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Took Step 1 on December 17th 2009 ... WOW

5168 Views 12 Replies 8 Participants Last post by  Pixie
After reading a few threads I decided I should show a different side to the exam.

I felt the exam was very clinical. It is 100% American - Female with Cancers, Old, Obese, High Cholesterol, High Fat diets, Smoking, Lack of exercise = 100% on the exam. It's AMERICA...think why would I see an American patient? Understand the "what" in questioning from the biochemical to the gross of every major US MCC of death and MCC disease "X" found in America population (including RECENT immigrants). Understand physiology in simple simple terms that if I disrupt it(disease) what will happen - this is 98% of the test. I swear to this.

The exam had some tough questions. However if you spent time on the UW or Kaplan qbank. I did both of them, the ?s were each very similar only with UW much more difficult in concept, which is great because you are learning while doing questions, not testing...this is key IMHO.. Kaplan Q bank brought me back to reality and out of the fetal position in the corner after UW questions, which I feel is needed. I did a few NBMEs so it wouldn't be too new or scary. I am an IMG at a small Carib school, and it wasn't too bad at all. The questions are not "what" questions.

They are "why" questions, which is more important to me IMHO that my doctor thinks "why" and not "what" because it is impossible to memorize everything, but thinking "why" will never cease in learning its your Parietal lobes not the hippocampus doing the work in "why" questions. Honestly.

Everyone on here thus far(IMHO) is grumbling over an exam (step1) they have
1) not taken
2) don't have their results (that would be me!)
3) Forget that USMLE has thrown away questions.

Please read the websites on one's exams and follow the status on ones biggest exam. If its the most important thing, one should be responsible and show disregards of the "I don't have time" speech. Especially before going all mob like scared and confused wrapped up in a shower curtain with a bucket on your head running down the street.

Going to the websites one would know that the NBME is trying to incorporate Step 1 and Step 2 together, IT IS going to happen folks, Now something as big as say THE USMLE, one would like to collect data over a period of time blindly to the subjects and never report the data results to the subjects, thus being able to turn questions on a dimmer switch (weighted grade assuming this is how it is graded) vs an on - off switch in questions without the subjects ever knowing they are being tested on the throw away questions! So what does that mean? If I know that my test takers are trying to incorporate step 1 and step 2 (more clinical), I should prepare for battle by at least reviewing some clinical findings (UW has a ton of these questions) in the top ten of diseases in all organs, it takes about another 20 mins per system of time. Now it would stand to reason that the really really clinical question in STEP 1 (how does one judge this is beyond all me) it is safe to assume on the side of statistics that this question probably is going to be thrown out.

My understanding of the math, please correct me.

They say getting 60-70% is passing the USMLE. What they don't really say is this is after removing the thrown away questions. NBME says 10-20% (I believe its on the website) are thrown out. thus remove 10-20% of the questions from the block and the wrongs you got within those 10-20% don't count against your 60-70% right you need. You need to get 136 questions WRONG to PASS with just saying you need to get 60-70% of the total questions right. What about my theory? - that number would be even greater, I believe a teacher told me it wears down to roughly 45% right to pass. THAT IS A LOT OF QUESTIONS YOU CAN GET WRONG. They are there to trip you up. OF COURSE you are going to get this question wrong. THEY KNOW THIS...but the next 3-5 questions will be fairly easy. Did that really hard one mess you up and you get these simple 3 questions wrong? - THAT IS ANOTHER TRICK OF THIS EXAM BE READY FOR THIS.

USMLE score on my educated guess:

One's score based on a weighted question exam shows that on past data this score signifies that this type of person scored this exam greater than passing score which others have found a correlation with GPA and MCAT scores (with a p<0.05) and various other records on an individuals life that say a LICENSING committee has access too, in order to allow this exam taker to remove tissue/organs and directly issue a specific non-food item into another human's blood, digestive, etc system with a sound intelligent thinking mind all based on statistics. This would be one of the only mathematical ways to produce a doctor. It doesn't mean there are not other ways, this way you can produce a good doctor based on math which shows a percentage of a probability not possibility!

We are the directors of our possibilities even when it is not probable, it is still possible! That is step 1 IMHO. Be probable in thought process more then possible.

Thus everyone should calm down, take the time to read the websites and follow what is going on. The audio's were ridiculous but there was only maybe 4 out of 336. Yep 4 out of 336. I am not going to cry over that. Why would I? I focus on the "why" in the question.

UW questions: read the website! -they say students that use their question banks score higher than average. I believe namely that one can say average being 220 SD 20 = UW scores for greater than 50% are from 200-240. If you read the research on NBME and apply it to UW stats which they are using. This is simple math.

UW qbank scores are 50-60% for first time! 60-70% second time, So what does that mean? - first time stay above 55% (on random 48 ?s) REVIEW REVIEW REVIEW, RETAKE THE the qbank exams you made. Don't click on the answer because you memorized. Read the entire questions with the answer you know to be 100% true (you just did it!) find out in the question WHY would you pick the answer by reciting the answer to yourself as you read the question take the next 4 or whatever question's wrong answers and read the vignette and figure out WHY you WOULDN'T YOU pick this answer that you know is 100% to be wrong. THIS BUILDS CONFIDENCE IN YOUR THINKING PROCESS = a HIGH STEP ONE SCORE. It takes time and it sucks but it pays off, because understanding why, you don't have to know the material you just know that these 4 answers are dead wrong and this last one here letter E is the only way physiologically that makes sense in any question.

USMLE to me on the my bests blocks (not all my blocks)
35 questions even a C student should know 100%. (73% total)
5-7 questions of just sheer torture = 35-49 questions total
6-8 questions that a B student should know 100%

My grade score scale:
B = 62% on UW on the last 200 random questions
C = >55% on UW on the last 200 random questions

All questions even if you remember them because I had questions on the exam that I had in the NMBE NUMBER 6 on my step 1! - this all gives you the whole pool of questions not just your last ones in case you did.

My stats:
total UW 57%
total Qbank 57%

Last 300 questions
UW 61%
Kaplan 64%
UW comp I exam 490 - 214
UW comp II exam 500 - 220
NBME number 6 $60 (3 days prior) 500 220

My score? - I will chime in and tell ya Jan 14th.

I reviewed my NBME and studied the questions I got wrong, looked up the answers and tried to UNDERSTAND WHY the test writer wrote like this. this was the biggest gold nugget. IMHO doing the NBMEs with review ($60) ones were the best bet. You can review real USMLE questions you got wrong and figure out the answers (look them all up) and re read the "why" in the question making"

Don't disregard though about knowing the "what's" though
, It is medicine. Its not the for the weak, It shouldn't be. You have to be confident in your answers be confident in yourself even before stepping into the patients room or in the test room. Believe...even if you are scoring something that you don't like, find your weakness, fix them, understanding your weakness is crucial because after the step 1 I can say I knew my weaknesses two weeks prior before the exam and their they were right on the exam right there to haunt me, but I felt I prepared for these weaknesses, I accepted that my weakness will be on the exam and not be in denial and think they wont be on there, ALL my weaknesses will be on there. Almost all were. Denial is not the same thing as confidence in yourself.

First Aid, Goljan Rapid Review Path and Clinical Lab, and Questions are all you need for this exam. But use everything you personally love. Understand the "why" in the question when you review them,

On practice exams:
SLOW DOWN on DOING QUESTIONS at first, Do 5-10 questions a day at first read all the multiple answers, understand WHY you DO and why YOU DON'T pick one of the 5 answers. 10 Questions review all 5 possibles answers = 50 total possible questions.

Develop this thinking pattern. I KNOW it SUCKS, its ANNOYING..
It's SLOW...but it is so worth it, I can not tell you enough. Thanks to a Path II teacher, THANK YOU teaching ME THIS! Understanding how to read charts and graphs too for every disease that has one in FA =100% chance you have one on the exam so do it!

Good luck Good luck God bless those taking the exam. Have a little faith in yourself.

Good luck to all those taking it.


I base all my numbers and grades on my opinions as others will differ but from my understanding of myself, 3 people from US schools, 16 students from my school this is my conclusion. All these individuals shared with me all their scores throughout our studying and I feel these to be more solid than some bumped scores I have seen on threads making them incorrect by a large shot. The numbers all fall inline with Kaplan predictor score, NBME score predictor and UW comp predictor and UW equation predictor.
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After reading .......predictor.
Thanks for showing us all the brighter side of the picture :)
Best of luck for your result.
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Well written

what an article
you should publish this in New York Times :)
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This is really a detoxifying article
You touched on the core issue which many of the folks here and in other websites are not getting ...
Thank you
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Disagree with one point
Step1 is still about "what" more than "why"
If you don't have the necessary knowledge is a background you can never then deduce the "why"
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marutha thanks for realy boosting up da moral man...


before going in to battle the usmle step-1 exam..... one should have emphasised on not only the basic sciences but clinical knowledge should be upto a highest level as well.... and dont expect an easy exam... polish up all ur weapons well guyz...

BEst of luck to all!!!!
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A teacher once caught me writing stuff down twice...he responded, 'write it down a third still wont get it."

Disagree with one point
Step1 is still about "what" more than "why"
If you don't have the necessary knowledge is a background you can never then deduce the "why"
This is true...Step 1 is quantum physics. The deeper you dig...The question is
the answer and the answer is the question..I guess "what" I am trying to tell everyone is not to memorize 100% of everything you read for the USMLE..they hardly ask you what is this, in a straight forward fashion as we all would love to have...

Not to go all Socrates but if one must know why, it is implied you must understand there is a what. Because a why deciphers that there is greater then one in possible truth and thus a "why" deciphers a greater amount of "whats" in your head (pun intended). which is HARDER..which is why the USMLE is designed this way. Cerebro is is about "whats" in the question but it is much worse then she/he is painting here. It is about the "why" more then "what"

- I guess I am suggesting this based on two things common sense and I Have a teacher who scored a 278 on the step and ask him..HOW IN F did you get a 278?! - His response "I didn't know what they were asking me but I knew why they were lying to me four times out of five"

Cerebro is 100% right, I should of suggested this more but no one will listen anyway.. I got friends memorizing HLAs diseases just after 40 of us just took the darn thing and didn't have one of those on there but they can't tell me why does diabetes cause necrosis in the left toe...

(if you are seriously trying to figure out "the left toe" fell for a trap..its not important that its the left toe..its the why does it happen...this is the USMLE exam, student memorize left toe diabetes, left toe diabetes, the exam comes..patient has dry gangarene in the RIGHT fifth digit in the foot, they have.....(doesn't tell you)...why is this occurring in a 55 year old female 320lbs with a past history of poor diet control? THERE IS NO LEFT TOE OMG OMG I DONT KNOW I DONT KNOW IT WHAT'S A DIGIT?!!...... NO YOU DO KNOW IT...

I see this dramatic over done statement in myself and my friends.

I think with all of us, we are afraid. we are afraid to admit we are afraid, this test is told to us that it represent us as a person in this field, that it is like a banner over our heads. Our residency man! It's like OUR LIFE man! I want to freak out man! - CHILLLLLLL so wound up...its killing me just to read...

Thankfully this is not the case? How can I say this? Well because I actually took the time to go the website...for the match and download the survey that program directors (these are the people who give the residency) and I read what they told the Match people what they like in candidates all in nice little bar graphs.....what matters the most MSPE!(yes step 1 does matter too)..take the time to read and research all this stuff if you are freaking out (compared to Pakistani saying eat almonds and pray or Native Americans got a stomachache find a round stone = CHILL OUT! )

When you use data that is relevant - NBME, Match etc. I found this out for being an IMG....If I score a 260 guess what? I still have a 50% chance of getting a residency that this grade can get me...but what about a 205? well guess what you too got a 50% of getting this residency...

IN THE END FOR AN IMG...nothing seems probable so dont think probable about yourself only possible. THE EXAM IS THE EXACT OPPOSITE..sit around long enough and you can figure out its possible to make ice make a fire...dont sit around on matter how numb you are getting eventually it will burn ya..

When people are afraid they panic, they just doing what they think is education, which is memorizing. We need to be educated on being educated.
Read education books on learning "Einstein never used flashcards" great book to learn how we learn...

It is true you need to know the whats, you need to build up endurance for long question times as well so practice doing 400 ? days at least twice before taking the exam, sitting around for 336 will be a relief when it comes..

My score numbers are not the highest posted. I am not trying to say my way is the only way. I hope I dont come off cocky or rude...but man everyone is memorizing all this stuff, its like whY? why? I dont understand it, maybe I got RMSF.... But I do see that students (and myself included) are memorizing but they can't tell the mechanism why diabetes causes Lactic acidosis for example, unless they have a biochem question then it clicks then they know; this is memorizing. Im sure you can ace the exam that way but to me, its wasting time to forget it two weeks later. Humans do why questions, Computers do "what" questions. This is why humans are needed in medicine. IF we have a 1% chance of making it, a human will give me the shot against those odds, a computer would let you die...unless will smith is in the film..

I see all these high absurd USMLE scores on all these websites and forums while studying, I freaked out, how can Dr2bBlunt420 score a predicted 265? and I can't get predicted scores like that. He says he did on It must be true!!!! Dr. Blunt420 you are smarter then me!!!

USMLE forums are like weightlifting forums..everyone is asking how much ya bench?
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i would second cerebro in this regard.... learning the material is infact very very important.... if u r out of touch even for a few weeks...even if u have understood it well the minutiae of material in ur mind starts fading .... u r not able to get vignettes ryt.... although usmle does ask the clinical aspect and analysing practical stuff... u cannot separate the learning and remembering facts from the preperation...

about the scores and stuff.... every single person has a different brain capacity to learn nd answer... there r geniouses around... einstein was a genious... dats y there in no 2nd einstein... if someone got 265 in practise session or real exam and someone else is unable to get... it means the fault isnt in the person getting 265... the mental and analyzing capacity of other ppl are lower than him...

and i dont think this forum is there to show anger to US boards policies or watever... we cant do anything abt it... if an img wants a residency... its the img's wish.... its then his luck dat could lead him forward.... dats wat i feel...
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This is just like the egg from the chicken or the chicken from the egg dilemma.
You don't know why disease X is different from disease Y until you know What is disease X and What is disease Y. Also sometimes you don't know what is disease X until u know why it's different from disease Y.
I think both "what" and "why" are equally important for USMLE Step 1. However, WHY is more about intelligence and thought processes and WHAT is more about memory and hard work reading.
Since there's little you can do about your IQ then you best bet is to try as much as you can to improve on your knowledge base.
If you get wrong a question because of a "though processing" trick in UW and you will most probably memorize that trick then you are likely to get it right in the exam, while for super intelligent people they may not need to have seen that trick before in UW as they'll get it correct rightaway from the first shot.
Bottom line: high IQ people need less prep while low IQ people need more prep and practice but at the end they can both get the same score if their prep was proportionally equal.
The key is to understand where you stand on the IQ spectrum. If you see yourself doing consistently bad in UW then you need more and more practice until you have MEMORIZED all the tricks so that you rely on your hippocampus in the exam and no need for the higher cortical functions (that you have it deficient).

Good luck to you all

It's a great thread by the way.
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Great post, I hope you get the score you want!!

just a question though what about USMLE World? Is it as good as they say. Does it have all the concepts? Can one just do USMLEWORLD and forget about Kaplan Q bank?

Please comment
Great post, I hope you get the score you want!!

just a question though what about USMLE World? Is it as good as they say. Does it have all the concepts? Can one just do USMLEWORLD and forget about Kaplan Q bank?

Please comment
If you have to choose between UWorld and Kaplan then it's probably UWorld that's more exam relevant.
See this poll
After reading a few threads I decided I should show a different side to the exam..... Kaplan predictor score, NBME score predictor and UW comp predictor and UW equation predictor.
Thank you for the great post!
WOW excellent post. I am going to store it on my PC and review it again whenever I feel disheartened.
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