This article was originally posted in USMLE Forums After reading a few threads I decided I should show a different

side to the exam. I felt the exam was very clinical. It is 100% American - Female with Cancers, Old, Obese, High Cholesterol, High Fat diets, Smoking, Lack of exercise = 100% on the exam. It's AMERICA...think why would I see an American patient? Understand the "what" in questioning from the biochemical to the gross of every major US MCC of death and MCC disease "X" found in America population (including RECENT immigrants). Understand physiology in simple simple terms that if I disrupt it(disease) what will happen - this is 98% of the test. I swear to this. The exam had some tough questions. However if you spent time on the UW or Kaplan qbank. I did both of them, the ?s were each very similar only with UW much more difficult in concept, which is great because you are learning while doing questions, not testing...this is key IMHO.. Kaplan Q bank brought me back to reality and out of the fetal position in the corner after UW questions, which I feel is needed. I did a few NBMEs so it wouldn't be too new or scary. I am an IMG at a small Carib school, and it wasn't too bad at all. The questions are not "what" questions. They are "why" questions, which is more important to me IMHO that my doctor thinks "why" and not "what" because it is impossible to memorize everything, but thinking "why" will never cease in learning its your Parietal lobes not the hippocampus doing the work in "why" questions. Honestly. Everyone on here thus far(IMHO) is grumbling over an exam (step1) they have 1) not taken 2) don't have their results (that would be me!) 3) Forget that USMLE has thrown away questions. Please read the websites on one's exams and follow the status on ones biggest exam. If its the most important thing, one should be responsible and show disregards of the "I don't have time" speech. Especially before going all mob like scared and confused wrapped up in a shower curtain with a bucket on your head running down the street. Going to the websites one would know that the NBME is trying to incorporate Step 1 and Step 2 together, IT IS going to happen folks, Now something as big as say THE USMLE, one would like to collect data over a period of time blindly to the subjects and never report the data results to the subjects, thus being able to turn questions on a dimmer switch (weighted grade assuming this is how it is graded) vs an on off switch in questions without the subjects ever knowing they are being tested on the throw away questions! So what does that mean? If I know that my test takers are trying to incorporate step 1 and step 2 (more clinical), I should prepare for battle by at least reviewing some clinical findings (UW has a ton of these questions)

in the top ten of diseases in all organs, it takes about another 20 mins per system of time. Now it would stand to reason that the really really clinical question in STEP 1 (how does one judge this is beyond all me) it is safe to assume on the side of statistics that this question probably is going to be thrown out. My understanding of the math, please correct me. They say getting 60-70% is passing the USMLE. What they don't really say is this is after removing the thrown away questions. NBME says 10-20% (I believe its on the website) are thrown out. thus remove 10-20% of the questions from the block and the wrongs you got within those 10-20% don't count against your 60-70% right you need. You need to get 136 questions WRONG to PASS with just saying you need to get 60-70% of the total questions right. What about my theory? - that number would be even greater, I believe a teacher told me it wears down to roughly 45% right to pass. THAT IS A LOT OF QUESTIONS YOU CAN GET WRONG. They are there to trip you up. OF COURSE you are going to get this question wrong. THEY KNOW THIS...but the next 3-5 questions will be fairly easy. Did that really hard one mess you up and you get these simple 3 questions wrong? - THAT IS ANOTHER TRICK OF THIS EXAM BE READY FOR THIS. USMLE score on my educated guess: One's score based on a weighted question exam shows that on past data this score signifies that this type of person scored this exam greater than passing score which others have found a correlation with GPA and MCAT scores (with a p<0.05) and various other records on an individuals life that say a LICENSING committee has access too, in order to allow this exam taker to remove tissue/organs and directly issue a specific non-food item into another human's blood, digestive, etc system with a sound intelligent thinking mind all based on statistics. This would be one of the only mathematical ways to produce a doctor. It doesn't mean there are not other ways, this way you can produce a good doctor based on math which shows a percentage of a probability not possibility! We are the directors of our possibilities even when it is not probable, it is still possible! That is step 1 IMHO. Be probable in thought process more then possible. Thus everyone should calm down, take the time to read the websites and follow what is going on. The audio's were ridiculous but there was only maybe 4 out of 336. Yep 4 out of 336. I am not going to cry over that. Why would I? I focus on the "why" in the question. UW questions: read the website! -they say students that use their question banks score higher than average. I believe namely that one can say average being 220 SD 20 = UW scores for greater than 50% are from 200-240. If you read the research on NBME and apply it to UW stats which they are using. This is simple math. UW qbank scores are 50-60% for first time! 60-70% second time, So what does that mean? - first time stay above 55% (on random 48 ?s) REVIEW REVIEW

REVIEW, RETAKE THE the qbank exams you made. Don't click on the answer because you memorized. Read the entire questions with the answer you know to be 100% true (you just did it!) find out in the question WHY would you pick the answer by reciting the answer to yourself as you read the question take the next 4 or whatever question's wrong answers and read the vignette and figure out WHY you WOULDN'T YOU pick this answer that you know is 100% to be wrong. THIS BUILDS CONFIDENCE IN YOUR THINKING PROCESS = a HIGH STEP ONE SCORE. It takes time and it sucks but it pays off, because understanding why, you don't have to know the material you just know that these 4 answers are dead wrong and this last one here letter E is the only way physiologically that makes sense in any question. USMLE to me on the my bests blocks (not all my blocks) 35 questions even a C student should know 100%. (73% total) 5-7 questions of just sheer torture = 35-49 questions total 6-8 questions that a B student should know 100% My grade score scale: B = 62% on UW on the last 200 random questions C = >55% on UW on the last 200 random questions All questions even if you remember them because I had questions on the exam that I had in the NMBE NUMBER 6 on my step 1! - this all gives you the whole pool of questions not just your last ones in case you did. My stats: total UW 57% total Qbank 57% Last 300 questions UW 61% Kaplan 64% UW comp I exam 490 - 214 UW comp II exam 500 - 220 NBME number 6 $60 (3 days prior) 500 220 My score? - I will chime in and tell ya Jan 14th. I reviewed my NBME and studied the questions I got wrong, looked up the answers and tried to UNDERSTAND WHY the test writer wrote like this. this was the biggest gold nugget. IMHO doing the NBMEs with review ($60) ones were the best bet. You can review real USMLE questions you got wrong and figure out the answers (look them all up) and re read the "why" in the question making" Don't disregard though about knowing the "what's" though, It is medicine. Its not the for the weak, It shouldn't be. You have to be confident in your answers be confident in yourself even before stepping into the patients room or in the test

room. Believe...even if you are scoring something that you don't like, find your weakness, fix them, understanding your weakness is crucial because after the step 1 I can say I knew my weaknesses two weeks prior before the exam and their they were right on the exam right there to haunt me, but I felt I prepared for these weaknesses, I accepted that my weakness will be on the exam and not be in denial and think they wont be on there, ALL my weaknesses will be on there. Almost all were. Denial is not the same thing as confidence in you. First Aid, Goljan Rapid Review Path and Clinical Lab, and Questions are all you need for this exam. But use everything you personally love. Understand the "why" in the question when you review them, On practice exams: SLOW DOWN on DOING QUESTIONS at first, Do 5-10 questions a day at first read all the multiple answers, understand WHY you DO and why YOU DON'T pick one of the 5 answers. 10 Questions review all 5 possible answers = 50 total possible questions. Develop this thinking pattern. I KNOW it SUCKS, its ANNOYING.. It's SLOW...but it is so worth it, I cannot tell you enough. Thanks to a Path II teacher, THANK YOU teaching ME THIS! Understanding how to read charts and graphs too for every disease that has one in FA =100% chance you have one on the exam so do it! Good luck Good luck God bless those taking the exam. Have a little faith in yourself. Good luck to all those taking it. Maruthas I base all my numbers and grades on my opinions as others will differ but from my understanding of myself, 3 people from US schools, 16 students from my school this is my conclusion. All these individuals shared with me all their scores throughout our studying and I feel these to be more solid than some bumped scores I have seen on threads making them incorrect by a large shot. The numbers all fall in line with Kaplan predictor score, NBME score predictor and UW comp predictor and UW equation predictor.

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