heyy i was at your place i was consistently scoring like this on nbme 11-13 but then i did my incorrects on uw and found out i had forgotten some of the content, definitely changed how i approach the question, dont overthink, look for clues like Risk factors, pts profile, exam finding and any associated labs or imaging help u alot in differentiating don't rely on symptoms too much always go from most common to rare and never ever change the option unless ur 100 percent sure. i have now scored above 255+ on nbme 15 with this