Step 1 score – 264

I had got my score report around a month back. Had been on vacation and couldn’t write my experience until now. Was about to start my CK preps, when I thought I’d give some feedback. Sorry if there are any errors, I typed this out very fast.

If I could give only one advice, it would be that you shouldn’t book the exam triad, unless your NBME reaches +/- 20 close to your target score. The amount of money that ECFMG earns through exam cancellations is too damn high.

Here are my NBMEs:

* NBME 13 242(?)
* NBME 12 246(?)
* NBME 11 244(?)
* NBME 15: 246
* UWSA 1- 253
* UWSA 2 – 260
* NBME 18 262
* NBME 16 266
* NBME 17: 264

Time of Prep

Graduated med school, and spent about 18 months or so on this prep – 6-8 hours for the first 14 months, and more towards the end. Spent the first 4-6 months just reading up on Kaplan, and watching every lecture video available. Am not so sure now, if it helped, and if I could start over again, I would just start with First aid. But it depends on your current knowledge level. If your base is very weak, you could quickly do Kaplan without spending too much time on it. In the long run, you’re not going to remember Kaplan or any other big textbook you’re going to study, and all that’s going to matter is UFAP – UW, FA, and Pathoma and what you make of them.


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So the lesser the time spent on Kaplan and others, the better it is, in my opinion. Please note, everyone’s very different, and in the end, you know what works for you.

Overall, the best thing I probably did with my prep was making my notes for everything and using my first aid digitally.

I started off with Pathoma and started making short notes on each topic on Microsoft word, with the intention of using it for revision.

Your whole prep should be designed for the revision period. I took around two months, but in the end, I had personalized revision notes on Pathoma, Biochem, Pharma, Immuno and Micro, all made in a tabular form for easy revision and reference.

All this while, I had started my First Aid reads by the side, as each topic got over. And every single part of FA, that I didn’t understand or was doubtful about, I Googled/searched book pdfs (Kaplan, etc.), watched relevant pieces of boards and beyond, and found the answer and copy pasted it as a comment box into my FA pdf. So that next time I was reading FA, I wouldn’t waste time dwelling on that topic or Google again. For parasitology alone, I did Sketchy. I made a ton of mnemonics either by myself or modifying on the ones from google. This probably was the core of my prep and took about 6-8 months by the side. And every time I had doubt, I could just use the search option in my first aid, and find the answer, since it searches through the annotations also.

I started off with UWorld next, and was surprisingly not that hard as expected, and was scoring in the late 70s and early 80s in each test. I also took digital notes specifically the parts of UWorld explanations that I thought were important, and useful and worth going through again, instead of writing them down. That took about two months, but I thought that was okay and worth it, in the end for revision purposes. Halfway through UWorld, I started the offline NBMEs (old ones) and annotated what I thought was important to my FA in the front of each corresponding chapter.


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With two months left, I had my UWorld completed once, First aid finished (explained and annotated), and the short tabular notes on each topic.

Then, I started the newer NBMEs 11, 12, 13, but my score stayed in the 240s and was wondering what I could do about it. I began revising First aid for a few hours daily. My friend had done Kaplan qbank, USMLE-Rx, Kaplan HY course, and DIT course, etc. (had been preparing for two years now), and he had just the screenshots of essential parts of explanations of them on his laptop. I really didn’t want to do Kaplan and Rx questions, as everyone kept telling me those questions aren’t representative of the real exam at all. He was kind enough to give me his huge folder of screenshots in exchange for my study materials, and the next three weeks, I spent revising FA and quickly reading these screenshots, spending time on anything that seemed unfamiliar, and rushing through ones that I knew. Spending around 12-14 hour days during this period really helped I think, cos the next NBMEs I did online, showed me in the 260s, and I was happy.

Last month, I finished one NBME/UWSA on a weekly basis, revised my short notes on each subject, managed to do one last read of FA, go through my UWorld screenshots, and also through all wrong questions of my UWorld and NBMEs as if I were doing them for the first time.
Towards the last four months, I was heavily addicted to the internet, and getting stressed out from posts about low scores and recalls, I decided to delete my FB profile, to maintain some peace of mind.

Like I said before, you know what works for you best. I had a lot of people call me crazy for using my pdf instead of a hard copy as my main FA, but I really didn’t notice any difference.

During exam time, I could remember the page of the pdf, just as well as I would have recognized the page of a textbook, I feel. And the best part of annotating into pdfs is that it takes way lesser time than writing down.


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Stay away from negative people. Keep talking to the nice ones. I tried out study partners for a few weeks, but found a lot of weird and crazy people around, and thought that it’d take time adjusting or finding a right study partner, and I didn’t have that, and I thought I’d instead do it alone. Anonymity isn’t an excuse to be an asshole, as a lot of people think. I heard about a few people getting questions from other exam takers, and also about few that got banned for it, and hence I didn’t want to play with my future and avoided the temptation of asking around for it.

Also, if you have issues that affect your memory like depression or problems that affect your exam taking skills like anxiety, or problems concentrating due to either, unless you get it sorted out, you’re never going to reach your real potential. So don’t be afraid to ask for help if needed. There is absolutely no shame in it. So if you’ve been studying for a long time, and still feel like you’re reaching nowhere, it’s time to ask yourself why, and actively seek help.

Sorry, if this has been longer than necessary. I had read a few such advice posts long back, and they had really helped. Will add more to this post, if I remember.

Some friends took four months for a 260, some took two years or more, and regretted all that effort, because, you really don’t need a 260 to match, and all that’s important in the end, is whether you match or not, and not this score. Having a well-rounded application matters more than your Step 1 score.

I believe in the end, this exam is about proper planning and studying smart, taking the exam at your peak; and your ability to deal with pressure, not about the months spent studying at all. Good luck all! You’ve got this!

Doubts Solved by the Author

Q – can you plz guide on how efficiently the NBMEs can b done? Because there are no explanations m finding it very difficult to understand why my answer is wrong. Thank You
A – almost all of the NBMEs have been explained either in Facebook groups or USMLE-Forums or Student Doctor Network. You might have to spend time searching for them though. You can search by NBME no in FB or google a line of the question, to reach the explanation. It does take a lot of time, but its worth it, since NBMEs are essential. Hope it helps.


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Q – What subjects were most high yield? Micro? Physio?
A – everything was asked. I think, studying some subjects more than others wouldn’t be a wise idea. Knowing physio is crucial for most concepts though.


Q – Congratulations, Do you think that taking the exam after graduation helped more than taking it during medical school?
A – I think yes, cos I had more time.



Q – great score congrats.did you take the NBMEs offline or online? How many correct needed for scoring 260? Please tell the correlation.
A – I think around less than 25 wrong in 7 blocks would be 260+ not sure.



Q – I graduated in the year 2011. Is it still reasonable for me to prepare for the USMLE?
A – yes people with more than ten years since graduation are also matching if they have good scores


Q – Is FA UW enough?
A – yes, I feel so



Q – can you please tell me how did you calculate the NBME offline? I know it doesn’t give a real score but approximately
A – rely only on online for prediction. consider offlines with +- 10



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  • Sid Reply

    Congrats! How did you feel about the exam? Was it hard or easy? How many questions you thought you got wrong after coming out of exam as compared to the score you got? I ask about hard and easy because NBME curves scores up or down depending on the toughness of the exam. I took mine a couple of days ago. Feel like missed about 25-30 questions. I know no correlation exists but your reply would give me an idea! Thanks!

  • Mukherjee Narayan Reply

    Congratulations on your success and best wishes for your future!

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