Stuck at low score, what am I doing wrong??

[step1plan]

Hi guys, I need serious help from those who are scoring in 230-260 range. I scored 188 on NBME 12 yesterday and few weeks ago nbme 11 was 192. I feel stuck and continuously studying isn't helping me. I don't know why my score won't increase while other students study in short time and get 240+. But, I guess I can never be like those students and am not as bright and smart like them, but yet I keep trying. I am trying to find out what I'm doing wrong. I just don't know what I'm doing wrong.....

I'm severely depressed as I have been studying for over a year and still got this score. After this NBME I was finally deciding to sign up for the exam and finally get out of this situation of studying all the time, but now I have to continue studying. I have finished uworld + FA-2x+ pathoma 2+ half UsmleRx+ some kaplan q+ Old NBMEs 1-7. I was supposed to do DIT, but skipped it.
Now, I'm planning to do DIT and then take another NBME. I might not go over the answers for this NBME 12 and redo this one after DIT since I'm running out of NBMEs. I only have NBME 13-15-16 left.

Please, help assess my reports if you can. I took NBMEs in this order NBME 11=193 in May, UWAS1=201-10=191 in June, NBME 12=188-July

---

Members don't see this ad.

 

[J ROD]

I found DIT to be really helpful as a quick review and helped get me my base. I would say maybe give it a try. It seems like you need to find a way to build your knowledge base. And, if the review books are not working, then it almost seems like you need to go back and redo the first 2 yrs and learn the material better. What were your grades like in the first 2 yrs?

 

[FA2014]

JDub, Do you really think someone will go back to repeat 2 years? Most students don't do well in their first 2 years but they do manage to study for step 1 in short time and do well.

 

[J ROD]

I was not saying they would or should. But, if you can't get it from the review books then you need to learn it better the first time. Basically, they need to just do the best they can with DIT or something similar and go over FA really well a couple times. Then, see where they are. There is no base to built off based on how long they have been trying. Over a year....eventually you have to take the test and let it be what it be.

 

[SBR249]

OP: I think the important thing is to pinpoint the problem. When you did the NBMEs and UW did you go back and look at the questions you missed? How did you feel about those questions? Were they stuff that you knew or thought you knew but you just didn't remember? Or were they stuff that had you scratching your head going like "WTF is this??". When you look at explanations in UW or online for the NBMEs did those things jog your memory and make sense to you? Or do you have a hard time wrapping your mind around them? Your reactions to the questions and the explanations can tell you a lot about what you should do.

- If you have absolutely no idea on most of the questions and the explanations are hard to understand then you need to go back to basics and relearn some stuff. I'd say get some more in depth books like BRS series, High Yield series, or the First Aid Basic Sciences books and really hammer those basic topics at a deeper level before coming back to the review books.

- If you don't remember the stuff but knew that you knew it at some point in the past, then you need another review strategy that will help you retain the stuff better. Maybe try other resources like flashcards, picmonic, firecracker, DIT, Goljan, etc

- If you remembered the facts but for some reason just can't make the connections then I'd say you need to find a study partner or tutor and just go over questions with them. Listen to how they reason out questions and then read explanations to see how question writers want you to reason out questions.

In any case, I would not continue like you have been and just do repetition upon repetition. There is a diminishing return there and I think after over a year, you've reached the plateau on that strategy. Not to mention you'd be wasting valuable practice question resources.

 

[rodmichael82]

Did you learn and understand Pathoma thoroughly? That alone will get you in > 220 margin.

 

[step1plan]

Seriously, thank you for responding. I need help making a schedule starting today and see what results I get in few weeks. I want to follow the advice I get from you guys and see if I improve.

Here's my schedule for 3 weeks:

Rx questions- 2 blocks
DIT-starting with my weak subjects
Uw questions- 2 blocks
Pathoma

At the end of August take another NBME.
------------------------------------------------------------------------------------
@SBR249,
" If you don't remember the stuff but knew that you knew it at some point in the past, then you need another review strategy that will help you retain the stuff better. Maybe try other resources like flashcards, picmonic, firecracker, DIT, Goljan, etc

- If you remembered the facts but for some reason just can't make the connections then I'd say you need to find a study partner or tutor and just go over questions with them. Listen to how they reason out questions and then read explanations to see how question writers want you to reason out questions.
"
These 2 were my issue and I think another thing that I did wrong was that I stopped doing questions for 4 days before the assessment and when I started the NBME I was having hard time pacing through and thinking fast.

What other options are there to help make connections if I don't find it helps me when I study with a partner? I think I need help with test taking strategies.
------------------------------------------------------------------------------------

@ Jdub, can you tell me how DIT is used? Did you use the videos first and then the work book? What score did you get after using DIT?

-----------------------------------------------------------------------------------
@rodmichael82, I have done pathoma 2 times and on the last NBME it shows I need to work more on it. So, I might do it one more time.



Any advice regarding my schedule would be greatly appreciated and I will report back in 3 weeks after taking an NBME. What else can I do in days leading up to an NBME?

 

[USMLEstudent01]

Keep working on it, you will get there. Your schedule is similar to mine except for the Rx question bank. Don't just focus on your weak make sure to review your other subjects too. And not doing questions can have bad impact on your score so that's one thing you should not stop doing everyday.

 

[Transposony]

What other options are there to help make connections if I don't find it helps me when I study with a partner?

After looking @ your NBME/UWSA charts it appears that your problem lies with integration of subjects.
I suggest doing Integrated Cases for USMLE Step 1 by Dr. Lionel Raymon instead of DIT.
He really integrates all subjects well and DIT is only useful if you are not motivated enough to prepare on you own.
A good study partner is very helpful to discuss topics and clear concepts but beware of "study partner from hell".

 

[Psai]

pathoma made me jump from around 210s to 230s imo
don't learn facts. try to understand why things happen. goljan is good for this if you have time to read his book or listen to the audios passively (while you exercise or cook)

 

[Ismet]

Did you learn and understand Pathoma thoroughly? That alone will get you in > 220 margin.

You think Pathoma alone gets you in the 220 margin??? Pathoma is just path...

 

[rodmichael82]

You think Pathoma alone gets you in the 220 margin??? Pathoma is just path...

Just like Psai stated, Pathoma alone made me jump from a 210ish to a 230ish in 1 week so I would say yes.

Pathoma is not just path, there's some very high yield Immuno, Micro, Pharm, Physiology and Anatomy integrated into his lectures.

 

[Ismet]

Just like Psai stated, Pathoma alone made me jump from a 210ish to a 230ish in 1 week so I would say yes.

Pathoma is not just path, there's some very high yield Immuno, Micro, Pharm, Physiology and Anatomy integrated into his lectures.

Right, then you would say Pathoma is worth a 20 point bump. Not that Pathoma gets you to >220. Because it doesn't. It's not going to make someone averaging 190 jump to a 220, especially for someone who has already gone through it twice.

I know there's more than just straight path in Pathoma, but it's not enough of the non-path material to make up for any weaknesses in pharm or micro or anything. You'll get some high-yield tid-bits.

 

[rodmichael82]

Right, then you would say Pathoma is worth a 20 point bump. Not that Pathoma gets you to >220. Because it doesn't. It's not going to make someone averaging 190 jump to a 220.

Well I think of the effects of Pathoma as a sigmoid curve, the lower end folks can probably get a bigger jump. I'm no genius and I gained 25 points from it in 1 week to be exact. Obviously the more passes I did the higher I scored. So I would imagine someone with 190 continuing their prep with whatever they are doing and adding Pathoma could easily hit 220. Now if we are talking about > 230 then probably not.

 

[Ismet]

Well I think of the effects of Pathoma as a sigmoid curve, the lower end folks can probably get a bigger jump. I'm no genius and I gained 25 points from it in 1 week to be exact. Obviously the more passes I did the higher I scored. So I would imagine someone with 190 continuing their prep with whatever they are doing and adding Pathoma could easily hit 220. Now if were talking about > 230 then probably not.

Unless their biggest weaknesses are in high-yield basic science topics, as in OP's case. My weak areas were largely micro and pharm. Pathoma made me good for general path. Based on OP's score reports, he could use a solid boost in Path, but the weakest areas are basic science.

I don't mean to disagree with you about the benefits of Pathoma, because he seriously saved my butt in 2nd year and on Step. I'm just saying there's more at play to getting to 220 from 190 than path.

 

[rodmichael82]

Unless their biggest weaknesses are in high-yield basic science topics, as in OP's case. My weak areas were largely micro and pharm. Pathoma made me good for general path. Based on OP's score reports, he could use a solid boost in Path, but the weakest areas are basic science.

I don't mean to disagree with you about the benefits of Pathoma, because he seriously saved my butt in 2nd year and on Step. I'm just saying there's more at play to getting to 220 from 190 than path.

I agree and I think you're kinda cute.

 

[Ismet]

I agree and I think you're kinda cute.

Aw shucks!

 

[step1plan]

After looking @ your NBME/UWSA charts it appears that your problem lies with integration of subjects.
I suggest doing Integrated Cases for USMLE Step 1 by Dr. Lionel Raymon instead of DIT.
He really integrates all subjects well and DIT is only useful if you are not motivated enough to prepare on you own.
A good study partner is very helpful to discuss topics and clear concepts but beware of "study partner from hell".

I never heard of his cases, that's new to me. I'm going to look into it.

 

[step1plan]

Well I think of the effects of Pathoma as a sigmoid curve, the lower end folks can probably get a bigger jump. I'm no genius and I gained 25 points from it in 1 week to be exact. Obviously the more passes I did the higher I scored. So I would imagine someone with 190 continuing their prep with whatever they are doing and adding Pathoma could easily hit 220. Now if we are talking about > 230 then probably not.

Yeah, I plan to go over it again. How should I use it this time? I have already watched videos and even took notes.

 

[step1plan]

For DIT, should I only do the subjects I'm weak in or the entire course in order?

 

[rodmichael82]

Yeah, I plan to go over it again. How should I use it this time? I have already watched videos and even took notes.

Reread Pathoma a couple times (should take no more than 3 days) and then rewatch all the videos.

 

[step1plan]

Reread Pathoma a couple times (should take no more than 3 days) and then rewatch all the videos.

I'm following what you guys are telling me. Hopefully, I get out of this range and into 230+ on my next NBME. I don't know why I feel it's impossible, but I will do my best.

 

[sobored]

I'm following what you guys are telling me. Hopefully, I get out of this range and into 230+ on my next NBME. I don't know why I feel it's impossible, but I will do my best.

Try not to spread yourself too thin with all those resources. I think you should focus on 1 or 2 sources and learn them well over the next few weeks. I agree with rodmichael that you should really hammer home pathoma. If it was me I would just go Pathoma, FA, questions all day everyday for the next 3 weeks. I bet that will bring your score up quite a bit. Keep at it and don't get discouraged. It will work out.

 

[rodmichael82]

Try not to spread yourself too thin with all those resources. I think you should focus on 1 or 2 sources and learn them well over the next few weeks. I agree with rodmichael that you should really hammer home pathoma. If it was me I would just go Pathoma, FA, questions all day everyday for the next 3 weeks. I bet that will bring your score up quite a bit. Keep at it and don't get discouraged. It will work out.

+1 Yah all you really need is Pathoma, First aid and Uworld. The whole DIT thing is a complete waste of money and time.

 

[operaman]

The score reports show some serious deficiencies in multiple areas, though different ones on each exam. You clearly addressed your weaker areas after the first one, though at the expense of others. I'm not sure what exactly is causing this, but here are a few possibilities for you to consider:

1) Wholly inadequate study strategy made up of cramming/forgetting. This may have been enough to survive the first two years, but now that it's time to integrate material the weaknesses shine through. There may also be inadequate repetition of material as well. Possible strategies would be a spaced repetition program like Firecracker or making your own Anki cards, etc. Yet another would be enrolling in a larger prep course for a few weeks.

2) Study strategies that develop short term retention while neglecting long term memory. These people will study something in the AM and then do practice questions on that same topic in the PM. This artificially inflates their scores. If your UWorld averages are drastically different from your NBME scores, this may be the problem. Taking a large comprehensive test means that a large fraction of material is stuff you haven't covered recently. Another clue is constantly feeling like you "know" the answer but just can't quite remember it. Everyone feels this from time to time, but if you feel it constantly it may be a sign of poor strategy.

3) Generally lackluster performance from day 1. While it's possible to have average grades and then pull out an above average step score, realize this is the exception. If you have had to repeat/remediate some classes already, then you are set up to be one who struggles on Step 1 and a 230+ score may not be possible, especially since you're stuck at <200 after 3 months of study. If this is the case, I think some prep courses like Kaplan or DIT just to build your knowledge base would be a wise investment. I would do the whole course because you are weak in every subject.

4) Test anxiety. You are blowing some really easy questions. Either you don't know them or you get too nervous and can't think straight. It's easy to tell which one you are by how you feel when you review your wrong answers. If it's really test anxiety, I would talk with your physician about possible options as there are some drugs used off label for this. If you don't know the answers to the easy ones even on review, then you need some serious remediation.

I think after 3 months of study, your goal now should be passing rather than a 230. I say this not to be mean but because I think it would predicate a change in strategy. You need to focus on content knowledge and picking off the low hanging fruit enough that you can pass and possibly break 200. Generally, I would say find some comprehensive review course -- any course -- and do it. All of it. In order. Pathoma is great but only covers pathology; you need to cover everything. DIT, Kaplan, etc. Something that covers all the bases. Your scores are unchanged after 3 months (remember NBME and the real deal have a +/- 6 point standard error on the 3 digit score). Do something different. Drastically different.

 

[step1plan]

The score reports show some serious deficiencies in multiple areas, though different ones on each exam. You clearly addressed your weaker areas after the first one, though at the expense of others. I'm not sure what exactly is causing this, but here are a few possibilities for you to consider:

1) Wholly inadequate study strategy made up of cramming/forgetting. This may have been enough to survive the first two years, but now that it's time to integrate material the weaknesses shine through. There may also be inadequate repetition of material as well. Possible strategies would be a spaced repetition program like Firecracker or making your own Anki cards, etc. Yet another would be enrolling in a larger prep course for a few weeks.

2) Study strategies that develop short term retention while neglecting long term memory. These people will study something in the AM and then do practice questions on that same topic in the PM. This artificially inflates their scores. If your UWorld averages are drastically different from your NBME scores, this may be the problem. Taking a large comprehensive test means that a large fraction of material is stuff you haven't covered recently. Another clue is constantly feeling like you "know" the answer but just can't quite remember it. Everyone feels this from time to time, but if you feel it constantly it may be a sign of poor strategy.

3) Generally lackluster performance from day 1. While it's possible to have average grades and then pull out an above average step score, realize this is the exception. If you have had to repeat/remediate some classes already, then you are set up to be one who struggles on Step 1 and a 230+ score may not be possible, especially since you're stuck at <200 after 3 months of study. If this is the case, I think some prep courses like Kaplan or DIT just to build your knowledge base would be a wise investment. I would do the whole course because you are weak in every subject.

4) Test anxiety. You are blowing some really easy questions. Either you don't know them or you get too nervous and can't think straight. It's easy to tell which one you are by how you feel when you review your wrong answers. If it's really test anxiety, I would talk with your physician about possible options as there are some drugs used off label for this. If you don't know the answers to the easy ones even on review, then you need some serious remediation.

I think after 3 months of study, your goal now should be passing rather than a 230. I say this not to be mean but because I think it would predicate a change in strategy. You need to focus on content knowledge and picking off the low hanging fruit enough that you can pass and possibly break 200. Generally, I would say find some comprehensive review course -- any course -- and do it. All of it. In order. Pathoma is great but only covers pathology; you need to cover everything. DIT, Kaplan, etc. Something that covers all the bases. Your scores are unchanged after 3 months (remember NBME and the real deal have a +/- 6 point standard error on the 3 digit score). Do something different. Drastically different.

Thanks for the detailed reply. I understand what you're saying. Most of the time the questions I get wrong are not something new to me. I do make stupid mistakes on easy questions even though I know it. I think I over think on the stupid mistakes, sometimes can't really recall info correctly, and at times unable to make connections. Also, when I do new sets of 46 questions I usually get +70%.

I don't know if this should be worth considering, but when I was taking the NBME 12 some kids were doing fireworks when it wasn't even 4th of July anymore and not the small ones, but the one that sound like a bomb, 2 times. At first I was like I should stop and see if it was just the kids or if there's something really going on lol., but then I continued thinking I should continue and finish it no matter what. Then later on my mom came into the room to get something when I was on the 3rd block. So, I did lose concentration few times.

You said "Do something different. Drastically different" I'm not sure what I can do drastically different, but I will give DIT a shot, redo Pathoma, and continue doing questions.

 

[FA2014]

OP: " I think another thing that I did wrong was that I stopped doing questions for 4 days before the assessment and when I started the NBME I was having hard time pacing through and thinking fast."

Guys, not doing questions for 4 days, can it have a big negative impact on score?? So that should be a reminder to all to not stop doing questions just to continue reviewing a week before exam.

 

[operaman]

If you're getting 70% right on new blocks of 46 random, timed (NOT tutor) questions, then that correlates to about a 220-230. If you aren't doing random or you're doing untimed or doing timed tutor or something, then that would explain the difference. If you are really doing testlike conditions for your practice questions, then there's something else going on because that's too large a drop. My top 2 ideas:

1) Test anxiety. You may be putting a lot of emotional investment into the NBMEs and doing think clearly. You may want to see an MD about options for managing your test anxiety if this is indeed what's going on.

2) ADD. Ever been evaluated? Are you getting distracted and can't refocus and end up running out of time? This is also an area where you might benefit from a visit to your MD.

My gut tells me there's some big difference between those blocks of 70% and your NBMEs like you're doing timed tutor or non-random or something.

 

[Petypet]

OP: " I think another thing that I did wrong was that I stopped doing questions for 4 days before the assessment and when I started the NBME I was having hard time pacing through and thinking fast."

Guys, not doing questions for 4 days, can it have a big negative impact on score?? So that should be a reminder to all to not stop doing questions just to continue reviewing a week before exam.

No. The last 2 weeks of my dedicated prep I only did a few NBMES and did fine.

Also, when I do new sets of 46 questions I usually get +70%.

You said "Do something different. Drastically different" I'm not sure what I can do drastically different, but I will give DIT a shot, redo Pathoma, and continue doing questions.

70% on uworld, first pass, is more like a 230-240+. It sounds like you have test anxiety, or you aren't studying enough, or correctly. You need to cut to the basics and build a foundation, as a 180-190 is a lack of foundation. Uworld, FA, DIT or pathoma, as someone else said don't spread yourself to thin. If it were me, I would do ONLY uworld and FA, honestly. Until you know those sources cold, why fill your head with other stuff. 100 questions Uworld a day and 50-60 pages of FA a day. This schedule would take 8-9 hours if you actually spent time in a quiet room focusing.

 

[rodmichael82]

Yah CONSISTENTLY getting > 70 % on Uworld timed, randomized, all sections is definitely > 230. I'm not talking about getting 70 % + every now and then. So yah if you're not getting that on NBMEs sit down and try to really figure out what you are doing wrong before or during the exam. I think the most important thing for me was to practice Uworld questions and NBMEs at the same time as my actual exam which was 8 AM, try doing that if you're not already.

 

[super_mom]

help needed i am a mom of twins who about 14 months. i have been studying for STEP since last year june on and off from 10am to about 8pm monday thru friday in the library. but last year i was not too focused from traveling but november last year i took UWSA and got a 204 .Due to the fact that i travelled a lot last year I decided to focus very well on FA and UW this year.I started Mid january using FA and Uworld. later this year i took UWSA 2 in march and got 190 then I took NBME 7, May 17 and 250=175 and i took NBME 11 today and even dropped to a 180=160. i am so devastated because i am tired of studying i was planning on taking my exam this month if NBME 11 goes well but my eligibility ends sep 30. so i am moving ti to sept 30 giving me about 7 weeks to bring my score up. i will love to get a 250 but at this point i jus want to pass step 1 even if i don't get a high score because i am so tired of glueing myself to my books. I am join to take the advice above and make a 3 wk schedule where i do pathoma, FA and uworld. hopefully i see an improvement end of august.