January 13, 2020

Don’t Sprint the USMLE Step 1

By Contributing Author

What exactly am I training myself for?

It’s January of your M2 year. The first semester flew by almost as fast as Christmas break did, and you’re approaching the halfway point in your medical school career. In the back of your mind you may have been thinking about it as the test-that-shall-not-be-named (cue dramatic music here), but it’s now time to start openly thinking about the USMLE Step 1. It’s a marathon and not a sprint; it’s time to begin training.


The intention of this post is to help you begin planning and preparing to tackle this milestone in your education by understanding what your objectives are. Studying for Step 1 truly is a marathon and not a sprint. Success is more easily achieved by making a training schedule in advance, identifying weaknesses and preparing at a pace that allows you to be in a healthy place for the main event.


Preparing for Step 1 is largely about two things: Content review and answering board-style questions.

1. Content Review: Understand that not all content taught in modules is relevant to the exam, and not all content relevant to the exam is taught in class modules. Therefore, it is important to use resources that cover this content both completely and concisely as possible. Your first step should be identifying which review materials work best for you (not your friends; you!).


Below are some helpful resources; my list is suggestive and not comprehensive. The idea is to pick ones that help you keep content in long-term memory. It should also cover testable content as much as possible without getting into the weeds, so to speak.


                           A.    Knowledge Banks: These are places where large volumes of medical                                         content specifically related to USMLE Step exams are stored, and very                                       helpful organizing and referring to facts and medical knowledge                                               Examples: First Aid for the USMLE Step 1, MedBullets, AMBOSS

                           B.    Video Series: These are resources where the concepts of content are                                       explained, and additionally help keep you feeling more sane than trying to                               read textbooks.                                                                                                                                Examples: Pathoma, Boards and Beyond, Osmosis

                           C. Picture-Style Resources: These are popular resources that help provide                                   long-term memory hooks for facts that are unintuitive and seem esoteric.                               Examples: SketchyMedical (Pathology, Microbiology and Pharmacology),                                   Picmonic


2.  Answering Board-Style Questions: Learning how to tackle these questions takes a lot of repetition and practice. It is helpful to think of this as a skill separate from actually knowing the content itself.


Module NBMEs and the Basic Science NBME taken in January do not directly predict if you will pass Step 1, but they do inform you of your skills in answering board-style questions. This information is very important. Sometimes all of the content review in the world is not going to help unless you know how to tackle these often multi-step, multi-layered vignettes.


My first piece of advice is that if you feel that you have a history of consistently not being able to perform what you consider well on past exams with board-style questions, you are not alone. The most important thing to do is to ask for help early, and be persistent about finding someone to help you learn to answer these questions. Practicing questions and figuring out why you are answering them incorrectly is the goal here.


So, the next question is, how do we train such a specific skill? The answer is: Question banks.


Step 1 is just a series of blocks of questions full of random content to be worked out on a time schedule. The more often you do this, the better you will be at it. Generally, I advise doing small blocks, untimed and random early on in the spring of M2 year on a regular basis. This should be something not too strenuous to cause problems with learning class content. The intensity can be ramped up slowly as you approach your dedicated study period, where you then should be treating every block like it is a block on the exam.


I hope this helped you to understand exactly what skills you are training when studying for Step 1. Please keep an eye out for future blogs that will be discussion creating schedules and test-taking hygiene, both of which are important when preparing for Step 1.  Remember it’s a marathon and not a sprint.

Ryan Oliver COM4 Student, Contributing Author