USMLERx is hard.

[auburnO5]

I've been doing blocks of 48 with "hard" questions. And they are hard.

I'm averaging about 85-90% on UW, the last NBME I took predicted me at 254, yet I can barely get 60% on USMLERx. And it has my predicted score at "224." Way too hard.

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[CatFactorial]

How does redoing UW compare to RX? I mean in the sense of utility.

 

[ijn]

I mean, you're setting it on hard. That probably means most of the questions that aren't topics in First Aid.

I found USMLERx on random to be quite a bit easier than UWorld, and somewhat easier than an NBME. Yeah there are a lot of questions that have absurdly low % rights, but those are the exception rather than the rule.

 

[tootheye]

I did usmlerx on hard only mode, blocks of 48 qns. It was hard and some concepts weren't from FA. Tho' I nearly completed all hard ones,I was scoring better in UW than RX some times even with medium ones!
The phrasing of fact presentation or focus of questions are no comparison with UW. I switched to redoing UW which I found more productive with my assessment tests atleast. I started Rx to break monotony of FA but realized I was more demoralized! My 2 c.

 

[Phloston]

I'm ~ 85% finished with Rx at this point, and I've definitely found it to be a strong shelf-knowledge builder/reinforcer. To that effect, I would consider USMLE Rx and FA collectively as one resource because they both help reinforce each other. In terms of usefulness of actual question-style, I can't relate Rx to UWorld yet (I'm still 8 months out from my exam), but I had already read FA in its entirety before starting Rx, and the latter has been great for delving into FA's details that I ordinarily [for certain] would have overlooked.

 

[auburnO5]

I'm ~ 85% finished with Rx at this point, and I've definitely found it to be a strong shelf-knowledge builder/reinforcer. To that effect, I would consider USMLE Rx and FA collectively as one resource because they both help reinforce each other. In terms of usefulness of actual question-style, I can't relate Rx to UWorld yet (I'm still 8 months out from my exam), but I had already read FA in its entirety before starting Rx, and the latter has been great for delving into FA's details that I ordinarily [for certain] would have overlooked.

 

[Phloston]

Is it crazy that I'm 8 months out?

 

[MrBeauregard]

Yes, its crazy that you're 8 months out and are studying this much. I wish we all had the ability to do that. I'm not finished with class and I'll have ~5 weeks to blast through UWorld twice. You could do USMLERx, Kaplan and UWorld twice each (easily) at your pace. I'm incredibly jealous.

 

[auburnO5]

I'm incredibly jealous.

I'm not.

 

[Phloston]

Yes, its crazy that you're 8 months out and are studying this much. I wish we all had the ability to do that. I'm not finished with class and I'll have ~5 weeks to blast through UWorld twice. You could do USMLERx, Kaplan and UWorld twice each (easily) at your pace. I'm incredibly jealous.

I will do Rx, Kaplan and UWorld all twice, in addition to FA Q&A and some other resources. Don't be deceived though. The added time, questions, repetition, etc., will probably function very much like a Hb-O2 dissociation curve from 60-100 mm Hg in terms of increasing the final score. A lot of extra work will get me little numerical progress (kinetic energy) as time goes on, but the true gain will be security (potential energy) more than anything else. We're all very aware that, in the end, any minutiae could show up on our real exam that we might not get right no matter how long we had studied or no matter how many questions we were lucky to have done.

Depending on the particular questions on the actual Step that might hit weak or strong points, people probably have a range of scores they're likely to achieve. For example, if you're strong in micro and weak in anatomy and get none of one and tons of the other on the real exam, you could very well operate on a 10-point swing (and vice-versa). The plateau phase, I believe, functions to raise the minimum possible score more strongly than the maximum one, thereby reducing the lability, or "swing," that could potentially occur on the real exam. In other words, I'll probably be no more likely than most other people in actually coming out with a desired score, but I will be less likely to fall below my mean if I get a "hard" exam.

I'm not.

I am always impatient with every minute and rarely socialize, so I agree with auburnO5, I wouldn't be jealous either. My girlfriend, who somehow can deal with me only studying and never paying her any attention, is the only branch point for sanity that I can relate to.

 

[Robot Skeleton]

you're going to get a 280.

 

[Zoopeda]

What does FA stand for?

 

[NotAsking4Much]

you're going to get a 280.

Eh...Obviously I wish Phloston the best.

However, I have seen many cases where people use a few resources (like FA + Uworld) and get 260+ and people who use like every book and qbank and do far worse.

Quantity doesn't always equal quality.

 

[Phloston]

Quantity doesn't always equal quality.

I would say that's fairly accurate.

FA + the QBanks are collectively a well-consolidated study plan. A few select adjunct resources are also beneficial.

 

[BlueElmo]

I've been doing blocks of 48 with "hard" questions. And they are hard.

I'm averaging about 85-90% on UW, the last NBME I took predicted me at 254, yet I can barely get 60% on USMLERx. And it has my predicted score at "224." Way too hard.

How are you getting a 60% and a 224? I'm getting 62% on Rx right now and it gives my predicted score at 187 with CI at +/-20?

 

[auburnO5]

How are you getting a 60% and a 224? I'm getting 62% on Rx right now and it gives my predicted score at 187 with CI at +/-20?

Probably because I have only done hard questions.

 

[Phloston]

USMLE Rx doesn't weight questions based on difficulty.

They use a simple formula: [(%correct)x2.64 + 42] +/-20

However, I've found that if I finish a block and check the predicted score, it's higher than if I start a new block and haven't answered any questions yet. In other words, even though they give that formula on their website, they must also factor it in proportion to the number of questions completed. Therefore, their actual formula must be: [(%correct/#questions used)x2.64 + 42] +/-20

Finish a block, then check your predicted score (especially if you're doing tutor mode).

 

[BlueElmo]

USMLE Rx doesn't weight questions based on difficulty.

They use a simple formula: [(%correct)x2.64 + 42] +/-20

However, I've found that if I finish a block and check the predicted score, it's higher than if I start a new block and haven't answered any questions yet. In other words, even though they give that formula on their website, they must also factor it in proportion to the number of questions completed. Therefore, their actual formula must be: [(%correct/#questions used)x2.64 + 42] +/-20

Finish a block, then check your predicted score (especially if you're doing tutor mode).

Okay, thanks. These scores fluctuate, too. Now my 62% puts me at 195.

 

[johndoe3344]

But of course Rx is down again...

 

[deano5709]

But of course Rx is down again...

I've been having problems with it all day. I have a path final on Monday that I'm trying to study for. I sent an email and someone responded and said that they weren't down and they hoped I could get my problem worked out.

 

[auburnO5]

I've been having problems with it all day. I have a path final on Monday that I'm trying to study for. I sent an email and someone responded and said that they weren't down and they hoped I could get my problem worked out.

This is such BS, and yes they are definitely down.

 

[teenmachinery1]

down. :I

 

[dr seuss]

It's not down for me.

 

[johndoe3344]

It goes down, comes back up for a few minutes, then goes down again, then repeats.

 

[auburnO5]

So I have been in contact with USMLERx customer support, and they are blaming all of the problems on "bot attacks."

 

[johndoe3344]

Well, I guess that's an improvement from denying that they are down...

 

[PIPEGOMEZ]

I've been doing blocks of 48 with "hard" questions. And they are hard.

I'm averaging about 85-90% on UW, the last NBME I took predicted me at 254, yet I can barely get 60% on USMLERx. And it has my predicted score at "224." Way too hard.

I thought I was the only one.... Medium and Hard are really really difficult.

 

[PIPEGOMEZ]

So I have been in contact with USMLERx customer support, and they are blaming all of the problems on "bot attacks."

I tried calling their support team and it was just a voicemail. I left a message but nobody replied. I e-mailed them and they e-mailed back asking details about my browser and what error message I was getting... Still no answer.

 

[Phloston]

The QBank is down AGAIN. I know you guys had mentioned having problems earlier, but mine was working fine today, and just now went down.

I sent them an email this time saying that I don't even want additional time added back on because I'm just thoroughly disappointed.

They're rich enough at this point with the entire USMLE universe buying their products that you'd think they'd have the minimal technical support to maintain their servers.

Edit:

I just received an email from them. One of you guys up above mentioned "bot attacks":

"Thank you for your email. We seem to be having quite a few bot attacks on various pages of our website. They are not able to get through our firewalls, but they are slowing down the response time for our customers. We are reviewing the firewall settings now to see how we can prevent this from happening."

I hope that must be some sort of a joke on their end.

 

[BlueElmo]

The QBank is down AGAIN. I know you guys had mentioned having problems earlier, but mine was working fine today, and just now went down.

I sent them an email this time saying that I don't even want additional time added back on because I'm just thoroughly disappointed.

They're rich enough at this point with the entire USMLE universe buying their products that you'd think they'd have the minimal technical support to maintain their servers.

Edit:

I just received an email from them. One of you guys up above mentioned "bot attacks":

"Thank you for your email. We seem to be having quite a few bot attacks on various pages of our website. They are not able to get through our firewalls, but they are slowing down the response time for our customers. We are reviewing the firewall settings now to see how we can prevent this from happening."

I hope that must be some sort of a joke on their end.

Drives me nuts when it automatically kicks you out when you're in middle of a question block, when I'm already frustrated from getting pwned. Brings you to a page with Error 504, can't get back in. Makes me want to tear my hair out.

 

[johndoe3344]

Drives me nuts when it automatically kicks you out when you're in middle of a question block, when I'm already frustrated from getting pwned. Brings you to a page with Error 504, can't get back in. Makes me want to tear my hair out.

I couldn't have expressed how I felt any better.

There was a 5 hour period yesterday where I was trying to do questions and this would happen to me, and unfortunately, anyone who tried to call me during that time got screamed at and hung up on. :S

 

[Phloston]

I couldn't have expressed how I felt any better.

There was a 5 hour period yesterday where I was trying to do questions and this would happen to me, and unfortunately, anyone who tried to call me during that time got screamed at and hung up on. :S

Well at least you won't get a question on displacement wrong if it comes up.

 

[jatt12]

Eh...Obviously I wish Phloston the best.

However, I have seen many cases where people use a few resources (like FA + Uworld) and get 260+ and people who use like every book and qbank and do far worse.

Quantity doesn't always equal quality.

Phew at least someone agrees with me, in case of quality VS quantity.

 

[PIPEGOMEZ]

Why is it that the average for everyone else is always 67% on USMLERx? Does this happen to anybody else?

 

[Phloston]

Phew at least someone agrees with me, in case of quality VS quantity.

I don't think anyone had ever debated that quantity takes priority over quality.

However at the same time, a greater # of questions under the belt builds the safety net.

 

[auburnO5]

Why is it that the average for everyone else is always 67% on USMLERx? Does this happen to anybody else?

Yeah, the test average is ALWAYS 67%. I just took an extremely hard test, yet again, and the average was..... you guessed it..... 67%. There is no way in hell that was correct.

 

[PIPEGOMEZ]

Yeah, the test average is ALWAYS 67%. I just took an extremely hard test, yet again, and the average was..... you guessed it..... 67%. There is no way in hell that was correct.

I just tried one in Easy mode.... The average for everyone else?? 67%... Are you EFFing serious??

 

[auburnO5]

I just tried one in Easy mode.... The average for everyone else?? 67%... Are you EFFing serious??

I went back and reviewed, and there was not a single question that 67% of people got correct. I think the highest % was 64% on a relatively easy question. Yet the overall average for that specific test was a 67%?

 

[yaparqa]

q: have you completed any of the kaplan q bank? I've read through some other threads on this topic, but it seems as if you're well versed here - so any input on the kaplan q bank? I've made one pass through uworld and I'm looking for something good to plow through - not sure I can get both rx and qbank done in the next 4-5wks. I understand kaplan also has FA page references.

 

[BlueElmo]

Average was 66% about a week ago. It went up to 67% now...

 

[Phloston]

I would ignore the community percentage on USMLE Rx. Since the 67% never changes, it's an overall % for everyone having sat all questions on the QBank, and it is non-specific. As far as the %s based on question-difficulty are concerned, I actually wouldn't even worry about those either. I've encountered questions that have been (I'm not even kidding) literally just "67F, back pain, IgG spike," with 28% answering correctly, then others that would be based on some obscure biochemistry detail that >70% get right, so I've learned to just ignore the %s.

 

[PIPEGOMEZ]

I would ignore the community percentage on USMLE Rx. Since the 67% never changes, it's an overall % for everyone having sat all questions on the QBank, and it is non-specific. As far as the %s based on question-difficulty are concerned, I actually wouldn't even worry about those either. I've encountered questions that have been (I'm not even kidding) literally just "67F, back pain, IgG spike," with 28% answering correctly, then others that would be based on some obscure biochemistry detail that >70% get right, so I've learned to just ignore the %s.

I've been trying to do the same, but today I took NBME 13 and it was horrible... I was hoping that the results would differ from what USMLERX was telling me but they were pretty similar, so I really don't know what else to do... any suggestions??

 

[LaCasta]

Seems like a lot of unhappy customers with Rx. Why didn't you guys go with Kaplan?

 

[ijn]

Seems like a lot of unhappy customers with Rx. Why didn't you guys go with Kaplan?

Kaplan is bad for your blood pressure and mental health.

Look up Tangier disease. I think like 50 people in the world have it, yet apparently Kaplan deems it high enough yield to write a question specifically asking what protein is mutated in it (ABCA1).

I officially gave up on that Q bank after running into that question. Whoever wrote that question is a sadist and isn't interested in preparing you for STEP 1.

 

[Phloston]

Seems like a lot of unhappy customers with Rx. Why didn't you guys go with Kaplan?

Although Rx has its fair share of problems, I'm 87% finished with the QBank at this point, and I can tell my future score has definitely gone way up because of it. I think a lot of us just get frustrated because we want things to be perfect, but in the end, if our results are better off, then enough said. I would hands-down recommend Rx and FA as one collective resource (in addition to Kaplan and UWorld).

Kaplan is bad for your blood pressure and mental health.

Look up Tangier disease. I think like 50 people in the world have it, yet apparently Kaplan deems it high enough yield to write a question specifically asking what protein is mutated in it (ABCA1).

I officially gave up on that Q bank after running into that question. Whoever wrote that question is a sadist and isn't interested in preparing you for STEP 1.

Yeah, I agree. In terms of the low-yield that could be assessed, there still needs to be a degree of overlap with USMLE relevance (i.e. a LY detail regarding a HY topic).

However I must say, there are 220 articles on PubMed about Tangier disease, whereas there are only 4 on radial traction (UWorld assessed that).

Edit: now that I've done a little reading on Tangier disease, it's actually not that LY after all. I mean it's an alpha-lipoprotein deficiency, which is definitely USMLE-relevant, but I still see where you're coming from with Kaplan.

 

[iCY]

Kaplan is bad for your blood pressure and mental health.

Look up Tangier disease. I think like 50 people in the world have it, yet apparently Kaplan deems it high enough yield to write a question specifically asking what protein is mutated in it (ABCA1).

I officially gave up on that Q bank after running into that question. Whoever wrote that question is a sadist and isn't interested in preparing you for STEP 1.

People give kap Q bank a bad rep. Even if a question is asking something detailed, you have to be intelligent enough to understand that a qbank question does MORE than just teach you "what protein is deficient". If you were looking for quick hit questions like "what protien is deficient" there are faster ways to approach that (i.e., deja review series).

Qbank gives you a clinical picture of the disease (through the vignette), then it gives you a great explanation about the disease, & also about what diseases the wrong answers are associated with. You could ignore the primary question thats being asked, & still learn a whole lot from qbank.

 

[ijn]

Although Rx has its fair share of problems, I'm 87% finished with the QBank at this point, and I can tell my future score has definitely gone way up because of it. I think a lot of us just get frustrated because we want things to be perfect, but in the end, if our results are better off, then enough said. I would hands-down recommend Rx and FA as one collective resource (in addition to Kaplan and UWorld).




Yeah, I agree. In terms of the low-yield that could be assessed, there still needs to be a degree of overlap with USMLE relevance (i.e. a LY detail regarding a HY topic).

However I must say, there are 220 articles on PubMed about Tangier disease, whereas there are only 4 on radial traction (UWorld assessed that).

Edit: now that I've done a little reading on Tangier disease, it's actually not that LY after all. I mean it's an alpha-lipoprotein deficiency, which is definitely USMLE-relevant, but I still see where you're coming from with Kaplan.

Knowing every detail about Tangier disease is like knowing every detail about Hers disease, a type VI glycogen storage disease. von Gierke and McArdle's are high yield, Hers most certainly is not. Familial hypercholesterolemia is high yield, ABCA1 protein defect most certainly is not.

 

[Phloston]

I'm not saying Tangier's is high-yield, but I could see reason as to why it wouldn't be nearly as low-yield as Hers or Tarui's diseases.

Tangier's ABCA1 would explain why a patient with exceedingly low HDL may be refractory to high-dose niacin.

I actually find that incredibly interesting (also because I'm doing a PhD in cardiology research, so I'm very likely a bit biased).

Either way, I'm fairly sure neither one of us will forget about Tangier's disease now that we've had this discussion, so hopefully it will show up on our exams.

 

[ijn]

Haha yeah, that's one thing I give Kaplan. I get so mad at some of their question prompts I'll never forget them.

Another one that really irked me was a guy with proximal muscle weakness and asthma. They gave you nothing else, so you had to assume it was corticosteroids instead of dermatomyositis/polymyositis. I mean really, if you want to suggest the person has Cushing syndrome then tell me about fat maldistrubion PLUS proximal muscle weakness, etc. Instead the only clue is proximal muscle weakness. The asthma never clicked in my head since for some reason I wanted to say that inhaled steroids are highly unlikely to cause Cushing syndrome vs systemic corticosteroids. Maybe my basic science lecturers were wrong. Never the less, the prompt seemed needlessly cryptic (really now, a Cushing patient without any fat problems? doc didn't think that was important enough to mention?) and only 20% got it right. Feels better to vent! lol

 

[Phloston]

I'd have to see the specific question, but there isn't a relationship between asthma and the myositides; the former is overactive Th2 cells leading to eventual increased IgE and eosinophils, whereas the latter is predominantly CD8+-mediated. When you said proximal muscle weakness + asthma, Churg-Strauss was actually the first thing that popped into my head, however that would be more likely to present with pain rather than PMW, so that could be eliminated as well. That's actually an interesting question because I wouldn't be surprised if a patient had mere proximal muscle weakness before any external changes were even evident. Therefore, the consideration of Cushing's is making the Dx early (i.e. before the patient actually demonstrates notable fat redistribution and muscle wasting). Kaplan may have written a good one there.