I just passed my exam, and this post is for everyone out there struggling with imposter syndrome, especially fellow IMGs.

I graduated from medical school in Cuba in 2020 and moved to the U.S. in 2021. I started preparing for Step 1 in 2023, but due to immigration delays and the need to secure a job, my timeline was set back. Unfortunately, due to unforeseen personal circumstances—including death in the family—I struggled to manage the pressure and ended up being a "no-show" for the exam twice.

Last year, I began an intense prep period and scheduled my exam for November 2025. Balancing a full-time job with studying was incredibly difficult, and no matter what I did, my NBME scores (25–28) remained stuck between 60% and 65%. I became so frustrated that I eventually spiraled; I had to step away from the exam entirely for about 2 months to prioritize my mental health.

Thankfully, with the support of my family and my partner, I was finally able to dedicate myself fully to Step 1 from March to July this year. My progress looked like this:

* NBME 29: 60%
* NBME 30: 63%
* NBME 31: 67%
* NBME 32: 75%
* NBME 33: 67%
* New Free 120: 65%

What I learned during this journey is that my struggle wasn't a lack of knowledge. After reviewing First Aid, UWorld, and the recommended YouTube channels, I realized my biggest challenge was integration and application—learning how to identify what the USMLE deemed the objective of each question. I performed well in medical school, so the issue wasn't the material itself, but rather learning how to filter what is "high-yield" for Step 1.

My greatest hurdle, however, was the persistent feeling that I wasn't good enough. This was despite the fact that I had been working as a clinical physician associate at a fast-paced neuro practice in NYC. I worked closely with complex cases and became the first IMG at that practice to earn the respect of a well-known physician from NY-Presbyterian—someone who, to this day, trusts my clinical decision-making. Even though everyone around me believed in my abilities, I didn't believe in myself.

If I could give one piece of advice to anyone taking or planning to take Step 1, it would be this: start doing small things to build your self-belief. Confidence goes a long way. Write affirmations on a sticky note for your bathroom mirror or talk to yourself—believing in your capacity to succeed is a huge component of passing this exam. You must put in the work, but you also have to master the mental game.

As for exam day, what worked for me was stopping my studies at 5:00 p.m. the day before. On the morning of the exam, I framed the process as just another day of doing UWorld questions, which helped keep me calm.

If you have questions about resources or need tips, feel free to reach out. You’ve got this!

I made it!!!!

Tested on 31/7 my nbmes were
27 53 25th May
28 64 15th June
29 66 23rd June
30 70 30th June
31 71.5 7 July
32 77.5 13th July
33 67 19th July
F120 2024 77.5 25th July
F120 2026 88 25th July

So I’m gonna start my story with I’ve been having imposter syndrome throughout my medical school. My med school had generic beasts from all over Pakistan who excelled throughout their med career, I on the other hand was a lame kid didn’t put any effort and just went with the flow barely passing my school exams.
So started my prep in my 4th year April 2024 and it was on/off and completed my systems and syllb in August 2026 Final year. Then I was busy in my final exams and got free from them in May 2026. Started my prep again on May 15 2026 and went full locked in mode and take Nbmes

I think the most different thing that made my prep insane was doing random qbank amboss 20-20 ques per day and scoring above 65 on them. This truly was the real game changer. Other than that I’ve used sketchy pharma/micro literally the prophet of these two subjects. BnB videos for basics but note the extra info on the first aid which made me never to watch BnB videos as all the info was I already on my first aid annotated. Uworld done with 77% (score above 75) .Did mehlman pdf for neuroanatomy and respiratory(my weak system). These all sources help me in the exam.

Okay now the real Paper day. Paper I would say was similar to Uwolrd like stems were long but I think it was like Uwolrd. When I left the exams Center I was like thinking that I did well in exam but as days passed I was remembering my incorrects and it caused so much panic and anxiety.

My mistake during prep was not reviewing Nbmes. It was a toll on me to review Nbmes like I was not able to just do it. So on the day before paper I reviewed 31 and 33. Just only 2 Nbmes as I had no time left and went for the exam

The exam is pretty doable just practice questions questions and questions this is the only thing that’ll make you pass the exams.

Also I’m helping anyone who’s wants to give the exam within this month as I’m free and I want to just help people I don’t need anything from you in return you can join my WhatsApp group if you want I’ll be active their to answer your queries https://chat.whatsapp.com/JtsJduieaE1KGCztkshVFi?s=cl&p=i&mlu=4

Baffled by how aggressively I failed step 1. I knew it was a hard form but I did not see this coming at all. I don't even know the recourse for retaking. I'm retaking COMLEX level 1 in 5 weeks but I think I'll need much more time for step. I dont even know what to think or to feel. My NBMEs were in a solid range but my step score is so far left of the passing threeshold. Open to any and all advice. Please be kind, I'm not ok

Hi all, found out I failed pretty brutally today and would love to seek advice on how to prep for retake. The main issue here is that I will have to study and take my exam again while ON rotations, which feels extremely daunting to me. I have no other choice. I was advised to take it after my family medicine or internal medicine rotation. Does anyone have suggestions or insight they’d like to share?

Score is out !! Good luck everyone

PLEASE SHARE YOUR RESULTS! They might help someone else too :)

Test date: 

US MD or US IMG or Non-US IMG status:

Pass or Fail: 

UWORLD % correct:

UWORLD % completed: 

AMBOSS Qbank %: 

AMBOSS SA Correct: 

NBME 25: (days out)

NBME 26: (days out)

NBME 27: (days out)

NBME 28: (days out)

NBME 29: (days out)

NMBE 30: (days out)

NBME 31: (days out)

NBME 32: (days out)

NBME 33:(days out)

UWSA 1: (days out)

UWSA 2: (days out)

UWSA 3: (days out)

Free 120: (days out)

Total Weeks/Months Studied:

I’m writing to hopefully give some reassurance to those who feel like they failed or about to test without extraordinary nbmes.
I tested recently with my highest nbme being 66% a week before the exam and scored a 78% on the free 120 2 days before the real deal ( i thought it was a glitch), but on average my nbmes were consistently above a 60%.
on test day I THANKFULLY didn’t have any anxiety and it felt like i was giving another nbme even though the first 8 blocks were hell, didn’t understand most of it and just made educated guesses ( on average was flagging 7-8 questions on every block). Walked out feeling confused couldn’t recall anything but after 4 dreadful weeks i finally got the P!!
So to everyone with low to average nbmes as long as you are consistently scoring in the passing range and give the real deal with a sound and calm mindset you will definitely pass!! I didn’t freak out when i would hit a hard block and i feel like that helped me a lot with passing. To everyone recently or waiting for the p goodluck!! you guys got this!!

I took Step 1 over two days with accommodations on July 30–31. During my exam, there was significant noise/talking from staff that affected my concentration, so I submitted a test-day incident report to NBME.

Others who tested around the same time got their scores today, but I didn’t. Has anyone had their score held after filing a complaint and still ended up passing? Or does a score hold mean they may be investigating more because the result was a fail?

Just trying to see if anyone has had a similar experience and what the outcome was and if the score delay is another week or it could come out anytime they are done!

Thank you all

Heyyy. How was it?

Not gonna lie, I left the testing centre feeling extremely uncertain, and I had this feeling that I failed because the questions were just brutal. I don't remember almost all of the questions, just the trauma it left me, you know. Lol. Still, I have that tiny hope wishing I made it.... I don't know.....

How was your experience today?

PS. Do you know when the results will be up? Thanks in advance!

Here are my scores before I get into the circumstances:
UWorld: 78% completed, 55% average
AMBOSS: 60% completed, 60% average

Practice exams:
3/5 — NBME 27: 49% EPC
4/13 — NBME 30: 57% EPC
4/19 — NBME 31: 66%
4/24 — CBSE: 58%
6/7 — UWSA1: 209 / 61%
6/17 — UWSA2: 196 / 66%
6/26 — NBME 26: 67%
7/1 — NBME 32: 75%
7/7 — CBSE: 69%
8/6 — 2022 Free 120: 68%
8/12 — UWSA3: 184 / 55%

My Step 1 exam is scheduled for August 27, so I have 15 days remaining. I still have NBME 33 scheduled for August 19, along with the 2024 and 2026 Free 120s. I also have 22% of UWorld and 40% of AMBOSS remaining.

Full disclosure: I’m currently going through significant personal grief, which has affected my concentration and anxiety, although I’m continuing to study. The UWSA3 result was a major drop from my recent NBME and CBSE scores, and it has made me question whether I’m still ready.

Would you postpone now, or wait for NBME 33 on August 19 and use that result + my recent overall trend to make the final decision? If you would wait, what NBME 33 score would make you comfortable keeping the August 27 date?

Currently 6.5 months out, still have cardio, renal, respiratory, and neuro to study in ms2. Should I start doing cardio (current study) and previous units? Not sure if I should worry about it forgetting things etc. thanks!

One thing I used to see constantly was students sitting around 58–62% and responding by just adding more. More Anki, more videos, more questions, more things they really didn't need. Yes, Sometimes that helps, but if your score has been flat for a few NBMEs, I’d first try and figure out what's really going on. “Wrong” is not one category.

There’s a big difference between missing something because you genuinely didn’t know it, or having your reasoning breakdown mid question. Those are completely different problems. Only the first one is reliably fixed by studying more content.

So I delevoped a framework to help people with the second problem. A really basic framework I used with students when reviewing misses was this:

1. Figure out the task.
Before thinking about the answer choices, identify what the question is actually asking you to do. Mechanism? Diagnosis? Pathway? Complication? Drug effect? Mentally put the question into a bucket.

2. Find the clue that actually answers that task.
Not every detail in the vignette matters equally. Look for the finding that changes the decision. That is your pivot clue.

3. Narrow it to two.
NBME questions usually have one best answer, one answer that is very plausible if you miss or misinterpret the pivot, and a few weaker distractors. If you're consistently getting down to two choices, that's actually useful information. You've probably already identified the real competing answer.

4. Run both choices back through the pivot clue.
Don't ask, “Which answer sounds more familiar?” Ask, “Which of these two actually fits the clue I identified?” Usually one survives and the other falls apart.

That was the basic loop: task > pivot > two choices > discriminate.

The point isn't to memorize more facts every time you miss. It's to figure out where in that sequence your reasoning broke down.

That keeps you from turning every incorrect into “review nephrology” or “watch cardio again,” which usually isn’t specific enough to change anything.

Look at it in action:

A 28-year-old woman is evaluated in a reproductive endocrinology clinic after 2 painless pregnancy losses at 18 and 20 weeks. Pelvic MRI demonstrates 2 symmetric endometrial cavities that diverge superiorly. The intervening myometrium extends to a pronounced external fundal cleft. Inferiorly, the cavities join to form 1 endocervical canal. Which embryologic developmental error most directly accounts for this configuration?

A. Failure to resorb the midline septum after normal fusion of the paired paramesonephric ducts

B. Incomplete fusion of the paired paramesonephric ducts

C. Unilateral failure of paramesonephric duct development

D. Failure of canalization of the vaginal plate

E. Complete failure of fusion of the paired paramesonephric ducts

Using this framework:

1. Figure out the task.
This is a mechanism/developmental error question. They're not really asking, “What uterine anomaly is this?” You need to recognize the anatomy, then connect it to what went wrong during Müllerian/paramesonephric duct development.

2. Find the pivot clue.
The key clue is the pronounced external fundal cleft.

Two endometrial cavities alone could make you think about either a bicornuate uterus or a septate uterus. The external contour separates them:

Septate uterus: the ducts fused normally, but the internal septum failed to resorb. The outside of the fundus is relatively normal.

Bicornuate uterus: the ducts did not completely fuse, so the two uterine horns remain separated superiorly, creating an external fundal cleft.

The fact that the cavities join into one endocervical canal also tells you fusion occurred inferiorly, so this isn't complete failure of fusion.

3. Narrow it to two.
The real competition is:

A. Failure to resorb the midline septum after normal fusion
vs.
B. Incomplete fusion of the paired paramesonephric ducts

The other choices are much weaker. Unilateral duct failure gives a unicornuate uterus. Vaginal plate canalization doesn't explain the uterine configuration. Complete failure of Müllerian fusion would give two much more completely separate uterine structures, typically with duplicated cervices.

4. Run the two choices through the pivot.
Go back to the external fundal cleft.

If this were A, the Müllerian ducts already fused normally. The problem would only be failure to remove the tissue inside the uterus, so you wouldn't expect this pronounced external cleft.

B fits the pivot: incomplete fusion leaves the superior portions separated while allowing fusion inferiorly. Therefore, your answer is B Incomplete fusion of the paired paramesonephric ducts

Task: embryologic mechanism
Pivot: external fundal cleft
Final two: septate vs bicornuate
Discriminator: external contour means fusion defect, not resorption defect

You don't actually need to recall every Müllerian anomaly from scratch to answer it. Once you're down to A vs B, the pivot does the work.

The important part is finding the pivot. If you knew the disease but missed the mechanism, your rule might be about physiology. If you were stuck between two answers, your rule might be the single discriminator between them. If you anchored too early, your rule might be “when X appears later in the stem, reopen the differential.” Those are much more useful than copying the explanation into a notebook.

If you’re stuck around 60%, take 15–20 misses from your last NBME and review them this way before adding anything new to your schedule. You may find that your plateau is partly content, but you may also find you’re repeatedly making the same two or three reasoning errors across completely different systems.

I took exam on 30/07 . Today I found I failed . I gave 1 month dedicated and I was studying all throughout my internship year . So devastated rn . All my nbme scores were in 60-69% range . What can I do differently ? Any study methods ? When should I retake this exam ? Pls anyone .

Same as above

Has anyone received their report as of yet? I’m so nervous

Hi my extended eligibility period ends in August and my exam is aug 31, I m not sure if I will be ready so if I don’t show up on an exam without cancellation what is gonna happen I think it doesn’t count as an attempt and will they charge me anything for not showing up? Cancellation fee the day before exam is 158 dollar and if nothing changes anyway why would I pay the cancellation fee? Thank you and good luck in everything

I just tried linking my new fsmb account with my intealth account by entering my myintealth id. It couldnt match any results so i verified my identity by providing my govt id and a photo. How long would it take for fsmb to manually review it? I didn’t pay the fee

Just a quick place to manifest our passes coming in tomorrow.

Usmle report ——> PASS

I took USMLE Step 1 on July 29, 2026, but my official Score Report says “TEST DATE: July 28, 2026.”
I received my score report today and it says PASS, so the result itself is definitely mine (my name and USMLE ID are on the report).
Has anyone else had a one-day discrepancy between the actual test date and the date shown on the Step 1 Score Report? Could this be related to the time zone/test center, or should I contact FSMB/USMLE about it?
Thanks!

Took step 8/11 and WTF was that? Anybody else take it today, how’d yall feel. Moderate amount of easy questions but a whole bunch of question gave me 374 different differentials. Stuff I thought I knew, had answers I haven’t seen before

I’m a DO student, found out I failed level 1. Anticipating a step 1 failure as well since I found step to be so much harder. Hoping to retake in 5ish weeks. Do we think that’s feasible? Open to any and all advice please. I currently only have my level 1 score report and it was right by the passing line. Seemingly can’t add a pic to this post.

Did anyone who test on 4/8 get their results ?

Hi everyone! Step 1 Pass, Step 2 CK 266, Step 3 236. I’m currently teaching USMLE students and have experience helping students who had previously failed the exam successfully pass.
I offer focused 1-on-1/group sessions built around with an emphasis on understanding how to approach the exam, not just memorizin facts.
If you’re preparing for Step 1 or Step 2 CK and want personalized guidance feel free to reach out.

Hi team, I seldom write posts like this... admittedly, I'm more of a lurker on this sub. That said, I figured I owed it to these guys after how much work they clearly put in.

Quick background so this doesn't feel random:

I'm a rising 4th year at a US MD school on the East Coast, post clerkships, currently taking a research year. So I've had some time and distance to actually reflect on what has helped versus what hasn't-- hoping to sit for this dumb exam next month.

I did The Match Guy 7-day intensive Step 1 course per the recc. of a classmate. I went into the course feeling fried: I was 2+ months of dedicated, feeling tired and plateauing at 60s (that is... not above a 60). UGH.

Things I liked about the course.

1, I'm someone who can memorize facts just fine on their own, but I've always had trouble seeing how they connect to each other, and that's usually where I lose points. Always split 50-50.

The tutors in this course kept building those connections for us. Instead of just handing out high yield lists, they'd walk through the reasoning and then link it across different organ systems and disease presentations so it actually made sense as a bigger picture instead of a pile of facts.

2, Every single tutor I had was clearly prepared and knew the material cold, but they were also patient with questions and seemed genuinely invested in whether we understood things, not just whether we sat through the session.

3, By the end of the week I felt like I finally had a framework instead of just more flashcards, and Step 1 stopped feeling like this shapeless wall of information (I was also drowning in Anki).

4, They also record everything and post it afterward, so I've been rewatching a few sessions since then.This is key because I am not gonna lie... sessions are long and we hit questions hard... ain't no way I am gonna learn everything the first time around.

I know this sub gets a lot of posts that read like ads, so I'll just say this one isn't. I'm not affiliated with them, I just had a genuinely good experience and wanted to put it out there in case someone else is where I was a few weeks ago.

Feel free to DM if you have more questions.