feeling so good about it