USMLE STEP1 264 (99th percentile)

This all started with covid, I was a normal medical student at Damascus University, digging through piles of lectures that never end, in a desperate effort to score competitively in school exams, aiming to eventually get accepted at an academic residency program which pays you a whopping $20 a month throughout the years of training. Big dreams I know. Then everything started to change when classes stopped for covid, studying for classes that don’t exist didn’t make sense anymore, hanging out doesn’t make sense either because there is no “out”. Depression stepped in and I was feeling worthless. I had to do something.. And although we had no prometric centre in Syria, all borders to other countries were closed, all Syrians were banned from traveling to the U.S., and I had 0% of the USMLE application fees, I decided to set USMLE as my goal.

I heard that AMBOSS were providing scholarships, so I applied, and was very happy when they granted me access. AMBOSS was my only online resource back then, so I started chopping through that. Everything was going smoothly and I was satisfied with my progress, until my university decided that education was still important, and figured they’d continue testing us for stuff. I was so deep in USMLE that university was just a distraction rather than a main pathway. I half-assed all of my classes and saw my rank, which I previously obsessed over, dive down the list. I had to withstand the blaming of my classmates saying that my efforts were pointless and my goals were more fiction than reality.

NBME were then providing 5 free forms. I thought I’d take one, and was surprised to get a decent score. I decided I had to take step. I approached a family member and asked them to pay for a UW subscription, as well as pay the exam fees, I scheduled the exam the day before my school’s OSCHE exams, I didn’t read a single word from my school’s curriculum which approached a 1000 pages per class, for which everybody though I was crazy and going to fail the year for sure. Under the enormous load of university, traveling logistics, and never-ending USMLE content, I was severely burnt out to the point where reviewing one block of UW a day, only reading bold points, was actually a struggle. I hardly did any content review and did not have any time for FA, anki, or pathoma. I had to travel by airplane to Lebanon which is only 80kms away. I arrived at the airport at 1:00 AM and didn't get to sleep until 2:00 AM, which I previously slept at 10 PM. I thought my sleep schedule was completely ruined and I won’t get enough sleep before my exam. I slept at a friend’s couch which wasn’t bad really, and we got to hang out instead of studying the last couple of days which removed some of the stress, but then I had to move to a hotel because it was closer to the prometric the day before, I was sweating blood from anxiety which I don’t normally get before exams. Although I woke up early that day, and barely had any caffeine, it took me a while to start to fall asleep, only to be woken up by my driver who brought a lab worker with a swab test for PCR, which I had to do to be able to come back to Syria after the test, I was not able to get any sleep after that and ended up only closing my eyes for the rest of the night, which I opened to the sound of the pointless alarms that I set up the day before, I’ve never had zero sleep before any exam. On top of that, I had the worst headache of my life (not SAH, it was worse) I tried to do push ups, wash my face, drink coffee, nothing worked.. I then decided, I’m not going to back from this, I’ve trained so well and now I will bring up every drop of will power that I could possibly get, and put that training into application, this has not ended until I see that blank screen at the end of the exam, everything before then is my responsibility..

So I packed my things and carried them to the prometric, I remembered a friend advised me to pack paracetamol with me, so I gulped a bunch of pills, flushed them with coffee, put on my mask and headed to the exam room, the lack of oxygen from the mask made my headache only worse. Surprisingly, during the exam, it felt like somebody grabbed time and stretched it three times its original size; I was zoning out like three quarters of the time, but somehow still managed to read every stem multiple times and answer all questions with 5 minutes to spare each block (while I normally had timing issues during prep), the severity of my headache doubled after every block, which got a little better with taking long rests (having added up time from my blocks instead of using that for review), and tons of coffee and paracetamol. The test took 3 forevers to finish. I was so drained I wanted to guess answers and move on so badly, but every time I felt like that, I remembered my mother, whom I would never forgive myself if I disappoint. I managed to walk out of the prometric alive but was absolutely traumatized. My parents picked me up from the Lebanese border, my mom stuffed some cake and pies in my mouth, my 60 year old father insisted to carry my very heavy bag. And my friends organized a really nice vacation the day after. Although the predictor had me at 260+, I did not expect much at all, to the point where I was actually so relieved when I saw PASS on FCVS the morning of the infamous score release date 7/7.

I actually cried when I saw a 264 on the score report. I was finally proud of an accomplishment that was actually my choice. After all of this I just want to say that you got this! Believe me, you do, the only time you’ve failed is the time that you’ve decided to give up, yes things happen and they can really disturb your plans but the best thing you can and should do then is NOT give up. Now I have been enjoying my last couple of weeks (although it’s exam season) and been advising and tutoring other students to be able to pay back to this community (check “Coaching”).

I’ll do a write up soon! And thanks for listening :).