Where do I start from here??

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Dec 9, 2014
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So I just took UWSA 1 and am distraught. My test is a little over 2 months away (June 5) and I scored a 183 (53% correct) on it. This was my first practice test and we still have to finish psychiatry for the school curriculum before dedicated starts. I was honestly expecting a 200+ but man, seeing that scores makes me feel terrible. There were so many different sections that were well below average, with the exception of neuro, which we are currently doing in class. Where should I even start from here????

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What resources are you using? What have you done currently and what is your future plan?
@LyMed thanks for your reply! I’ve been using UFAP, sketchy micro, some sketchy pharm and boards and beyond for my classes. Ive been trying to study for boards since winter break, basically by watching boards and beyond, underlining in FA, then doing practice questions (USMLE rx, then uworld). I got thru general principles/biochem, a lot of sketchy, derm/msk and heme, but my practice test is still relatively low in those sections (very low in ones I haven’t looked at in awhile: endocrine, resp, repro). My future plan was to work on my weakest sections for the next few weeks until we take our CBSE (marks the start of dedicated), then for the 6 weeks of dedicated try to finish as much uworld and nbmes as possible. After glancing thru the uwsa questions, i could’ve made about a 70% if it wasn’t for the questions that I got down to 2 answers and chose the wrong one. At this point I know I need to work on my weaknesses, but how?? I'm not sure if i should just review BnB/FA/pathoma for the systems I did worst and then do relevant questions (which is how I initially studied for class) or switch it up because maybe the first way I learned it wasn't as good. Also should I be taking a nbme before the CSBE?? Thanks
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I would consolidate all my resources into a single source of notes. I recommend a total review of all systems. When you’re below the pass mark, all subjects are weak points.
You don’t need to rush and take another nbme before dedicated study time if you plan on taking 6 or more in total.
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@LyMed ok I’ll start doing a review of systems today and keep everything only in FA, hopefully finish in the next few weeks. I recently found out that the results from the csbe we take in 2.5 weeks won’t get back to us until 1-2 weeks after we take it. Would it be wise to take an nbme maybe a few days after the csbe (or immediately after I finish the review of systems) or should I just wait for the results to gauge my progress?
If that’s the case, then yes you should take a nbme at the start of your dedicated.
Cut and pasted from my post in the sticky thread, for relevance.

I got a 164 on my first NBME practice test, and got a 246 on Step 1 50 days later. Obviously this took some big mistakes during preclinical to end up in such poor shape, basically I figured out how to effectively game our curriculum. It was not on purpose, just landed on a very efficient way to do fairly well on our exams that ultimately amounted to cram/purge. I knew I needed to get on top of step study before dedicated came, but in the middle of our last semester I had a break up and was super unhappy and just didn't make it happen. Also, I got a 516 on the MCAT and I'm not trying to do anything super ambitious as far as specialty, so I wasn't worried about trying to get a sky-high score and pretty confident I would be fine. I figured I would be at about 200 to start and end up in the 235-240 range with a moderate amount of studying. Clearly, that's not how it went. I think what I landed on was really the only way that I had a chance, so here's my tips. You have to pick a couple modalities and stick with them, if you're second guessing constantly it will be [more of] a nightmare.
  1. Zanki- This was far and away the number one tool for me. It's not perfect, if I had a time machine I would have used the preclinical years to edit and improve the deck as we went, but as far as I can tell it is the most complete resource there is. I reset the deck and did the whole thing. With fairly normal settings, it's impossible to keep up with the reviews, so I used my discretion on how many passes I needed for any given section. For example, with several blocks I just made a pass or two through the physiology, but reviewed the path several more times. I'll warn you right now that the two big sand traps in the deck are metabolism in biochemistry, and the MSK anatomy. Basically you can try to memorize the entire anatomy of the body to get one more question right, or you can save yourself days of studying and just plan on guessing on the one or two pure anatomy questions you're likely going to get. I could manage about 2000 clicks a day on average, about 250 an hour. So that's 8 full hours of nothing but cards every day. It's rough, but possible. And you'll need the rest of the hours for...
  2. Uworld- Also important, I did it block-by-block after I'd seen the Zanki cards. I hate doing questions I don't have a clue about, I don't think it builds any connections to guess wildly. If you have enough knowledge on the topic to think hard about it, that makes things stick. I ran out of time to do my misses, which I would have liked to do. I had to do about 65/day to get though, which meant at least 2 hours with thorough review. I read all the info, unless I thought it was a really easy question. My final percentage was 70-something, keep in mind I was making at least a partial pass of the cards before I got into a topic.
  3. Sketchy- Micro and Pharm, I watched all of them, and did the corresponding zanki cards, except I used lolnotacop for micro one someone's recommendation. I tried skipping the videos and just doing the cards and it was not as good. It's time consuming but worth it. I don't see how pharm is possible without it, for step 1 level pharm it's almost complete and super clutch. I'm on clinicals now and still think about pharm sketches on a almost daily basis. I wavered a bit on reviewing in sketchy vs. zanki pharm reviews, zanki takes longer but sticks better IMO. If you're in a hurry though you can go look at a bunch of sketches pretty quickly.
  4. NBME practice tests- This guy's unpopular opinion, screw those things. They take about 2/3s of a day to do and review, provide no explanations for their answers, and lots of the questions are just utter ****. The real test looks more like uworld. Now, you're probably going to do them anyway because it's hard to get away from and everyone else on here told you to do them. But just one guys anecdote, my forms went 164, 198, 213, 225, and then I got a 246 4 days after that last one. Had I not wasted my time to get that very disappointing 225, I'm confident I would have done even a little better, since in the time it took to do it, I would have knocked about about 1600 cards. I would do the uworld sims preferentially over the NBMEs, since they at least give you explanations. In my experience the NBMEs are neither an effective learning tool, nor an accurate predictor, also the NBME doesn't deserve your $60 when that website looks like it was made in 2001 by a guy named Gary in his mom's basement and they can't even be fussed to write up a blurb about why they think you got their ****ty question wrong.
Getting this done took all day, every day, for the ~50 days. I did truncated days twice, on Christmas and my birthday. Other than those, I think I went out to dinner once, and never did any rec activities really. I usually watched a show or something before going to bed, just to try to get my mind of it before falling asleep. Honestly, much of it was an absolute nightmare. I slept terribly because of the constant anxiety about what I had to get through the next day, I dreamed in Zanki cards, and repeatedly fell apart and had to get it together again, especially after every disappointing NBME form. It's a **** time, but that's pretty much by design, and you will learn that you're capable of pushing yourself more than you thought. So I hope some of that is useful, best of luck!
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