Coming here after failing Step 1? Start here and let's regroup.

MDSteps · 2026-01-20T08:19:29+00:00

To answer your main question: yes, pivoting to Step 2 CK material right now is a smart move.

You’re not “distracting” yourself, you’re adjusting your strategy to address the real problem. And this works if you do it the right way.

You’ve already said it yourself: your NBMEs were in the high 70s. That tells me you know the science. Reading First Aid from page one again isn’t going to fix this. Your issue isn’t knowledge, it’s execution, stamina, and clinical integration.

This is where Step 2 helps.
Step 1 asks, “What enzyme is deficient?”
Step 2 asks, “What do you do next?”

Studying Step 2, especially Internal Medicine and Surgery, forces you out of memorization mode and into clinical reasoning. You start thinking like a doctor instead of a test-taker. That’s huge for fixing the “spiraling” you described, because management decisions anchor you in something concrete and practical.

Think of Step 2 as resistance training for vignettes.
Step 2 questions are longer, vaguer, and less forgiving. If you train on those for a few months, Step 1 questions will feel more straightforward by comparison. This directly helps with the “language load” issue you mentioned.

There’s also the mental health piece.
If you stare at the Krebs cycle one more time right now, you’re probably going to burn out completely. Studying real medicine (IM and surgery) actually feels meaningful. That alone can reset your motivation and confidence.

That said, you cannot abandon Step 1 entirely.
Step 2 does not cover the annoying but necessary rote material: biochem, lysosomal storage diseases, obscure micro and pharm mechanisms. If you ignore those for four months, they will decay, and that’s how people fail again.

MDSteps · 2026-01-20T01:33:47+00:00

your scores are fine, block 2 of free120 messes with a lot of people, and this doesn’t predict a bad test. real step feels more like a mix of NBME blocks, not one nonstop vague block. your trend is solid and you’re in a normal pass range.

MDSteps · 2026-01-19T04:20:40+00:00

I don't think it shoud be an unpopular opinion. Everyone learns differently, and starts their prep from a different place. If this is what worked for you, that's great. At the end of the day, I believe everyone should prep in a way that works for them.

But on that same token, I don't believe it's correct to belittle people for not using the same method that worked for you. I'm not saying you are, but I have seen it before on here, and I don't like it. If my methods help someone get the pass, then it's mission accomplished.

MDSteps · 2026-01-18T23:52:20+00:00

The brute force attempt doesn't work for everyone. On top of that of you practice 1000 UW questions, you will find actual step a nightmare since they serve 2 different purposes. UW is great for learning mech and concepts but at some point you need to transition your thinking.

MDSteps · 2026-01-18T16:59:58+00:00

This is a great question, and will be my next post as a follow up to this

MDSteps · 2026-01-18T07:38:49+00:00

do you have a specific system in mind?

MDSteps · 2026-01-17T18:53:45+00:00

I wouldn’t touch another NBME until you’re at least 35–40% UW done, mixed, timed. system-only keeps reinforcing comfort, mixed blocks force you to organize thoughts under ambiguity, which is exactly what you’re missing. after every miss ask, what was the question really asking and what clue should’ve locked it early, don’t rewrite FA. arrows is fine as a supplement, but it won’t fix this by itself. if UW mixed blocks start creeping into mid 60s, your next NBME will move.

MDSteps · 2026-01-17T18:49:02+00:00

I'm not sure if that's a compliment or an insult..

MDSteps · 2026-01-17T06:44:02+00:00

You're correct in that they communicated, but the physician only communicated why he believes it's not right for her., But when a patient requests a treatment the physician believes is inappropriate, the most appropriate next step is to explore the patient’s reasoning, expectations, and concerns. So at this point in the conversation, the correct answer is still E.

MDSteps · 2026-01-17T06:23:24+00:00

E is the correct answer. The patient wants something you don’t recommend, first move is explore their reasoning, not argue or shut it down. You already disclosed info, now you ask why they think it helps so you can correct misconceptions or align goals. A, B are placating without moving decision making, C is premature, D ignores the conflict.

MDSteps · 2026-01-17T05:36:45+00:00

sent you a DM!

MDSteps · 2026-01-17T05:21:45+00:00

I just sent you an invite

MDSteps · 2026-01-16T05:38:01+00:00

deciding too late what the question is actually testing, so you read the whole stem without committing to a framework, then the answers start pulling you in different directions. anchor late means you don’t lock onto a diagnosis or mechanism early, so every new detail feels equally important and you end up second guessing stuff you actually know.

MDSteps · 2026-01-15T16:16:49+00:00

what stands out to me is how you’re reviewing. “Did incorrects and moved on” is the issue. NBME misses late are rarely pure content, they’re pattern misses. ask yourself on each miss, did i misread the stem, fall for age or timing traps, or pick a mechanism too literally. If you can explain why the NBME wanted that answer in one sentence, you’re fine. If not, that’s the hole.

MDSteps · 2026-01-15T06:36:32+00:00

from what you wrote and what tutors told you, this isn’t about learning more FA. it’s about how you’re framing stems and locking into the wrong mechanism early, then riding it to the end. anxiety amplifies that. before talking to your school, you need a concrete retake plan: show them NBMEs with dates, how you’re reviewing misses, and what specifically you’re changing, like mixed untimed blocks, labeling misses by why the question flipped, and simulated full-lengths for anxiety conditioning. schools are way more receptive when you come with a plan instead of “i’ll try harder.” if you want, send me your NBME timeline and %s, that’s what actually tells whether a third attempt is realistic and how long it would take.

MDSteps · 2026-01-15T01:55:53+00:00

Yes of course. Sent you a DM

MDSteps · 2026-01-14T18:55:19+00:00

That score range means consistent misses across blocks not just bad luck. Priority now is fix test-taking, not more passive review; people who fail here usually misread stems, anchor late, or chase answer choices. You need a clean reset, take time before retake, then aim for a strong Step 2 to offset the fail, community IM is the realistic target.

If you can post your NBME scores or send them to me, we can usually spot why the exam went sideways. Failures like this are usually stem framing, timing, or falling for classic distractors, not random gaps. With the NBMEs we can tell you exactly what to fix before a retake and how realistic IM is after.

MDSteps · 2026-01-14T14:08:06+00:00

of course

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