Real Deal Difficulty Level

[morkdaddy21]

So I keep hearing that for most people the real deal is easier than USMLE world. I'm curious to know if there are people that took the exam already and felt that it was much more difficult than USMLE world. I only ask because I did 80% of USMLE world and felt good going in. On the first 2 blocks I was just blown away with the difficulty of the questions. I felt that USMLE did not prepare me well for the questions on those blocks. Overall I think that 4 of the blocks on the real deal were the HARDEST blocks I've ever taken (practice and all). Kind of feel like **** because I prepared so hard and I feel like I got an unfair exam. Waiting for 1 month is going to suck. Hopefully there's some sort of curve that accomodates for this or I'm screwed.

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[yohimbine1]

I thought the real thing (just took it today) was easier than UW. That said, there were a lot of questions on the real thing that I just did not know the answer to. But I could tell they were simple questions if only I knew the information behind them. Unlike the often convoluted and multiple step questions on UW. Many real deal questions were straightforward "what is the diagnosis", "what is this drug side effect", "what microorganism", or "what drug mechanism" and other one step reasoning questions.

I actually did have a "worst headache of his life" question.

 

[LUBDUBB]

I am sure of this. it is not recall bias. There were pharmacodynamics questions that were way beyond the range of FA.

...There are many other examples of stuff I had never seen before/ever considered/was not prepared for after >500 hrs of studying.

As for exam day, I was destroyed at the end. Bloodshot eyes like out of a comic, wasted, exhausted, could barely speak beyond sentence fragments. Maybe my constitution just isn't as strong as yours Lilnoelle. I'm not being facetious. I am being serious. The test just took so much out of me.

People, one thing we cannot deny, if someone says the questions were longer and harder than UWorld, then they probably were. And if someone says the questions were the same length or shorter, they probably were.

Bottom Line for all of us who have yet to take it: pray you get one of those straightforward exams but be ready for a whopper!

 

[Vizsla]

People, one thing we cannot deny, if someone says the questions were longer and harder than UWorld, then they probably were. And if someone says the questions were the same length or shorter, they probably were.

Bottom Line for all of us who have yet to take it: pray you get one of those straightforward exams but be ready for a whopper!

its gone from doable...to impossible..to laugh out loud ridiculous. awesome..

 

[Anaphylactic]

to ana:

as for prevaricating things, i don't know what that word means, so maybe i've been prevaricating my whole life and not known it. and for that matter, how do you know I wasn't postvaricating? it's all the rage these days, or didn't you hear?

Hi Brisket: you seem a little bit emotionally wrought up there but those are eloquent words. I am sure your life has been meaningful, and will continue to be once you find out about your score. If anyone's life has been a prevarication, it would probably be mine. I'm sure you did fine. Sometimes, the uncertainty of the future, coupled with the great import that the result of that future may have on our life, may predispose us to think about it a certain way. If anything, your post really woke me up from the dogmatic slumber of contentedness that SDN and UWorld perpetuated. So, thank you for that and hope you find some peace of mind.

 

[skm95]

There is no need to panic. I don't think there will be any change in calculation method for the USMLE final score. It will still be derived by mapping the raw score to a pre-defined distribution. There may be slight shift in the predefined distribution, but overall anyone who would have scored 185 in 350-exam will still score 185 in 336-exam and those who would have scored 265+ in 350-exam will still score 265+ in 336-exam.

I don’t think USMLE picks questions randomly from there question-bank for each administration of exam. They have pre-defined exams, and for each exam there is a pre-defined mean and standard-deviation. Let's consider a hypothetical example of 2 exams. Each exam has 300 questions (assume 36 are experimental out of 336). Exam-1 has mostly difficult questions. So based on statistical analysis of each question in that exam, the mean for Exam-1 is M=180 and standard-deviation SD=15. Exam-2 has easy questions, where M=240 and SD=25.
Now let's pick 2 students A and B.
During exam preparation student A gets 480 (214 3-digit) on all 6 NBMEs and student B gets 680 (253 3-digit) on all 6 NBMEs.

They both take Exam1 one day and Exam2 the next day.
Student A scores 175 on Exam1 and 235 on Exam2.
Student B scores 205 on Exam1 and 285 on Exam1.

Now let's map this to our USMLE distribution with M=218 and SD=22.

Z for Student A in Exam1 = 175-180/15 = -0.3333
Z for Student A in Exam2 = 235-240/25 = -0.2

Z for Student B in Exam1 = 205-180/15 = 1.6666
Z for Student B in Exam2 = 285-240/25 = 1.8

USMLE score for student A in Exam1 = -0.33*22+218 = 211
USMLE score for student A in Exam2 = -0.20*22+218 = 213

USMLE score for student B in Exam1 = 1.66*22+218 = 254
USMLE score for student B in Exam2 = 1.80*22+218 = 257

So, relax! You will still get a score close to what your NMBE average is/was (as long you don't panic during exam!).

Now, for fun, here are 3 equations to compute your percentile, 2-digit score and 3-digit score from NBME score.

Enter you NBME score in spreadsheet cell A1

Enter following 3-digit equation in cell A2
=IF(AND(200<=A1,A1<=800),ROUND((70.2-0.0000002067*A1^3+0.0000937*A1 ^2+0.30096*A1),0),"Error")

Enter following 2-digit equation in cell A3
=IF(AND(100<=A2,A2<=300),IF(A2 > 236, 99, ROUND((0.4715*A2-12.5),0)),"Error")

Enter following percentile equation in cell A4
=IF(AND(200<=A1,A1<=800),ROUND(NORMSDIST((A1-500)/100)*100,2),"Error")

 

[VPDcurt]

Now, for fun, here are 3 equations to compute your percentile, 2-digit score and 3-digit score from NBME score.

I used to think there was only one definition of "fun." How naive!

But seriously, that's a pretty intense post - very informative though - so thanks.

 

[osli]

So you think NBME is just using mean and SD for that test version, and not looking at individual questions? If so, it seems like they are missing something... at least I think so.

Student A and B both take form 1, 336 questions, and both miss 50 questions. Student A misses the 50 easiest, and student B misses the 50 most difficult. Should their scores be equal? Does getting hard ones correct offset getting easy ones wrong?

 

[skm95]

So you think NBME is just using mean and SD for that test version, and not looking at individual questions? If so, it seems like they are missing something... at least I think so.

Student A and B both take form 1, 336 questions, and both miss 50 questions. Student A misses the 50 easiest, and student B misses the 50 most difficult. Should their scores be equal? Does getting hard ones correct offset getting easy ones wrong?

No, I tried to keep example simple, therefore some confusion!

I still think that they use individual question scores to compute final raw z-score, which is then mapped to USMLE-distribution; as I described here:

http://forums.studentdoctor.net/showpost.php?p=6625862

But outcome will still be same, i.e. the final z-score for a difficult vs. easy exams will be within +/- 1%.

Computing final score using these statistical procedures also ensures that the scores from different years are on a common scale and have the same meaning. Therefore it does not matter if someone took exam before May-15th or after.

 

[ambulancedriver]

i'm going to corroborate what some have mentioned about the questions on average being longer and/or more convoluted on the real deal than in USMLE world. I never had an issue with time when doing USMLE world and always had ~20 min. to spend time reasoning through the more difficult questions. on the real thing, it was often only 10-15 min. I felt this difference did contribute significantly to making boneheaded mistakes on easy questions simply because I always had this feeling of being rushed.

also, it's a good idea to simulate what 7 blocks of questions feels like (and 3-4 back to back) because you won't realize how tired your mind gets with having to concentrate for so long. fatigue played a big factor in my test by about the 4 block mark.

 

[synapse lapse]

As said in the experiences thread, wanted to chime in and say it wasn't that bad. My question stems weren't too bad, though time was much more of an issue than it had been on practice tests, it was managable in all but 1 block (had no time to review). The stems were about the same as UW on my exam, and the test was slightly easier than UW I felt. I feel very fortunate to have recieved the exam I did, as it could have been much worse. I agree with those who noted that recall bias and expectations may play into perceptions of difficulty. I don't expect a 260, and know there is tons of stuff I don't know and lots of questions I missed, so perhaps thats why I didn't think it was all that bad. I think I probably did as well as an average med student would on that test, and will be happy if that turns out to be the case. Had tons of biostats I felt.

 

[nvshelat]

I really don't think the exam is graded against your peers. I always thought it was based on how you do statistically on each and every question you get. Even though you might take the USMLE on the same day as another person, you two will not have the same questions.

I'm convinced in my mind that there is a huge pool of thousands of questions and every time you go on to the next block it randomly selects 50 (now 48) questions from that magical pool. I think everyone will feel violated after the exam.. it's just a matter of degree, like "I got touched on the knee by Uncle Jack" violated, or "Bend over and don't ask questions" violated. I'm hoping for the former.

You got that one uncle too, eh?

 

[ZonaRidicularis]

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