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 USMLE Step 1 Passed 244  

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Hey everyone I took my exam on December 18th, 2014 and received my grades in January four weeks after.

The exam was hard, but balanced amongst disciplines with path being the most frequently tested topic. Had about 5 anatomy, 5 biostats, 20 path, 10 physio, 5 pharm, 5 genetics, 2-3 WTF questions per block.

I distributed my break time like this.

Block 1
5 min break
Block 2
5 min break
Block 3
5 min break
Block 4
15 min lunch break
Block 5
10 min break
Block 6
10 min break
Block 7

The questions were MUCH longer than UW and felt myself completing to the last minute on blocks 3 and 4 which were super difficult. Blocks 1 and 2 felt exactly like UW, so I didn't really get anxious until I saw the super long questions in block 3.

NBMEs overshot me by 5-10 points, but they are very accurate predictors.
So if anyone is wondering if they will fail the USMLE or not? Or if you are looking to JUST pass?
The ONLINE NBMEs will tell you.If your ONLINE NBME score is not AT least a USMLE scale of 205-210, you have a high chance of not passing the exam.

For example if your ONLINE NBME score is a 192 or lower on the USMLE scale. There is a high chance that you will NOT pass this exam. I know this exam is very difficult, but DO NOT SIT this exam unless you take an ONLINE NBME which can tell you your predicted score with some comfortable +10 or - 10 room for error.

DO NOT DO OFFLINE NBMEs to gauge your progress, the answer keys are OFTEN WRONG and have a high chance of being HURTFUL to your goals.

I felt if you can learn and memorize FA and understand all UW explanations inside out you can score 230+ on this exam.

Study plan
Time preparing:
7 months
- FA 2014
- ALL KLN Videos
- HY Neuro
- HY Behavioral Science for Milestones
- Rx qbank
- Kaplan qbank
- USMLE world
- FA Q&A book
- FA Cases book
- Kaplan Live 7 week Review Course (HIGHLY HIGHLY RECOMMENDED if you have the funds, will help you get around a 10-15 point increase on your NBMEs.)

-Study consistently everyday.
-Take 4-7 months to study for this exam.
-One day off here and there is okay, but DO NOT TAKE WEEKS OFF AT A TIME.
-I was studying 10-14+ hours a day on MOST days. But I would recommend 4.5-5.5 hours daily MINIMUM. This exam requires sacrifice and you've got to be willing to make the sacrifice. There are NO shortcuts to do well on this exam.

- Do the books subjects wise, it makes life easier. (NOT ORGAN SYSTEM WISE)

FIRST take an NBME to see where you stand. I took NBME 7 since it was the oldest.

Watch KLN videos ONCE (For example Cardio physio videos), Read KLN for that section ONCE (Cardio physio), Read FA for that section (Cardio physio), Do UW questions for that section (Cardio physio). Read ALL explanations and put any notes from the explanations you've found important directly into FA.
This process should take 2-3 months MAX.

Only repeat videos or KLN if you feel you did not grasp the concept at all.

~~~I repeat read ALL explanations, even if you got it RIGHT. There were TONS of questions that were formulated from the EXPLANATIONS of UW on my exam. I thought this was common knowledge, but I guess it needs to be said.~~~

Read FA multiple times including the all UW and qbank notes.

Take practice NBMEs, doing practice questions is the highest yield source for doing well on this exam.

First Aid Q&A question including the mock full length exam book is a hidden gem. Closer to my exam I would take an NBME + 3 of the 7 mock blocks from FA Q&A to simulate full length exam

Practice makes perfect, simulate a full length exam AT LEAST 2 times before you sit for the actual exam.

The last 4 weeks leading up to the exam take an NBME every 7 days while repeating weak concepts in between. You should see a gradually improving NBME grades. Save NBME 15 & 16 for the End. This is how I did it:

(Before Step studying to see where I stood, major let down. Gave me intense strength and motivation to push myself forward.)

NBME Medical School Comprehensive
FINISHED UW 2 times, KLN ONCE, ALL KLN VIDEOS ONCE, FA Q&A and FA 3times before I took this.

Did only DIT + a 4th read of FA.
(30 days after MD 5 spending time mostly at home, Major Freak out! Notice the trend in grades? Don't take breaks/become complacent in between step studying! In my humble opinion.)

A month into the 7 week Live Kaplan Review Course + Now at the 6th Read of FA + Finished Rx qbank + Started Kaplan Qbank


Finished Kaplan Qbank

Started UW again third time

Completed UW third time


Free 150
Predicted: 244

Real Deal
Pass: 244

Free 150 questions have some repeated concepts on the actual exam. A great source of practice questions a few days out from the exam.
Shame how some people don't know about this.

NBMEs 7, 11, 12, 13, 15, 16
Do all NBMEs ONLINE only. Answer keys are WRONG ALOT OF THE TIME.
Shame how some people don't know about this either.

If you are failing the NBMEs, you will have a high chance of failing the exam. DO NOT WRITE THE EXAM UNLESS YOU FEEL COMFORTABLE WITH YOUR ONLINE NBME GRADES.
Use NBMEs to guide you, this exam is hard but NOT impossible. Work hard and it will all pay off.
Don't be demotivated by NBME failures, learn from the mistakes and keep moving forward!

Say when I say UW in down below, I am referring to the question concepts, the pictures, and ALL explanations. It is essential to understand and retain the information.

Behavioral Science
FA+ UW + Kaplan + 100 cases by Conrad Fischer a must for IMGs that don't know the rules of ethics in the U.S.

FA + UW + Kaplan = Enough

FA + UW + Kaplan = Enough

FA + UW + Kaplan = Enough
Know transmission and prevention for all organisms.

FA + UW + Kaplan = Enough
Know how to differentiate all immunologic disorders, hypersensitivities, and graft types and rejections.

FA + UW + Goljan Audio + Goljan book OR Kaplan = Enough

FA + UW= Enough

FA + UW + Kaplan = Enough

FA + UW + Kaplan = Enough

FA + UW + Kaplan = Enough

FA + UW + Kaplan = Enough

FA + UW + Kaplan = Enough
The anatomy questions were vague and difficult, and even reading HY Anatomy was not helpful to me.
Underground Clinical Vignettes for Anatomy seemed like a good book but I was unable to get through it before my exam.

FA + UW + Select HY Neuroanatomy chapter + Webpath Gross and MRI anatomy pictures = Enough

FA + UW + Kaplan = Enough

FA + UW + Kaplan = Enough

FA + UW + Kaplan = Enough
Know very importantly how to differentiate Pneumothorax, Hemothorax, Pleural effusion, TB, Aspiration, and Cardiomegaly on Chest X ray.

Rapid Review Section of FA Step 1 is great also.

Also know the presentation, pathophysiology, and treatment of Stress, Urge, and Overflow incontinence.
Know how to identify cranial nerves on gross brainstem.
Be able to identify the micro bugs just by looking at the picture.

Overall the exam was very tiring and I felt I had failed when I walked out, there were at least 10-15 Step 2 management questions that made me feel like I had the wrong exam. But overall you have to believe in yourself and be confident in your answers.

This is a passable exam, it is important to master few sources, than to be mediocre at a ton of sources. I started off with an NBME scale of a 202 and still ended up breaking USMLE scale 250 within 7 months.
I read FA 4-7 times before it was committed to memory strongly, 4-7 times!
So I am posting this to give hope that IT IS POSSIBLE.
If I can do it ANYONE can do it.

I sincerely wish everyone here the best of luck, and wish everyone here succeeds in their goals.
Let's work together and beat this exam, and increase the passing rates for the years to come.

Hope this helps.

This is my entire journal for a daily overview of everything that I did.

Edited by indomethacin on May 05, 2015 - 4:58 PM


Thnx for your sincere experince's post.

Congratulation again and wishing you more success in ur usmle to residency nod

Will ask you more Q re material u had used soon ... liek what if I skip this and that books, QB etc wink


GL nodcoolnod



Congrats on your amazing score! It proves to show that hard work pays off. Thank you kindly for sharing and best of luck with your future endeavours. Please keep us posted on your journey to residency! Thanks again smiling face

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