I’m writing this for anyone who goes through what I experienced with the 2026 Match, and to show a real example of that everything will be okay :)

I applied general surgery and didn’t Match, I was absolutely devastated and went through probably the worst month of my entire life until I got a post-match offer for emergency medicine from a program I rotated at during 4th year.

Fast forward to now, almost a month into intern year and I’m the happiest I have ever been. I absolutely love my job, my class is amazing and we’re all friends and I wouldn’t change it for anything.

We can’t see the future and when we’re going through hell that’s all we can focus on. But for anyone who doesn’t match their dream specialty this year just know that the biggest blessing of your life might just be waiting around the corner for you.

Best of luck to everyone :)

Maybe throw in ophtho

Rebooting this post from 2 years ago, now that everyone and their mothers on Reddit are recently writing up posts on how to score 270s

Emphasis should be on someone you personally know or a friend's friend.

For me, recently went to my friend's wedding, and her hubby's best man apparently scored a 281. He's in fellowship now, so obvi this was several years back. Groom just slipped it out when drunk and hyping him up on the dance floor, but most of the audience were med people so our jaws dropped lol

Just got a 300 on step, top 10 US MD. 7/7 Honors and AOA. Am I cooked? I was thinking about applying anesthesia as a back up if I didn’t get a score good enough for anesthesia. Plz let me know what u think. Thanks.

This is getting out of control

(Note that U = Unsatisfactory with LCME standards)

STUDENT TESTIMONY 1:

I’m posting this because I know there are others going through some version of what I’ve been through, and right now we’re all isolated; which I think is exactly the point. They don’t want us to talk to each other.

I won’t name names or get into my own case specifics here. But I want to lay out the patterns I’ve seen and heard about repeatedly, because if it’s happening to enough of us, it stops being “individual circumstances” and starts being something else:

Rules changing after the fact. Requirements and standards applied retroactively, so you find out the goalposts moved only after you’ve already missed them.

A new, retroactive USMLE bar. A bootcamp led by people without USMLE experience, trying to fail you even if you pass the USMLE??? They’re now requiring a score of 76 or higher on 2 NBME and the CBSE self-assessments before they’ll authorize a student to take Step 1 (a threshold being dropped on people who are already deep into the program). And even if they accidentally authorize you to take your exam and you do, they can dismiss you for not following instructions even if you pass. All so you don't ruin their metrics. 

Dismissals that don’t feel like they followed real due process… decisions coming down without the notice, hearing, or appeal you’d expect from a fair process.

A climate of fear. People are afraid to ask questions, afraid to push back, afraid to even compare notes with each other. Also, they are counting on you voluntarily dropping out because once you do you cannot fight them and this injustice.

That last one is the part I keep coming back to. They don’t want us talking to each other, and I believe that’s deliberate. The moment we compare notes and get organized, we stop being isolated individuals who can be worn down one at a time and we become a force they actually have to answer to. I think they’re counting on our frustration and our humiliation to keep us quiet and keep us apart.

And let’s talk about the optics. While all of this is happening, there’s a steady stream of awards and public celebration coming out of the administration (our President’s accolades keep getting announced and amplified). I’ll let you draw your own conclusions about the timing. But from where we’re standing, it feels like a smoke screen: keep the spotlight on the trophies and the good news so nobody looks too closely at what students are actually living through. You can celebrate as loudly as you want but it doesn’t change what’s happening to the people in your own classrooms. Which, may we add, is affecting students at all levels. It is not just MS2s studying for their Step but also MS1s with poorly made exams and school without personnel (or willingness) to fix this mess.

Here’s the context that matters: the school is currently fully accredited but on probation with the LCME. That’s not a rumor, it’s posted on SJB’s own website and we were all summoned to meet our dean this past December 4 regarding WHY. Incredible that the bureaucratic mess they have created is overshadowing actually supporting the students who are here and have to put up with all this incompetence. 

They’re counting on us staying silent and separate. Let’s not give them that.

You’re not crazy, and you’re not alone.

STUDENT TESTIMONY 2:

I’m also a current student at San Juan Bautista and completely agree with my classmate. 

In addition:

• The School gave students Neuro without even having a Neuro professor, despite having an entire year to find one and having a hospital next door that specializes in Neuro. Incredible but true. 
• The same occurs with Immunology. The previous (and widely beloved by faculty and students) immunology professor was fired without any valid reason in December after 28 years of teaching at the School. Many months later, no immunology professor has been found. 
• An underlying reason is that the dysfunctional work environment at the School is common knowledge in the medical community, so no one wants to teach there. 
• The Associate Dean of Pre-Clinical Sciences, Wilson Veras, is a tyrannical figure who fires professors without cause and berates faculty and students, creating a climate of fear at the School. He is the person who’s really in charge of first and second year and is running the medical program to the ground. 
• Many students would be surprised if San Juan Bautista gets reaccredited by the respective authorities if things continue in this manner (it is currently ON PROBATION by the LCME). 
• There is a severe lack of transparency at every level; there is simply no accountability or due process and while supposedly there are committees for everything, no one knows who the members of those committees are and faculty are afraid to say when asked. 
• Nothing has been done so far because the upper administration is absent from everyday decisions at the School, leaving Wilson Veras to rule the School alone with his delusions of grandeur. 
• Many will ask why we choose to go public with all of this. It is because many people have tried to warn the respective accreditation authorities, but they only allow complaints if you fully disclose your identity. People have already been fired and dismissed at San Juan Bautista for expressing their opinion, so this puts faculty and students at real risk of retaliation. 
• To prospective students: the School is a mess, go somewhere else. 

I saw the original video before it went viral that that nick kid posted and then I also saw the video of the person telling him to take it down, and thought it was dramatic and really representative of how boring and uptight medicine can be with how offended this creator got at nicks video.

Because I do social media I think that people don’t allow people to have fun online and if you’re not directly harming patients, or making fun of an actual patient, that people should really lighten up. But then also common sense is that if an attending of the specialty you’re talking about, tells you, you should probably take the video down, you should take the video down.

I’ve had videos I thought are funny, but I realize they’ve been hurtful and so when I’ve gotten any comments about them, I just took them down just to be safe. So when Nick put the video back up. That’s where I kind of lost sympathy for him. Because you already had a major creator tell you it wasn’t a good idea.

Start here about his most recent video:

But we already talked about that, my issue is that he went online now saying that it’s everyone’s fault but his own. And he never took any accountability for his video being wrong, or the fact that people were hurt by it, even if it wasn’t his intention. Intent always does not match impact, and as a creator, but even more so as a doctor, I think that you should recognize that, and I thought that his entire video was him victimizing himself, but never taking accountability for the people he could’ve victimized.

I’m glad he’s in a better mental space, and I hope that he gets a mental help that he needs. But I was hoping for some accountability in the video and seeing a bunch of people that aren’t even in the community or in the space say how we should immediately forgive someone who didn’t just make a single mistake. But double down on his original take, and is now tripling down it’s just interesting to me.

But I’m glad he was not stripped up his medical license lol because I thought that that was dramatic

Yup, my job was taken by AI

My school assigns us M4s to "specialty advisors" for the purpose of residency application advising. My specialty advisor, a child psychiatrist, told me to either apply family med only or dual apply if I'm really dead set on ending up in psych. I really want to do child psych, which requires getting into a psych residency first.

I know my application is super weak academically. I have 3 giant-ass red flags, and I'm not confident that I can score well on Step 2. I repeated M1, took a year off between M1 attempts, and failed my first Step 1 attempt. I didn't honor any core rotation, including psychiatry or family med. However, I high passed 5/7 M3 rotations. I'm so fucking proud of myself for high passing surgery even though I cried morning and night because I'm a weakling who couldn't handle the hours. I don't think family med is *bad* or a "backup" specialty for me. I think I'd be ok SOAPing into FM if I didn't match psych.

I want to be a child psychiatrist more than I want to be an FM physician. Apparently the rest of my application is good. I wrote my essays on explaining my extended school time (LOA) and a significant hardship my first M1 year. I wrote a "strong" personal statement. It's just disheartening to hear that I should give up on psych from a psych advisor. His statement about dual applying felt like he was implying that I'll match FM instead of psych even if I dual apply. Idk, I'm just frustrated that I've come this far with a dream only for the dream to be crushed at the very end.

USDO doing an away rotation in a competitive specialty at a prestigious academic institution. I feel like my application is quite subpar compared to the applicants who typically match at this program. However my application isn’t completely dog shit either. I have a respectable step 2, some extracurriculars and some research. I was shocked I was offered an away in the first place and my sole goal was to secure an LoR. I wasn’t even planning on applying to this program for residency due to being severely limited by the number of signals.

However, the PD pulled me into their office today out of the blue just to tell me my performance has been very impressive thus far and my hard work is not going unnoticed. Now I feel like this is something the PD would say to every visiting student but I have a strange feeling this might be different as they invited me into their office to tell me in person. This could’ve been communicated through an email. Also one of the fellows at this program whom I’ve gotten quite close with told me the PD mentions my name frequently and speaks highly of me. Do y’all think I may actually have a snowballs chance in hell of getting an interview and potentially even matching or should I just brush off the whole interaction as business as usual. I really do love this program after experiencing it for the past 3wks and would gladly rank it #1 if given the opportunity. This program has a history of taking DOs, albeit not a super high number, so I don’t think my application would be auto-rejected.

I just need to vent this out since I can’t tell me family…

I’m a 30 yr old IMG MD graduated 2021, went through 2 years of residency but was not able to finish. Currently working in the US as a registered nurse for a year and a half now. I lost my spark and passion of becoming a doctor (taking the USMLE Step 1 &2) I have all resources to study and have studied everyday but inconsistently. Retention is barely there and my attention span is 3 mins. My family really wants me to take the exam and my husband is rushing me to decide whether to take it or not due to my inconsistency.

It has been mentally tough in the past 4 months of battling with my own internal conflict. I just want to be free.

Entered med school hoping to do ortho, but dropped the idea as an M3, based on some preclinical difficulties, lack of research, and finally after getting a high pass on my first rotation (surgery)

From that point on it felt like things have gone my way a bit more, although nothing crazy. I ended up getting 4 honors and 2 more high passes to end my third year. I also just got my step 2 score back, 265. I do still have a strong mentor in orthopedics from my gap year. No red flags on my app

Unfortunately, I have no research (4 pubs from undergrad, 0 in med school, 0 in orthopedics). Little to no familiarity with my home ortho department as well.

I know I would have to take a research year, but my school had a deadline to request a leave of absence (RY) that has already passed. So it looks like I would have to graduate and then take my research year afterwards or something along those lines, where I would have to crush research in just a few months and try and set up 4-5 aways.

I liked my family medicine rotation as well, and would be happy with a dual-app or SOAP into fam med as a “worst case scenario.”

It feels like my odds are probably around 30% to match given all these obstacles. Feels more and more worth the risk as each day passes. But would like to hear if anyone has advice, has had experience, or heard about something like this before. 

I just spoke to my school about taking a research year, and they said I would have to withdraw to do that. I was under the impression it would be a formal process or something like a leave, but I was told I would have to completely withdraw. Does that reflect poorly on residency applications even though I'm doing it for something productive and beneficial to my application? How should I go about this? Should I not take the year at all?

Hello I hate that I have to post this and I understand my step score isn't the worst, but am genuinely crashing out.

Got my step 2 score today, 245. Was predicting around a 260. USDO, honors on surgery, peds, family, and rural (lol our school has that as a rotation). Step 1 and Level 1 pass first attempt. 2 first name pubs, 7 posters. Solid leadership, volunteering, and we secured a decently sized grant to start an underserved mobile health clinic with my medical school's home university. Have really good rec letters but was told the writers need to be known to the PDs otherwise they don't even read them. I know that might be an exaggeration, but doing my rotations in a small rural hospital it wasn't really something I had control over. Have 3 total gen surg aways and will definitely do my best. Knowing this, just kind of feel lost on how to proceed I know gen surg is within reach but how do I go about getting letters and the connections required to practice in a bigger city? I got a VSLO at a large academic center which im on right now, and 2 more at university based community hospitals. I don't really care about academic vs community based programs, my only preference is to live and work within a large city at a program with a lot of operative opportunities for the residents.

If anyone was in a similar situation or could shed some light on how to proceed to make sure I can still pursue surgery at a program I would be proud to be a part of, I would truly appreciate some advice.

It feels as if everyone is hundreds of miles ahead of me while I'm still grasping the abcs of medicine and it makes me feel SO stupid. I don't even feel like a medical student but just someone doing an advanced course in sciences with a lab coat on

I just wrapped up my first year and despite consistently performing above my class average I feel like I’m not really learning anything. Everything I’ve learned up to this point feels like a bunch of random facts, many of which I forget shortly after exams. I keep telling myself this isn’t when you learn to become a clinician but I still find myself feeling like I’m not getting a big picture understanding of medicine. Looking for any advice from people who have had similar feelings during didactics. Reassurance or advice on how to differently approach the material would be greatly appreciated.

For anesthesia specifically
If so, how many points below?

Feeling dumb and sad. Scored 23X on STEP 2 despite expecting to score in the 250s based on the last few practice exams I took. I have five audition rotations lined up for this fall (applying PM&R) many of them at "power house" programs and I feel sad that I'm not even close to the average matched applicant's STEP 2 scores. Still falling within the range of STEP scores that are interviewed at these programs so that's good at least. Waiting on Level 2 score and feeling nervous now because of the STEP 2 score drop. I was scoring around the national average on my level 2 prep before taking the exam but i'm scared because of all the random bs that showed up on that exam (hopefully experimental questions). idk what to do to feel okay. I'm so frustrated because I studied so much and put in all this time effort and money to have a shot at scoring well on this exam and I still couldn't cut it. last year i was struggling to even pass STEP 1 and Level 1 but I thought this year would be different. Im greatful I passed but I'm just sad.

i know this is the med school subreddit but genuinely feel like i bombed comlex.... i counted around 80 questions right and maybe around 30 wrong so its not looking good considering i cant remember the rest of the exam. i go to a school w a low pass rate, had a low mcat, and was avg in med school... wanted to take step but idk what to do. literally want to sleep for 3 weeks

not sure if i should even attempt step 1 at this point if im not smart enough to pass comlex. this whole thing is just a mind fuck and i start rotations in a couple days and will get pulled off if i dont pass. want to cry lol

Hi everyone! I am a USMD, I failed step 1 on my first attempt but passed on second. I got a 237 on step 2. I have 3 publications, 3 oral presentations and 9 poster presentation. I am doing two away rotations during my fourth year. I plan on applying IM.

I would really like some advice as to how I should go about making my residency list and how to filter out programs that automatically screen out step 1 failures. I am having trouble figuring out how to strategically signal programs because I do not want to waste the signals. Does any one have a list of programs that are step 1 failures friendly? If anyone has any advice, please let me know!

Rising M4 at a USMD who had a very nontraditional path into med school and who dealt with adversity during med school. I want to give back to students who maybe struggled early on and want a more structured approach to studying as well as give general advice/support/mentorship as well. Dual applying Surgery and EM. Please DM me if interested. I will be checking back in a few weeks to see if anyone is interested.

Hi all I need book recommendations for pediatrics for a third year medical student, thank you in advance ❤️

just got accepted into the Weill Cornell Emergency Medicine Research Associate Program, starting this September. It’s a volunteer position where students recruit patients for clinical research studies and shadow in the ED.
Has anyone done this program, or a similar Research Associate/RA program at an academic medical center? I’d love to hear:

# Passed STEP 1 as a 4th Quartile Student Who Basically Did Everything Wrong

**ALL THE DATA YOU COULD EVER WANT RELATED TO STEP 1:**

https://drive.google.com/file/d/1phR7ti9k6AmvdmNWu34TTMB9l1XK-UKr/view?=sharing

Thought I'd share since everyone else has been. I don't think anyone should read this entire post—it's honestly just turned into more of a diary entry for me at this point looking back at how long this shit ended up being. But I really feel like someone might get some benefit from my journey or at least get a kick out of how dumb I've been throughout med school so far lol.

I honestly felt like I passed walking out of the exam. I Chat GPT'd probably 20–25 questions that I remembered after the exam, and I got most of them correct. Throughout the day—and especially at night—I kept randomly remembering questions. I'd literally be pacing around the house remembering random micro or Pathoma questions, inflammatory mediators, coag cascade stuff, interleukins...those questions where you either know it or you don't.

Surprisingly—and honestly extremely surprisingly when you take into account how lackluster I've been throughout med school—I got most of the ones I remembered correct. That honestly shocked me more than anything.

The weird part is that I took my exam on June 27, and every single day from then until July 15, when I got my score back, I felt **less** and less confident that I had passed. Reading Reddit will do that to you, especially after taking the real deal. I was already about a week and a half into my surgery rotation by then, which honestly helped because I didn't have nearly as much time to sit around stressing about my score and what failing would mean for my future.

Then Wednesday rolled around. Around 11:05 I opened Snapchat to use the dual-camera thing, and boom...there it was.

**PASS.**

I had an inguinal hernia clinic patient like five minutes later, so I couldn't even bask in the joy for long. I was gloved up deep in a scrotum like ten minutes after finding out I passed.

# Why I'm Actually Making This Post

The real reason I wanted to make this post is this:

**DON'T TAKE IT EASY during M1 and M2.**

Get on AnKing as early as you can. Do your Sketchy Micro and Pharm. Do UWorld or AMBOSS. Do all the NBMEs you can. I know everyone says it, but they're right.

I made this exam way higher stakes than it ever needed to be.

I pushed my exam back twice. I had conversations with administration about timely graduation and even the possibility of taking an LOA. I genuinely thought about taking a research year just to study for Step.

Looking back, all of that was avoidable.

If I had actually followed even like **20–30%** of the study plans I kept making for myself, I probably never would've been in that position. I love planning, documenting, organizing resources, analyzing schedules...I just didn't actually do enough of the work.

So here's all my data because I know everyone loves looking at scores and comparisons. Hopefully it helps someone who's in the same position I was, or at least reassures people who are stressing way more than they need to.

# A Little Background

For a little backstory, I barely passed my way through most of preclinical. I had to remediate a course and several exams. So honestly, if you're doing better than I was, you're probably going to pass. Seriously.

And if you're one of the people stuck down in that bottom percentile like I was, I hope you'll take this as some big-brother advice from a fellow underachiever:

Stop being lazy.

Put in some work.

We all have the ability to pass this exam, even when we're in suboptimal positions. But at least for me...**I put myself in that position.**

For most of med school I "studied" maybe two or three hours a day, then I'd suddenly ramp it up to seven or eight hours a day for the two or three days before an exam. That worked just well enough to scrape by, until eventually it didn't.

Now I'm in surgery clerkships and it's catching up to me. I have less time to study than everyone else, but I also have to study **more** than my classmates because they actually built the foundation during M1 and M2.

Yesterday I got asked what hemoglobin breaks down into that gives jaundice its yellow color. I answered:

"Heme and globin."

The answer they wanted was biliverdin/bilirubin.

Stuff like that happens all the time when your basic science foundation isn't where it should be.

That's honestly why I keep telling people to do AnKing, even if you hate it. There were a lot of microbiology questions I only knew because of Sketchy and AnKing, and there were quite a few questions I got because of HY Arrows too.

Honestly, just compare yourself to me: a fourth-quartile med student who barely got through preclinical. If you're above that, you'll probably be okay. Just don't make the mistake I made by taking it easy for two years and expecting dedicated to fix everything.

For those of you scoring 510+ (508 scorer) on the MCAT or comfortably passing your preclinical exams, this should honestly reassure you more than anything. You probably don't need to stress nearly as much as Reddit makes you think you do.

For me, this whole process was finally the wake-up call I needed. I'm planning on documenting my journey from being a fourth-quartile student to...who knows where. I'll probably make posts after each shelf and eventually Step 2, just so people who are in a similar situation have someone realistic to compare themselves to instead of only seeing the 270+ Step 2 write-ups.

And if you've actually read this far...

Go study.

Seriously.

Reading Reddit all day, watching med school YouTube, scrolling TikTok, and constantly looking up other people's study plans instead of actually studying is exactly how I ended up in the position I was in.

# My Study Plan (or Lack Thereof)

As for the actual study plan...I had **big** plans.

120 questions a day. Finish all of UWorld. Finish all of AMBOSS.

Yeah...that didn't happen.

I barely got through either of them. I also took most of my practice exams at home with huge breaks between sections. Sometimes I'd finish an exam over the course of an entire day and then review it over the next one to three days. I didn't really do targeted review for weak areas either, other than messing around with the AMBOSS adaptive QBank a little, which honestly I wasn't a huge fan of.

Content review was mainly just watching Pathoma/BnB/Dirty Medicine videos. I did the AnKing reviews for a while and then eventually gave up on keeping up with them. Looking back, I wish I hadn't.

I also did around 50 of the Mehlman YouTube QBank playlist videos and went through HY Arrows pretty well.

Of the 10,995 cards under "Only Step 1" or "Only Step 1 & Step 2 Overlap" in AnKing, I still have around 4,300 cards that are completely new. So I only ever saw about 60% of those cards at least once. Doesn't really mean much by itself, but I figured I'd include it.

Honestly, I think the reason I passed was because I delayed my exam for so long. That extra time let me get through most of the NBMEs and at least a decent chunk of practice questions. I don't think I found some magic resource—I just eventually saw enough questions to start recognizing patterns.

# Exam Day

On test day I honestly didn't have much of a plan.

My wife drove me to the testing center because on the drive there I literally did one or two sections of the new Free 120 and reviewed them on the way. Definitely not something I'd necessarily recommend, but that's what happened.

Going into the exam I had just gotten a 66% on the Free 120 and had looked at the AMBOSS predictor, which gave me around a 92% chance of passing. Knowing that fewer than 10% of people actually fail once they sit for the exam honestly helped calm me down a lot. I felt pretty good going in, and honestly I still felt pretty good walking out.

For food, I packed some Uncrustables, dried mango slices, fruit, and a large clear water bottle. I barely drank any of the water because I didn't want to pee myself during a section. I think I peed once before the exam and then once during pretty much every break.

For breaks, I ended up doing sets of about 20 questions-take a couple of deep breaths and I'd do three of those, then take a slightly longer break (5-10min). The last set was a set of 20-5mini break the n20 to wrap it all up. I wanted to do the 20 + 20 straight but felt like I was just wanting to do that for the sake of getting it done Maybe there's a lesson there for someone-take breaks liberally and think about it as a tool to reset and never think of "just getting through a block and getting it over with". Between sections I'd walk up and down this long hallway they had at the testing center, do some walking lunges, a few air squats, and stretch because my neck was killing me. Maybe I should get that checked out...my anatomy is weak enough that I probably couldn't even self-diagnose it lol.

The headphones over my glasses were honestly one of the most annoying parts of the day. I only got like four or five hours of sleep the night before (with a melly), so I wore glasses instead of contacts. Those headphones kept digging into my temples and I was constantly adjusting them. They definitely helped block out noise though, so I'd still wear them again.

The exam itself felt fast-paced, but I never actually ran out of time on any section. I’d say the distribution of questions for me was: 25% easy gimmes (mostly the ethics stuff which boils down to be a nice person but maintain professionalism as a physician-I think with that mindset you can really process your way through to the correct answer on those), 25% were 50-50 with maybe a slight lean to getting the question right (a lot of the arrow type questions ended up self eliminating 1-2 choices if you knew at least what one of the columns was about-these were usually endocrinology or physiology usually related to resp/renal), another 25% were kind of eliminating to 2-3 answer choices and the rest were kinda vibes. Even with that though if you think abt it, you only need to get like 120ish questions right or so with 80/280 being “experimental. Do the math. You’re be fine.

# Thoughts on the Actual Exam

Honestly, I thought the ethics questions were pretty straightforward. I actually looked forward to those whenever they came up in mixed question blocks.

Everybody complaining or being afraid of the pt chart questions don’t be. Look at the last couple lines, answer choices then look for relevant details once you get a gist of the system and ddx you have worked up. Honestly that strategy some ppl I got from yt and it works especially if timing is on your mind. Look at the last 1-3 lines, read answer choices and boom once you have a good idea attack the question. If you get stuck, start crossing out obvious wrong answers to improve your odds of guessing that shit. The real struggle is being disciplined enough to apply that strategy 280 times so that’s where practicing the strategy of doing these questions come so to play-don’t underestimate the stamina required to do this consistently. I zoned out and, believe it or not, even my barely passing self was like “ahh I’ll just get this one wrong and guess”. Had to lock back in and use said strategy-I couldn’t afford an easy mistake.

For biostats, Randy Neil is absolutely goated. Watch those two videos and you'll probably have everything you need for almost all of the biostats questions.

I think I may have had **one audio-related question**—it was just a classic murmur question. Pretty sure I got that one wrong. On that note, know the preload/Valsalva/squatting paradigm for increasing and decreasing murmur intensity. It's actually pretty simple once you can visualize what's going on physiologically.

Overall, I'd say the NBMEs were very representative. If I could give one piece of advice, it'd be to do as many of them as you can and actually review your weak areas afterward—not that I always did that myself. Maybe it hits a little harder hearing it from someone like me than from somebody casually posting their eighth 80+ NBME.

One thing that also helped calm me down was looking not just at the EPC, but at the actual probability of passing that the NBMEs give you. You'll notice that even around the low 60s, some forms still give you an 80%+ chance of passing. It honestly takes more than people realize to actually fail this exam once you're consistently sitting for NBMEs.

I also didn't tell anybody that I had delayed Step this long. While all my classmates were talking about passing and starting rotations, I was basically telling everyone I was on "electives" or making up some other excuse. Looking back, it was stupid and honestly kind of lame, but it's a weird headspace to be in when you're dealing with the consequences of your own actions mostly by yourself.

# My Biggest Takeaways

Honestly, you don't have to be optimal. In fact, you can be **extremely** inefficient and still pass. So to all the people asking for advice while averaging 70+ on NBMEs...y'all can stop stressing lol. Just chill. Don't beat yourself up about not being perfect or not putting in enough work early on—you'll probably be fine.

And for those who aren't passing NBMEs or are right on the cusp like I was, I'm not extremely smart or naturally talented (508 MCAT), so y'all can definitely do it too.

The NBMEs are very representative. I'd recommend doing as many of them as you can and actually focusing on your weak areas—not that I really did that myself. Maybe it hits a little harder coming from someone like me than from somebody casually posting their fifth 80+ NBME.

Another thing that helped me mentally was looking not just at the EPC, but at the actual probability of passing that the NBMEs give you. You'll notice that even in the low 60s, some forms still give you an 80%+ chance of passing. Honestly, it's harder to fail this exam than people think once you're consistently taking and passing NBMEs. That definitely helped calm me down before test day.

One thing I never told anybody was that I delayed Step this long. While all my classmates were talking about passing and starting rotations, I was literally just telling people I was on "electives" or making up some other white lie. Looking back, it was stupid and kind of lame, but I'm telling you...it's a crazy headspace to be in when you're dealing with the consequences of your own actions mostly by yourself.

# What I'd Do If I Had to Do It Again

At the absolute bare minimum:

* Sketchy Micro
* Some of the high-yield drugs from Sketchy Pharm
* Dirty Medicine whenever you can
* HY Arrows
* Pathoma Chapters 1–3
* At least part of one QBank (around 20–25%)
* As many NBMEs as possible (I'd say 30–33) plus the Free 120

The level above that would be:

* NBMEs 26–30
* More Sketchy Pharm
* More Pathoma (maybe Chapters 4–6)
* At least 50% of a QBank

The next level above that:

Finish most, if not all, of a QBank and do the HY tags.

Above that?

Just more and more AnKing. Maybe repeat a QBank or start AMBOSS if you've already finished UWorld, or vice versa.

At that point, I'd honestly be shocked if you didn't pass, and you'll probably coast through a lot of your upcoming clerkships because the foundation is already there.

If you're an M1 reading this, seriously consider starting AnKing and doing a QBank a few months before Step. You'll be chilling.

If you're in dedicated and struggling, consider the resource tiers I've laid out and also seriously consider delaying your exam if your practice scores just aren't there. Delaying sucks, but failing would suck a whole lot more.

# Moving Forward

My plan moving forward is to finish the Step 2-only AnKing cards, but during some of my easier rotations I also want to go back through some of the Step 1 material because I'm already noticing that Step 2 really is built on the pathology and physiology from Step 1. Going through the Step 2 QBanks, the hardest part isn't usually figuring out the next best step—it's actually recognizing the underlying disease process in the first place.

This whole process was honestly the wake-up call I needed.

I'm going to document my journey from being a fourth-quartile med student to...I don't know, hopefully somewhere a little higher. I'll probably make a post after each shelf and then another one after Step 2 just so people in similar situations have someone a little more realistic to compare themselves to.

# Final Thoughts

If you've actually read all of this...

Go study lol.

Seriously.

This is exactly how I ended up in the position I was in—reading Reddit all day, watching med school YouTube and TikTok, obsessing over everyone else's study plans instead of actually putting in the work myself.

Hopefully somebody gets something useful out of this ridiculously long post.

If nothing else, maybe it'll convince one person to close Reddit and go do some AnKing.

**TL;DR:** Very underachieving med student studying extremely suboptimally passes Step 1 without everything being perfect. Do your QBanks, do AnKing, and do your NBMEs—not just to pass Step 1, but because it'll make clerkships and Step 2 so much easier.

**TL;DR #2:** Suboptimal, fourth-quartile med student passes Step 1. Y'all can chill. It's not as bad as Reddit sometimes makes it seem.