Assumed, Actual, and Average Performance: Preparing for the horrors of Step 2 using the defense mechanism of Intellectualization

In exactly one week (7 days -- 168 hours -- 10,080 minutes -- you get the idea) I will be sitting in a prometric testing center taking, depending on whom you talk to, the most important test I have ever taken capable of determining all of my future career successes, or just something I need to pass to graduate: The United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge.

Tensions are running high, but I am actually quite proud of myself. I began studying weeks, no... months ago, and I find that even though I only have a week left, I am doing a lot less cramming than I had to do for Step 1. And I actually might finish reading an entire review book cover to cover. I may actually do well on this exam.

But do you know what's more important than doing well on exams? Knowing, fairly accurately when you leave the testing center, that you have most likely passed the exam with a 95% confidence interval (did I use that term correctly? I still haven't studied biostatistics). Which is why I have begun analyzing my Usmleworld QBank tests. Upon hitting submit, I quietly contemplate how well I think I may have done, remembering how many questions I "knew" verse how many were "good guesses" verse the inevitable "I have narrowed it down to two, equally likely choices" verse "I have not heard of any of these conditions. I will choose the answer choice that seems most viable." Then I write down my assumed score. Then I write down my actual score and the national average for those 44 questions.

Test Results of QBank tests numbers 93 through 101

What conclusions have I come to? First, my actual performance varies widely. Hopefully over my next tests I can become more consistent, although this isn't likely. I believe this is the nature of any test designed to ask many questions on broad topics.

Second, my predictions are much more conservative than my actual performances. Which is nice to know, although a given: more people feel like they failed an exam than actually did, at least in medical school.

Third, my predictions seem to follow my actual scores fairly closely, although doing really well on test 94 improved my confidence so that on test 95, I assumed I did much better -- even though I in fact did much worse.

And now I have to study for at least six more hours before I can go to sleep. I love summer break.