r/usmle

I want to cry

My exam is in 3 weeks. I've given NBME 26-30 with the following scores:

NBME 26: 65%

NBME 27: 65%

NBME 28: 60%

NBME 29: 73%

NBME 30: 65%

I plan on giving NBMEs 31, 32 and 33 each 1 week apart and free 120 as well. The problem is as the exam day is getting closer my anxiety about not improving in the subsequent NBMES and not passing given the borderline scores that I have is getting the best of me. I haven't been able to be productive in my preparation. I keep on thinking I'm stupid for not being able to score better. I'm really scared and could really use some advice/words of encouragement. Thank you.

Most people's wrong answer review looks like this: read the explanation, understand why the right answer is correct, move on.

The problem is that process tells you nothing about what actually went wrong in your reasoning. You already knew the content half the time. The failure was earlier — in how you read the question.

What actually helps:

Before reading the explanation, write one sentence: "I chose X because I thought the question was asking about ___"

That sentence almost always reveals the real error. Either you misidentified what was being tested, anchored on the wrong finding, or picked an answer that would be correct in a slightly different clinical context.

The explanation then becomes useful — not because it teaches you new content but because it confirms exactly where the read broke down.

After two weeks of doing this you'll notice you make the same 2-3 reasoning errors repeatedly. Fix those and your accuracy jumps more than any content review will.

Took NBME 33 today . This was 1st one which I have taken online .

Got 68% EPC ,

Rest all taken offline -

NBME 31 - 66%

NBME 32 68%

NBME 27- 68%

NBME 25 - 73%

NBME 28- 74%

U WORLD - 95% Complete- with 64

TBH I found old NBMES way easier than recent ones . Honestly, was never comfortable during 33 with questions. Older ones had so many freebie questions which gave me confidence to go through it .

This one felt like a long walk in a maze .

Got 10 days , what should I be doing from here ?

Thanks )

Hi ms4 here appearing for step 1 on tuesday.

My nbme scores are

31: 64%

32: 58% (taken in march)

Free 120: 2024 64.5% (3 weeks from exam)

33: 63.5% (1 week from exam, but i made veryyy foolish mistake got tonns of easy qs wrong idkw 😭)

Free 120: 2026 85.5% (76% on new qs) today

Am i risking it, or should i delay?

Any last few days, prep advice from recent test takers would be appreciated.

I’m looking for USCE and have not received any response from cold emailing. I also need a letter for visa. Should I go for third-party services or should I contact a physician who can give paid observership ?

Hello~Let’s make some plan everyday and keep going !

Need some genuine advice from fellow IMGs regarding visa delay and Match timeline.
I’m a 2025 IMG, passed Step 1, cleared OET, and currently preparing for Step 2 CK (scheduled for July 27). Earlier this year I went to the US for an observership at Saint Mary’s Hospital and was able to get 2 US LORs from Internal Medicine physicians.
Recently, I had another visa interview for upcoming observerships planned for Aug/Sep 2026 However, the embassy placed my case under 221(g) and asked me to submit my Step 2 CK score before they make a final decision.
Now I’m feeling a bit stressed and confused about how to proceed strategically.
My concerns:
Step 2 result will likely come mid-August

Then embassy processing may take additional time

I may miss part of my observership timeline

I currently have 2 US LORs and was hoping to get a 3rd strong US LOR before applying for Match

For people who went through similar situations:
How long did visa processing take after submitting Step 2 scores under 221(g)?

Is applying with 2 strong US LORs still reasonable for IM?

Should I fully prioritize Step 2 now and stop stressing about observership timing?

Did anyone match despite visa/rotation delays?

Honestly just looking for some guidance and reassurance from people who have been through the IMG journey because this process can feel mentally exhausting sometimes.
Thank you in advance.

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.

So after almost 3 months of research of how this whole thing works, I have decided to give it a go for usmle, but I would love if someone can give me a more clear view, as most video's or posts I read have been 3-4yrs old and I'm finding it difficult to search for a newer perspective on this exam.

For starters I'm from a peripheral medical College, currently in 3rd yr. With my finals approaching in 2 months and only 2 passout batch (I'm from the 5th batch), no alumni, no one who has done usmle, no connections, actually the first from the entire family in this course, and the teachers and staff are also a bit unreceptive, so it becomes hard to trust myself to pass this usmle as a whole.

And secondly, for step1 I have compiled the basic resources list, and have decided to stick w bnb, pathoma, f.a, sketchy, if anyone thinks a better resource is available pls do help me out, and I'm hoping to take uworld once my 3rd yr finals are done, I'm more confused on how my timeline shd be, and how do I approach, like which subject do I start with and all😓 pls do help me out...

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. 💪🙏

Hi everyone, I am a non-US IMG, recently cleared Step 1, and just passed my final year MBBS. I’ve recently started my internship and am currently looking for U.S. clinical electives/externships before the end of September because my visa expires soon.

My college is VSLO-certified, but there are very limited slots available. I’ve already applied to a few programs, though they mentioned it may take several weeks to hear back, and unfortunately I can’t afford to wait too long and risk missing the timeline.

I would really appreciate any guidance regarding

CBSE: 59 EPC diagnostic, no prep (the week after my final) Mid February

Early March NBME 29 offline: 62% correct

Late March NBME 33: 66 EPC

Last week NBME 32: 65 EPC

Yesterday Free 120 at prometric center: 74%

I was advised to do another NBME, but I am tired, and I don't want to get burnt out and get sick. Thoughts? I have rotations coming up, so I am in a bit of a conundrum in regards to time. I'm scared of pushing it back again.

My score is as follows for Step 1
UWSA - 71.5%
NBME 25 - 75.5%
NBME 26 - 74%
NBME 27 - 67.6%
NBME 28 - 73%
NMBE 29 - 79.4%

Would like some advice on my passing probability , exam is in 2 weeks
I will give the rest of the NBME and free 120 in next 10 days

Hi, I wanted to take Step 1 but i was so unsure about my ability that I only started creating a Myintealth account after i reach 70% on NBMEs. My account status is still "submitted or Identification Review", now that I've reach 80% range and only 5 NBMEs left plus the new Free 120 for me to do I'm afraid that I might ran out of NBME before I can register for the exam, and i might fatigue myself. Is this wait time for NotaryCam normal and is there any way i can contact ECFMG to process this faster?

https://preview.redd.it/fbdkgybcd92h1.png?width=2089&format=png&auto=webp&s=d843109a505e62ba7d2dc86d994dcd4d0b4ac373

Im 4 weeks out and due to time crunch i can only fit nbme 30-33 & free 120. How imp is it to do uswa?

I have my exam in 10 days

I have given nbmes with score

28- 66

30- 61

31- 67

32- 72

33- 68

What should I do?

I feel like I have forgotten many facts

Not given free 120 yet

And what should I do about uwsa

How many uwsa is necessary?

Can someone please tell me what to study from the biochem section? is it the diseases like lysosomal or glycogen storage diseases? Someone also said to study genes not sure what was meant by that. Also as far the nutrition questions goes are those just the vitamins and mineral questions and maybe that is tied into the biochem portion .

Hi, I will be doing an observership with an ESTA this summer. I have my plane tickets and accomodation. The doctor I will be observing wrote me a letter stating that I will be doing an observership at X date. I wasn't sure about how much cash I need to show at airport control and if there are any other documents I might need. Also if someone has any tips on what to say during airport control that would be great. thanks!

My Step 1 exam results are coming out tomorrow, and I'm incredibly anxious. I have a question for those with experience: after the exam, I remembered 180 questions. I'm sure about 130-140 of them were correct, but I still can't remember the other 100. Do I have a chance of passing?