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  #1  
Old 01-13-2014
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Listening Residency chances after failing step 1

Hi,
I am an IMG. I took my step 1 last month recently received my test scores for the same and I didn't clear it. While I am terribly disappointed with the results, I wish to retake the exam.

But before I commit to it, I would like to know the realistic chances of getting placed into a residency program.
1) Is there a good probability of getting placed in a program?
2) If so, what are the fields that I can apply for? Is IM a possibility?
3) How much more important are observerships and Letters of recommendation now that I have a failed attempt?

I would really appreciate some help so that I can start planning my next move.
Thank you in advance for the help!
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Old 01-13-2014
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The first thing, is that you should always follow your dreams no matter what.
Unfortunately it is very hard after attempts, you should go to the match statistic from 2013, all the IMG who matched passed in the first attempt, they all had. Scores between 220 to 240, YOG ranged from 3 to 5 or 6 y. Anyway the only thing that you can change now , is obtain high scores in all your exams, get usce, good letter of recommendations and step 3

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  #3  
Old 01-13-2014
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Thank you...
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Old 01-13-2014
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Quote:
Originally Posted by meenaxi View Post
Thank you...
i'm sorry to hear about your result , its really unfortunate . If i may ask, what were your NBME and UWSA score like before you took the exam?
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Old 01-13-2014
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Originally Posted by CisternaChyli View Post
i'm sorry to hear about your result , its really unfortunate . If i may ask, what were your NBME and UWSA score like before you took the exam?
I scored between 230 and 240 with NBME. I didn't take UWSA..I think that's where I erred. But I was told that NBME was a pretty good indicator. That's what makes this all the more baffling. My results don't co relate with the predictive scores
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Old 01-13-2014
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Originally Posted by meenaxi View Post
I scored between 230 and 240 with NBME. I didn't take UWSA..I think that's where I erred. But I was told that NBME was a pretty good indicator. That's what makes this all the more baffling. My results don't co relate with the predictive scores
wow, that totally doesnt make any sense . Actually the UWSAs arent a good indicator because the questions are much more confusing at first glance, than the real exam...at least i felt so. But if you got a 230-240 on NBMEs, then i dont understand how you failed.
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Old 01-13-2014
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Believe me...That's what I am searching for...An explanation..
Even if I retake the exam, I am looking for ways to improve..I don't want to commit the same mistakes...But I still don't know what I did wrong.

But is there a chance of still getting through a program?
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Old 01-13-2014
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Quote:
Originally Posted by meenaxi View Post
Believe me...That's what I am searching for...An explanation..
Even if I retake the exam, I am looking for ways to improve..I don't want to commit the same mistakes...But I still don't know what I did wrong.

But is there a chance of still getting through a program?
what sections were you deficient in on your score report?

I know of people getting in on the second try; those people have high step 1 scores on the retake and high step 2 scores. Plus observerships/externships, etc. It can be done, nothing is impossible.
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  #9  
Old 01-13-2014
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Well..I failed..so was pretty much deficient on all the subjects..I scored well only in biochemistry and microbio...ironic, given that they were my potentially weak subjects.
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Originally Posted by meenaxi View Post
Well..I failed..so was pretty much deficient on all the subjects..I scored well only in biochemistry and microbio...ironic, given that they were my potentially weak subjects.
interesting; again i'm sorry that this happened . Even i cant really offer an explanation because it doesnt make any sense. How did you feel during and after the exam?
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  #11  
Old 01-13-2014
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Such a long exam..it was difficult to gauge..I was taking it one question at a time..I wasn't too happy with my performance in behavioural science and anat questions were almost completely ob-gyn questions. I knew that I had messed up in these sections...I only thought that this might bring down my scores slightly..didn't think I would fail...

but could you please give me some studying strategies?
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Originally Posted by meenaxi View Post
Such a long exam..it was difficult to gauge..I was taking it one question at a time..I wasn't too happy with my performance in behavioural science and anat questions were almost completely ob-gyn questions. I knew that I had messed up in these sections...I only thought that this might bring down my scores slightly..didn't think I would fail...

but could you please give me some studying strategies?
Now that the exam is emphasizing Anatomy; time to go hard on that. Maybe look into getting HY Anat or BRS Anat and just keep looking at Atlases. Thats what i did the last few days of my exam...although anatomy did show up on my exam, it wasnt as bad as i thought it was going to be, or maybe i just dont remember anymore. I thought Kaplan Anatomy was pretty good though. In the end, i actually wish i did more anatomy lol.

Behavioral is a subject that bugs the hell out of everyone, especially me. All i can say is that HY Behavioral is pretty good. Check out First Aid for 2014, maybe they have updated their Behavioral sections. I will say i didnt feel too great about some of the Behavioral on my exam either. Some of the questions, all the answers looked good and i hated that!! Kaplan's behavioral book is good as well.

Other subjects, if you had gotten a 230-240 on your NBMEs..then i dont see what the problem was. How did you study the other subjects?
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  #13  
Old 01-13-2014
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I did do BRS anat...my neuroanat was weak..but there were hardly any from that section...it was all OB and that bugged me...cuz neither kaplan nor brs had many questions from that

I had mainly studied Kaplan, except in anat where I did BRS also.
I plan to get high yield this time round.

Behavioral I faced similar issues..At best, I could narrow it down to 2 options. Quite a few questions from Doctor-Patient interaction. You would think that this would be a cakewalk..turned out to be real hard.

But I am unable to find an area where I could have majorly gone wrong. I don't really know what I should different this time round..That's why any help/ advice is greatly appreciated.
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Quote:
Originally Posted by meenaxi View Post
I did do BRS anat...my neuroanat was weak..but there were hardly any from that section...it was all OB and that bugged me...cuz neither kaplan nor brs had many questions from that

I had mainly studied Kaplan, except in anat where I did BRS also.
I plan to get high yield this time round.

Behavioral I faced similar issues..At best, I could narrow it down to 2 options. Quite a few questions from Doctor-Patient interaction. You would think that this would be a cakewalk..turned out to be real hard.

But I am unable to find an area where I could have majorly gone wrong. I don't really know what I should different this time round..That's why any help/ advice is greatly appreciated.
yeah thats why i am finding it hard to give you any sound advice because it looks like you did all the right things. Frankly i dont remember much of OB anat being on my exam; and i had studied it before i took the exam. I know people say that 100 cases by Conrad Fischer is good for ethics, so maybe thats worth looking into.

I'm a little scared now, my score is supposed to come on wednesday and you had good scores in your NBME and still you couldnt get there...doesnt make sense to me .
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  #15  
Old 01-13-2014
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Oh no!..I don't mean to worry you...I am asking people only because I am trying to figure out an explanation..so that I don't commit the same mistakes.

I am sure you will do well...good luck with the results.
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Quote:
Originally Posted by meenaxi View Post
Oh no!..I don't mean to worry you...I am asking people only because I am trying to figure out an explanation..so that I don't commit the same mistakes.

I am sure you will do well...good luck with the results.
thanks . Yeah i'm trying to find an explanation, but you did well in your NBMEs..thats why i cant really give you that much of an explanation. I really dont know what to tell you myself . If you were committing gross mistakes, then your NBME scores wouldnt be that good.
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  #17  
Old 01-13-2014
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You can understand why I am perplexed.. I really don't know what I should do different next time round...that makes it so much more harder!
When did you take your exam?
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Originally Posted by meenaxi View Post
You can understand why I am perplexed.. I really don't know what I should do different next time round...that makes it so much more harder!
When did you take your exam?
Dec 13th, when did you take your exam? No i understand why you are perplexed; anyone would be. Fixing it is also confusing because i dont know what you did wrong. The only thing to do is to study it all again and to not miss any details.
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  #19  
Old 01-13-2014
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12th december!!!..
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12th december!!!..
oh jeez... . We are all in that December boat. What is with last month lol !
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  #21  
Old 01-13-2014
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no idea!..i am sure that your story has a happier ending!
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Originally Posted by meenaxi View Post
no idea!..i am sure that your story has a happier ending!
i really hope so . Again, i'm really sorry i cant offer you more advice. I think best would be to just start all over again, go through everything with a fine tooth comb and see if you missed any details.
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  #23  
Old 01-13-2014
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I'm really sorry to hear about this situation. My NBME score overpredicted by 17 points, so it's super frustrating to practice at a high level, then have a bad day on test day.

I want to direct your attention to the newest "Charting the Outcomes for the Match" for IMGs that was published a few days ago. In it, the average non US citizen IMG who matched to any specialty had a Step 1 score of 227, and had 1.1 attempts. Looking at the chart on page 12 of the study, it appears that a non-US IMG who had 2 attempts at step 1 has about a 25-30% chance of matching overall.

For IM, the average non-us IMG had a step 1 score of 231, and 1.1 attempts. Out of all the non-US IMGs that applied with 2 attempts at step 1, 39 matched and 163 did not.

Not trying to be a sour puss, or be negative. You should look at the data before committing to any course of action. This was data for match prior to 2014, and by all accounts, this match season is even more challenging for IMGs.

Best of luck with whatever path you choose.
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I'm really sorry to hear about this situation. My NBME score overpredicted by 17 points, so it's super frustrating to practice at a high level, then have a bad day on test day.

I want to direct your attention to the newest "Charting the Outcomes for the Match" for IMGs that was published a few days ago. In it, the average non US citizen IMG who matched to any specialty had a Step 1 score of 227, and had 1.1 attempts. Looking at the chart on page 12 of the study, it appears that a non-US IMG who had 2 attempts at step 1 has about a 25-30% chance of matching overall.

For IM, the average non-us IMG had a step 1 score of 231, and 1.1 attempts. Out of all the non-US IMGs that applied with 2 attempts at step 1, 39 matched and 163 did not.

Not trying to be a sour puss, or be negative. You should look at the data before committing to any course of action. This was data for match prior to 2014, and by all accounts, this match season is even more challenging for IMGs.

Best of luck with whatever path you choose.
twostep, mind if I ask what were you NBME scores going into the exam? I remember reading your post somewhere that your step 1 was in the 220s. I got a week left, sorta want to mentally prep myself a sort of mark to expect In the last 2 months Ive gone over NBME 7-15 online, except for 13, all the others were sitting around 240(-2 to +5). I am very anxious, cant really sit still.
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Originally Posted by nacht hund View Post
twostep, mind if I ask what were you NBME scores going into the exam? I remember reading your post somewhere that your step 1 was in the 220s. I got a week left, sorta want to mentally prep myself a sort of mark to expect In the last 2 months Ive gone over NBME 7-15 online, except for 13, all the others were sitting around 240(-2 to +5). I am very anxious, cant really sit still.
Not at all man,

I had a 241 on NBME 15 and a 249 on NBME 11... those were my last two. I still have no clue what happened on test day, but I'll do my best in clinicals and on CK to offset my mark

I'm sure yours went fine!!
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Not at all man,

I had a 241 on NBME 15 and a 249 on NBME 11... those were my last two. I still have no clue what happened on test day, but I'll do my best in clinicals and on CK to offset my mark

I'm sure yours went fine!!
which one overpredicted by 17 points?
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Originally Posted by nacht hund View Post
twostep, mind if I ask what were you NBME scores going into the exam? I remember reading your post somewhere that your step 1 was in the 220s. I got a week left, sorta want to mentally prep myself a sort of mark to expect In the last 2 months Ive gone over NBME 7-15 online, except for 13, all the others were sitting around 240(-2 to +5). I am very anxious, cant really sit still.
yeah i'm waiting for my score on wednesday as well; just worried about how i did. I really want to help out meenaxi here but it seems the OP did everything right as far as prep went, maybe getting tripped up more with anatomy and behavioral science. I didnt think doing poorly in those 2 subjects would cause somebody to fail....
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I averaged the two of them (the NBME scores).

But none of this helps OP. I know you both are super nervous, but my case is not the norm... I had an unfortunate test day where I made too many dumb mistakes. I'm sure you all did not do that!! Keep calm as best you can
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I averaged the two of them (the NBME scores).

But none of this helps OP. I know you both are super nervous, but my case is not the norm... I had an unfortunate test day where I made too many dumb mistakes. I'm sure you all did not do that!! Keep calm as best you can
Yeah i know none of this helps OP, im just trying to figure out what a plan of action could be for the OP. The only thing i can think of is to really hit Anat and Behavioral hard, and maybe do Kaplan Qbank and USMLERX. What helped for me was litterally writing out the tough questions in U world with the explanations as notes in a big notebook.

Hell i know i made dumb mistakes...i know that. My UWSAs would actually been a lot higher if i hadnt made dumb mistakes too. In fact after the real exam i counted like 10-15 of them. After that, the exam was a blur.
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Yeah i know none of this helps OP, im just trying to figure out what a plan of action could be for the OP. The only thing i can think of is to really hit Anat and Behavioral hard, and maybe do Kaplan Qbank and USMLERX. What helped for me was litterally writing out the tough questions in U world with the explanations as notes in a big notebook.

Hell i know i made dumb mistakes...i know that. My UWSAs would actually been a lot higher if i hadnt made dumb mistakes too. In fact after the real exam i counted like 10-15 of them. After that, the exam was a blur.
I hear that, man. My mistakes will never stop haunting me. If I had just gotten those silly mistakes right, I could be at a 230. I'm very, very happy that I'm a US citizen and that all my CE will be done in US hospitals... I was really worried until I saw that charting the outcome data. I've really only wanted IM, and I believe that's still do-able.

Keep calm, man. Again, my situation (and to a greater extent, OP's situation) is very rare. For most of the people on this forum, those NBMEs were spot on. I think I might have gotten cocky at that last NMBE, and that might have led to many more dumb mistakes.
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I hear that, man. My mistakes will never stop haunting me. If I had just gotten those silly mistakes right, I could be at a 230. I'm very, very happy that I'm a US citizen and that all my CE will be done in US hospitals... I was really worried until I saw that charting the outcome data. I've really only wanted IM, and I believe that's still do-able.

Keep calm, man. Again, my situation (and to a greater extent, OP's situation) is very rare. For most of the people on this forum, those NBMEs were spot on. I think I might have gotten cocky at that last NMBE, and that might have led to many more dumb mistakes.
i'm a USIMG as well, but not a carib grad. I still need to pick up some more clinical experience out here. Now that i think about it, its not so much dumb mistakes as is getting things jumbled up in your head. There is just so much to know, and sometimes we do fumble up easy questions...and then only realize it after we finish the exam. What do you think the OP can do to score well next time round? I'm sorry to say that i'm all out of ideas .
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i'm a USIMG as well, but not a carib grad. I still need to pick up some more clinical experience out here. Now that i think about it, its not so much dumb mistakes as is getting things jumbled up in your head. There is just so much to know, and sometimes we do fumble up easy questions...and then only realize it after we finish the exam. What do you think the OP can do to score well next time round? I'm sorry to say that i'm all out of ideas .
Bro (or sis, not being gender specific!), I'm with you... the only thing that OP can do is really KNOCK it out of the park. The potential is there, something must have happened on test day.

OP, please think real hard about your next attempt. I know the stats I posted earlier are not... encouraging, but if this is your dream, don't let some numbers stop you from trying. If you truly believe that you can destroy step 1 the next time, do it! Several of those people matched after one failure... and that was just IM!

The only other thing I can possibly think of would be to get real US clinical experience. I'm not talking about observerships... actual months working in a US hospital. My dad came over from India, and before he was able to match into a residency, he had to work as a free extern for a year. With a family. This is the sort of dedication you might need to have... if it is your dream to come here and practice, find a way to make it happen.
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  #33  
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Bro (or sis, not being gender specific!), I'm with you... the only thing that OP can do is really KNOCK it out of the park. The potential is there, something must have happened on test day.

OP, please think real hard about your next attempt. I know the stats I posted earlier are not... encouraging, but if this is your dream, don't let some numbers stop you from trying. If you truly believe that you can destroy step 1 the next time, do it! Several of those people matched after one failure... and that was just IM!

The only other thing I can possibly think of would be to get real US clinical experience. I'm not talking about observerships... actual months working in a US hospital. My dad came over from India, and before he was able to match into a residency, he had to work as a free extern for a year. With a family. This is the sort of dedication you might need to have... if it is your dream to come here and practice, find a way to make it happen.
I'm a guy, so you can call me Bro lol. I honestly think the OP is right there, with an extra push, the OP will be fine.

How would you get externships now though? How do you touch patients without even having passed the step exams? Or can you do an externship after taking the steps?
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I'm a guy, so you can call me Bro lol. I honestly think the OP is right there, with an extra push, the OP will be fine.

How would you get externships now though? How do you touch patients without even having passed the step exams? Or can you do an externship after taking the steps?
It was different when my dad was doing it... FMGs had a totally different exam to take. I have no idea now, actually! Just don't show up to a random hospital and start treating patients
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It was different when my dad was doing it... FMGs had a totally different exam to take. I have no idea now, actually! Just don't show up to a random hospital and start treating patients
yeah lol. USCE is a lot harder to come by now, if you arent a carribean grad.
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  #36  
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Have you tought of getting the test score revised? although unlikely they do make mistakes sometimes.
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Originally Posted by clockmer View Post
Have you tought of getting the test score revised? although unlikely they do make mistakes sometimes.
i was also going to suggest that to the OP.
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  #38  
Old 01-13-2014
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Hey guys,

first up, I don't think you guys should worry about the results..not yet..cross that mountain if it does come to that.

@Two step...I know the stats are not exactly encouraging. especially for an IMG. But I still have a few obsevership options open. I know a few doctors there who are willing to help me with observerships and write me letters of recommendations..hopefully that counts a bit.. So I am not giving up hope..not yet...

But my main issue is I need to pin point areas where I could have gone wrong.
My NBME scores were averaging 235..the worst score was 217 (I think form 9)..
Kaplan Q-book scores were always between 70 and 75%
I did all the Kaplan books..Plus BRS for anatomy. Made my own flash cards, flow charts..studied 6 months
Even if I got all my questions in anat and behavioral wrong, how did I still end up failing?..That's what makes no sense to me. I thought I might end up with slightly lower scores, but not fail.

What can I do different next time round?
I need help with that. That's why I posted in the forum..need a fresh pair of eyes.

Maybe I got too cocky...but it's hard to believe that I could have messed up so bad. Theoretically, I still remember most of my stuff.
Anat, yes scope for improvement.
But the remaining subjects, I am drawing up a blank. What should I do?

Any ideas?
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  #39  
Old 01-13-2014
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Quote:
Originally Posted by meenaxi View Post
Hey guys,

first up, I don't think you guys should worry about the results..not yet..cross that mountain if it does come to that.

@Two step...I know the stats are not exactly encouraging. especially for an IMG. But I still have a few obsevership options open. I know a few doctors there who are willing to help me with observerships and write me letters of recommendations..hopefully that counts a bit.. So I am not giving up hope..not yet...

But my main issue is I need to pin point areas where I could have gone wrong.
My NBME scores were averaging 235..the worst score was 217 (I think form 9)..
Kaplan Q-book scores were always between 70 and 75%
I did all the Kaplan books..Plus BRS for anatomy. Made my own flash cards, flow charts..studied 6 months
Even if I got all my questions in anat and behavioral wrong, how did I still end up failing?..That's what makes no sense to me. I thought I might end up with slightly lower scores, but not fail.

What can I do different next time round?
I need help with that. That's why I posted in the forum..need a fresh pair of eyes.

Maybe I got too cocky...but it's hard to believe that I could have messed up so bad. Theoretically, I still remember most of my stuff.
Anat, yes scope for improvement.
But the remaining subjects, I am drawing up a blank. What should I do?

Any ideas?
did you take all the NBMEs?
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  #40  
Old 01-14-2014
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I'm really sorry to hear that. But 230 and 240 were your approximate three digit scores or your CBBSA scores? Did you take nbmes online?
It's really sad that you failed with these high predicted scores. Don't give up!!!
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  #41  
Old 01-14-2014
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Quote:
Originally Posted by CisternaChyli View Post
did you take all the NBMEs?
All the ones after form 5
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  #42  
Old 01-14-2014
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Quote:
Originally Posted by meenaxi View Post
All the ones after form 5
wow thats a lot of them...
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  #43  
Old 01-14-2014
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Fat lot of difference it made!
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  #44  
Old 01-16-2014
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Quote:
Originally Posted by meenaxi View Post
Hey guys,

first up, I don't think you guys should worry about the results..not yet..cross that mountain if it does come to that.

@Two step...I know the stats are not exactly encouraging. especially for an IMG. But I still have a few obsevership options open. I know a few doctors there who are willing to help me with observerships and write me letters of recommendations..hopefully that counts a bit.. So I am not giving up hope..not yet...

But my main issue is I need to pin point areas where I could have gone wrong.
My NBME scores were averaging 235..the worst score was 217 (I think form 9)..
Kaplan Q-book scores were always between 70 and 75%
I did all the Kaplan books..Plus BRS for anatomy. Made my own flash cards, flow charts..studied 6 months
Even if I got all my questions in anat and behavioral wrong, how did I still end up failing?..That's what makes no sense to me. I thought I might end up with slightly lower scores, but not fail.

What can I do different next time round?
I need help with that. That's why I posted in the forum..need a fresh pair of eyes.

Maybe I got too cocky...but it's hard to believe that I could have messed up so bad. Theoretically, I still remember most of my stuff.
Anat, yes scope for improvement.
But the remaining subjects, I am drawing up a blank. What should I do?

Any ideas?
I'm sorry, I was reading through this history, and I couldn't find if you'd done any question banks! Did you do UWorld at all during your prep?

Sadly, observerships won't really do anything. How will a physician be able to evaluate your performance as a future physician if there's no curriculum? All they can really say is "This person followed me, but wasn't allowed to have much patient contact, and I was unable to judge them in any medically relevant setting." As an observer... you're JUST observing. That LOR won't do much, I think. It's better than no USCE, but it's NOT USCE at all. If you're already a medical graduate, you need to try and find externships. Again, I have no clue how to do that, but hopefully someone will know.

You do seem bent on rocking out the next time, though. You're motivated, and that's good! The only real advice I can give is to try and do as many questions from UWorld as you can. If you had some severe anxiety on test day or something, that could have had an impact. When you take NBMEs, try to simulate the actual test environment as best you can. I would delete all other browsers, put my FA book downstairs, and then take the test.
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  #45  
Old 05-13-2015
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Default Failed step 1!!!help

Hi got my result today ... Failed 176... I m an IMG ..passed in 2006 from a very good collage..had few years of clinical experience in my country... Came to us after marriage 4yrs back... Have a toddler girl goes to daycare...
As I failed now it really scares me.. Don't feel like looking at the books...I dint take any NBME which was the biggest mistake I did...
Now I m thinking whether to retake the exam or not ... How it affects my residency match considering my long abstinence from clinical touch?
Plz H-E-L-P me..... Plzzzzzzz... As I have wasted my years already... Don't know whether m going in wright direction or to try something else....
Plz helppppppp!!
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