This is one of the worst question banks I have ever used. I have tested in the top 10th percentile on every step and board exam thus far. However I can see this question bank is not representative of clinical practice or exams. They rely on knowledge of exact percentages for example to increase the sense of qbank difficulty. The information has not been updated to reflect current screening standards. Answers often contain typos. The questions require no critical thinking and instead rely on the test taker to "read the mind" of whoever wrote the question or whatever small study they happened to reference. Poor job and I would recommend against buying. Unfortunately not many other options exist in this space.