NBME score stuck around 200. help

[jack.jaret]

My test is in 2.5 weeks and my score has been stuck around 200. Pharm especially is killing me. There are so many side effects, I never know which one to focus on. How much can I really improve in 2.5 weeks? Delaying unfortunately isn't an option. Really starting to get depressed and freak out. Thanks for any advice.

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[recycledpaper]

Just gotta keep seeing them. Most drug cases have specific side effects that they like to ask about. So if you go for those high yield side effects, it's more worth your time.

Everything that is in UW is very good, obviously. Drugs that have narrow therapeutic windows are often tested so memorize those side effects (digoxin, theophylline, warfarin, etc). Also, if you know what the drugs do, most of the time you can kind of pick the side effect out of a multiple choice set.

 

[jack.jaret]

Do you think 2.5 weeks is enough? I still feel like I'm super close to failing :/

 

[Lya]

Do you think 2.5 weeks is enough? I still feel like I'm super close to failing :/

Have you tried sketchy pharm or picmonic? I used both for pharm and especially sketchy does a wonderful job. It might take several days to go through all pharm videos but 90+% of my pharm knowledge is coming from those two sources.

As you read FA, I would look up a corresponding video for each drug.

 

[deleted763299]

My test is in 2.5 weeks and my score has been stuck around 200. Pharm especially is killing me. There are so many side effects, I never know which one to focus on. How much can I really improve in 2.5 weeks? Delaying unfortunately isn't an option. Really starting to get depressed and freak out. Thanks for any advice.

Ok, first off... chill. Studying for Step 1 is pretty much the worst. It's normal to be stressed, and all of your classmates are feeling the pain. I think 2.5 wks is a considerable amount of time, during which you should be able to improve your score with diligent studying. What specialty are you shooting for? Review the NRMP match data here to get an idea of the kind of score you will need: Charting Outcomes in the Match, 2014

Next, why do you think delaying is not an option? If you walk into your dean's office and tell them you need to delay your Step 1, they'll make it happen. Several people in my graduating class did it. This is no problem, unless you have some other reason you can't delay.

For pharm specifically, I used pharmcards by lange (you can get them on amazon) to memorize the minutiae. If you are having trouble with side effects specifically, think of the drug's mechanism of action. Many side effects are a direct consequence of the mechanism. For example, SSRI's commonly cause nausea/vomiting/diarrhea. That makes sense because the gut has serotonin receptors, that are stimulated by increasing amounts of serotonin, thus the patient pukes.

Another way to think about side effects is in terms of toxidromes. For example, TCA's are anticholinergic drugs. The anticholinergic toxidrome is "can't see, can't pee, can't spit, can't ****". Boom! Now you know the side effects of all the anticholinergic drugs like TCA's, benadryl, scopolamine, etc.

 

[jack.jaret]

Ok, first off... chill. Studying for Step 1 is pretty much the worst. It's normal to be stressed, and all of your classmates are feeling the pain. I think 2.5 wks is a considerable amount of time, during which you should be able to improve your score with diligent studying. What specialty are you shooting for? Review the NRMP match data here to get an idea of the kind of score you will need: Charting Outcomes in the Match, 2014

Next, why do you think delaying is not an option? If you walk into your dean's office and tell them you need to delay your Step 1, they'll make it happen. Several people in my graduating class did it. This is no problem, unless you have some other reason you can't delay.

For pharm specifically, I used pharmcards by lange (you can get them on amazon) to memorize the minutiae. If you are having trouble with side effects specifically, think of the drug's mechanism of action. Many side effects are a direct consequence of the mechanism. For example, SSRI's commonly cause nausea/vomiting/diarrhea. That makes sense because the gut has serotonin receptors, that are stimulated by increasing amounts of serotonin, thus the patient pukes.

Another way to think about side effects is in terms of toxidromes. For example, TCA's are anticholinergic drugs. The anticholinergic toxidrome is "can't see, can't pee, can't spit, can't ****". Boom! Now you know the side effects of all the anticholinergic drugs like TCA's, benadryl, scopolamine, etc.

Thanks for the response and words of encouragement! I can't delay because I already have. I studied about 3.5 weeks and raised my score from a 160 to a 190 then burned out. So I delayed my rotation, took a week or 2 off, and started back up. I've been in it for 2 weeks and it feels like i've plateaued at 200 :/

 

[deleted763299]

Thanks for the response and words of encouragement! I can't delay because I already have. I studied about 3.5 weeks and raised my score from a 160 to a 190 then burned out. So I delayed my rotation, took a week or 2 off, and started back up. I've been in it for 2 weeks and it feels like i've plateaued at 200 :/

If you've already delayed, then it's go time! Put your feet to the fire and make what time you have left count. You've already improved drastically, and you only have 2.5 more weeks of this crap to slog through.

It's a little late for this type of stuff, but: Which resources are you using? What's your daily schedule like (hrs/day, breaks, etc.)? Are you taking care of yourself (eating, sleeping, exercise)?