Hey everyone, taking step 2 06/16!
I’m aiming for a 250 at least
03/14 NBME 9: 209 (first one to see baseline)
04/14 NBME 10: 229
05/03 NBME 11: 246
05/04: NBME 12: 251
05/06: NBME 13: 261
05/07: NBME 14: 255
05/09: UWSA 2: 258
05/21: NBME 15: 257
Saving NBME 16 and free 120s for these next few weeks but do you think I have a good shot getting the score I want?
Hi everyone. I've posted before but am posting again because I, again, don't know if I am missing something. I'm now testing 06/03 with a goal of 255+ (realistically) but actually really want a 260+. I just took UWSA2 and the 2020 Free120 yesterday (05/20, 2 weeks out) after a 1.5-2 weeks of focusing on strategy because of a 3-form long platuea (forms 13-15) in which I saw great score improvements on CMS forms (85-90+) and Amboss blocks (75-85% correct). Here's my question though:
UWSA2: 245, 71% raw correct, 83 EPC
2020 Free 120: 85% correct
Is my issue just that its NBME vs Uworld? I've greatly analyzed my incorrects to figure out and categorize them into why I got them wrong, made myself test taking "rules" secondary to the areas I was frequently getting incorrect (ex. not trusting obvious diagnosis --> if it seems obvious, and its an answer choice, its most likely that answer), as well as actually not looking at the answer choices and just coming to a conclusion in my head beforehand to drown out any distractors. And like I said, I've seen improvements everywhere else, except on a form. I know everyone says UWSA2 is very predictive but I'm having a hard time believing that all of my hard work went to a 2 point increase and that's it.
CCSE 1 (Jan 21): 234
Form 12 (Feb 15): 225
CCSE 2 (Mar 4): 246
Form 10 (April 4): 220
Form 11 (April 10): 249
Form 13 (April 18): 238
Form 14 (May 4): 242
Form 15 (May 10): 243
Shelf scores over the year were Surg 85, IM 79, FM 84, OB 88, Peds 77, Psych 85
How do I cover this patient safety and quality improvement?I have no idea where to start from . This is my very weak area . I dont know which resource to follow . Reading the explanation feels like what is being said . I am that kind of weak in this subject . Kindly give me a road map . I haven’t done this portion on my Uworld . Because I am unable to solve the question. Don’t even get the question . Help me out . I want to best best at this subject . Give me a road map
Ask me any questions you have! This group helped me a lot when I was worrying about my NBMEs and leading up to the exam.
Study period: November 2025-End of April (I only got serious with studying daily after January 1st)
Materials: UWorld (finished around 92%), took NBMEs 10-16, free 120 (old new + new new), and did around 3 CMS forms for most of the subjects. I used Amboss to look up diseases I hadn’t seen in awhile & to read about ethics/QI/patient safety (only did this in the last month, in my free evenings). I studied full time from Jan- April 17th. Didn’t take many days off and was extremely burnt out by test day. Wouldn’t recommend that part!
I listened to very few DIP when I walked my dog, but can’t say if I really recalled things from it or not.
Other: Passed Step 1 end of August 2025, so I was going in with a good foundation from that. In my very last week I was all over the place, but did review biostats from my step 1 notes & screenings from USPSTF. Was just going through my prior NBMEs and trying to read my incorrect notes.
My NBME scores: my first score on 10 was a 230. My last 3 scores were 257,258,254 on 14-16. My free 120 was 80% (2021 version) and 74% (2023 version) taken 4 days before exam.
Test day: slept around 6-7 hours and brought water and lots of protein bars. Ate half a protein bar on every break. I took a break after each block of 40. I did rush a lot, felt time was working against me. I had to make guesses based on the context and what fit best and move on quickly. However, I stayed positive and tried not to fixate on one weird question! Answer, move on, pray and hope for the best!
One thing I wish someone told me earlier about Step 2, so I’m sharing it with the people who haven’t taken it yet:
What’s not talked about enough is what to do when you’re stuck between two answers.
Because honestly, that’s where a massive part of the exam lives.
A lot of people walk out of blocks thinking:
“I narrowed it down to two and still got it wrong.”
And I genuinely think that’s one of the biggest transitions from Step 1 to Step 2.
Most of the time, getting stuck between two answers does NOT mean you missed the diagnosis.
Usually you already recognized what the disease/process is.
The exam is now testing whether you understand:
what matters MOST right now
what needs to happen first
what is unsafe to miss
what can wait
what the patient in front of you actually needs at this moment
One thing that changed my approach completely was this:
When you’re stuck between two answers, stop asking:
“Why is my answer right?”
Instead ask:
“Why is the OTHER answer wrong right now?”
Sounds simple, almost obvious, but during the actual exam when you’re time-constrained, mentally fatigued, and anxious, people stop thinking this way and start defending the answer they emotionally attached themselves to first.
That subtle difference matters a lot.
Because on Step 2, both answers are often technically correct.
The difference is usually:
one is too invasive too early
one skips stabilization
one ignores instability
one is the definitive treatment, but not the next step
one makes sense for the disease, but not for the patient in front of you
Example:
A patient clearly has ascending cholangitis.
You’re stuck between:
ERCP
IV antibiotics + fluids
Both are legitimate management steps.
The exam isn’t really testing whether you know cholangitis.
It’s testing whether you understand sequencing, stabilization, and management priority.
Another thing I noticed:
The stem usually tells you what the question is REALLY about.
If they spend half the vignette emphasizing:
blood pressure
oxygenation
mental status
worsening progression
instability
vitals
…then the question probably stopped being about diagnosis already.
A lot of Step 2 comes down to recognizing that when two answers both seem right, the exam usually wants the safer, less invasive, more immediately appropriate option first.
Feel like there is a good number of questions where management changes due to size.
The question is like a 5cm pseudocyst, and the answer is don't treat, but observe. The next question 3.5cm pancreatic cyst. And the answer is whoa bigger than 3cm must be treated.
How are people memorizing all these cut-offs?
I’ve done all the NBMEs and UWSA2 and take free 120 on Saturday
NBME 13: 251
NBME 14: 242
NBME 15: 253
UWSA2: 251
NBME 16: 249
Honestly if I end up scoring a 250 I’m more than happy and want to maintain these scores but I’m really worried I’ll underperform on the exam, NBME 16 felt so weird and the HPI questions really tripped me up
I’ve done Amboss most of the 200 concepts and all the QI, currently working through ethics
Should I be doing uworld incorrects?
Should I be doing 1 CMS per day 2 CMS? (I’ve done pretty much all the CMS except psychiatry and Neuro since I didn’t feel like it was high yield but realized they were my weaker areas, I also haven’t done the latest surgery and IM one that’s online, should I pay for them?)
I have like 8000 flashcards
Should I also do the old free 120?
Should I just revise all my nbmes??
Should I do mehlman HY pdfs?
I’m feeling like I don’t know anything and I’m kind of freaking out, NBME 16 fucked me up and I don’t know if I’m ready for this
It just doesn’t feel like there’s enough hours in a day and every time I get a question wrong it’s like fuck why is my reasoning the worst, I’m worried day of I’ll overthink everything or under think or just straight up realize it was all luck until now
I tested NBME 10 today. This was after doing first pass of UWorld with an average of 65%
My first NBME so most probably my baseline but I expected more.
I want to test in about a month but I’m not sure if that’s possible atm.
My goal score is 250+
Any advice as to how I should pivot? What should I do to increase my score?
I’ve only been using UWorld as my study resource.
Is this a good score? Should I be happy or sad? Please help🥲
I’m gonna say something that probably won’t be popular here, but this subreddit feels exhausting sometimes.
I get it. Medical training is brutal. A lot of people here are anxious, burned out, sleep deprived, isolated, depressed, scared about exams, scared about matching, scared they’re not enough. None of that is fake.
But somewhere along the way, negativity started becoming the default language of the community.
Someone shares motivation? “Cringe.”
Someone builds something? “Advertisement.”
Someone talks positively about improvement? “Gunner.”
Someone tries to help? Immediately assumed to have bad intentions.
And honestly that mindset spreads faster than people realize.
Medicine is already hard enough without turning every discussion into cynicism Olympics. There’s a difference between being realistic and making misery part of the culture.
A better culture would probably look more like people openly sharing what worked, being real about what didn’t, helping others avoid the same mistakes, and not treating burnout and cynicism like they’re the only acceptable emotions in medicine.
A lot of us came into medicine wanting to help people and somewhere during training we started treating each other worse than strangers online.
You don’t have to agree with every post. You don’t have to like every app, opinion, or study method. But automatically assuming the worst in people all the time is a miserable way to live.
Somebody out there is barely holding it together while reading these threads. The culture we create here actually matters more than we think.
Hi everyone, took NBME 9 today and got a 222. Honestly devastated because the exam felt easy while I was doing it, and I genuinely thought I was scoring 240+.
Background:
UWorld first pass: 58% avg
CMS averages around 75–80%
Currently started doing AMBOSS, 4% done (not very consistently)
I’ve seen people jump from NBME 9 low 220s to 240s/250s on NBME 10. How do you make that jump? What actually helped you improve?
I’m hoping to take Step 2 by early July, so I’m limited on time. Right now I’m thinking AMBOSS + thorough NBME review + CMS Anki cards.
I really want to hear from people who actually went from scores like this to very good scores, how did you do it? What do you think was the real factor that improved your score so much? Honestly, this result has completely shattered me.
Question describes a man with progressive difficulty swallowing solids. Heavily implies esophageal cancer with his vignette, which I understand. Correct answer on NBME was EGD for most appropriate next step in evaluation. I selected video fluoroscopic barium swallow as the next step, however, because I was under the impression that even though EGD + biopsy is needed for diagnosis, you are supposed to obtain the swallow study first to identify location of lesions and potential safety issues with EGD.
Is this just a bad question, or can anyone explain? How should I approach something like this on the actual step exam?
Update:
I figured out that I learned this from like 3 different cards in the anking step 2 deck. Did some further digging into what algorithm they were using and apparently they meant barium swallow first in either oropharyngeal dysphagia or in mechanical esophageal dysphagia with history of prior radiation, caustic injury, complex stricture, or surgery for previous cancer. :|
mechanical esophageal dysphagia without any of that prior history is okay to go straight to EGD
​
Test date
US MD or US IMG or Non-US IMG status:
Step 1:
Uworld % correct:
NBME 9: ( days out)
NBME10: (days out
NBME11: (days out)
NBME12: ( days out)
NMBE13: (days out)
NBME14: ( days out)
NBME 15: (days out)
NBME 16:(days out)
UWSA 1: ( days out)
UWSA 2: (days out)
i keep seeing that on the score release thread people say that scores are going to take 6–8 weeks to be released.
has anyone experienced this already, or is this just reddit being reddit
i'm lowkey scared bc i may have to take my exam mid-late july and i want to have everything ready for application in september
I passed Step 2 through pattern recognition and that should concern medical education
By the end of my Step 2 preparation, I had stopped reading questions the way I once thought doctors were supposed to.
I was no longer carefully evaluating full of clinical pictures. I was scanning for fingerprints.
A few trigger words could collapse an entire question into a likely answer before I had fully processed the stem. A young woman with abdominal pain and hypotension. An elderly smoker with painless hematuria. A postoperative patient with fever on day two. Sometimes I could predict the test writer’s intention halfway through the vignette.
And the uncomfortable part is this: it worked.
The deeper I got into dedicated study, the more I realized that success on Step 2 was not purely about understanding medicine. It was also about understanding the architecture of the exam itself. The patterns, shortcuts, wording habits, elimination strategies, and psychological tendencies embedded into question design.
I learned how NBME questions “feel.” I learned which answers were often too aggressive, too outdated, too risky, or too definitive. I learned to identify distractors before fully understanding the pathology behind them. Sometimes I could arrive at the correct answer through statistical instinct rather than true diagnostic certainty.
Eventually, I realized I was developing two parallel skill sets: one for medicine and another for taking medical exams.
To be clear, pattern recognition is not fake medicine. In many ways, it is medicine. Experienced physicians rely heavily on illness scripts, heuristics, and rapid recognition developed through years of exposure. An emergency physician does not slowly rebuild every differential diagnosis from first principles each time chest pain walks into a room. Human beings survive cognitively by recognizing patterns quickly.
But there is a critical difference between meaningful clinical pattern recognition and what standardized exams can unintentionally reward.
Real medicine forces humility. Real patients do not present as cleanly as board questions. Symptoms overlap. Histories are incomplete. Laboratory values conflict. Patients fail textbook treatments. Atypical presentations punish premature closure. Clinical reasoning in the real world often means sitting inside uncertainty while balancing risk, probability, and incomplete information.
Board exams, by necessity, compress reality into solvable archetypes.
That compression creates a dangerous illusion. If students repeatedly succeed by recognizing the exam’s preferred archetypes, they may begin confusing test fluency with clinical fluency.
At times during my preparation, I felt less like I was learning medicine and more like I was learning how question writers think. The goal subtly shifted from asking, “What does this patient have?” to asking, “What answer is this exam trying to reward?”
Those are not always the same exercise.
The issue is not that Step 2 lacks value. Standardized testing has an important role. Medical knowledge matters. Clinical reasoning matters. Pressure testing matters. And to be fair, many Step 2 questions are thoughtful and educational.
But I believe we should be more honest about what high performance on these exams actually represents.
A strong Step 2 score may reflect medical knowledge. It may reflect discipline and endurance. But it may also reflect mastery of pattern compression, test psychology, and probabilistic elimination strategies that are only partially transferable to patient care.
That distinction matters because medical students internalize what the system rewards. If exams disproportionately reward recognition shortcuts, students will naturally optimize for recognition shortcuts.
These realizations eventually pushed me to build Step2Drill, a learning platform designed around the exact mechanisms I noticed during preparation: pattern recognition, diagnostic pivots, cognitive traps, and rapid illness-script formation.
Not because I believe pattern recognition should replace clinical reasoning, but because medical students deserve honesty about how modern exams are actually conquered and where the gap between test performance and clinical understanding still exists.
I passed Step 2, and I am grateful I did.
But after months of preparation, one uncomfortable question still lingers in my mind:
Did I become better at medicine, or simply better at decoding medicine exams?
Somewhere along the way, a lot of people preparing for Step 2 start feeling like they don’t belong here.
Like one bad score prediction, one failed block, one Reddit post, or one comparison suddenly erases everything they already survived to even reach this point.
But pause for a second and really think about your journey.
You passed prerequisites people quit during.
You survived medical school exams, rotations, sleepless nights, self doubt, burnout, sacrifices, pressure from family, pressure from yourself, and moments where you genuinely questioned whether you were capable.
And despite all of that… you’re here.
Preparing for Step 2.
Do you understand how far that actually is?
You did not accidentally end up here. You earned your seat at this table.
This exam is hard because medicine is hard. But difficulty does not mean you are incapable. It means you’re doing something that demands growth.
Have confidence in the work you’ve already put in. Reflect on the obstacles you’ve already overcome. The version of you from years ago would probably be shocked you even made it this far.
Rooting for all of you. Keep pushing. 💪🙏
Nbme 13...243
Nbme 14... 245
Nbme 15... 249
Exam in 3 weeks.
250+ possible on real deal??
So guyssss
I am at a phase where I have to book date since my block is ending in June.
Tests so far-
UWSA 1- 220
NBME 10-242
NBME 11-244
NBme 9- 253
Nbme 13-254
Nbme 12-256
All taken 7-10 days apart with last nbme12 taken 10 days ago.
I need to take nbme14-16 the majorr ones and uwsa2.
So I thought to take a date and then spread out rest of practice test according to it.
Am I ready 😭😭??
I don’t feel like I am
Have to give in June because Need to apply to upcoming Cycle!!
Any guidance for the last days upto exam would be very helpful!