I haven't posted on this site in ages... but figured I'd chime in. I am in a unique situation (and a crappy one) that I am totally responsible for. I am in my PGY5 year of ENT residency and have been putting this exam off for far too long. No good excuse! It has been years since I've thought about OB, peds, even most of the medicine topics. So, I started off with an uphill battle. Basically I spent about 6 weeks preparing, which was not enough to make me feel confident. I'd spend maybe an hour or so after work and occasionally on light days another 2 or so during the work day studying and obviously more on the weekends. I read through crush the boards which I thought was largely useless. I did about 90% of the USMLE world MCQs. Did all blocks of 48, random and time and finished with a 64%. I went through all of the cases once during the week before my exam. Needless to say, I did not feel very confident going into the exam but had already dug my grave at that point. I easily got > 250 on step 1 and step 2 but I was actually prepared for those exams...
Anyway the exam was very tough, just as everyone else has said. My thoughts on the test were almost identical to the previous poster's. Day 1 was really tough and quite demoralizing. Question stems were super long and filled with details. Like others have said, there were a lot where I could narrow it down but really couldn't pick which was the "best" next step (hate those questions!). I was able to get through the blocks with a few minutes to spare and didn't have to randomly guess but there were two blocks that I finished with basically no time left. The emergency setting blocks seemed the hardest to me. The drug adds weren't bad but the abstract-based questions were tough and weird! Tons of cardiology and OBGYN and derm. I left feeling really deflated and questioning whether I should even return. I think the natural tendency is to harp on all the ones you knew you got wrong or made silly mistakes on - the next thing you know you feel like there are so many of those questions even thought it's probably about 10 that you just keep thinking about over and over. Definitely psyched myself out though and got very little sleep overnight.
Day 2, thankfully, and similar to how others have described it, seemed much much better. The question stems were shorter and the questions seemed more straightforward. I did feel though that these questions were about more esoteric diseases and many were definitely not general medicine (give me a break!). The cases were fairly straightforward and none of the diagnoses were hard to get. I'm sure I forgot orders and counseling here and there but overall the blocks ended early and I seemed to be getting positive responses from patients and consulting services. I left day 2 feeling much better.
In the end, I feel very nervous about this exam. It's comforting to hear that everyone else feels the same way for the most part. While I do think about all the silly mistakes I made and questions I clearly got wrong I do feel comforted that I got almost all the sequential question chains correct. Those are pretty sadistic but it makes you feel really good when you see that you got the previous question correct. Obviously it also feels pretty crummy when you find that you got the prior question wrong.
Overall, this exam was what I expected (difficulty of it) and also not what I expected (content). UWorld is great prep but beware that it doesn't cover all of the exam content and, in my opinion, is easier than the actual exam. Like most others, I feel very crummy about this exam and am worried about my ability to pass. Truth of the matter is that almost everyone passes this exam, so we should all chill out. I know I won't, though, until I get my score back. And, if I do fail, it's my own fault! Best of luck, everyone.
