It’s a wonderful time of year. Birds are chirping, flowers are beginning to bloom, the weather outside is just perfect for bike rides and patio brunches, but you, my friend, are stuck inside making color-coded flashcards and learning the TCA cycle in preparation for step I.
Relax, young medical Padawan. Fear not this beast of an exam and take some time to frolic amongst the daffodils. Here’s some advice from myself and other senior medical students on how to rock the heck out of this exam:
Before the test:
1. Buy First Aid early.
We’re talking first year, folks. While this may be too late if you’re currently signed up to take the exam, if you are just starting medical school, pick up a copy of First Aid. I’m not saying to all-out gun and read the entire thing within the first weekend of having it, but use it in conjunction with your block textbooks. It’s a good outline that won’t teach you concepts necessarily, but gives you a good idea of the topics you should really understand. You should know this book inside and out. Also, don’t forget about the errata that is published online since the book does contain mistakes interspersed throughout. Just because it was written by a bunch of really smart people, doesn’t mean that they’re infallible humans!
2. Tailor when you begin studying according to your study style.
“When should I begin studying?” is a common question students ask. This is where you are probably going to get all sorts of conflicting advice. Some people will start studying in the summer after first year and some people will spend an intense 4 weeks before their test date cramming in UWorld questions and isolating themselves from the rest of society. Whatever you choose to do depends on how you learn best. For some, especially those who have definite areas of weakness, beginning early, potentially 6 months in advance of their test date, allows them time to review in depth topics they are lacking knowledge in. On the other hand, if you’re the type of person who tends to burn out, don’t begin studying for step I on the first day of med school. Do some light reviewing before your ‘designated study time’ and allot however many weeks you feel you need to cover the required material. Says a 4th year medical student, “I started in January and burned out really hard during my last month of studying since I had been doing it for so long.”
3. Make a study plan
However long you decide to study, put together a schedule. Assign a certain amount of days for each topic and make sure you stick to it. Because life happens, you may fall behind on a given day, but be sure to make up for it and to incorporate break time into your schedule for unwinding and in case something unexpected arises.
4. Do practice questions
Some people may decide to do multiple questions banks (USMLE World, Kaplan, USMLERx), but the one resource you absolutely, positively need is USMLE World. Do UWorld as many times as you possibly can. The wonderful thing about this question bank is that it gives explanations for why answers are correct or incorrect. The most common mistakes students make are not doing enough questions (ie. not finishing or going through UWorld only once) and not using QBank as a learning tool. Make sure you review your questions (even if you got the answer correct) and take notes from the tests you construct. I kept a notebook file of important UWorld concepts on my computer and reviewed them at the beginning of every day. What many people also don’t know is that you can search for keywords, so if you’re reviewing biochemistry and want to look up a glycogen storage disease question several 100s of questions ago, you can just enter it into UWorld’s search field.
Assign yourself a certain amount of practice questions a day. Do the questions corresponding to your study topic at the beginning and/or end of each day. If you are someone who has difficulty with finishing tests on time, do the questions in test mode, in 46 question blocks at a time. Make sure you leave some questions to do in mixed-subject question mode as to simulate the real exam.
Also, don’t fret if your percentages are alarmingly low at the beginning of your study period. Many of my peers and I started out in the 30s and 40s and we ended up doing just fine!
5. If you do a review course, don’t save it for the last few weeks before your test
Whether you decide to go with DIT, Kaplan, or some other review program, don’t plan to use those aids in the weeks immediately preceding step I. Save the last few weeks for QBank use. For example, if you take your test June 7th, you should be finished with your review course by May 10th if you decide 4 weeks is the appropriate time for you to spend QBanking. The period before this should be spent reviewing material and solidifying concepts, but your last few weeks should consist of questions, questions, questions.
6. Take breaks
I already mentioned scheduling breaks, but just want to reiterate the point again. Some people choose a full day at the end of each week, some people do half days here and there, and some don’t like the idea of taking a half day off at all, but be sure to make time to have dinner with family or friends, go to the gym, and see a movie to de-stress from having your nose in a book all day. Even if you decide an hour a day is all you can afford to take off, play Super Smash Bros during a break or do something completely unrelated. A group of our friends took an afternoon plank break every day and chatted on the grass outside for about 15 minutes to keep our sanity.
Also, if you decide that 9am-5pm is that the right study hours for your personal style, stick to it and do something relaxing afterwards before going to bed. Don’t try to do too much in one day as you can easily start getting burnt out.
7. Take some practice tests, but don’t go overboard.
The NBME sells practice exams and UWorld gives you an option of purchasing self-assessments with your question bank. It’s a good idea to take a practice test at the beginning of your study period to establish a baseline. Then, do several more periodically after that, but don’t take another one beyond 1-2 weeks out from your exam date. There have been people I know who have taken a practice test several days before their exam and gotten a lower score than expected, resulting in panic and hysteria, and a pushing back of test dates.
There is a point of diminishing returns for everyone and delaying the exam because of a potentially stress-induced spurious result on a practice test may cause you to do even worse on the real thing.
8. Review biochem and biostats in the days preceding your test
For most people, biochemical pathways and statistical methods are not intuitive. Save time towards the end of your study period to review these topics as it may just come down to pure memorization for certain pathways and statistical tests.
The day before the exam:
9. Take it easy
You may want to review some notecards do some questions, but this should not be an intense, hardcore study day. Any studying done should be rather leisurely and end several hours before you go to bed. Take a relaxing bath. Get a good night’s sleep. Save all your energy for the long day you have ahead of you tomorrow.
The big day:
10. Arrive at the test site early
If you have an 8:00 a.m. test administration, arrive a half an hour or so earlier because the check in process can be long. Beat the crowd and try to be one of the first few people checking in, otherwise you may find your anxiety building as you wait an hour in line before even getting to sit down at your testing computer.
11. Dress comfortably and bring a sweater
Sometimes it’s frigid at the testing site and other times, it can be quite warm. Dress to be to adapt to either scenario.
12. Bring snacks and take your breaks
Maybe you’re the type of person that just likes to barrel through your exams and finish, but this is a marathon and will be mentally exhausting. Take a break (even for a few minutes) between every section to clear your mind and bring snacks to fuel you through the long day. Take a relaxing lunch after 3 or 4 sections and chat with another classmate, as you will likely see some familiar faces on your test day. Just don’t chat about exam material!
13. Don’t psych yourself out.
No matter how smart you are or how well you’ve prepared, there will be questions you just absolutely have no clue about. Hopefully, those will be minimal, but just remember that there are experimental questions built into every test. Thinking they’ve performed poorly on a section test psyches out many people and results in a drop in morale. A positive and focused state of mind is required to perform well on this test, so don’t be your own enemy!
After the exam:
14. Have a cocktail
Hell, have two. You deserve it.
15. Take a post-test vacay Hey, you’ve worked hard.
You thought the MCAT was tough, but this has now easily surpassed that wimpy exam as the hardest test you’ve ever taken in your life. Reward yourself by taking a weekend trip to the coast or purchasing a plane ticket abroad before you throw yourself into the trenches of 3rd year. You’ll be glad you did when you’re retracting bowel for the 15th hour on surgery and wishing you were outside instead.
Good luck. You’ll be amazing!