Took it today. Demoralized--people have said that this is normal coming out of the exam but I just can't shake the feeling. Definitely worried that I ended up making some serious errors and cannot stop thinking about the easy work-ups and gimmie questions that I missed. Actually had a thought while I was driving home from the exam about how I would have to explain my CK score during residency interviews. Sigh.
That being said, I want to do a quick write-up while the experience is still fresh in my mind. Wasn't very active on this forum but was around on the Step 1 forum last year so it's great to see familiar names.
Overall, the stems were long. Generally, they are 1.5 to 2x the length of NBME practice tests and UWorld questions. They tend to be full of extraneous information, obscure or borderline lab values, and are spaced out so that you have to keep your eye jumping around the page--you can't just glance at a few key words or values to create a differential. Being efficient at highlighting key info goes a long way--there were times when I took a look at a question I read and realized that I basically had the whole stem highlighted. That did not get me anywhere. So just don't zone out when you're reading a long stem and be mindful of what you're seeing so that you do not have to continually backtrack to the top of a question stem. I know that sounds like very simple advice but being mindful of how I needed to focus really helped me out on a few blocks (especially one where I had a nightmare drug ad).
Time is also a major issue. On most blocks, I finished with about 5-6 minutes left whereas I would have about 20-25 minutes left on UWorld, the UWSA, and NBME practice exams. Also, a lot of questions have a long list of lab values serving as distractors. Rarely, do they use a buzzword or classical finding to make a diagnosis easy for you. The main issue I had was that many questions were narrowed down to two equally valid answers and ended up vacillating between the two.
The exam was a fair balance of all subjects. I think the way that the biostats questions are presented on CK vs Step 1 makes it a subject that is important to cover, but if you are strapped for time (like I was) then it might be wise to not devote too much time to it. The way those biostats questions are written and the fact that you might be running low on time makes it easy to make simple errors. Just memorize the basic equations and I think you'll be set.
Step 1 Background: 245
Shelf Exams:
Did well during 4th year and generally read UptoDate while on rotations and did FC a few times a week to go through key concepts. Felt that FC was a good resource (especially when I was getting pimped) but questions are definitely the way to go for Step 2. I also picked up
Step Up to Medicine and
MTB2 but they just weren't for me, so I only referred to them if I had a specific question. Both books basically sit unused, though. Pestana's book was a good resource for surgery and I also found Blueprints to be a good FM and OBGYN resource.
Questions:
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USMLE Rx, mainly used this qbank for shelf exams. The questions highlight important concepts and the explanations are a quick, easy read. I found it very manageable during busy rotations.
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UWorld.
The single best resource. I began it during my 4-5 week dedicated period and completed it 1.9x prior to the exam. I went through it slowly for the first pass (72% avg, random-timed), taking notes on questions. Then, I spent a few days slowly re-reviewing my incorrects. Afterwards, I began a second-pass and got through about 90% of the qbank (89% avg, random, tutor) before exam day.
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Kaplan. Bought this. Unecessary and only used it to go through some renal questions and remind myself of basic path. The questions are poorly written (not representative of the type you'll see on exam day). Also, the questions focus on nitty gritty details that really don't do much to further your knowledge base. It's also important to note how bad the interface is, how it seems questions are rarely updated, and how the lack of a true qbank app highlights how much this resource has been neglected by its owners and how little they value improving it. If you are going to use resources all year then you might want to do UWorld, Rx,
and Kaplan, but I think that UWorld and Rx are sufficient.
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NBME Practice Exams. Again, I wasn't very active on this forum so I am not sure how the NBMEs rank and how highly they are valued compared to UWorld. I did practice exams in the following order, approximately every 5-6d during my prep and went through incorrects with another forum member--found this to be very helpful:
- NBME 7: 248
- NBME 6: 242
- NBME 4: 242
- UWSA: 262 (6d out)
- Free 131: 87% (1d out)
I highly recommend doing all of the NBME exams. I think the concepts emphasized on these exams were representative of things on exam day. The dip in scores between NBME 7 and NBMEs 6 and 4 kind of freaked me out and motivated me to study, so just keep that in mind if your scores fluctuate.
Will share my score and add details later if I feel anything else needed to be mentioned.
