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Thank you! The fastest solution is to go with your gut instinct and run. Just pick the one that seems right first. This second choice sometimes seems like it could be correct. Lastly, instinctively guessing the correct choice is another reason to do tons and tons of practice questions from a reputable source.

You can develop your innate question sense by practicing and practicing. Using low-budget or alternative questions can be a bit dangerous, as some of these resources over-test minutia or try to trick you in ways that are not typical of the real USMLE. Thanks for all the helpful tips! Students with good exam taking skills go a long way. Thanks for taking time to write this down. Best, Snigdha. A buddy of mine who was in premed classes with me, is super smart and hard working, and scored the same as me on every undergrad and med school test we had together scored shittily on his step exam.

Especially the three digit scores. Cheers, and nice work on that MCAT. May I ask you for an advice please? My strategy was to collect high yield materials from other sources and put onto FA First Aid , and then study and memorize FA. It sounds stupid, very stupid, but it is true. What should I do? My feeling is, whether or not your preparation was optimal, the only way to get an idea of what will happen on test day is take some practice tests.

Hi I found your article really helpul. I am realy worried right now COz my eligibility period will end in November but I have to leave for my home country to see my parents by early November. I took nbme 11 in september and scored and after revising first aid again I took nbme 13 today and score that I such a bummer coz i was planning to take my exam in next 2 weeks.

In part, it would depend on where your weaknesses are and the main reasons behind why you get questions wrong. I would like you to ask you some advice about improving my performance because my real problem is anxiety and low self confidence. I did the same for step 1 and I almost failed I got Thank you. Most people hurt themselves more often than not when switching in general. My normal advice is to only switch when you are absolutely sure the other answer is correct and know you made a clear mistake in your original choice.

But if the ability to switch is what causes you anxiety, just never switch. Thank you Ben, I really appreciate your advice, I will follow it on the uwsa that I am taking soon and will let you know. Thanks once more. Ben, could you tell me please the mean difference between leydig cell tumor and aromatase deficiency? Both cause virilization, acne etc.. Leydig cell tumors are acquired and thus have symptoms later in life, most frequently during young adulthood. Leydig tumors can but do not always produce testosterone, but they do not lower estrogen levels. Thank you once more , Ben.

Well I applied your advice and I got Never forget that the real thing can really feel terrible. The questions you had to guess on will weigh heavily in your mind. This is all test psychology. Thank you for your really informative article. Please what will you advise as focus of study for someone who scored 83 incorrect on NBME 7 ,most incorrect from General principles of health and disease and who has to write the test in 2months.

How can I improve in 3 weeks? Focus on questions, take time to savor the explanations. In particular, each question contains several possible additional questions in the form of the alternative answer choices. UW explains what in the question stem makes the best answer the correct one, but the explanations also teach you what factors would lead you to the alternatives. Learn to unlayer the stem; each line is in there for a reason.

Thank you man, I am doing exactly that, I am spending more time at the explanations and looking for the reason of every word. I need to work harder to get …not easy but not impossible!!! Hi Ben, I ran into a practice question from a qbank that is very similar to the trauma case? And among the familiar choices, CXR is selected as right answer because obtaining a radiologic diagnosis of the exact nature and extent of the problem the patient is fully awake and alert, no distended neck veins , and chest tube thoracostomy is wrong because should not be inserted blindly without yet knowing what is going on.

The patient may very well need a tube at the pleural base if the x-ray film shows a hemothorax, but the physician might prefer to put it at the top if all there is in the pleural space is air. What is your opinion on the answer of this particular question? That leaves you with a stable patient that you need to work up! In that situation a CXR gives you a gross analysis of his injuries pneumothorax, hemothorax which will guide the immediate management. Colposcopy is typically used to work-up abnormal paper smear results for cervical cancer or to further evaluate cervical abnormalities seen on a speculum.

Not as a first-line test for bleeding. The question stem is unclear if a speculum exam was included in the physicial exam. If it was, then it was normal and no colposcopy would be indicated in the abscence of abnormal pap results. Additionally, the story here is more indicative of possible endometrial cancer vs dysfunctional uterine bleeding: cervical cancer typically does not cause menometrorrhagia as often as uterine cancer, in part because there is no uterus to collect the blood.

So the bleeding is more commonly contact bleeding related to friable tissue after sexual activity, exams, etc. Lastly, her body habitus puts her at increased risk of endometrial cancer. Score I would like to apply for pediatrics and I got a bad score on step 1, Thank you once more. The improvement is solid. Your Step 1 would be fine for a US grad but on the low side coming from elsewhere. Hey Ben! When I go over the incorrect questions It disheartens me because most of the time I know the answer.

25 High Yield Topics for USMLE Step 2/3- Cardiology

Most times you will actually know the fact being tested even when you get it wrong. Part of doing questions is continuing to pair up facts with answers, and it takes time. One of the difficulties some of my former students had with studying through questions is that getting questions wrong can be demoralizing. Ultimately, this process of demoralization and self-doubt feeds into your anxiety.

This is a hard cycle to break. One thing I believe is that the more you care, the worse you do. I know, horrible- I actually was surprised I passed. Improving your Step 2 will be very important. Thanks for all the advice you post its really helpful. I took my step one and i failed. Im quite discouraged esp since i am an us img. But i know my problem was lack if confidence and not doing enough questions. I have a 9 to 10 week study period now. I will take your advice and focus on questions. I think anxiety and not doing enough questions probably account for essentially all regret when it comes to Step 1.

An alternative would be to buy a bunch of the NBME pratice exams, but that can be quite pricey. Ultimately, when it comes to retaking anything: If the previous failure motivates you, then use it as fuel to get through the inevitable tough times that dedicated study brings to your physical and emotional well being. Forget about it. Give yourself some slack and a clean slate. I have been reading all the comments on this site. I took Step 2 ck last month and failed it by 20points.

I would answer the last questions from every block in matter of 4 minutes. I was depressed even going through the last blocks. My question from you is, do you recommend doing anything else aside from what I mentioned? I have this fear in me now that it will be my second time taking the exam but I want to take it towards the end of august.

I would appreciate any honest word you might have for me. Thank you in advance. My thoughts on Step 2 CK are summarized here. Dedicated Step 1 review overall is probably not the highest yield use of time. Step 2 CK is a clinically focused exam. When you look at your UW stats, do they demonstrate any trends, areas where you are stronger or weaker? If you have weak areas e. Since time management has been a problem, then questions are probably where you need to focus the bulk of your time.

Timed mode is good, just make sure you really take your time with the explanations after. Hi Ben, majority of my studying prep will be doing practice questions from different sources. Also, did it help to master 2 step process thinking and 3 step process thinking while doing Q bank? I think the decision to annotate anything is deeply personal whether within a question bank, in First Aid, or in some Word document, massive PowerPoint slideshow, or complex spreadsheet.

I think the patterns generally emerge organically over the course of the study process. It is absolutely worth mastering the process of second and third order questions though to be clear, first order questions are actually quite common and third order much less so [except in UW, where they are seemingly omnipresent]. If you can answer the third order, you can nearly always answer the easier versions. Typically, common topics e.

Esoterica, say, a question about brucellosis, is more likely to be a straight first order problem. Thank you for your very comprehensive posts. I already know that.

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How to approach NBME/USMLE questions

Most appropriate next step in Mx? Most appropriate next step in diagnosis? Thank you again for This blog and being thoughtful enough to extend your advice :. Dear Ben , I have tried my very best to prepare for step 1. At the beginning of my preparation I was motivated and hopeful for myself and lived in the fairy tale world that hard work can beat any obstacle. My goal is I want my score to help me save myself from a lot of explanations that I might have to give later on to prove my worth on the time gap anyways.


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My exam period ends in 4 weeks. All I have to do has to be done NOW. I am left with one NBME to check myself , the last and latest one.


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  • I am so mad and sad at not being able to figure out where my deficiency is. Perhaps there are many. In my traditional school system I was not trained to be a critical thinker so through questions and UW I somewhat tried to improve that. I am a slow thinker too. I was not taught short cuts to questions that sometimes are great time savers but I tried to pick up the trends from UW as much as I could based on geography , ethnicity , gender.

    Pralidoxime within 6 hrs helps inhibit enzyme aging. The answer was atropine!! I cannot overcome that deficiency on my own. Numbers and calculations make me nervous when attempting a block in timed mode. Genetic questions look like riddles to me. In the real exam I might wrongly think they are experimental questions Cannot recognize murmurs. Electrolyte panels consume my time. I was thinking of doing UW in 7 block pattern just like the real exam a couple of times OR buying Kaplan Q bank for a month but I do not want to be bogged down by low yield stuff which many people say Kaplan Q bank is now that I am so near to my deadline.

    At the same time I want to improve my speed and recognition of question patterns , pick up clues , improve genetics , biostatistics and acid base questions. I think they are all better than me if they can score close to me with that thought pattern. What good is my knowledge if it doesnt translate to a rich score. So my question is : how can I improve my score without burning myself out within the next few weeks? You need to start by not beating yourself up. Your specific goal of is awesome and I hope you get it, but you need to know that goals are only helpful as a means of motivation.

    Not something to tie your entire self-worth into.

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    I would just focus exclusively on questions. When you get questions wrong, flag them and do them again. There are lots of reasons to get questions wrong and you need to approach the explanations as a chance to learn, not a chance to be disappointed. I want to repeat that. The reason UW and qbanks are good tools is twofold. The best way to see how to apply it to a question is with a question. A lot of people shortchange themselves on 2.

    You should almost want to get questions wrong, because then it means you have an opportunity to improve, a potential blindspot to weed out. The other thing people do is use that negative emotional valence to overread the explanation.

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    They take an exception and turn into a new rule. All of this comes from stress and self-doubt. Remember, this is about learning. You can switch to timed blocks to simulate the exam the last week. Get into a groove. Find the confidence to go with your gut, not agonize, not get stressed by a long question stem, etc.

    Screw murmurs. You can get by sometimes based on the history. The way to not burn out is to switch your attitude from fear to excitement. That is astoundingly exciting. I got a My UWSA scores 1 week out were and You should be in great shape to get That said, I have a friend just like you—same practice test stats—he got a Cannot thank you enough. I do see the pearls in your advice. I will be reading your message multiple times to apply it to the best in the last stretch of my exam.

    Since yesterday I have gone through your other articles even the one about how to study. I will update you. Really found this link helpful. Question is, how do I move forward? I have spring break in about a week and I was trying to figure out what to do. Should I finish up uworld and try to get through it again by dedicated which starts in may for me?

    Should I do a run through first aid more frequently and focus more on details? Do another q bank not sure which one would be good? I totally agree a huge part of it is about gaming the test and I do think uworld has taught me to get better at that and I learn incredibly well from doing questions. I think you can pick up more details and hone skills via questions. You may want to trigger such focused detail-review when you get a question wrong on UW. Track your performance by topic, and get individualized explanations of questions.

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