NBME Self-Assessment Tests and USMLE Review – Part II

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Today, we will talk more about the NBME self-assessment tests. We previously discussed what the NBME self-assessment tests are and how they impact your USMLE review. You can read the posts here. Now we will cover three important topics. When to use the NBME self-assessment tests, how to use the NBME self-assessment tests and how wise it is to use the USMLE World self-assessment tests instead.

We now know that the NBME self-assessment tests are accurate in predicting actual USMLE performance. And we also know that the main reason for this accuracy is the correlation study done by NBME between the two tests using AMGs performance in both tests rather than to any real similarity between the 2 tests. This correlation has also been borne out by most test takers who narrated their experience in forums. It can be used to gauge whether you will pass the examination and even if you have a good chance of achieving the score you are aiming for.

How to use the NBME Self-assessment tests

Best time to take the NBME Self-assessment tests

So when is the best time to take the NBME? The best time is when you think that you are ready for the USMLE. When all parameters indicate that you are probably ready for the USMLE examination, you take the NBME to confirm that you are ready for the examination. In other words, use the NBME as a diagnostic or confirmatory test, instead of a screening test. You can use your performance in USMLE World Q Bank or Kaplan Q Bank as a screening test.

Use NBME Self-assessment Tests to assess readiness, not identify weak points

The practice of many to take the NBME Self assessment tests to identify weak points and measure progress in review is not very practical. First, there are only 7 NBME tests (for Step 1) and second, you can take it only once. Taking it more than once invalidates the correlation and therefore its accuracy in predicting actual USMLE performance. Therefore, what do you do if you are still not ready after taking all six tests? You just used up your most valuable tool for predicting your actual performance in the USMLE.

Personally, I used the NBME exam to confirm my readiness to achieve my targeted score of 99. In preparing for USMLE Step 1, when my Kaplan scores were hitting 84 and above, I felt I was ready for the test. I took NBME form 1 only and 740 confirmed my readiness for the USMLE exam since I was aiming for a 99. 600 was enough for a 99, but I would have postponed if I got less than 660. Why? Since I decided I want only a 99, I was giving myself a 10 point leeway (600=240 and 660=250) to make sure I make it to a 99 no ifs, ands, or buts. ๐Ÿ˜‰ The same thing holds true for Step 2 CK, I took the exam when my one and only NBME assessment test scored 700, way above what I needed for a 99.

Timed NBME Self-assessment Tests for best results

Another common question is whether to take the NBME examination timed or self-paced. Since you are trying to test your actual readiness for the USMLE examination, it is best to simulate actual exam conditions. In my case, I took self-paced but finished everything in the 1 hour allotted for it. I may look over the questions after 1 hour, but I will not change them so as not to alter the score predictability too much. Make sure everyone in the house knows not to disturb you while doing this. Although you can pause the exam, it is not recommended. Also I do not recommend you do it in a public library. There was one person who took the USMLE despite getting a low score in NBME self assessment test. He attributed it to the fact that he took it in a noisy public library and “upward adjusted” his predicted score. He failed. So, take it properly and trust the score. One warning, though, correlation is not 100% therefore always give yourself some leeway in case things do not go too well. Never, ever go for the USMLE examination if you scored 400 or less. Your chances of failing is too high and even if you passed 75 and 76 are with you for life.

What about the USMLE World Self-assessment tests

Recently, USMLE World started offering their own assessment tests for US$ 30 each, US$ 15 cheaper than NBME’s assessment tests. The question foremost in everyone’s mind is, can I switch to UW assessments tests instead of NBME’s. How wise is a decision like that?

The reason for using assessment tests is to make sure you are ready for the USMLE and to lessen the risk of getting an adverse score. NBME has proven throughout the years, after thousands of test takers, that it is a reliable predictor of your actual score in the USMLE. It is also backed up by correlation studies that have been published in journals. Now, although USMLE World’s assessment test may also be a reliable predictor of your actual USMLE performance, all we have is their word for it. No study has been cited or provided to independently verify such claim. And not enough empirical evidence from test taker’s experience forums allow us to make any judgment on its accuracy at all. Surveying forum after forum reveals variable experience with the tests as of now.

My take is that since you only have one shot at the USMLE, it is better to go with what is proven and tested rather than take a risk. Although, you can retake the USMLE if you fail, that failure is recorded and counted against you. If you pass, the score is with you the rest of your professional life. If you chose to, maybe you can use the UW assessment tests as a screening tool. Just be sure to use the NBME assessment test, whatever form to confirm your readiness before actually sitting for the USMLE.

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230 thoughts on “NBME Self-Assessment Tests and USMLE Review – Part II

  • July 29, 2008 at 5:04 pm
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    actually u r doing a great job…a lot of valuable information in this blog

    wish u the best

  • August 1, 2008 at 9:11 am
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    also would like to ask:

    which nbme to take as there r 6 nbmes?

    r they all the same dificulty as i hear from some usmlers they vary in difficulty

    so if so which form is the best correlated to usmle scores?

  • August 16, 2008 at 5:25 pm
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    Thank you for your incredible effort in this website.
    I’d like to know; if my score is below 400, and I postponed the exam for more preparation, can I re-take NBME again? and which form?
    And in general, which form is the most accurate in prediction?

  • August 19, 2008 at 7:38 am
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    Each NBME form should only be taken once as retaking them can inflate your score and lower predictability. Based on the first 4 forms, Form 1 has highest correlation. No information on Form 5 or 6 yet. But even so Form 1 has only 0.89 correlation and therefore not 100% guarantee. Some would use 2 forms and if they agree with each other than possibility that predictability is high. Since each form should only be taken once to maximize predictability, it is poor practice to use up all forms in your review. Since if you’ve done all 6 forms and the last form predicts below 400, you’ve just run out of forms to accurately assess your readiness for the examination. Now, if you’ve actually used up all 6 forms, suggest you use UW assessment, since preliminary reports state it is fairly accurate although not yet proven as NBME has been. This time try to conserve it and use it only if all other parameters like UW Qbank or Kaplan Q Bank indicates you are scoring high.

  • August 31, 2008 at 5:13 am
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    Thanks so much for the inciteful info. I’ve been searching out info on all the blogs about the Uworld assessments. I am taking the the test on Tuesday, about a week ago I took the first Uworld assessment and got a score of 224. Two days later I took the second Uworld assessment and got the same exact score. Yesterday I took NBME 3 (because I heard this was the most accurate predictor) and received a 209. I do not know which one I should assess myself with. Should I just go by what NBME says? Thanks so much…

  • August 31, 2008 at 6:22 am
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    Hi Jay,

    The assessment tests usually have good internal correlation with each other. So the close correlation between tow UW forms is expected, just as close correlation between 2 NBME forms is expected. There is no data on correlation between UW results vs. NBME results although that would be interesting. Personally, I would still go with NBME since it has been tested against the USMLE more times the UW. Again it does not mean UW is less reliable, just less proof of reliability and that is not the same thing. But for now, at least it appears you have a very good chance of passing this exam.

    Good luck on your exam. Remember to rest well the night before and don’t eat too much on the day of the exam (more carbo than protein) so you don’t get sleepy. After lunch is worst, and the more full you are, the sleepier you get. (increase visceral blood flow for digestion and metabolic alkalosis as HCl stays longer in GI for digestion. metabolic alkalosis = hypoventilate = less O2 to brain)

  • September 13, 2008 at 6:07 am
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    Hi, i failed twice in usmle, and now feel confuse what to do.
    Can u pl tell me my attempt will affect to get residency, if i get good score.
    Pl be helpful.
    Thanks

  • September 14, 2008 at 8:38 am
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    Hi,
    Can u pl say about form 5 and 6?

  • September 18, 2008 at 9:57 am
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    hi dr patel,

    Failing the USMLE twice will negatively impact your chances for a residency. However, as in everything there are ways to remedy them. One is to get a good score once you pass it. The higher the better, but nothing less than 90. Even then you need to work harder than other people though to get a residency. The reason is as always supply and demand. Too many applicants and too few positions which makes programs especially choosy.

    As to commenting about form 5 and 6, if you read my post on Donating to Askdoc’s USMLE Blog, you know why I can’t really comment on form 5 and 6.

  • September 23, 2008 at 4:41 am
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    Hello, doc.
    Thanks you very much. Can u pl tell me how can i assess my self & be sure i am ready for exam? usmlerx or usmle world , which one is worth ?
    I appreciate ur help.
    Dr patel

  • October 10, 2008 at 11:29 pm
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    I am so thankful to you askdoc that i can only pray God blesses you forever,Your input for USMLE has made a great difference to alot….I myself wasnt so motivated and very stressed out as to how to start and where to start and what if i fail and all those i asked just gave answers which i already new….study kaplan books n do this n do dat but i wasnt sure where i stand and i was getting scared of myself that i know nothing and becoming a hipocrit….but after reading your post i am back to my senses and i will start from today evalute myself and see how to start and its basically from scratch the learning phase is what i need to get the basic concept then i can move ahead or else i will never reach my goal…..is there anyway i can reach you by means of mail or contact incase i get stuck n need advise???Please let em know.God be with you always.Thankyou.

  • October 12, 2008 at 8:05 am
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    Hi Asiya,

    You can reach me through personal messaging system in my forum at http://forums.askdoc-usmle.com. My callsign is of course askdoc

    If you have to start from scratch you need to start with textbooks and not reviewers and you should cover the subjects in the order your medical school did it which is Anatomy and Physiology first, then Biochemistry, then Microbio/Immuno and Pharmacology, then lastaly Pathology. Behavioral Sciences, you can just use a reviewer. After you finish your learning phase, you can use the review methodology I outlined in my forum, “Askdoc’s Method of USMLE Review for Step 1”

    Good luck in your prep. Feel free to contact me for help if you need them.

    Mike aka “askdoc”

  • November 27, 2008 at 9:28 pm
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    Hi, can u pl tell me, if i registered for usmle in india, can i able to trasfer my testing region from india to usa?
    Thanks

  • January 4, 2009 at 9:17 am
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    hi, iam saba .i got a score of 520 in nbme self assessement form 2 test .iam planning to write step by 25th jan 2009 . please tell me should i write the exam or postpond it till i get a good score

  • January 5, 2009 at 1:45 am
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    Hi saba,

    Depends on the score you are aiming for. 520 is equal to around 214 or thereabouts which is high 80’s. If you are aiming for passing the exam or getting 80’s then the score is good enough. If you are fresh grad and not aiming for surgery or other tough specialty, you don’t need really that high a score. However, if you are old grad or going for competitive programs, the higher your score the better your chances.

  • January 13, 2009 at 7:40 am
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    hai, please help me . as i have already told u that i got a score of 520(224) in nbme self asse form 2. after 2 days i wrote usmle self asse form 1 & 2 and i got a score of 510&520 resp. iam planning to give step in jan last week . iam very afraid of the exam . please tell me ?
    is actual step 1 more like nbme or u world

  • January 16, 2009 at 7:29 am
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    To saba,

    The actual step 1 questions are more like Kaplan and U world q Bank, rather than NBME. However, that is immaterial since if you have studied well and prepped properly, you would do well in the USMLE. The NBME assessment tests have proven to be fairly reliable in predicting your score. It seems recent data (from forums) also indicates that the UW assessment tests is also fairly reliable in predicting your score.

    DO NOT BE AFRAID of the exam. If you prepped right and both NBME and UW assessment tests predict a good score (like in your case) you should do well. But relax and don’t get too uptight. Some people failed not because they were not prepared for the exam but because they were too nervous and suffered anxiety attacks. These can cause you to score lower, stay calm, Remember you are a doctor. Used to taking pressure.

    I was so uptight when I took my Step 1 that my heart was pounding and my hands was shaking. I took a break, washed my face, took a beta-blocker to decrease my heart rate. Went back finished the exam and got my 99/256. Now relax, breathe deeply. concentrate the last week doing flashcards or rapid review of First Aid. Don’t cover new topics as that would just stress you out. Look through pathology images in First aid or in my High Yield Fast Facts course in http://prep.askdoc-usmle.com.

    2 to 3 days before the exam, do not study, just take a break, sleep well. On day of exam. Wake up early, do not take too much fluids( a cup of coffee or tea would do) since you want to minimize going to the bathroom. Make sure you eat some breakfast. preferably high energy and high carbohydrate. Avoid meats (ham, eggs, etc.) Make it light so you don’t feel sleepy. Light lunch only, again high energy, high carbohydrate with little meat so as not to make you feel sleepy. After you finish, go out celebrate with your family. Take the next 3 weeks off, then wait for the result.

    Good luck on your exam

    Askdoc

  • January 21, 2009 at 4:36 pm
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    Hi askdoc…hope you r fine……well i jsut got 245/630 on uwsa the first form……some people tell it is 99 ..others say uwsa overinflate the score…….and i dont want to get a score less than 99…..my exam is on 10 march and am really scared……..still have form 2 to do…..cant do nbme because lack of funds and also i did most of their questions on the forums.

    really need to hear your opinion.

    cheers).

  • January 21, 2009 at 6:35 pm
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    Hi. I am relatively new to your blog, but I already like it. It has already helped me in many ways. I specially liked this post about the NBME.
    I am about to take the Step 1 examination and want to know which of all the NBME forms do you recommend over all. I ask this question because I have relative little time to spare before taking the test, and want a really good assesment of my studying so far.

    Thank you for your time.
    Dr. M

  • January 21, 2009 at 10:31 pm
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    Hi haitham,

    Although, 630 does correspond to a 99, there are differences when done on assessment tests vs. real exam. For one the actual exam is longer (fatigue is a bigger factor). The pressure is stronger because its now the “real” thing. Therefore there is a strong tendency to score lower on the actual exam instead of the assessment test. In my case, My NBME assessment was 740 which would merit a 99/265 or thereabouts, but my actual score was 99 / 256 a 9 point loss. When I assessed the various correlation of the NBME, I noted that a variation of 10 points (2SD) from predicted score was the norm for NBME assessment. (I have not had the chance to see if current spread still holds since this was done in 2006 when I took my exam). Therefore I made a cutoff of 660 = to 250 or 10 points from 240 which was the minimum 3 digit score to get a 99. When I hit 740, I decided to proceed with my examination. I do not know the exact predictability and spread for the UW assessment forms, but I think it would be close to NBME although not exact. And you are right, there has been some complaints of overinflation with UW compared to NBME.

    The actual score you will get will probably depend on how much effect fatigue and pressure will have on your final score and the amount of additional points you can get by having one more month to review. My suggestion is that you go through high yield stuff on February concentrating on 3 subjects, Pathology, Micro-Immuno (especially Immuno) and Pharma (especially prototype drugs, most common side effects, therapy of choice) Go through rapid review section of First aid or the High Yield Fast Facts Review course in my prep site http://prep.askdoc-usmle.com. If you have notes for q Banks, review them thoroughly. If you still have qBank enrollments, do speed drills. That is answer questions as fast as you can without reviewing your answers. This is to drill you to read fast and recall fast rather to attain the highest score possible. Take the next form around 10 to 14 days before your actual exam. If you get a score above 660 or so, I think your chances for a 99 is very high (If this was NBME, I would say it is a sure 99).

    Come back to me after and I’ll give you some tips on how to prepare for the day of the examination, ie, pacing, diet, medications to bring, etc.

    Good luck on your prep

    Askdoc

    PS. relax, Do your best, if you are meant to get a 99 you will. And your chances for doing that is very high.

  • January 23, 2009 at 9:12 am
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    Hi Dr. M,

    Actually any of the first 4 would do. The best is to do two forms and if both correlate to more or less same score, then your chances of getting that score would do. I have less data on the other forms so will not venture to give judgment on them. But based on experience of my students and other users, the first 4 forms are very consistent with each other give or take a few points.

    Askdoc.

  • February 16, 2009 at 11:05 am
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    Hi there !
    I intend to enter the part 1 exam somewhere in beginning of March. I have been studying for almost 6 months now but I did not make that much of an effort ( study times short and far between ) anyway last night I could not sleep and I didnt feel like studying so I decided to try the NBME .
    I took NBME basic sciences 5 since it said NEW on it . Anyway , it took me less than 2 hours to finish it (I dont like to dwell a lot on answer , you either got it or you dont !!) and my end result was 560 : ( that was disappointing because although I still need to go through the curriculum for one final review (the last time I read naything in Anatomy or Embryology for example is about 5 months ago) , still I did not get an idea of where my performance was bad .
    My performance on USMLE Qbank varied . If I waited to take it AFTER I had studied AND revised a subject I get over 80% while other times I just take timed tests in a particular subject before having completed studying it , so my overall has fallen to about 67% (90% completed now) , I never used tutorial mode .
    So tell me , what do you think my chances are at getting a high score ? Should I take NBME 1 so I can get a better idea ?I was going to take test on first of March , should I “beware the ides of March” ? : D thank you

  • February 18, 2009 at 5:19 am
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    Hi Ahmed,

    560 is already mid to high 90’s. Of course if you are aiming for a 99, that is not high enough. If you finished all 4 blocks in 2 hours then the score will probably hold in the actual examination. If you are happy about getting 90’s then one last revision is all you need before taking the examination. You can take form 1 about 7 days before your scheduled exam as a final test of your readiness. If you are aiming for a 99, 2 weeks is a bit too short to raise your scores to that level albeit not impossible.

    The ides of March is on the 15th, therefore taking it anytime in the first week should be safe ; )

    Good luck on your prep.

    Askdoc

  • February 20, 2009 at 6:32 pm
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    I returned!!! lol!

    just finished uwsa 2 …….4 blocks done in a rown except i took few minutes to pee after block 1 ……the urge came in the middle of the first block but i said to myself deal as if u r in the middle of a block in the exam!!

    guess wat was the score?…….the same!

    630/245

    although i wanted to get higher than the previous but at least i didnot get a lower mark!

    now my friend wat about the exam day tips regarding pacing and food?

  • February 22, 2009 at 1:10 pm
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    Hi Haitham,

    Welcome back. If you like, take a look at one of my student’s exam experience at my forum at http://forums.askdoc-usmle.com. He got a 97/232. Guess what his NBME scores were.

    One fact about your experience. I think you have reached a plateau in your prep, that is why you are no longer improving even if you are still studying. Everyone plateaus eventually although the peak is different for different people. It’s a good thing you will be taking the exam by next week. Do not delay the exam because you will eventually go into decline, when what you forget is more than what you learn or study. When we start learning, we tend to start forgetting some of what we studied immediately. Initially, the rate of learning is faster than the rate of forgetting, but eventually it plateaus then go into decline. It’s about 6 to 8 months for most people.

    Therefore, I suggest that you take the last few days going through high yield stuff and pics. This is to maintain your score, not to raise it. You should not be learning new material as it may accelerate the decline.

    Two days before the exam, drop your books and do not study anything. Relax and take your mind off the examination. Go watch a movie, preferably a comedy or do anything that takes your mind off the exam. Sleep well the night before. Take a hot bath, but do not take tranquilizers as you’ll not be at your peak the next day.

    One word of advise. On the day of the exam, do not leave any question unanswered. An unanswered question is a sure wrong, while a question answered even with a guess is a possible right. And just one additional right answer may mean the difference between a 74 and 75 or a 98 and 99.

    The best pacing schedule makes use of a couple of facts. One, you are more alert in the early morning than in the afternoon when the exam will have taken it’s toll. Therefore it makes sense to schedule more blocks before lunch. So 4, 3 would be good. Now you are sleepiest after lunch, because of the act of digestion, therefore schedule only 1 block after lunch then have a break afterward. Never take more than 2 blocks before you take a break with some food or sugared drink. Your sugar level starts falling after 2 hours and sugar is the main fuel for your brain.

    So best to schedule 2 blocks, 15 minute break, 2 blocks then 25 minute lunch, then 1 block, 10 minute break, then last 2 blocks. You can take a break between the last 2 blocks if you feel you need it. Notice that the total break is 50 minutes. Reason is that the actual break will usually be longer than the time you scheduled it. Just logging in and out of the room will take 1.5 to 2 minutes. The rest room is usually two doors out (both the exam center in my home country and the one in San Francisco where I took Step 3 have the same layout. So I presume all Prometric centers have the same general layout) So you have to walk.If you need a short break between 1st and 2nd block or 3rd and 4th block, just sit on your cubicle and rest for a minute or two before starting the next block. As I said logging in and out is a time waster.

    Now, for meals. Light breakfast in the morning preferably no meat but high energy carbohydrate. (High protein, high fat foods can make you sleepy, so no ham and eggs, sorry) Now coffee or tea to keep you awake, but limit to a cup since they increase urine formation.(increased heart rate, increased GFR = increased urine formation)

    For the morning break, do not bring sandwich. It takes too long to finish eating it. Bring something sweet, high energy, high carbohydrate that can give you a sugar boost. (I ate a small high sugar cake that I finished in 4 to 5 bites.) You can opt to wash down with a cola (which can provide both sugar and caffeine boost)

    For lunch break, do not eat full meal. A sandwich, preferably not high protein (egg sandwich or cheese sandwich comes to mind) is advisable. It’s actually basic physiology. A heavy meal will cause blood flow to be diverted to your gi tract longer therfore less blood flow to brain. Plus, proteins and fat will cause secretion of more HCl for digestion leading to Metabolic alkalosis. This leads to hypoventilation (to increase CO2) and therefore less oxygen to the brain. Longer digestive time causes longer time for HCl to be reabsorbed. This is the main reason why you are sleepiest after lunch.

    For the afternoon break, a high sugary drink whether cola or juice will suffice. Limit total water intake as that can increase need for bathroom breaks.

    Now for the meds, you need the following
    .
    1. Pain reliever – paracetamol, in case of headache or any other ache.
    2. Loperamide – in case of gastrointestinal emergency eg. diarrhea
    3. Antacid – in case of hyperacidity (anxiety can cause it)
    4. Beta blocker – in case anxiety and palpitation become too distracting.

    Good luck on your exam. Come back and tell me how it went.

    Askdoc

  • February 24, 2009 at 10:29 am
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    hi, i gave u step 1 and got a score of 93/223. thanks for the advice u have given me before writing the exam.

  • February 24, 2009 at 12:47 pm
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    Hi saba,

    Way to go. Congratulations, that is a great score. Now concentrate on Step 2 CK. Feel free to ask me questions if you need help for Step 2 CK. If you can get the same score for Step 2 CK or higher, I won’t be surprised if you get over a dozen interviews. If you don’t need visa, you may get twice that number of interviews. Watch out though, it is better to have only a high Step 1 score rather than a high step 1 score and a low Step 2 score for getting interviews. So make sure your NBME is very good before sitting for Step 2 CK.

    Askdoc

  • February 25, 2009 at 3:35 pm
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    Hi, im really frustrated i hada a 380/186 in UWSA. Should i take a chance and take the exam on 1 week or postpone it? What iยดve seen in the rest of the forums everyone does well at least 200s. I did another predictive exam 2 weeks ago which result was 185, no improvement i dont seem to be getting it any more. i just cant focus any more.

    Any advice?

  • February 25, 2009 at 11:14 pm
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    Hi Robert,

    Alas, your case is fairly common. To be honest, I rarely see anybody with less than 400 pass the USMLE. And you need a 450 for an almost sure pass. Therefore it is very dangerous to take the exam at this point. It costs the same amount of time, money and effort to cancel the exam and retake it when you are ready and to fail the exam altogether, except that failing does a lot of harm to your chance for a good residency. If you fail, you still need to retake it.

    The fact that you are not improving and you can’t focus anymore showed you’ve plateaued. The advise I usually give in this situation is to reboot. That is take some time off, maybe 2 weeks to a month (cancel the exam) then restart your prep. I know it is frustrating and most often the person I advise do not take the advise and continue with their exam. And almost always they fail. So it is still your choice. The reason you have this problem is that you did not evaluate yourself right at the beginning of your prep. When you prep, you need to evaluate yourself at the outset to see if you’ve made progress. Read my post on Guide to Self-Evaluation in USMLE Prep on this blog.

    If you do decide to reboot your prep, come back and I’ll give you a series of links to my posts on how to prep right.

    Askdoc

  • March 2, 2009 at 9:25 am
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    Hi I love your site!IT is so informative. Thank you so much for helping aspirants like me with your advice. I do have one question though… what do you mean buy the Ides of March? I am scheduled to take the exam on March 19. IS this not a good date? What days should I beware of: (first time I heard the beware the Ides of March?!?

    Also, I will be doing my NBME assessment on the 6th. As you mentioned, form 1 has the highest correlation, so I will take that!

    Thanks. You are doing a really great job!

  • March 2, 2009 at 11:52 am
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    Hi 99alltheway,

    Thank You! The 3 digit score predicted by NBME + or – 10 points is 2SD of predicted scores. That means most scores will fall within 10 points of the predicted 3 digit score.

    The Ides of March which is the 15th of March, is the day Julius Caesar, ruler of Rome (he is not the emperor as the first emperor is his heir Octavius, called Emperor Augustus) was assassinated by the Roman Senate. He was allegedly warned by a seer to “Beware the Ides of March”, which he did not heed. Therefore the Ides of March is considered an omen of bad luck by the Romans.

    My remark was in answer to Ahmed’s Joke about “the Ides of March”. ๐Ÿ™‚

    Good luck on your exam.

    Askdoc

  • March 2, 2009 at 12:50 pm
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    Thanks for the quick repsonse!:)

  • March 5, 2009 at 6:41 am
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    Hi! I stumbled upon your site during one of my ‘nbme score correlation’ google sessions! it appears to be more helpful than any forums ive come across!!…and ive come across alot ๐Ÿ™‚
    well, i downloaded the forms off various forums, and started off with form 2 (got a 620) and then form 5 (got a 572). Firstly, since i did not purchase these from the nbme site, I had to use some correlation charts which im not sure were the latest ones(got those off some forum too). if possible, could u please send me a link or email the latest(if theres any such thing) one to me.
    Secondly, ive gone thru tons of forums and some say that form 3 is the best predictor, some say 2, some 4 and so on. Which form would u say is the best predictor, so that scoring well on that particular one essentially guarantees a high score.
    Thirdly, and lastly, some people report having seen ALOT of molecular biochem on their exam, some report the traiditonal patho/pathophys abundance and some report anatomy. does every exam have a different subject majority or do they all contain roughly 48 questions of each subject?

  • March 7, 2009 at 6:50 am
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    Hi Mazhar,

    About those “downloaded” NBME. Copyright problems aside, the question you have to ask is who, where, what, how. Who did the correlations study? Where is that study? What institution is backing the study? How was the study conducted? In case of the online NBME we know who did the study (it’s in the website and the assessment report given you) where the report is (you can google the research paper), What institution is backing the study (NBME and USMLE itself) and How the study was conducted (Read the research paper). With the downloaded version, Do you have any information of the who, where, what and how. If not, why will you entrust your entire future on someone you do not know at all and choose to be anonymous.

    Two, if you read my post and if you understood your biostatistics, you will know that the best predictor does not guarantee the highest score. It predicts more closely what your actual score will be. However, this is based on correlation studies and the accuracy of correlation studies to a specific instance of a result can never be guaranteed. Only its accuracy on a wide range of results. That is the basics of biostatistics. If that is possible. Then get me one who can do that, get me to Vegas and I don’t have to be a physician to earn big bucks! ๐Ÿ™‚ Biostatistics deals with probabilities not certainties.

    Lastly, people tend to remember what took them the longest to answer, because it was the hardest for them. That accounts for the tendency to think a lot of molecular biochem will appear in the exam. Unless, USMLE now believes that the medical field needs molecular biologist than clinicians, that will hardly happen. Go to my forum at http://forums.askdoc-usmle.com. Read the post on Askdoc’s Method of USMLE review. Read all three posts in order. It is explained there what is the percentage of coverage in the exam of the different subjects in the USMLE. Unless a major percentage of all examinees report an increase in Anatomy questions, I hardly believe again that anatomy will comprise the bulk of the exam. USMLE is a very fair and very logical exam, unlike the local boards of most other countries including mine. Their rationale for the questions they ask in the exam is based on what you need to know to be a good clinician and not to test how good you are at memorizing obscure medical details.

    Askdoc

  • March 7, 2009 at 8:08 am
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    thank you for the detailed reply.
    as for the NBME forms, well maybe i should have phrased my question differently; for instance, i just recently completed form 5 and got 143/200 correct; i have just one block of form 4 left to do and should probably end up with about 160/200 correct. SO, do you think these scores mean that im well on my path to getting a 99? the correlation chart stuff i mentioned before seems to have clouded my actual question! ๐Ÿ™‚

  • March 22, 2009 at 11:08 am
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    Hello Askdoc, I wrote to you a couple of months ago regarding which NBME exam to take before writing the USMLE step 1. My exam is the 20 of April, 2009, and these have been my scores so far.

    NBME 5 = 580 (Suppose to be 236 on step 1)
    NBME 2 = 630 (Suppose to be a 252 on step 1)

    I found NBME 5 to be much more challenging…

    I know these are good grades, but I still dont “feel” ready for the test. Everybody tells me its been getting harder and that they have been adding these wierd experiment questions, etc.. What do you thing I should do from this point on? I was planning to review first aid once more, and maybe pay NBME 3 or 6 (NBME 6 is supposed to be the closest to the real thing. Thats what i read somewhere on the net).

    Thanks in advance for the advice. Really appreciate what youre doing w/ your site. Keep it up !
    Dr. M

  • March 27, 2009 at 7:29 am
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    Hi Dr. M,

    Really sorry for the late reply. Anyway there seems to be some disparity on the scores you got with both NBME although they still predict a 99. However, again the correlation is not 100% and in most cases people tend to score lower than predicted score although some do get higher. I think you should try NBME 6 since that is the latest set. I do notice that people who used the first few NBME’s tend to score lower than their predicted scores while those who used the last 2 NBME tend to have predicted scores that hold better. Again, I don’t have enough data points (from looking over reported scores and statistics in the various forums) to make a conclusion as yet. But it does make sense that since we know the USMLE is getting tougher yearly, (mainly due to the fact that people are scoring higher due to better prep) that the newly constructed NBME exams may reflect the tougher USMLE exams better. Again, not enough data to make a conclusion but seems logical.

    Based on your scores, it seems 90’s is safe for you, which means you are assured of scoring in the 90’s. 99 is not so sure but you do have a chance. Important for me to know, when you plan to take the exam, have you finished q bank and which one, so we can decide how best to proceed. If you are aiming for a 99, you’re not there yet but very close. Again, you may still get a 99 if you take the exam now, but a possible 99 and not a sure 99 in this case.

    Askdoc

    PS. If your exam is in 2 to 3 weeks time, concentrate on high yield stuff. Both first aid and my High Yield Fast Fact Course are good sources. Your choice.

  • March 27, 2009 at 10:47 am
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    Hello Askdoc. Thanks for the sound advice.

    My test date is the 20 of April, 2009, so i have about 20 days left for my test. As to my preparation so far, i did USMLE World Qbank and scored 60% of the questions correctly. I reviewed First Aid and then i did the Qbook that came with the Kaplan Course just to see how i was doing. I scored 76% overall. After this i felt like i plateaued. I started to surf the net looking for what to do next and that’s when i found your site, which motivated me to finally try out these NBME’s. Before all this, i basically did the Kaplan course. It really helped me out to fill all the gaps in my knowledge, me being an IMG and all.

    Initially i wasn’t aiming for a 99 on the test. I really just wanted to score above 90, but these NBME scores motivated me to give it a try. I found NBME 2 very easy, w/ very short questions. On the other hand NBME 5 had longer questions, which were more clinically oriented and required more time to think them through. All i hear is that the test is getting harder and harder, and that kind of freaks me out a bit. What do you think about the test getting harder? I heard that there’s a lot of molecular questions and questions dealing w/ transgenic mice experiments :S. Not exactly my favorite type of Q’s.

    I’m going to follow your advice. These last 20 days i will concentrate on High Yield material, focusing on the recall of important information. I have a few other questions to ask you…

    1- How long before my test date do you think i should take NBME 6?
    2- Do you think i should do another type of Qbank before the test? (I have a bunch of older Qbanks some friends gave me).
    3- Any advice on mentally/physically preparing for the test these last few days?
    4- Some advice for the day of the test, and pacing through the test.

    Thanx a lot in advance. Keep up the excellent job.
    Dr. M.

  • March 29, 2009 at 5:05 am
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    Hi Dr. M,

    1. Around 1 week to 10 days before the exam.
    2. Just do it to drill for the exam. Do not use it to learn new things as that would be bad for you. You tend to remember the last things you studied and if they are full of low yield stuff, that is what you remember and not the high yield ones.
    3. and 4. Read my post on this blog on What to do on the day of the USMLE exam.

    Askdoc

  • March 29, 2009 at 10:50 pm
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    Hello Askdoc,

    I’ve been a silent reader of your posts since I started studying prepping for step 2 Ck about a month ago. I have my step 2 CK this tuesday – march 31st.

    I studied mostly from First Aid and Kaplan and USMLE World (around 68% correct) plus Kaplan Q bank.

    NBME Form 1 – 520
    NBME Form 2 – 580 (taken 14 days after Form 1, this wednesday – 5 days before actual exam)

    I have a green card. My Step 1 score 96/230

    I thought I was not as nervous for CK as I was for Step 1 but I am extremely jittery today and feel like I’ve forgotten everything. I cannot postpone the exam because it’s the last day of my eligibility period and frankly, I just want to get it over with.

    My question to you is – will I be able to make a 90+ score? And do you think I will get any interview calls with just a 96 plus an unknown, hopeful 90+? ๐Ÿ™

    I’ve studied till now and plan on studying more tomorrow just because I am jittery. I’ve never been this way before. Any of your words would be greatly appreciated. Thanks in advance!

  • March 30, 2009 at 2:21 am
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    Hi Kay,

    If both your scores are above 85 with Green Card and relatively fresh grad, you will get interviews. Your performance in the interview will determine if you match. However with a 96 in Step 1, so long as you can hold above 90 for Step 2 CK, I won’t be surprised if you get over a dozen interviews unless you are aiming for surgical fields. That will be harder.

    As to will you be able to get 90’s. Your score seems to indicate that you have a good chance of getting 90’s. But there is still a possibility of 80’s probably on the high side. My own suggestion is to study only high yield stuff the next few days. First Aid will do. But do not study anything new. It’s too late for that. Do not study the day before the exam. Relax and regenerate energy for next day’s long gruelling exam. With your NBME scores, I don’t see any reason why you would want to extend your eligibility period. Take the exam. Your chances for 90’s are very good. I know things can go wrong on exam day, but the chances of that happening is just as good if you postponed your exam, right. So relax. Read my post on What to do on the day of the USMLE exam.

    Good luck and may you get your dream score.

    Askdoc

  • March 30, 2009 at 12:49 pm
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    Thank you, AskDoc! (if I knew your name, I would thank you differently ๐Ÿ™‚ )

    You calmed my nerves quite a bit. My exam is tomorrow. I am just planning on reading through high yield facts and doing some questions now.

    I am planning on applying for Internal Medicine, not Surgery. So according to what you said, I would atleast get some interviews. Yay! ๐Ÿ™‚

    I have read your What To Do On The Exam Day and found it extremely helpful. I love the way you express yourself concisely. I am sure a lot of people appreciate your efforts. But I don’t think it gets stale when I say – Kudos to you.

    I will be back with my score to report, hopefully.

    PS : If it’s not too personal – are you working as a resident now?

    Thanks again! ๐Ÿ™‚

  • April 1, 2009 at 5:48 am
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    Hi Askdoc…..do u remeber me

    got my score today………>99/237!

    thnx god was about to lose 99!!!lol

    ur advices were very very helpful

    uwsa1…..>245-50 days before exam-

    uwsa2…….>245 2 weeks before the exam

    nbme form 6 ……> 234!!!! …..5 days before the exam

    my opinion is uwsa doesnot exagerate the score on the contrary form 6 underestimate and the reason i got less than 245 is bad performance on the examination day ……i didnot get long sleep night before the exam……..also i missed 10 straight questions that were very easy cause of stress……i didnot feel stressed when solving asssessment exams

    but allhumdilla it is 99!

    thnx a lot ASK doc……u r wonderful

    and also my score in uw q bank was 69%…….only did it once timed mixed

    any one in this forum want to ask any thing am glad to help…….also read the posts of askdoc carefull especially the tips for the exam day and how to prepare for it………i beleive i could have done better if i have read it before…but for my luck it was written after my exam!

  • April 1, 2009 at 1:36 pm
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    Hi… i took NBME form 6 2 weeks ago and did terrible. I am currently revising Kaplan Lecture notes and FA. I plan to take my second NBME on April 8th. I’m set to take the real exam on April 23. Should I take form 5 or 1? Is there still sense taking form 1? THanks!

  • April 4, 2009 at 8:36 am
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    Hi Kay,

    Glad I could help. Actually my real name is somewhere in my blog. It is written in a copy of my Step 1 and Step 2 Score report published somewhere here. See if you can find it.

    Askdoc

  • April 4, 2009 at 8:38 am
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    Hi Haitham,

    Congratulations!! Remember a 99 is a 99 is a 99. It does not matter how close it was. What matters is that you made it. Again congratulations for a job well done.

    Askdoc

  • April 4, 2009 at 8:45 am
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    Hi tom,
    Whether you’ll be ready to take the real exam on the 23rd really depends on how terrible your score was in NBME form 6. It will also determine that whether just reading through Kaplan Lecture notes and FA alone are enough to remedy the situation. There are some indications that Form 5 and Form 6 tend to underestimate your scores a bit, while the first 4 forms tend to overestimate your score a bit. So Form 5 may be better. However, again whether what you do in between now until the exam will work or not depends on how terrible your Form 6 is.

    Askdoc

  • April 20, 2009 at 11:54 am
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    Hi

    I have been a silent reader of your writings, thanks a lot for your tips.

    I wonder if you can help me please.

    Ria

  • April 20, 2009 at 12:09 pm
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    Ok that was a check message. I typed out a lengthy paragraph and it disappeared before it could go through.

    Right, I am taking Step 2 CK in the 3rd week of May (absolutely) . Today I did NBME form 4 (thus used up all of them) and scored 215/ 490. 2 weeks ago I had done usmle world self assessment and scored 224 / 530. I am aiming for a score in high 90s (atleast 95 + 2 digit score). What can I do to achieve this?

    My test prep strategy (and its different for every individual) has been to revise the HY topics multiple times (reviewed First aid 6 times atleast) , listened to Goljan lectures, review his HY notes,and do uw q bank twice (scoring 79% second time round). I cannot say I opened a lot of text books during this time but did go back to Kaplan notes / CMDT / looked up the internet if something was a problem consistently.

    I have been putting in 6-8 hours of study (atleast) since January and don’t feel totally ‘burnt out’. What should I do ? I don’t want / cannot give up, too much is at stake here. Should I now do Kaplan q bank or just keep revising First Aid / Kaplan/ Goljan.

    Please advice freely what you think about my preps

    Thanks

  • April 20, 2009 at 6:44 pm
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    I took my step 1 and got a 93/223 first try. I have a green card and am a foreign medical student via the new “fifth pathway” now called “year of supervised clinical training” at NYMC. I would like to know what score should I shoot for on Step 2 CK to be considered for surgery residencies and which NBME correlate best with Step 2 CK?

  • April 22, 2009 at 9:15 am
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    Hey Askdoc

    Are you there? Waiting with baited breath for your response

  • April 22, 2009 at 10:23 am
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    Hi Ria,

    I’m here. but I have 3 emails, 9 personal messages and 2 questions from my forum to answer before I get to answer yours. Not to mention the questions in the blog. Unless you want me to give short answers, like you’ve made a very big mistake in your prep if you are aiming for 95++ rather than long responses that explains why this is so and what remedial measures you might take to score at least 90’s although you have to be very, very lucky to get high 90’s

    Askdoc

  • April 23, 2009 at 2:48 am
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    Hi Ria,

    Now for the long answer. If you are aiming for high 90’s, your prep strategy is wrong. If you are aiming for 80’s with some chance of hitting 90’s then it is right. The problem with first aid is that it is enough to pass but not enough to score high. Another thing, Goljan’s forte is Pathology not Clinical medicine. If your problem is pathophysiology which is 20% of Step 2 CK, Goljan is good but if it is clinical medicine which is 80% of Step 2 CK, then Goljan will not help much. If you look at most effective prep strategy used by those who got high 90’s and 99’s. It is centered on 2 things. Kaplan Notes which is read multiple times and UW Q bank which is studied and reviewed not just answered. CMDT is wonderful. For Step 3. It emphasizes clinical practice more than theoretical clinical medicine which is what Step 3 is all about. In fact if you want to do really well in Step 3, then use CMDT. However, for Step 2 CK it’s emphasis on the practical does not jive as much on Step 2 CK’s emphasis on theory.

    Even if you did go to Kaplan, CMDT etc. with problems, what is wrong with that strategy is that YOU decided what you needed to learn, rather than letting Kaplan decide what you needed to learn to score high. Again nothing wrong with your strategy if you are aiming to pass or get average scores. Big problem if you are aiming for a high score – high 90’s or 99’s.

    If you read my post on What to Study for the USMLE, I mentioned that the reviewers you pick have certain assumptions about your goal in the exam. This is because, they’ve set the amount of information you will learn when you use their reviewer. This in turn limits the scores you can achieve, even if you studied them a hundred times. Also in my post on High yield topics, you will know that only knowing the high yield can at most give you average scores, not high scores in the high 90’s or 99’s.

    So what can you do to remedy this. Well one month is not much to work with. However, from my explanation above, the answer is a bit obvious. It now depends on how fast you can do all of this.

    First, you need to go back to Kaplan rather than First Aid or Goljan. If your time is absolutely limited. concentrate on IM, then OB, then Pedia in that order. When you read through the topics, concentrate on building an algorithm for each topic you studied. For example, given a patient with dysphagia, how do you work up the patient. Given a solitary pulmonary nodule in an xray, what are the steps you will take. Patient came in with chest pain, what will you do. 12 year old girl with amenorrhea, how will you proceed. What if she was 18. and so on and so forth

    Then review UW q Bank, you must pay attention not only to the right answers but why other answers are wrong. If you do not know why they are wrong then you are not using the q Bank for it’s maximum effectiveness.

    These steps will raise your scores, however, I cannot be sure it will be enough to help you get up to high 90’s. Again depends on how much information you are able to absorb in a month.

    Askdoc

  • April 23, 2009 at 2:57 am
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    Hi Dr. R,

    Any score above 90 will give you a good chance to get interviews. However, your LOR’s are also very important in getting interviews. Your GC is definitely an advantage as there are significant number of hospitals that will not sponsor visas, so competition will be less stiff there. As to which NBME correlates best with step 2 CK, they all seem to correlate well based on what I have seen on scores reported in the various forums. I would suggest you try to get good LOR’s especially from NYMC.

    Askdoc

  • April 23, 2009 at 6:41 am
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    Hi Askdoc

    Thanks for your reply and valuable input. Sorry for hurrying you but I wanted to get your input asap for obvious reasons!Did not realise your are such a busy guy.

    Anyways, well my consistent problem has been psychiatry, mental health, preventive and social medicine.I am going back to Kaplan and reading it up thoroughly from there (Psychiatry).

    Paediatrics and Obs & Gynae were poor initially but have managed to bring the scores up in them but reading Paediatrics from Kaplan now.All along I have also been drawing flow charts for management plans for difficult topics / problem areas and revise these seperately. IM has been just average/above av in few topics like endocrine, musculoskeletal), will try to do the whole lot from Kaplan as well time permitting

    Regarding uw I have reviewed the answers thoroughly, writing down the additional info in the relevant chapter in first Aid so that I revise it along with First Aid. Today also got a score of 80 % in IM . However I take your views seriously and if nothing it will compel me to work harder and make the most of this 1 month. Thanks a lot for your input, much appreciated.

    What should I do for Psychiatry? I do really mess up the biases and interpretation of studies.

    Will wait patiently for your reply this time.

    Thanks

  • April 23, 2009 at 9:21 am
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    Thank you very much for your help. That puts me at ease. Your doing great work here.

  • April 24, 2009 at 11:33 am
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    Hello Askdoc,

    It is me again. Two days before my CK exam I came to your website seeking encouragement and you said if I got a score above 90, I would get interview calls.

    My score came two days ago and I got a 99/245

    Thank you for the last minute boost.

    Godbless!

  • April 29, 2009 at 6:17 am
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    Hi Ria,

    Psychiatry is a very small subject. I also had problems with psychiatry and I still got a 99 / 258. It was not a small problem but a rather big one. So very strong scores in the other subjects can cover low psych scores. Nevertheless go through them again at least once. Concentrating on the bigger subjects are a good idea.

    Now please understand that it will probably take 2 to 3x the amount of work to get from 90 to 95 as from 85 to 90. That is what most fail to understand. The higher the score you want, the amount of work you need is not additive but exponential. So many make the mistake of thinking, “Oh I’ll do just a little bit more and my score will go up.” In reality, you have to do much, much more the higher the score you are aiming for.

    Now for last 2 weeks, you enroll in Kaplan and do as many as 6 to 8 blocks per day. If you are scoring at least 72% you have a good chance at above 90 scores probably even high 90’s. Get mid 70’s and you have a good chance at high 90’s score. You’ve used up your NBME and you have to rely on a less consistent measure.

    Askdoc

  • April 29, 2009 at 6:18 am
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    Hi Dr. R
    You’re welcome
    Askdoc

  • April 29, 2009 at 6:22 am
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    Hi Kay,

    Great work! Knew you’d make it. Now concentrate on great LOR’s (from US physicians). Carefully select programs that meet your criteria. Apply on September 1st 2 weeks to maximize interview opportunities. Prepare for the interviews really well. And good luck on the Match.

    Askdoc

  • April 29, 2009 at 10:22 am
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    Thank you (again!), AskDoc,

    I don’t know how you do it – answering so many questions while still being so encouraging even for a “thank you. i got xx score” comments. Not that I’m complaining! ๐Ÿ˜€

    I am taking the CS in 10 days. Will definitely be back after that with hundreds of questions regarding the application process. Now that I’ve been here once, I’m sticking around till the whole shebang is done. ๐Ÿ˜€

    Will keep your pointers in mind. Also, even though having a green card means I do not need a Step 3 right now, I was planning on getting out of the way before September – do you think it will harm/improve my chances of getting matched if I have Step 3 scores too?

    Merci beau-coup, AskDoc! ๐Ÿ™‚

  • April 29, 2009 at 10:24 am
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    oops! edit – “i was planning on getting IT(step3) out of the way before september”

  • May 1, 2009 at 1:34 am
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    Hi askdoc

    Thanks a lot for your advice. Will concentrate on IM and keep working hard. I will take kaplan q bank after 15th May so that in the final 10 days I do many practice drills and also identify my weaknesses just before exams . I now have a strategy.I will keep you posted on my results

    You are doing a great job indeed!

    Thanks again

    Ria

  • May 7, 2009 at 6:24 am
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    Hi Kay,

    Since you already have a green card and do not need to take Step 3, I suggest you don’t. The reasons are as follows: First of course is you don’t need it. Second, most programs will help pay for your Step 3 Review once you are a resident. That is extra cash. Third, currently with your scores, you are golden. Programs will love to interview you. If you get a score lower than 90 or worse fail it, it will tarnish you. I mean you will still get interviews, but their impression of you will be lowered. So why even risk it. The only really valid reason you want to do your Step 3 before residency is to get an H1B, which you do not need.

    On the other hand, some people just want it over with. Rather than trying to review during residency, where duties can be quite demanding, you can concentrate on just working. Also there are cases of residents unable to pass Step 3 after multiple tries and face the prospect of losing their residency positions or if not required by the program to Pass Step 3 as condition for continuing with the program, face the prospect of unemployment after residency if they cannot pass Step 3. In this case, I recommend if you want to take Step 3, take it so the results come out after 2nd Week of September. Why? because you will need to transmit your USMLE result to programs when you apply and you cannot choose which Steps to show or not show. So if you file your application first 2 weeks of November, you can claim your Step 3 results are pending and transmit your other Step results. If the Step 3 results turn out to be very good, then rerelease them. If they turn out to be bad, present them only as needed or if requested, hopefully after you’ve clinched an interview.

    Askdoc

    PS. Most people do score much much lower in Step 3 than in Step 2 CK if they try to take it before residency. So you can expect your score to be lower as a rule.

  • May 7, 2009 at 6:34 am
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    Hi Ria,

    Good Luck on your prep. Hope you get your dream score.

    Askdoc

  • May 7, 2009 at 8:21 pm
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    Thank you very much, Askdoc. It is worth the number of times I check this page just to land here today and see two whole paragraphs from you. ๐Ÿ˜€ Trust me, totally worth it.

    I have my CS next week. And once that is done, I will just give up the ghost for a few weeks and relax without worrying about Step 3 then. I just figured, since I do not have any USCE, research etc, maybe a Step 3 score ( if 90+) will bulk up my rather scrawny CV. But what you said makes absolutely sense, times a million.

    And sorry for being such a leech, Askdoc – but I have another loaded Q. ๐Ÿ™‚

    For two years in between, I did my MS in Biology here in the States but I did not complete the degree because the thesis involved lab research and the time period for graduation was going to take another 4 yrs. I worked as a Teaching Assistant in Bacteriology for a year and a half at the same univ. Have one LOR from that US professor. I enjoyed my teaching experience – I used to teach the Bacteriology labs for Nursing students and I had great Evaluations every semester (did that for three semesters).

    I finished all my core classes with a GPA of 3.87. I just did not complete the research/thesis. It was a toss up between 2008-12 spent trying to isolate DNA or trying to get into residency (and finishing it).

    My question is – should I include all this info in the resume? I do not want 2006 to 2008 to be a big gap but I also do not want this info to dig me into a pit.

    I believe every institution in the States loves research oriented candidates – but I am the kind who gave up on research in the middle and I confess no great love for pipetting/isolating DNA/inoculating mice etc. On the other hand, I did enjoy all my classes and did very well on journal oriented research (writing up papers based on other people’s already published research etc). And I think I would be quite okay with Clinical Research.

    So should I tell the hospitals about my MS years? Will that raise all sorts of Qs about “why” I quit it?

    Anyway, that is my question and I promise you I will try not hound you more after this (no guarantees though. ๐Ÿ™‚ )

    Thank you so very much in advance. God bless you.

  • May 21, 2009 at 8:00 am
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    Hi Kay,

    Sorry for the really late reply this time. Got sick, so was backlogged for days in my prep course and day job. Finally able to answer q’s here. Anyway, first do not leave blank years in your resume. That would raise more questions than being honest about what you’ve been doing. Not everyone would ask why you did not finish your MS but everyone would ask what you did those two years and that might make them ask why you did not finish. However, in the instances that people ask why you did not finish. Be honest. Say that you want to be an M.D. You feel doing 4 more years will make it harder for you to get a residency since year of graduation is used as a cutoff in most residency programs. So you decided to do residency first. I don’t know if your MS means you can pick up where you left off after you finish your residency, If you can then say that you can finish the MS after residency, anyway. But finishing your MS first may mean you may have to forgo residency. Tell them I love Biology but I love medicine more.

    Askdoc

  • May 21, 2009 at 7:56 pm
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    Thank you, AskDoc! (I’m starting to sound like a broken record now :P)

    Your reply gave me all the valid points that I would like to make to the interviewers without highlighting the “quitter” part. As usual, it was worth the wait and I am sorry to hear that you were sick. Hope you are totally better now.

    Have a wonderful day!
    Kay

  • May 29, 2009 at 10:37 am
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    Hi askdoc,

    I’m amazed by your efforts to extend a helping hand to those in need. I’m an old IMG going to sit for Step 1 at the end of June. I was about to extend my eligebility period as I felt little confidence in my preparation , but with their new law its going to be complicated for me to secure the updated (Form 186) on time. Anyhow, being all confused now it seems that I’ll have to sit for the exam on-date which means I only have 1 month to go, so I took UW assessment form 1 and got 550/230 . I’m already through with 60% of UW qbank with an overall of 63% .So based on these circumstances:
    -Should I rely on this score or should I try and take NBME ? if yes which one?
    – Do you think that I can manage to raise my prospective score during this month ?
    -or should I really consider extending my period ?
    I’d like to add that my studying schedule was a bit chaotic and I missed out on some subjects like Immunology & Nueroanatomy.
    Any further advice will be highly regarded.

  • June 1, 2009 at 7:32 am
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    Hi DrIzzo,

    Your assessment score already shows a great score. First I suggest you spend around 2 days each to cover Immunology and Neuroanatomy. Because these two are relatively high yield. Neuro is the highest yield subject in Anatomy, whereas Immunology is the highest yield section in Micro/Immuno. Second, you do not need to extend your eligibility period as your scores seem to be good. You will increase your scores as you progress. However, after finishing the two subjects, concentrate on high yield information either from First Aid Rapid Review or my High Yield Fast Facts Course.

    It is also important to note the average scores so far for the blocks you have finished in UW. 63% is how many points above the average score for those blocks. 10 to 14 points would more or less confirm you 550 / 230 in the assessment form. You can take an NBME form around 2 weeks before you sit for the exam. If you are one who likes challenge, do form 5. However, if you tend to be disheartened by a lower score, take form 1 to 4. Form 5 will slightly underestimate your probable score, while form 1 to 4 will slightly overestimate it.

    Askdoc

  • June 1, 2009 at 2:22 pm
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    Thanks a million Askdoc ๐Ÿ™‚ That was so reassuring.
    I shall follow your advice. I will try to post results of my assessment exams so I can get more support from your wise words ๐Ÿ˜‰ also in case someone else might benefit from any of it.
    Thanks again and keep up the good work.

    DrIzzo

  • June 6, 2009 at 1:03 pm
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    I am so scared…. I got 230 on UWSA1, 252 on UWSA2, 590 on NBME (this was earlier on in studying).

    My USMLEWorld scores were 65% cumulative, last 10 blocks were ~70%.

    I took the exam the other day and I feel HORRIBLE about it. I think I failed. Is it possible that i did worse than my first practice test ? I am just SO SCARED

  • June 8, 2009 at 2:56 am
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    Hi worried,

    Don’t worry. With your NBME score, if you fail this exam, they should write a thesis on it. ๐Ÿ˜† Unless of course you are using the downloaded version with the alleged regression table, then all bets are off.

    It is normal to feel that the exam is hard and to be nervous. I did and I still got a 99. In fact, I’m more worried about people who feel the exam is easy, because either they are geniuses or know too little to realize they know nothing. So don’t worry. The assessment tests are fairly reliable. Now just relax, watch a movie. Take time out with your family.

    Mike

  • June 8, 2009 at 12:06 pm
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    Dear askdoc,

    I took an NMBE self assessment, form 3, and scored a 480/218. What does this score mean? Does it reflect an approximate of the actual Step 1 3-digit and 2-digit score? I have a little over 2 weeks to go till my exam date and I have only completed 5% of USMLEWorld Qbank. I intend spend the next 2 weeks doing questions. How much of an improvement can be expected if I take another assessment after that? Which assessments would you say are more representative of the actual STEP 1 scores? Do you have any suggestions for how to best use my remaining time?

    Thanks a lot!

  • June 9, 2009 at 7:13 am
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    Hi NeedSomeDirection,

    The NBME is fairly accurate +or- 10 on the 3 digit scores. But only if you do it properly. Strictly one hour per block and doing all four blocks continuously with at most 5 minute break. Otherwise, it may tend to overestimate your score. 480 is a good enough score. You have a good chance of passing this exam. However, there is a small chance of failing. You need a 500 for a sure pass. But on average people with that score get about 80’s. So if you are aiming for 90’s you have a long way to go. Doing the UW Q bank will increase your scores as you get better at doing q’s and you learn from the qbanks. 2 weeks though is very tight if you are aiming for high 90’s, but not impossible. I would suggest you finish q banks and also do high yield review. (Actually last 2 weeks should be focused on high yield review since you should be about 90% finished with q bank by this time, ideally) Anyway, you can use First Aid or my High Yield Fast Facts course for high yield review. Take an NBME at least 7 days before the exam (so you can still have enough time to move your exam date if needed) If you do not like the score than move the date. In your case an additional 2 weeks would have been more ideal or a total of 4 weeks to maximize the benefit of q bank plus high yield review on your score. But we’ll see what will happen in the next week or so. You need to work on q bank fast though.

    Askdoc

    PS. Form 5 tends to underestimate your score while the earlier forms tend to overestimate them a little.

  • June 18, 2009 at 5:53 pm
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    Hi askdoc,
    I took UWSA 2 ( I already had a subscription ) and scored 700/256 , but to further assess my situation because USWA 2 felt quite easy I decided to take NBME5 and I scored 560/236 !! It was somehow disappointing as I ,uncomfortably, felt good while doing the exam. Although I notice that you say that form 5 tends to underestimate my predicted score I’m not sure where does that put me as my target is around 240+.
    I also seem to score the lowest on Reproductive & Renal systems + Physiology. With my exam on 6/30 should I focus on these weaknesses or just keep on with the general review ?
    Thanks alot
    DrIzzo

  • June 21, 2009 at 8:59 am
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    Hi DrIzzo,

    Continue with high yield items only. Learning new things in the last week will only complicate things. Anyway, whatever actual score you get, it will be high. Read my post on What to do on the day of the USMLE exam. and Good luck on your exam.

    Askdoc

  • June 21, 2009 at 2:32 pm
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    Hello ask doc, came across this website when checking NBME for 3 correlation. I have taken 2 NBMEs for Step 2 CK, form 2 -660, form 3 – 760. I know this is supposed to be a good score, but why do I feel like I just got lucky?? Form 3 seemed very simple as compared to Form 2…is that possible? or does it mean that I was better prepared? Taking the exam in 2 days….

  • June 21, 2009 at 8:29 pm
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    Hi chits,

    Lots of reasons for having that kind of discrepancy in your NBME scores. First of course, correlation is never perfect. An 80% correlation is considered high, so discrepancies do occur. Plus each set is a subset of a full exam and therefore not all topics could be represented equally. Therefore if the form happen to cover a few more questions on your favorite topic, you tend to score higher. The same holds true for the actual exam. Being lucky can boost your score a few points. Plus exam conditions can affect your score, too. ie. whether you are well-rested, in a good mood, etc. Anyway, your 2 NBME points to a fantastic score. And short of a disaster on exam day, you will get a very good score indeed. Good luck on your exam.

    Askdoc

  • June 22, 2009 at 9:05 am
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    Thank you for your prompt response. Its like a cool misty breeze on a hot afternoon….dramatic, I know, but thats how I feel right now with only 1 more day to go for the exam….

  • June 26, 2009 at 1:07 pm
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    Hi Askdoc

    I don’t know if you remember me. I had asked for your help & advice 1 month before my Step2 CK exam about my prep strategy. I took my exam in end of May, got my result 97 / 235.

    I don’t know how I did it, but I did manage to get my dream score (>95) . Thanks a lot for your input and advice. It was a big help.

    I am now going to Mount Sinai in NYC to do observership and selecting programs. I am also contemplating on doing Step 3 asap while the knowledge is still very fresh. Can you advice me now how to prepare for Step 3 please (this time I am going to follow your advice from the very beginning rather than 1 month before the exam)

    Thanks again, you are doing a great job out there

    Ria

  • July 7, 2009 at 7:51 pm
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    Hello Askdoc:

    Thank you for these valuable comments in the post.
    I am a first time writer, having a concern about Step 2 CK.
    Here is what I did so far. I read Kaplan review books twice. I finished all UWorld Q’s (accumulative average: 55%) within two months. I did not purchase any Kapaln Q’s. I have not done any NBME’s. My Step 2 CK is in three weeks. I really want to ace this exam since my Step 1 was high 80. I am not so sure that I have been studying in a right way past three months. Would you recommend taking one of NBMEs or UWSA, just to find out where I stand exactly now?
    Also, is there any recommendation that you can make in terms of my study?

    Thanks.

    Toshi

  • July 8, 2009 at 4:17 pm
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    hey there
    I am taking the test saturday. I have taken a few nbmes, one month ago I got a 255 and then fell into an unfocused slump for a few weeks. 5 days ago I took nbme 6 and got a 251. I am still freaking out and dont feel ready. My ave on world is 75%. I still havent even learned everything (ie embryo/anatomy and forgot meds) You really think these scores are predictive???

  • July 9, 2009 at 12:11 am
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    Hi Ria,

    Sorry for the delayed reply this time. Been really busy. But first congratulations on getting a great score. Now as to taking the Step 3. My advise is not to take it unless you need it for visa issues. The main reason is that with your current scores, you are golden and you will get lots of interviews. So a Step 3 score will not add anything to that except if you need it for visa purposes. (H1B). I have yet to see somebody score higher on Step 3 than they did on Step 2 CK. There are a variety of reasons why this is so, but having at least a year of residency on your belt can help you a lot in scoring high in Step 3. So getting a low score in Step 3 can tarnish you a bit. More so if you fail. (Knock on wood). So my suggestion is this. If you really have to take Step 3, then take it so the result will come out after September. This is because you apply for interviews in September. When you release your USMLE scores to the programs, all available scores are released not just the one you choose. So on September when you apply, you can transmit your step 1 and step 2 scores and rightfully state that you are waiting for your Step 3 results. If it is a great score >90 then retransmit the scores. If it is a not so great a score, then do not retransmit the scores. Wait for the interview and show your scores when they ask for it. This way you already got the interview and your step 3 scores cannot affect whether you get an interview or not. Whether you get matched or not depends on your performance in the interview and not so much on your scores (although they still are very important)

    I’ll post more advise on how to study for the Step 3 in future posts. Suffice it to say, you still need Kaplan Notes (Step 2CK not Step 3) and either Washington manual or MCDT (instead of Step 3 Kaplan notes) So prepare this materials ahead. Plus the algorithms are more important then ever. You also need to be able to identify pictures of skin diseases, ECG tracings, x-rays, etc.

    Askdoc

  • July 9, 2009 at 12:27 am
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    Hi Toshi,

    First, I would say you need to do at least one NBME, the online one of course and do it under exam conditions, one hour each and limited breaks. That will give you an indication on where you stand and what you need to do in the next few weeks. Reading Kaplan review books twice is adequate as far as knowledge needed to score in the high 80’s to low 90’s, however, it now depends on how much you have mastered and retained. The only way to have a gauge of that is your NBME score. Your UW score is a bit on the low side if you are aiming for high 80’s although passing should not be too difficult. However, you probably also did it by subject as a review rather than simulate the actual examination.

    I would suggest that you plan to get Kaplan q bank so you can use it to simulate actual exam conditions. Believe me that helps a lot on actual exam day. That means 7 blocks in 8 hours with timed breaks. Random, mixed and timed. Again how much you need to do depends on your NBME score, so do that first.

    Askdoc

  • July 9, 2009 at 12:34 am
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    Hi j,

    If you took the NBME under exam conditions. That is one hour per block, limited breaks. Plus you did not review the questions before, in those discussion forums. Then predictability is high. Usually + or – 10 points from predicted score. I suggest you relax. Your NBME predicts a good score, although not necessarily the exact predicted score but nevertheless a good score. Your UW seem to agree with your probable score. So unless some disaster happens on the day of the exam, you will do well.

    Read my post on What to do on the day of the USMLE exam for pointers. Plus do not study or do anything in the next 2 days, just relax and stay focus on the exam.

    Good luck and may you get your dream score.

    Askdoc

  • July 9, 2009 at 10:25 am
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    Hello Askdoc:

    Thank you for your advice. It helped me a lot. So, I took the online NBME (the first one) for Step 2 under exam conditions, one hour each, and limited breaks inbetween. The outcome was rather very disappointing. I got 330/171. I was very upset, disppointed, and discouraged after I got this result. Should I risk it? Well, I don’t want to risk it anyways…so, I am pretty sure that I have to postpone it at this moment. My biggest questions are WHAT I DID WRONG (did I go too fast? did I just finish the UW qbank just to get by as quick as I can?) and WHAT I SHOULD DO NEXT then. Even though it is very hard to accept the fact, I know (by reading your other blogs) I have to accept it and do the damage control now. I have to go back to the rest of my clinical rotations from August, so I will not have this two to three months off for a while. But I am glad that I took the NMBE to find out where I stand. I can think of this fact as a wake-up call. Regardless my schedule from now on, I can still study hard and efficiently. It is obvious that I have not retained and mastered enough of materias for the Step 2 preparation. I can recall that I had some KA problems and majority of KR probelms during the NMBE assessment, leading that I was very irritated.

    Well, I would very appreicate if you could help me out for some more guidance.

    What did I do wrong? What should I do next then?

    Thank you so much for your attention and support.

    Regards,

    Toshi

  • July 12, 2009 at 6:46 am
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    Hi Askdoc,

    Could you help me solve my puzzle? I got 440 in NBME form 4, which is generally considered very low. But I heard that form 4 was considered the hardest of all forms. Is 440 bad or still acceptable? I did the first three forms with the downloaded version. As there are no official answers to them, so I don’t know how much I can trust of the scores of forms 1,2,3 (If the answers provided are right, I got 71%, 75%, 78% correct rate, respectively ). But for form 4, I did it on NBME website and got only 440. So I was wondering what was going wrong. Thank you very much in advance for your replies.

  • July 20, 2009 at 6:51 am
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    Hi askdoc..stumbled on your blog..awesomw stuuf here..find it hard to believe that selfless sould like you exist..

    my question..I scored 510(224) on form 2…3 weeks later took form 4. scored 560(236).my exam is on 18th august..how do i go from here..i seem to be plateauing..

    thanks a ton..

  • July 20, 2009 at 1:35 pm
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    Hi Abdur,

    I was wondering whether you could answer my question ( see the paragraph above yours). As you got higher score in form 4, so does form 4 seem easier for you? Also do you have a rough idea what percentage of the questions you got right answers for form 2 and form 4? Thanks a lot in advance.

    Xij

  • July 25, 2009 at 4:13 am
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    Hi,

    I was wondering about the NBME self assessment exams, which of Form 1 and Form 2 in your opinion is more accurate. I did both and Had 740 on Form 1 and 640 on Form 2. quite a difference. so what to make of that?

    Thanks

  • July 28, 2009 at 8:24 am
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    Hi Toshi,

    Sorry for the really late reply. Really busy for the past 2 weeks. Anyway, what did you do wrong? Well it is hard to evaluate since I do not have enough details of your situation. However, I will try. Presuming people studied enough, most people who have problems in Step 2 CK are due to the following.

    1. Around 25 to 30% of the questions in Step 2 CK are about the next best step in the work up and management of the patient. The best way to learn this is to make diagnostic algorithms (to work up a patients) and treatment protocols (Step by step management of a patient) rather than reading them in a narrative. When you read Kaplan, these facts are in narrative form. It makes it that much harder to consolidate the information when you have to answer a next best step question. So organize Kaplan notes into algorithms to help you with this type of questions.

    2. Pathophysiology or Mechanisms of disease is around 20% of Step 2 CK. If you didn’t do too well in Pathology in Step 1 or you are an old grad (which you are not) more versed in clinical medicine than in basic science. This is a problem.

    3. Atypical cases or clinical vignettes. Unlike in step 1 where the clinical vignettes are classical. Vignettes in Step 2CK are atypical, which means they are harder to diagnose. Plus the question makers like to put in a lot of useless clinical data to confuse you. In actual clinical practice, majority of the cases you will see are typical presentation of common cases, then atypical presentation of common cases, then typical presentation of uncommon cases then atypical presentation of uncommon cases. Step 2 CK primarily focus on more common cases. Therefore think of common cases rather than uncommon cases. I mean when you have a case of a male teenager with nosebleed, think of trauma (nosepicking) rather than nasopharyngeal angiofibroma. ๐Ÿ™‚

    4. Of course, it might just be that reading through Kaplan text twice was not enough for you to master the details.

    Which one is the main problem, you must analyze and decide accordingly. The qbanks can help you refine your knowledge and improve your ability to analyze and answer tough questions. But they cannot cover a deficit in knowledge.

    Askdoc

  • July 28, 2009 at 8:31 am
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    Hi Xij,

    sorry for late reply. My problem with using the downloaded version is the reliability of first, the answer sheet and second the correlation table you are using for your estimated scores. So it is hard for me to answer your question. However, one thing that bothers me a lot is that NBME q’s are being discussed in forums and these same q’s or variations of them are appearing in published q banks. This can skew the results of the NBME forms and affect their predictability. In fact, since the earlier q banks seems to be the one most discussed in forums and have found their way to other qbanks, I am beginning to think that people should use the later forms like form 5 and 6 rather than the earlier forms

    Askdoc

  • July 28, 2009 at 8:43 am
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    Hi abdur,

    You should be doing your last revision by now and studying high yield stuff only. Go through your qbanks and review the answers. Everybody plateaus eventually and the higher the scores you have, the slower your progress will essentially be. It may be due to fatigue or it may be due to the fact that you’ve reached your maximum capacity to absorb information. In either case, there is nothing you can do about it right now. Just take it easy. Your main goal is that you don’t go into decline. Studying just high yield stuff and taking enough rest is the best way to go. Do not try to study new lower yield stuff in an effort to boost your scores. Those things should have been done at the beginning of your prep not near the end.

    Anyway, you have good scores in the 90’s which isn’t bad.

    Askdoc

  • July 28, 2009 at 8:55 am
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    Hi Oshafez,

    First, the assessment tests uses correlation studies to predict your scores and as we know, correlation is never 100%, more like 70 to 80% and therefore difference will exists. When I took the exam in 2006, the predicted score has a 2 SD variance of around 10 points in the 3 digit score scale.(based on scores I picked up from various forums) or about 60 in the 800 score scale.

    In your case it is about 100 in the 800 scale. Firstly, this is based on the online NBME tests and not the downloaded one. The problem with the downloaded one is the correctness of the answer keys and the accuracy of the correlation table available. (There is only one, when there should be 1 per form since question difficulty in each form is different) So if your scores are the result of the downloaded tests, then this could be the simplest explanation.

    Another case I have noticed is that NBME questions from earlier forms have been discussed to death in forums and variations of them have appeared in various published qbanks. This can compromise the predictability of these forms since the testtaker may know the answers to a few of the questions beforehand. Therefore a case may be made to use the later forms for better predictability.

    Askdoc

  • July 28, 2009 at 12:49 pm
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    I’m talking about the online forms not the downloaded ones, and I’m talking about the Step Ck exam not the Step 1. but what do you think should I go ahead and do the exam in 5 days or what?

  • July 28, 2009 at 12:50 pm
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    and I didn’t know any answers beforehand.

  • July 28, 2009 at 11:51 pm
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    Hi Oshafez,

    Okay. But either of your scores is quite good. And what I said about Step 1 also applies to Step 2 CK. except of course that they are less discussed in forums than the Step 1 exam. Both your scores indicate somewhere in the 99 range. As someone who got a high 99 once told me, he believes how high you get above 250 is a matter of luck already. Since there’s probably less than 20 questions between 250 and the highest score, he may be right. Anyway, good luck with your exam. So long as you keep your cool during the exam, you’ll probably have no problem getting a really high score.

    Askdoc

  • July 29, 2009 at 3:13 am
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    Thank you very much askdoc, you’ve been really helpful. thanks

  • August 1, 2009 at 12:23 pm
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    Dear Askdoc:

    Thank you so much for your advice. Very helpful and concise. These 4 points you made were very clear and pin-pointed some problems that I currently have. I started making some flashcards to master each topic now. I have also started making my own algorithm chart for management in each case that I am not clear about.
    I just would like to ask you whether you know a good book to purchase for pathophysiology. When I checked my Step 1 score distribution yesterday, I did just OK (not excellent) on pathology. If you know anything about a good review book for pathophysiology, I would very appreiciate your advice.

    Thank you again for your time and support. ~TOSHI

  • August 3, 2009 at 7:55 am
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    Hi askdoc,

    Thanks a lot for your reply. I learned quite a bit from your other replies as well. Thank you.

    Xij

  • August 7, 2009 at 3:42 am
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    Hi askdoc,
    i really need some help. with 1st step.
    i got 80% u world 82% kap qbank
    and 252 on uwsa form ! before starting any of the q banks (weird) i don’t think uwsa means much.
    i am aiming for a high 99 coz i really need it.
    the problem came when i took nbme form 6 in late july 2009. i got only 570/238! then i reviewd my answers )i took extended feedback) and found that while i was saving the questions (screenshot) my answers to 4 questions had changed.
    anyway, i pushed back my date and studied some more anatomy coz that was weakest but i’m all freaked out and my exam is in 10 days. should i push it back? what should i do??? please help me? disturbingly, i still haven’t figured out the answers to some of the anatomy form 6 questions. they were so hard!!
    i have been studying for 6 months more or less and i’m absolutely plateaued, fatigued and frightened! but i need too give this test coz i need to take the others by the end of the year! somehow save me please ๐Ÿ™

  • August 7, 2009 at 11:57 pm
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    oh askdoc! where are you!

  • August 8, 2009 at 5:59 am
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    Hi ps,

    I’m here, just a bit busy. Anyway, you don’t need my help. If you ask me you are doing very fine on your own. Both your scores seem to indicate you are going to hit 99, although there is no guarantee it will be a high 99. NBME form 6 tends to underestimate your score at least Most of the time, so there is bigger probability that your actual score will be higher rather than lower.

    Actually, you should not be worried about your plateauing, you should be more worried about you declining. For most people 6 months is enough to plateau and begin declining. My suggestion to you is to take it easy, relax and get yourself ready to take the exam. Do not be too obsessed about getting a high 99. Being too anxious and worried during the examination in fact can negatively impact your performance on the day of the examination. Relax the next few days. You need to be at full strength and relaxed on the day of the exam. That will ensure that you will give your peak performance on that day. Spend only about 3 to 4 hours a day on the next few days studying, High yield stuff only. Do not attempt to study anything new as that would serve to confuse you. Do not spend it too relaxed either as some anxiety is needed to keep you at your peak. Spend the rest of the day relaxing and recuperating so you are not fatigued on the day of the exam. That will affect your performance more than anything.

    I would not advise postponing the exam. When you are plateaued, postponing will lower your score not raise it. You cannot will a particular score into existence. You can only do your best. If your best is good enough, well and good. If not, then there’s nothing more you can really do. But if you ask me you’ll have a great score already. If it becomes a fantastic score, who knows, right?

    A fellow 99er once told me that any score above 250 has an element of luck in it. There are probably less than 20 questions between 250 to the top score possible, a lot of luck is involved to get those questions right. ask anyone who got high 99’s. They would tell you that they guessed the answer to at least 20 to 30 questions in the exam (I know I did) so how high a 99 you get has an element of lucky guesses, right? So make sure you are at your peak on the day of the exam. If you’re lucky, you may get a really high score. If not, well high 90’s and 99 are really great scores already.

    So relax, read my post on What to do on the day of the USMLE exam. Good luck on your exam. I know you’ll get a great score.

    Askdoc

  • August 8, 2009 at 6:05 am
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    Hi Toshi,

    Quick Pathophysiology review for Step 2 CK would probably be Goljan’s Rapid Review of pathology. I mean it is not enough to score high for step 1 pathology, but enough for Step 2 CK. Concentrate on Systems Pathology more than General pathology as that is tested more in Step 2 CK.

    Askdoc

  • August 8, 2009 at 10:50 am
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    Thank you so much hor your advise. Let me study for several months as you advised me previously. If I need some help from you, I will leave a message in this blog. Thanks!!!

    Toshi

  • August 8, 2009 at 1:26 pm
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    Thanks so much askdoc, you make me feel much calmer ๐Ÿ™‚
    i’ll be back after my test,hopefully with a good score. TTYL!

  • August 10, 2009 at 1:33 pm
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    hey askdoc
    just wanted to say you were right!!! I ended up with a 259/99 just got my score last week (even then on zero sleep and post trying with an ambien). I guess the nbme and free 150 was predictive (although my highest practice was 255) I definately made some very silly recall mistakes on test day
    thanks

  • August 20, 2009 at 7:01 am
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    Hi Toshi,

    You’re welcome!

    Askdoc

  • August 20, 2009 at 7:02 am
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    Hi ps,

    You’re welcome and good luck!

    Askdoc

  • August 20, 2009 at 7:03 am
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    Hi j,

    Congratulations! Am I ever wrong? ๐Ÿ™‚ Kidding aside; that is a really fantastic score. Good luck!

    Askdoc

  • September 19, 2009 at 7:30 am
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    dear doc,
    I was planning to write NBME tomorrow.hav USMLE exm in 5days…so no question of changing the schedule.But was seriously confused,I need the form which corelates the best….
    my scores till nw are as follows,,,
    Uworld Qbk-75%(64-87%)
    Usim 1-a mnth before-234
    usim 2-15days after-252
    As you can see,the variation in score is very high…even in the Qbook and the U sim…so i am really worried….so pls suggest me the NBME that can best corelate with usmle score…

  • September 19, 2009 at 7:58 am
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    Hi suresh,

    I would suggest you use NBME form 5 or 6. Not because it correlates best with USMLE score, but because you want to know if you will get a high score. Since form 5 or 6 tend to underestimate your actual score, it probably will be a better confirmation that you will get a high score. Your UW qbank score also seems to indicate you will be getting an almost sure 99 (if you did not repeat the questions and you did it random, mixed, timed) You need > 80% in UW to get possible high 99 or > 255. So barring any major disaster on the day of the exam, you have a high probability of a 99 with a small probability of a high 99. So good luck on your exam. Be sure to read my post on what to do on the day of the exam. And DO NOT STUDY the day before the exam. Just relax, get enough rest as the exam is a marathon, and endurance counts as much as what you know.

    Askdoc

  • September 20, 2009 at 12:13 am
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    dear doc,
    thanks for ur suggestions.I took the NBME form 5..But i got very depressed after the results because i have just 5 days more left for my exam and my score was 550 that’s 234…As u said,forms 5 n 6 underestimate the score,i still hv hope of getting 99…how far can we correlate this score with the actual usmle score??
    Do we think its advantageous to take another NBME exm most probably form 6 again to get a better estimation of the corelation???
    hoping for your reply
    Suresh

  • September 20, 2009 at 1:24 am
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    Hi Suresh,

    You still have a good chance of getting a 99, although it is not a sure thing. The question is not whether to take NBME form 6. The questions is what will you do if form 6 do not give you the score you like. If the answer is that you will still proceed with the exam, then my suggestion is not to take it anymore. If the answer is that you will postpone the exam, then taking it makes sense. However, if you postpone the exam, the next question is for how long and how sure are you an additional month of study will raise your scores higher. Everybody plateaus eventually and then decline. You might run the danger of declining and getting a lower score instead.

    99 currently is 236 to 238 depending on the exam set you get. So 234 is not bad. You still have a good chance of getting a 99 with your current score. Taking form 6 may just make you more apprehensive in case you fail to get 236 again. In the end it is up to you. But my feeling is that you should take the exam. The score you get will be excellent and you have an even chance of getting a 99. What is important is to make sure you are relaxed and in top form when you sit for the exam. That is worth more in helping you get a high score than anything else you can do in the next few days.

    Askdoc

  • September 20, 2009 at 3:03 am
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    hi,
    thnks askdoc for your valuable suggestions.You are right…There is no point in being more apprehensive..I just need to be calm enough for the exam…But believe me,form 5 was damn tough,It had all in it,the behav science concepts out of Kaplan,genetics difficult than u world,biostat and neurology tough like anything.may be it estimates the lowest score i can get in the mains if the usmle were to throw me questions out of all the subjects i am comparatively weaker at..
    I am just an UG medical student now in Nepali aiming family medicine+psych,family med or psych for myresidency…I wonder what might be the cut off mle socre for that?I will let you know more about my score after a mnth or so..Pls help me in planning for my exms and residency……..

  • September 25, 2009 at 2:28 am
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    Hi Dr Mike,
    Thank you so much!! You were right about every single thing. Form 6 DID underestimate my score! yay!
    thank God i didn’t postpone like i originally intended to before i talked with you.
    i got my score back yesterday and it was 99/267 !! Thank You =3.
    you have this down to an art ๐Ÿ™‚
    Is this still a competitive score for an img who wants medicine?( the mean is 221 sd =21)
    I would really appreciate your advice for step2 ck which i have to take in 2.5 months from now…
    thanks to you once again and also to GOD because he had a BIG hand in it
    yours ecstatically,
    ps

  • September 26, 2009 at 8:32 am
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    hey askdoc,
    I finally took my test.you were right..My paper was very much like NBME 5 that i wrote just 4 days before which included more neurology and cardiology..Thank god i had revised the topics after my poor performance in NBME form 5.The difficulty level was very high compared to u world or even NBME…So I can’t even say,how much score i will get…But let us hope for the best…But i have one suggestions for all those who are appearing for USMLE..please take NBME 5 or 6 and not 1-4.at least 2weeks before exm so that you can see your weak points and postpone the exam date if needed…Otherwise taking these forms would only lower your confidence at the last moment…
    PLEASE DON’T USE FORMS NBME forms 5 and 6 to ESTIMATE YOUR SCORE.better TAKE THEM TO EVALUATE YOUR LEVEL OF PREPARATION……finally thank you again for supperting me at the last moment…..

  • October 2, 2009 at 3:47 pm
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    Hi ps,

    A hearty congratulations!!!. That is a fantastic score. It is very competitive. Remember the mean and SD is for AMG’s. IMG’s score lower than that. Mean will probably be around 200 based on 35% failing rate for IMG’s. Now get a high score in Step 2 CK and you are golden.

    Askdoc

  • October 2, 2009 at 3:49 pm
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    Hi suresh,

    Glad you took the advise. Read PS’s result. Anyway, wishing you a fantastic score. Now relax, watch a movie, take a vacation. ๐Ÿ™‚

    Askdoc

  • October 4, 2009 at 2:14 pm
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    Hello!

    Ive been searching for some info regarding the NBME self assesments because i was able to get version 1 and 2 in hard copy with a separate sheet with the correct answers.
    How can i score them correctly? Each test is 200 questions… If i get between 110-130 correct of 200 that means im getting aprox 55-65% correct… How would that correlate with an actual score?
    Any help?

  • October 8, 2009 at 10:13 am
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    Hi MnM,

    If the hard copy version is the one circulating among people in the various forums, then thee is a big problem with using those. First, I do not completely agree with the all the “correct” answers in the answer sheet. So the question of the actual percentage correct may be problematic. It may just be 2 to 3 questions per block or 8 to 12 answers but 4 to 6% difference in raw score mean a difference of 12 to 15 points in the 3 digit score. Second, there is only one correlation table available when there should be 1 for each form. 55% to 65% correct means 163 to about 188 in 3 digit scores. I talked about this in the updated post on NBME. I suggest not to use this “hard copy” or “downloaded versions”

    Askdoc

  • October 14, 2009 at 4:29 am
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    Dr.Mike,
    was calmer after reading ps result….congrts ps….i am getting my results most probab today….hope it goes good…will let you know the reults asap……..

  • October 14, 2009 at 8:09 am
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    Dr. Mike,
    contrary to what i expected,,i got a score 94/226…i was atleast expecting above 95 if not a lower 99…given that i had already scored 97 in NBME 5 which is supposed to underesmtimate the score…but i was shocked to see my score….i don’t know what to say about my score….i wanted family medcine or psychiatry…i wonder if that is a good score enough for step 1 given that i have step 2 to improve….anyways thanks for your support….i have after all realized my mistakes during preparation..please suggest me is i can continue with step 2 ck this score for the specialities i want…….
    suresh

  • October 16, 2009 at 12:40 pm
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    Hi suresh,
    Ouch! I know how that feels. My predicted score was 265 but the score I got was 256. A 9 point drop right there. I was lucky in that both scores are 99. If I’d gotten a 235 predicted score (for 97), I would’ve gotten a 226, too right! Anyway, advise still holds, 9 out of 10 times form 5 and 6 still underestimates actual results. As to how you will fare in the match, depends on your step 2 CK score. For a fresh grad (within 2 to 3 yrs from date of graduation) IMG who needs visa with a score of low to mid-90’s in both exam (for example 94/92) applying for IM categorical, you’ll probably get 6 to 12 interviews. If you are GC or US Citizen, probably around 16 to 20 interviews. Family medicine and Psych are easier to get into than IM categorical, so you’ll probably get more interviews.

    Askdoc

  • December 5, 2009 at 11:40 pm
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    I have 3 weeks to step 1. I took the NBME form 6 and scores a 540 (correlates to 231). I’m scoring 88% on the free practice tests on the USMLE website. Do I have a chance of improving at getting a 99 on the exam?? I’m freaking out. Please help.

    Thanks

  • December 5, 2009 at 11:41 pm
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    just adding to the previous post, I scored a 68% average on the UW q bank

  • December 5, 2009 at 11:44 pm
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    also should I take another NBME a week before the exam after going through first aid and my weak points?

  • December 5, 2009 at 11:46 pm
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    if yes, which form should I take? one of the earlier ones or form 5? sorry for my posts all over. please help

  • December 9, 2009 at 7:12 am
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    Hi Hello,

    It seems you are headed for a mid to high-90’s score. You do have a 50-50 chance of getting a 99. First, you should concentrate on high-yield review. If you took notes when you did UW qBank, then study those too. Do not try to study anything new as that may just make you forget what you already know. As to taking another NBME form, the reason you want to take another form is to see if you will postpone the exam, which I do not advise. Therefore, if you will go through with the exam whatever the score you get, then I don’t see why you need to do another one.

    Read my post on “What to do on the day of the USMLE exam” and good luck.

    Askdoc

  • December 19, 2009 at 11:43 pm
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    Can you plz guide me for step2 ck prep…when should i plan my CS so that i can apply for 2011 match.

  • December 23, 2009 at 7:24 am
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    Hi Docjay
    If you want to make is to 2011 match, best to finish Step 2CK by August, so results are available by September. Step 2 CS can be taken anytime between now until August. I suggest doing it after your first reading of Step 2 CK. You need to know how to diagnose, how to do differentials and how to order lab tests and you learn that in Step 2 CK.

    Askdoc

  • December 26, 2009 at 7:39 am
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    hi askdoc,
    thanks alot for all your advice and suggesstions during my step1 prep. i got my score for step1 237/99.how do you find this score for neurology residency. how should i start my prep for ste2ck? once again thanks alot…..

  • December 27, 2009 at 4:17 pm
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    Hi,
    Yesterday I took NBME form 1 for step1 and I got 600. I’ve read kaplan and took USMLE world q bank which the last time I reviewd the whole thing, average score was 86% (between 81 to 93%). I thought Iwould do better in NBME assessment. I am planning to take step1 sometime in Jan. How do you think I can improve my score? I really want to get a 99 in step1 as I am an IMG and it is almost 9 years from my graduation. So I need a high score to get into a good programm. (Right now I am doing a PhD in immunology which I am going to finish it by summer 2010)
    Thank you for your advice.

  • December 27, 2009 at 4:21 pm
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    Adding to the prevous post, my week areas were behavioral science and genetic and I had difficulty with the pictures in NBME assessement exam. How do you think I can improve these areas?

  • December 30, 2009 at 10:06 am
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    Hi DocJay,

    Congratulations, 237/99 is a great score. If you are a fresh grad, you should get a lots of interviews. Step 2 CK is also done in 3 revisions. First revision, I recommend you read through Kaplan Lecture Notes. But make sure to make diagnostic algorithms and treatment protocols. You need to know how to work up a patient and how to manage their treatment, not just what are the tests done and drugs given if you know what I mean. In short, positive or negative tests may lead to further testing. Reaction to treatment may lead to modification of treatment. They are in Kaplan but is basically not organized like an algorithm. On second revision, revise the algorithms and also read through Kaplan a second time. During 3rd Revision, Study the algorithms, read through Kaplan quickly and do UW qbanks at the same time. Use the qBank to guide you through your weak points. Check your progress with NBME. Do a 4th or 5th revision as needed in order to get a higher score.

    Askdoc

  • December 30, 2009 at 10:10 am
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    Hi Nooni,

    Yes, there is a complete disconnect between your UW qbank score and your NBME form score. You have to answer this question for me before I can give you further answer. was your UW world q bank done random, timed, mixed blocks with no repetition of the questions. Because repeating the questions will artificially raise your scores. When I repeated my blocks (as an experiment) I was averaging 99%, so completely useless to gauge your competency.

    Askdoc

  • January 1, 2010 at 11:09 am
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    Hi askdoc,
    First of all happy new year.
    Ok let me explain how I did. About 1 year ago I went through all the UW Qbank once system by system. but as I told you I am a PhD student so my speed for preparing for usmle is not great. In two months I went through first aid and all my notes from UW qbank twice and I did random and timed for the same qbank which was stupid as I had to go through a new set of tests like kaplan, I think. Now I got kaplan Qbank and I am taking random blocks timed and almost 4 blocks a day on weekends and about 2-3 on week days after work (finish all blocks and then go through the answers)
    The first few blocks I felt so pressured that I couldn’t even breath well ( as I was so disappointed because of NBME score) and the average was 72%. I felt I don’t know anything. But I realized most of my mistakes was the one that I couldn’t concentrate. So I took 2 days off, relaxed and started again. Now my score went up to 80 to 88%. And still my weakest point is behavioral science!!!!
    But I still feel bad because I think what if this is the case for the actual exam that I get so stressed that I can’t think and even breath.
    So would you please give me some advice? I really appreciate your input.
    Thanks
    Nooni

  • January 10, 2010 at 1:22 am
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    hi askdoc,
    i am preparing for my step 1 exam. i have completed reading the kaplan material once. i have watched the videos also. i havent studied the first aid material yet. i want to give my exam after one month. someone suggested me to write NBME exam to assess my preparation and then do the USMLE WORLD accordingly. then write another NBME block to assess my readiness for the exam. Please advise…

    thanks in advance….

  • January 11, 2010 at 7:22 am
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    Hi Nooni,

    I suggest you continue doing Kaplan qbank. Relax and do not stress yourself out. You will get a lower score if you let stress get the best of you. Part of the reason you were scoring high in UW is because you took notes and studied UW qbank. Doing Kaplan now will in the end test how good you will perform later. a score of 78 to 80% correlate with a 600 in NBME. which is 99 already by the way, although not yet a high 99. You should relax, take it easy. You will do well in the exam, unless the stress takes you out. I suggest you schedule your exam ASAP. Relax the last week before the exam. study at most 4 hours a day and in the last 2 days not at all. Important to get enough sleep so you are in top form on day of exam. Read my post in this blog on What to do on the Day of the Exam. Good Luck and have a great score.

    Askdoc

  • January 11, 2010 at 7:24 am
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    Hi Ramesh,

    Depends on the score you want to get. Based on what you have done so far, if you are planning to just pass this exam, then your plan is good. If you plan to score high, then it is not enough. Again depends on what you are aiming for.

    Askdoc

  • January 11, 2010 at 8:11 am
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    hi askdoc,
    thanks for suggestions..i m done with kaplan reading and started with usmleworld.what cummulative score correlates with 250 or more in real ck exam.

  • January 11, 2010 at 9:28 am
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    hi askdoc,

    thanks for the reply. i am in the final year of my medical school. i will graduate in 2010. i am planning for a score of 95+ preferably 99… you say that if i want a better score, this is not enough… please suggest what i can do in this one month to get the score i desire??

    ramesh

  • January 20, 2010 at 8:50 am
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    I got a 68% on my UW qbank and I got so freaked out that I took an NBME without doing much research on which form to take 2 weeks before my exam. I did form 6 and got a predicted score of 231, which freaked me out even more and I extended my exam date by 1 week. I then read through all the kaplans again, spending 2 days on each subject and revised first aid in a week. I took NBME form 1 two days before my exam and got a predicted score of 249. I just got my result and my score is 251/99…such a relief after my first NBME and UW scores!

  • January 22, 2010 at 6:42 am
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    hello askdoc,
    i graduated in 2009 thn i started my usmle prep.n cleared step1 236/98 and preparing for ck.but all these time i was not attending any hospital. will it affect me in anyways that i sat so long unemployed.

  • February 13, 2010 at 9:56 am
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    Hello askdoc,

    First off I must say I am very impressed by your dedication to all of us by responding with such detailed and personal messages.

    My story is… I have graduated from a Caribbean Medical school that barely taught me anything. I have been studying for a year now, I took a review program because I had to start from scratch (basically re-learn my 2 years of medical school). I started off with 200’s,300’s on NBME 1&2 in the beginning of my learning process (I realized now after reading your blog that I should have used the NBME’s as a confirmatory tool instead of screening!)

    Nonetheless, I have finally worked my self up and somehow stayed motivated…studying 12 hrs a day/7days a week even though I use to have a reputation of never studying in my family. I really just want to do well… so I have really gotten serious so much so that I have my peers asking for help explaining concepts. ( I am good at explaining concepts and mechanisms but I have a hard time recalling quick facts, because I feel like my memory is poor). All my classmates and friends feel I am ready to take the exam because of my strong ability to understand the material…but I do not feel this way at all so I have been postponing my exam. I refuse to go into the exam with atleast a 450 or above… that has always been my descion from the first day of studyng.

    Like you said, alot of students just get frustrated and want to take the exam of hoping a miracle will come out of it and they will pass even after failing all NBMEs. I cannot afford this risk, even though I am only 22 fairly young graduate, I rather just work hard now rather than having to fail and retake the exam. The problem is, everyone around me (family,classmates) feel that I am taking TOO long, and its time I just go in and take the exam…regardless of anything…”how much longer do you need to be confident about taking this exam… its already been so long”…is a question I hear often, which is true…I am also eager to finish but now I am starting to wonder if this is my “plateau”..If I will ever get better than this?

    I recently took NBME form 5 (offline…once again,learned from you not a good idea!), I received a 340ish on there.
    Then about 2-3weeks after that I took NBME form 7, received a score of 470.
    Then only after 3 days, took NBME form 6 to receive a score of 290.

    I never have lost motivation or lost hope in my studying process because I believed that studying for STEP 1 is time-dependent. One cannot rush in to take the exam, “just because you want to.” But after NBME 6 I have felt a bit defeated, especially because after form 7… I finally saw my dream becoming a reality, the confidence in me grew which was never there before because I just never ACTUALLY thought I can PASS STEP 1!

    So here I am, back to studying after taking a day off to be “depressed” after my last NBME. I had my exam scheduled for last week of this month. I don’t know if I got lucky in form 7 or I had a bad day with form 6.

    On my usmle world qbank I average between 60’s to 70’s at times (unused).

    I really have come to the point that I want to REALLY take this exam, but I am too afraid to go in without a good NBME score average backing me up…just wondering how much longer that will actually take because my long hours are getting ridiculous!

    I’m sorry that was an extremely long message, I guess it’s easier to type this out to someone who is well-researched then speak to a classmate who already has a preconception before I even speak that I should go take the test!
    I really hope you can get back to me as soon as you get a chance!!!

    THANK YOU!!!!!!!!! =)

  • February 16, 2010 at 12:37 pm
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    Hi Nerd,

    First, studying too long is not a good idea. Of course studying too short is not a good idea either. There needs to be a balance. Getting the right balance is important but discussing all the details is too long to do here either. In my course, it is covered in the first 1.5 hour lecture, How to Master the USMLE Step 1 and discussed further throughout the course. Anyway to make the long story short. You need to cover a lot of material in the USMLE step 1. And you need to keep all of it in your head for that one day you sit for the exam. For the purpose of the USMLE, what you cannot recall during the exam and you have about 1 minute to do that, you DO NOT KNOW. It does not care if you have read it a hundred times. It does not care if you’ve answered thousands of questions in qbanks. Therefore, you need to be able to keep all those information in your head and recall them at the same time. There are methods that can help you do that.

    In order to do this right you need a lot of time to study, learn and memorize the materials needed. But your biggest enemy is still time. Why, because immediately after you finish reading something, you start forgetting it. That is true for everyone, you, me and and every other person out there including people who gets double 99. Therefore the longer the total study time you invest into reviewing, the more you forget. That is the only results guaranteed. Whether you learn more with a longer studying time depends on a lot of factors, including studying things the right way. So it is a common misconception that you can study as long as you want to get a high score.

    Everyone plateaus eventually. Where studying more will not increase your scores. In fact delaying the exam longer after you plateau will insure that you start declining and will actually score lower. Everyone plateaus eventually, some at 99, some at 85, some at 75. You just pray you don’t plateau with a failing score. Studying properly from the start can help you plateau at a higher score though, so it pays to have good study methodology and not just hit the books and read. Per my experience with people I have taught, most people plateau in 6 to 8 months so it is best to be ready to sit the exam by that time.

    In your case, you might have plateaued and declined already, which is not good. My suggestion is this. If you still have unused qbank question. Do about 4-5 blocks, random, timed, unused, mixed. If your average score is equal to the UW average for the blocks. You have an even chance of passing this exam. which means your chance of passing is about 50-50. If you get about 5 points above UW average, you have a good chance of passing. If you get 10 points above UW average, you’ll score in the high 80’s. If you get 15 points above it, chances are you will score in the 90’s

    Askdoc.

  • February 18, 2010 at 5:23 pm
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    Hi doc,
    I am 1/4 int usmle world with 71% average(timed, unused random) and my NBMEs are – Dec-form 2 – 500, January NBME 4 – 570, Feb NBME 5 – 550(dunno what happened).
    I plan to write in March 22nd and I am aiming for at least 240(25 would be sweet but not confident abt that one). I plan to finish world and do first aid the 3rd time and goljan the 3rd time – (using Taus method). What do you thing my chances are?
    thanks.

  • February 18, 2010 at 5:26 pm
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    sorry made some typo – i meant into -not int, 250- not 25, think- not thing
    thanks

  • February 23, 2010 at 12:44 pm
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    Hi articulate,

    Based on your current performance, you are near your goal yet not quite. Based on NBME you will score between 225 to 235. Although you still have 30 days to study more or less, the problem is we do not know if you have plateaued. Plateauing means that further study will not increase your score and that happens to all of us. I suggest you continue covering high yield materials in your review in the last 4 weeks and taking it easy on the last week. Do not attempt to study additional low yield material just to boost your score as you seem very close to plateauing and doing that can lead to decline and that would be worse. Your plan seems good at this stage. Whether you can reach your dream score will depend on whether you have plateaued or not. extending study time will not help because it may even lead to decline and you will get a lower score than you have now.

    So stick to the exam date, You have very good chance of getting a score in mid to high 90’s which is already very good. You have a fair chance of getting a 99 so it is not impossible at this stage. Anyway, good luck in your exam and make sure you read my post on What to do on the day of the USMLE exam.

    Askdoc

  • February 25, 2010 at 12:38 pm
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    Hi doc,
    I failed step 1 in May 09 with a score of 172/69. I have now studied from July to now (8 months). I got 330 in NBME 5, and 350 in NBME 6. I am so confused as to why my score are not higher as I usually am able to answer questions correctly while discussing with people who eventually end up scoring in the 90s. I am so tired and my exam is in a few days. Any advise for me?

  • February 26, 2010 at 4:16 am
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    Hi Vimo,

    First, my advise is not to take the exam. You have a very good chance of failing it. Even if you are lucky enough to pass it, your score will be so low that your chance of getting interviews will be virtually nonexistent, especially with a previous failure. Postponing your exam for 3 months may not work either because from the look of things you are burnt out and have plateaued already. Which means that studying further will not increase your score by much. That is part of the reason why I tell people to finish your prep within 6 months as most people plateau between 6 to 8 months. When people have plateaued, the only solution is to stop studying for 2 weeks to 1 month altogether. (for some it can take 2 months to recuperate) then restart your prep. Usually you need less time for prepping this time around as you still remember a big chunk of what you have reviewed previously. All this is discussed in my prep course lectures and are some of the most common mistakes made by people prepping for Step 1.

    As to why your score is low, I could think of a dozen reasons why you are having these problems but writing all that down will take pages. In fact those reasons occupy most of my live lectures in the course. But the single biggest reason is lack of mastery of the topics tested. Make no mistake, you know most of the topic tested in the USMLE, but you have not mastered those topics in the level required by the USMLE.

    Is there a difference between knowing a concept and mastering it? Yes a lot. If you know a concept, given enough time and clues in the question, you can come up with the answer for the question. But given this is the USMLE, you do not have enough time nor enough clues. The higher your mastery of a subject, the faster you can recall them and the less clue you need to realize what the question is asking for and coming up with the answer. When you discuss questions with your friends, you take more than a minute to tackle the question and that means more time than the minute you are given in the actual exam. Second, unless you confined your discussion to the exact wording of the questions, you gain extra clues to what the question is all about during the discussion, hence you are able to get the answer. In the actual exam, you don’t get these extra time or extra clues.

    That is part of the reason why I frown on this question discussion exercises in forums and do not bother to include it in my prep course. They just give you a false sense of security that your are improving when you are not.

    There are a lot more reasons why you are having this problems including not assessing your progress regularly or properly, prepping for too long, prepping the wrong way, etc. All these are addressed in my prep course from the beginning so people do not waste so much of their time prepping the wrong way with adverse results.

    After reviewing for so long, people always find it hard to accept that they have no choice but to restart their prep, correctly this time. In fact, some of them decides to proceed with the exam and failed it, which of course just makes it that much harder for them to match later on. Again, my advise is not to take this exam. Take a break for 2 weeks to 1 month. Restart your review, doing it the right way this time.

    Askdoc

  • March 3, 2010 at 1:02 pm
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    Hi Askdoc,

    Thanks for your feedback. I sent you a PM and would be grateful to get your response as soon as possible given the next steps I decided on. Thanks again.

    vimo

  • March 5, 2010 at 6:44 pm
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    Hi..Doc. I have been Stdying for Step 1 now more than 6 months.. i revised Kaplan TExt Books four times.. and REviewd First Aid twice.. so i thought i should assess myself soon before the REal Thing..as i took the upcoming month for my Exam.. so i decided to take NBME..took form 2 i gave it last night with full enthusiasm and confidence.. but its unfortunatley its awkward and sad to tell u that.. i scored 200. and thats more than worse for me. it destoyed my whole courage and i feel insulted. As i have much actual knowledge than i was being test on. but anyways.. Plz Doc. Help me on this.. what should i do..i wanted to take the reall exam within 15 days..but i m confused now. is there something i could add up to my study strategy or m i missing something. or what..! I am impressed by ur scores 99..i wana know what i am lacking here..

    please do reply soon..as i am counting my days..

    Adnan

  • March 6, 2010 at 1:31 pm
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    Hi Adnan,

    sorry to be the bringer of bad news. But 200 is as bad as it can get. You need a 400 to have a good chance of passing this exam. Since you have used the right materials to study (except for qbanks, you need to do qbanks too) the main problem maybe is that you do not know how to study for the USMLE. If you look at the forums, people study the same materials all the time, some get 99’s, others fail. So problem lies elsewhere. There is no way you can take the exam in 15 days. In fact with your score, there is no way you can take the exam in the next couple of months. If you were to make a chart, after 6 months of study how much progress have you made. If you started at 0 (highly doubtful, since when I started my prep I was around 200 and this was because I was an old grad 16 years out of medical school and ended at 740 when I finished.) It took you 6 months to reach 200 and to reach 400 you may need about the same time. However, I believed you started somewhere at 200 to and that means you have done 0 progress in 6 months.

    That is something that cannot be fixed by just a few words of advise. That is the main reason I created my prep course. Most people will be able to pass this exam with just some advise, but there is always a subset of people that can only pass this exam with thorough coaching and that is what my prep course is about. But it is your choice. It seems you need a lot of help to pass this exam and not just advise. I wouldn’t advise the Kaplan prep course as what they’ll probably do is just give you a bunch of books to read and lectures to listen to without teaching you how to study. USMLE PASS in Chicago offers some one on one coaching but they are very expensive. I think it’s about US$ 3K for 2 weeks and most stay for 6 weeks or pay around US$ 9K. The cheapest alternative will be to find a friend who knows how to teach you how to study and willing to sit down with you for 6 months.

    If you want to understand why you need to know How to Study, listen to my video on How to Master the USMLE Step 1 – an Introduction. As I said most people can pass this exam without enrolling in courses. But you my friend may not be one of them. So you have a big decision to make.

    Askdoc

  • March 9, 2010 at 11:45 pm
    Permalink

    HI. DoC ! i guess ur rite.. from day 1 my strategy wasnt great at all.. but 3 months back i wanted to go thru all those text books at least 2wice for my Basic Concepts which i did pretty well but the problem i lack was.. how to modify my knowledge and practice the most important tested material.. so its past now i can not take that tiring journey back into those Kaplan books.. so here is a thing.. as i have decided to delay my test but i dont want it to be 6 months..i think 3 more months or so..if thats ok in ur opionion.. secondly, tell me someone told me to go thru USMLE WORLD materials.. they are helpful? also tell me, is it fine if i just practice MCQs thoroughly and USe First Aid Review Instead.. coz its a big pressure on me and also a time factor.. i mean my basic Concepts are well but i wasnt really familiar with what kinda
    MCQs would surprise me… ๐Ÿ™

    My last Question is that… which Assessment FORM ..either UWORLD or NBME is a straight away actuall corelation with this EXAM,, coz i have been told that nowadays USMLE WORLD is the real thing and that they are what you will see 80% in the real exam and NBME just distorts ur emotions and might bring down ur confidence one way or the other way.. i mean totally confused.. also tell me where can i find ur Prep Stuff and ur strategies…

    THANKS
    ADNAN

  • March 13, 2010 at 10:33 am
    Permalink

    Hi Adnan,

    My problem is I am not sure what you plan to do will be enough. You can try, but I still fell you need to do Mastery phase rather than go from learning phase to Test preparation phase and do well.

    Next, the reason NBME is a good predictor of USMLE performance has nothing to do with how well it mimics the actual USMLE exam. It has everything to do with the correlation done between the performance of thousands of examinees who have done NBME vs. the actual USMLE result. In fact, NBME does not really reflect the questions that will appear in the actual USMLE. lastly anyone who tells you that UW is the real thing is either pulling your leg or does not know what he is talking about. both UW and Kaplan has more tough questions than in the actual USMLE, although UW has more tough questions than Kaplan. So either one is good enough for the USMLE. In the actual USMLE you get about 20-60-20 ratio of easy-medium-tough questions. In UW you get about 20-40-40 easy-medium-tough questions.

    Lastly, I have written a lot about how to prep and exam strategies throughout my blogs and in some of the forums. But as I said, the most complete and well-organized discussions with numerous examples are of course in my prep course.

    Askdoc

  • March 15, 2010 at 12:30 pm
    Permalink

    Hi. I have an issue. I took NBME 1 and received a 440, than took nbme 2 received a 560, took USMLE world and received a 530, and finally took nbme 3 and received a 490.. So what am I suppose to think? Should I stop studying?

  • March 22, 2010 at 6:41 am
    Permalink

    Hi,
    so after ur last advise, I got depressed cos i thought i have plateaued but i decided to pushed the exam forward from march 22nd to April 6th.
    My improvements are Finished usmleworld with 72% average random timed unused with my last 10 being 80s and 70s, NBME 1 = 660/250, USMLEWORLDASSESSMENT = 650/248
    NBME 6 (yesterday) = 620/244, Free 150 (yesterday) = 83,85,94, average = 87 , medfriend predicted 254.
    I am planning to redo all the USMLE world questions i missed, do NBME 7, I am 5 days into doing DIT second time- plan to finish the remaining 10 days,
    and I plan to read FA for five days b4 the exam.
    what do you think. l felt like i dont see anymore new concept in every questions i do, just silly mistakes.

  • March 24, 2010 at 2:47 pm
    Permalink

    Hi JJ,

    NBME correlation is not exact, there will always be variation. In order to actually understand what happened you need to at least give me when you took the exams. then what you did in between.

    Askdoc

  • March 24, 2010 at 2:51 pm
    Permalink

    Hi articulate,

    that is great. Your improvement is enough for you to get your dream score. Good Luck and keep me posted. I call your last statement “in the zone” that was how I felt when I did my exam. Of course, anxiety was still there but that is healthy as it keeps you on your toes.

    Askdoc

  • March 24, 2010 at 10:17 pm
    Permalink

    Hi askdoc,
    Thank you for your advice and sorry I got back to you so late. As I wrote in my previous posts, I was going to take my step 1 exam in Jan. but because my NBME score was 600/244 so decided to got though Kaplan q bank and my overall performance on that was 80%. Meanwhile I had some problem and was hospitalized so I had to postpone my exam. Finally I took step 1 on March 5th and today I got my score and it is 99/267. Much better than my NBME score and thanks to you for your advice.
    Now I have to prepare for step 2. But the only thing that I know I can study is Kaplan lecture notes. Can you please help me?
    As I told you before I am PhD student and have only 3-4 hours a day to study and I really want to pass the step 2 CK and CS before Sept. to apply for residency this year. Do you think I have a chance to finish before Sept.?
    Again thank you for your time.
    Nooni

  • March 25, 2010 at 9:38 am
    Permalink

    Hi Nooni,

    That’s great! Congratulations for a fantastic score. You are just in time. I am finishing an article called Most Common Mistakes in Step 2 CK prep. Hope to have it up in a day or two. Plus I have an article written for Step 2 CK years ago and was published in prep4usmle. I will repost it here in a day or two. it needs a rewrite but that will take time. So will just post it as is with some caveat.
    Yes, there is enough time for Step 2 CK, You can take the exam on August. You can apply in September with Step 2 CK results pending and still have a good chance for interview with your step 1 scores. Just release it ASAP once the results come out.

    Again congratulations for a really great score.

    Askdoc

  • March 28, 2010 at 11:04 am
    Permalink

    Well AskDoc, I took them about a week a part and since my last post I took a few more.. NBME 5 I got a 244 and USMLE world number 2, i got a 247. However I just took NBME 6 and got a 223.. I dont understand what the heck is going on. I had an avg of 67% on USMLE world Q bank.. I know there variations but a drop in 20 pts from one week to the next is ridiculous..

  • March 28, 2010 at 11:55 am
    Permalink

    Hi JJ,

    Actually it isn’t. Remember that the maximum deviation from the mean is 4SD or Standard Deviation. The SD for the NBME as far as I know is about 10, so 4 SD is 40 so a drop of 20 is possible. But if you notice, the mode of the scores is in the 240 range. having 1 outlier is not significant.

    Askdoc

  • April 13, 2010 at 9:07 am
    Permalink

    Hi,
    I am an orthopaedic surgeon preparing for USMLE to get into fellowship.
    I did NBME form 1 to 6 offline and got around 91%+?3%(doubts).
    Am i ready for exam?
    I am planning to take exam by end of may2010.
    thankyou

  • April 18, 2010 at 5:04 pm
    Permalink

    Hi chanduortho,
    First, the offline or actually pirated version is not very reliable. Please read my post NBME Self-Assessment Tests and USMLE Review – an Update. First, because the answer key may or may not be correct. Second, different forms have different equivalent scores as they are correlated and curved. So raw scores are not very meaningful without the correlation and curve.

    However, 91% is high. based on available curves it would be mid to high 90’s depending on the form you are using. But again, the reliability of the answer keys are crucial.

    Askdoc

  • June 3, 2010 at 6:22 am
    Permalink

    Hi,

    This forum has been really helpful. I just want to know more information about scoring. Especially the 2 digit score. I just received my score and got a 98 I was very happy but really confused as to what it meant. Specifically what is the difference between 99 and 98 in terms of residency specialty options? I know if you want to do something extremely competitive 99 is the only way, but what is a 98 good for?Also there seems to be a range of 3 digit/2digit scores. Does the 2 digit reflect difficulty of the exam if one person scores in the 20s and another in the 30s but gets the same 2 digit score? Thanks for the help!

  • June 7, 2010 at 12:39 pm
    Permalink

    Hi,
    I dont know if it is wise to go ahead, took NBME 4,6, UW SA 1, 7,5 and had 201,19819,209,207. my goal is 240. I need advice.

  • June 7, 2010 at 1:22 pm
    Permalink

    Hi Happybutconfused,

    I can understand why you are happy and why you are confused. ๐Ÿ™‚ Anyway, there is very little difference between 98 and 99 actually, but psychologically it has an impact on how people see you. and this can make a difference during interviews when sometimes competition for positions are so competitive every small edge counts. Anyway, the reason for a 2-digit and 3-digit score has to do with how USMLE evolved. In relatively ancient times (the 80’s) there were 2 exams. NBME for AMG and FMGEMS for IMG. NBME was reported using a 3-digit score while FMGEMS was reported as a 2-digit score. When the examination was consolidated into the USMLE sometime in the early ’90’s both scores were reported so as to make the scores comparable to earlier groups. Hope that clears things up.

    askdoc

  • June 7, 2010 at 9:14 pm
    Permalink

    Hi R.E.,

    I’m sorry to tell you this, but those scores are not too good. You still have a chance of failing this exam. even if you pass it will be really low. $ days is not enough to raise your score.

    Askdoc

  • July 25, 2010 at 5:30 pm
    Permalink

    7 days until my exam… its really hard to shake the stress at this point… i scored uworld 65% 1st time around 78% second time around… i took u world self assessment 1 4 weeks ago and scored 212.. I took my second assessment (form 2) today and scored 244(79%,79%,62%,74%… i am happy to have good up but i am really worried about my inconsistency… in the third block… NBME 6 240
    kaplan qbank 1st time around 69%(beforeuworldq’s)
    A friend of mine who took it in june scored 200(didnt freak out, understood q’s and was baffeled by difficulty)… and he had relatively230-250) hi scores in his assessments…
    205 is really close to failing now that passing is 188..
    I also took the cbt 2011 practice test off of the usmle official website and scored 80%(80 80 79 81)… i thought that this test was really difficult and was really impressed by the detail of the questions… im curious as to the how this test correlates with step 1…

    any thoughts as to how manage my stress???

  • July 27, 2010 at 9:50 am
    Permalink

    hi 7days,

    I’ve always said that the exam is tough and the questions are very detailed. It’s just really hard to convince people of that fact since it seems most forums are recommending that reading FA a few times is the key to scoring a 99. ๐Ÿ˜ฎ Anyway, a little stress is always good as it keeps you alert. Too much stress however, is bad. In my case I stopped studying 3 days before the actual exam. Watched movies, comedies mostly. Took a warm bath the night before. Made sure no caffeine for breakfast, just a light snack with high sugar content. Took beta-blockers. In the end, you need to have the attitude that you’ve done all you could already by the time you sit for the exam and worrying about it will not raise your scores but may even lower it. If you want to know more about what you need to do for the exam. Read my post on What to do on the Day of the USMLE Exam

    Askdoc

  • July 31, 2010 at 1:47 pm
    Permalink

    Dear askdoc,
    Am an old img,and just recently came across your blog.I am really impressed at what you are doing to help us.I am interested in joining your prep lectures/courses.is it too late for the july class?

  • August 2, 2010 at 4:18 pm
    Permalink

    Hi Angel U.A.,

    You can still enroll for the July class. Actually there are no more batches. You can apply now if you want. You will be given access to all the online materials for 9 months. You can join 9 months of group chat sessions. Plus you can attend all the lectures which is done every Tuesday so long as your account is active. Just apply through the website and I will process your application.

    Askdoc

  • August 20, 2010 at 11:36 pm
    Permalink

    Hi askdoc

    I am a new graduate. I studied for step1 for 6 months and my NBME score is 530. My test is in a month. What do you think will be the best method? I have done a complete kaplan review and UW

    1. Review the FA+UW and whatever I was doing until now
    2. Buy a KAPLAN Q bank and solve more problems

  • August 26, 2010 at 2:13 am
    Permalink

    Hi kuk2000,

    If you feel you are not yet burning out, then the best is do both. If you feel you are, I suggest just do Kaplan questions and high yield review.

    Askdoc

  • August 31, 2010 at 8:15 pm
    Permalink

    Hi,
    I gave nbme form 7 score 490, gave form 5 score 460.
    Exam on 8th october. What should i do?

  • August 31, 2010 at 8:16 pm
    Permalink

    can you tell me which nbme form is the most accurate predictor for step1 score? can u mention any two? i am confused coz a lot of people have different ideas.

  • September 1, 2010 at 7:10 pm
    Permalink

    Hi Masoom,

    Depends on what your goal is. If you want to pass or get an average score, you are already doing good. Just continue what you are doing? If you want higher score, depends on what you have already done, so we can know what else you have to do. All the forms are accurate in predicting the Step 1 Score. If you understand what correlation and norming means, you know that “more” accurate is not really a meaningful question.

    Askdoc

  • September 2, 2010 at 10:13 pm
    Permalink

    i did kaplan twice. now goin through the third reading. did uworld once. studying FA currently along with the the third reading. Then planning to revise uworld and do Fa once again.
    Exam is on the 8th oct.
    i dont wanna postpone it.
    the thing is i m doing well on the 1-4 forms. I did uwsa form 2 got a 242/99 on that

    I dont understand why i got such poor score in nbme.
    My uworld one time score is 65%

    but in the last 15 tests i never got below 70
    I want a 99. nothing less.
    I feel frustrated with my nbme result. probably i took it too early.
    I took form 7 15 days back
    form 5 10 days back

    still have 35 days for exam. After doing nbme i started revising kaplan again.

  • September 2, 2010 at 10:13 pm
    Permalink

    i did kaplan twice. now goin through the third reading. did uworld once. studying FA currently along with the the third reading. Then planning to revise uworld and do Fa once again.
    Exam is on the 8th oct.
    i dont wanna postpone it.
    the thing is i m doing well on the 1-4 forms. I did uwsa form 2 got a 242/99 on that

    I dont understand why i got such poor score in nbme.
    My uworld one time score is 65%

    but in the last 15 tests i never got below 70
    I want a 99. nothing less.
    I feel frustrated with my nbme result. probably i took it too early.
    I took form 7 15 days back
    form 5 10 days back

    still have 35 days for exam. After doing nbme i started revising kaplan again.

    please help me out

  • September 2, 2010 at 10:15 pm
    Permalink

    i forgot to mention, i did goljan rapid review two readings… goin to do third reading in 4 days

  • September 4, 2010 at 8:03 pm
    Permalink

    HI Askdoc
    i am an IMG graduated in 2008.. i started my prep with goljan in mid jan and then i went on to read kaplan test and was done with it by april.. then i strted u world and was halfway thru but for some reason had to break for a month..ithas been dow the hill since then. not knowing the next best thing to do i joined kaplan live lecture.. and after tht i gave nbme 1 and scored a v low score of 200
    i started reading FA with study partners.. but i have been so tired of studying plus with my ADD i ifind it v difficult to get on.. i gave my nbme for 2 few days back got a 430 and 71 on free 150.. i know ihave to just push myself a little more to start getting 80% questions correct on the nbme.. but i feel totally exhausted and burned out

    i am also aware tht if i take a break i will have to start all over again and put in another 2- 3 months..
    pls advice

  • September 5, 2010 at 3:51 am
    Permalink

    Hi Masoom,

    If you understand what correlation is, you know it is never 100%. It is always a mean +- something. Therefore there will be variations and no one nbme form is more superior than another in terms of accuracy. Best to use 2, one from NBME form 1 to 4 and the other from NBME form 5 to 7. It seems a lot of people tend to get an overestimated score in the UWSA, especially if they use UW qbank primarily in their prep. So always use the NBME. I have always advocated the use of the NBME over that of UWSA if you noticed.

    How much progress you make in the next 30 days depends on whether you are plateauing or not. If you are plateauing additional review will not raise your score, and you might be in danger of decline. Reading Kaplan again is a good strategy, but as I said may or may not work depending if you are on plateau. One more thing, obsessing too much about getting a 99 may have an opposite effect and actually lower your score. I always say, try your best, hope for a 99 and if you will get it, you will.

    Askdoc

  • September 5, 2010 at 3:54 am
    Permalink

    Hi Bella,

    Looks like you have plateaued. So just continuing to review will not raise your score. I know it is frustrating but you do need to take a break. If you have to study longer than so be it. There is no other way.

    Askdoc

  • September 5, 2010 at 8:23 am
    Permalink

    Hi Askdoc
    thanku for yr reply.. what i was hoping to finish my steps till jan 2011 and put in 6 months of USCE as i am an IMG to apply for match 2012..

    my aim in the USMLE is 240.. nothing less.. i dont want to compromise on my score at any cost. My prep consists of one reading of KLN, Goljan, UW and FA. i am familiar with everything but i am realizing tht i have started to forget the finer points.. i have a lot of pressure on me to finish Step 1 by this Sep and i really dont know wht to do.

    If i do take a break and start again.. wht wud yr advice be as for the resources.. wud reviewing FA again and UW explanations suffice?

    thanks in advance for yr invaluable advice.

  • September 7, 2010 at 11:36 pm
    Permalink

    Hi Bella,

    when you break, You need to reread Kaplan again, then UW then FA. If you skip Kaplan, it will not work. You should be able to move faster because you should still remember most of what you have read. But as to 240, May not be possible because you plateaued at a very low score and the study materials you use are barely enough to score high 90’s.

    Askdoc

  • September 14, 2010 at 11:28 pm
    Permalink

    when you select programs in ERAS appl. it asks you whether you are applying for Prelim or Catagorical position? of course that applies only for programs who offers both. the question is; if is it considered good or bad from a program director point of view to apply for both?in few applied both? what should i do ?

  • September 19, 2010 at 9:01 pm
    Permalink

    Dear Doctors,
    I’m really confused with my scores and I have only 1 wk left for the exam, what should I do?
    Can you someone tell what could be my actually scores.

    NBME 1 430
    NBME 3 450
    NBME 4 450
    NBME 6 440 –209(as per nbme) but http://usmle-score-correlation.blogspot.com/ indicate 83 which one to trust

    UW world timed unused first time 59% (100% completed)
    Kaplan timed unused first time 64% (80% complete) averaging 65% these days.
    Am I ready to go. I’d be happy if I can cross 90.

    Appreciate your feedback

    Thanks,
    Kiran

  • September 21, 2010 at 10:45 pm
    Permalink

    Hi docjay,

    I don’t think it is bad per se to apply for both. It depends on the program director. Some may look at it positively, others negatively. Others may not mind at all. Personally, I will apply for both as that gives me a better chance at getting interviews. But that depends on you.

    Askdoc

  • September 21, 2010 at 10:48 pm
    Permalink

    Hi kiran,

    You have a chance of crossing 90, but its not guaranteed. Mid to high 80’s is more likely although 90’s is still possible. Read my post on What to do on the day of the USMLE exam. Keep me posted on your result. Good luck.

    Askdoc

  • September 24, 2010 at 1:33 am
    Permalink

    hi askdoc
    m goin to write step 1 in 5 days
    my uworld score is 78%
    u world sim 1 score of 238
    uworld sim 2 score of 252
    kaplan qbank score of 79%
    and NBME form 6 score of 500/223
    what do u think about these scores
    what are my chances of gettin good score

    Thanks
    SAH

  • September 27, 2010 at 6:31 am
    Permalink

    Hi SAH,

    Based on your stats, you can easily score in the low to mid-90’s. High 90’s is still possible but not likely. Anyway depends on what you consider a good score. ๐Ÿ™‚

    Askdoc

  • October 4, 2010 at 5:13 am
    Permalink

    Hey AskDoc,

    I posted a while ago on the forum re: preparing for Step 2CK. I just got my score (249/99) and I just wanted to say thank you for your advice, as it gave me confidence for test day. Wish you all the best, and to all the other test takers that will be taking the exam.

    -AJ

  • October 5, 2010 at 5:51 am
    Permalink

    Hello Doc,
    do these practice test scores have any effect on the actual exam score?, ๐Ÿ™

  • October 11, 2010 at 5:37 am
    Permalink

    Hi AJ,

    Great News! Good luck on your match.

    Askdoc

  • October 11, 2010 at 5:41 am
    Permalink

    Hi Asianlion,

    They have no effect at all. But they are predictive of your actual exam scores.

    Askdoc

  • October 19, 2010 at 10:12 pm
    Permalink

    Hi ASKDOC i am back again.. after a break of 1.5 months.. what would be your advice on study material, prep time.. thanks

  • October 20, 2010 at 6:43 am
    Permalink

    Hi Askdoc,
    I just received my score. I got 90/214.
    Even after working hard, I got less score. I’m feeling frustated. I dont know what to do now.
    Askdoc, Due to family requirements I can only apply for universities in Southeren California, and I see(from residency forums) that most people who got residency have a score of 95.could you please give me some advice now. what I should do proceed for step 2 or not?
    Is there any hope for me now.

    Thanks,
    Kiran

  • November 7, 2010 at 8:06 am
    Permalink

    Hi Bella,

    First, depends again on score you want. Kaplan Notes and UW Qbank will be good for 80’s up to mid-90’s. If you want higher you need to supplement. Prep time. Average should be about 4 to 5 months. although there will be significant numbers that will take up to 8 months. Since your second round, you should be able to cut down total prep time a bit. Remember you need to concentrate also on details not just general understanding of the concepts.

    Askdoc

  • November 7, 2010 at 8:10 am
    Permalink

    Hi Kiran,

    There is always hope. If you need a 95 to get a residency positions then about 20% of the residency position will remain unfilled since there won’t be enough people with those scores to fill all position. So don’t believe those posts as they do not present complete picture. Of course higher scores means better chance at getting residencies, especially highly competitive positions. Scores are most important to get interviews. Although scores do have impact on being matched, the interview occupies a bigger weight in match decisions for most programs. Just make sure you research your programs very well.

    Askdoc

  • November 19, 2010 at 9:05 am
    Permalink

    Hi askdoc
    I just took nbme 5 and got 550 (234 3-digit) do I still have
    a chance of getting 99? my exam is 1 month away. I would like to
    get into IM residency. Am I doing ok? Please advise
    thanks

  • February 18, 2011 at 12:03 am
    Permalink

    Hi
    I did nbme form 4 with 480 which is equivalent to usmle three digit score 225. I did it timed mood. and I did not take any advantage to improved my score. After one month I took real usmle step 2 ck exam with 188/74(fail). 37 points devaluation has been occurred .How could it possible,

  • February 19, 2011 at 5:51 am
    Permalink

    Hi Morshed,

    Very hard to say without additional information, but I will give you the possibilities. You plateaued then declined. All reviewees experience a plateau, when additional studying does not raise your scores. It means your rate of forgetting is equal to your rate of learning. Then eventually you go into decline where rate of learning is slower than rate of forgetting. If you are in decline when you took the NBME, you could wind up with a lower score.

    A second possibility is that you participated in those posted questions in the forums. A lot of those questions are from the NBME and if you did, that will artificially inflate your scores in the NBME.

    A third possibility is you perform poorly under stress. 37 points is almost 4 SD drop in scores. The average is about 2 SD drop. Anything greater than that can be caused by poor performance due to stress.

    Or it could be all three.

    Askdoc

  • March 16, 2011 at 11:15 pm
    Permalink

    Hi
    i did my step 2 ck.I failed.I had done UW qqbank and also self assessment 70 percentile. Also did kaplan lecture notes and questions..I did not do any nbme. I wish to retake the exam in three months..wat do you think shd i do ..pls advice..really in desperate need..i used to study around 12 hrs/dayfor 3months . i am a person who gets tension 1 week before any exam (this also affected me)could you pls advice me me on a specific study plan or sme thing..pls
    can i reapply after 60 days from my last attempt..??

  • March 17, 2011 at 3:00 am
    Permalink

    Hi Silby,

    My suggestion is this. First take a few days off to recover from this. Restart your prep this time reading up on my posts on Step 2 CK Prep. You can find them by clicking on the USMLE Step 2 CK Category. Pay special attention to the article on Most Common Mistakes in Step 2 CK Prep and note if you have any problem. Follow the suggested remedies. Ask question for clarification. Make sure you take the NBME this time. And do not reapply until you are reasonably sure you will pass this time. Trying to rush it and failing again is not recommended.

    Askdoc

  • March 21, 2011 at 7:44 am
    Permalink

    Hello! I was scheduled to take my USMLE step 2 CK in a week. I have been studying for 5 months (3-4hours a day, cause have a full time job) did USMLEworld 3 months ago, end up with 65-70% average after doing 60% of the bank, most of it random and timed. After the USMLE world self-assessment, I got 213 which was around 89-90. then i review my notes again started kaplan and got 59% after 40% of kaplan q-bank. I took the NBME self assessment form 2 weeks ago and got 500/230/96,I felt that my problem was basically of recall and memory, so I though that 2 more weeks of intense study will be enough to polish it. So I dedicated to study 6 hours a day for the last two weeks, read againg the FA, keep doing questions and took the NBME form 2, and now got 450/218/90 again. I freak out, so i canceled the exam, but i don’t know what strategy to use, to be sure of getting a better score.

    Any recommendation?
    Thanks

  • March 24, 2011 at 1:07 am
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    Hi JA,

    My problem is I can’t be sure if your lower score is because you are burning out or it’s just the result of standard deviation in score. Remember 2SD can be as high as 20 points in the 3 digit score. How are you doing in q bank? Are scores going up or going down too? If you are burning out, then postponing the exam was the wrong decision as that could cause you to have an even lower score later. So it’s important to know if that is the problem.

    Askdoc

  • March 26, 2011 at 9:42 pm
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    Hi, thanks for your response! I think i was burning out due to that high pressure I put over last week, working 9-10 hours and studying 7 hours a day,besides the actuall stress for the proximity of the test, i think was not healthy. Although is possible that was the results of the 2SD. I was doing worse on q banks too. But after 1 day of complete rest, calm down, and re-focus, I started studying my 4-5 hours a day and I’m going up on q-banks again. Now my average in kaplan q-bank is 63%, (it was 55% the week before). I’m planing to take the test in 2 weeks if I keep doing better! Let me know if have any other recomendation!
    Thanks again, I’ll keep you posted!

    JA

  • June 28, 2011 at 7:00 am
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    Hi Askdoc, I am an img graduated in 2010, have passed step 1 with a score of 194 this year and now prepping for step2ck.
    I have finished reading Kaplan notes (IM more than twice, others twice and Pysch once) and Secrets(2001 ed.)(which I still haven’t finished..) for almost 5 months now. About 8 hours of reading. Been doing kaplan qbook and qbank since 1 month now. I take mixed blocks including all subjects and I do one block of 44 qs. at a time, been getting around 55-60% only..
    I have actually scheduled my date in Aug 1st week but I am probably going to postpone it. Took NBME form 1 (offline) today and got 100/184 if the source answers were right and reliable.
    I have First aid and UCV also, been referring and reading FA but still left with more than 50% of it, and haven’t touched UCVs yet.
    Now my questions are:
    1. Shall I start with UWorld before trying and waiting to finish Kaplan Qbank? As you said I am trying to master Horses along with the Zebras, kap qbank has a lot of questions on zebras..and i’m aiming for a 99 in ck in light of the low score of step 1.

    2. How to deal with difference in the management of conditions cited in different ways in KL notes v/s FA?
    I am aiming for 2013 match, i do have plenty of time but I wanna finish my CS before the end of this year and give my next year to O’ships.

    3. All the forums say that “Don’t spend much time on books, solve more and more questions instead.”..Does it really help? coz after properly completing and grasping the KL notes thrice it still doesn’t feel cofident.. And the new kap qbank of 2010 has so many new kind of questions on zebras that take up a lot more time to read explanation, with those explanation videos included. As you said we shouldn’t use kap qbanks for learning but use for assessments, then what about those new qs which we can’t answer right even after finishin KL notes properly?
    Looking forward to your best tips and suggestions.. Studying for this exam feels like swimming in atlantic ocean and not able to see any shores..
    Thanking you,
    isolveurprobs@gmail.com

  • August 29, 2011 at 7:38 am
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    hi Ask docโ€ฆ how are you??? i am studying for step 2 ck nowโ€ฆ

    have been doing uworld questionsโ€ฆ

    i took nbme 4 two weeks ago and got a 188

    i took nbme 2 yesterday and got a 207โ€ฆ

    do you know how close is nbme 2 to the exam? i am so scaredโ€ฆ my exam is in 2 weeksโ€ฆ please helpโ€ฆ

    thanksโ€ฆ

  • September 3, 2011 at 5:54 am
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    HI drsharma,

    Based on NBME alone, you have a good chance of passing. However, there is still a small chance of failing. You need at least a 210 for a sure pass. What is your qbank average?

    Askdoc

  • November 17, 2011 at 6:10 pm
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    hi ask doc,
    plz need ur advice, i’ve been studying for CK for the past 4 months, have done KLN 3 times, mtb2 and 3 atleast 4 times, UW first time cumulative score of 64% n second time 80%.
    took nbme2 n got 370/200 studied more for 1 week n took nbme4 n still got 380/202.
    my exam is in 15 days, i dont know what to do, i dont wanna fail n i dont wanna pass with a low score. my eligibility ends with the end of december. plz tell me what to do.
    thanks

  • November 23, 2011 at 4:19 pm
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    i took uwsa today n got 231 in it, plz askdoc tell me what should i believe, nbme or uwsa?

  • November 23, 2011 at 9:12 pm
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    i wanted to get the nmbe step 2 ck forum 4 .. am an international medical graduate … can you please post the link for it .. as i searched for it cant find it .. thank you

  • November 26, 2011 at 9:36 am
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    hi drsbQaisrani,

    NBME

    Askdoc

  • December 13, 2011 at 8:46 am
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    hi
    m preparing for step 2 ck before step 1
    what u say how shuold i proceed and what should i ndo differntly from others to have a good score even with this plan
    have done with 2 readings of kaplan
    going to have 3rd after which i m planing to start UW
    what are ur suggestions
    thanking in anticipation……..

  • July 22, 2012 at 11:39 am
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    Hey,
    Along with everyone else I share the uncertainty of when I will be ready. I have went thru UW once over the past year on and off. Recently reset it and cracked down doing 88 questions a day along with review which takes me 4-5 total along with doing my 4th year roations. My UW timed random now is 71% I did about 40% Kaplan Q bank thus far think I am about 58%. Today I took NBME form 2 and scored 510/232. I was fairly surprised. I just want to make sure I pass this thing. I have the exam in about 5 weeks and I am dedicating the entire time to prep. I plan on doing a few more NBME’s to make sure I am ready. As with everyone else how accurate is NBME? For Step 1 it was within 4-5 points from the last two NBMEs I had taken. Again I don’t need a 99 just want to know when I walk in I am there to pass. Any suggestions to boost confidence?

  • August 3, 2012 at 8:39 am
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    Hi Zerodoc,

    Again it depends on how you used the NBME. Please look at my reply to Becky on the post Which NBME Self-assessment Form to use for the USMLE Step 1. Anyway, Lots of questions from the NBME forms are being discussed in the forums. And if you had join or even looked through such discussions, then it could skew your NBME results. Plus some qbanks have incorporated similar questions from the NBME into their q bank. If you are familiar with the questions it could artificially raise your score. the big question is why your q bank score is not correlating with your NBME score. I suggest you take another NBME soon and go from there.

    Askdoc

  • August 3, 2012 at 9:14 am
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    Are my scores that far off? I just finished U world with 71%.. Ok I just entered panic mode… My Kapaln Q bank 58% I thought was about average. I honestly thought I was safe. At least I wasn’t going to fail the thing. I did it of course online paid version and I had not seen any questions but I admit some were similar to U world.. I had read your step 1. And I found on my step 1 after 3 NBMEs my final was within 4 pints of my last NBME. I wondered if one could expect shuch accuracy with CK. Or what is safe number ot walk in to CK with knowing that worst case.. you are going to pass.

  • August 3, 2012 at 9:16 am
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    Oh and my Kaplan Q bank I stoped at like 38% I didn’t go all the way thru it I was thinking that was about average.

  • August 7, 2012 at 3:11 pm
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    Hello Askdoc,
    well, already had USWA purchased to took it and got 610.. So we will see I will no an NBME and see how it goes as well thank you for the advice.

  • August 9, 2012 at 8:44 am
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    Hi Zerodoc,

    Didn’t mean to alarm you. No doubt you will pass. That is not the question. The question is how high. Your Kaplan q bank score predicts somewhere in the low to mid 80’s range, while your NBME is predicting somewhere in the 90’s. Using UWSA may not be as reliable since you had studied the UW Q bank very well. Anyway, correlations are never too exact. more like .6 to .8 correlation so there will always be exceptions. Good luck and let me know how it turns out.

    Askdoc

  • August 9, 2012 at 8:54 am
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    Whew, thanks.. I can handle anything long as it is Pass. I study about 18hrs/7 days a week no joke least for the past month. But I have never put a book down since step 1 last year. Just want to walk in with the feeling hey I know I am good enough to pass. I have found once that anxiety is gone I tend to perform much better. In trying get rid of some the anxiety I turned to this blog which I have found very useful over the years. So many thanks to you. I will do another NBME and hope it is within range of like I said passing with some wiggle room. Again many thanks to you for your efforts in helping so many students.

  • August 12, 2012 at 6:39 am
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    Well Askdoc,
    I jsut did my second NBME I did form 1. I am not sure if it matters which one we do. But in any event after studying I am at 520… SO the resounding question as far as I am concened is I have 3 weeks left of study time. How confident can I be based on your observations, that when I walk in CK I am going to pass the thing? Would you care to speculate on score? Thanks again for your support and advice.
    Best Wishes,
    Z

  • August 13, 2012 at 8:52 am
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    Hi Zerodoc,

    That is good. The way I assess my chances of passing is always to assume worst case scenario. That is if absolutely everything is going wrong for me on the day of the exam, I will still pass or get the score I want. For step 2 my NBME was 700 and for Step 1 it was 740. I was aiming for a 99 and I needed a 660 for sure 99 or 240. I got 256 in Step 1 and 258 in Step 2 CK. (predicted 265 and 260 respectively) So in your case if we use your worse score 58% in qbank, you have a very good chance of passing but not 100%. If things go really bad on exam day you could still fail. 60% in Kaplan qbank is the 100% chance passing level. That said, if things went OK, not ideal, but nothing disastrous, you will pass with probably low to mid 80’s. If we base in on your NBME, worst case is high 80’s, probably more like low 90’s. I would not trust UWSA since it tends to overestimate scores by a large margin especially if you really studied the UW online qbank very well. Again, good luck.

    Askdoc

  • August 13, 2012 at 9:05 am
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    Hey Askdoc,
    Ironic you said that. As I jsut clicked over to 60% today on Kaplan Q bank with 60% of the Q bank complete. My score is climbing and 2 weeks till touch down. So again. I am like you just if the earth cracks in the middle of my exam I at least won’t have to do it over. My only true concern the rest is gravy. It is hard to believe 2 NBME with 230 could be off more than 40pts. I don’t read much other than what other folks have seen on their correlation and I certainly have not read any of the NBME information other than what I have gotten from doing UW and Qbank. Also doing Gunners (not a bad little qbank at least I kind of like it as a quick run through). Thank you again for the advice. I will certainly let you know how it goes. I would be happy if NBME was more give or take 15pts. Again praying it isn’t 40. Goal 220s
    Best Wishes,
    Zerodoc

  • September 28, 2012 at 7:54 pm
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    Hi Dr,

    Thanks for the informative post! I have done my step 2 ck and scored well. Been preping for step 1 for 5 months now. Happy to say that I am done with my first kaplan read+solved 50% of kaplan Qbank (av 68%+ read/annotated FA along. But I am kind of confused about what to do now. I was thinking of taking an nbme (form 3) for self assessment. But after reading your post..Im starting to have second thoughts! So, what would you advice me to do now, since I feel I forgot some stuff and need to evaluate my progress so far. I am leaning towards taking a UWSA. Would that be a good idea or should I head for a 2nd kaplan read? My next step would be to read FA+DIT then hit UW qbanks and do nbmes till test day. AIMING FOR A 99! ๐Ÿ™‚

    Thank you so much in advance. Hope to hear from you soon and end my dilemma ๐Ÿ™‚

    Happy weekend!

  • October 18, 2012 at 4:24 am
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    Hi Zaina,

    My suggestion is this. Do a second read of Kaplan and finish Kaplan qbank before doing an NBME assessment. Whether what you have studied is enough to get a 99 depends if you are an Old IMG or relatively fresh grad. 68% in Kaplan qbank would probably be good for mid to high 80’s.

    Askdoc

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