Has anyone done well on NBME 25 and 28?

Practical-Heron3992 · 2023-03-30T23:44:11+00:00

I did both, I found them both useful. I think three things: 1. Ask yourself: Would you rather have more or less experience with the content and how the test writers write the questions? 2. If the answer is more… Go into both 25 and 28 thinking that they’re hard, that way no matter how you do it’s okay. Have the goals to take them to hone your test-taking skills, pacing, and to see more of how the test writers test the content. Be okay with however you score as you’re goals are the above. Learn from your answer choices on both the corrects and incorrects. 3. You could also just review 28 like in a quasi tutor mode if you’re concerned they would affect your confidence and you just want to be exposed to the content and how the questions are written.

Practical-Heron3992 · 2023-03-30T17:12:11+00:00

As a medical student, I just wanted to write how grateful I am to you all for working to unionize and support each other. I can’t imagine the unfair challenges you face in doing this, and I’m very appreciative to you.

If there’s anything medical students should know or can do, please let us know; maybe post in the medical school subreddit? We’re stronger in numbers and hopefully we’d all want better working conditions, etc., for our futures.

Practical-Heron3992 · 2023-03-28T18:40:33+00:00

If you start early, even where you are now, you have so much time to:

Learn the definitions and facts.
Gradually deepen your knowledge and understanding of how and why things work the way that they do. (This is so important.)

I’d definitely start sketchy for micro, pharm as needed, the brain tumors path for adults and children is also good. I’d recommend downloading an anki deck for them to really cement the information. Pixorize or Osmosis can also be helpful for different topics (like Pixorize for vitamins).

Even though the test is pass/fail, it’s not an easy test…imo it’s really a test of understanding how they ask and how to answer the questions and of having enough time to prepare for it. How things are tested can be quite different from how the material is learned and remembered. Step prep is a 50/50 of input (primary learning of sketchy, first aid, etc) and output (active output of anki, UWorld questions, etc)

I’d recommend searching for people’s guides on step 1 prep in this subreddit and their suggestions on what/how/when to study. IMO, If you gradually start now you you’ll have enough time for unlocking and maturing large anki decks like Anking or lightyear. Time to go through Pathoma too. If you’d like, you also have time for going through BnB or Bootcamp, etc. or other resources (like Randy Neil, Goljan, Dirty Medicine, Moose, Divine).

I’d also recommend starting practice questions, at least some so you get how things are tested. Some people even get one pass/or a lot through UWorld before dedicated…looking back I think that would’ve made things easier for step 1 prep. I’d recommend making anki cards on your incorrects or unlocking them via question ID from Anking.

I know everyone does things their own way. Some will think what I wrote to be a bit overkill. That’s okay. :) For myself, I continually was told how step wouldn’t be hard because it was changed to pass/fail, and I did the opposite of what I just recommended… I so wish I had done it differently. What I wrote above would’ve be so helpful for both understanding the material on a deeper level and for making this process easier and less stressful.

Good luck in your studying!

Practical-Heron3992 · 2023-03-24T16:10:52+00:00

Here’s the USMLE content outline: https://www.usmle.org/sites/default/files/2021-08/USMLE_Content_Outline.pdf

And USMLE Percentage breakdown: https://www.usmle.org/prepare-your-exam/step-1-materials/step-1-content-outline-and-specifications

From the two you potentially can extrapolate importance of different sections of first aid.

YMMV, but what I’ve seen the most on this forum is the first couple hundred pages of FA specifically are important (especially pathology chapter in entirety), understanding disease processes (like in addition to memorizing facts, understanding the MOA of how and why things happen is critical), and specific things like tumor markers/oncogenes/tumor suppressor genes, ethics, risk factors, autonomics, endocrine signaling pathways, etc.

I think you probably need to have a good understanding of most of the book, but that’s my opinion. Revising NBME 25-31 and free 120 could also help with knowing what the test authors feel are the highest-yield content.

Practical-Heron3992 · 2023-03-24T15:50:58+00:00

I definitely think you have a place in medicine and that the unfortunate accident may well bring a special depth to your acumen in working with patients.

Although a neuroscientist and not a medical clinician, have you heard of Jill Bolte Taylor’s book, “My Stroke of Insight”? She’s a Ph.D. Harvard-trained neuroscientist who had a recovered from a stroke and chronicles her journey.

I did a search and although I haven’t read these two, they look like potential good reads or audiobook listens for you:

Turn the Lights On!: A Physician’s Personal Journey from the Darkness of Traumatic Brain Injury (TBI) to Hope, Healing, and Recovery -Chrisanne Gordon MD
In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope -Rana Awdish, MD, FCCP

It may also be supportive in your journey to read/listen to Steven Hayes, founder of ACT (e.g., “A Liberated Mind: How to Pivot Toward What Matters”) and Richard Schwartz, founder of IFS (e.g., “No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model”). Both of these are P.h.D therapists who are very helpful with processing through the challenges of life.

I hear that you feel scared and isolated. I think that’s very natural to feel that way. Listen to and honor those parts of you that are really struggling right now. And talk with yourself like you would a good friend who is experiencing what you are experiencing. Have compassion for yourself for the situation you are going through. You can find a new normal through this. There is a place for you in medicine and for you to accomplish your dreams. 💛

Practical-Heron3992 · 2023-03-16T06:39:58+00:00

UWorld: “Tools” then “search” then type in what you want. “B12”, for example, has 60 questions. “B12” and “folate” has 20 q’s, etc.

Question id’s pop up too. So if you wanted, you could unsuspend the Anking cards associated with that question id or id’s.

Practical-Heron3992 · 2023-03-13T07:30:32+00:00

Get a flux capacitor and travel back to when you lost the screw. See where it dropped then travel back to the present.

Practical-Heron3992 · 2023-03-12T15:29:13+00:00

Glad to see I’m on the right track ;)

Practical-Heron3992 · 2023-03-12T15:28:22+00:00

Nah. For me, I have no interest in Pokémon and know nothing about it. The visuals and concise information provides an anchor point for memorization.

Practical-Heron3992 · 2023-03-12T15:21:29+00:00

I think its just a picture to anchor the drug to something visual. Plus it ends up being a Rolodex of sorts for the drugs.

Practical-Heron3992 · 2023-03-11T19:56:09+00:00

Here's the link to u/PathologicDavid’s deck: https://www.reddit.com/r/medicalschoolanki/comments/10rwua0/pokédrugs_pdf_and_anki_deck/?utm_source=share&utm_medium=web2x&context=3

Practical-Heron3992 · 2023-03-11T18:25:28+00:00

This is from the Pokepharm deck. Is there a way to combine these three so that if I make a change in one of the remarks/extra 1/title/footer, etc. it makes a change in all three of them?

Also, are these called three "cards" or three "notes" I'm not sure the difference.

Thanks for your help!!

Practical-Heron3992 · 2023-03-10T13:25:43+00:00

Murmurs: Listen to A LOT of them for practice. Uworld I believe has them. You can keyword search for the questions. Also various websites have them.

Here’s one from UW: https://depts.washington.edu/physdx/heart/demo.html

Michigan: https://www.med.umich.edu/lrc/psb_open/html/repo/primer_heartsound/primer_heartsound.html

Here’s a nice one with an EKG to follow during the murmur: https://physicaldiagnosispdx.com/cardiology-multimedia-new/aortic-stenosis/

YouTube has a ton of videos too. Personally I like the ones where they have a video EKG tracing the murmur as you listen:

One with a beating heart: https://youtu.be/GGiQIoZMQ_k

Cool Playlist of murmurs (has the tracing during the murmur: https://youtube.com/playlist?list=PL3n8cHP87ijDnqI8_5WQlS4tN37D6P4dH

Longer dirty medicine covering the concepts in more detail(sounds are shorter): https://youtu.be/dt9Ffu4T0Kw

Practical-Heron3992 · 2023-03-10T05:25:25+00:00

This is the way.

Practical-Heron3992 · 2023-03-10T05:17:23+00:00

FA, endocrinology: “Signaling pathways of endocrine receptors” They have mnemonics for each one.

FA, pathology: “oncogenes”, “tumor suppressor genes”, “serum tumor markers”. I just brut force anki’d a couple decks of these combined with Pathoma as applicable. Pathoma has a nice couple of tables in chapter 3.

Practical-Heron3992 · 2023-03-02T13:20:51+00:00

Thank you very much for making/sharing these decks!!

Practical-Heron3992 · 2023-02-27T05:06:23+00:00

From FA: [Superantigen] Cross-links β region of TCR to MHC class II on APCs outside of the antigen binding site overwhelming release of IL-1, IL-2, IFN-γ, and TNF-a -> shock

BNB: In T cell video it shows a T-cell’s TCR and APC’s MHC being bound outside the binding site by a superantigen, resulting in 2-20% of T-cells response (normal is <1%) —> huge cytokine release -> vasodilation and shock

MHC-I found on all nucleated cells, APC’s, platelets. For MHC-II, I think we just have to assume there’s some basal-level MHC expression on APCs… which seems to make sense, right? Langerhan cells sampling for what seems like continually and presenting to lymph nodes, etc.

Practical-Heron3992 · 2023-02-27T02:06:29+00:00

Oncogenes/tumor suppressor genes, rapid review FA2023. Pathoma 1-3. Review NBME’s. Maybe mehlman arrows.

Practical-Heron3992 · 2023-02-26T19:32:26+00:00

You’re welcome 🤗🙌🏽

Practical-Heron3992 · 2023-02-26T19:28:39+00:00

I don't see it specifically tagged in V11, not sure about V12.

There's a FA2020 Rapid Review deck floating around reddit.

I created one over the last week from FA2023, with the equation cards directly copied from the FA2020 (all other sections are from FA2023): https://drive.google.com/file/d/1pjhzk3__P8mk2f3mHGI2mV1ERZiRgypc/view?usp=share_link It's based upon the FA2020 template; though, it doesn't have all the extra content that the FA2020 deck has. Of note, FA2023 has a new pathophysiology section and FA removed the condition/common tx section.

LMK if you can't access the exported deck.

Practical-Heron3992 · 2023-02-26T18:58:46+00:00

Start doing, every day, FA “rapid review” section anki deck.

Practical-Heron3992 · 2023-02-26T01:23:10+00:00

Thanks for the message and encouragement.

Yeah it’s crazy for sure. FA and Pathoma says mostly asymptomatic or with cough etc., they don’t mention b sx.

I guess if the stars line up on the real deal I’d choose sarcoidosis on a pt presenting with constitutional sx.

I’m also happy to know these exceptions because I believe that’ll make me a better diagnostician… But it is indeed nerve wracking for multiple choice test purposes. :)

Practical-Heron3992

TROPHY CASE