USMLE Official 2018 Step 1 Experiences and Scores Thread

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Foot Fetish

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I've always wanted to start one of these...So here we go! :)

My stats:

M2
Test time: June 2018
Goal score: 270

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4 years old boy have been brought to the emergency department with his father after he found him in dark room. he said once I switched on the light, a bat "which was in the room" ran away.
on examination, there is no sign of scratch or skin marks. vital signs are normal. neurological examination is normal
what is the best next step ?

1) vaccinate the child
2) do not vaccinate the child
3) admit the child to the hospital under observation
4) MRI of the brain
5) prescribe antiviral medication and follow up week later

Can you guys help with this question

You do nothing, according to OME on Trauma Surgery for Bites and Stings.
 
That question they posted looks like it came right from sketchy, who says always vaccinate because it's too easy to miss a bat bite. But ^^^ sounds a little more up to date lol.

According to Mayo you always vaccinate because sometimes the bite can be very small and easily missed.
 
A little bit to late but I owe some ppl here to give back.

UWSA 1: 273 (less than a week b4 the exam)
UWSA 2: 263 (less than a week b4 the exam)

NBME19: 236 (two week b4 the exam)

NBME18: 254 (10 days b4 the exam)

Exam date: 20/6

Step 1 score: 256

Made a couple of naïve mistakes (very direct questions which I first do right then later changed to wrong) due to overthinking, but all in all more than happy with the result.

One shocking thing I never thought I'll see in a USMLE exam was the time adequacy. I had about 18 minutes remaining after finishing every block that I sometimes revised the whole block (which isn't always a good idea I made my silly mistakes this way) and sometime ended the block early to use that time in breaks :D
 
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A little bit to late but I owe some ppl here to give back.

UWSA 1: 273 (less than a week b4 the exam)
UWSA 2: 263 (less than a week b4 the exam)

NBME19: 236 (two week b4 the exam)

NBME18: 254 (10 days b4 the exam)

Exam date: 20/6

Step 1 score: 256

Made a couple of naïve mistakes (very direct questions which I first do right then later changed to wrong) due to overthinking, but all in all more than happy with the result.

One shocking thing I never thought I'll see in a USMLE exam was the time adequacy. I had about 18 minutes remaining after finishing every block that I sometimes revised the whole block (which isn't always a good idea I made my silly mistakes this way) and sometime ended the block early to use that time in breaks :D

congrats on that awesome score! Please share your study resources and your thoughts on the exam if you can. Thank you!!
 
congrats on that awesome score! Please share your study resources and your thoughts on the exam if you can. Thank you!!

I always try to simplify things for me so I used the least possible resources (FA, UW, B&B), never did Pathoma, started with Kaplan lecture notes but it was a complete distraction and waste of time.

For me B&B is the closest source to perfection for STEP 1; not too long not too short, to the point and very satisfying; unfortunately I knew about it too late so I didn't have the time go through all of it b4 exam I just used it to review some defective topics.

Exam was a little different from most of UW and NBMEs question but totally doable if you mastered concepts and knew how to apply it in different settings (I assume you heard this phrase a lot "master the concepts", I didn't know what it means until I gave the exam.
 
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I’m devastated. I scored thirty points below my practice test average. A 207. I’m a DO and I’m worried al my options are gone but family med
I am sorry this happened to you but a drop of 30 points is so rare that I think that you (1) Didn't take enough practice tests to maximize the diagnostic value (or use UWSA1 as your only practice test) (2) Didn't take practice tests in ideal condition (timed, not looking stuff up, not going through ANKI, Quizlet specific to that specific NBME/UWSA).

I am inclined to think you either took UWSA1 as your only practice test and scored a 237 and then took the real thing or you somehow tampered with your NBME practice sessions and got artificially inflated scores.

Not saying this to antagonize you but for future students who read this thread and get scared. NBME 18, 19 and UWSA2 have great predictive value when taken under ideal condition, a drop in 30 points is incredibly RARE.
 
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I am sorry this happened to you but a drop of 30 points is so rare that I think that you (1) Didn't take enough practice tests to maximize the diagnostic value (or use UWSA1 as your only practice test) (2) Didn't take practice tests in ideal condition (timed, not looking stuff up, not going through ANKI, Quizlet specific to that specific NBME/UWSA).

I am inclined to think you either took UWSA1 as your only practice test and scored a 237 and then took the real thing or you somehow tampered with your NBME practice sessions and got artificially inflated scores.

Not saying this to antagonize you but for future students who read this thread and get scared. NBME 18, 19 and UWSA2 have great predictive value when taken under ideal condition, a drop in 30 points is incredibly RARE.
I took NBME 13, 16, 17, 18, 19, UWSA1 and UWSA2. UWSA2 was the 237. All timed. All under test conditions. Never looked a single thing up. Did Zanki starting from day one of second year and matured the whole deck.If I hadn’t I would have understood why this happened. Or my advisor could have given me any advice other than just being shocked. What happened to me has no explanation and believe me I’ve searched for anything. For most people this won’t happen. I still am in shock it did to me.
 
I took NBME 13, 16, 17, 18, 19, UWSA1 and UWSA2. UWSA2 was the 237. All timed. All under test conditions. Never looked a single thing up. Did Zanki starting from day one of second year and matured the whole deck.If I hadn’t I would have understood why this happened. Or my advisor could have given me any advice other than just being shocked. What happened to me has no explanation and believe me I’ve searched for anything. For most people this won’t happen. I still am in shock it did to me.
Mind sharing your NBME scores?
 
NBME 13 was a 205 baseline
NBME 16 was 216 6 weeks out
NBME 17 was 225 5 weeks out
NBME 18 was 231 3 weeks out
NBME 19 was 235 2 weeks out
This makes no sense. I am sorry you are a statistical anomaly. Somehow all the NBMEs and UWSAs failed to detect your weak spots and the real Step 1 did because a 207 tells me there are gaps in your knowledge base that most other test takers don't have. It's still a pass and I doubt your option is limited to FM only if you do better on Step 2. Good luck!
 
This makes no sense. I am sorry you are a statistical anomaly. Somehow all the NBMEs and UWSAs failed to detect your weak spots and the real Step 1 did because a 207 tells me there are gaps in your knowledge base that most other test takers don't have. It's still a pass and I doubt your option is limited to FM only if you do better on Step 2. Good luck!
Thank you, I appreciate it! For anyone who ends up in a similar situation or has a disappointing drop,just hang in there. It’s hard but being any type of doctor is still an amazing gift. Good luck to you all!
 
is this year’s average still 229? Reading this thread I feel like national average is at least 245 and I can only do rural FM with my 230
 
A little delayed, but I just wanted to post this for individuals who score low on the CBSE and fairly low on their first few self-assessments, ending up in full blown panic. Or for people who get nervous in regard to what other people are doing and feel like they are falling behind and not doing enough. I am a non-trad US MD student with a mix of P/H my first two years. I focused on my classes and did not do anything for step until dedicated. I made a good step one schedule but realized it was unrealistic very early on and had to change my plans drastically. For the first 3 weeks I probably studied 8 focused hours, bumping that up to 10-11 focused hours the last 3.5 weeks (focused meaning no distractions - I probably was technically studying for much longer). I studied for 6 weeks and 4 days.

Step one goal: > 230

CBSE (before studying): 182.5
UWorld SA 1 (1 week of studying): 205
NBME 18 (3 weeks of studying): 203 (I was really rethinking my goal at this point and was absolutely demoralized)
NBME 16 (4 weeks of studying): 215
NBME 17 (5 weeks of studying): 230
NBME 19 (6 weeks of studying): 230
UWorld SA 2 (6 weeks of studying): 243
UWorld Questions: Timed random from day 1, originally scored around 40-50% with some even in the 30's, by the end averaging >70%, 66.7% was my overall average

Actual Step One Score: 241

Flashcards weren't my thing. I made some Anki flashcards but honestly never used them. I had a horrible percentage with the Rx flashcards, so I gave up on those early on. I didn’t start UWorld until dedicated and didn’t quite finish, I had 230 questions left. I was very thorough and read through every explanation, making a UWorld diary but never went back through my incorrects or diary. I maybe got through 400 Rx questions in weak areas. I bought Kaplan and barely used it (guilty of resource overload there). I skimmed some of the blue boxes in Moore since I was horrible in anatomy. I had used sketchy during the semester but it didn’t really work for me so I did not use this during dedicated. I used Boards and Beyond early in my studying. In retrospect, I would have used this throughout the year and then only watched videos in areas where I was weak since the learning was too passive and took way too much time (I think this is why my scores were initially fairly stagnant while I was watching B&B and drastically increased as a did more and more UWorld). I got through re-watching about half of pathoma (I had used this during the year). I listened to nearly all the Goljan lectures (some twice) during runs outside. I did run a marathon during dedicated which I would not recommend (it would have been better just to take that day off). I read through FA once and skimmed through areas I was weak in during the last 4 days.

There were thunderstorms the night before the exam and I was anxious so I maybe slept 2 hours, if that. I walked into the exam feeling like my brain was empty. I walked out of the exam in complete daze but initially felt like I passed. It felt like UWorld on steroids to me. I finished each section with about 10 minutes to spare (just like UWorld) and was able to revisit all my marked questions (I marked >50% in each section but am a very liberal marker). As the days went on, I slowly convinced myself I failed to the point where I was absolutely sure I failed. When I got my score (which was in line with my NBME 19 that I’ve read generally under predicts by up to 10 points) I was in disbelief. Would I have done things differently knowing what I know now? Yes. But just know that if you don’t complete everything, if you get off track with your schedule and don’t check all your boxes before the exam, you will probably be okay if your NBME scores are indicating that you are close to your goal. I prioritized practice exams over anything else, which is one thing I would not have changed about my approach. I also feel doing timed random from day one in UWorld, even though my percentages were terrible at first, was the best way to do it. Some exams M2 year were 6-7 hours, which I think really helped with stamina during the actual test.
 
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is this year’s average still 229? Reading this thread I feel like national average is at least 245 and I can only do rural FM with my 230

Curious about this as well. Obviously there is a selection bias with people on SDN but how are school averages this year compared to last year.
 
I’m devastated. I scored thirty points below my practice test average. A 207. I’m a DO and I’m worried al my options are gone but family med
Bro "head down and numbers up", meaning put this behind you and dominate your step 2, you will get plenty of interviews with a solid step 2 score, aim for 250+, you just have to apply more broadly to residencies, just study now and don't look back! have faith and be strong!
 
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Has anyone's school told them you class average yet? And serious question here, anyone know what rads programs would accept a 238 USMLE or 652 Comlex ( Comlex is high but I want an MD program)
 
Hey guys, I took the test on July 12th in Sydney Australia. I wonder if the result will be out this coming Wednesday? Thankssss :)
 
Curious about this as well. Obviously there is a selection bias with people on SDN but how are school averages this year compared to last year.

The average in my score report indicate it was 229. You’re obviously not going to hear from ppl who didn’t do so well or as well as they like.
 
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The average in my score report indicate it was 229. You’re obviously not going to hear from ppl who didn’t do so well or as well as they like.

Score reports show the average for 2017. But I think you are right that people who do well are more likely to post here. The average has been stable for past few years and it’s pikely still around 229.
 
Do the scheduling permits disappear on both Sunday and Monday or only Monday? I'm on the 4th week so I'd expect my score to be released this Wednesday and was wondering if anyone's permits have started disappearing yet? My test date was 7/9.
 
Did anyone else take it today (7/30)?

If so, did you feel like the blocks got progressively harder? By the end I barely had any time left at the end of my blocks. I usually avg around 10-12 min left at the end of my random/timed UWorld blocks to review my marked Q's (scoring 78-83%), but the real thing felt like all of the questions were specifically selected to use up 95% of my time.

That being said, it was a very fair exam. Nothing crazy out of the ordinary like people have told me. However, the test writers are clearly shifting from knowledge-based to knowledge + logic, or exclusively logic based questions.
 
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I took it today; just came back from the testing center.

I had the opposite impression, i.e., that the blocks were getting progressively easier. My background is in math/stats and I did some work/research in psychometrics (IRT, latent models) before going into medicine and I had the clearest impression that I was taking an adaptive test (by block).

Right off the bat my first 2-3 questions were insanely WTF and I ended up marking almost 20 questions on my first block; I'm a liberal marker but not that liberal.

Second block was undoubtedly easier, but still an easy 1 sigma above UWorld. Finally, on the third block I started marking about 4-7 questions per block and things seemed "normal". At that moment I was "certain" it was an adaptive test, which was quite a bummer as I "knew" I had screwed up by not setting my score on a higher plateau (in a nutshell, adaptive tests "converge" on your "true" score by changing difficulty as you take the test, or blocks, according to your right/wrong answers). Now, adaptive algorithms should theoretically be able to work both ways, hard->easy or easy->hard, though the former path takes a higher psychological toll, in my view.

That said, as Google make me realize, it seems the USMLE Step 1 Exam is NOT an adaptive test after all. As a matter of fact, as far as I could gather there is virtually no transparency whatsoever about how exams are scored etc. But that's a different thread all together.

In any case, I felt the increased time pressure as well. I usually had 10-18 minutes left in each UWorld block during prep (averaging about 75% correct) and I found myself with about 5-12 minutes left on the real thing.

After taking about 8 or 9 NBMEs (6 online + other offline) my opinion is that those questions are NOT representative of the real exam. Some concepts may be the same, specially in pharm/anatomy/biochem, but the overall "take" is very different. Content-wise, the Online Free 120 seemed the closest, UWorld coming second (I sometimes felt that UWorld question writers try overly hard to come up with super duper clever ways to ask very simple things).

Unfortunately (to me), there were too many anatomy questions to my taste, as well as the usual rote pharm/biochem/immunology/embryology memorization. And I redid ALL UWorld anatomy questions days prior to the exam; and still some 6-8 questions were simply NOT there.

Digression: no wonder Anki cards are the coolest thing. I would really really like to hear what Osler and Cushing would have to say about people claiming they are "learning medicine" by going over 3000 cards per day. End of digression.

But this could be just an heuristic bias as these areas tend to be more "painful" me (coming from math I just can't do memorization; my problem, I know).

As the fellow test taker wrote above, my last 5 blocks were also reasonably decent in terms of difficulty, though I tackled them a little bit more tired than I could have. It is what it is.

To sum up: remember your training, sleep well the night before, keep your glucose level high during the exam and you should be fine. Adrenaline does wonders.

Finally, I think I passed but that's not nearly enough being the non-US IMG that I am (or anyone for that matter). Won't be hitting 250 either but that's fine too.

I'll post all my prep details when results are up on the 22nd. Or not. I wouldn't like to spoil the 260+ SDN average. ;-)

Back to my caipirinha.
 
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Do the scheduling permits disappear on both Sunday and Monday or only Monday? I'm on the 4th week so I'd expect my score to be released this Wednesday and was wondering if anyone's permits have started disappearing yet? My test date was 7/9.
Took it on July 12th, permit disappeared today
 
...I had the clearest impression that I was taking an adaptive test (by block).

...That said, as Google make me realize, it seems the USMLE Step 1 Exam is NOT an adaptive test after all. As a matter of fact, as far as I could gather there is virtually no transparency whatsoever about how exams are scored etc. But that's a different thread all together.

Very interesting writeup in general. What in particular convinced you its not an adaptive test? I havent taken it yet, but it would explain a lot of common features in peoples experiences that I keep coming across

Unfortunately (to me), there were too many anatomy questions to my taste
Without obviously giving away specifics, would you be able to provide some more clarification? Im terrified of getting insertion/origin questions for muscles as its something I simply chose to ignore altogether as low yield info. Anatomy is my weakest area for similar reasons to you - dry memorization is something I struggle with.
 
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Score came back today:

NBME 13: 219.
Uworld #1: 241.
NBME 18: 242.
NBME 19: 236.
UWorld #2: 249.
Free 120: 80%.

Actual: 249.

Absolutely ecstatic, I’ve spent the past 4 weeks worrying every day I’d failed. Just waiting on COMLEX to come back at the end of the month, but at least the scary one is out of the way.
 
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Score came back today:

NBME 13: 219.
Uworld #1: 241.
NBME 18: 242.
NBME 19: 236.
UWorld #2: 249.
Free 120: 80%.

Actual: 249.

Absolutely ecstatic, I’ve spent the past 4 weeks worrying every day I’d failed. Just waiting on COMLEX to come back at the end of the month, but at least the scary one is out of the way.
Congrats!
When did you test?
 
Very interesting writeup in general. What in particular convinced you its not an adaptive test? I havent taken it yet, but it would explain a lot of common features in peoples experiences that I keep coming across

Thanks! The first thing I did when I got back home was to google "usmle step 1 adaptive" (I didn't even bother to take my phone with me). A lot of posts came up (on SDN and elsewhere) and people kept debating about it and then some people from Kaplan mentioned that it isn't yadda yadda yadda. The thing is, had NBME used IRT and related technologies on scoring the Step exams wouldn't they have to present scientific data on the effectiveness/fairness of this "intervention"? Since I couldn't find anything confirming it, I reasoned I should be "wrong". I know; absence of evidence is not evidence of absence but with Step 2 CK looming on the horizon I guess it doesn't matter much now.

But, honestly, I really felt like I was taking an adaptive test when suddenly (it was a discrete change) easy blocks started coming, to the point of me second-guessing myself a lot, like "do they really want me to say that insulin decreases plasma glucose concentration? There must be an exception I'm not seeing, c'mon!". That was the moment when I felt bad; when a lot of these easy (but not "gimme") questions started coming up and I realized "man, I must be at a very low baseline right now".

Eventually things picked up and I got a question on an infectious disease that is the bread and butter of any med student/physician in Rio and I remembered that a colleague who scored 250 told me his very first question on the exam was on the same disease (and then went on to saying that this calmed him down etc). I then relaxed a bit since it seemed I was on "good company", from the adaptive testing perspective. Of course, this could also mean nothing and they just randomly assign block order to test takers.

I would really like to hear about those "common features" with which you keep coming across. Perhaps we can all crack this code as a community...

Without obviously giving away specifics, would you be able to provide some more clarification? Im terrified of getting insertion/origin questions for muscles as its something I simply chose to ignore altogether as low yield info. Anatomy is my weakest area for similar reasons to you - dry memorization is something I struggle with.

These were some of the questions I got... And others like "if you go through this structure laterally, not medially, what structure are you going to injure and what will be the damage?" Hate it. Just hate it.
 
Score came back today:

NBME 13: 219.
Uworld #1: 241.
NBME 18: 242.
NBME 19: 236.
UWorld #2: 249.
Free 120: 80%.

Actual: 249.

Absolutely ecstatic, I’ve spent the past 4 weeks worrying every day I’d failed. Just waiting on COMLEX to come back at the end of the month, but at least the scary one is out of the way.

Congrats on the score!! What percentage of the exam do you think was covered by UFAPS? Thank you!!
 
Congrats!
When did you test?

Congrats on the score!! What percentage of the exam do you think was covered by UFAPS? Thank you!!

Thank you, I appreciate it! I tested on 7/9. As for what percent was covered in UFAPS, I would say probably about 90-95% was covered between them. I would also highly recommend USMLERx. The questions there can seem kind of out there at times but I definitely got a good number on the real thing that asked questions in the same type of “Huh, I hadn’t thought of this from that perspective before” way. However there were definitely a few, probably 5-10, that weren’t covered anywhere and you just had to go with your gut. I looked up one of my questions afterward and I only found that pathology in a single medical journal, published this year.
 
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Probably lower than the SDN average, but I’m ecstatic with my score. Posting on here because everyone else’s posts has helped me the past few months.

NBME 15 - 200 (6 weeks out)
NBME 16 - 205 (4 weeks out)
UWSA 2 - 222 (3 weeks out)
NBME 17 - 219 (2 weeks out)
NBME 18 - 219 (1 week out)
Free 120 - 80% (2 or 3 days out)

Actual - 232

I’m also a DO student, so still waiting on comlex scores.
Combank Self Assessment 2 - 590
Comsae Form E - 622
 
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My exams tomorrow!! Just wanted to say Thank You to everyone here cause it was great help!!!!! I'll write a write up once i get my score back! Congrats to everyone who got their scores back!! You guys are the best!!!!!!!!!!!!
 
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Thank you, I appreciate it! I tested on 7/9. As for what percent was covered in UFAPS, I would say probably about 90-95% was covered between them. I would also highly recommend USMLERx. The questions there can seem kind of out there at times but I definitely got a good number on the real thing that asked questions in the same type of “Huh, I hadn’t thought of this from that perspective before” way. However there were definitely a few, probably 5-10, that weren’t covered anywhere and you just had to go with your gut. I looked up one of my questions afterward and I only found that pathology in a single medical journal, published this year.

Thanks so much!! Would you recommend USMLERx over Kaplan?
 
Thanks so much!! Would you recommend USMLERx over Kaplan?


100% absolutely. Unless your school provides it I wouldn’t waste any time on Kaplan. I found that a good number of times they would have a presentation that was totally wrong for their answer explanation, like 1 out of every 50. Overall not that much but enough for it to matter. There were even more times where they would ignore a vital piece of information in the explanation that didnt fit their intended answer, because acknowledging it would make another answer better.

USMLERX on the other hand makes you think, and they provide a First Aid screenshot to support their explanation. It’s a good supplement to Uworld to help approach questions from a different perspective.
 
NBME 13 = 200
NBME 15 = 213
NBME 16 = 221
UWSA = 234
UWSA2 = 230

USMLE = 230

Comsae D = 594

Comlex = 490

Do I have a decent chance at general surgery, radiology, or internal med in an urban area?
 
Slightly below average US MD student about to start second year. Curious on any advice to my plan.

Curriculum type: M1 normal, M2 abnormal
Test date: Early May 2019
Dedicated period: 5 weeks
Goal: 250+

Will have done most/all Zanki cards related to my first year by the time school begins (~10k with ~4k matured). Will be continuing Zanki throughout the year and aiming to finish all new cards a week before dedicated. I'll be supplementing classes with UWorld, FA, Pathoma, Sketchy, and B&B (if absolutely necessary). I'll aim to finish a first pass of UWorld by dedicated so I can do a second pass during it.

Thoughts? Suggestions?
 
left the test feeling pretty good last week but i keep remembering stupid stuff i got wrong. The only time I felt good after a test was 19 and I completely screwed up that test due to complacency. I feel like I'm gonna score 20 points lower than my average alone..
 
Slightly below average US MD student about to start second year. Curious on any advice to my plan.

Curriculum type: M1 normal, M2 abnormal
Test date: Early May 2019
Dedicated period: 5 weeks
Goal: 250+

Will have done most/all Zanki cards related to my first year by the time school begins (~10k with ~4k matured). Will be continuing Zanki throughout the year and aiming to finish all new cards a week before dedicated. I'll be supplementing classes with UWorld, FA, Pathoma, Sketchy, and B&B (if absolutely necessary). I'll aim to finish a first pass of UWorld by dedicated so I can do a second pass during it.

Thoughts? Suggestions?


Probably too many resources. To be honest if you are considering Boards and Beyond, I’d just pull the trigger and do it. Replace Pathoma with it. Also make sure to not blow off classes, believe it or not there is valuable information taught in them.
 
Probably too many resources. To be honest if you are considering Boards and Beyond, I’d just pull the trigger and do it. Replace Pathoma with it. Also make sure to not blow off classes, believe it or not there is valuable information taught in them.

Really? I’ve heard Pathoma >> B&B though. I would only reference B&B if I reaaaally don’t understand something. Also, yes I’m definitely going to include my lecture material but those will be after I’ve gone through Pathoma/FA to figure out what’s high vs. low yield.


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