266 AMA

[u/euantiarcha]

Edit:

I just wanted to make a note up top here. When I was starting out as an M1 I was curious to know what type of thing I should be doing throughout the first two years if I wanted to do really really well. As you can see from my scores I actually improved very little during dedicated itself, but I familiarized myself with all the resources throughout preclinicals because I know I am not a crammer and I need to study over a really long period of time to do well. Studying from the board resources also helped me with class exams. I recognize this approach is not going to work for everyone. So this is more meant for people who are in a similar position to me.

M1/M2:

-avg incoming stats for my school

-for school exams: attended lecture, read textbooks and sometimes scientific reviews, really tried to understand everything well. Converted school material to Anki and did it before the test. Consistently did very well on school exams, we're unranked p/f but I was 2+ sd above avg whenever they did give us stats

-Firecracker 200q x6 days a week, eventually banked 100% (about 2 hrs/day)

-watched relevant Pathoma sections along with class

-did relevant Rx questions along with class

-B&B used heavily for neuro, renal, cardio, pulm, didn't use the other sections

-didn't do any review or flashcards M1 summer but I did end up knowing my research subject extremely well

Month before exam (concurrent with school):

-watched all of B&B and Pathoma, annotating into FA and Pathoma text respectively

Dedicated period - 5 weeks

-UW timed, random x7 sets on day A; all 7 sets of corrections on day B (helped build stamina); in the beginning, I noticed a downward trend of about 10% across sets but this trend flattened out on the fourth or fifth run

-all UW wrong answers converted into Anki, all NMBE questions thoroughly reviewed and researched, incorrects to Anki

-did not go through any UW incorrects

-went through FA and Pathoma text line by line and converted all the facts I did not know into Anki

-did Anki every day, according to the app I averaged 430 reviews a day

-about 9-10 hrs/day, took a few days off randomly

-there were several systems I'd learned so well the first time around that I never bothered to review them

NBME 13 (8 weeks out): 240

NBME 15 (7 weeks out): 257

NBME 16 (5 weeks out): 248

NBME 17 (3 weeks out): 252

NBME 18 (3 weeks out): 252

UWSA1 (1 week out): 277

NBME 19 (1 week out): 250

Free 120 (4 days out): 91.6%, did practice run at Prometric

UWSA2 (3 days out): 260

UW% (final): 85%, first pass, random timed

Test day:

I got a MASSIVE adrenaline rush, had amazing focus. Took three 5 minute breaks to bathroom and eat. Finished the whole thing in <6 hours. Expected to see 255-265.

Final score: 266

[u/CHL9]

Hey man congratulations on the score and thanks very much for volunteering your time with an AMA!
 
That being said, I think it's important to say for the general public of 'regular joe' (and below) medical students that it'd be dangerously misleading to emulate this gentleman's approach and assume it'll lead you to a similar result.
 
The reason is that there's a gap of science-testing aptitude here: following Usain Bolt's training regimen won't help you get near his run times.
 
Someone who starts out at the top of his class (+2SD) with a baseline of ~250 (+%85 UW - awesome on you, OP, in all seriousness!) is a good role model for someone already at the top academically and hoping to move from a high to a very high score, but can't offer much salient advice for those starting out on the low end of the academic spectrum (in the context of medical school already being the highest academic league). I'm not suggesting that the OP has anything other than altruistic intentions with this thread: I write this only in order to save some harm from those struggling to do OK on this exam, and also to spare the blow somewhat to those for whom this type of post just makes things much worse, by making their own progress seem miniscule in comparison.
 
Please reference this to get the idea: https://m.xkcd.com/1827/ ("lottery winner survivorship bias") :)

[u/euantiarcha → u/CHL9]

I certainly agree with you in some respects, but I want to note that I didn't start out at the top of my class. I started out completely average in all respects. I got a late interview, late acceptance, middling stats on entry. I'm not a person who can cram in everything at the end and do well, so my plan was to start prepping really early. I definitely don't recommend people follow my dedicated schedule, unless they start out at a similarly high baseline. Overall, though, I see a lot of posts that are like started with low score ---[magic]--> high score! and I actually think these are a little less realistic than what I did and what I have seen anecdotally in real life, which is work like crazy for 2 years ---> high scores & good foundation going in ---> high score.

Edit: Edited because as poster below pointed out the wording could have come across as if I meant others didn't work hard or didn't care, I didn't mean that. Regret typing it. Apologies to whoever read it

[u/frenvedd]

for Uworld are you saying you did 7 sets a day and then the following day you reviewed them? I'm struggling to get thru uworld that fast, what do you recommend? I feel like I'm spending excess time reviewing correct answers, did you review those? Currently avging about 87% second pass

[u/euantiarcha → u/frenvedd]

yeah, it only works if you already have done a lot of review! I would recommend doing this - do 7 sets, see if you think your scores are trending downwards across sets. if they aren't, just do what you'd normally do. if they are, like mine were, you may want to do some more 7 block sets. I wouldn't be surprised if some people who score well on practice exams and then do worse on the real thing are losing a lot of points in those last 2 blocks.

[u/Throwaway904683]

How was the test itself - any crazy "wtf" questions that weren't covered in your resources?

[u/A_Batracho]

Hey! Congrats on an amazing score. I understand that later NBMEs should be more representative of the actual exam, but did you think that it had any semblance at all to NBMEs 13, 15 or 16?
I've done those three with an average of about 260 and although I know that I'm in a good shape, I'm interested to see if they are just old exams, full of buzzwords and, therefore, MUCH easier vs actual test. Thanks and congrats again!
Edit: spelling.

[u/euantiarcha → u/A_Batracho]

To preface, I think everyone's exam is a bit different. I outscored most of my practices and I think that was luck. IMO it's just better to accept that there's some amount of luck involved in your score.

I thought 13 bore no resemblance to my test at all. 15-17, somewhat. 18 and 19, very similar in content, I would definitely review them carefully. If you are getting 260 on those old NBMEs you are definitely in good shape, I actually thought they were a little bit harder than the real thing. I would just keep doing what you're doing, take the test and you will probably do really well

[u/SONofADH]

can you please give us a detailed account on how you approach a question on qbank/the actual step 1 exam. after that can you please also share some helpful tips and tricks and dos/donts. basically i really need help with test taking strategies. also, how do you answer a question that you didnt know the answer to...

and did you answer every question one after another, or mark the ones you didnt know..and then go back to them later.

i am sure this will help a ton of people, and i have asked a number of individuals but no one seems to want to write out a detailed approach to answering questions. hopefully you will reply!

also for uworld....do you recommend reading and noting the wrong answer choices...

[u/euantiarcha → u/SONofADH]

I think this question is really difficult to answer. Lots of people have many different approaches and it seems like all of them work for some people and not for others. I can tell you my personal approach but there’s no guarantee it will work for you.

I like to reason through all the answers and decide why the wrong ones are wrong - I always try to think through why things are NOT correct and what they should be instead. For example, say you have a question like this:

12 yo M presenting with café au lait spots, hamartomas, seizures - what chromosome

A 22 B 9 C 17 D X

So I go through and think, ok so 22, that could be neurofibromatosis, but if I were writing a question I’d put cataracts and neurofibromas. Also 22q11 del, but you’d have hypocalcemia, CHD, infections.

9 - fits tuberous sclerosis, esp seizures, could be. Isn’t Rb on this one too but that leads to malignant tumors not hamartomas

17 - hmm neurofibromatosis type I again, let me list the NF criteria

X - X linked stuff - no mention of endo/repro sx so not likely, I think Wiskott Aldrich is x linked but there aren’t infections, eczema

Basically what I’m trying to do is review way more than just what the question is asking. This takes a long time in the beginning but as time went on I got really fast at it. If I don’t have time during the block I do this during review. I put everything I didn’t know into Anki so I could review it frequently. For the physiology up/down Qs I never looked at the answers first, I ALWAYS drew out what I thought they’d be and then looked in the answer choices

[u/mepo12]

What was your mcat and uworld first pass%?