What else can we do? Practice nbme's, sat back to back exams to test the real deal endurance, decrease expectations, for example use caffeine/theanine/tyrosine shoots every 2r hours on the real deal, it will help to concentrate and go through. If you score 250 on nbme, yes you can score 230 on real deal, that's the life. Today you can be hit by a car, or you can't, it's sort of luck many times and usmle is also about a luck in some understanding. It will not make me a better or worse surgeon, sometimes life about a luck. So my range is from 230 - 260, of course I will work hard as much as a I can for 260, but somewhere in the deepth of my soul I know that If I will get a crazy form on real deal, anyway I need to break 230 and I will do great. I know that 260 will open many more doors for me, but I also know that I can match with 230 + also.

For example I am aiming for only surgery, and only. You can do back to back forms, or one online and 100 questions offline that will be 300 questions and will be a good estimate of you endurance. If you run out of time, go and do 11+ forms it will be around 1400 questions. First you can do all the 2800 nbme questions, Of course half of them is retired questions from 1-7 forms, but It's a good way to practice. If that's the problem, I think it's curable. So I gave you two examples about macros and crypto, what's your problem? It's about to know all the concepts and all the details about this concepts. Concepts + details = gets you to infinite scores, if you wish 270.

What's you problem? Saying that usmle is about concepts and only is bull****, concepts are as important as knowing all the details that all are listed in first aid. So you think that you are decent in concepts, you understand well most of them but you are deficient in the details? For example you know that macrolides inhibit p450 system but you don't remember that azthreonam has no effect on p450? But you know well the effect and correlation of p450 and other drugs like warfarin? Or for example you know that cryptococus can be stained by two stains, by india ink and by mucicarmine, but you don't remember which one is used in crypto meningites (india to stain csf) and you don't remember that mucicarmine is used in sputum? But you definitively know that both of this stains is classical for crypto.

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