I wish I knew before taking the USMLE Exams…
Written by Summer Bailey, MD
USMLE: it's an acronym that elicits palpitations, perspiration, and pimples in even the most confident of medical students. It stands for United States Medical Licensing Exams and is a series of three medical examinations that medical students have to take. USMLE Step 1 is taken typically after the pre-clinical years and either before or during the clinical years of medical school. USMLE Step 2 is taken before graduation (usually in between the third and fourth years of medical school) as it is a requirement to receive your diploma. USMLE Step 3 is taken after graduation and usually during residency and is a requirement to be eligible for licensure to practice as a physician in the United States. I have completed all three and have told many people taking the MCAT "If there were things I had known years ago that I know now, I would've done things much differently". So I decided to share my thoughts here about things I wish I knew.
1. The USMLE Step exams build off of one another: time and time again during medical school, the theme is "just pass Step 1, just pass this test, and get to the next point". I feel like this can set up a student for the bare minimum to pass which doesn't allow them to be successful on the subsequent exams to come. Especially with the USMLE Examinations, even if the exact questions or wording of Step 1 isn't what you have on Steps 2 and 3, the basic knowledge you have to know is ultimately the same. While Step 1 focuses more on the preclinical classes (histology, pathology, biochemistry, physiology, anatomy, etc), Step 2 is more about diagnosis and management. However, to know diagnosis and management, you ought to know the basics right? Additionally, while there are students studying for the bare minimum I previously mentioned, there are many students who already know this information I shared with you preparing for Steps 2 and 3 while others are struggling with Step 1. That's not to say that you should become overwhelmed by learning material you haven't reached, but make sure to cover your bases while you're on the field instead of trying to play catch up later. Of note, Step 1 is becoming pass/fail in mid-January, which may cause one to think their study habits can be different because of this. I would strongly advise you to study for the test as though it is still a numerical score because that knowledge will be important for you on the subsequent USMLE exams. Knowing which study and test-taking strategies work for you early on will be key to your success!
2. Find a couple of materials that work for you and stick with them. Another thing that is easy to do during medical school and even residency is to use as many resources as possible including reading many books, doing as many question sets, and listening to as many videos as possible. However, success tends to come from sticking to one or two materials (books, question banks, etc) and learning those well. Even if you were able to cover every single material for the USMLE exams, I can almost guarantee you that there will be at least a few questions you were not prepared for. Going back to point #1, it's important to cover as many subjects as you can but to the best of your ability. More importantly, having a strong foundation for Step 1 will benefit you for Step 2. A strong foundation for Steps 1 and 2 will help you with Step 3, which is especially important because this exam is typically done during residency when you are working within your chosen specialty. If possible, you could even complete an online course such as Kaplan or Medquest, an in-person course such as the PASS or the Wolfpacc Programs. If you have the ability to help boost your score, take advantage of opportunities.
3. Don't rush taking the USMLE exams. This can be difficult to do especially since each of the Step examinations tend to have a "due date". However, control this to the best of your ability. Do not rush taking an exam because you simply feel like you have to get it done, and don't rush it because others are taking the exam during a certain time. If I could go back and do one thing over, it would be to not rush taking the exams and to make sure that I was as prepared as I could be. The worst that could happen by waiting to take one of these examinations is holding off on your training for a certain period of time. However, that time would be worth it if you were ensuring that you were as prepared for the exam as you could be. If you pass these exams, even by one point, you cannot go back and take an exam over. Likewise, a failure on a USMLE examination could be seen as a "red flag" by residency programs and/or fellowship programs. Make sure you have as much time as you need to be set up for success.
4) Have faith in yourself. Remember all those standardized tests you took to get to this point: the SAT, the ACT, standardized examinations required in high school and college, the MCAT, and any other examinations you have taken. You would not have made it to this point by sheer luck or chance. You can crush these exams with the right tool kit, so believe in yourself!
