According to the second years, this is the hardest exam of year 1. I can certainly see why they'd say that. It ratcheted up the difficulty a fair bit, and I hadn't really given it the time it required. Rather than make a last push this weekend in PPS, I made a last push in microbiology and pulmonary physiology. I held onto my 498 spot and pulled an A in both exams, so I'd say I made the right call.