Passed after M3/ Stacking Step 1 and Step 2
I didn't see a lot of posts from people who went through the same thing so maybe my post will be helpful to someone.
Background: USMD, finished M3, passed step 1 on my second attempt.
First attempt happened last year, after M2. You can go search my post from a year ago for more details if interested, but long story short, F came as a shock as I've always been a good student, had reasonable passing scores and was cleared by my school advisor. That F crushed me, because I've never failed a test before, and I thought that my dream of becoming a surgeon was over.
My school allows you to start M3 without Step 1, and quite a few people postpone as they feel not ready. And that is absolutely not an issue, if you're applying IM/FM/peds just based on the way all the 4th year scheduling works (you aren't allowed to start scheduling your M4 until you pass step 1). For me (applying general surgery) it meant that I had to take Step 1 either during my 3rd year or immediately after to make sure I get the score in time to get all the department approvals. My last shelf exam was May 1, and I took Step 1 on May 5th so no dedicated period for me.
But let's go back to the beginning of the 3rd year first. I had to collect myself back together piece by piece and rebuild my confidence. It was not an easy task. But I did well during my clinical year, I am finishing with 4 Honors and 3 High passes. I also got really good evaluations throughout the year from my preceptors.
The real struggle started towards the end of the year when I had to study for my last couple of shelf exams, Step 1 as well as Step 2 that I am taking on June 1st. I've seen a lot of advice saying that taking Step 1 after the clinical year helps, and in a sense it does. You're familiar with USMLE and their bs through exposure to shelf exams, the way they ask questions and the traps they're building. But you also forget a lot of basic clinical science during the M3.
I remember taking my very first NBME (I did a pdf of form 30, i think, and I only did a couple of blocks to test the waters. I got 58% on my first block, and something like 38% on my second block. I was pissed. I did not remember anything it seemed. But then I took a step back, and asked myself - what is that I am missing. Turns out that I was getting the dx correct 100% of the time as I was reading pt vignettes, but what i was missing was basic science factoid, like what's the cofactor in RLS of this biochemical reaction. I thought okay, I can work with this, I just need to remember all the things I've known but had forgotten.
So I redownloaded the Step 1 Anki deck, completely reset it, and starting grinding. On top of my shelf studying I was hammering 300-400 new Anki a day. I was also flipping through First Aid, reading my highlighting and annotations from the last year, and it started to come back to me.
I knew I didn't have much time, and I had absolutely no desire doing numerous NBMEs. I took NBME 31 after a week of targeted studying (spring break, so I was between the rotations and had a whole week just for Step 1) and got a 65. After that, I had to step back from Step studying to focus on the demanding rotation, and I was only doing maybe 100 new cards a day or even less, and overall my Step 1 studying became haphazard.
But still I took the next NBME 32, and got 61. Then NBME 33, and I got 61 again. I was angry, because I felt like the basic science knowledge was coming back to me, I don't know why it wasn't reflected in my score. At that point, it was mid-April, and I had 2 weeks left of my last rotation, so less than 3 weeks to Step 1. Thankfully, my last rotation was psychiatry so the studying for the shelf wasn't very demanding (but I didn't get lucky schedule-wise, I still had to work 7am-3pm 5 days a week). I hammered my NBME incorrects, I was doing 80-120 Uworld questions a day, and I was also doing Melhman's arrows pdf (absolutely goated resource, I am yet to miss an arrow question on both Step 1 and Step 2 NBME forms now that I've went through it a couple of times).
The same day I took my psych shelf, I sat down and took Free120 under testing conditions because I simply had no time left. I ended up with 78% which boosted my confidence tremendously, it solidified for me that I was ready.
Test day went fine, I paced myself nicely, ended with a few minutes left after each block. There were only a few wtf questions, the rest I thought were reasonable overall. The two weeks wait was okay until the last couple of days when i lost sleep, and started having random bouts of palpitations. It was just too much at stake for me. But I am relieved to say that I saw the PASS today, I cannot be happier that I've overcome this, and all of my hard work had paid off.
Side note, Step 2 prep is going so much better. Once all the shelves and step 1 was taken, I could finally breath out and focus on just one exam. I am progressing in my scores nicely, and hoping to meet my goal of 260+, but that would be a separate post in a different subreddit when the time comes.
Feel free to ask me anything. I know I had quite a niche experience, but hopefully that write-up would help someone.