Thanks to all that have helped me through the years on this forum. Time to pay it back...
I took the exam a week ago. I gave myself exactly two weeks to prepare. Although I always wish I had just one more day before an exam, this was an appropriate amount of time.
Background on me:
Slightly above average student Med1/Med2, kicked it into high gear and got 255 on Step 1. Med 3 grades were very strong (top 25%) and I studied quite a bit (lots of reading and a good chunk of UWorld). Shelf scores: OB/Gyn 98, Peds 89, Neuro 89, Psych 91, Family 84, IM 93, Surgery 94. I also had a couple emergency medicine rotations under my belt, which I think was tremendously helpful.
I studied for those two weeks focusing on UWorld. I did 150-250 questions a day depending on my motivation and made it through all of them. I started around 75% and quickly improved to the 80s. I made it through with an 80% average overall, which medfriends.org puts at a predicted 276. The last 48 hours or so, I read through my weak areas in Secrets. I made it through probably half the book. I wish I had made it through all of it, but I don't think it made too big of a difference.
Test day went well. I expected the worst based on what people were saying on here, but the exam felt just like UWorld with most of the questions being on the easier side. Yes, there were difficult/impossible questions, but I think many people have a skewed perception of how many of these there really are. Take what people say with a grain of salt and don't let it psych you out. UWorld was outstanding preparation.
8 blocks with 41-45 questions each. I marked 4-7 per block, although there's a good chance I missed more than that. Most of those were questions that no amount of preparation would have prepared me for. A few were dumb things that I simply couldn't remember (of course, one of those appeared twice as nearly identical questions... bummer). My exam seemed well-balanced. If anything, I would say that immunology and addiction medicine seemed a bit over-represented. I was glad that I had reviewed the immunology section of Secrets immediately before my exam and would highly recommend doing so.
Overall, I'm optimistic. I want >260 just so I don't slide from my Step 1 score, but would certainly be tickled by hitting 270. I'll update as soon as I have my score.
Hope that helps someone!
Edit for additional info: I finished my UWorld blocks with right around 20 minutes to spare every time. The questions on the exam seemed slightly longer, but not dramatically so. Nonetheless, I finished each block with only 3-5 minutes on the real deal. More than anything, I think I was being more cautious and spending more time trying to figure out the really difficult ones.