The move from a three-digit score on Step 1 of the United States Medical Licensing Examination (USMLE) to a pass-fail evaluation hasn’t changed the fact that passing the exam is of major importance to a career in medicine.
For students entering dedicated study time—a period of four to eight weeks of blocked-out preparation time before the test—that reality can weigh heavily. An expert who has been helping students and physicians prepare for the USMLE series of exams for more than a decade offered some key tips on how to spend the dedicated study window.
The AMA Succeeding in Medical School series offers tips and other guidance on a wide range of critical topics, including preparing for USMLE exams, navigating clinical rotations, publishing scientific research, and maintaining optimal health and wellness.
Accelerate pace
Ideally, medical students have been preparing for the exam in one way or another for months before the dedicated study window. What changes as dedicated time approaches is the pace of that preparation. For users of UWorld question banks, the number of practice questions in a week during dedicated study time should be around 420, according to Kelly Chopra, UWorld’s director of business development for medical products.
Chopra described the last 12 to 18 months as “tortoise mode,” in which medical students prepping for Step 1 have been “slowly and steadily moving along the path, not hopping through the race, trying to finish fast,” she said. “What you need to do now is really hone in and work on those weaker areas and really build that speed and stamina so you are prepared for test day as it's quickly approaching.”
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Set realistic goals
Even in the final push, it’s important not to overdo it.
“A realistic goal could be: OK, I am in week three of dedicated, I have five weeks left. I'm only doing 200 questions per week. UWorld recommends about 420,” she said. How can I ramp that up a little more? Setting a realistic goal, how long can you go straight without having to take a study break? It is not realistic to go through the question bank and burn yourself out by studying 10 to 12 hours straight.
“You have to take those breaks” to do some breathing exercises and ensure adequate food and water, she said. The aim is “to set those realistic goals on what your days look like, really plan it out, set it down, look through your planner.”
That goes so far, she said, as specifying the hours of study and building in time for 10-minute breaks each hour.
Simulate the real thing
When you take a practice test, make it as close to the real thing as possible.
“If you're planning to study six days a week for this eight weeks, then I would take at least three of those days and do true-exam simulation,” Chopra said.
“Do it in timed mode and really have zero distractions. Turn the phones off, turn the TV off, turn music off. Really put yourself in a position that it will be the most realistic for test-day simulation.”
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Stop the sprint before test day
Pacing yourself is important. Chopra recommended taking one day off from study during a seven-day period. Beyond that, you want to be in a good headspace before the exam.
“The full day before your exam, get your mind and body ready for the exam,” she said. “Take that day off of studying and really just get yourself prepared for what that is going to feel like sitting in a different environment and doing the exam. I would recommend really powering through up to about two to three days before the exam.”
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