Did UW twice, but still scoring low 40s on NBME— feeling stuck, need advice please

Looking for advice,please

My prep so far

•	Completed Sketchy Micro, Patho,Pharm,biochem

•	Finished 100% of UW first pass over 8+ months

→ Average: 45%

•	UWorld second pass

→ 61% completed

→ Average score: 51%

My biggest struggle

My basics were weak/fragmented from the beginning, and because my prep has been long, I feel like I forgot a lot of what I studied along the way.

Recent NBME scores

•	NBME 21 — 41%

•	Reviewed NBME 21

•	NBME 23 — 42.6%

These scores were honestly very discouraging.

What I feel I’m struggling with

•	Knowledge gap

•	Recall under pressure

•	Pattern recognition / NBME-style thinking

•	Test-taking confidence

My current plan

Before doing more NBMEs, I’m thinking of focusing on:

•	Mehlman PDFs

•	Mehlman videos (especially weak topics)

•	FA rapid review

Passive reading has never worked well for me, so I’m trying to avoid rereading First Aid .. I did use First Aid while doing UWorld

I know Mehlman can sometimes raise NBME scores artificially, but I’ve also heard many people say his material is very relevant for the real exam and helps with pattern recognition in exam.

I honestly feel like my confidence has taken a big hit. My prep has stretched close to a year, and after going through the same material multiple times, I didn’t expect to still be scoring this low on NBMEs. Seeing those scores has been really discouraging.

I haven’t booked my exam yet, and I’m feeling pretty exhausted mentally.

At this point, I’m considering taking another 2 months to go through Mehlman PDFs thoroughly and continue reviewing NBMEs, then reevaluate before moving forward.

I’d be really grateful for any advice—on my plan, anything you’d do differently, or any suggestions from people who’ve been through something similar. Thank you very much