Step I exam....how did you feel as you left the exam?

Pre-Med & Medical School Pre-Med Topics
1

A mom sent me a PM earlier this week wishing my son good luck on his Step I exam. She told me when her son took Step I, he felt like throwing up when he left because he felt like he failed. In the end, the son did quite well.

I warned my son about that possible feeling (feeling like you’re failing) so that he wouldn’t get too discouraged during the test.

Well, the test has been over for an hour and he and one of his housemates are feeling pretty down. I know that both son and this housemate have done very well at their med school, and both studied a LOT for this…over a very long period of time.

So…how did you all feel RIGHT AFTER (or during) your Step 1 exam?

Is the test so nasty because it includes everything under the son, and therefore there’s going to be a good bit that you don’t remember or what?

( The other housemate will take his exam later. …so his gut feel will be known in a few weeks)

2

S took Step 1 4 years ago. As such rest of post is what I can best remember, S indicated that USMLE has very large question banks that they can pull from that covered everything under the sun and then some, including questions/responses being developed for future sittings. I thought S stated that he understood that although USMLE tries to balance subject material matter for each sitting, sometimes luck of draw could mean variations between tests with one sitting having say a few more biochem questions than another sitting and if biochem wasn’t your thing, then it could be problem I also remember that questions were not a simple question but involved a patient’s vignette (ie short history of 3 or 4 sentences) often with not choices a through e, but a through k. You had a little over a minute per question to process lot of facts and potential answers. I also seem to remember S saying that it wasn’t type of test where there was a right answer, but asked for most correct answer. And questions often had multiple distractors where if you missed a certain signpost in vignette you could very easily end up arriving at “less correct” answer. It was simply hardest test he ever took (even including Steps 2, 3) in terms of breadth of material and the depth of understanding needed to do well. Very draining. But S felt good afterwards but with a will have to wait and see kind of response. S ended up with very good score. Good luck to S.

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If you search my name I answered this exact question on here a couple years ago

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@iwannabeBrown lol…link?? This??
http://talk.collegeconfidential.com/discussion/comment/16483237/#Comment16483237

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By the time D. took the Step 1, I believe that she got used to NOT knowing a lot on these exams. I do not remember any special comments, but I believe it is normal to feel the way your S. feels. It would be totally out of line if anybody felt that they did well.
D. did very well.

Do not get discouraged, just trust that he did as well as all previous exams in his life. This type of thinking has been very helpful. …and as another note of encourangement, while Step 2 is also hard, it is NOT as hard as Step 1. Send him some gift, the guy deserves it!!
D. will be taking Step 3 next year while working crazy hours in her Prelim year residency.

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<<<
it includes everything under the son


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lol…oops…SUN

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IWBB is giving too much work to moms and dads instead of spoonfeeding them. I am ruling out Geriatry as an acceptable specialization for him for not being kind to parents in distress. :slight_smile:

Here is the thread he is referring to.

http://talk.collegeconfidential.com/other-med-school-topics/1508736-usmle-step-1-p1.html

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@texaspg found the thread I was thinking of

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thanks

10

I thought it was miserable. I didn’t necessarily think I had actually failed (ever the optimist!) but I was not at all confident about how it went. I was exhausted. I was also bitter that I had to waste a perfectly nice summer day taking this difficult test that no one (besides my classmates) could understand the importance and difficulty of (a lot of my non-med school friends are in the fields of law, education, and business). I guess you could say I mostly felt numb.

My score was pretty consistent with my practice exams–I think they ranged from 228 to 240, and my actual score was 233. (If I’m anything, it’s consistent–my MCAT score was within my practice exams (29-35, actual score 30) too!) I didn’t bother taking a practice test for step 2, but was happy to improve my score by >20 points. And I, like 98% of other US M4s, passed step 2 CS.

Med students LOOOOVE pity especially when it is disguised as commiserating. I’m not sure why. They’re always trying to out-stress, out-work, out-complain, whatever each other. I’m sure your son is legitimately unsure what to think of his performance. But to probably jump to the conclusion that at best he did way worse than expected and at worst he failed is almost certainly incorrect, but par for the course as far as med students are concerned.

(Examples by year: “OMG I just studied biochem for 6 straight hours and I wanna die.” “Yeah biochem’s the worst. I reviewed all the notes and powerpoints for 12hrs this weekend and feel like I didn’t learn anything.”

“OMG if I do another Qbank question I’m going to lose it. I thought doing 1600 questions in 4 days was a good idea but it’s just making me hate myself.” “Yeah, I got through the kaplan Qbank 1.5x already and am nearly done with uworld, but my % correct just isn’t improving. I’ll probably fail or get such a low score I won’t match anywhere.”

“OMG my life sucks, I had to get to the hosp at 0445 to preround my gen surg patients” “I hear ya man. When I was on gen surg, my senior made me get there at 0330 on Wednesdays. It was terrible. At least you don’t have a 24hr L&D shift tonight like me.”

“OMG our lives are awesome!” “Yeah they totally are! I’m so excited for residency!”

“God I miss being an M4. That was such a fun and amazing year.” “I hear ya man. I’m on my 4th consecutive 14hr night shift and I feel like I’m getting sick and I don’t have more than 1 day off at a time until 3 mos from now”)

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“God I miss being an M4. That was such a fun and amazing year”

  • one comment based on D’s experience. I totally agree with this minus residency application. The residency application was pretty torturous and more so for someone who just “glide” into colelge and Medical School, with the applications cycles to both being more fun than stress. Well, D. had few “moments” on her Med. School interview trips, but none of that had prepared us to the residency application cycle. Thank goodness, she matched, not everybody was so lucky though.
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The really interesting thing for me about that was that my high school was the complete opposite. Kids constantly trying out-do each other with how little work/effort they put into things. Med school was like bizarro land for me.

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@mom2collegekids USMLE step 1 was the hardest test I have taken in my whole life just because of the sheer breadth of material covered. Hard to believe that was 20 years ago!
Fortunately, I took a 2 week prep class before the test called Arcventures that distilled the content to a manageable amount and for that reason I pulled off the second highest USMLE step 1 score in my class. The guy who beat me did Arcventures too!
If Arcventures still exists, I highly recommend it.
And yes - it is normal to want to puke before, during and after the exam!

PS - I bet your son did better than he thinks!

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<<<
Arcventures still exists, I highly recommend it.


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I wish I’d known about this before! lol

I think he did do better than he thinks. He’s not a fast reader and he mentioned something about some “gimme questions” and not having enough time for a few.

Well, no rest for the wicked…the day after Step I, he began his block for his Research Elective, which he’ll be doing for the next 90 days…and then rotations ( I guess) will start. ?

Part of me really thinks he did better than he thinks just because he has a good memory for info and he has very good reasoning skills. But…I also know that he’s a slowish reader, which may bite him in the fanny.

So…what’s the deal…I know he wants a competitive residency…so if he doesnt get a top score, does that mean that goal is dashed? His SOM doesn’t give grades…all they do is tell them which quartile they’re each in…and son has stayed in the top quartile the whole time.

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@mom2collegekids The USMLE used to be a factor in getting into residency along with grades etc. I am not sure how important the percentiles are nowadays. I will say this: I firmly believe that there are programs out there in any specialty available if you are willing to go to them.

For example, when I was applying for residency, orthopedics was very competitive. A classmate of mine who didn’t have very good grades managed to get into an ortho program in Detroit. Now I’m sure the neighborhood wasn’t nice, and the work hours were probably long, but you can do anything for five years if you have to…

So in summary, I dont think a substellar USMLE part 1 would be a deal breaker. Passing is the most important thing.
Most people do better on step 2 because it is clinically oriented. He can still make his mark there.

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mom2,
I can reassure you that your S. did much better than he feels right now. Do not worry, enjoy the fact that he is a bit free for some time before all other things will roll.
As D. commented, Step 2 does not have as much effect on residency application as Step 1. She did not have her Step 2 result when she applied (to competitive residency). She scored exactly 10 points higher than Step 1 on her Step 2 and somebody mentioned here (Kristin?) that they scored 20 points higher.
D’s SOM also is p/f, so basically AOA was out the window (only one person in D’s specialty got AOA and this person did not match as well as others, although the ultimate goal is to match, period, which was accomplished).

D. did not do “away” rotations either, while another person in her specialty did 5 of them. The result was that while D. had only 12 interviews, the person with “away” rotations had 20 and was able to attend 18 of them. However, at the end D. and the person with 20 interviews matched to a very comparable residencies. I would say that after 10-12 interviews, additional interviews seem NOT to make any difference. So, since “away” rotations are for the goal of obtaining the additional interviews, they may or may not make any difference. On the other hand, one person who did not match in D’s specialty, had only 6 interviews.
D. also did NOT have publications. Her big research paper (first author, no other med. students, all co-authors are MDs and other practitioners, will receive award at graduation for it) has been submitted, but we do not know results yet. She tried to publish few smaller things, but was not successful. But not all specialties are as research oriented as D’s specialty, so it may or may not be as relevent
What I am trying to say is that there are other factors in residency application than just Step 1 score. However, I am not in position to determine the weight of these other factors as my D. could not “show” them on her application.

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“So…what’s the deal…I know he wants a competitive residency…so if he doesnt get a top score, does that mean that goal is dashed?”

Although Step 1 is an important factor in considering whether to offer interview, it’s not the only one. All of his third year, perhaps early fourth year as well (e.g clinical performances, LORs (especially if from MDs in specialty), Step 2, MSPE, etc) also will play important roles in deciding whether S gets IIs to his desired specialty. The point is there is still much in S’s control which hopefully will go along with his soon to be learned strong Step 1 score.

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[QUOTE=""]
@mom2collegekids The USMLE used to be a factor in getting into residency along with grades etc. I am not sure how important the percentiles are nowadays. I will say this: I firmly believe that there are programs out there in any specialty available if you are willing to go to them.

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For example, when I was applying for residency, orthopedics was very competitive. A classmate of mine who didn’t have very good grades managed to get into an ortho program in Detroit. Now I’m sure the neighborhood wasn’t nice, and the work hours were probably long, but you can do anything for five years if you have to…
So in summary, I dont think a substellar USMLE part 1 would be a deal breaker. Passing is the most important thing.
Most people do better on step 2 because it is clinically oriented. He can still make his mark there.


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@Nerdyparent I will pass this along to son. thanks.


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Although Step 1 is an important factor in considering whether to offer interview, it’s not the only one. All of his third year, perhaps early fourth year as well (e.g clinical performances, LORs (especially if from MDs in specialty), Step 2, MSPE, etc) also will play important roles in deciding whether S gets IIs to his desired specialty. The point is there is still much in S’s control which hopefully will go along with his soon to be learned strong Step 1 score.

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@Jugulator20 Thank you…I will pass this along as well.

Do you think that “away rotations” help in a better way?

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" I firmly believe that there are programs out there in any specialty available if you are willing to go to them."

  • not in any specialty any more (based on D’s experience, I do not have any other experience). She mentioned that even in cases of not matching, her specialty does not have a “quick” scramble process, there may be some 3 spots not filled in the whole country and if you did not match, you cannot do anything between Mon. and Fri. of the matching week like it is done in other specialties.
  • "away rotations" help in obtaining more interviews. It is a normal practice to at least invite to "curtasy" interview all who rotated at the certain place. Actually, there are some places that would count your rotation as an interview. Depending on specialty there is a certain goal for the number of interviews. D's goal was 10 and it seems to be reasonable based on the results.

Looking back, D. think that one of the heaviest in her interview process was a great letter from nationaly known in her field person who was also known for writing “hard” letters. D. was told that at several interviews as the most of D’s interview places knew this person very well.

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@mom2collegekids YES - I definitely think away rotations at programs he is interested in will help - especially if he has a winning personality [which I’m sure he does! :wink: ].