i failed for the third time

[jj_hope]

For the longest time i've been a silent member of valuemd, and thye've been plenty of times that i found encouraging suggestions and i'm hoping for the same help this time i'm being more vocal.i'm desperate for help...i failed the exam for the third time with a score of 182 (74) the first 2 times that i took the exam i had really scores....so this was truly a grave improvement but to be so close and fail....i'm wasting no time i'm back to studying again.
I did the nbme's and i took one 3 days before the exam and score 224, i felt more than prepared. I just feel so discouraged...but i'm not going to give up i'm going to work even harder than before and i'm hoping for the best. i plan on taking the exam within 2months i don't want to prolong the study time. i've already taken kaplan and i do feel like the material i have is sufficient.
i'm going to purchase uw and do questions daily for the next 2 months.
I know i've messed my chances for residency but i need to think ahead realistic what programs do i have a chance in?
thanks for any help.

[BrendaB_MD]

I am sorry to hear your news.

I am curious: what was you NBME history prior to taking this test? Did you only take one NBME exam or did you take several prior to taking the real deal?

The standard deviation for the a real USMLE score is about 16. The NBME exams have 1/2 the number of questions as the real exam so the standard deviation of the NBME is about sqrt(2)*s.d. = 1.4*16 = 22.4. So, you scored about 2 standard deviations below the level predicted by your most recent NBME -- which is a pretty big swing.

If you other NMBE scores were in the 220 range, then I would say that you either have test anxiety or simply had bad luck. If your other NBME scores were much lower, then it may be that your most recent NBME was simply good luck (luck goes both ways!) and was not representative of your true score.

If there is anything to be learned from your story is that it is important to use the NBME exams to be certain that you will pass. This means that you should be able to take 3 NBME exams over a period of 6 wks prior to the exam with all of them having a passing score. It is silly to take the exam hoping that you will pass. Prepare until you are certain that you will pass.

It sounds like there may be hope. Although you didn't give the exact details, it sounds as if your USMLE score improved significantly over your past attempts. In addition, you recent NBME score also shows improvement. Taken together, these facts suggest that you are improving. My only advice is to take all the NBME exams (multiple times if necessary) and only take the real exam if your NMBE results consistently show that you have a wide safety margin.

I

[MDXRS22]

Sorry to hear that you also failed that many times :(This is not the end of the game for you, as I can see you have a mind set to keep on going also, and you should stay positive and also keep on praying. You are in my prayers, and I am sure you will pass.

By the way do not worry about what program you will fit into...stay focus and see the exam first.

Keep hope alive and keep on trucking until the job is done!

[jj_hope]

Thanks BrendaB_MD for the advice. I took 3 nbme's: first one 3 months before the exam ( 194), seond one a month before (220) and the third one 3 days before as mentioned above.
I think it was a case of bad luck and nerves too, i was extremely anxious becasue i was desperate for passing, but my being over cautious just ended up being my downfall. I'm trying not to dwell ont he negatives and just push forward with full force and faith that this time around the hard work pays off.

[jj_hope]

MDXRS22 thank-you so much for your kind words, thank-you for keeping me in your prayers. I want this even more than before. I on a strict study schedule and i got uw quesetions and i plan on doing them everyday for the next 2months. I registered for the march-may block hopefully i can take the test in april, and God willing i will pass this exam this time around and move forward. Once again thanks for the encouraging words.

[med etudiant]

What school did you go to?

[BrendaB_MD]

Based on your NBME results, it sounds like you were well prepared and, given those scores, it was quite reasonable to go ahead and take the test. My guess is that you either had (very) bad luck, or you got a bad case of nerves.

My only advice is to keep up your study, and take a few more NBMEs to assure yourself that you are prepared. Really, if you are consistently scoring well on your NBMEs that should do much to settle your nerves. Apparently you know the material so you don't need to worry about that. You need to avoid getting psyched out: i.e., getting nervous about getting nervous!

It sounds like you have conquered the hard part. Now you need to get control of your nerves.








Thanks BrendaB_MD for the advice. I took 3 nbme's: first one 3 months before the exam ( 194), seond one a month before (220) and the third one 3 days before as mentioned above.
I think it was a case of bad luck and nerves too, i was extremely anxious becasue i was desperate for passing, but my being over cautious just ended up being my downfall. I'm trying not to dwell ont he negatives and just push forward with full force and faith that this time around the hard work pays off.

[red_chillie09]

jj_hope i'm sorry that you didn't pass. But it's truly commendable that you're optimistic of your road ahead, and this is exactly what you need to succeed. I failed the step twice and passed on my third try,i'm currently doing my rotations. At the end of the day for me failing twice and passing on the third time hasn't hindered my medical career, I just consider it as a temporary deviation. It's good that your strongly focused, keep working harder than before and I am more than certain that you will pass this exam this time. Wishing you all the beest and I will keep you in my prayers as well.
Good Luck!!!

[lifeAgift]

Your residency chances don't have to be shot unless that's the reality you create, in which case here are your options:

Prepare to become a big pharma sales rep, tell yourself every night that the clinical trials aren't flawed and you really are helping people. Drive a lexus where a blue suit and pay back your loans.

Apply to dental school. Pray for advance standing. Finish in 2 years and come out making more money then most MD's. Pay your loans back.

:idea:Consider teaching at a college or university and become a premed advisor. Pray for a contract at a state institution and maybe they'll pay bak 5 k of your loans.

Get to circulating, work on your abs and marry up and become an educated stay at home trophy hubby/wifey.

Apply to ND, DO or chiro school. Pray for advance standing. Woo all your future patients with your MD degree and integrative health savviness. PAy back your loans

RECREATE YOUR REALITY and believe that the UNIVERSE/DIVINE/MOST HIGH has a plan for your life... that includes a choice residency custom made for someone with your tenacity and charecter! At the end of the day give yourself a big hug for following your dreams, and then pay back your loans!

GOOD LUCK...use what you can scrap the rest:peace:

[red_chillie09]

I disagree with lifeAgift. True that your road towards residency will be extremely difficult but it isn't impossible. Perhaps you won't get into the program that you've always wanted but i'm certain that you will find something. The doctor that i'm currently working with failed his step 1 3 times , step 2 twice and still got is residency in at a medical university.
It's a tough road ahead of you but stay strong, keep the faith and keep working hard. Don't let negativity drag you down.
Good Luck.

[gschneid]

On the flip side, while it's nice to be determined to reach your goal, it kind of makes you wonder whether you are cut out for medicine. You've probably paid a pretty penny to take all these exams. At what point do you say enough is enough and find something else to be successful doing?

[stanfordpa2005]

This person has asked for advice so please be kind and offer him suggestions on how he can improve and give him strength and encouragement. Sure this is a big test, but test is not always a true measure of a persons ability to become a competent clinician. If you can't be supportive or positive, please don't say anything.

jj_hope, I know you want to take the exam again within 2 months, but please don't take it unless you know you are ready. I recommend taking couple days off and clear your mind. Go for a walk on a beach. Go for a movie or spend time with family and friends.

Then create a plan and stick with it. Don't focus on residency. If there's a will there's a way. You have come a long way and you just have to be confident that you will prevail. Study hard, do as many practice exams as possible. If you are not clear on a concept, ask someone to help you understand it.

I am confident you will pass. Stay positive...you have what it takes other wise you would not be there in the first place. Stay strong!

[windsorMD]

as hard as u have spent studying for the exam it is just as important if not more to stay calm during the exam itself. you can study for 1 year straight and know everything cold but if you start to trip during the exam then nothing can save you. you have done well on nbme's which shows that you know the material well. focus on simulating the exam as much as you can, do 8-hour exams at home, work on your stamina, see your doctor on getting an anxiolytic, i know if you work on these factors during your prep now you have the potential to do very well the next time. don't lose hope. don't listen to people telling you to become pharm reps. you will be a doctor just continue to work hard..and dont stresss now or during or after the exam.

[jj_hope]

Thankyou all so much for so many kind words, even the one's who were negative. I took an nbme yesterday and i scored 242, i know for a fact its not that i don't the material, my nerves got the best of me and in the end it hurt me more than anything else. I'm not goin to dwell on the failure, i'm just going to move ahead and push forward. I plan on doing kaplan q bank for one month and uw for the next month and taking one more nbme 3 weeks before the exam. I've already registered for my block just waiting for CIN then i can register for the test date.
This time around I am more confident in myself, by falling down so many times the greatest lesson i've learned is that the end of the day you and you only control the path you choose to take. I let my nervousness hinder my path, but no more.

[john_md7]

hi jj_hope,
My son uses this forum often and he asked me to read your post. And I just wanted to share my experience with you, I too was in your predicament- I failed my step 1 4 times, on my step 2 i scored 99, and the rest was history. I got my residency in new york and I own a private practice. It is evident that you are a bright, strong willed individual, I hope my experience shines some light of optimism in you. Don't let nay sayers deter you from your course, where there is a will there is always a way.
Good luck and I hope to see you post again in two months saying that you passed.
All best!!!

[gschneid]

This person has asked for advice so please be kind and offer him suggestions on how he can improve and give him strength and encouragement. Sure this is a big test, but test is not always a true measure of a persons ability to become a competent clinician. If you can't be supportive or positive, please don't say anything.

jj_hope, I know you want to take the exam again within 2 months, but please don't take it unless you know you are ready. I recommend taking couple days off and clear your mind. Go for a walk on a beach. Go for a movie or spend time with family and friends.

Then create a plan and stick with it. Don't focus on residency. If there's a will there's a way. You have come a long way and you just have to be confident that you will prevail. Study hard, do as many practice exams as possible. If you are not clear on a concept, ask someone to help you understand it.

I am confident you will pass. Stay positive...you have what it takes other wise you would not be there in the first place. Stay strong!
I'm sorry, I didn't realize this was a positive comments only thread. It wasn't my intention to put the OP down or be overly negative. Sometimes you have to be realistic about things. You can't just charge ahead blindly in the same direction. If something isn't working you have to stop and reassess the situation. I understand that step 1 is not the best indicator of future success but it is a step in the process. It obviously has a purpose. Medical practice is a series of multiple choice tests and if you aren't finding success on the first one, maybe it's time to do something else.

[BrendaB_MD]

I agree -- your comment was completely reasonable. Too often, people on valueMD offer a reflexive chearleading rather than thoughtful comment. I think it is quite reasonable to ask whether a person with three failures should continue.

I am always amused at the comments that the USMLE has little to do with being a competent doctor. I agree to some extent. There is much more to being a good doctor than having command of a fact base; however, I think it is important for a doctor to be able to master the knowledge base at some point. I think it is quite reasonable for the authorities to require passing the USMLE as a necessary but not sufficient condition for being a doctor. Certainly, the inability to pass the exam should raise questions.

In the past, I have often questioned whether people with multiple failures should continue; however, in this case, there is some good evidence that the person actually knows the material but has a problem that can be solved. Thus, I think there is some reason for optimism.


I'm sorry, I didn't realize this was a positive comments only thread. It wasn't my intention to put the OP down or be overly negative. Sometimes you have to be realistic about things. You can't just charge ahead blindly in the same direction. If something isn't working you have to stop and reassess the situation. I understand that step 1 is not the best indicator of future success but it is a step in the process. It obviously has a purpose. Medical practice is a series of multiple choice tests and if you aren't finding success on the first one, maybe it's time to do something else.

[jj_hope]

gschneid, I do appreciate your comments, and you're right this isn't a passive forum, just as this field isn't.
I take both the positive and negative comments with sincere appreciation, it's true I have to be realistic about my future and trust me I'm examining everything to it's finest detail. But I just don't want to look back in life and just think what if I would've tried just one more time. I do believe that I am capable of passing this test, and I have very realistic expectations of what lies ahead of me in life. I'm certainly not aiming for a super competitive field, I'm willing to take whatever program I get into.
Thanks for being straightforward.

[gschneid]

Thanks. Best of luck to you.

[Naveenanirada]

Dear jj hope, God bless you, and dont worry about people who hide and make snide remarks. Ignore them. I was reduced to tears when I read johnmd7's post. He failed 4 times, and he came back and fought his way out.

You go JJ, get up and fight!
And ,johnmd7, I will probably never see you , but I want to say this, your one line on this forum meant a lot to me. God bless you and thankyou for coming and sharing your story.Stanfordpa2005, thanks for trying to make this world a saner place.

Go JJ!!!

[Chopdoc]

For the longest time i've been a silent member of valuemd, and thye've been plenty of times that i found encouraging suggestions and i'm hoping for the same help this time i'm being more vocal.i'm desperate for help...i failed the exam for the third time with a score of 182 (74) the first 2 times that i took the exam i had really scores....so this was truly a grave improvement but to be so close and fail....i'm wasting no time i'm back to studying again.
I did the nbme's and i took one 3 days before the exam and score 224, i felt more than prepared. I just feel so discouraged...but i'm not going to give up i'm going to work even harder than before and i'm hoping for the best. i plan on taking the exam within 2months i don't want to prolong the study time. i've already taken kaplan and i do feel like the material i have is sufficient.
i'm going to purchase uw and do questions daily for the next 2 months.
I know i've messed my chances for residency but i need to think ahead realistic what programs do i have a chance in?
thanks for any help.

PASS Program.

New branch campus in St. Augustine Florida starting in April if that suits you better.

Your chances? You still have a real chance. I can't say how much or little without knowing your whole "package", but certainly you can still do it. I have known people who have done it.

PASS Program. Just do it.

[lifeAgift]

I disagree with lifeAgift. True that your road towards residency will be extremely difficult but it isn't impossible.

WHY do you disagree?:doh:

I never said it was impossible I just sarcastically laid out the options if he/she did give up on him/herself and then wrapped things up with and encouraging word to hang in there.

Did you red the whole post chillie pepper;)

[jj_hope]

Chopdoc-Thanks for the advice, I'm going to do the Pass Program in Chicago in March, hopefully 3 weeks after it I can take the test.
John_md07- Thank-you so much, your one post as truly revitalized me. I'm not ever going to give up, I'm even more determined than before to pass this test this time around and move forward.

[hayfaelamin]

Don't worry you can do it.

[cooli]

is the score estimator that comes with kaplan qbank accurate? according to their score estimator an average of 50% is equivalent to a 211 on the real step? just wondering if anyone who used qbank score estimator got the estimated score on step?

[handsomeroses100]

winners dont quit,quitters dont win

[BrendaB_MD]

These overly simplistic platitudes are unhelpful. While it is strictly true that 'quitters don't win and winners don't quit' the situation is more complex. The probability of success diminishes with each failure on Step I. Yes, there are anecdotal accounts of people with multiple failures who went on to succeed; however, those are the exception rather than the norm. More often, people slog on, burning more time and money before they eventually give up. Perhaps a more nuanced version would be: "you got to know when to hold 'em, know when to fold em, know when to walk away and know when to fight". Unfortunately, the answer is not simple. Using your logic, I would still be training for a shot at the NBA....

Also, there are many ways to win in life. There are many careers that are satisfying, pay well, and may be better suited to ones strenghts. There is little sense in pursuing a career that will be a constant uphill battle.






winners dont quit,quitters dont win

[red_chillie09]

BrendaB_MD i understand what your saying...it's true that the road for jj_hope is going to be harder than most but obviously he's trying harder than before, and from the sounds of it I think he's working towards this line of work not just for the money. Considering that the poor guy's test it coming up in a week, the least you could do is pass on encouraging message.
JJ_HOPE i hope and wish you much success. You are in my prayers, good luck with the exam.

[elcubano]

drop some propanolol dude!
u are rdy for step.

go in thinking u will crush test.

m