Step 1 Preparation and Experience

“229, and I’m Okay with it” – Step 1 Experience by YhormElGigante

Don’t get me wrong, I’m not thrilled to death or anything, but I’m okay. It’s below what I wanted, a little below average, but I can make it work. Middle of the class at a DO school. The test got pushed back for about 2 months. Didn’t take a single day “off” for the last couple of months and that was a major mistake. I would get about 4 effective hours of studying a day and sit at my desk for 10 hours a day because I was chronically burned.

NBME 24: 183 in the first week of May

NBME 15: 196 on 7/25

UWSA 1: 243 on 8/6

NBME 16: 215 on 8/13

UWSA 2: 190 on 8/21 (full panic attack, body went numb, almost canceled exam)

Free 120: 85% 3 days out

UW%: 64%, only completed about 70% of a first pass

Reddit predictor: 233

Real: 229 on 8/31

So I probably read about 20 pages total from 1st aid, referenced it less than 10 times. Didn’t finish UWorld. Didn’t keep up with Anki at any point, though I ran through probably 80% of it at some point during 2nd year, would do relevant cards up until an exam, swear I’d keep up, that would last about 0.2 days and I would just do the new cards. Watched all of Pathoma a few times, watched almost all of Boards and Beyond at least once, about half of it twice, maybe 30 videos I never saw. Watched Sketchy micro and pharm but never really kept up with the cards. Constantly felt guilty about not doing enough.

If I could go back I would take days off as my number one absolute biggest change. I was SO burned. Within like 3 days after the exam, I felt the most clear-headed I’d been in months. I studied hard all day before the exam too. Next, I would have nailed down the Rapid Review at the end of FA, I mostly used a deck to go through it the week before and probably could have been 5 points higher if I’d had it down cold. Pathoma is bae, the first 3 chapters HY factor is not overblown. I would have had Sketchy drugs down better. Dirty USMLE was really good for a lot of things, sometimes not enough detail but that is the trade-off for the time.

I feel like if I kill step 2 I’ll be good for most things I want to do, so it’s enough that I can keep taking steps forward and keep moving. I don’t want to do anything really competitive, but I do want a good pick of locations. It’s been a trip. Honestly, I’m so much happier now that I’m out on rotations. It’s super fun. I started to questions whether I’d made a giant mistake, but this is the way.

These are just ramblings, but thought I’d get my feelings out there. It’s so hard not to compare my score to others and be disappointed, but having an extended dedicated because of Thanos and not being able to study at a library was tough. It’s hard to listen to your toddler knock on your door just saying “Daddy” over and over and stay focused on studying, both because it’s adorable and distracting. Considering how poorly my UWSA2 was just over a week out I should be immensely grateful, and I am. I know I’m not some high scorer, but if anyone has questions feel free to ask and I’ll answer while patient loads are low.

Conversation with the Author

Q – What would you have done differently in your prep?

A – Take days off, keep up with anki for sketchy micro and pharm, worry more about HY biochem facts (Dirty medicine level), and less time on as much nitty-gritty. I got nitty-gritty questions don’t get me wrong, but I missed easy questions

Q – What did you feel like your exam resembled the most, NBME/USWA/Free120?

A – I would say a mix of course, but I would say actually the Free 120 and just blocks of UW felt pretty representative if I could only pick 2.

Q – What do you feel like was the reason your USWA2 score dropped, do you feel like it was just a hard exam, or was it material that you had just not covered?

A – I was soooo burned out. I honestly gave up a little during and wanted to finish. I was averaging less than 50% on the first 3 blocks, pumped myself up before the last block, and got 72%. Also, it was wayyy more biochem than the real deal or anything I’d seen yet, and biochem isn’t my strongest. A combo.

Q – Also what would you recommend someone to do in the last month with scores very similar to yours on practice exams?

A – Freaking nail that rapid review at the end of FA, Dirty medicine for biochem, make sure I had all the sketchy drugs and micro down, easy points if you know it, I would be sure to WATCH pathoma chapters 1-3, I preferred to watch most of the rest too but read a few due to time constraints but he provides so much extra in the videos. I know some people like to just read which is great, but those first 3 were worth the watch for me with no doubt in my mind. Besides that, I took my lowest percentile stuff from UW and then watched the relevant boards and beyond videos. Make sure you absolutely understand the nephron and its response to various hydration and disease states.



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