young_doc
Forum Guru
Topics: 55
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ohh man.. that was some test...
First off... that was the longest day of my life... wow. I'm exhausted.
The exam was tough. Hands down. It was a hard test. Many ambiguous questions, many times where i felt there were more than one answers, many times where i couldn't even tell the difference between different answers in the same question! (ex. biliary fibrosis vs biliary sclerosis vs scarring of the biliary tract??????)
Now i'm not here to whine and complain about the difficulty of the test, i mean i'm pretty sure i'll pass, but i just want to warn others NOT to take this test lightly!
About 50% of my test IM. Of the remaining 50%, it was actually mostly Psych, maybe about 30%. (i'm not kidding). And the rest divided evenly between Peds, OB/GYN, and Surgery.
Heavily tested topics on my test were Opthalmology, Infectious Disease, developmental disorders, and Neuro. I think i had every possible combination of questions they could ask about an adult with neuro symptoms (ex. lower extremity UMN with upper extremity LMN, or pain radiating down the neck with muscle atrophy, or ataxia this, or tremor that, or midbrain this, or pons that, or gait this, or nerve compression that.. )
I had many zebras on my test. I mean i kept waiting for the questions on MI, HTN, DM, Hepatitis, HIV, developmental milestones, eclampsia... etc, etc. But they never came! Instead i had questions like the color of the tick that causes Lyme Dz?? 
I also had a few Step 1 questions..which weren't too bad. Straight forward, things most of you will probably remember.
Well overall, i don't feel as confident as i did after taking the Step 1, even though i felt more ready this time (NBME 245, 2 weeks before my test.... compared to NBME 220, 2 weeks before my Step 1). Now i know why other's get really worried after taking this test, lot of difficult, ambiguous questions. It's really hard to judge how you do, and if you answered correctly or fell for the baits.
Here's what i used to study:
-First Aid for CK (5th edition)
-Blueprints OB/YN
-Step-up to Medicine: I used this as my medicine reference book. It was pretty good and i always found what i was looking for in it. I hear a another good one is "Current medical diagnosis and treatment"... or you can go all out and get Cecil's Medicine or Harrison's Medicine. I found the Step-up to Medicine to be enough for the Internal Medicine portion of Step 2.
-I'm also currently completing my clinical rotations, so i was pretty confident with the treatment plans of most common conditions.
(No Kaplan... i don't know why i never liked Kaplan. Didn't use it for Step 1, and didn't want to use it for Step 2). And looking back, the questions that were weird & difficult, i don't think Kaplan would have had the answers either!
Here are the questions i did:
-USMLE World
-Kaplan Qbook (too easy, answers were obvious, this was a waste of time)
-Bluprints Q&A for OB/GYN (answers are too short, and lack good explanations)
-MKSAP for students (latest edition) QBook: i thought this book was awesome for Medicine questions. The questions are extremely up-to-date and relevent, they're high-yield, and the answers are all backed by current research. Very good set of questions for Medicine.
Here are my numbers:
-USMLE WORLD score: 60% (Time moded, all topics randomized)
-NBME form 1 (3 months out): 213
-NBME form 2 (2 weeks out): 245
-Questions from USMLE CD: low 80's
-Kaplan Qbook: didn't really score myself, but i would estimate i was in the 70's.
This test was harder than UWorld, NBME, or the USMLE CD.
Again i don't mean to scare anyone who's about to take the test, but that is my honest opinion. I guess we'll just see what happens, all that matters now is that it's DONE!!!!!!!!!!  G'lcuk everyone!
All questions are welcome of course 
Edited by young_doc on 07/19/07 - 04:58 PM
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| arlete
Intern in 2009!!!!!
Topics: 30
Posts: 2,208
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Good luck! Score will be great, I am sure!
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| cirus
Forum Guru
Topics: 108
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hey young_doc,
well im at least happy ur done im sure ull get a wonderfull score..
Good luck
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| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,796
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hey yound-doc, good luck with ur scores, and did u say opthalmology....wow, i am about to give it my first read, and my exam in next week....God bless my poor soul
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| doc_clotaire
Forum Guru
Topics: 159
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Hi young _doc !
Mine was exaclty the same as yours . I am glad you write your experience down because most people said that exam is easier than UW ...... I guess that 's a pure luck factor . It depends on your luck that day . I don' t mean to scare anyone but be ready for ANYTHING guys .
Well , mine was way harder than UW but the good thing is I passed that sucker and I am sure you will too because as long as you do your job , you will be rewarded for that besides I heard that the harder is the exam , the easier it is to score
Congradulation and Excellent spirit ...
Wish you a good score ...Good Luck !
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| dr_arc
Forum Senior
Topics: 5
Posts: 156
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good going young doc.
rest assured you have done well . you have definitley given it your best and hard work always pays off.
so relax chill and enjoy your life.
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| virgola82
Forum Guru
Topics: 85
Posts: 348
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Guys you're really scarying me.... It's so stupid to ask these kind of question in a test that should assess if you are able to work. I am very upset because of this. So basically, if don't know the color of a tick or if I don't know how to change the therapy to psychiatric patient, does it mean I am not good enough to work? This is really non-sense. I tell you why they do so. it's because they are so close minded that they just reason in terms of percentages. Because of all these resources we have (kaplan, UW, the forum, worlwide available internet etc) I think the level of performance has increased a lot in the last years and so yhey belive that, just because the scores are higher this a good reason to make it tougher with unreasonable questions... Is it done just to scare foreign people and discourage them from moving to the US? I don't care if that's the case, it's not my buisness but I still think this test is certainly well conceived but exagereted in some aspects and hope I will have good luck on my side on test day but you know what, if I will fail because I don't know the difference between biliary sclerosis and fibrosis (which I am happy to say I don't know) even though I can't think these kind of qs can really affect the score, but anyway if won't pass because of that it is actually better.... It would mean I am trying to move to a system I really don't like at all.
Edited by virgola82 on 07/20/07 - 06:47 AM
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| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,796
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wel maybe that's one way to look at it, but virgola my friend dn't be so emotional, i would say that despite the very difficult exam, preparing for it has been one of the most memorable and fruitful experience in my life so far...
good luck to all
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| doc-o8
Forum Elite
Topics: 28
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best of luck young_doc.
u scared me... mine is tomorrow.
well BTW wts teh color of tick of lymes?
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| jaisiyaram
Forum Junior
Topics: 13
Posts: 56
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Thanks for sharing ur experience with us. It is a very well written post. Please could u share ur dos and donts for a good preparation. If possible, I request u to post link to step-up to medicine. It is not available in Indian markets and I just cannot find the link on the net.
GL to u.
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| young_doc
Forum Guru
Topics: 55
Posts: 732
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Hey everyone! First off, thank you all VERY much for the support. It is appreciated
Thanks Arlete, thanks Cirus (keep the great discussions on the forum going), ssrpk (yes be ready for anything!  ), thanks drArk, Do-08 (if i knew your test was tomorrow i wouldn't have put such a negative post!! Sorry about that buddy, i'm sure your experience will be better than mine, and i'm sure you'll do great )
I just noticed that the title of my Post is "June 19"... just shows how tired i was last night! haha It should have been July.
Thanks Doc_clotaire, i didn't know you took it! I don't remember reading your exam experience (assuming there was one?). But thanks for the post, it made me feel better that i wasn't the only one with a Hard test! The other recent exam experiences had made me think the test was easy 
Thanks Virgola, as my post said (and as Doc_clotaire's post said), my post was not meant to scare, but to advise not to take the test lightly. Like i said i'm sure i'll pass. I mean those weird questions won't add up enough for me to fail, so don't worry Virgola, i know you'll pass. There will ALWAYS be weird/hard questions, but your goal is to get the other easy questions right! You'll do great i'm sure.
Thanks Jaisiyaram...i bought the book a long time ago on amazon.com. I'm sorry but i'm not sure where you can find a copy to download?
Again thanks everyone, g'luck to you all!
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| khorshid
Forum Guru
Topics: 32
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best of luck on your score
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| Aashi
Forum Moderator
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All the best for a gr8 score doc..
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| Justice
Forum Fanatic
Topics: 100
Posts: 1,882
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Hey young_doc...
Now, when you know what you went through and could survive, you must be proud of yourself... And so we are of you... Good job, man, best of luck...
J
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| Hotobhaga
Forum Elite
Topics: 41
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I am confused with the extreme experiences on step 2. Are the exams not meant to be uniform?
It will be good to see how arlete motorola and now young doc scores. Then I think the guys to come next will then get a better idea. Wish you all the best in scores.
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| virgola82
Forum Guru
Topics: 85
Posts: 348
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well ssrpk you are right I am taking it too emotionally, but you know... I am really getting crazy with this: here it's everyday more than 35°C, everyone is on holiday, (even my dog! he went with my family in our sea-house) and I haven't seen the beach yet.... Think that I am so out of mind that this afternoon I closed myself out of my house without taking the keys! I wasted all the afternoon to manage to get back inside... And my test is in 3 days.... I really hope this pain to end soon....
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| DaddyO
Forum Newbie
Topics: 2
Posts: 27
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I agree with you 100% young doc. I took the exam last December and it was an unbelievable exam. I am giving you guys a link to look at from last December/January when for some reason the exam was more difficult for a lot of people that had taken it in the past. I don't want to go on and on but let me tell you my opinion of how difficult my exam was.
I think that because there are a lot of 99% scores in the last few years the test makers think that they have to make it more difficult. I mean you can't just have the knowledge anymore and expect to do well. The reason there higher scores is because of a lot of international doctors that move here and literally study 12 hours a day 7 days a week for 6 months for step 2 and then do the same thing for step 1. And these are doctors, from other countries like India, that have already been to medical school and gone to residency and know a lot about diagnosis and treatment. They just increased the score of course, and why, because getting a 183 means that you aren't prepared enough to be an intern student doctor?
Honestly, it just seems that they think that asking questions that are straightforward is just too easy and that maybe people off of the street could get them right as well. For example, they would never ever ask a question like this: A 55 y/o female presents to the E.D. with complaints of lightheadedness and fatigue. She reports a history of HTN. After performing a physical exam the patient has a B.P. of 90/42, muffled heart sounds, while lungs are clear to auscultation. The patient has no fever, reports no recent travel, and has no history of trauma. You also notice on physical exam that her neck veins are distended. What is the diagnosis?
Of course this is Beck's triad and she has cardiac tamponade.
You definitely have to have the knowledge as a 4th year medical student that these physical signs likely prove cardiac tamponade and the next step would be a pericardiocentesis. But USMLE will never ask a question like this because it is too straightforward.
I swear when I took my exam I had not one question that near this easy. I don't think 370 questions or so should be this easy but at least 3 or 4 questions out of 8 blocks should be something like this.
My exam was best described as this: Vague, questions were twisted, all of the studying I had done was really futile because like young doc said there were just no questions representative of basic clinical sciences. I did not have any questions on cardiovascular disease, pneumonia, diabetes, ecclampsia, Fetal heart monitoring, none of the basic GI problems like Crohns or ID, or IBS, no infections, no STD's, no HIV. Basically, the 98% of all medical presentations to the ED or IM floor in the hospital were NOT on my exam. They would literally put up a picture of a very weird lesion and ask the type of cytokine response, so weird. In summary, the 2% of zebra medicine that you would have to look through 10 sources until you find the definition was what comprised 98% of my exam. I am not exaggerating. I swear I am not.
And the hardest part was how long the questions were. For about 80% of my questions I literally had to scroll down just to finish reading the text in the paragraph and this was before I even got to the lab values or the answer. Almost every question I was just ready to scroll down when I went to the next question. I got so sick at my stomach from all of the long question I decided to count the number of lines of the paragraph for the question I was on and it was 35 lines!!! I am not kidding and this was close to the average length of questions...35 lines! I went back and counted the average number of lines for Usmle World questions and it is about 7 or 8 lines. And I'm talking about before lab values.
And on the real exam about 75% of the questions had lab values and so often they gave about 15 lab values...seriously 15. I know that often they are in there as distractors but you have to look at them to see if they are distractors and looking means time away from other questions. And I had numerous questions that had 20 answer choices...that is right 20. I kid you not...I would have answer choices "A" through "V". And even if you pick your answer right out you have to look at the other 19 to make sure it is not it. For example, they are really tricky with this, let's say that the answer is "hyperglycemia" well they might also have an answer that says "hyperglycemia with hypernatremia" and then you look back at the question and the patient does indeed have hypernatremia too so you have to read all 20 answer choices.
Now I'm not writing all of this to scare you guys but I just don't know what some test takers are talking about when they say that it was easier than UW or the same level of difficulty. Actually, I would give UW about a 6/10 and the actual exam 10/10. Basically, UW questions just aren't vague enough, they aren't twisted enough, and they aren't near as long enough. And I averaged about 68% on UW and I did not do well on the exam. I honestly felt like I had the knowledge to get at least 90th percentile if not 95th or higher but this exam is not a knowledge. I used Kaplan, UW, Secrets, Q book and spent a lot of time studying but felt like my time studying the basics was just a waste. I honestly felt that studying only improved my performance by about 10%. And actually that the last month that I added on to keep going over the high yield material was a waste because NONE of it was on there. I mean I was ranked 11th in my medical school class out of 250 and I really struggled with this exam. How is someone supposed to read and answer a questions when the question is around 30 lines long, there are about 10 lab values and between 5 and 20 answer choices and they only have one minute and 15 second per question. And you hope that the next question will be a 4 liner but they never were, most of them were over 15 lines. I think that maybe 2 or 3 questions out of each block were less than 8 lines...maybe 2 or 3. And on UW about 75% are less than 8 lines.
The best way to sum up this exam is this: I have numerous friends and colleagues that have gotten 99th percentile on the CK and every single one of them thought that they very easily could have failed it when they walked out of the exam...they were clueless how they did, because the questions are so vague and twisted. One of my friends who got a 256, on the day that he took the exam after studying for 3 months he came right home at 8pm went back to his desk and started studying that very night for the exam he just took. He then studied everyday for the next 3 weeks until he got his score and saw 99th percentile. My point here is that if the people that blow this thing out of the water think that they failed it then how are the people that usually perform around 80th to 90th percentile supposed to feel.
Best of luck to all of you!
Here is the forum from when I took the exam and others that experienced the same thing.
http.//www.prep4usmle.com/forum/thread/46850
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| virgola82
Forum Guru
Topics: 85
Posts: 348
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ok daddyO, you know actually your post made me feel better because now I know that I could even study 1 more year and be always at the same point... I just hope I could get out alive from test center....
Edited by virgola82 on 07/20/07 - 04:18 PM
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| doc1981
Forum Senior
Topics: 12
Posts: 203
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Hey young_doc,
Don't worry.. I'm sure you did really well. All the very best for your score. You should try to relax, although the next few weeks will be nerve wracking.
If you don't mind me asking... how long did you study for? I've gotta write ck within two months and I'm not at all ready. Looking back I think step one was much easier compared to this crap!!
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| cirus
Forum Guru
Topics: 108
Posts: 740
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Come on guys, I know the exam may have been a drastic experience to some but rest sure that when u make an effort it will not go in vain, if the exam is hard on u then its hard on others
& its not a matter of how u score as it is a matter of ur place between the examiners, so give all u got so u won't look back & say I didn do my best, but on the other hand, don't just terrify urself from the exam---> this will only jeoperdize ur prep time, have confidence guys & always look to the front..
For daddyo..can u tell us how was ur score after that drastic exp?
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| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,240
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Guys , I have a little joke for you !
When I first read Daddy 's post , I was like .... get the hell out here , this guy is EXAGERATING , he just want to scare the hell out of people man . Those guys shoudn ' t be in this forum . I didn ' t even bother finishing to read his horrible post .
and then after I worked out the test center with a similar exam , I am like No S*** . He wasn' t messing around .. He was for real and I started looking for his post again to get some confort .
Actually I scored very low in CK 81 / 199
but I feel so PROUD of myself to pass an exam so hard . I never thought I could do such thing . I used to have a low self estim about medicine . After this exam , my self- estim grewp up BIG TIME . Now I am sure that I know Medicine and have a some COMMON SENSE
Young _doc , I decided to post my exam experience in my prep journal to avoid scaring people .If you wanna see it go to .....
http://www.prep4usmle.com/forum/thread/50575/6/
Go to June 13 and you will see my nightmare !
Morale of the story :Guys , If you think like me at first that this guys is exagerating , please think again ! Now , if you are lucky enough to have a easier exam ,Please praise the Good Lord because some exam are really LIKE HELL MAN !
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| DaddyO
Forum Newbie
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Thanks Doc Clataire...I'm sure people reading my post were like no way, this can't be possible, just like you. And if you are one of those people that are lucky enough to get an exam that is comparable to USMLE World then you are very very lucky.
But to be honest, I really don't care if Doc Clataire validates my point because I know exactly what my exam experience was made of...I remember after taking it that I thought to myself that no 4th year medical student on the face of the planet would be able to pass the exam I was given and they shouldn't be able to pass it because when they don't ask about basic clinical medicine when you aren't even in residency yet then why would you be expected to do well.
Fact is this: First time I did Usmle World I had a 64% cumulative with about 75% of the bank left and it was for the most part random questions on timed mode, I did do some tutor modes for subjects I needed work on like Neuro. I kept getting better as my studies went on. And I left enought at the end for to do a times test so I could use the score estimator and I did 6 blocks of unused questions on timed mode, just what the score estimator says to do and I got a 68% which is pretty good. And the score estimator says that it correlates to a score of "244" so I'm thinking I will get close to 99th percentile right cause 247 is 99th percentile. After all of my questions were done my cumulative score was 66% on UW but that is also counting questions that I did like a month ago so I had gotten better. And a 66% is still a 237. Well I failed the exam. Just failed it. And it tooks 6 weeks to get my score back because it was over Christmas break so I guess they take longer during that time. I was sad and hurt and upset but then I remembered exactly how I felt when I left and I knew that no one should pass the exam that I took. I thought maybe they gave me Step 3 or something but I have read about other people having the same experience.
I got a 219 on Step 1 and that was after only studying for 3 weeks...3 weeks and I got a 219 so I knew if I studied for 2 or 3 months like my colleagues I could get a 99th percentile. So, I studied for 3 months for step 2, which is actually shorter than a lot of people that I know, and I failed it.
And now I'm doing UW again and my cumulative is over 70% now.
It's crazy because I read so many times that if you get over 70% on UW then you will get 99th percentile and if you get in the 60's you will do well. I actually had a friend that got a cumulative of 50% and he got a 215 on it. Amazing how a 66% yields a fail. But I can't explain adequately enough how confident I am that no one should be able to pass the exam I took. The exam I took makes UW look like the Kaplan Qbank. I mean how are you supposed to do well when you have a question that is 33 lines long with 12 lab values and 15 answer choices and you only have a min an 15 sec and then the next ? is even longer, then you hope for a 4 liner but the next one is 35 lines long with 20 answer choices, and then the next one is 38 lines, and then the next one is 32 lines.
I'm just being honest. I wish I was lucky enough to get questions that compared to Usmle World. Thank your lucky stars if you get a test where you think there aren't many zebras. For example, I read a post by arelete the other day who took the exam and she seems like a great person but she said that there weren't any zebras and that the exam is very doable and that it is basic clinical medicine and if you study Kaplan notes and do UW you will do great. I couldn't believe what I was reading and I couldn't believe that people are so lucky to get an exam where they can come away from it actually thinking that there are no zebras. Zebras made up at least 60% of my exam. And if there was any basic subject like GI it was again something so far removed from the basics; I never had anything like GERD, achalasia, ZE syndrome, hepatitis, pancreatitis, esophageal tears, PUD, cancer of the GI tract, IBD, IBS, I never had any of those topics...if they asked me anything from GI it was something I couldn't even find in my book when I got home. And if PUD or GERD or IBD was mentioned it was just that the patient had a history of one of those it wasn't something that contributed to the answer it was just one of the past medical conditions. Oh and real quick...in respiratory when they told me about a pt that presented with dyspnea etc it was NEVER one of the COPD or Restrictive lung disease and you know how I know because nothing related to any of the basic diseases were in the answer.
When I say my exam last December was vague and twisted I am actually understating. I'm kind of nauseous from talking about it again cause I haven't revisited it in awhile. I just remember that being in the top 5% of your class and honring every single one of your clinical rotations except one and 3 months of studying Kaplan Notes and doing UW with a cumulative of 66% wasn't merely enough...not even close. Not for the exam I took.
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| DaddyO
Forum Newbie
Topics: 2
Posts: 27
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I just finished writing another long post and now I'm thinking back and wondering if I should have been so honest about my experience because I don't want to upset anyone or deter anyone or scare anyone. Now I really feel bad because I was so honest with my exam experience and I am so so so sorry if it scares anyone. I just was so honest and detailed because I wanted people to know and since I heard that someone had doubted that my experience was not true until they had a similar I wanted to retell my story so people can know.
Just be prepared. Sorry if I scared anyone...I would never do that intentionally.
All the best.
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| virgola82
Forum Guru
Topics: 85
Posts: 348
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It's ok, I mean you definitely scare me but it's good you did because at least now I am prepared... I am very sorry for what happened you... It's ridiculus to allow this kind of test to be administered. This is not the way to select people... I think the test you got must have been something like dr fischer's q book, a book that I hate because qs are so twisted that makes you actually confuse more than what you already are. I did some qs from it and then left it because thought it was too tough. Maybe i should have prepared some more on it.... Anyway I am sorry to hear such a variability in tests difficulty and wish you all the best for your next try. I hope this time you're gonna get an "arlete-kind" test
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| arlete
Intern in 2009!!!!!
Topics: 30
Posts: 2,208
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young_doc:
You are welcome! We are all in the same boat...
Doc_clotaire:
Congrats for passing, I bet you will find a good residency program, although not Harvard, good enough to train you and make you feel secure when working by yourself, in a few years.
Thank you all for sharing your experiences and being so sincere, it's not easy to, when you feel low. Some people only talk when it's bragging...
Kisses, I am praying for you all.
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When men make the rules, God decides the exceptions.
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