usmle,plab,amc,mci screening test and other medical step exams study tips n
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vice, which is payable by credit card or money order. For more information regarding
the CBSSA, please visit the NBME’s Web site at www.nbme.org and
click on the link for “NBME Web-based Self-Assessment Service.”
DEFINING YOUR GOAL
It is useful to define your own personal performance goal when approaching
the USMLE Step 1. Your style and intensity of preparation can then be
matched to your goal. Your goal may depend on your school’s requirements,
your specialty choice, your grades to date, and your personal assessment of the
test’s importance. Do your best to define your goals early so that you can prepare
Certain highly competitive residency programs, such as those in otolaryngology
and orthopedic surgery, have acknowledged their use of Step 1 scores in
the selection process. In such residency programs, greater emphasis may be
placed on attaining a high score, so students who seek to enter these programs
may wish to consider aiming for a very high score on the USMLE Step 1.
However, a great number of residency programs value other criteria more
highly than a high score on Step 1. For more information, fourth-year medical
students who have recently completed the residency application process
can be a valuable resource.
TIMELINE FOR STUDY
Make a Schedule
After you have defined your goals, map out a study schedule that is consistent
with your objectives, your vacation time, and the difficulty of your ongoing
coursework (see Figure 4). Determine whether you want to spread out your
study time or concentrate it into 14-hour study days in the final weeks. Then factor
in your own history in preparing for standardized examinations (e.g., SAT,
Typically, students allot between five and seven weeks to prepare for Step 1.
Some students reserve about a week at the end of their study period for final review;
others save just a few days. When you have scheduled your date, do your
best to keep to it. Recent studies show that a later testing date does not translate
into a higher score, so avoid pushing back your test date.5 This highlights the importance
of working out a realistic schedule to which you can adhere.
Another important consideration is when you will study each subject. Some
subjects lend themselves to cramming, whereas others demand a substantial
long-term commitment. The “crammable” subjects for Step 1 are those for
which concise yet relatively complete review books are available. (See Section
IV for highly rated review and sample examination books.) Behavioral science
Fourth-year medical students
have the best feel for how
Step 1 scores factor into the
residency application process.
Some competitive residency
programs use Step 1 scores in
their selection process.
Time management is key.
Customize your schedule to
your goals and available time
following any final exams.
and physiology are two subjects with concise review books. Three subjects
with longer but quite complete review books are microbiology, pharmacology,
and biochemistry. Thus, these subjects could be covered toward the end of
your schedule, whereas other subjects (anatomy and pathology) require a
longer time commitment and could be studied earlier. Many students prefer
using a “systems-based” approach (e.g., GI, renal, cardiovascular) to integrate
the material across basic science subjects. See Section III to study anatomy,
pathology, physiology, and pharmacology facts by organ system.
Practically speaking, spending a given amount of time on a crammable or
high-yield subject (particularly in the last few days before the test) generally
produces more correct answers on the examination than spending the same
amount of time on a low-yield subject. Student opinion indicates that knowing
the crammable subjects extremely well probably results in a higher overall
score than knowing all subjects moderately well.
Make your schedule realistic, and set achievable goals. Many students make the
mistake of studying at a level of detail that requires too much time for a comprehensive
review––reading Gray’s Anatomy in a couple of days is not a realistic
goal! Revise your schedule regularly on the basis of your actual progress. Be careful
not to lose focus. Beware of feelings of inadequacy when comparing study
schedules and progress with your peers. Avoid students who stress you out. Fo-
F I G U R E 4 . Typical Timeline for the USMLE Step 1.
Register for USMLE Step 1
Schedule test date and
to take exam
Expect scores 3–6 weeks
“Crammable” subjects should
be covered later and less
crammable subjects earlier.