DO student Write-up 265 Step, 780

COMLEX
Hey everyone! After over a month of waiting, I finally got my COMLEX score back today, so here is a
write-up that covers both USMLE and COMLEX!
Disclaimer: take everything I say here with a grain of salt. I studied hard, and had good results, but
this is only the experience of one person, and there are thousands of us that take these tests. I could
have taken Step 1/Level 1 a hundred times and gotten a hundred different results depending on the
day and the questions. Your test results do not define you as a person, and they do not determine
the quality of physician you will become.
About me:
I go to a fairly well-respected US osteopathic school that has a history of underperforming on the
USMLE. Our school focuses heavily on sending students to rural Family Medicine residencies, and
thus board-prep is less of a focus for the school. Certain faculty attempted to make their lectures and
topics relevant to USMLE/COMLEX, but the vast majority of our class material was based on
clinician or PhD lectures. Entering medical school, I was interested in some competitive
subspecialties, and having (stupidly) ventured onto SDN to see what the chances of a DO matching
would be, I was immediately informed by some very energetic individuals that without hundreds of
authorships, a perfect USMLE, all honors, and the sacrifice of my first-born child, I wouldn’t be
considered for anything competitive. Retrospectively, SDN is a little hasty with their
recommendations, and you really shouldn’t take the advice of anonymous people on the internet.
However, it scared me enough to realize that I needed to do something outside of classwork if I
wanted to increase my chances of a competitive match, and I went searching. Firecracker was
popular at my school initially, but after digging around on the r/medicalschool page, I discovered
Zanki. I had used anki during my undergraduate to learn pharmacology, and I liked it, so I decided to
stick with it. I attribute about 99% of my success to Zanki and Lolnotacop1, and highly recommend
them to anybody. Here is how I used them to study for boards:
M1
Focused on class material, with 50 new anki cards per day from the relevant subdecks. Initially I
made my own cards for classroom facts, but after the first semester this was overwhelming and non-
sustainable. I am not good at making my own anki cards, and I had much better results with the
premade decks. I used my class material, Pathoma, and Sketchy micro and pharm to learn the initial
material, and then made it stick with Zanki. I kept up with all reviews every day (or finished them the
next day if I had an exam), and never let them build up. My average day was usually to watch
lectures in the morning, attend whatever lab or mandatory thing was in the afternoon, and then
review some lectures before dinner. Then after dinner I would do my anki cards.
Early M2
Starting in summer, I added lolnotacop1’s amazing micro deck to my rotation, which paid off hugely
as my school emphasizes micro within every class. I also started to do questions from Kaplan
USMLE qbank when I had time. Overall I finished about 500 questions before dedicated. If I had to
do it again I would try to finish that qbank before dedicated, as having the experience with the
practice questions was extremely helpful. I listened to Goljan audio in the car during a few roadtrips,
which I found mildly helpful. Did it get me any questions on the actual exam? I don’t think so, but it
helped to synthesize information.
Late M2
My school has a notoriously difficult final semester of M2, and both my mental health and free time
tanked during this semester. My original goal was to mature all of Zanki and lolnotacop1 by the time
dedicated started, but this didn’t happen. I had to stop doing practice questions in order to leave
enough time to finish my anki every day and still pass my classes.
Dedicated
I had 8 weeks of dedicated study time before USMLE, and I scheduled COMLEX for 4 days after. My
game plan for dedicated was to finish my anki reviews in the morning, do 2 blocks of random timed
UWorld in the afternoon, and review any material I was weak on in the evenings. I mostly stuck to
this plan, with the exception of the first week, where I studied pretty late into the night trying to finish
all new cards for Zanki and Lolnotacop. After finishing those, the reviews quickly became very
manageable, and I could put all my focus into UWorld.
I highly recommend doing UWorld on random, timed mode. I think this was a huge factor in my prep,
and helped me feel confident on test day and during NBME’s. Timing was not an issue on the real
deal, mostly because of all the practice. I aimed to finish blocks with 15-20 minutes to spare, leaving
me time to review all my flagged questions and make sure I had not made dumb mistakes. Once I
got faster at doing questions and spending more time reviewing them before submitting, my scores
improved.
I took a practice test every week, and reviewed it that afternoon. This was also super useful, and I
tried to simulate the testing environment every time (timed breaks, no distractions, headphones on,
etc). People have varying opinions on the usefulness of the NBME’s; I say do them. More practice
questions = better performance, especially under timed conditions.
My personal tips for success:
1. Study a little every day throughout M1 and M2. It matters less what source you use (anki,
firecracker, amboss) and matters more that you do it every day to retain your knowledge. I did
not do any dedicated material review once dedicated started; 1200 hours of anki had
hammered those details in, and I could move directly into practice questions.
2. Review each and every UWorld question you do, and take your time. UWorld really is as good
as they say it is. If you know why each answer is correct and why all the others are wrong for
every question, you will score well on USMLE, no exceptions. Read all the answer choices,
even if you thought the question was easy.
3. If you are going to be using a long-term learning tool like anki, learn how to use it right. Watch
some videos, learn how the program works. Don’t do any of that “I did all the new cards for
cardio in one day and then never looked at them again” crap. Congrats, you just wasted a day
doing 1500 flashcards you’ll never remember. It’s a long-term learning system for a reason;
use it long-term.
4. Do practice tests. If you score well, it boosts your confidence and gives you hope. If you score
poorly, it motivates you to study harder. It shows you gaps in your knowledge, and provides a
way to practice test-day environment before you show up.
5. Sketchy, Pathoma, and UWorld are as high-yield as everyone says they are. Do not skip
these resources.
My scores
UWorld average, first pass: 90% (finished 3 days before USMLE)
NBME 20: 252 (baseline, 8 weeks out)
NBME 21: 257 (7 weeks out)
NBME 22: 248 (6 weeks out)
COMSAE 105: 709 (6 weeks out)
UWSA1: 271 (5 weeks out)
NBME 23: 257 (4 weeks out)
NBME 24: 267 (3 weeks out)
NBME 18: 271 (2 weeks out)
UWSA2: 281 (1 week out)
Free120: 91% (3 days out)
USMLE Step 1: 265
COMLEX Level 1: 780
Thoughts on the real deal exams: USMLE was fair, felt like a mix of UWorld and NBME. Timing was
not an issue. Very few questions out of left-field, most gave you a fighting chance if you studied
hard. I took breaks after every block, ate protein bars, and used all my time on each block to review.
Walked out and felt okay. On the other end of the spectrum, COMLEX was a shit-show, and I felt
bad walking out. It asked about laws I had never heard of, micro that was never covered in any
material I had ever read, weird management questions, and very little actual OMM. My 4 days in
between was spent studying Savarese and doing COMBANK OMM questions, which covered most
of the stuff I was asked. I did most of the TurnUp2OMT anki deck as well, which helped Savarese
stick. Don’t be surprised when you feel like crap walking out of COMLEX; it is a poorly written exam.
Timing was rough, breaks were short, and the vignettes were way too long. Fatigue is a real issue
with this exam so prepare yourself for it.
Final thoughts: I didn’t include a lot of specifics about my studying, mostly because I don’t know if
anybody is interested. If you want to know more details or have questions, please comment and I will
happily fill you in! I attribute a lot of my success to this sub and the help I received, and I definitely
want to help pass that along.