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I've read tons of Step I experiences on SDN over the last year or so, and so I figured I might as well contribute my own. My overall experience was good, although now that's it's over, I have a number of opinions that differ quite a bit from those which I have heard repeated as gospel.
What I found surprising:
What blew me away about the test was the raw number of questions that were about general principles, meaning that you couldn't study for them by simply popping open first aid and memorizing some random crap. Although LAUGHABLE in retrospect, I "browsed" (picture= furious page turning) First Aid on my subway ride up to Penn Station, my testing site. Didn't net me a single question! A good percentage, perhaps the majority, of the questions required knowing general principles and being able to think on the fly. They'd give you a totally novel, or straight out weird, application of something you've probably seen before, but if you hadn't processed it but had simply memorized it. . . well, good luck answering usmle q's.
Whether this is a good thing or a bad thing, I think, depends on your perspective. It seems like the test is designed so that after preparing for a limited period of time, you'll plateau with minor additions to your databank of memorized trivia making little difference. In an academic journal (you can search my posts if you want to find the exact reference), some researcher placed this at about 3 weeks. I didn't believe them. Now I do.
Another thing that stood out was the large number of visual questions, not so much pictures as graphs, charts, arrows, etc. None of the question banks out there approach the real step I in terms of the percentage of questions that have information presenting in a graphical or pictorial format. Actually it makes the questions easier to interpret, but if you aren't used to it, it can slow down your thinking and/or accuracy.
About randomization:
My test had a pretty fair distribution of questions w/ the emphasis definitely being on path, as most people report. I got only a handful of molecular bio questions, 4 or 5. I had been expecting more (and prepared more for these), having heard that some people got nailed on this. Must be true that the test truly is randomized. I used to think that some people were off their rocker, had selective recall, or were making up stuff, but apparently it ain't so. Tests do differ. Recall accuracy differs but I think most people are at least in the right ballpark when they give estimates.
About "hard" and "easy" subjects:
I've heard many people here talk about hard subjects (mol bio, genetics, immuno, and whatnot) and easy subjects (supposedly pharm and micro). I think that's bunk. Within EVERY subject area there were easy questions (how many fingers are there on the hand?), med-easy, med-hard, hard, and WTF questions. And this only makes sense, since within each category they are probably trying to generate something resembling a Gaussian distribution.
Numbers going in:
Q bank 82%, all randomized (range 68-92), finished all but last 200 q's
Q book 76%, did these before q bank
NBME Assessment 690, 1 week before, never had time for the 2nd one
Rapid Review Q book (by the Goljan dude) 70's, first question set I did and never computed average
What helped, what didn't:
I did most of the standard things other people have done to prepare. And most of them were useful to some extent, but in the end, were they really all that useful?
Instead of disparaging what I thought sucked, I thought I'd mention what seemed good.
Thumbs up -->
NBME assessments (these are absolutely the closest to the style of questioning that you will get to the real thing). If you have to choose between q-bank and these, it isn't even a competition. Q-bank was good for practicing doing randomized sets of 50, so you could develop the ebb and flow of computerized testing, but other than that, it was only so-so. Especially ridiculous about q-bank is the fact that they ask too many ridicously detailed questions that the step usually doesn't even seem to get into. Out of the 350 questions I got on the real deal, fewer than 10% of the questions revolved around not having been exposed to a concept before. The problem was usually a secondary or tertiary block in thinking through the problem, or not knowing quite enough about a common subject. With q-bank the block is too often simply not even being able to recognize the concept because you haven't been exposed to it. (guess I couldn't help disparaging q-bank)
Robbins Pathology Review (the question book) - I did these during my path course, but forgot all about them during usmle prep. Thinking back, the questions in this book, especially the ones on general path, are closer to step I questions than the ones I labored through in the last month of prep.
What I found surprising:
What blew me away about the test was the raw number of questions that were about general principles, meaning that you couldn't study for them by simply popping open first aid and memorizing some random crap. Although LAUGHABLE in retrospect, I "browsed" (picture= furious page turning) First Aid on my subway ride up to Penn Station, my testing site. Didn't net me a single question! A good percentage, perhaps the majority, of the questions required knowing general principles and being able to think on the fly. They'd give you a totally novel, or straight out weird, application of something you've probably seen before, but if you hadn't processed it but had simply memorized it. . . well, good luck answering usmle q's.
Whether this is a good thing or a bad thing, I think, depends on your perspective. It seems like the test is designed so that after preparing for a limited period of time, you'll plateau with minor additions to your databank of memorized trivia making little difference. In an academic journal (you can search my posts if you want to find the exact reference), some researcher placed this at about 3 weeks. I didn't believe them. Now I do.
Another thing that stood out was the large number of visual questions, not so much pictures as graphs, charts, arrows, etc. None of the question banks out there approach the real step I in terms of the percentage of questions that have information presenting in a graphical or pictorial format. Actually it makes the questions easier to interpret, but if you aren't used to it, it can slow down your thinking and/or accuracy.
About randomization:
My test had a pretty fair distribution of questions w/ the emphasis definitely being on path, as most people report. I got only a handful of molecular bio questions, 4 or 5. I had been expecting more (and prepared more for these), having heard that some people got nailed on this. Must be true that the test truly is randomized. I used to think that some people were off their rocker, had selective recall, or were making up stuff, but apparently it ain't so. Tests do differ. Recall accuracy differs but I think most people are at least in the right ballpark when they give estimates.
About "hard" and "easy" subjects:
I've heard many people here talk about hard subjects (mol bio, genetics, immuno, and whatnot) and easy subjects (supposedly pharm and micro). I think that's bunk. Within EVERY subject area there were easy questions (how many fingers are there on the hand?), med-easy, med-hard, hard, and WTF questions. And this only makes sense, since within each category they are probably trying to generate something resembling a Gaussian distribution.
Numbers going in:
Q bank 82%, all randomized (range 68-92), finished all but last 200 q's
Q book 76%, did these before q bank
NBME Assessment 690, 1 week before, never had time for the 2nd one
Rapid Review Q book (by the Goljan dude) 70's, first question set I did and never computed average
What helped, what didn't:
I did most of the standard things other people have done to prepare. And most of them were useful to some extent, but in the end, were they really all that useful?
Instead of disparaging what I thought sucked, I thought I'd mention what seemed good.
Thumbs up -->
NBME assessments (these are absolutely the closest to the style of questioning that you will get to the real thing). If you have to choose between q-bank and these, it isn't even a competition. Q-bank was good for practicing doing randomized sets of 50, so you could develop the ebb and flow of computerized testing, but other than that, it was only so-so. Especially ridiculous about q-bank is the fact that they ask too many ridicously detailed questions that the step usually doesn't even seem to get into. Out of the 350 questions I got on the real deal, fewer than 10% of the questions revolved around not having been exposed to a concept before. The problem was usually a secondary or tertiary block in thinking through the problem, or not knowing quite enough about a common subject. With q-bank the block is too often simply not even being able to recognize the concept because you haven't been exposed to it. (guess I couldn't help disparaging q-bank)
Robbins Pathology Review (the question book) - I did these during my path course, but forgot all about them during usmle prep. Thinking back, the questions in this book, especially the ones on general path, are closer to step I questions than the ones I labored through in the last month of prep.
