Took it yesterday...my thoughts

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darice

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Took it yesterday and wanted to give some of my thoughts.

Talk a bit about content first. Overall, pretty balanced. I'd say the majority of it was pathology/physiology as expected. It seemed like there wasn't hardly any biochem/metabolism questions at all, maybe 10-20 at most. Like others have said, though, I thought there was a good bit more cell/molec than maybe should have been. If you know your pharm, you should be able to get most of the pharm questions.. I don't remember too many toxicity type questions, and the ones I do remember were autonomic drugs so fairly easy. I did seem to have 4-5 questions dealing with psych/seizure drugs, though, which wasn't fun. Not much embryology and maybe 1 or 2 biostat questions. Behavior was pretty easy. Surprisingly, I did seem to have 3-4 questions dealing with "stats" e.g. prevalence of certain diseases, etc. which kind of sucked. Everything else was spread pretty evenly. Heavy hitters on my form seemed to be path/phys and cell/molec.

Next, question structure. I thought the test was extremely general, extremely vague at times. Most path/phys questions were 2,3 step questions. There weren't that many "what is the likely diagnosis" type questions. And the very rare times that there were these questions, they were very vague in describing the symptoms, used probably the least common symptoms of a disease, so that you were left kind of guessing what exactly they were describing. There were of course your usual WTF? questions as well (I'm hoping these were the "experimental" questions). I'd say maybe 1/4-1/3 of the questions were pretty straightforward. Overall, though, I think the majority of the questions were critical thinking, multiple step questions; which is why I think so many people really don't know if they did well or not, b/c the answers aren't really black and white. How well you do kind of depends on how good you were at reasoning through the answers. Honestly, I'd say this test focused a whole lot on your knowledge of basic, general pathology rather than just specific diseases. Much of the time, I felt like I was being tested on my 1st year knowledge rather than 2nd.

In retrospect, what would I do different?? First off, QBank pretty much proved to be worthless. In fact, I think it maybe ended up hurting me. It may be a good learning tool, but it DOES NOT prepare you for the real thing. It forces you to focus your studies on way too many details and may cause you to "lose sight of the forest because of all the trees." If I had it to do again, I honestly don't know if I'd use QBank b/c it may do more harm than good. The NBME forms are so much closer to the real thing (in fact, I had 3-4 questions that were the same questions stems verbatim from the NBME, just asking different questions). So I would definitely spend some time studying the big picture, making sure you have a good grasp on general pathology concepts. And of course, I'd spend a little more time with cell/molec.

So I honestly have no idea what to expect regarding my score. According to QBank (77% average on last 8 random sets), I should make 245+, but I have little doubt that my score will be much closer to my 211, 204 that I made on the NBME tests. Honestly, the way I feel right now, I'll be happy just to pass, thrilled if I break 200, and ecstatic if I score above average.

That's all I can think of right now, I'll add anything else if it comes to mind. I'll be around all day before leaving town tommorrow if anyone wants to ask anything....
 
Hi Darice,

Thanks for your really helpful description. Based on your insight into the test, I wouldn't be surprised if you significantly exceeded your expectations.

Good luck!
 
darice said:
First off, QBank pretty much proved to be worthless. In fact, I think it maybe ended up hurting me. It may be a good learning tool, but it DOES NOT prepare you for the real thing.

Darice, thanks a lot for your thoughts. Although I haven't taken the exam yet, I do feel that Qbank concentrates on minutiae. I have a few questions:

- Pharm, micro, embryo and immuno: was FA enough?
- Cell/Mol Bio: what books do you think are good prep? HY?
- Anat: is FA enough or should I supplement it with HY neuroanat and HY anat?
- Path/phys: did you do Robbins review questions, BRS questions, or Qbook? Do you think these are better prep than Qbank?

Thanks for your help. I'm sure you did very well.
 
I also took the test yesterday.. I agree with you about Qbank. DO NOT use it as your primary source of questions...I don't know how the questions from USMLERX look...

I had a lot of biochem, physio, and neuro on my test...

If I could go back in time, my study plan would be:
1)Pretest or some other question books for Neuro, Biochem, and Physio
2)Robbins question book for Pathology
3)First Aid for Behavioral Sciences, Microbiology, Pharmacology, Embryology, Anatomy (make sure you know nerve lesions..lower extremities included!!)
 
I left out Immunology...I recommend another source other than First Aid...skimming the section in Levinson's might help

Everyone should do Robbins Review questions...there were numerous questions that I answered easily because of this masterpiece
 
acab said:
- Pharm, micro, embryo and immuno: was FA enough?
- Cell/Mol Bio: what books do you think are good prep? HY?
- Anat: is FA enough or should I supplement it with HY neuroanat and HY anat?
- Path/phys: did you do Robbins review questions, BRS questions, or Qbook? Do you think these are better prep than Qbank?


FA was definitely enough for pharm, micro, embryo, and immuno. I really didn't seem to have that much micro on mine, honestly. I think there were 1 or 2 questions that asked about obscure parasites, but the others that asked about specific bacteria/viruses were pretty straightfoward. There were a few questions about general bacteria characteristics as well. For immuno, as long as you know that section in FA cold, you should be able to reason your way through most of the questions. I honestly don't even remember any embryo questions, so there couldn't have been many.

I only used FA for cell/molec, so since there seemed to be a good deal of it on my test, I would definitely suggest supplementing with another source.

FA is also enough for anatomy. The little anatomy that I had was tied to pathology....these were mainly arm/leg innervation injuries and neuro tract lesions. I also had like 3 questions about abdomen lymph node metastasis sites, which sucked cause I didn't really know them.

As far as other questions go, the only other ones I did were the BRS for path/phys as I got done with each chapter...and these were much easier than the real thing. Use these just to judge if you have the facts about the diseases memorized. Like I said, the closest questions to the real thing are the NBMEs.......
 
darice said:
I also had like 3 questions about abdomen lymph node metastasis sites, which sucked cause I didn't really know them.

About how detailed were these? Is anyone else clear on abdominal lymph node met sites? A couple of google searches haven't really helped. There are few lymph node drainage site tables around but, honestly, I can't seem to decipher them.
 
diet_dr_thunder said:
About how detailed were these? Is anyone else clear on abdominal lymph node met sites? A couple of google searches haven't really helped. There are few lymph node drainage site tables around but, honestly, I can't seem to decipher them.

They weren't really detailed, the questions just gave a certain abdominal cancer and then basically asked which lymph nodes they spread to first....kind of silly to have 3 questions on that I think. If anyone has a list, I'd like to know so I can see if I got any of them right (I don't know if I'm allowed to specifically tell which ones my questions asked about)....
 
freddydpt said:
I'm a little slow 🙂 I only see one practice exam there related to Step 1... is there something I'm missing?
Thanks for the help!
Fred

Go to the toolbar on the left and open an account. You will then have the option to purchase ($45 a piece) any of 4 different practice tests. They're not free, but the closest thing to the real test that you'll get....
 
I know the test make up is variable from test to test, but biochem wasn't a big portion? I guess that's the subject i'm most unsure about since i've only used first aid for it.
 
I think the main concept they were probably after was:

Sigmoid colon cancer: IMA lymph nodes
Small intestine cancer: SMA lymph nodes
Stomach cancer: celiac lymph nodes (or L supraclavicular)

darice said:
They weren't really detailed, the questions just gave a certain abdominal cancer and then basically asked which lymph nodes they spread to first....kind of silly to have 3 questions on that I think. If anyone has a list, I'd like to know so I can see if I got any of them right (I don't know if I'm allowed to specifically tell which ones my questions asked about)....
 
nrosigh said:
I think the main concept they were probably after was:

Sigmoid colon cancer: IMA lymph nodes
Small intestine cancer: SMA lymph nodes
Stomach cancer: celiac lymph nodes (or L supraclavicular)

Actually, they only asked about one of those (and it looks like I got that one right)... The other two weren't on that list...Any idea where some of the other abdominal/pubic cancers go???? Perhaps the gonadal tumors in each sex???
 
SurgeryRA said:
I know the test make up is variable from test to test, but biochem wasn't a big portion? I guess that's the subject i'm most unsure about since i've only used first aid for it.

I'm having a really tough time remembering specific biochem (metabolism) questions that I had, which means I didn't have too many. I can only specifically remember like 5 right now, though I'm sure I had more. But yeah, I would say I didn't have more than 20 at the most...
 
Testicular or ovarian tumors go to para-aortic lymph nodes.
Squamous cancer of the penis or vulva goes to inguinal lymph nodes.

Just think of the venous drainage...

darice said:
Actually, they only asked about one of those (and it looks like I got that one right)... The other two weren't on that list...Any idea where some of the other abdominal/pubic cancers go???? Perhaps the gonadal tumors in each sex???
 
nrosigh said:
Testicular or ovarian tumors go to para-aortic lymph nodes.
Squamous cancer of the penis or vulva goes to inguinal lymph nodes.

Just think of the venous drainage...

Well, looks like I got 2/3 for sure, which I can live with.....but hypothetically, let's say para-aortic nodes wasn't a choice for ovarian tumors, and you had to choose b/n internal iliac, external iliac, and nodes at the aortic bifurcation (common iliac), which would you pick????
 
Hey Darice et al

My test was very different from urs, its amazing how different they can be! Mine had lots of biochem, but 95% was answerable with FA/HY Biochem alone. I really felt like I got certain questions, like almost the same q, twice..how is that possible?

I think mine was a good spread tho..got a good amount of repro, tons of kidney, not much anatomy, more embryo that I woulkd have liked, lung physio that I totally did not get..pharm straightforward, micro ok.. I had some qs that were at least 3 jump questions. I got tired and started not caring tho...

bonnie
 
missbonnie said:
I really felt like I got certain questions, like almost the same q, twice..how is that possible?


Yup, definitely had this happen to me on several occasions....don't know how many times I put Staph as an answer...
 
I had a q on knowing that the inferior alveolar nerve goes into the bone of the mandible (q on MVA accident - BTW, i felt like alot the qs had to do with some some sort of MVA!)

The other day a friend told me that this yr's hot topic is gout - I had at least 5 maybe 10 qs on this! Like diagnosis, treatment, etc..weird!

I had a few to many biochem qs per block - a bunch on those storage dz (yes just rote memorization required), maple syrup dz, PKUs, INH/B6 stuff,actually now that I think of i realyl think i had a HUGE amount of biochem, including genetics, mol/cell bio.

bonnie
 
missbonnie said:
I had a q on knowing that the inferior alveolar nerve goes into the bone of the mandible (q on MVA accident - BTW, i felt like alot the qs had to do with some some sort of MVA!)

You talking about the question that had the x-ray showing the jaw fracture asking what was likely injured??? I put inferior alveolar nerve (or artery...can't remember which it was) as well....
 
Alright, I'm signing off for the night and headed out of town tommorrow for 10 days. Hope this thread has helped some folks and good luck to all who will be taking their tests while I'm gone. See you when I get back...
 
para-aortic LN is definitely the answer for gonads. The USMLE likes that question because it's somewhat of a "trick" question.

know the test make up is variable from test to test

Ain't that the truth. My USMLE was very heavily biochem. I think it's luck of the draw--they have a huge pool of questions to pull from when your test is assimilated, you can't be sure what you're going to get :scared:
 
I didn't think there would be so much biochem! It sounds like quite a few people had a good number of biochem questions.

Besides HY biochem and first aid, what you would guys suggest using? Biochem is one of my weakest spots and knowing my luck, I can just see myself having tons of biochem on my exam too!!! 😱
 
om207 said:
I didn't think there would be so much biochem! It sounds like quite a few people had a good number of biochem questions.

Besides HY biochem and first aid, what you would guys suggest using? Biochem is one of my weakest spots and knowing my luck, I can just see myself having tons of biochem on my exam too!!! 😱

i dont wanna freak u out, but i honestly think I had close to 60-70 qs (not all were straight biochem, some integrated with path)...

bonnie
 
om207 said:
I didn't think there would be so much biochem! It sounds like quite a few people had a good number of biochem questions.

Besides HY biochem and first aid, what you would guys suggest using? Biochem is one of my weakest spots and knowing my luck, I can just see myself having tons of biochem on my exam too!!! 😱
I thought Rapid Review Biochem was great...i just finished going through it last week...I would imagine its not much different than HY though - you can probably just stick with that.
 
My fourth-year buddy had exactly 3 biochem qs on his Step 1, 2 years ago...you just do the best you can in studying, and don't prepare for someone else's past exam!

Also, I can't afford to freak out because my exam starts in 11 hours. I'm just reminding myself that I have at least 30% wiggle room of questions that I do not have to get right in order to pass!
 
MeowMix said:
...you just do the best you can in studying, and don't prepare for someone else's past exam!
Well said. 👍
Good luck.
 
Just took Step 1 today....what stood out was that there seemed to be quite a lot of Psych/behavioral science type of questions for me....like probably 10% of the test....they were definitely easier than the Kaplan QBank ones though.
Another thing I felt was that I found the stuff I remember from BRS Path to show up much more than the stuff I remember from First Aid. So much for high sensitivity of the material for First Aid....oh well.
 
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