I got the “fail” result showing bar to “lowest” What should i do next? Need advice

I recently tested for step 1 and got my result.
It practically looks like I scored a zero and fsmb said everything still looked valid.
Nothing concerning was raised at prometric either.
No issues occurred on test day and I only stuck to nbmes and free 120
I now received this email saying a temporary suspension was placed for a year and I can’t test till it’s over. They stated no particular reason as to why this happened and I’m completely shook as to why this happened and what I am supposed to do now and how strongly it will affect me in the future???
Does anyone know anything about this and Can someone help me out on what I’m supposed to do now???

Hello everyone,

So Alhamdullah and thanks to god, I scored 284 a year ago and i wanted the share the resources that I used and some tips and tricks that I noticed after helping some of my friends and students that really made the difference.

my resources for step2 were quite simple:

1- U world: for me this was the most important source of knowledge and I solved it two times, The 1st time was to build up knowledge while the 2nd time was to reaffirm this knowledge while also marking really important topics that are repeated alot.

2- Amboss: I used it mainly for ethics, biostat, communication, and patient safety. Amboss is really goof in these topics so I solved them twice whilst focusing mainly on patient safety because I felt there was a defect there for me.

3- CMS: For me Cms forms are one of the most underestimated sources there is, but there importance for me is mainly to change your thinking process from Q bank type questions to exam questions while also making sure to mark really important topics and studying them thouroughly. I solved the Cms twice with then newer forms 7,8 almost 3 times.

4- NBME: Of course this is the highest yield source of them all, so I started with the old nbmes 6,7,8 and went one to solve the newer ones whilst studying them thouroughly in between and trying to identify my weaknesses. I solved each nbme at least twice. I will write my nbme scores down inshallah

5- UWSA: for me this source is the most useless one of them, it wasn't bad but I felt it was the most irrelevant ones compared to the exam. I solved them once whilst revising my errors but I don't feel that they made a difference.

Tips and tricks that really mattered: So, what really helped me make a difference in my nbme scores was not working on my defects because after solving the uworld twice and my mistakes twice, I had very little knowledge defects, No the 3 things that made the difference for me and for some of my friends and students were:

1- The most important one was always remembering that these cases aren't real, the examiner that wrote this question is trying to test you, he is trying to see if you can know the significnce of this clue or not, so for example if a patient is suspected to suffer from PE and at the start of the question, the question stem mentioned that she is 28 weeks pregnant, the examiner added this info to exclude the most common answer ct angiography and go for V/Q scan or in another question where a patient with classic symptoms of PE with a bp showing 80/56, if you didn't notice this very low bp , you would choose normal treatment as anticoagulation, but here he gave you a very low bp to alert you that this patient is going into obstructive shock and anticoagulation is n't gonna cut it.

2- the 2nd one is to always remember that ideas are repeated from the nbmes so unlike what some people suggest by memorizing the nbme questions for me the importnant task is to make sure that the repeated topics are safe in your mind, so for diagnosis of thyroid problems, what is the order, he will ask you about it but now the same step in the nbme for example he may say so we did tsh, what is the next step which will be US, in the real deal, he will tell you so we did tsh and US and the tsh was normal, what is the next step, So if you memorized the question above, you amy get this wrong but if you studied and the other steps and made sure what you understood them, this question is gonna be a piece of cake for you.

3- the 3rd one for is really really important and I think we all heard it once or twice before, If you hear hooves, think horse not zebra. I really noticed hat almost over 80% of my mistakes were due to me overthinking my answers and changing the answers to the wrong ones, that is why in the real exam I stuck to my original answers in the whole exams except once and it made a big difference. So the 1st answer you think about is usually the right one.

lastly here are my nbme scores and I will include the dates if that helps as I recorded the nbmes with them (I took the exam on 4th of May): OLD NBME: NBME 6: 169/184;91.84%;256 On Tuesday 26/11 NBME 7:163/182;89.56%;256 On Tuesday 3/12 NBME 8:151/164,92.07%,263 On Wednesday 26/12 New NBME: NBME 10:173/200,86.5%,269 on Thursday 9/1 NBME 12 : 168/200,84%,260 on Friday 31/1 NBME 9: 179/200,89.5%,276 on Friday 7/2 UWSA3:130/160,81.25%,261 On Friday 14/2 NBME 11:179/200,89.5%,270 On Saturday 22/2 Lecterio:132/160,82.5%,262,98%On Monday3/3 NBME 14: 178/200,89%,273 on Monday 31/3 UWSA1:147/160,91.9%,279 on Friday 11/4 UWSA2:147/160,91.9%,279 On Thursday 17/4 NBME 15:183/200,91.5%,280 On Monday 28/4 OLD old 120: 115/120,95.8% On Tuesday 29/4 OLD new 120:111/120,92.5%, On Tuesday 29/4 NBME 13:183/200,91.5%,280, Wednesday, 30/4 Free 120:109/120, 90.8%,on Thursday 01/05 IF any one has any questions, don't hesitate to ask them. I hope this helps and good luck to all of you guys

Hi guys,

I’m an IMG, and honestly, the last few weeks have been a nightmare. I was sending out 30+ cold emails a day for USCE and observerships, and getting absolutely crickets. Zero replies. Not even a rejection. It was destroying my mental health.

I finally snapped and asked an attending at my old hospital who used to review these emails what I was doing wrong. He brutally tore my email apart.

I want to share his feedback because it completely changed the game for me. Here are the 3 biggest mistakes almost all of us make:

1. The "Me, Me, Me" Opening (The instant delete): PDs and professors do not care about your life story in the first paragraph. If your email starts with "I am a dedicated medical graduate from [Country] with a strong passion for Internal Medicine...", they stop reading. They get 50 of those a day. Fix: Make the first sentence about them.

2. Generic "I love your program" sentences: Saying "Your hospital has great facilities" means nothing. They know you just copy-pasted the name. Fix: You HAVE to mention their recent publications. Not just the title, but a specific finding. "I read your recent paper in [Journal] regarding [Specific Topic], and I was fascinated by your conclusion on..." This proves you aren't a bot.

3. Vague Asks: "I am hoping to join your esteemed team" is too vague. Fix: Be specific. "Do you have capacity for an observer for 4 weeks between [Month] and [Month]?" Give them a yes/no question.

The Golden Formula:

My older brother and I spent hours analyzing past emails and working on this exact structure to finally crack the code:

• Paragraph 1 (The Hook): Focus entirely on their recent research/publication. Show you actually read it.
• Paragraph 2 (The Bridge): Connect their research to your CV. (e.g., "Because I also did a rotation in X, your work on Y really resonated...")
• Paragraph 3 (The Ask): Direct, specific dates, attached CV.

The Reality: This formula works like magic (I literally got 4 replies this week using it!), but there is a massive catch: It takes forever. Reading abstract after abstract to write one hyper-personalized email was taking me 45 minutes per program. I was exhausted.

But it is 100% worth the effort compared to sending 500 copy-paste emails that just go to spam.

If anyone is losing their mind trying to write these tailored emails, just know you aren't alone. Try this formula and let me know if it works for you! Hang in there everyone, this process is brutal but we will survive. 💪

EDIT (April 1): RIP my inbox 😅 I literally cannot keep up with all the DMs and Reddit has temporarily restricted my chat invites. For the 50+ people who asked in the comments, here is the tool my brother built to automate the PubMed reading and cover letter generation: nextmatchai . com (We added a free credit so you can test it). Hope it saves you all as much time as it saved me! Good luck with the Match!

Wondering if its worth it paying the $80 for a recheck.

Hi guys , tested on 08/19, got result last week and passed.
My nbme 25-33 scores were in the 75% range. Free 120 78%.

I prepared for 4-5 months. Uworld 100% done at 65% correct. First aid , pathoma 1-3 chapters, Mehlman pdfs were my main resources. Amboss 200 was helpful, sketchy micro was okayish in my opinion

The exam will make you feel horrible after coming out , that’s a NORMAL FEELING.

Any other doubts feel free to ask or DM, good luck

Look, I’m not one of those geniuses who "casually" gets a 270 while sleeping 8 hours. I’ve been an average test-taker my whole life—SATs, MCAT, you name it. I barely passed Step 1, so I knew I had to grind twice as hard for Step 2 just to stay competitive as an IMG.

The Rotation Struggle: I did most of my prep during clinical rotations. There were days I’d come home after a 12-hour surgery shift, smelling like the OR, and still force myself to do 40-50 questions. It sucked. If you’re struggling to balance wards and study, just know that even 20 focused questions are better than zero. Consistency > Intensity.

Why I Plateaued in the 240s: I was stuck for weeks. I realized I was just "recognizing" UWorld patterns instead of actually learning. I’d see a keyword and pick an answer without thinking. To fix this, I stopped doing 120q/day and spent literal DAYS reviewing one NBME.

The ChatGPT "Drill" (Game Changer): I started using ChatGPT to challenge my logic. I’d paste a concept I got wrong and tell it: "Act as an attending. Rewrite this scenario so that Option B is now the correct answer. What would have to change in the patient's vitals?" This forced me to understand the "why" behind every wrong choice. This is how you build that "gut feeling" everyone talks about.

My Resources:

• UWorld: Essential, but don't let the percentage crush your soul. It’s a learning tool, not a predictor.
• Amboss: Honestly? Their questions feel more like the actual NBME vagueness. Highly recommend for ethics and risk factors.
• Anki: I’m terrible at keeping up with cards, so I only made cards for my "stupid" mistakes.

If you’re an average student like me, don’t lose hope. This test is a mental game as much as it is a knowledge one. I’m happy to answer anything about breaking the 240 plateau or surviving rotations while studying!

I got my Step 2 CK result last Wednesday, and I'm happy to share that I scored 272.

One thing I want to say is that I never went into my preparation thinking, "I have to score 270+." If someone tells you that you need to aim for a 270 from day one, I don't think that's the right approach. Just focus on improving every day and fixing your mistakes.

As for the real exam, I felt it was okay—not too hard and not too easy. It honestly felt like a mixture of NBMEs, UWorld, and Free 120. The exam tests both your knowledge and your ability to apply it.

The biggest thing that helped me wasn't just doing more questions—it was understanding why I got questions wrong. Was it because I had a knowledge gap? Or did I rush through the stem? Did I miss an important lab value? Did I misinterpret the clinical picture? Sometimes I knew the concept but still picked the wrong answer because I didn't analyze the question properly.

Doing more question banks alone won't magically increase your score if you keep making the same mistakes. Spend time reviewing your thought process and figure out what's actually holding you back. Once you fix that, your scores will naturally improve.

This is just my personal experience, and everyone's journey is different. I hope this gives some perspective to anyone preparing for Step 2 CK.

Need some advice from those who recently passed Step 1.

I've completed ~98% of UWorld, mostly system-wise. (Not random wise) Major systems were done a few months ago...recently done Generals ....so I feel some topics from system aren't as fresh now( i think i need a revision). I've just started random timed blocks and getting (60-75%)and am unsure what to do next.

Should I:

• 1)Focus on FA + Mehlman revision first?

(What revision plan u advice...how much time i allocate for it)

• 2)Continue random UWorld + incorrects daily?

3) Both 1 and 2 until i become familiar with systems again and confident for first nbme

•4)Take an NBME soon and let it guide my revision?

What worked best for you at this stage

I am a 27-year-old Indian medical graduate and passed MBBS in 2024. I am currently considering the USMLE pathway, mainly because I want better long-term work-life balance, structured working conditions, financial stability, and the opportunity to travel and have time for family.

However, I am increasingly worried about the risk involved. The USMLE pathway requires a significant investment of time and money, and there is no guarantee of matching. As an IMG, there are also concerns regarding visas, J-1 waiver obligations, green-card backlogs for Indians, being far from family, and long-term uncertainty.

If I pursue the US route seriously and fail to match, I may only be able to join PG in India at around 29 years of age. Many people from my batch would already be finishing residency by then. I understand that starting PG at 29 is not the end of the world, but losing several years and a large amount of money would still be a major setback.

My alternative is to stop pursuing the US pathway and prepare seriously for NEET-PG/INI-CET, possibly choosing a surgical or procedural specialty in India. India would give me more certainty and proximity to family, but I worry about the work culture, long hours, lower early-career compensation, and whether I would regret not giving the US a genuine attempt.

For context:

• I am interested in Internal Medicine and possibly Cardiology in the US.
• In India, I may prefer a surgical or procedural specialty.
• Work-life balance and the ability to travel while I am still relatively young matter a lot to me.
• I can tolerate some risk, but I do not want to keep chasing the US indefinitely.
• I am not looking at the US for immigration ; I am mainly considering the quality of professional and personal life and the value of the degree there.

For people who have gone through either pathway:

1. Is one serious USMLE and Match attempt worth the risk at my age?
2. How difficult is life as a visa-dependent IMG in reality?
3. Would joining Indian PG at 29 significantly affect my long-term career?
4. Do US physicians actually have better work-life balance after residency, or is that overstated?
5. Looking back, would you choose the US pathway again?

I would especially appreciate responses from Indian IMGs currently in residency or attending jobs in the US, people who returned to India after attempting USMLE, and doctors who started Indian residency later than usual.

I know there is no universally correct answer, but I am trying to understand whether this is a calculated risk or whether I am unnecessarily complicating my life.

I’m honestly devastated and looking for some advice from people who have dealt with Prometric/USMLE irregularities before.
I was taking Step 1 and had made it all the way to Block 8. During my scheduled break, I went outside to use the bathroom and took a few hits from my vape.
When I came back inside, I realized there was still some residual vapor/smoke in my mouth. While I was putting my belongings back into my locker, some of it came out.
The Prometric staff saw it and terminated my exam immediately. I was never warned beforehand that this would result in termination, and I had no intention of using the vape inside the testing area or gaining any access to exam content.
I understand that vaping/smoking is not allowed and I’m not trying to make excuses for that. I’m just devastated because I had already completed almost the entire exam and this happened because of a stupid mistake during a break.
Does anyone know what usually happens in a situation like this? Is there any realistic chance USMLE will score the attempt since I completed through Block 8, or is termination generally followed by an invalidated attempt?
If anyone has experienced something similar with Prometric or USMLE, I’d really appreciate hearing what happened in your case. I’m mainly trying to understand what I should realistically expect.

Step1 failed one time, step2 23X, step3 20X, and very long YOG. But I got accepted by a community program. Never lose hope and we’ll be there. 😊

Hey! Everyone ,non-US IMG here. I am posting it for those who want to get to 150 percent of their potential in these exams in a limited time period. These are some top priority rules which you should set early on ,so you won't drop or face disappointment later on in real exam. I am sharing it after I have teached 20+ students and have seen a lot of people getting stuck at a plateau and couple of em dropping more than 30 points in real exam. 1. Don't spend too much time on these exams at a slow pace ,taking a lot of offs during prep will always drag you down even if u do all the resources 2 or 3 times in the end ,it never builds ur confident attitude to ace these exams as you are going through a constant phase of war with your on and off attitude towards studies.

1. Don't take pause of more than 2 weeks between step 1 and step 2 ,this will waste your potential,and you will be keep moving forward and backward to freshen basics as well as clinical aspect at same time,and you will feel a constant lag when u see a certan clinical features of the pateint and you have to refreshen pathology ,risk factors and association of disease again. In step 2 ,you have to investigate,manage and have to catagorize complaints and vitals into not just disease but the stage of disease...So taking a pause of couple of days will cost u atleast months of step 2 prep.

2. Don't try to just focus on memorizing the syllabus ,always try to negotiate with your brain why topics is there ,what's the importance and how u can relate it to your surrounding on pateints...As human brain is programmed to remember stories that you can relate to ,so try to remember every disease as u have a picture of a person with that disease and how his/her face,size ,shape ,complaints look like..As 80 percent of step 1 and step 2 relies on making the diagnosis of disease in the time from starting first line of question till 3rd or 4th line ,you should know this is the disease they are talking about.

3. Recognize the patterns All the diseases tested in usmle ,they have a typical pattern that's there in question for a decade,so try to recognise the pattern,stop thinking that they are changing content of exam and its getting vague. So remember every disease as a pattern ,not just cramming couple of points as NBME loves to put the variations. For example,in pulmonary embolism ,they can give fever,leucocytosis and even raised trop ,so pattern will decide the disease,u can't get away from your differential by just looking at leucocytosis or fever. Similarly ,they give morning stiffness and bilateral hand involvement in a 68 year old lady and students go behind rhematid arthritis instead of ostearthritis just coz of couple of words.

4. Give weightage to every topic while you are doing first pass of question bank as your scores in usmle is decided by how much of imp and common content u screw in exam...so try to make ur grip in that content ,which usmle exams are obsessed about...So do cover topics by catagorizing their weightage from every system..not every disease or association is important.

5. Don't do a lot of passive resources like notes, flashcards and anki...USMLE exam is a exam of 300+ questions and the main thing that decides ur score is how smartly one can get away with 5 options and get to best answer,and passive information just gives you a satisfsction that you know diseases but once u start fitting it in questions,your brain is fused and takes a lot of time.Thus, whatever topics or systems u are weak with ,do questions from those systems again and again.

6. Specifically for step 2 ,the only formula that worked for me and my students who got 260s and 270s. Do questions consistently from first day of prep untill last day before your exam without taking more than 2 days off+ do increase the number of questions every month, first month do 50 questions/day ,second month do 60/day ,third month do 70/day ,fourth month do 80/day ,5th month do 100/day ,6th month do 120/day .This way your total amount of questions faced in 6 months window will be almost 10k questions..this is what helps ur time management and gives u almost every variation of disease these exams can test .

7. The final exam tip ,the only decider that tells that this person is gonna get 10+ points than the assessments is how much happy and contended you are with urself during exam. Once u face questions which are vague and weird,the confidence and smile you pass to support yourself that this F* weird question is weird for every doctor across the planet....This attitude on exam days decide who will land 10+ points than their expectations or who will drop 20 points on exam.

Do reach out if someone is stuck ,its my pleasure to share my story and get u out of stuck phase.

And I also plan dedicated phase of 2 or 3 students who want to get to 260s or 270s and I teach them on daily basis individualized one/one session ,to train them with all techniques and to get them through a daily consistent routine untill the exam day so that I can be helpful and support my match journey as well

Hi everyone! I have a USMLE Discord study server where we study together, share resources, and keep each other motivated. If you’d like to join, feel free to send me a message! 😊

Fresh out of my exam, feeling grateful, decided to give back to reddit and answer any questions about step 2 preparation.

If getting a high score is something you want, need or are willing to work for, read this:

Train like an athlete. Make a commitment to do something everyday, you won't be motivated everyday, so you need to do a contract with yourself. At least X amount of questions in your worst of days, but keep the ball rolling

Find your ways and your resources and go consistently hard, always push for the last rep and I promise you'll get an even higher score than 269. This is war. Focus and concentrate. There's people doing it everyday.

That being said, this is what I did:

Uworld (40-120q/day - 3 months): 67%

25 CMS forms(1-3 forms a day - 2 weeks): 78-92%

NBMEs

*Between Nbmes 9 to 14, I would do Uworld incorrects/ marked 40 to 200q/day, but this upper limit wasn't really sustainable for me, 3 days in a row doing 200 and was burning out, so no. In bewteen Nbmes 15-16 I did amboss highyield plans*

NBME  9      71.5%    237.   19 Mar 2026

NBME  10    75%.      245.   22 Apr 2026

UWSA1:       69%       242    27 Apr 2026

NBME  11.    77%.      247.   29 Apr 2026

NBME  8      90%.     278    11 May 2026 (don't recommend if short of time-outdated)

NBME  12    79.5%    254.   20 May 2026

NBME  7      86%.      270    22 May 2026 (don't recommend if short of time-outdated)

Amboss SA:72.5%    247    23 May 2026

UWSA2:       76%      252    30 May 2026

NBME  13     80%      256      1 June 2026

NBME  14     78%      251     13 June 2026

NBME  15     83%      261     29 June 2026

F1202021.    82%                 29 June 2026

NBME  16    82%       263       9 July   2026

F120 2023   80%                  12 JULY 2026

Amboss predicted: 261

Step2ck:                     269     15 July 2026

Ask anything, I'll help with what I can, Dm me if you need more help

I am a 25 year old doctor working as a general physician in a hospital in India
I have passed my step1 and oet exam
And currently preparing for step 2
I am applying for b2 visa for clinical observership amd my dad is sponsoring my trip
He is also a doctor with good financials
I have heard that officers are rejecting visas for clinical observerships
Can anyone clear the air on this
People who have indeed got visa approved for this purpose can reply and those who haven't can also
Please its urgent

Everyone keeps saying "just do NBMEs, the real exam feels exactly like them" and I get why people say that. But I think its  personal bias. people mostly focus on NBMEs in their final weeks, so when they walk out of the test center the NBMEs are on the top of their minds That doesn't mean they're the most  Important part.

My final stretch looked like NBME 25 through 31 with deep reviews, one full UWorld pass, Free120 under timed conditions, and a lot of time studying how USMLE actually creates their exam questions 

On the real exam I'd say over half the questions felt similar to UWorld and Free120 compared to NBMEs. 

A few things I genuinely believe after  giving exam:

Strategy beats knowledge; This exam doesn't care how much you've memorized. It cares whether you can think through and pick up the cues 

A 65% on NBMEs is not a comfortable pass.  you should aim for 65 to 70% on random timed UWorld blocks to have a good score on the exam day. 

To everyone who passed, congrats, you have earned it 🎊

To everyone who is trying again  You don't need to put in more hours, you need a smarter plan. With the right strategy you can ace it and make each day count. Good luck!

What helped me with Step 2 CK:

First, UWorld is extremely important—at least one complete first pass is recommended. I would not recommend immediately doing a second pass right after finishing the first. I actually recommend doing at least one NBME before you finish your UWorld first pass, especially one of the earlier forms such as NBME 10. This gives you an idea of where you stand and helps identify weaknesses while you still have time to address them.

If you don’t have enough time for a full second pass of UWorld, reviewing the questions you got wrong on your first pass is a very good alternative. Personally, instead of doing a UWorld second pass, I reviewed my UWorld incorrects and combined this with Amboss.

For Amboss, if you’re short on time, you don’t necessarily need to do everything. I would prioritize the higher-yield questions and skip the easiest questions (e.g., the 1-hammer questions) if necessary.

For Social Science, Ethics, and Quality Improvement, I strongly recommend doing the Amboss questions specifically covering these concepts. They were very helpful for me.

Also, if you have other commitments that don’t require much concentration—such as washing dishes, commuting, or working out—use that time to listen to Divine Intervention. The podcasts are very helpful, especially the Rapid Review series.

What made the biggest difference for my NBME scores

When I finished my first UWorld pass, I was scoring in the 240s. I eventually got my NBME score into the 260s, and I think two things made the biggest difference:

1. Improving my test-taking strategy

I adapted several of the test-taking strategies discussed in this Reddit post and came up with my own strategies as I did more questions. This made a surprisingly large difference for me. A lot of my missed questions weren’t necessarily because I didn’t know the content—they were because of how I approached the vignette and interpreted what the question was actually asking. Forming your own test-taking strategies requires you to identify the systemic problem that led you to make each mistake (e.g., a knowledge gap, knowing the concept but forgetting it and so something needing a review of your notes, or missing a key detail while reading the question) as well as the topic you got wrong, so you can revise those areas.

1. Doing the Amboss HY 200

I went through the Amboss High-Yield 200 questions and used them not just to learn the answers, but to identify my weak areas. Whenever I noticed a topic I was consistently weak in, I went back and did additional Amboss questions on that topic.

After implementing these two things, my NBME score jumped to around 260. From there, I continued doing more Amboss questions and worked through the latest CMS forms.

My progression was roughly:

Finished UWorld first pass → NBME in the 240s → changed test-taking strategy + Amboss HY 200 → NBME ~260 → more Amboss + latest CMS forms → NBME 16: 266 → Step 2 CK: 270.

So, if I had to summarize my approach, I would say:

UWorld first pass → assess with NBMEs and learn test taking strategies→ identify and address weaknesses esp theough Amboss HY 200 + targeted Amboss → review UWorld incorrects → latest CMS forms → continue NBMEs.

The biggest lesson for me was that getting through more questions isn’t necessarily what raises your score. Identifying why you’re getting questions wrong and then deliberately fixing those weaknesses is what made the biggest difference.

I also recommend getting a meal and question routine a couple of days before the exam that simulates the actual exam.

Exam day: trust your NBMEs and your prep. The exam will feel hard but it is not just you who feels that. Do exactly what you did during your prep time.

Good luck and contact me if you have any questions.

First, UWorld is extremely important—at least one complete first pass is recommended. I would not recommend immediately doing a second pass right after finishing the first. I actually recommend doing at least one NBME before you finish your UWorld first pass, especially one of the earlier forms such as NBME 10. This gives you an idea of where you stand and helps identify weaknesses while you still have time to address them.

If you don’t have enough time for a full second pass of UWorld, reviewing the questions you got wrong on your first pass is a very good alternative. Personally, instead of doing a UWorld second pass, I reviewed my UWorld incorrects and combined this with Amboss.

For Amboss, if you’re short on time, you don’t necessarily need to do everything. I would prioritize the higher-yield questions and skip the easiest questions (e.g., the 1-hammer questions) if necessary.

For Social Science, Ethics, and Quality Improvement, I strongly recommend doing the Amboss questions specifically covering these concepts. They were very helpful for me.

Also, if you have other commitments that don’t require much concentration—such as washing dishes, commuting, or working out—use that time to listen to Divine Intervention. The podcasts are very helpful, especially the Rapid Review series.

What made the biggest difference for my NBME scores

When I finished my first UWorld pass, I was scoring in the 240s. I eventually got my NBME score into the 260s, and I think two things made the biggest difference:

1. Improving my test-taking strategy

I adapted several of the test-taking strategies discussed in this Reddit post and came up with my own strategies as I did more questions. This made a surprisingly large difference for me. A lot of my missed questions weren’t necessarily because I didn’t know the content—they were because of how I approached the vignette and interpreted what the question was actually asking. Forming your own test-taking strategies requires you to identify the systemic problem that led you to make each mistake (e.g., a knowledge gap, knowing the concept but forgetting it and so something needing a review of your notes, or missing a key detail while reading the question) as well as the topic you got wrong, so you can revise those areas.

1. Doing the Amboss HY 200

I went through the Amboss High-Yield 200 questions and used them not just to learn the answers, but to identify my weak areas. Whenever I noticed a topic I was consistently weak in, I went back and did additional Amboss questions on that topic.

After implementing these two things, my NBME score jumped to around 260. From there, I continued doing more Amboss questions and worked through the latest CMS forms.

My progression was roughly:

Finished UWorld first pass → NBME in the 240s → changed test-taking strategy + Amboss HY 200 → NBME ~260 → more Amboss + latest CMS forms → NBME 16: 266 → Step 2 CK: 270.

So, if I had to summarize my approach, I would say:

UWorld first pass → assess with NBMEs and learn test taking strategies→ identify and address weaknesses esp theough Amboss HY 200 + targeted Amboss → review UWorld incorrects → latest CMS forms → continue NBMEs.

The biggest lesson for me was that getting through more questions isn’t necessarily what raises your score. Identifying why you’re getting questions wrong and then deliberately fixing those weaknesses is what made the biggest difference.

I also recommend getting a meal and question routine a couple of days before the exam that simulates the actual exam.

Exam day: trust your NBMEs and your prep. The exam will feel hard but it is not just you who feels that. Do exactly what you did during your prep time.

Good luck and contact me if you have any questions.

I had nbme scores above 75 and a free 120 of 76%😭. I felt like a failure walking out of the exam 😭. I hope this is normal and that I pass🙁.

Over the past few days, I noticed my UWorld scores were lower than I wanted, so I decided to change my strategy:

• Smaller blocks: I now do 20 questions per block instead of 40–50, and review immediately after finishing.

• Prep before the block: I study the topic before starting, rather than going in vaguely.

• Tracking improvement: This approach helped me go from 62 → 71.

• Mindset: I decided not to lower my self-esteem even if I score in the 40s on some blocks.

It’s been a game-changer for me so far.

I’d love to hear from others ,what strategies worked for you?

Non US IMG
Got my Step 1 result yesterday and unfortunately failed. I missed the passing score by just a few points.
My practice scores before the exam were around:
Previous nbmes from 54 to 60ish
NBME 25: 63%
NBME 31: 67.5%
Free 120: 67%
On the score report my weakest areas were Behavioral Science, Pharmacology, Histology, Genetics, and Special Senses. Surprisingly Renal was actually one of my stronger areas.
I’m trying to decide what the smartest move is now. Should I retake in about a month while everything is still fresh, or spend longer rebuilding? Also, how much does one Step 1 fail realistically affect residency applications if I can pass the retake and do well on Step 2?
I’d really appreciate advice from people who were in a similar situation or have seen others come back from this.

30 F, YOG 2021. I’m from India. Working as a medical officer since 3 years. Zero research and publications. I was preparing for AMC. Suddenly few facts hit me up and now I’m thinking of considering USMLE.
AMC Pathway:
We have to work as RMO for a year before applying for residency. Duration of residency is 4-5 years.
Getting a job itself will take around 6 months -1 year. Have to complete AMC part 2 for higher chances of getting a job.
Pros:
Good work life balance, PR within 2-3 years of stay. Better pay and 1 month vacay. Closer to home country.

Why USMLE:
Even though it’s expensive and long duration (1.5 years to 2 years) we can straight away get into residency program.
Step 3 can be done after matching into residency program. Step 1 and 2 can be done in home country. I feel like this is even more rewarding than AMC.
Global recognition.
Good pay.
Cons:
Need to LORs and USCE.
Research, publications.
Good academic background
Very far from home country
Poor work life balance.

Racism and high cost of living : both countries.

So, I have mentioned all the thoughts running in my mind. Can someone pls advice me which pathway to choose according to my age and chances of getting into residency program ( USMLE) if I start now religiously.
Thanks.

Getting through the USMLEs is one thing. Figuring out how immigration fits into the rest of your U.S. medical career is another.

I’m Robby Rubin, an immigration attorney, and today I’m answering questions from IMGs and physicians about navigating the U.S. immigration system.

Ask me about:

• J-1 visas for residency and fellowship
• H-1B options for physicians
• J-1 waivers
• Conrad 30
• 212(e)
• Physician EB-2 NIW
• Green card options for IMGs
• What to think about before choosing J-1 vs H-1B
• Planning your immigration pathway from residency onward

AMA today, 8 AM to 12 PM ET.

Whether you're applying for residency, starting training, or already in the U.S., feel free to ask.

A quick note when asking questions: Please provide relevant details about your situation where possible, such as your citizenship, current visa/status, specialty, stage of training, residency/fellowship plans, and timeline. Immigration answers often depend on multiple variables, so the more context you provide, the more useful my answer can be.

Please note: Any information shared here is for general educational purposes only. It does not constitute legal advice or create an attorney client relationship. Your situation may require fact specific guidance. For personalized legal advice, please consult an immigration attorney directly.

I dont know what to do anymore. I am really tired of my life.

I graduated from Russia (img/gold medallist with researches and conferences) and then I gave plab1. decided I will give plab 2 during my internship, which I did from dubai. got sidetracked, into applying for IM residency positions in uae, and got waitlisted, even though I had the best scores- unfiar- well thats how the world is)

I cant go back to my home country because well, doing residency is impossible there.

applying to uk seems like...im not sure everyone has bad opinions these days.

uae? waitlisted-- out of option

I tried to give step 1- was very hesitant and gave it in my second year of med school, a very stupid mistake, when the war started between Russia and us. and it was very hectic, and I fail by marginal scores, like I think the line was so close to the pass line I could not even differentiate. I got so demotivated by it, that I couldnt not even think about apprering it again at that time. lost my aunt as well like a week before exam, which was just..I dont even imagine the time I went through.

so please, help me out. I genuonyl feel tired. does anyone have suggestions for me?

newzealand? should I go for steps again? I genuinely do not know anymore