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Overcoming low NBME scores - Zaroon Haider Khan

 

Hi everybody,

I am Zaroon Haider Khan, student of final year MBBS at CMH Lahore Medical College. Mostly a below average student, only producing good when necessary xD.  Mostly gulping huge volumes of knowledge in the last minutes. Someone who when studying always looks for shortcuts and always thinks about barely passing the exams, since I have a life and I want to focus on that too. On step 1 Alhumdulillah I was able to manage a 230s which to me is a quite comfortable place to be in.

I will write shortly about the gold standard method of step 1 as I will be talking more about the bad decisions we make and then bad results we see.

Standard Step 1 route

Time duration as a medical student: 12 months to 18 months.

Time duration as a graduate with lot of free time at hand: 9 months to 12 months

Time duration when it becomes pass-fails: 6 months

Sources:

1.       Medical school curriculum. When in medical school I would highly recommend studying course books thoroughly. Baseline knowledge and testing your studying methods in college exams will help navigate you to right studying strategies. Pick course books that align with usmle path. For example KLM for anatomy, just an example see what suits you best.

2.       Kaplan: mostly bnb has taken over it and it’s kind of outdated now and to me it’s a waste of time especially when its pass fail now.

3.       BNB: solidifies your baseline knowledge. Complete the lacking concepts in FA.  

4.       First aid:  gold standard and bible of step 1 as everybody would say. bnb and questions banks are keys to unlock and bridge the concepts written in here.

5.       Questions banks: essence of step 1, method to ace an American board exam, points out the highest yield concepts, keep you intrigued and connected, tool to gauge your day to day and overall performance.

6.       Anki: do anatomy shelf-notes (regret not doing it)

7.       Ethics:  100 cases by Conrad, uworld, Rx and amboss.

8.       Sketchy: I will kiss the sketchy team when I meet them. This man tells you that your college microbiology professor is a villain in the story and you should be having a rave at the time when microbiology class happens.  

First year and second year

Just do whatever you are doing, wholeheartedly. Go through as much syllabus as possible. Know as many things as possible. Pick usmle-oriented books and make a good grip of whatever you are studying. Baseline knowledge do wonders. Do BNB for physiology and biochemistry. You can enjoy first two years if you wish.  

Third year

This is where you should start inculcating step 1 studies among your college studies. SET A TARGET SCORE IN YOUR MIND. Do pharmacology from Kaplan, it was definitely helpful. It’s my bad luck that I didn’t like sketchy at first and did micro from levinson and came to sketchy in fourth year when Levinson couldn’t help me there. Do sketchy pharm if you can but it’s a lot. Do general pathology from Robbins but do Pathoma first 7 chapters here and if possible finish pathoma as well, you have a lot of time in third and fourth year.

This way you can pass the proff without even actually studying and worrying for it. Honestly don’t study for third year, study subjects of third year from step 1 course instead :D

Fourth year

Don’t study for it again and follow your step1 path. Your step 1 knowledge will help you pass 4th year pathology proff. I directly started doing Uworld and I still regret starting it late because I was 6 months into my 4th year when I started it. Start a question bank somewhere in your 3rd year. Don’t come to me telling me it’s not doable. xD  

Final year

Take step 1.

Took my exam on sept 08, 2021

CONTACT RECENT EXAMINEES:  stay in touch with all recent examinees. Ask them regardless of your level of friendship with them. You have no idea who’s technique might help you one day. Make a few your mentors, learn from their experiences.

 

 

MY PURPOSE FOR WRITING THIS WRITE-UP STARTS HERE

 

Why am I writing this?  

I am writing this because I see there is a bias on the internet about step 1 journey. We get to see a lot of write ups about the people whose first nbme score is a big hit-off and so are the scores and people who get average or low scores don’t post much about their experience, so when someone with low nbme score tries to find a way out of bad nbme score loop, he doesn’t have much to see around. Also it gives you depression and anxiety in a way when everybody started off with high nbme and you re the one sitting in absolutely wrecked ship. This makes you believe that step 1 Is something not for you and you start questioning your own capabilities. You tell yourself what a blunder you have made opting for this journey and the fear of losing step 1 haunts you. And this all is natural to feel about because you don’t have many experiences in mind about the people who got out of this loop because of the bias I mentioned above. I don’t think many people know that average first nbme score in the US according to stats is 192 or somewhere around that.

 After first round of uworld revise whatever you have in your book for one month.

So what to do about low nbme loop?

It’s about practice, patience, perseverance and an attacking mindset. Don’t let it take over you because it can.

1.       There are two ways to go about this: read FA and uworld annotations, which is pretty low yield way to do as you can confirm it from the sections of First aid book which tells you about methods to approach this test and from high yield to low yield approaches.  Keep memorizing and rereading the things in the book and annotations and I guarantee you that your scores won’t even budge by a few millimeters.   

2.       Questions, questions and questions. Can’t stress about this thing much. You should be aiming at doing around 7000-10000 questions. I know people who did like Rx, Uworld and Amboss and then many nbmes and reviewed them all. It’s like a game. You start off by doing really bad. Initially, it’s a disaster when it comes to percentages. What matters is that your scores curves should have an upward trend and you should be able to finish a section somewhere around 70-80 percent on first pass. For second pass it should be in 90s and the order should be first Uworld 1st pass then 1400 amboss 234 or 345 hammer questions from amboss and then Uworld 2nd pass.

3.       Questions polish you and offer your preparation of many months a perfect finishing touch.

4.       In your second round. Do 100 questions with thorough review daily. All timed all random. 100 100 100 a day would be like 3000 questions in 30 days and that has a huge impact at the end. If possible, do 120 or 150 each day. Its interactive, touches all corners in your brain and pretty intriguing. Keep doing it till you see yourself up the racks where you want your scores to be in. This helps you go through max syllabus in minimum time. It gives you idea of your progress on day to day basis. Combined with nbmes every weekend you can actually gauge your performance on weekly basis.

5.       Start nbmes 2 months out. Start with uwsa1 and take it seriously since a bad first nbme crushes all your dreams in a blink of an eye plus uwsa1 plays the role of a mother in this situation.

6.       Keep 5 days for the old offline good nbmes. Do them as a home work too . See why you got them wrong. Do ten if possible. They are questions too, different angle to look at the same topic and highest yield topics since nbme is the board that makes your step 1 exam.

7.       I know a guy who got really low on uwsa2 but after spending one month on questions he was able to take his score up by 40 points.

 

I know this post won’t be any helpful one month from now but what you learn from step 1 helps you in step2ck process because the same methodology applies there also half of the stems requires understanding from step 1.  

 

CONCLUSION: PRACTICE QUESTIONS TILL YOU ARE IN A COMFORTABLE RANGE.

 

Last few days before the exam

Uwsa 2 and free120 are your final exams, after them just revise weak topics. See things that you would forget most. Do pathoma first 3 chapters and relax you got this exam. Exam is easy or at least doable after all you have gone through.

 

Please contact all your seniors or friends who have taken this exam without any hesitation.

Contact me at zaroonhaider968@gmail.com  





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