USMLE Step 1 Experience – 247 – US Medical Student 2

Just took it


Will share score when it comes out. I didn’t have a survey at the end. I just had a screen saying I was done but that doesn’t guarantee I finished all sections (I answered every question, so I guess that’s just a standardized message). Goal score is 250. I can live with anything 230+.


Practice Scores

U World Average 71% timed random while I was doing organ systems. One week after finishing organ systems, I did last 16 blocks and averaged 75%.


(All taken before studying)

CBSA 190

NBME 13 180

UWSA 180


(2 weeks into hardcore studying)

UWSA 236


(Taken while going through organ systems)

NBME 15 236

NBME 16 232

NBME 17 222

NBME 18 236


(After reviewing all organ systems)

NBME 19 244

Free 117 85%


What I did

Study time: 10 weeks about 8-10 hours a day (took some time out of school’s normal curriculum to begin early and lowered my grades a bit for the last module)

U World 1.5X (I did my incorrects and marks after my first run through on tutor mood)

First Aid 2X

Pathoma 2X

Goljan 1X

DIT (About 70% and coupled it with first aid, since I lack the discipline to sit there and read)

Kaplan 70% completion (mostly done through med school)

USMLE RX 70% completion (along with First Aid and DIT to hammer first aid)


Test Experience

Some blocks were easy and felt like NBME 18 and 19. Some blocks were about the difficulty level of U World. It felt like recall questions with weird organisms or drugs as the correct answer were all purposely designed so that someone who knew all the high yield information could effectively eliminate all of the other choices. The most difficult questions had to do with pathogenesis. It was a lot of “can you figure out the most reasonable explanation/mechanism for this common medical phenomena.” The physiology was easier than both Kaplan and U World. The pathophysiology was on the same level. I’m generally a good standardized test taker and fast reader, so, when practicing, timing was never an issue. On the actual exam, the easy blocks took me about 40-50 minutes and left me a good amount of time for double checking. However, I needed almost all the time just to get through the tougher blocks. The people at my test center were super slow at signing people in after breaks. I lost a bit of time on my last block. I still managed to finished, but it wasn’t a good feeling to see those red digits wind down as I frantically clicked the bubble for my last answer.


I definitely made some really dumb mistakes here and there, especially in the later blocks. Test fatigue is very real. I practiced taking 8 blocks a day on more than a few occasions. However, the pressure and multistep questions on the real deal really do wear you down. By the last three blocks, I started to be less thorough with my reading of questions. But I’m not really going to beat myself up over this because I think test fatigue affects almost everyone and almost everyone makes a few dumb errors they wouldn’t normally make due to it.


How I would study differently?

Specifically for STEP 1, I wouldn’t study differently at all. I can distinctly remember questions on my exam that I only knew because of a combination of one or two of the resources listed above.


How I would study differently in med school to be in a better position at the beginning of my dedicated study period?

READ more. The exam tests if you know the mechanisms behind disease. All of the rote facts can be readily memorized in a few weeks. It’s hard to gain a good background in pathology in that time period. Reading Robbins during your actual coursework is golden. If you had lecture based exams that asked nit picky details off of slides like at my school, time spent reading might take away a bit from grades on exams. However, I think sacrificing your grades a bit to read the right resources more is worth it for two reasons: #1 you gain a broader background and framework to actually understand medicine as a system rather than an assortment of disjointed facts #2 It helps a lot come boards study time, when you start with a strong base of understanding the “why” and the “how” rather than just the “what” of processes.

The way scoring on USMLE STEP 1 most likely works is as follows:


All questions you get were given as experimentals several times to different pools of test takers. The statistics regarding %who got it right vs. %who got it wrong for those questions are used to compute a difficulty rating for each of the questions. On your exam you get say 280 questions. Say 40 are experimental. Therefore 240 count towards your score. Each of those questions has its own individual difficulty rating, computed by the test makers via the aforementioned technique. The difficulty ratings of all of your questions is averaged. That rating is used to generate a “curve” or standardization for your test. This is then used to finally compute your score.


Now your questions actually come from a pool of 20,000 questions. NBME essentially makes sure you get a nearly random set of 280 questions. However, to ensure that you get a certain number in every topic, all of the topics have a minimum number of questions that NEED be asked for them. For example, “pathology” probably has the highest minimum and something like biochem would have a lower minimum. Hope this makes sense


Also questions, where say under 15% got it right and there were only 5 choices, are probably thrown out. This is because it is hard to tell if people got it right because of luck or knowing the answer.

As promised, here is my score: 247. Long way up from a baseline of 180. Even professors lacked confidence in me, given my baseline and merely average preclinical grades. Work hard and don’t listen to the haters.

If this experience helped you, check out the following experiences:


269 – USMLE Step 1 Experience

USMLE Step 1 Experience – 257 IMG – Dr. Mohamed Mustafa – Egypt


December 27, 2017
%d bloggers like this: