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.”


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.


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


Typical period

to take exam

Expect scores 3–6 weeks

after exam

“Crammable” subjects should

be covered later and less

crammable subjects earlier.

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