You know how to take tests…great.
You survived your first year of medical school, now what?
Time to turn your attention to the United States Medical Licensing Exam (USMLE) Step 1, aka Boards.
If you thought the MCAT was a make or break test you’re in for a rude awakening. The USMLE matters a lot more because the stakes are higher. The MCAT got you into medical school and if you couldn’t score well on the MCAT you find a different career.
However, this is not the case with the USMLE. You’ve already invested in your medical education and need a top score to get the residency of your choice and land a job.
I don’t have to remind you everything you learn in medical school is fair game for your Boards. I was actually surprised myself to see how much detail can actually present on the USMLE.
With only have a few weeks before second year begins here’s what I would do.
Are You Good on First Year?
Brush up on everything you learned during first year.
If you have any weaknesses, concepts you don’t know well or topics that give you trouble start overcoming them now.
Second, year is going to come fast and it builds on your first year. If you attend a medical school like mine the profs will say, “I’m not covering that, you guys learned it last year, let’s build on that with…” so it is to your advantage to have a strong foundation starting second year of medical school.
So how do you actually brush up on your weak areas?
You’re not going to reread all your lecture notes, open up your textbooks or go about this process willy-nilly because there’s just too much to cover.
I advise you to use a program called Firecracker. It’s going to cost money but definitely well worth the investment.
Firecracker will allow you to use spaced-repetition to learn and what’s great it is an electronic version of First Aid, your medical school Bible for passing the boards.
With Firecracker go ahead and start flagging all the topics you covered in first year and quiz yourself on the topics each day until they become second nature.
It’s going to take time but getting started now will save you from the should’ve, would’ve, could’ve dilemma in the spring as you realize you’re not where you need to be in your board prep.
Making the Most Out of Classroom Time
Second year is where you start to cover the pathology and pharmacology that is going to make up a big chunk of your Boards. So pay attention.
I can remember doing problems for Boards and thinking, “Professor X, spoke about this topic in class, man I should’ve paid a little bit more attention to him to get this answer.” You’ll probably feel the same way too at times but seriously go to class and really get all that you can from your lectures.
Your curriculum can make a huge difference too.
I was lucky to attend a school that used systems-based learning during second year. So we’d have module exams that covered one organ system at a time such as:
which made life easier when studying for boards.
Remember how I said First Aid was your Bible, well you’re going to put it to use second year.
As you go through your modules or organ systems, however you want to call it I want you to annotate First Aid with important facts and tidbits of knowledge you pick up in the classroom.
Read First Aid, highlight, memorize and understand everything in this book. You don’t have to go crazy with adding notes to First Aid though because this book distills everything down to just the facts you need to do well on your USMLE Step 1.
You’ll find your professors may talk about topics and things not mentioned in First Aid so not necessary for the Boards per se but it may be fair game on your class examinations.
Problems, Problems and More Problems
How to do well on boards comes down to doing as many practice problems as possible.
You’ll never be in the wrong by doing problems.
There are some discrepancies on the best way to go about doing problems and I will lay them out for you.
But first let’s talk about the gold standard.
UWorld is the gold standard for your question bank. It beats everything on the market. I think this should be your number one resource.
Coming in a close second would be USMLE-RX.
Now for the problem.
Some argue you should do UWorld twice because there’s so much you can get out of the program. I’m not a fan of that idea at all.
If you’re doing the same question bank you’re really not learning, you’re doing an exercise in memory and recall. Believe me there are enough questions available where you shouldn’t have to resort to doing the same question bank twice.
Another concern is saving the best for last.
Let’s be honest, students like to save questions until they feel they are comfortable with the topic and then will do them the final days leading up to an exam. This may work in the classroom but will be harder to pull off with Boards.
If you’re systems based during second year pick either UWorld or RX and do those respective problem sets as you work on that organ system in the classroom.
Then when you have your dedicated study time you can switch over to the other question bank.
How to Use the Question Bank
Do everything under timed mode because you have to get used to taking your exam under timed conditions.
Also you will learn the most from reviewing the problems. A rule of thumb is to spend 3-4x the amount of time it took you to take the test reviewing. While reviewing there are several things you want to do to make the most of each question.
Understand why you got a question right or wrong.
Then you will want to assess why each answer choice is wrong and what would need to be changed to make it correct. As you can tell this is going to take a lot of work but it will pay off when you get the score you want on your Boards.
You have to remember if you have 5 answer choices on a particular question then that means 80% of the answers are wrong. If you can start to think like a test writer and understand what are the common “tricks” used to start you down the incorrect path you will be ahead of the game come test day.
Lastly, you’re going to be going over a lot of problems and you’ll want to keep track of things.
Having a notepad and taking notes on what information you needed to answer a question is a good idea. Then you can constantly come back to this notepad and review periodically the topics that gave you trouble. Basically, you’re making a personal High Yield notebook for yourself.
Make Weaknesses Your Strength
It is only human nature to avoid that which we do not like. Unfortunately, you do not have this luxury on your USMLE. Everything is fair game so you cannot pick and choose what you want to study.
If you are weak in an area do not save it for last.
Instead, spend time now learning it so you can make it an area you know very well. Besides, if you can become strong in that area you have the ability to see a big boost in your score.
Think about this if you’re extremely weak in a topic but then you’re able to make it a strong suit you can have a huge jump in your score as opposed to reviewing a topic you know fairly well, when there is only minimal room for improvement.
There you have it everything you need to know and do to have your best chance of success on your Boards!
About the Author
Jason Spears is a medical student and founder, DoctorPremed. He can be reached on Twitter @DoctorPremed