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Old 01-06-2015
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Default Unbelievable 7months journey to step 1..it's not over yet! (in depth - with pics)

Hi guys, have a good read: if you’re interested in the topic you won’t regret it!

I am an Italian medical student, male 23 yo (lol clinical vignette) at my 5th year of med school (we have a different medical education system from the American one).
In June 2014, after quite a lot of thinking, I decided that completing my medical education by applying for a residency program in the US was (and still is) simply the best way to fulfill my dream: become a surgeon, hopefully a plastic surgeon (as my father was. He left us when I was 13yo).
--> Step 1 target score: 240+ (to have a possibility with plastic surgery)

By the end of July 2014 I started studying.
-August: read once Goljan’s RR (right now I feel it was almost useless even though the book is great per se). Completed almost all of Biochem kaplan videos taking notes and literally sticking Kaplan “lecture notes” pages in my first aid (great collage work lol).
-September: Completed almost all of physiology and pharmacology kaplan video as I did with biochem.
*October: Completed first aid with particular attention for microbiology. On October 15 I did my first NBME (#15) and was shocked cause I got 179 --> http://imagizer.imageshack.us/a/img538/9369/sIsxa6.png .
After 3 months of intense studying, I really did not expect to do score so poorly and I recognized I had a lot of work to do. Before that NBME I thought that I could give the exam by the end of December but I had to change my mind cause I was far below my target score.

* So by half of October I bought Usmle World Q bank for 3 months planning to set my exam for January the 21.
Each day I did at least 1 random timed test and correct all the mistakes taking notes on my FA. As I expected the qbank tests soon confirmed I was way behind the average.
On November 17 I did UWSA 2 and took 204. I was improving too slowly considering that it overpredicts your real preparation --> http://imageshack.com/a/img913/8272/XnaMJM.png

* Finished the q bank in December with 49% of correct answers (the mouse arrow points at my last random q test. So just don’t look at the next part of the curve as it doesn’t have a predictive value) --> http://imageshack.com/a/img909/3757/VqQVPF.png .
Then I continued to test myself on weak subjects and keep doing random tests on marked questions (the ones I felt were more tricky/hard). When you see high scores it’s because I can recall the answers from the first time I’ve gone through the qbank thus I guess this is not such a great learning tool for me anymore as it was when I began it.

* On the 21st of December I did NBME 13 and took 202 → http://imagizer.imageshack.us/a/img913/2794/xxjHzN.png
I felt I was forgetting what I learnt in September (especially biochem) so to solve (?) this issue and focus on weaker areas I bought a firecracker subscription (firecracker.com). However I realized that I had to low my target score: considering such studying and results it wasn’t realistic to aim at 240+ so I started aiming for a 230, that would still be enough to match in a general surgery program. I postponed the exam to January 28 and since December 21 I am studying more than 9 hours a day (excluding the brakes of course).

* On January 2 I did UWSA 1 but results were even more disappointing than I thought: 195 --> http://imageshack.com/a/img661/2520/hFCYJG.png .
Each time I did a test I tried to understand on which area I’ve been weak but since the situation was so worrying I’ve analyzed the mistakes I made in UWSA 1 trying to understand “why” I was wrong and not “where”. Therefore, I classified them by “type of mistake”. This is what I got being as strict as possible with myself --> http://imageshack.com/a/img661/1280/OG9TcE.jpg
As you can see the vast majority of the errors are due to “study issue” (i.e. lack of knowledge): I simply do not know the necessary info to answer the question (which is different from knowing the info but not being able to recall it to answer the question). However, a significative percent of my mistakes was due to a recalling issue, which is a scant consolation. Of course, I realize that this is UWSA1 and not the real deal, but this is just to give you an idea of the shitty situation I’m in.

* One last thing: from August to December 21 I’ve been studying at least 7h/day and I’ve been using “picmonic” along with other mnemonics (especially from FA) every now and then cause I feel it helps me memorize peculiar diseases.

Right now I feel that If I take the exam on January 28 it would be a complete fail for me (guess I’d barely reach 210) and my future plans of becoming a surgeon.
However I believe that there’s no point in postponing the exam cause I’d risk to forget the old infos more quickly than I memorize the new ones (even though I’m working so hard) as it’s already happened with biochem. Moreover after almost 7 months of studying with no vacation at all I’m getting burned out and I should study for my Italian medical exams too. Ultimately I want to end this asap.
So here’s the big question.. What’s the best way to improve my score in these 20 days left?
Moreover, here we go for the “desperation” question: what’s the probability for an IMG to match for a general surgery program with a score let’s say between 210 and 220?

Probably some of you may think that I’m overanalyzing the situation but as you all know it’s a “one shot” exam (especially important if you're an IMG) thus I just want to be as accurate as possible in my self-evaluation and preparation.

Sorry for the long post and my poor English.

Any constructive feedback is indeed appreciated.

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Old 01-06-2015
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Old 01-06-2015
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People told me to do pathoma or DIT. do you think it could help me right now?
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Old 01-07-2015
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Default Re

Originally Posted by ilnovi View Post
People told me to do pathoma or DIT. do you think it could help me right now?
Hi! I used to analyze things a lot too and I think it helped me a lot

However, trust your NBME scores!! esp 13, 15 & 16.
It would be quite hard to get into surgery with a score around 220s-230s, but not impossible. But why take a chance when things are in your hands?

You need to attack and improve on all your weaknesses which may include insufficient knowledge (work on UWorld: careful active digesting of info, use of google for any confusion), recall (testing yourself mentally/verbally or on paper), weak areas (understanding them by going into depth and formulating mnemonics if required) and test taking strategy (46Q in 46 minutes, random-timed, good quality questions): it requires a strategy and some more time. If you are writing your exam in 20 days, you should be around -10 points from your score and revising FA 3rd time, a rough estimate.

Pathoma may help you score a few points higher, however it's not a magic bullet in itself. Take into account all your weaknesses, not just pathology and not just deficient knowledge.

Bottom line: target your weaknesses, trust the newer NBMEs before going in for exam and take your time for step 1. With the kind of analysis you have, hardwork and a bit more patience, I'm sure you can reach your target score.

All the best!
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Old 01-07-2015
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Default DIT

Hey i was getting 202 on my nbmes!! and when i did DIT i got 215, 220 on the real exam!!
You can do it in 12 days !!! its really good, helped me a lot!
And good luck! you should aim for more than 220 for surgery it is a very competitive specialty but if you do rotations, LOR you can make it with that score, but 220 is the cuttoff point for a lot of programs!
Good luck
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Old 01-08-2015
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Dear Ilnovi

I agree that studying more than 7 months will risk you forgetting a lot of stuff, however I need you to ask yourself again, realistically. Is surgery the only specialty that you want? Are you flexible enough to accommodate a very different specialty, such as primary care?

I am sharing my experience from being an old graduate. I have graduated on 2010 and I have entertained the idea of going to the US earlier but due to some personal problems I did not, I decided to work instead and I just started preparing for the exam. As IMG, I had a lot of difficulties understanding the basic science concepts taught by Kaplan, due to a very different medical school background. It is not easy, but doable. I think you have been studying really hard, however there is something not done right, otherwise you would have seen improvement. This is what I have been doing a lot. First I pick the system I got most wrong answers on. Then I got more specific. I asked myself, what does this exam want me to know? Why would this concept be important? What other concepts are related to this? Especially when I read lecture notes or watch videos. It helps you recollect information and hopefully retain better.
I started with 37% on my diagnostic test. After 3 months of Kaplan lectures, I got 63% average on uworld. My target score is 80%. It is not yet where I want to be, but I will not give up! My exam is in 3 months.

Next I'd suggest find a study partner, if that is your thing. A study partner would ask you questions then by explaining to them you find that you will retain the concepts more.

Another advice is to stick to Kaplan notes, and really understand the concepts. Again it depends on your deadline for the exam, but I'd suggest doing that if your main problem is insufficient knowledge. Moreover, when you do questions on qbank, try paraphrasing in your mind for every sentence, and at the end imagine the patient in your head. It works for me when working things out for the clinical questions.

Regarding your exam, it depends on you, really. If you are dead set on surgery, then I would suggest you postponing the exam. If you are flexible enough to "convert" to primary care, then you could probably continue. I wouldn't do that, but it depends on you. Finally, I just want to stress again, you are not alone!! Many people have gone through this, and the fact that you have spent so much time analyzing your preparation and trying really hard, is a positive thing to have in a doctor. That being said, I wish you best of luck and let's rock the boards
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Old 01-08-2015
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Guys thank you so much for your advice and support.

Right now I'm doing DIT and I should be able to finish it a few days before the exam day, even though I'm still doing random tests from uworld qbank.

I feel DIT is the best way to review fa cover to cover, which is what I need I guess. the bonus videos at the end of each lectures are pretty funnny too and this helps your morale.

I'll give NBME 16 almost 10 days before exams. If results don't change enough I will have to find the strength to postpone the exam.

I'll keep you guys update here If I can.

thanks again!
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