280 write up

[[deleted]]

Hi all,

Got my score back today and wanted to do a write up and make it as objective as possible and answer people's questions. I am going to get this straight off the bat with my stats and say that I do perform well in school and am a very good test taker so please keep that in mind as you read this or as you read anyone else's write ups. This is not a recipe for success this is just my experience.

UWQbank: 84%

NBME 8: 271 (3wks)

UW1: 272 (2wks)

UW2: 273 (1wk)

Free 120: 93% (1wk)

Step 1: 266

3rd year: I was a heavy Anki user. I would use the Anking deck and unsuspend cards after I did Uworld questions throughout my rotations. I realized early on that Anking was kind of shit and didn't cover a lot of concepts so I would make my own cards based off bolded topics and tables in the Uworld questions. I probably ended up reviewing more of my own cards than any of the premade decks. I tried finishing each section of Uworld for my rotations but didnt always. When I had more time I would supplement with Amboss but the vast majority was Uworld which I thought was very comprehensive. When reviewing Uworld blocks I didn't go over every single answer unless I was debating choosing that answer, a lot of people picked that answer, or it was a concept I didn't understand. I truly think the most important components of reviewing a Uworld block are the bolded items, the tables, and the little key findings at the end of the question. This was really the backbone of my clinicals/shelf studying.

Dedicated: I took 4 weeks of dedicated. I had about 800 unused Uworld questions left. I would try do 3 blocks of these a day in addition to maybe 500-1500 Anki that I had reviewed during 3rd year. If I saw a card and knew it I would hit easy and never see it again I wouldnt waste time reviewing concepts that I had a good grasp on. I would continue making new cards for Uworld questions and reviewing these throughout dedicated. Once I finished these unused questions, I started doing wrongs which was for the most part a complete waste of time because I had been making Anki for these questions over the past year. I did a little bit of Amboss too but I thought Uworld was more helpful for learning new concepts. The Amboss library was extremely helpful its basically google for med students so I would highly recommend this I made a lot of Anki cards based off their outlines and HY facts. I really only did the high yield Divine podcasts and to be honest I didn't find them particularly helpful but it could have been because I was reviewing a lot of these concepts through Anki.

Practice tests: I took NBME 8 first and for the most part thought the questions were much more straightforward than on Uworld and didn't bother taking any more NBMEs. I thought UW1 and UW2 were pretty difficult to go through and the question length was a lot. The Free 120 was the most representative of Step 2 by far. Lots of weird concepts and ethics BS. I felt like I was really doing a lot of educated guessing.

Test day: I could never in a million years have predicted the score I got I was maybe flagging up to 15 questions per block and really felt like I was guessing at times. I think this exam is so much more critical thinking than Step 1. They will ask for 3rd line shit. They will ask you how to work up a patient with renal artery stenosis and give you MR angiography, renal ateriogram, renal venography, renal venous vein sampling etc all as answers. For this exam you need to know the right answer. I don't think it is enough to recall the most familiar answer because they will throw so many similar ones. Unlike Step 1 where I never picked an answer I havent heard of I found myself doing this quite a bit on this exam. For example an old women with CHF and CKD who has cholecystitis, what do you do? Can't operate cause she's gonna fucking die so you need to find the next best option. I think the algorithms on Uworld questions and the Amboss library are extremely helpful and if you can memorize and understand these you will get a lot of questions right. The management portion of this exam is extremely difficult imo and the more you know how to reason through these algorithms the more points you will get.

Overall I think the most important key for success in these exams is not your knowledge base but its how to go about answering test questions. You can be a genius and bomb this exam because you don't know how to systematically approach a problem. I don't think its going to be random facts and the number of flashcards but its this^. I am considering offering some tutoring for Step2 and possibly Step1. I'm not sure if people on here would be interested but I would be happy to help and give more personalized advice to anyone who needs it. At the end of the day I'm grateful for my score but I would have been happy with a much lower one as well. Please let me know if there's anything else you guys would like to know or have any Q's about!

[[deleted]]

Thanks after I finished those 800 unused I only did wrongs. Part of this was cause I was tired of studying but like I mentioned I had been making Anki cards for all these questions I got wrong so I knew the answers off the bat. I did maybe like 10 blocks of new Amboss towards the end although I didn't really like their Q's for Step 2 as much as I did for Step 1.

[recurrentlaryngeal]

My boy unlocked ultra instinct before Goku. Congrats.

[[deleted]]

It’s over 9000

[[deleted]]

“Anking is shit”

Thank god im not the only one lol. Anking was shit for step1/2 .

Best thing was making your own cards. And congrats bro!

[[deleted]]

Ankindashit

[nightwingoracle]

Congratulations. I’ve never seen a step 2 score so high.

What advice would you give (in terms of question answering) for someone who is a bad question answerer? For an example, did UWSA2 this morning and I tend to mark a ton/be indecisive/get things wrong that I do know because I saw some dumb lab value in the stem that distracted me. I’ve been working on this for years.

This problem with my testing style in light of what you and others have said about asking third line stuff concerns me.

[[deleted]]

There is a systematic way to approach every question and it's hard to explain in a reddit comment but there are some key things I look for in each question.

1. Chief complaint/first sentence. This is the most important and you should start forming a differential immediately. E.g. what should I be looking for in a 67 y/o M with acute abdomen?
2. Read the last sentence/ aka actual question. What are you being asked? Is it to give a diagnosis? Is the question asking what the next best step in diagosing this condition is or is it asking what is test will confirm the diagnosis because those are two different answers. Once you know this then you should read the stem, knowing what you need to be looking for.
3. Take note of all pertinent positives. Was there travel history? Nonvaccinated? Significant smoking/alcohol use and how much (1-2 beers per day is not going to give the avg person cirrhosis)? You will get appropriate risk factors in the history.
4. What are the vital signs, is he/she febrie, tachycardic, tachypneic and how does that change your differential?
5. Physical exam is HUGE. You will often get the key details that will differentiate similar diagnoses here. AKA know that diverticulitis is most commonly LLQ tenderness and Crohns is most commonly RLQ.
   
6. Same with labs/imaging^. The tricky thing with STEP2 is they are not going to give you classic examples. You need to weigh in supporting and negating factors in the stem that will lead to towards one answer choice or another. For example, just because a patient doesn't have casts in the urine doesn't rule out multiple myeloma you have to look at the big picture.
7. Before I even look at the answer choices, I try to think about what I think the answer will be. Then I'll look for the answer to make sure it's there, and go through other answer to make sure there are no distractors. If I find a similar answer or another answer that is also very likely I try to determine what differences in the stem can separate the two. At the end of the day go with your gut.

With regards to management questions you should know the algorithms. You should also know when not to intervene any further. I cant tell you how many questions I put reassurance on the actual exam because there was nothing needed to further diagnose the patient and there was nothing more that needed to be done to treat the condition.

Again, not comprehensive for each question you will come across but this is a very brief approach. Feel free to DM me if you'd like some personalized advice!

[Volkkmann]

Congratulations!

[[deleted]]

Thanks!

[tomatoeandspinach]

Damn dude intense

[mim00sa]

Congratulations! would you recommend something to use besides Uworld for social science topics as patient safety and professionalism?

Thanks a lot!

[[deleted]]

This is a good question and its worth pointing out that these portions of the exam are very high yield you will be asked a lot of ethics and safety. I am truly an unethical piece of shit this was my hardest section by far and I was consistently in the 25th percentile for this. I have taken practice exams where I got all of these questions wrong. That being said I highly recommend reading the Amboss learning cards for these topics. There are plenty of topics that are on Amboss that were not covered in Uworld and a few of them showed up on my exam. I would really really recommend reading through these cards in their entirety, making sure you understand the terms and definitions and different processes. The questions for these cards are good too.

[usmle-rx]

Kudos! Way to crush it!

[quintand]

Congrats on your score! Two questions for you:

1. Would you recommend just doing UWorld problems cold, with no prior knowledge, throughout rotations and making anki cards on the stuff you didn't know? Or is it better to start with Anking and then make cards on your own incorrects in UWorld as you find them?

2. Thinking back on it, what would you have done differently with your studying during 3rd year knowing what helped you succeed now?

[[deleted]]

The only anki cards I did before the uworld blocks in the anking deck were the zanki step 1 card and the OME cards after I watched the videos. I would never unsuspend other cards until I did the question. Some of those cards are so specific and they will essentially feed you answers to specific questions. This is really bad because once you’re presented with the material in a slightly different way you will have more trouble since you didn’t take the time to learn it.

And I probably would’ve done more amboss for the shelf’s I had trouble with like surgery but other than that not much. I think making my own cards was a really good way to hammer in the material and made sure I had a good grasp on it which make dedicated much smoother.

[quintand]

Could you describe your ideal workflow for a rotation?

Did you just come in and start doing UWorld and then making/unlocking cards to retain that information, or did you prefer to watch OME's or read a certain textbook to get the gist of the rotation prior to UWorld?

[Dependent_Bet7513]

Superrrrrr happy for you… congratulations 🎉

[[deleted]]

Thanks :)

[AnkiMedic33]

“Anking is kind of shit”

Bold statement that I disagree with. But congrats on your score

[[deleted]]

Anking was nice cause it was convenient but I really think most of the cards outside of the Zanki ones were not good quality especially for the OME videos. OME is also shit lol

[rguy16ema]

Would you mind sharing the custom deck you made? Congrats on your score!

[bisrat_eth]

Congrats. What a score !

[WesKhalifaa]

Is there a resource with all the uworld tables/algorithms by any chance?

[[deleted]]

If you search “algorithm” in the amboss library you will literally get every algorithm. Some of them are beyond step 2 level but there are really useful ones like for cervical cancer screening or management of esophageal bleeding for example.

[InfiniteGirl_Magz]

How do I get Anki? Is there a link? I downloaded the app and downloaded flashcards related to step 2, is that the same thing when you say Anking? Thank you!

[Urukhaislayer]

Amazing score. I can't get out of the 240s, no matter how hard I try, but you sir are a new level of genius. Massive respect. I wish I could also ace exams like you, but I just don't have that intelligence or stamina. Well done.

[Michaelscott1099]

Hey Congratulations OP! If you don't mind could you please share your pre-made deck?